WorldWideScience

Sample records for academic hospital medicine

  1. Academic Hospitality

    Science.gov (United States)

    Phipps, Alison; Barnett, Ronald

    2007-01-01

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

  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. Whistleblowing in academic medicine.

    Science.gov (United States)

    Rhodes, R; Strain, J J

    2004-02-01

    Although medical centres have established boards, special committees, and offices for the review and redress of breaches in ethical behaviour, these mechanisms repeatedly prove themselves ineffective in addressing research misconduct within the institutions of academic medicine. As the authors see it, institutional design: (1) systematically ignores serious ethical problems, (2) makes whistleblowers into institutional enemies and punishes them, and (3) thereby fails to provide an ethical environment. The authors present and discuss cases of academic medicine failing to address unethical behaviour in academic science and, thereby, illustrate the scope and seriousness of the problem. The Olivieri/Apotex affair is just another instance of academic medicine's dereliction in a case of scientific fraud and misconduct. Instead of vigorously supporting their faculty member in her efforts to honestly communicate her findings and to protect patients from the risks associated with the use of the study drug, the University of Toronto collaborated with the Apotex company's "stalling tactics," closed down Dr Olivieri's laboratory, harassed her, and ultimately dismissed her. The authors argue that the incentives for addressing problematic behaviour have to be revised in order to effect a change in the current pattern of response that occurs in academic medicine. An externally imposed realignment of incentives could convert the perception of the whistleblower, from their present caste as the enemy within, into a new position, as valued friend of the institution. The authors explain how such a correction could encourage appropriate reactions to scientific misconduct from academic medicine.

  4. Whistleblowing in academic medicine

    Science.gov (United States)

    Rhodes, R; Strain, J

    2004-01-01

    The authors present and discuss cases of academic medicine failing to address unethical behaviour in academic science and, thereby, illustrate the scope and seriousness of the problem. The Olivieri/Apotex affair is just another instance of academic medicine's dereliction in a case of scientific fraud and misconduct. Instead of vigorously supporting their faculty member in her efforts to honestly communicate her findings and to protect patients from the risks associated with the use of the study drug, the University of Toronto collaborated with the Apotex company's "stalling tactics," closed down Dr Olivieri's laboratory, harassed her, and ultimately dismissed her. The authors argue that the incentives for addressing problematic behaviour have to be revised in order to effect a change in the current pattern of response that occurs in academic medicine. An externally imposed realignment of incentives could convert the perception of the whistleblower, from their present caste as the enemy within, into a new position, as valued friend of the institution. The authors explain how such a correction could encourage appropriate reactions to scientific misconduct from academic medicine. PMID:14872069

  5. Hospital Medicine Resident Training Tracks: Developing the Hospital Medicine Pipeline.

    Science.gov (United States)

    Sweigart, Joseph R; Tad-Y, Darlene; Kneeland, Patrick; Williams, Mark V; Glasheen, Jeffrey J

    2017-03-01

    Hospital medicine (HM) is rapidly evolving into new clinical and nonclinical roles. Traditional internal medicine (IM) residency training likely does not optimally prepare residents for success in HM. Hospital medicine residency training tracks may offer a preferred method for specialized HM education. Internet searches and professional networks were used to identify HM training tracks. Information was gathered from program websites and discussions with track directors. The 11 HM tracks at academic medical centers across the United States focus mostly on senior residents. Track structure and curricular content are determined largely by the structure and curricula of the IM residency programs in which they exist. Almost all tracks feature experiential quality improvement projects. Content on healthcare economics and value is common, and numerous track leaders report this content is expanding from HM tracks into entire residency programs. Tracks also provide opportunities for scholarship and professional development, such as workshops on abstract creation and job procurement skills. Almost all tracks include HM preceptorships as well as rotations within various disciplines of HM. HM residency training tracks focus largely on quality improvement, health care economics, and professional development. The structures and curricula of these tracks are tightly linked to opportunities within IM residency programs. As HM continues to evolve, these tracks likely will expand to bridge clinical and extra-clinical gaps between traditional IM training and contemporary HM practice. Journal of Hospital Medicine 2017;12:173-176. © 2017 Society of Hospital Medicine

  6. 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

    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...

  7. Oiling the gate: a mobile application to improve the admissions process from the emergency department to an academic community hospital inpatient medicine service.

    Science.gov (United States)

    Fung, Russell; Hyde, Jensen Hart; Davis, Mike

    2018-01-01

    The process of admitting patients from the emergency department (ED) to an academic internal medicine (AIM) service in a community teaching hospital is one fraught with variability and disorder. This results in an inconsistent volume of patients admitted to academic versus private hospitalist services and results in frustration of both ED and AIM clinicians. We postulated that implementation of a mobile application (app) would improve provider satisfaction and increase admissions to the academic service. The app was designed and implemented to be easily accessible to ED physicians, regularly updated by academic residents on call, and a real-time source of the number of open AIM admission spots. We found a significant improvement in ED and AIM provider satisfaction with the admission process. There was also a significant increase in admissions to the AIM service after implementation of the app. We submit that the implementation of a mobile app is a viable, cost-efficient, and effective method to streamline the admission process from the ED to AIM services at community-based hospitals.

  8. Professionalism, responsibility, and service in academic medicine.

    Science.gov (United States)

    Souba, W W

    1996-01-01

    Academic medical centers have responded to health care reform initiatives by launching a series of strategic plans designed to maintain patient flow and reduce hospital expenditures. Thought is also being given to processes by which the faculty can individually and collectively adjust to these changes and maintain morale at a time when reductions in the labor force and pay cuts are virtually certain. Physicians are concerned because managed care threatens their autonomy and jeopardizes the traditional ways in which they have carried out their multiple missions. Some doctors believe that it will become increasingly difficult to obtain genuine satisfaction from their job. The strategies that academic medical centers have begun to use to address the numerous challenges posed by a system of health care based on managed competition are reviewed. Potential mechanisms by which academic departments can continue to find fulfillment in an environment that threatens their traditional missions and values are discussed. A study of the social and historical origins of medicine in the United States reveals that the introduction of corporate medicine in the United States was destined to happen. Strategies implemented by academic medical centers in response to managed care include building an integrated delivery network, the acquisition of primary care practices, increasing cost-effectiveness, and creating physician-hospital organizations. Emphasis must be placed on integrating traditional core values (excellence, leadership, and innovation) with newer values such as patient focus, accountability, and diversity. A shift from rugged individualism to entrepreneurial teamwork is crucial. These reforms, although frightening at the onset, can serve to reaffirm our commitment to academic medicine and preserve our mission. The evolving managed care environment offers unique opportunities for academic medical centers to shape and positively impact health care delivery in the twenty

  9. 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.

  10. The Attitudes of Physicians, Nurses, Physical Therapists, and Midwives Toward Complementary Medicine for Chronic Pain: A Survey at an Academic Hospital.

    Science.gov (United States)

    Aveni, Eléonore; Bauer, Brent; Ramelet, Anne-Sylvie; Kottelat, Yolande; Decosterd, Isabelle; Finti, Guillaume; Ballabeni, Pierluigi; Bonvin, Eric; Rodondi, Pierre-Yves

    2016-01-01

    To assess the attitudes of physicians, nurses, physical therapists, and midwives toward complementary medicine (CM) at a Swiss academic hospital and toward its use for treating chronic pain. The cross-sectional survey took place from October to December 2013. An e-mail sent to 4925 healthcare professionals (1969 physicians, 2372 nurses, 145 physical therapists, and 111 midwives) working at Lausanne University Hospital, Switzerland, invited them to answer a web-based questionnaire. The questionnaire was answered by 1247 healthcare professionals (response rate: 25.3%). Of these, 96.1% strongly agreed or agreed that CM could be useful for the treatment of chronic pain, with more nurses (96.7%) and midwives (100%) than physicians (93.8%) agreeing that CM could be useful (P chronic pain. Respondents listed migraine (74.7%), tension headaches (70.6%), and low back pain (70.1%) as three main conditions for which they would refer patients for acupuncture. The three therapies with which respondents were the most unfamiliar were neuraltherapy (57.2%), mindfulness-based stress reduction (MBSR) (54.1%), and biofeedback (51.9%). Over half of respondents, 58.3%, had never referred a patient to a CM practitioner. A total of 84.3% of the respondents felt that they lacked the knowledge to inform their patients about CM. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Leadership values in academic medicine.

    Science.gov (United States)

    Souba, Wiley W; Day, David V

    2006-01-01

    To gain a deeper understanding of the guiding core values that deans of academic medical centers (AMCs) considered most essential for their leadership and the major leadership challenges that confront them. In 2003-04, semistructured interviews of 18 deans at U.S. colleges of medicine or AMCs were organized around four dimensions: background, leadership challenges, organizational effectiveness, and systems enablers/restrainers for leadership. A values Q-sort was used to determine how widely core values were shared among deans and how the complex challenges they faced did or did not align with these values. Fourteen of the 18 (78%) deans identified financial difficulties as their most pressing leadership challenge, followed by weak institutional alignment (61%), staffing problems (33%), and poor morale (28%). Open, candid communication was reported as the most effective means of addressing these complex problems. Enacting espoused shared values and having a positive attitude were identified as the most important enablers of systemic leadership, whereas micromanagement and difficult people were the major restraints. Q-sort results on 38 positive leadership values indicated that participants considered integrity most essential. Integrity was positively correlated with humanistic values and negatively correlated with results. Vision, another highly espoused value, correlated strongly with performance-oriented values but correlated negatively with humanistic values. A dynamic tension exists in AMCs between humanistic values and performance-based core values. The ability to manage that tension (i.e., when to prioritize one set of values over the other) is inherent in a dean's work.

  12. Analysis of Herbal Medicine Prescriptions for Patients in An Academic Korean Medical Hospital: A Cross Sectional Study of Electronic Medical Records (2010-2013).

    Science.gov (United States)

    Lee, Byung-Wook; Lee, Hyeon-Yeop; Heo, Kwang-Ho; Cho, Hyun-Woo; Hwang, Man-Suk; Heo, In; Shin, Byung-Cheul; Hwang, Eui-Hyoung

    2018-06-01

    To obtain fundamental information for the standardization of herbal medicine in Korea. We analyzed the herbal medicine prescription data of patients at the Pusan National University Korean Medicine Hospital from March 2010 to February 2013. We used the Dongui-Bogam (Dong Yi Bao Jian) to classify prescribed herbal medicines. The study revealed that the most frequently prescribed herbal medicine was 'Liuwei Dihuang Pill (LWDHP, )' which was used for invigorating 'Shen (Kidndy)-yin'. 'LWDHP' was most frequently prescribed to male patients aged 50-59, 60-69, 70-79 and 80-89 years, and 'Xionggui Tiaoxue Decoction (XGTXD, )' was most frequently prescribed to female patients aged 30-39 and 40-49 years. According to the International Classification of Diseases (ICD) codes, 'Diseases of the musculoskeletal system and connective tissue' showed the highest prevalence. 'LWDHP' and 'XGTXD' was the most frequently prescribed in categories 5 and 3, respectively. Based on the percentage of prescriptions for each sex, 'Ziyin Jianghuo Decoction ()' was prescribed to mainly male patients, and 'XGTXD' with 'Guima Geban Decoction ()' were prescribed to mainly female patients. This study analysis successfully determined the frequency of a variety of herbal medicines, and many restorative herbal medicines were identified and frequently administered.

  13. Nigerian Quarterly Journal of Hospital Medicine: Submissions

    African Journals Online (AJOL)

    Nigerian Quarterly Journal of Hospital Medicine: Submissions. Journal Home > About the Journal > Nigerian Quarterly Journal of Hospital Medicine: Submissions. Log in or Register to get access to full text downloads.

  14. [Glass ceiling for women in academic medicine in France].

    Science.gov (United States)

    Rosso, C; Leger, A; Steichen, O

    2018-06-03

    To determine whether career development in academic medicine is more difficult for women than for men, and, if any, the nature and level of barriers to this progression. Extraction of full-time medical staff in a Parisian hospital group, through the SIGAPS platform; an online questionnaire survey of career choices and barriers experienced by full-time male and female physicians. The study population comprises 181 hospital practitioners and 141 academic physicians (49 associate professors and 92 full professors). Women represent 49% of the medical staff but 15% of full professors. This underrepresentation of women is more important among intensivists/anesthesiologists than technique-based specialists (such as radiologists, biologists…). There is no difference in scientific output, marital status and parenthood between women and men. On the other hand, there is a difference in attitudes highlighted by the EVAR risk-taking scale as well as in the burden of familial involvement and the prejudices felt by women during the academic selection process. The glass ceiling exists in one of the largest French hospital group. Career development principles promote merit, but should decrease the benefit of "masculine" attitudes in the competition for academic positions. Academic selection criteria should evolve to limit the disadvantage of women related to deeper familial involvement and less competitive strategies and risk-taking attitudes. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  15. 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.

  16. Career choice in academic medicine: systematic review.

    Science.gov (United States)

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

    2006-12-01

    To review systematically the evidence about what factors influence the decision to choose or not choose a career in academic medicine. A systematic review of relevant literature from 1990 to May 2005. Searches of The Cochrane Library, Medline (using Ovid and PubMed) from 1990 to May 2005, and EMBASE from 1990 to May 2005 were completed to identify relevant studies that explored the influential factors. Additional articles were identified from searching the bibliographies of retrieved articles. We attempted to identify studies that included residents, fellows, or staff physicians. No restrictions were placed on the study methodologies identified and all articles presenting empirical evidence were retrieved. For cohort, case-control, and cross-sectional studies, minimum inclusion criteria were the presence of defined groups, and the ability to extract relevant data. For surveys that involved case series, minimum inclusion criteria were a description of the population, and the availability of extractable data. Minimum inclusion criteria for qualitative studies were descriptions of the sampling strategy and methods. The search identified 251 abstracts; 25 articles were included in this review. Completion of an MD with a graduate degree or fellowship program is associated with a career in academic medicine. Of the articles identified in this review, this finding is supported by the highest quality of evidence. Similarly, the completion of research and publication of this research in medical school and residency are associated with a career in academic medicine. The desire to teach, conduct research, and the intellectual stimulation and challenge provided in academia may also persuade people to choose this career path. The influence of a role model or a mentor was reported by physicians to impact their decision making. Trainees' interest in academic medicine wanes as they progress through their residency. In order to revitalize academic medicine, we must engage trainees

  17. 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.

  18. Women Physicians: Choosing a Career in Academic Medicine

    Science.gov (United States)

    Borges, Nicole J.; Navarro, Anita M.; Grover, Amelia C.

    2011-01-01

    Purpose Despite recent efforts to understand the complex process of physician career development, the medical education community has a poor understanding of why, how, and when women physicians embark on a career in academic medicine. Method In 2010, the authors phone-interviewed women physicians in academic medicine regarding why, how, and when they chose an academic medicine career. Project investigators first individually and then collectively analyzed transcripts to identify themes in the data. Results Through analyzing the transcripts of the 53 interviews, the investigators identified five themes related to why women choose careers in academic medicine: fit, aspects of the academic health center environment, people, exposure, and clincial medicine. They identified five themes related to how women make the decision to enter academic medicine: change in specialty, dissatisfaction with former career, emotionality, parental influence, and decision-making styles. The authors also identified four themes regarding when women decide to enter academic medicine: as a practicing phyisican, fellow, resident, or medical student. Conclusions Choosing a career in academic medicine is greatly influenced by the environment in which one trains and by people—be they faculty, mentors, role models, or family. An interest in teaching is a primary reason women choose a career in academic medicine. Many women physicians entering acadmic medicine chose this after or during fellowship, which is when they became more aware of academic medicine as a possible career. For many women, choosing academic medicine was not necessarily an active, planned decision; rather it was serendipitous or circumstantial. PMID:22104052

  19. 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...

  20. 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...

  1. Multigenerational challenges in academic medicine: UCDavis's responses.

    Science.gov (United States)

    Howell, Lydia Pleotis; Servis, Gregg; Bonham, Ann

    2005-06-01

    Academic medicine is a unique work environment, one of the few where members of four different generations regularly interact and where multigenerational teams are key to fulfilling its missions, particularly education. This can lead to increased creativity, but also to intergenerational conflict, since each generation has different values and expectations. The authors describe multigenerational challenges confronted at the University of California, Davis, School of Medicine, and that school's responses to them. These challenges include issues related to work hours, workload, compensation, evaluation for advancement, recruitment and retention, and attendance at required meetings. Awareness of the different generational qualities and values allowed the school of medicine to identify the multigenerational origin of many of these ongoing issues and challenges and to plan appropriate solutions within the Office of Academic Affairs. These include policy changes related to work-life balance, utilizing multiple faculty tracks with different roles, allowing part-time faculty appointments, creating a variety of faculty development programs geared toward different generational needs (which utilize flexible modules, menus of options, and alternative technologies for presentation), defining appropriate reward and incentives through compensations plans, and creating peer-reviewed awards. The authors conclude that these efforts mitigate conflict, promote diversity, and allow multigenerational teams to function more effectively and creatively in education, research, and clinical care. Ongoing evaluation will further refine this approach.

  2. 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.

  3. The Market for Hospital Medicine in Denmark

    DEFF Research Database (Denmark)

    Hostenkamp, Gisela

    2012-01-01

    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...

  4. Mentoring in academic medicine: a systematic review.

    Science.gov (United States)

    Sambunjak, Dario; Straus, Sharon E; Marusić, Ana

    2006-09-06

    Mentoring, as a partnership in personal and professional growth and development, is central to academic medicine, but it is challenged by increased clinical, administrative, research, and other educational demands on medical faculty. Therefore, evidence for the value of mentoring needs to be evaluated. To systematically review the evidence about the prevalence of mentorship and its relationship to career development. MEDLINE, Current Contents, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, PsycINFO, and Scopus databases from the earliest available date to May 2006. We identified all studies evaluating the effect of mentoring on career choices and academic advancement among medical students and physicians. Minimum inclusion criteria were a description of the study population and availability of extractable data. No restrictions were placed on study methods or language. The literature search identified 3640 citations. Review of abstracts led to retrieval of 142 full-text articles for assessment; 42 articles describing 39 studies were selected for review. Of these, 34 (87%) were cross-sectional self-report surveys with small sample size and response rates ranging from 5% to 99%. One case-control study nested in a survey used a comparison group that had not received mentoring, and 1 cohort study had a small sample size and a large loss to follow-up. Less than 50% of medical students and in some fields less than 20% of faculty members had a mentor. Women perceived that they had more difficulty finding mentors than their colleagues who are men. Mentorship was reported to have an important influence on personal development, career guidance, career choice, and research productivity, including publication and grant success. Mentoring is perceived as an important part of academic medicine, but the evidence to support this perception is not strong. Practical recommendations on mentoring in

  5. 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.

  6. Challenges of using Hospital Information Systems by nurses: comparing academic and non-academic hospitals.

    Science.gov (United States)

    Ahmadian, Leila; Dorosti, Nafise; Khajouei, Reza; Gohari, Sadrieh Hajesmaeel

    2017-06-01

    Hospital Information Systems (HIS) are used for easy access to information, improvement of documentation and reducing errors. Nonetheless, using these systems is faced with some barriers and obstacles. This study identifies the challenges and the obstacles of using these systems in the academic and non-academic hospitals in Kerman. This is a cross-sectional study which was carried out in 2015. The statistical population in this study consisted of the nurses who had been working in the academic and non-academic hospitals in Kerman. A questionnaire consisting of two sections was used. The first section consisted of the demographic information of the participants and the second section comprised 34 questions about the challenges of HIS use. Data were analyzed by the descriptive and statistical analysis (t-test, and ANOVA) using SPSS 19 software. The most common and important challenges in the academic hospitals were about human environment factors, particularly "negative attitude of society toward using HIS". In the non-academic hospitals, the most common and important challenges were related to human factors, and among them, "no incentive to use system" was the main factor. The results of the t-test method revealed that there was a significant relationship between gender and the mean score of challenges related to the organizational environment category in the academic hospitals and between familiarity with HIS and mean score of human environment factors (pinformation systems are the factors related to the human environment and the human factors. The results of this study can bring a good perspective to the policy makers and the managers regarding obstacles of using HISs from the nurses' perspective, so that they can solve their problems and can successfully implement these systems.

  7. 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...

  8. 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...

  9. An index to characterize female career promotion in academic medicine.

    Science.gov (United States)

    Brüggmann, Dörthe; Groneberg, David A

    2017-01-01

    Imbalances in female career promotion are a key factor of gender disparities at the workplace. They may lead to stress and stress-related diseases including burnout, depression or cardiovascular diseases. Since this problem cannot be generalized and varies between different fields, new approaches are needed to assess and describe the magnitude of the problem in single fields of work. To construct a new index, operating figures of female and male medical students were collected for Germany in a period over 15 years and their progression throughout their studies towards specialization and academic chair positions. By the use of different female to male ratios (f:m), we constructed an index that describes the extend by which women can ascent in their academic career by using the field of academic medicine as an example. A medical student f:m ratio of 1.54 (52,366 female vs. 34,010 male) was found for Germany in 2013. In 1998, this f:m ratio was 0.999. In the same year (2013), the OB/GYN hospital specialists' f:m ratio was 1.566 (3347 female vs. 2137 male physicians) and 0.577 (516 female vs 894 male physicians) for ENT hospital specialists, respectively. The f:m ratios concerning chairs of OB/GYN and ENT were 0.105 and 0.1, respectively. Then an index was generated that incorporated these operating figures with the student f:m ratio as denominator and the chair f:m ratio as numerator while the hospital specialist f:m ratio served as a corrector in the numerator in order to adjust to the attraction of a given field to female physicians. As a result, the index was 0.044 for OB/GYN and 0.113 for ENT instead of ideally ~1 in a completely gender harmonized situation. In summary, a new index to describe female career advancement was established for academic medicine. By the use of this index, different academic and medical fields can now be compared to each other and future benchmarks could be proposed. Also, country differences may be examined using the proposed index and

  10. Pediatric hospital medicine core competencies: development and methodology.

    Science.gov (United States)

    Stucky, Erin R; Ottolini, Mary C; Maniscalco, Jennifer

    2010-01-01

    Pediatric hospital medicine is the most rapidly growing site-based pediatric specialty. There are over 2500 unique members in the three core societies in which pediatric hospitalists are members: the American Academy of Pediatrics (AAP), the Academic Pediatric Association (APA) and the Society of Hospital Medicine (SHM). Pediatric hospitalists are fulfilling both clinical and system improvement roles within varied hospital systems. Defined expectations and competencies for pediatric hospitalists are needed. In 2005, SHM's Pediatric Core Curriculum Task Force initiated the project and formed the editorial board. Over the subsequent four years, multiple pediatric hospitalists belonging to the AAP, APA, or SHM contributed to the content of and guided the development of the project. Editors and collaborators created a framework for identifying appropriate competency content areas. Content experts from both within and outside of pediatric hospital medicine participated as contributors. A number of selected national organizations and societies provided valuable feedback on chapters. The final product was validated by formal review from the AAP, APA, and SHM. The Pediatric Hospital Medicine Core Competencies were created. They include 54 chapters divided into four sections: Common Clinical Diagnoses and Conditions, Core Skills, Specialized Clinical Services, and Healthcare Systems: Supporting and Advancing Child Health. Each chapter can be used independently of the others. Chapters follow the knowledge, skills, and attitudes educational curriculum format, and have an additional section on systems organization and improvement to reflect the pediatric hospitalist's responsibility to advance systems of care. These competencies provide a foundation for the creation of pediatric hospital medicine curricula and serve to standardize and improve inpatient training practices. (c) 2010 Society of Hospital Medicine.

  11. The academic value of rehabilitation medicine meetings.

    Science.gov (United States)

    Sivan, Manoj; Smith, Matthew; Bavikatte, Ganesh; Bradley, Lloyd

    2010-01-01

    Twice-yearly meetings of The British Society of Rehabilitation Medicine (BSRM) take place at which posters and free papers are generated, as abstracts, to present novel research findings, audits and case reports. The aim of this study was to evaluate the academic value of these meetings, by determining the subsequent rate of publication in peer-reviewed journals of abstracts presented. This was compared to the publication rate of other European medical specialist society meetings. The authors used MEDLINE, PubMed and Google Scholar search engines to look for publication of abstracts presented at BSRM meetings within peer-reviewed journals over a 7-year period (2000-2006). The abstracts were categorised into sub-groups (original study, audit, review, case report and service description) to determine which type was more likely to be published. The above databases were used also to extract studies on publication rate of other medical specialties in Europe. In 7 years, a total of 251 abstracts (of which 152 are original studies) have been presented as free papers or posters in a total of 13 meetings. The publication rate for the described study categories were: total 34%, original study 52%, review 50%, case report 5%, audit 0% and service description 0%. Publication rates from other specialist meetings in Europe range from 10% to 70%. The average publication rate for an abstract submitted to a BSRM meeting is 34% for any abstract and 52% for an original study suggesting that the meeting is generating abstracts of comparable academic interest to other specialist societies.

  12. Does Stereotype Threat Affect Women in Academic Medicine?

    Science.gov (United States)

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

    2012-01-01

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

  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. Does Stereotype Threat Affect Women in Academic Medicine?

    OpenAIRE

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

    2012-01-01

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

  15. New ways of understanding and accomplishing leadership in academic medicine.

    Science.gov (United States)

    Souba, Wiley W

    2004-04-01

    Understanding leadership as being about a person in charge is not wrong, but it is no longer adequate. The challenges and problems confronting medicine today are so complex and unpredictable that it is practically impossible for one person to accomplish the work of leadership alone. More leadership requires more shared work, but as hospitals and medical centers begin to break down departmental barriers, people have to learn to work with individuals and groups who may have different work ethics, dissimilar styles of solving problems, or even contrasting values. Successful academic medical centers will make use of a broader repertoire of leadership strategies--besides developing leaders, they will develop leadership as a property of the system, as an organizational capacity. While leader development involves enhancing human (individual) capital, the emphasis in leadership development is on social capital and building more productive relationships that enhance networking, collaboration, and resource exchange. Leadership is created in and emerges from the relational space that connects people--accordingly, leadership development involves building high-quality connections between people. To make leadership happen more effectively, academic medical centers will have to identify and study the ingredients that catalyze and enhance human connectivity, augment social capital and activate leadership. Leadership is a uniquely human activity--studying it and how it works is core to the learning organization.

  16. Society for Academic Emergency Medicine Statement on Plagiarism.

    Science.gov (United States)

    Asher, Shellie L; Iserson, Kenneth V; Merck, Lisa H

    2017-10-01

    The integrity of the research enterprise is of the utmost importance for the advancement of safe and effective medical practice for patients and for maintaining the public trust in health care. Academic societies and editors of journals are key participants in guarding scientific integrity. Avoiding and preventing plagiarism helps to preserve the scientific integrity of professional presentations and publications. The Society for Academic Emergency Medicine (SAEM) Ethics Committee discusses current issues in scientific publishing integrity and provides a guideline to avoid plagiarism in SAEM presentations and publications. © 2017 by the Society for Academic Emergency Medicine.

  17. 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. Copyright 2014, SLACK Incorporated.

  18. 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…

  19. Residents' Perspectives on Careers in Academic Medicine: Obstacles and Opportunities.

    Science.gov (United States)

    Lin, Steven; Nguyen, Cathina; Walters, Emily; Gordon, Paul

    2018-03-01

    Worsening faculty shortages in medical schools and residency programs are threatening the US medical education infrastructure. Little is known about the factors that influence the decision of family medicine residents to choose or not choose academic careers. Our study objective was to answer the following question among family medicine residents: "What is your greatest concern or fear about pursuing a career in academic family medicine?" Participants were family medicine residents who attended the Faculty for Tomorrow Workshop at the Society of Teachers of Family Medicine Annual Spring Conference in 2016 and 2017. Free responses to the aforementioned prompt were analyzed using a constant comparative method and grounded theory approach. A total of 156 participants registered for the workshops and 95 (61%) answered the free response question. Eight distinct themes emerged from the analysis. The most frequently recurring theme was "lack of readiness or mentorship," which accounted for nearly one-third (31%) of the codes. Other themes included work-life balance and burnout (17%), job availability and logistics (15%), lack of autonomy or flexibility (11%), competing pressures/roles (10%), lower financial rewards (4%), politics and bureaucracy (4%), and research (3%). To our knowledge, this is the first study to identify barriers and disincentives to pursuing a career in academic medicine from the perspective of family medicine residents. There may be at least eight major obstacles, for which we summarize and consider potential interventions. More research is needed to understand why residents choose, or don't choose, academic careers.

  20. IRSN's expertise about nuclear medicine hospital effluents

    International Nuclear Information System (INIS)

    2009-01-01

    This brief note aims at presenting the radioactivity follow up of hospital effluents performed by the French Institute of Radiation Protection and Nuclear Safety (IRSN). This follow up concerns the radioactive compounds and radiopharmaceuticals used in nuclear medicine, and principally technetium 99 and iodine 131. The IRSN has developed a network of remote measurement systems for the monitoring of sewers and waste water cleaning facilities. Data are compiled in a data base for analysis and subsequent expertise. (J.S.)

  1. Learning behaviour and preferences of family medicine residents under a flexible academic curriculum.

    Science.gov (United States)

    Sy, Alice; Wong, Eric; Boisvert, Leslie

    2014-11-01

    To determine family medicine residents' learning behaviour and preferences outside of clinical settings in order to help guide the development of an effective academic program that can maximize their learning. Retrospective descriptive analysis of academic learning logs submitted by residents as part of their academic training requirements between 2008 and 2011. London, Ont. All family medicine residents at Western University who had completed their academic program requirements (N = 72) by submitting 300 or more credits (1 credit = 1 hour). Amount of time spent on various learning modalities, location where the learning took place, resources used for self-study, and the objective of the learning activity. A total of 72 residents completed their academic requirements during the study period and logged a total of 25 068 hours of academic learning. Residents chose to spend most of their academic time engaging in self-study (44%), attending staff physicians' teaching sessions (20%),and participating in conferences, courses, or workshops (12%) and in postgraduate medical education sessions (12%). Textbooks (26%), medical journals (20%), and point-of-care resources (12%) were the 3 most common resources used for self-study. The hospital (32%), residents' homes (32%),and family medicine clinics (14%) were the most frequently cited locations where academic learning occurred. While all physicians used a variety of educational activities, most residents (67%) chose self-study as their primary method of learning. The topic for academic learning appeared to have some influence on the learning modalities used by residents. Residents used a variety of learning modalities and chose self-study over other more traditional modalities (eg, lectures) for most of their academic learning. A successful academic program must take into account residents' various learning preferences and habits while providing guidance and training in the use of more effective learning methods and

  2. Hospital Intranet and Extranet in nuclear medicine

    International Nuclear Information System (INIS)

    Gambini, D.J.; Baum, T.P.; Spector, M.; Dumas, F.; Elgard, M.C.; Collington, M.A.; Barritault, L.

    1997-01-01

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

  3. Veterinary medicine books recommended for academic libraries.

    Science.gov (United States)

    Crawley-Low, Jill

    2004-10-01

    This bibliography of in-print veterinary medical books published in English may be used as an acquisitions or evaluation tool for developing the monograph component of new veterinary medicine collections or existing science, technology, and medicine collections where veterinary medicine is in the scope of the collection. The bibliography is divided into 34 categories and consists of bibliographic information for 419 titles. The appendix contains an author/editor index. Prices for all entries are in US dollars, except where another currency is noted. The total cost of all books in the bibliography is $43,602.13 (US).

  4. Measuring faculty retention and success in academic medicine.

    Science.gov (United States)

    Ries, Andrew; Wingard, Deborah; Gamst, Anthony; Larsen, Catherine; Farrell, Elizabeth; Reznik, Vivian

    2012-08-01

    To develop and demonstrate the usefulness of quantitative methods for assessing retention and academic success of junior faculty in academic medicine. The authors created matched sets of participants and nonparticipants in a junior faculty development program based on hire date and academic series for newly hired assistant professors at the University of California, San Diego (UCSD), School of Medicine between 1988 and 2005. They used Kaplan-Meier and Cox proportional hazards survival analyses to characterize the influence of covariates, including gender, ethnicity, and program participation, on retention. They also developed a new method for quantifying academic success based on several measures including (1) leadership and professional activities, (2) honors and awards, (3) research grants, (4) teaching and mentoring/advising activities, and (5) publications. The authors then used these measures to compare matched pairs of participating and nonparticipating faculty who were subsequently promoted and remained at UCSD. Compared with matched nonparticipants, the retention of junior faculty who participated in the faculty development program was significantly higher. Among those who were promoted and remained at UCSD, the academic success of faculty development participants was consistently greater than that of matched nonparticipants. This difference reached statistical significance for leadership and professional activities. Using better quantitative methods for evaluating retention and academic success will improve understanding and research in these areas. In this study, use of such methods indicated that organized junior faculty development programs have positive effects on faculty retention and may facilitate success in academic medicine.

  5. 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.

  6. 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.

  7. [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.

  8. Collaboration in academic medicine: reflections on gender and advancement.

    Science.gov (United States)

    Carr, Phyllis L; Pololi, Linda; Knight, Sharon; Conrad, Peter

    2009-10-01

    Collaboration in academic medicine is encouraged, yet no one has studied the environment in which faculty collaborate. The authors investigated how faculty experienced collaboration and the institutional atmosphere for collaboration. In 2007, as part of a qualitative study of faculty in five disparate U.S. medical schools, the authors interviewed 96 medical faculty at different career stages and in diverse specialties, with an oversampling of women, minorities, and generalists, regarding their perceptions and experiences of collaboration in academic medicine. Data analysis was inductive and driven by the grounded theory tradition. Female faculty expressed enthusiasm about the potential and process of collaboration; male faculty were more likely to focus on outcomes. Senior faculty experienced a more collaborative environment than early career faculty, who faced numerous barriers to collaboration: the hierarchy of medical academe, advancement criteria, and the lack of infrastructure supportive of collaboration. Research faculty appreciated shared ideas, knowledge, resources, and the increased productivity that could result from collaboration, but they were acutely aware that advancement requires an independent body of work, which was a major deterrent to collaboration among early career faculty. Academic medicine faculty have differing views on the impact and benefits of collaboration. Early career faculty face concerning obstacles to collaboration. Female faculty seemed more appreciative of the process of collaboration, which may be of importance for transitioning to a more collaborative academic environment. A reevaluation of effective benchmarks for promotion of faculty is warranted to address the often exclusive reliance on individualistic achievement.

  9. Women in academic medicine: perceived obstacles to advancement.

    Science.gov (United States)

    Bennett, N M; Nickerson, K G

    1992-01-01

    To investigate perceived obstacles to the advancement of women in academic medicine, we sent a questionnaire assessing perceptions of the fairness and supportiveness of the academic environment to the 229 female teaching and research faculty of the School of Physicians & Surgeons at Columbia University. The overall response rate was 85%. Forty-six percent believed that they had not had the same professional opportunities as their male colleagues, 52% believed that salaries were not equivalent for men and women in similar positions, and 50% believed that promotions were awarded in a biased manner. Thirty percent reported that sexist behavior was common and that sexual harassment occurred in the workplace. Eighty-one percent experienced conflicts between their professional and personal lives and most believed that the institution failed to adequately address the needs of women with children. This survey indicates that there are significant perceived obstacles to the advancement of women in academic medicine that must be addressed.

  10. Increasing women's leadership in academic medicine: report of the AAMC Project Implementation Committee.

    Science.gov (United States)

    Bickel, Janet; Wara, Diane; Atkinson, Barbara F; Cohen, Lawrence S; Dunn, Michael; Hostler, Sharon; Johnson, Timothy R B; Morahan, Page; Rubenstein, Arthur H; Sheldon, George F; Stokes, Emma

    2002-10-01

    The AAMC's Increasing Women's Leadership Project Implementation Committee examined four years of data on the advancement of women in academic medicine. With women comprising only 14% of tenured faculty and 12% of full professors, the committee concludes that the progress achieved is inadequate. Because academic medicine needs all the leaders it can develop to address accelerating institutional and societal needs, the waste of most women's potential is of growing importance. Only institutions able to recruit and retain women will be likely to maintain the best housestaff and faculty. The long-term success of academic health centers is thus inextricably linked to the development of women leaders. The committee therefore recommends that medical schools, teaching hospitals, and academic societies (1) emphasize faculty diversity in departmental reviews, evaluating department chairs on their development of women faculty; (2) target women's professional development needs within the context of helping all faculty maximize their faculty appointments, including helping men become more effective mentors of women; (3) assess which institutional practices tend to favor men's over women's professional development, such as defining "academic success" as largely an independent act and rewarding unrestricted availability to work (i.e., neglect of personal life); (4) enhance the effectiveness of search committees to attract women candidates, including assessment of group process and of how candidates' qualifications are defined and evaluated; and (5) financially support institutional Women in Medicine programs and the AAMC Women Liaison Officer and regularly monitor the representation of women at senior ranks.

  11. Development of emergency medicine as academic and distinct clinical discipline in Bosnia & Herzegovina.

    Science.gov (United States)

    Salihefendic, Nizama; Zildzic, Muharem; Masic, Izet; Hadziahmetovic, Zoran; Vasic, Dusko

    2011-01-01

    practice. The Development of emergency medicine as a separate specialization and independent academic discipline has had different way and pace of development, and there is no ideal model that can be applied in all countries. However experiences from countries with well developed emergency medicine, suggest that the model of the simultaneous development of emergency medicine as a distinct academic discipline on independent recognized residencies with a strong national association is the best way for the formation of an efficient health system. The establishment of Emergency centers--departments for emergency medicine at university and cantonal hospitals, introduction of emergency medicine as an academic discipline, implementation of specific post-graduate teaching and continuing medical education through appropriate courses, as well as academic development program for the teaching staff is the most important element of future development of this discipline. It would also contribute to it achieving the appropriate status in both the academic institutions and in practice within the health system of Bosnia and Herzegovina.

  12. Women in Academic Medicine: Measuring Stereotype Threat Among Junior Faculty.

    Science.gov (United States)

    Fassiotto, Magali; Hamel, Elizabeth Otto; Ku, Manwai; Correll, Shelley; Grewal, Daisy; Lavori, Philip; Periyakoil, V J; Reiss, Allan; Sandborg, Christy; Walton, Gregory; Winkleby, Marilyn; Valantine, Hannah

    2016-03-01

    Gender stereotypes in science impede supportive environments for women. Research suggests that women's perceptions of these environments are influenced by stereotype threat (ST): anxiety faced in situations where one may be evaluated using negative stereotypes. This study developed and tested ST metrics for first time use with junior faculty in academic medicine. Under a 2012 National Institutes of Health Pathfinder Award, Stanford School of Medicine's Office of Diversity and Leadership, working with experienced clinicians, social scientists, and epidemiologists, developed and administered ST measures to a representative group of junior faculty. 174 School of Medicine junior faculty were recruited (62% women, 38% men; 75% assistant professors, 25% instructors; 50% white, 40% Asian, 10% underrepresented minority). Women reported greater susceptibility to ST than did men across all items including ST vulnerability (p gender identification (p women reported lower beliefs in advancement (p = 0.021); however, they had similar career interest and identification, felt just as connected to colleagues, and were equally likely to pursue careers outside academia (all p > 0.42). Innovative ST metrics can provide a more complete picture of academic medical center environments. While junior women faculty are susceptible to ST, they may not yet experience all of its consequences in their early careers. As such, ST metrics offer a tool for evaluating institutional initiatives to increase supportive environments for women in academic medicine.

  13. ORIGINAL ARTICLES Academic hospital accreditation strengthens ...

    African Journals Online (AJOL)

    This case study originated from the combined experiences of the accreditation process of a ... (iv) the benefits of hospital accreditation and quality management. The study ... Tertiary healthcare is in a crisis after nearly 3 decades of neglect,2,3.

  14. Academic Emergency Medicine Physicians’ Knowledge of Mechanical Ventilation

    Directory of Open Access Journals (Sweden)

    Susan R. Wilcox

    2016-05-01

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

  15. Mentorship in an academic department of family medicine.

    Science.gov (United States)

    Riley, Margaret; Skye, Eric; Reed, Barbara D

    2014-01-01

    Lack of quality mentorship has been identified as an impediment to a successful academic career. This study serves as a needs assessment to understand baseline mentoring among faculty in an academic department of family medicine and the existing relationships between mentorship, job satisfaction, and academic productivity before the department begins a structured mentorship program. All faculty received an anonymous online survey inquiring about their current mentorship and their perception of the importance of mentorship, in addition to measures of job satisfaction and academic productivity. Of 62 faculty members completing the survey (83% of faculty), almost all indicated it is very or somewhat important to have a mentor (97%, n=60), although only 45% (n=28) reported having a current mentor. Junior faculty were less likely than senior faculty to be satisfied with their mentorship, particularly if they did not have a current mentor. Job satisfaction was high and was not associated with having a mentor. Faculty members with mentors were more likely to have presented a talk or poster nationally, to have taken on a new educational or leadership role, and to have had a greater volume of academic activities overall. Although faculty believe mentorship is important, less than half have a current mentor. Junior faculty are disproportionately dissatisfied by lack of mentorship. Mentorship was associated with some elements of academic productivity but not with job satisfaction. Further study of the impact of a more structured mentorship program is needed.

  16. Rural versus urban academic hospital mortality following stroke in Canada.

    Science.gov (United States)

    Fleet, Richard; Bussières, Sylvain; Tounkara, Fatoumata Korika; Turcotte, Stéphane; Légaré, France; Plant, Jeff; Poitras, Julien; Archambault, Patrick M; Dupuis, Gilles

    2018-01-01

    Stroke is one of the leading causes of death in Canada. While stroke care has improved dramatically over the last decade, outcomes following stroke among patients treated in rural hospitals have not yet been reported in Canada. To describe variation in 30-day post-stroke in-hospital mortality rates between rural and urban academic hospitals in Canada. We also examined 24/7 in-hospital access to CT scanners and selected services in rural hospitals. We included Canadian Institute for Health Information (CIHI) data on adjusted 30-day in-hospital mortality following stroke from 2007 to 2011 for all acute care hospitals in Canada excluding Quebec and the Territories. We categorized rural hospitals as those located in rural small towns providing 24/7 emergency physician coverage with inpatient beds. Urban hospitals were academic centres designated as Level 1 or 2 trauma centres. We computed descriptive data on local access to a CT scanner and other services and compared mean 30-day adjusted post-stroke mortality rates for rural and urban hospitals to the overall Canadian rate. A total of 286 rural hospitals (3.4 million emergency department (ED) visits/year) and 24 urban hospitals (1.5 million ED visits/year) met inclusion criteria. From 2007 to 2011, 30-day in-hospital mortality rates following stroke were significantly higher in rural than in urban hospitals and higher than the Canadian average for every year except 2008 (rural average range = 18.26 to 21.04 and urban average range = 14.11 to 16.78). Only 11% of rural hospitals had a CT-scanner, 1% had MRI, 21% had in-hospital ICU, 94% had laboratory and 92% had basic x-ray facilities. Rural hospitals in Canada had higher 30-day in-hospital mortality rates following stroke than urban academic hospitals and the Canadian average. Rural hospitals also have very limited local access to CT scanners and ICUs. These rural/urban discrepancies are cause for concern in the context of Canada's universal health care system.

  17. Revitalization of academic medicine in Macedonia--an urgent need.

    Science.gov (United States)

    Donev, Donco M

    2004-12-01

    This paper presents the current status of the academic medicine of the Skopje University Faculty of Medicine and the necessity of the medical education reform, initiated in 2001 by the decision of the Ss. Cyril and Methodius University Rectorate Administration to introduce the credit system in the university education in the Republic of Macedonia. This essay describes and reviews the actual conditions and priority problems and needs; proposes activities that should be undertaken to solve and overcome the existing problems and provide further development of teaching and research at the Faculty. Structural reorganization and overall mobilization of the human resources of the Faculty towards achieving the desired goals is needed.

  18. Race, Disadvantage and Faculty Experiences in Academic Medicine

    Science.gov (United States)

    Cooper, Lisa A.; Carr, Phyllis

    2010-01-01

    ABSTRACT Background Despite compelling reasons to draw on the contributions of under-represented minority (URM) faculty members, US medical schools lack these faculty, particularly in leadership and senior roles. Objective The study’s purpose was to document URM faculty perceptions and experience of the culture of academic medicine in the US and to raise awareness of obstacles to achieving the goal of having people of color in positions of leadership in academic medicine. Design The authors conducted a qualitative interview study in 2006–2007 of faculty in five US medical schools chosen for their diverse regional and organizational attributes. Participants Using purposeful sampling of medical faculty, 96 faculty were interviewed from four different career stages (early, plateaued, leaders and left academic medicine) and diverse specialties with an oversampling of URM faculty. Approach We identified patterns and themes emergent in the coded data. Analysis was inductive and data driven. Results Predominant themes underscored during analyses regarding the experience of URM faculty were: difficulty of cross-cultural relationships; isolation and feeling invisible; lack of mentoring, role models and social capital; disrespect, overt and covert bias/discrimination; different performance expectations related to race/ethnicity; devaluing of research on community health care and health disparities; the unfair burden of being identified with affirmative action and responsibility for diversity efforts; leadership’s role in diversity goals; and financial hardship. Conclusions Achieving an inclusive culture for diverse medical school faculty would help meet the mission of academic medicine to train a physician and research workforce that meets the disparate needs of our multicultural society. Medical school leaders need to value the inclusion of URM faculty. Failure to fully engage the skills and insights of URM faculty impairs our ability to provide the best science

  19. Race, disadvantage and faculty experiences in academic medicine.

    Science.gov (United States)

    Pololi, Linda; Cooper, Lisa A; Carr, Phyllis

    2010-12-01

    Despite compelling reasons to draw on the contributions of under-represented minority (URM) faculty members, US medical schools lack these faculty, particularly in leadership and senior roles. The study's purpose was to document URM faculty perceptions and experience of the culture of academic medicine in the US and to raise awareness of obstacles to achieving the goal of having people of color in positions of leadership in academic medicine. The authors conducted a qualitative interview study in 2006-2007 of faculty in five US medical schools chosen for their diverse regional and organizational attributes. Using purposeful sampling of medical faculty, 96 faculty were interviewed from four different career stages (early, plateaued, leaders and left academic medicine) and diverse specialties with an oversampling of URM faculty. We identified patterns and themes emergent in the coded data. Analysis was inductive and data driven. Predominant themes underscored during analyses regarding the experience of URM faculty were: difficulty of cross-cultural relationships; isolation and feeling invisible; lack of mentoring, role models and social capital; disrespect, overt and covert bias/discrimination; different performance expectations related to race/ethnicity; devaluing of research on community health care and health disparities; the unfair burden of being identified with affirmative action and responsibility for diversity efforts; leadership's role in diversity goals; and financial hardship. Achieving an inclusive culture for diverse medical school faculty would help meet the mission of academic medicine to train a physician and research workforce that meets the disparate needs of our multicultural society. Medical school leaders need to value the inclusion of URM faculty. Failure to fully engage the skills and insights of URM faculty impairs our ability to provide the best science, education or medical care.

  20. The polity of academic medicine: evidence-based democracy.

    Science.gov (United States)

    Willing, Steven J; Gunderman, Richard B; Cochran, Philip L; Saxton, Todd

    2005-04-01

    The authors consider the empirical data examining relationships between democratic governance and organizational success. There is overwhelming evidence that democratically run organizations excel in key parameters of success, such as business valuation, productivity, responsiveness, innovation, decision making, and worker morale and satisfaction. A review of physician surveys shows that discontent with academic administration is a major contributor to faculty turnover. Other data indicate that the basic concepts justifying autocratic governance of a department are deeply flawed and that autocratic governance is counterproductive. The authors conclude that the democratic governance of academic departments is the only model that is scientifically valid and would greatly enhance all missions of academic medicine in the 21st century.

  1. 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.

  2. Dinosaurs, Hospital Ecosystems, and the Future of Family Medicine

    Science.gov (United States)

    Glazner, Cherie

    2008-01-01

    The continued presence of the family physician within hospital systems is key to family medicine remaining an attractive, viable specialty in the ever-evolving world of medicine. One physician muses about her place in this complex ecosystem and believes that family physicians lose their voice and thus risk their own extinction when they opt out of hospital practice. PMID:18626038

  3. 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.

  4. Hurdles in clinical implementation of academic advanced therapy medicinal products: A national evaluation.

    Science.gov (United States)

    de Wilde, Sofieke; Veltrop-Duits, Louise; Hoozemans-Strik, Merel; Ras, Thirza; Blom-Veenman, Janine; Guchelaar, Henk-Jan; Zandvliet, Maarten; Meij, Pauline

    2016-06-01

    Since the implementation of the European Union (EU) regulation for advanced therapy medicinal products (ATMPs) in 2009, only six ATMPs achieved marketing authorization approval in the EU. Recognizing the major developments in the ATMP field, starting mostly in academic institutions, we investigated which hurdles were experienced in the whole pathway of ATMP development towards clinical care. Quality interviews were executed with different stakeholders in The Netherlands involved in the ATMP development field, e.g. academic research groups, national authorities and patient organizations. Based on the hurdles mentioned in the interviews, questionnaires were subsequently sent to the academic principal investigators (PIs) and ATMP good manufacturing practice (GMP) facility managers to quantify these hurdles. Besides the familiar regulatory routes of marketing authorization (MA) and hospital exemption (HE), a part of the academic PIs perceived that ATMPs should become available by the Tissues and Cells Directive or did not anticipate on the next development steps towards implementation of their ATMP towards regular clinical care. The main hurdles identified were: inadequate financial support, rapidly evolving field, study-related problems, lacking regulatory knowledge, lack of collaborations and responsibility issues. Creating an academic environment stimulating and planning ATMP development and licensing as well as investing in expanding the relevant regulatory knowledge in academic institutions seems a prerequisite to develop ATMPs from bench to patient. Copyright © 2016 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

  5. The spectrum of orthopaedics at Chris Hani Baragwanath Academic Hospital

    OpenAIRE

    Pillay, J; Ramokgopa, MT

    2013-01-01

    Chris Hani Baragwanath Academic Hospital (CHBAH) is the third largest hospital in the world and is the largest in the Southern hemisphere, serving a population of more than 3.5 million people.¹ The purpose of this review is to identify the orthopaedic-related health events that occur within the population being serviced by the hospital, and in doing so provide a tool to be used for improving orthopaedic-related patient care and outcomes in public health services.² We also took special interes...

  6. Hospital Medicine and Fellowship Program in Rural North Dakota - A Multifaceted Success Story.

    Science.gov (United States)

    Hyder, S S; Amundson, Mary

    2017-11-01

    Recruitment of hospitalists and primary care physicians for Critical Access Hospitals and tertiary care hospitals in North Dakota is difficult. To address this challenge, 2 programs were implemented in Bismarck, North Dakota. St. Alexius Medical Center created a hospitalist fellowship training program in collaboration with the University of North Dakota School of Medicine and Health Sciences and physicians willing to work in Critical Access Hospitals were offered a joint appointment to teach hospitalist fellows and obtain a clinical academic appointment at the university. Since it was created in 2012, 84 physicians have applied for 13 fellowships. Of the 11 fellows who have completed the program, 64% (7/11) remained in North Dakota to practice. Physicians are more likely to work in a rural Critical Access Hospital if they spend time working at a tertiary care center and have clinical academic appointments. Where recruitment is challenging, hospitalist fellowship programs are helpful in meeting the health care workforce demand.

  7. Nurse practitioners and physician assistants: preparing new providers for hospital medicine at the mayo clinic.

    Science.gov (United States)

    Spychalla, Megan T; Heathman, Joanne H; Pearson, Katherine A; Herber, Andrew J; Newman, James S

    2014-01-01

    Hospital medicine is a growing field with an increasing demand for additional healthcare providers, especially in the face of an aging population. Reductions in resident duty hours, coupled with a continued deficit of medical school graduates to appropriately meet the demand, require an additional workforce to counter the shortage. A major dilemma of incorporating nonphysician providers such as nurse practitioners and physician assistants (NPPAs) into a hospital medicine practice is their varying academic backgrounds and inpatient care experiences. Medical institutions seeking to add NPPAs to their hospital medicine practice need a structured orientation program and ongoing NPPA educational support. This article outlines an NPPA orientation and training program within the Division of Hospital Internal Medicine (HIM) at the Mayo Clinic in Rochester, MN. In addition to a practical orientation program that other institutions can model and implement, the division of HIM also developed supplemental learning modalities to maintain ongoing NPPA competencies and fill learning gaps, including a formal NPPA hospital medicine continuing medical education (CME) course, an NPPA simulation-based boot camp, and the first hospital-based NPPA grand rounds offering CME credit. Since the NPPA orientation and training program was implemented, NPPAs within the division of HIM have gained a reputation for possessing a strong clinical skill set coupled with a depth of knowledge in hospital medicine. The NPPA-physician model serves as an alternative care practice, and we believe that with the institution of modalities, including a structured orientation program, didactic support, hands-on learning, and professional growth opportunities, NPPAs are capable of fulfilling the gap created by provider shortages and resident duty hour restrictions. Additionally, the use of NPPAs in hospital medicine allows for patient care continuity that is otherwise missing with resident practice models.

  8. Research evaluation and competition for academic positions in occupational medicine.

    Science.gov (United States)

    Franco, Giuliano

    2013-01-01

    Citation analysis is widely used to evaluate the performance of individual researchers, journals, and universities. Its outcome plays a crucial role in the decision-making process of ranking applicants for an academic position. A number of indicators, including the h-index reflecting both scientific productivity and its relevance in medical fields, are available through the Web of Knowledge( sm ) and Scopus®. In the field of occupational medicine, the adoption of the h-index in assessing the value of core journals shows some advantages compared with traditional bibliometrics and may encourage researchers to submit their papers. Although evaluation of the overall individual performance for academic positions should assess several aspects, scientific performance is usually based on citation analysis indicators. Younger researchers should be aware of the new approach based on transparent threshold rules for career promotion and need to understand the new evaluation systems based on metrics.

  9. 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.

  10. Hospitalist and Internal Medicine Leaders' Perspectives of Early Discharge Challenges at Academic Medical Centers.

    Science.gov (United States)

    Patel, Hemali; Fang, Margaret C; Mourad, Michelle; Green, Adrienne; Wachter, Robert M; Murphy, Ryan D; Harrison, James D

    2018-06-01

    Improving early discharges may improve patient flow and increase hospital capacity. We conducted a national survey of academic medical centers addressing the prevalence, importance, and effectiveness of early-discharge initiatives. We assembled a list of hospitalist and general internal medicine leaders at 115 US-based academic medical centers. We emailed each institutional representative a 30-item online survey regarding early-discharge initiatives. The survey included questions on discharge prioritization, the prevalence and effectiveness of early-discharge initiatives, and barriers to implementation. We received 61 responses from 115 institutions (53% response rate). Forty-seven (77%) "strongly agreed" or "agreed" that early discharge was a priority. "Discharge by noon" was the most cited goal (n = 23; 38%) followed by "no set time but overall goal for improvement" (n = 13; 21%). The majority of respondents reported early discharge as more important than obtaining translators for non-English-speaking patients and equally important as reducing 30-day readmissions and improving patient satisfaction. The most commonly reported factors delaying discharge were availability of postacute care beds (n = 48; 79%) and patient-related transport complications (n = 44; 72%). The most effective early discharge initiatives reported involved changes to the rounding process, such as preemptive identification and early preparation of discharge paperwork (n = 34; 56%) and communication with patients about anticipated discharge (n = 29; 48%). There is a strong interest in increasing early discharges in an effort to improve hospital throughput and patient flow. © 2017 Society of Hospital Medicine.

  11. Female authorship in emergency medicine parallels women practicing academic emergency medicine.

    Science.gov (United States)

    Tinjum, Banu E; Getto, Leila; Tiedemann, Juliah; Marri, Maaya; Brodowy, Michelle; Bollinger, Melissa; O'Connor, Robert E; Breyer, Michael J

    2011-12-01

    Studies have shown that women in emergency medicine (EM) lag behind their male counterparts in academic productivity. We compared the proportion of female attending physicians from EM academic programs to the proportion of female first or second authors of original scientific manuscripts and case reports from four major EM journals in a single year. We used a retrospective cross-sectional design. Original scientific manuscripts and case reports from four major EM journals published in 2005: Academic Emergency Medicine, Annals of Emergency Medicine, American Journal of Emergency Medicine, and Journal of Emergency Medicine were reviewed to determine genders of first and second authors. The proportion of female first or second authorship was then compared to the proportion of female EM attending physicians from 134 academic EM programs in the United States. Data were analyzed using Pearson's chi-squared and Clopper-Pearson binomial confidence intervals as appropriate. A p-value of ≤ 0.05 was considered significant. The percentage of female faculty; 940/3571 (26.32%, 95% confidence interval [CI] 24.9-27.8%) vs. the percentage of female first or second authorship 289/1123 (25.73%, 95% CI 23.3-28.4%) was not statistically significant (p = 0.562). There was no difference in the proportion of male and female authors with multiple manuscripts (p = 0.889). As measured by first and second authorship, there was no discrepancy between the proportion of female EM faculty and the proportion of female authorship in EM literature from 2005. Copyright © 2011 Elsevier Inc. All rights reserved.

  12. 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.

  13. CAEP 2015 Academic Symposium: Leadership within the emergency medicine academic community and beyond.

    Science.gov (United States)

    Sinclair, Doug; Worthington, James R; Joubert, Gary; Holroyd, Brian R; Stempien, James; Letovsky, Eric; Rutledge, Tim; LeBlanc, Constance; Pitters, Carrol; McCallum, Andrew; Carr, Brendan; Gerace, Rocco; Stiell, Ian G; Artz, Jennifer D; Christenson, Jim

    2016-05-01

    A panel of emergency medicine (EM) leaders endeavoured to define the key elements of leadership and its models, as well as to formulate consensus recommendations to build and strengthen academic leadership in the Canadian EM community in the areas of mentorship, education, and resources. The expert panel comprised EM leaders from across Canada and met regularly by teleconference over the course of 9 months. From the breadth of backgrounds and experience, as well as a literature review and the development of a leadership video series, broad themes for recommendations around the building and strengthening of EM leadership were presented at the CAEP 2015 Academic Symposium held in Edmonton, Alberta. Feedback from the attendees (about 80 emergency physicians interested in leadership) was sought. Subsequently, draft recommendations were developed by the panel through attendee feedback, further review of the leadership video series, and expert opinion. The recommendations were distributed to the CAEP Academic Section for further feedback and updated by consensus of the expert panel. The methods informed the panel who framed recommendations around four themes: 1) leadership preparation and training, 2) self-reflection/emotional intelligence, 3) academic leadership skills, and 4) gender balance in academic EM leadership. The recommendations aimed to support and nurture the next generation of academic EM leaders in Canada and included leadership mentors, availability of formal educational courses/programs in leadership, self-directed education of aspiring leaders, creation of a Canadian subgroup with the AACEM/SAEM Chair Development Program, and gender balance in leadership roles. These recommendations serve as a roadmap for all EM leaders (and aspiring leaders) to build on their success, inspire their colleagues, and foster the next generation of Canadian EM academic leaders.

  14. Physicians' job satisfaction and motivation in a public academic hospital.

    Science.gov (United States)

    de Oliveira Vasconcelos Filho, Paulo; de Souza, Miriam Regina; Elias, Paulo Eduardo Mangeon; D'Ávila Viana, Ana Luiza

    2016-12-07

    Physician shortage is a global issue that concerns Brazil's authorities. The organizational structure and the environment of a medical institution can hide a low-quality life of a physician. This study examines the relationship between the hospital work environment and physicians' job satisfaction and motivation when working in a large public academic hospital. The study was restricted to one large, multispecialty Brazil's hospital. Six hundred hospital physicians were invited to participate by e-mail. A short version of the Physician Worklife Survey (PWS) was used to measure working satisfaction. Physicians were also asked for socio-demographic information, medical specialty, and the intention to continue working in the hospital. Data from 141 questionnaires were included in the analyses. Forty-five physicians graduated from the hospital's university, and they did not intend to leave the hospital under any circumstance (affective bond). The motivating factor for beginning the career at the hospital and to continue working there were the connection to the medical school and the hospital status as a "prestigious academic hospital"; the physicians were more satisfied with the career than the specialty. Only 30% completely agreed with the statement "If I had to start my career over again, I would choose my current specialty," while 45% completely agreed with the statement "I am not well compensated given my training and experience." The greater point of satisfaction was the relationship with physician colleagues. They are annoyed about the amount of calls they are requested to take and about how work encroaches on their personal time. No significant differences between medical specialties were found in the analysis. The participants were satisfied with their profession. The fact that they remained at the hospital was related to the academic environment, the relationship with colleagues, and the high prestige in which society holds the institution. The points of

  15. Optimizing the Internal Medicine Clinic at Evans Army Community Hospital

    National Research Council Canada - National Science Library

    Bonilla, Jose

    2003-01-01

    ...) 2002, the Internal Medicine (IM) clinic at Evans Army Community Hospital, Fort Carson, Colorado, failed to meet access to care standards for routine appointments, and was only marginally successful in meeting standards for urgent appointments...

  16. The association between money and opinion in academic emergency medicine.

    Science.gov (United States)

    Birkhahn, Robert H; Blomkalns, Andra; Klausner, Howard; Nowak, Richard; Raja, Ali S; Summers, Richard; Weber, Jim E; Briggs, William M; Arkun, Alp; Diercks, Deborah

    2010-05-01

    Financial conflicts of interest have come under increasing scrutiny in medicine, but their impact has not been quantified. Our objective was to use the results of a national survey of academic emergency medicine (EM) faculty to determine if an association between money and personal opinion exists. We conducted a web-based survey of EM faculty. Opinion questions were analyzed with regard to whether the respondent had either 1) received research grant money or 2) received money from industry as a speaker, consultant, or advisor. Responses were unweighted, and tests of differences in proportions were made using Chi-squared tests, with pmoney. Respondents with research money were more likely to be comfortable accepting gifts (40% vs. 29%) and acting as paid consultants (50% vs. 37%). They had a more favorable attitude with regard to societal interactions with industry and felt that industry-sponsored lectures could be fair and unbiased (52% vs. 29%). Faculty with fee-for-service money mirrored those with research money. They were also more likely to believe that industry-sponsored research produces fair and unbiased results (61% vs. 45%) and less likely to believe that honoraria biased speakers (49% vs. 69%). Accepting money for either service or research identified a distinct population defined by their opinions. Faculty engaged in industry-sponsored research benefitted socially (collaborations), academically (publications), and financially from the relationship.

  17. Nursing leadership in an academic hospital in Gauteng.

    Science.gov (United States)

    Maboko, D R

    2012-10-01

    This study was aimed at describing nursing leadership in an academic hospital in Gauteng, South Africa. Nurse managers' leadership styles affect nurses' attitudes, behaviour and work performance. However, little is known about how nurses experience nurse leadership and what leadership styles are found in academic hospitals in Gauteng. The study was based on Maxwell's framework of leadership (relationships, equipping, leadership and attitude). A qualitative design was used in order to describe the experiences of registered nurses and nurse managers. The population of the study was all registered nurses and nurse managers of the hospital in which the study was conducted. In phase one of the study, a discussion group with 35 registered nurses using the nominal group technique was held to respond to the following statement: 'Please explain how you have experienced leadership by nurse managers in this hospital'. In phase two of the study, five nurse managers were interviewed individually, using a semi-structured interview guide. Some nurse managers were practising autocratic leadership in this hospital. he nurse managers need to be taught about contemporary leadership styles such as transformational leadership and visionary leadership and also about supervision, role modelling and caring. © 2011 Blackwell Publishing Ltd.

  18. 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...

  19. A practical guide to manuscript writing with particular relevance to the field of pediatric hospital medicine.

    Science.gov (United States)

    Teufel, Ronald J; Andrews, Anne L; Williams, Derek J

    2014-11-01

    Publishing manuscripts in peer-reviewed journals, such as Hospital Pediatrics, is critical for both the academic development of practitioners in pediatric hospital medicine and the scientific advancement of our field. Understanding the purpose of scientific writing and developing a structured approach to the writing process is essential. Doing so will improve the clarity of your work and likely the ease at which your research is published and disseminated throughout the scientific community. The purposes of this article are to detail the structure of a scientific manuscript, to highlight specific writing strategies, and to provide writing tips that may help or hinder publication. Our ultimate goal is to advance the field of pediatric hospital medicine and its growing membership by promoting the dissemination of high-quality research. Copyright © 2014 by the American Academy of Pediatrics.

  20. 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.

  1. Women chairs in academic medicine: engendering strategic intuition.

    Science.gov (United States)

    Isaac, Carol; Griffin, Lindsay

    2015-01-01

    Because stereotypically masculine behaviors are required for effective leadership, examining female chairs' leadership in academic medicine can provide insight into the complex ways in which gender impacts on their leadership practices. The paper aims to discuss this issue. The author interviewed three female clinical chairs and compared the findings to interviews with 28 of their faculty. Grounded theory analysis of the subsequent text gathered comprehensive, systematic, and in-depth information about this case of interest at a US top-tier academic medical center. Four of five themes from the faculty were consistent with the chair's narrative with modifications: Prior Environment (Motivated by Excellence), Tough, Direct, Transparent (Developing Trust), Communal Actions (Creating Diversity of Opinion), and Building Power through Consensus (an "Artful Exercise") with an additional theme, the Significance (and Insignificance) of a Female Chair. While faculty members were acutely aware of the chair's gender, the chairs paradoxically vacillated between gender being a "non-issue" and noting that male chairs "don't do laundry." All three female chairs in this study independently and explicitly stated that gender was not a barrier, yet intuitively used successful strategies derived from the research literature. This study suggests that while their gender was highlighted by faculty, these women dismissed gender as a "non-issue." The duality of gender for these three female leaders was both minimized and subtly affirmed.

  2. Women chairs in academic medicine: engendering strategic intuition

    Science.gov (United States)

    Isaac, Carol; Griffin, Lindsay

    2017-01-01

    Purpose Because stereotypically masculine behaviors are required for effective leadership, examining female chairs’ leadership in academic medicine can provide insight into the complex ways in which gender impacts on their leadership practices. The paper aims to discuss this issue. Design/methodology/approach The author interviewed three female clinical chairs and compared the findings to interviews with 28 of their faculty. Grounded theory analysis of the subsequent text gathered comprehensive, systematic, and in-depth information about this case of interest at a US top-tier academic medical center. Findings Four of five themes from the faculty were consistent with the chair’s narrative with modifications: Prior Environment (Motivated by Excellence), Tough, Direct, Transparent (Developing Trust), Communal Actions (Creating Diversity of Opinion), and Building Power through Consensus (an “Artful Exercise”) with an additional theme, the Significance (and Insignificance) of a Female Chair. While faculty members were acutely aware of the chair’s gender, the chairs paradoxically vacillated between gender being a “non-issue” and noting that male chairs “don’t do laundry.” All three female chairs in this study independently and explicitly stated that gender was not a barrier, yet intuitively used successful strategies derived from the research literature. Originality/value This study suggests that while their gender was highlighted by faculty, these women dismissed gender as a “non-issue.” The duality of gender for these three female leaders was both minimized and subtly affirmed. PMID:26045192

  3. 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.

  4. Patient's medicines brought to hospital: an overlooked resource?

    Science.gov (United States)

    Ware, G J

    1993-10-27

    To quantify potential cost advantages and identify practical safeguards required for utilising patients own medicines while in hospital, and returning them on discharge. All medicines brought in by patients in two wards of a geriatric assessment and rehabilitation unit at Auckland Hospital were examined by the pharmacist, and their suitability for re-issue assessed. Medicines were regarded as suitable for use where they could be positively identified, had been dispensed within 3 months of admission, or if packed in foil, provided the expiry date and manufacturer identification were on the foil. Medicines (260 items) totalling $2,976, assessed over a 6 month period, were regarded as suitable for use by the patient, with a mean value of $11.36 per patient. Patients own medicines used within the hospital with a unit-of-issue distribution system, and taken home by them on discharge, would provide appreciable savings for the hospital medicine budget and reduction in waste of the overall health dollar.

  5. [Postdoctoral lecturer thesis in medicine: academic competence or career booster?].

    Science.gov (United States)

    Sorg, H; Betzler, C; Grieswald, C; Schwab, C G G; Tilkorn, D J; Hauser, J

    2016-06-01

    The postdoctoral lecturer thesis in medicine represents an essential success factor for the career of a physician; however, there is controversial discussion on whether this reflects academic competence or is more a career booster. In this context we conducted a survey among postdoctoral medical lecturers with the aim to evaluate the significance of this qualification. The online survey was performed using a questionnaire requesting biographical parameters and subjective ratings of topics concerning the postdoctoral lecturer thesis. Overall 628 questionnaires were included in the study. The significance of the postdoctoral qualification was rated high in 68.6 % and was seen to be necessary for professional advancement in 71.0 %. The chances of obtaining a full professorship after achieving a postdoctoral qualification were rated moderate to low (68.1 %); nevertheless, 92.3 % would do it again and 86.5 % would recommend it to colleagues. Accordingly, 78.8 % were against its abolishment. Wishes for reforms included standardized federal regulations, reduced dependency on professors and more transparency. The postdoctoral lecturer qualification in medicine is highly valued and the majority of responders did not want it to be abolished. Although the chances for a full professorship were only rated low, successful graduation seems to be beneficial for the career; however, there is a need for substantial structural and international changes.

  6. [Day hospital in internal medicine: A chance for ambulatory care].

    Science.gov (United States)

    Grasland, A; Mortier, E

    2018-04-16

    Internal medicine is an in-hospital speciality. Along with its expertise in rare diseases, it shares with general medicine the global care of patients but its place in the ambulatory shift has yet to be defined. The objective of our work was to evaluate the benefits of an internal medicine day-hospital devoted to general medicine. Named "Centre Vi'TAL" to underline the link between the city and the hospital, this novel activity was implemented in order to respond quickly to general practitioners having difficulties to synthesize their complex patients or facing diagnostic or therapeutic problems. Using preferentially email for communication, the general practitioners can contact an internist who is committed to respond on the same day and take over the patient within 7 days if day-hospital is appropriate for his condition. The other patients are directed either to the emergency department, consultation or full hospitalization. In 14 months, the center has received 213 (144 women, 69 men) patients, mean age 53.6, addressed by 88 general practitioners for 282 day-hospital sessions. Requests included problem diagnoses (n=105), synthesis reviews for complex patients (n=65), and treatment (n=43). In the ambulatory shift advocated by the authorities, this experience shows that internal medicine should engage in the recognition of day-hospital as a place for diagnosis and synthesis reviews connected with the city while leaving the general practitioners coordinator of their patient care. This activity of synthesis in day-hospital is useful for the patients and efficient for our healthcare system. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  7. Supporting Faculty Development in Hospital Medicine: Design and Implementation of a Personalized Structured Mentoring Program.

    Science.gov (United States)

    Nagarur, Amulya; O'Neill, Regina M; Lawton, Donna; Greenwald, Jeffrey L

    2018-02-01

    The guidance of a mentor can have a tremendous influence on the careers of academic physicians. The lack of mentorship in the relatively young field of hospital medicine has been documented, but the efficacy of formalized mentorship programs has not been well studied. We implemented and evaluated a structured mentorship program for junior faculty at a large academic medical center. Of the 16 mentees who participated in the mentorship program, 14 (88%) completed preintervention surveys and 10 (63%) completed postintervention surveys. After completing the program, there was a statistically significant improvement in overall satisfaction within 5 specific domains: career planning, professional connectedness, self-reflection, research skills, and mentoring skills. All mentees reported that they would recommend that all hospital medicine faculty participate in similar mentorship programs. In this small, single-center pilot study, we found that the addition of a structured mentorship program based on training sessions that focus on best practices in mentoring was feasible and led to increased satisfaction in certain career domains among early-career hospitalists. Larger prospective studies with a longer follow-up are needed to assess the generalizability and durability of our findings. © 2017 Society of Hospital Medicine.

  8. Selection of medicines in Chilean public hospitals: an exploratory study

    Directory of Open Access Journals (Sweden)

    Collao Juan F

    2013-01-01

    Full Text Available Abstract Background There is a growing interest in high income countries to control expenditure on medicines by improving the rationale for their selection. However, in middle income countries with differing priorities and needs, little attention has been paid to this issue. In this paper we explore the policies and processes for the selection and use of medicines in a group of hospitals in Chile, a middle income country which has recently joined the OECD. Methods A combination of qualitative and quantitative methods was used. A national survey questionnaire was distributed to investigate the role and operation of PTCs (Pharmacy and Therapeutics Committees. Interviews were conducted with key actors in the selection of medicines in large urban public hospitals. Results The national survey had an overall response rate of 42% (83 out of 196, whilst 7 out of 14 hospitals participated in the qualitative study. High complexity hospitals are large urban hospitals; all of which claim to have a working PTC. The pharmacy offices are mainly involved in dispensing medicines with little involvement in clinical duties. The interviews conducted suggest that the formulary of all the hospitals visited is no more than a stock list. PTCs are unable to influence the prescribing practices of doctors. Members do not feel prepared to challenge the opinions of specialists requesting a certain drug, and decisions are based primarily on costs. The inclusion of medicines in the clinical practice of hospitals is as a result of doctors bypassing the PTC and requesting the purchase of exceptional items, some of which are included in the formulary if they are widely used. Conclusions There is an urgent need to develop medicine policies in hospitals in Chile. The procedures used to purchase medicines need to be revised. Central guidance for PTCs could help ensure a more rational use of medicines. PTCs need to be empowered to design formularies which cover all the clinical

  9. Selection of medicines in Chilean public hospitals: an exploratory study.

    Science.gov (United States)

    Collao, Juan F; Smith, Felicity; Barber, Nick

    2013-01-07

    There is a growing interest in high income countries to control expenditure on medicines by improving the rationale for their selection. However, in middle income countries with differing priorities and needs, little attention has been paid to this issue. In this paper we explore the policies and processes for the selection and use of medicines in a group of hospitals in Chile, a middle income country which has recently joined the OECD. A combination of qualitative and quantitative methods was used. A national survey questionnaire was distributed to investigate the role and operation of PTCs (Pharmacy and Therapeutics Committees). Interviews were conducted with key actors in the selection of medicines in large urban public hospitals. The national survey had an overall response rate of 42% (83 out of 196), whilst 7 out of 14 hospitals participated in the qualitative study. High complexity hospitals are large urban hospitals; all of which claim to have a working PTC. The pharmacy offices are mainly involved in dispensing medicines with little involvement in clinical duties.The interviews conducted suggest that the formulary of all the hospitals visited is no more than a stock list. PTCs are unable to influence the prescribing practices of doctors. Members do not feel prepared to challenge the opinions of specialists requesting a certain drug, and decisions are based primarily on costs. The inclusion of medicines in the clinical practice of hospitals is as a result of doctors bypassing the PTC and requesting the purchase of exceptional items, some of which are included in the formulary if they are widely used. There is an urgent need to develop medicine policies in hospitals in Chile. The procedures used to purchase medicines need to be revised. Central guidance for PTCs could help ensure a more rational use of medicines. PTCs need to be empowered to design formularies which cover all the clinical needs of doctors, training members in the analysis of scientific

  10. 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.

  11. Use of complementary and alternative medicine within Norwegian hospitals.

    Science.gov (United States)

    Jacobsen, R; Fønnebø, V M; Foss, N; Kristoffersen, A E

    2015-08-13

    Over the recent decades complementary and alternative medicine (CAM) use within and outside of the public health care system in Norway has increased. The aim of this study is to describe to what extent CAM is offered in Norwegian hospitals in 2013 and investigate possible changes since 2008. In January 2013 a one-page questionnaire was sent to the medical director of all included hospitals (n = 80). He/she was asked to report whether or not one or more specific CAM therapies were offered in the hospital. Fifty-nine (73.8%) hospitals responded and form the basis for the analyses. CAM was offered in 64.4% of the responding hospitals. No major differences were found between public and private, or between somatic and psychiatric, hospitals. Acupuncture was the most frequent CAM method offered, followed by art- and expression therapy and massage. The proportion of hospitals offering CAM has increased from 50.5% in 2008 to 64.4% in 2013 (p = 0.089). The largest increase was found in psychiatric hospitals where 76.5% of hospitals offered CAM in 2013 compared to 28.6% in 2008 (p = 0.003). A small decrease was found in the proportion of hospitals offering acupuncture between 2008 (41.4%) and 2013 (37.3%). A majority of Norwegian hospitals offer some sort of CAM. The largest increase since 2008 was found in psychiatric hospitals. Psychiatric hospitals seem to have established a practice of offering CAM to their patients similar to the practice in somatic hospitals. This could indicate a shift in the attitude with regard to CAM in psychiatric hospitals.

  12. Academic medicine meets managed care: a high-impact collision.

    Science.gov (United States)

    Carey, R M; Engelhard, C L

    1996-08-01

    The managed care revolution is sweeping the country as a result of intense marketing on the part of managed care organizations and the widespread belief that price-sensitive managed care systems will control health costs. Although few believe that managed care alone can adequately stem the growth of nation health care spending, competition based on price has emerged as a powerful force in the health care sector. Academic health center (AHCs) stand to suffer with this new managed care regime because their special missions of teaching, research, and highly specialized clinical care make them more expensive than nonacademic hospitals and place them at a noncompetitive disadvantage. The traditional focus of the acute care hospital with individual departmentally designed programs will be narrow. Major changes will be required on the part of AHCs if they are to survive and preserve patient volume, maintain the integrity of medical education, advance scientific research, and provide highly specialized care. AHCs will have to make unprecedented adjustments in virtually every phase of their operations, particularly in the areas of clinical decision making and speedy patient-related information flow. A premium will be placed on multidisciplinary, inclusive medical services that can assume total health care risks for large populations. New ways of educating students in ambulatory settings with an emphasis on outcomes and population-based health will be needed along with the traditional responsibility of pursuing new approaches to the diagnosis, treatment, and prevention of disease. The extent to which managed care will ultimately alter the traditional role of AHCs in the American health care system is unclear, but successful adaptation in the short term will require them to respond broadly, flexibly, and in a timely fashion to the anticipated health care scene.

  13. 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.

  14. NEEDLE KNIFE SPHINCTEROTOMY - THE CHRIS HANI BARAGWANATH ACADEMIC HOSPITAL EXPERIENCE.

    Science.gov (United States)

    Thomson, J T; Smith, M D; Omoshoro-Jones, J A O; Devar, J D; Khan, Z K; Jugmohan, B J

    2017-06-01

    Deep biliary cannulation is essential in performing a therapeutic ERCP. Cannulation can be enhanced through the utilization of a pre-cut by means of a needle knife sphincterotomy. Retrospective analysis of the Chris Hani Baragwanath Academic Hospital's ERCP database was performed. All ERCPs performed with the aid of a needle knife were identified and analysed for successful and unsuccessful deep biliary cannulation. 2830 ERCPs were performed during the study period. 369 (13%) required needle knife sphincterotomies and successful deep biliary cannulation was achieved in 229 (62%) of these patients. Repeat ERCPs were performed on 125 (34%) patients. 61 (49%) of the repeat ERCPs were performed because of previously failed cannulation. 34 (56%) of these repeat ERCPs resulted in successful deep biliary cannulation at re-attempt. 99% of successful cannulations at repeat ERCP had had a needle knife sphincterotomy at the first ERCP. Needle knife sphincterotomy improves deep biliary cannulation at initial ERCP and subsequent ERCPs with low incidences of complications.

  15. Strategic planning in an academic radiation medicine program

    Science.gov (United States)

    Hamilton, J.L.; Foxcroft, S.; Moyo, E.; Cooke-Lauder, J.; Spence, T.; Zahedi, P.; Bezjak, A.; Jaffray, D.; Lam, C.; Létourneau, D.; Milosevic, M.; Tsang, R.; Wong, R.; Liu, F.F.

    2017-01-01

    Background In this paper, we report on the process of strategic planning in the Radiation Medicine Program (rmp) at the Princess Margaret Cancer Centre. The rmp conducted a strategic planning exercise to ensure that program priorities reflect the current health care environment, enable nimble responses to the increasing burden of cancer, and guide program operations until 2020. Methods Data collection was guided by a project charter that outlined the project goal and the roles and responsibilities of all participants. The process was managed by a multidisciplinary steering committee under the guidance of an external consultant and consisted of reviewing strategic planning documents from close collaborators and institutional partners, conducting interviews with key stakeholders, deploying a program-wide survey, facilitating an anonymous and confidential e-mail feedback box, and collecting information from group deliberations. Results The process of strategic planning took place from December 2014 to December 2015. Mission and vision statements were developed, and core values were defined. A final document, Strategic Roadmap to 2020, was established to guide programmatic pursuits during the ensuing 5 years, and an implementation plan was developed to guide the first year of operations. Conclusions The strategic planning process provided an opportunity to mobilize staff talents and identify environmental opportunities, and helped to enable more effective use of resources in a rapidly changing health care environment. The process was valuable in allowing staff to consider and discuss the future, and in identifying strategic issues of the greatest importance to the program. Academic programs with similar mandates might find our report useful in guiding similar processes in their own organizations. PMID:29270061

  16. Strategic planning in an academic radiation medicine program.

    Science.gov (United States)

    Hamilton, J L; Foxcroft, S; Moyo, E; Cooke-Lauder, J; Spence, T; Zahedi, P; Bezjak, A; Jaffray, D; Lam, C; Létourneau, D; Milosevic, M; Tsang, R; Wong, R; Liu, F F

    2017-12-01

    In this paper, we report on the process of strategic planning in the Radiation Medicine Program (rmp) at the Princess Margaret Cancer Centre. The rmp conducted a strategic planning exercise to ensure that program priorities reflect the current health care environment, enable nimble responses to the increasing burden of cancer, and guide program operations until 2020. Data collection was guided by a project charter that outlined the project goal and the roles and responsibilities of all participants. The process was managed by a multidisciplinary steering committee under the guidance of an external consultant and consisted of reviewing strategic planning documents from close collaborators and institutional partners, conducting interviews with key stakeholders, deploying a program-wide survey, facilitating an anonymous and confidential e-mail feedback box, and collecting information from group deliberations. The process of strategic planning took place from December 2014 to December 2015. Mission and vision statements were developed, and core values were defined. A final document, Strategic Roadmap to 2020, was established to guide programmatic pursuits during the ensuing 5 years, and an implementation plan was developed to guide the first year of operations. The strategic planning process provided an opportunity to mobilize staff talents and identify environmental opportunities, and helped to enable more effective use of resources in a rapidly changing health care environment. The process was valuable in allowing staff to consider and discuss the future, and in identifying strategic issues of the greatest importance to the program. Academic programs with similar mandates might find our report useful in guiding similar processes in their own organizations.

  17. 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.

  18. The Behavioral and Social Sciences: Contributions and Opportunities in Academic Medicine.

    Science.gov (United States)

    Smith, Patrick O; Grigsby, R Kevin

    2017-06-01

    The Association of American Medical Colleges plays a leading role in supporting the expansion and evolution of academic medicine and medical science in North America, which are undergoing high-velocity change. Behavioral and social science concepts have great practical value when applied to the leadership practices and administrative structures that guide and support the rapid evolution of academic medicine and medical sciences. The authors are two behavioral and social science professionals who serve as academic administrators in academic medical centers. They outline their career development and describe the many ways activities have been shaped by their work with the Association of American Medical Colleges. Behavioral and social science professionals are encouraged to become change agents in the ongoing transformation of academic medicine.

  19. 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.

  20. Improving Exclusive Breastfeeding in an Urban Academic Hospital.

    Science.gov (United States)

    Ward, Laura P; Williamson, Susan; Burke, Stephanie; Crawford-Hemphill, Ruby; Thompson, Amy M

    2017-02-01

    Breastfeeding has many well-established health benefits for infants and mothers. There is greater risk reduction in health outcomes with exclusive breastfeeding (EBF). Our urban academic facility has had long-standing low EBF rates, serving a population with breastfeeding disparities. We sought to improve EBF rates through a Learning Collaborative model by participating in the Best Fed Beginnings project. Formal improvement science methods were used, including the development of a key driver diagram and plan-do-study-act cycles. Improvement activities followed the Ten Steps to Successful Breastfeeding. We demonstrated significant improvement in the median adherence to 2 process measures, rooming in and skin-to-skin after delivery. Subsequently, the proportion of infants exclusively breastfed at hospital discharge in our facility increased from 37% to 59%. We demonstrated an increase in sustained breastfeeding in a subset of patients at a postpartum follow-up visit. These improvements led to Baby-Friendly designation at our facility. This quality improvement initiative resulted in a higher number of infants exclusively breastfed in our patient population at "high risk not to breastfeed." Other hospitals can use these described methods and techniques to improve their EBF rates. Copyright © 2017 by the American Academy of Pediatrics.

  1. 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. Copyright © 2011 Society of Hospital Medicine.

  2. Use of complementary and alternative medicine within Norwegian hospitals

    OpenAIRE

    Jacobsen, Renate; Fønnebø, Vinjar; Foss, Nina; Kristoffersen, Agnete Egilsdatter

    2015-01-01

    Background: Over the recent decades complementary and alternative medicine (CAM) use within and outside of the public health care system in Norway has increased. The aim of this study is to describe to what extent CAM is offered in Norwegian hospitals in 2013 and investigate possible changes since 2008. Methods: In January 2013 a one-page questionnaire was sent to the medical director of all included hospitals (n = 80). He/she was asked to report whether or not one or more specifi...

  3. Assessment of readability, understandability, and completeness of pediatric hospital medicine discharge instructions.

    Science.gov (United States)

    Unaka, Ndidi I; Statile, Angela; Haney, Julianne; Beck, Andrew F; Brady, Patrick W; Jerardi, Karen E

    2017-02-01

    The average American adult reads at an 8th-grade level. Discharge instructions written above this level might increase the risk of adverse outcomes for children as they transition from hospital to home. We conducted a cross-sectional study at a large urban academic children's hospital to describe readability levels, understandability scores, and completeness of written instructions given to families at hospital discharge. Two hundred charts for patients discharged from the hospital medicine service were randomly selected for review. Written discharge instructions were extracted and scored for readability (Fry Readability Scale [FRS]), understandability (Patient Education Materials Assessment Tool [PEMAT]), and completeness (5 criteria determined by consensus). Descriptive statistics enumerated the distribution of readability, understandability, and completeness of written discharge instructions. Of the patients included in the study, 51% were publicly insured. Median age was 3.1 years, and median length of stay was 2.0 days. The median readability score corresponded to a 10th-grade reading level (interquartile range, 8-12; range, 1-13). Median PEMAT score was 73% (interquartile range, 64%-82%; range, 45%-100%); 36% of instructions scored below 70%, correlating with suboptimal understandability. The diagnosis was described in only 33% of the instructions. Although explicit warning signs were listed in most instructions, 38% of the instructions did not include information on the person to contact if warning signs developed. Overall, the readability, understandability, and completeness of discharge instructions were subpar. Efforts to improve the content of discharge instructions may promote safe and effective transitions home. Journal of Hospital Medicine 2017;12:98-101. © 2017 Society of Hospital Medicine.

  4. Hierarchy as a barrier to advancement for women in academic medicine.

    Science.gov (United States)

    Conrad, Peter; Carr, Phyllis; Knight, Sharon; Renfrew, Megan R; Dunn, Mary B; Pololi, Linda

    2010-04-01

    Research on barriers to professional advancement for women in academic medicine has not adequately considered the role of environmental factors and how the structure of organizations affects professional advancement and work experiences. This article examines the impact of the hierarchy, including both the organization's hierarchical structure and professionals' perceptions of this structure, in medical school organization on faculty members' experience and advancement in academic medicine. As part of an inductive qualitative study of faculty in five disparate U.S. medical schools, we interviewed 96 medical faculty at different career stages and in diverse specialties, using in-depth semistructured interviews, about their perceptions about and experiences in academic medicine. Data were coded and analysis was conducted in the grounded theory tradition. Our respondents saw the hierarchy of chairs, based on the indeterminate tenure of department chairs, as a central characteristic of the structure of academic medicine. Many faculty saw this hierarchy as affecting inclusion, reducing transparency in decision making, and impeding advancement. Indeterminate chair terms lessen turnover and may create a bottleneck for advancement. Both men and women faculty perceived this hierarchy, but women saw it as more consequential. The hierarchical structure of academic medicine has a significant impact on faculty work experiences, including advancement, especially for women. We suggest that medical schools consider alternative models of leadership and managerial styles, including fixed terms for chairs with a greater emphasis on inclusion. This is a structural reform that could increase opportunities for advancement especially for women in academic medicine.

  5. 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.

  6. A Review of Tenure for Black, Latino, and Native American Faculty in Academic Medicine.

    Science.gov (United States)

    Fisher, Zedeena E; Rodríguez, José E; Campbell, Kendall M

    2017-01-01

    Tenure policies in US medical schools have been under scrutiny for decades while black/African American, Latino, and Native American faculty continue to be underrepresented in medicine. As medical institutions seek to improve diversity, tenure continues to be a major retention tool. We undertook a systematic review of the literature to investigate the role that tenure plays in the recruitment, retention, and advancement of underrepresented minorities in medicine (URMM) faculty in academic medicine. We searched PubMed, Google Scholar, Web of Knowledge, the Cumulative Index of Nursing and Allied Health Literature, and the Education Resources Information Center for articles relating to URMM faculty and tenure. Articles published in the last 20 years, in English, that discussed recruitment or retention of women, URMM faculty, and tenure in academic medicine, and were of high quality based on data were included in the study. Narrative reviews, opinion, editorials, and letters to the editor were excluded. Of the 1038 articles we reviewed, 23 met the criteria for inclusion. Tenure was associated with leadership, higher salaries, and comfort in the work environment. URMM faculty comprised the lowest percentage of tenured faculty in academic medicine, with the highest percentage pertaining to white men. More research needs to be done to determine whether tenure status can improve the number of URMM faculty in academic medicine. Tenure may provide URMM faculty the benefits that they need to progress in their careers and remain in academic medicine.

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

    International Nuclear Information System (INIS)

    Dias, T.M.; Pinto, A.L.; Bacelar, A.L.; Dytz, A.S.; Bernasiuk, M.E.; Baptista, I.S.

    1996-01-01

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

  8. 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…

  9. 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…

  10. 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. © 2011 by the Society for Academic Emergency Medicine.

  11. CAEP 2015 Academic Symposium: Current State and Recommendations to Achieve Adequate and Sustainable Funding for Emergency Medicine Academic Units.

    Science.gov (United States)

    Lang, Eddy S; Artz, Jennifer D; Wilkie, Ryan D; Stiell, Ian G; Topping, Claude; Belanger, François P; Afilalo, Marc; Renouf, Tia; Crocco, Anthony; Wyatt, Kelly; Christenson, Jim

    2016-05-01

    To describe the current state of academic emergency medicine (EM) funding in Canada and develop recommendations to grow and establish sustainable funding. A panel of eight leaders from different EM academic units was assembled. Using mixed methods (including a literature review, sharing of professional experiences, a survey of current EM academic heads, and data previously collected from an environmental scan), 10 recommendations were drafted and presented at an academic symposium. Attendee feedback was incorporated, and the second set of draft recommendations was further distributed to the Canadian Association Emergency Physicians (CAEP) Academic Section for additional comments before being finalized. Recommendations were developed around the funding challenges identified and solutions developed by academic EM university-based units across Canada. A strategic plan was seen as integral to achieving strong funding of an EM unit, especially when it aligned with departmental and institutional priorities. A business plan, although occasionally overlooked, was deemed an important component for planning and sustaining the academic mission. A number of recommendations surrounding philanthropy consisted of creating partnerships with existing foundations and engaging multiple stakeholders and communities. Synergy between academic and clinical EM departments was also viewed as an opportunity to ensure integration of common missions. Education and networking for current and future leaders were also viewed as invaluable to ensure that opportunities are optimized through strong leadership development and shared experiences to further the EM academic missions across the country. These recommendations were designed to improve the financial circumstances for many Canadian EM units. There is a considerable wealth of resources that can contribute to financial stability for an academic unit, and an annual networking meeting and continuing education on these issues will facilitate

  12. 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.

  13. 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.

  14. Predictors of job satisfaction among academic family medicine faculty: Findings from a faculty work-life and leadership survey.

    Science.gov (United States)

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

    2017-03-01

    To identify predictors of job satisfaction among academic family medicine faculty members. 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. 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. All 1029 faculty members in the Department of Family and Community Medicine were invited to complete the survey. 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?" 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 good or excellent. The findings from this study show that job satisfaction among academic

  15. 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.

  16. [Graduate Students in Medicine Course: Motivation, Socialization and Academic Recognition].

    Science.gov (United States)

    Magalhães-Alves, Cristina; Barbosa, Joselina; Ribeiro, Laura; Ferreira, Maria Amélia

    2017-04-28

    Students with a previous degree have personal and professional experiences that can contribute to a different academic path during the medical course. This study aims to: 1) analyze both satisfaction and impact of academic recognition; 2) investigate whether motivations and expectations at entrance are maintained along the course; 3) to evaluate socialization after regress to higher education. To accomplish the first objective a questionnaire was administered to 82 students who entered the medical school from 2011/2012 to 2013/2014. For the second and third goals a focus group was run (three groups with five students each, representing the three academic years). Students felt satisfied with the recognition, and 50% of them believe that accreditations replace knowledge acquired with the curricular units, and 47% preferred to obtain accreditation. Academic achievement was negatively associated with the satisfaction of recognition and positively with age, background and registration cycle. Socialization of these students is distinct from the younger ones, their motivations at entrance are intrinsic and, contrary to expectations, are maintained along the course. Students prefer recognition instead of attending the curricular units. The most satisfied with the recognition accomplish less credits and the younger ones, from health area and enrolled in the clinical cycle, accomplish more. Along the course, motivations become more solid, expectations change and socialization is carried out with greater responsibility.

  17. Student mistreatment in medical school and planning a career in academic medicine.

    Science.gov (United States)

    Haviland, Mark G; Yamagata, Hisashi; Werner, Leonard S; Zhang, Kehua; Dial, Thomas H; Sonne, Janet L

    2011-01-01

    Student mistreatment in medical school is a persistent problem with both known and unexplored consequences [corrected]. The purpose of this study was to determine whether a perception of having been mistreated in medical school had an association with planning a full-time career in academic medicine. Using Association of American Medical Colleges' 2000-2004 Medical School Graduation Questionnaire data, we evaluated the relationship between students' mistreatment experience and their career choice, academic versus nonacademic setting. Meta-analysis and regression were used to evaluate this relationship. At medical schools where relatively high percentages of graduating seniors were planning academic careers, students reporting mistreatment experiences were less likely at graduation to be planning careers in academic medicine. A perception of having been mistreated in medical school is related to students' career choices, a finding that may be useful to medical school administrators/faculty and students as mistreatment is addressed in program planning, counseling, and faculty recruitment.

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

    OpenAIRE

    McHenry, Leemon

    2010-01-01

    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 me...

  19. The Hospitalist Huddle: a 1-year experience of teaching Hospital Medicine utilizing the concept of peer teaching in medical education.

    Science.gov (United States)

    Elhassan, Mohammed

    2017-01-01

    The relatively new specialty of Hospital Medicine in the USA is one of the fastest growing fields in internal medicine. Academic hospitalists are largely involved in the medical education of postgraduate residents and medical students. Little is known about the effectiveness of peer-to-peer teaching in internal medicine residency training programs and how the medical residents perceive its educational value in learning Hospital Medicine. The Hospitalist Huddle is a weekly educational activity newly established by our Hospitalist Division to facilitate the concept of peer-to-peer teaching. It requires medical residents to teach and educate their peers about the clinical topics related to Hospital Medicine. Faculty hospitalists serve as facilitators during the teaching sessions. A survey disseminated at the end of the first year of its implementation examined the residents' perception of the educational value of this new teaching activity. Most residents reported that they see the Huddle as a useful educational forum which may improve their skills in teaching, create a better educational and learning environment during their inpatient rotation, and improve their understanding of Hospital Medicine. Most residents also prefer that their peers, rather than faculty hospitalists, run the activity and do the teaching. The survey results support the notion that teaching and learning with flat hierarchies can be an appealing educational method to medical residents to help them understand Hospital Medicine during their medical wards rotation. Some areas need to be improved and others need to be continued and emphasized in order to make this novel educational activity grow and flourish in terms of its educational value and residents' satisfaction.

  20. 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.

  1. "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

    2003-03-01

    To develop a deeper understanding of mentoring by exploring lived experiences of academic medicine faculty members. Mentoring relationships are key to developing productive careers in academic medicine, but such alliances hold a certain "mystery." Using qualitative techniques, between November 1999 and March 2000, the authors conducted individual telephone interviews of 16 faculty members about their experiences with mentoring. Interviews were taped and transcribed and authors identified major themes through multiple readings. A consensus taxonomy for classifying content evolved from comparisons of coding by four reviewers. Themes expressed by participants were studied for patterns of connection and grouped into broader categories. Almost 98% of participants identified lack of mentoring as the first (42%) or second (56%) most important factor hindering career progress in academic medicine. Finding a suitable mentor requires effort and persistence. Effective mentoring necessitates a certain chemistry for an appropriate interpersonal match. Prized mentors have "clout," knowledge, and interest in the mentees, and provide both professional and personal support. In cross-gender mentoring, maintaining clear boundaries is essential for an effective relationship. Same-gender or same-race matches between mentor and mentee were not felt to be essential. Having a mentor is critical to having a successful career in academic medicine. Mentees need to be diligent in seeking out these relationships and institutions need to encourage and value the work of mentors. Participants without formalized mentoring relationships should look to peers and colleagues for assistance in navigating the academic system.

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

    Science.gov (United States)

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

    2015-12-01

    We assessed the impact of completion and feedback of discharge summary scorecards on the quality of discharge summaries written by interns in a general medicine service of a tertiary hospital. The scorecards significantly improved summary quality in the first three rotations of the intern year and could be readily adopted by other units as a quality improvement intervention for optimizing clinical handover to primary care providers. © 2015 Royal Australasian College of Physicians.

  3. Dilemma of an indigent country: Is academic medicine a good investment?

    Science.gov (United States)

    Kardas, Przemyslaw

    2004-10-01

    Academic medicine is a discipline which requires much financial expenditure and the profit is not always immediate. Therefore, an idea has been raised in some circles to limit the expenditures on it. The experience of Poland points out, however, that such a limitation will not bring benefit in the long run--just the opposite, it can bring about both social and economic loss. Even the countries that are not wealthy should invest in academic medicine, as this is a necessary condition for their harmonious growth.

  4. 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…

  5. Cost of Treatment of Hospitalized Patients with Diabetes in Prenda Hospital Medicine Service, Angola

    Directory of Open Access Journals (Sweden)

    António Zangulo

    2017-07-01

    Full Text Available Introduction: Diabetes has a major impact on morbidity and mortality today. It is estimated that by 2040, about 642 million people are affected worldwide, of which, 34.2 million are from sub-Saharan countries. The direct annual cost of diabetes health care worldwide is estimated at about 153 billion dollars. These patients represent 30% to 40% of all admissions to emergency services, leading to high values of hospital expenditure. We aim to evaluate the cost of treatment of patients with diabetes admitted to Prenda Hospital Medicine Service in 2012. Methods: Retrospective analytical observational study, with data collected from the clinical processes of medical service (age and gender, length of hospitalization, resources consumed, cost of treatment per patient and discharge. Results: Out of 121 patients, the majority was female (n = 70, 57.9%. The age group of 36 to 45 years old was the most frequent among these patients (n = 26, 21.5%. November was the month that recorded the largest number of admissions (n = 17, 14%. About 45.5% were hospitalized during five to eight days, on average for nine days. The majority (76.9% was discharged due to health condition improvement. The price of materials used for treatment of the disease had high variation, and 31 550.15 kwanzas was spent to acquire them. The direct cost per patient per day was 4170.11 kwanzas and the estimated annual cost of care of diabetic patients admitted to Prenda Hospital was 45 525 490.9 kwanzas in 2012. Discussion and Conclusion: These results are in accordance with other studies, indicating a relevant cost of treatment of diabetic patients admitted to Prenda Hospital Medicine Service in 2012.

  6. Inadequate Progress for Women in Academic Medicine: Findings from the National Faculty Study

    Science.gov (United States)

    Gunn, Christine M.; Kaplan, Samantha A.; Raj, Anita; Freund, Karen M.

    2015-01-01

    Abstract Background: Women have entered academic medicine in significant numbers for 4 decades and now comprise 20% of full-time faculty. Despite this, women have not reached senior positions in parity with men. We sought to explore the gender climate in academic medicine as perceived by representatives to the Association of American Medical Colleges (AAMC) Group on Women in Medicine and Science (GWIMS) and Group on Diversity and Inclusion (GDI). Methods: We conducted a qualitative analysis of semistructured telephone interviews with GWIMS and GDI representatives and other senior leaders at 24 randomly selected medical schools of the 1995 National Faculty Study. All were in the continental United States, balanced for public/private status and AAMC geographic region. Interviews were audiotaped, transcribed, and organized into content areas before an inductive thematic analysis was conducted. Themes that were expressed by multiple informants were studied for patterns of association. Results: Five themes were identified: (1) a perceived wide spectrum in gender climate; (2) lack of parity in rank and leadership by gender; (3) lack of retention of women in academic medicine (the “leaky pipeline”); (4) lack of gender equity in compensation; and (5) a disproportionate burden of family responsibilities and work-life balance on women's career progression. Conclusions: Key informants described improvements in the climate of academic medicine for women as modest. Medical schools were noted to vary by department in the gender experience of women, often with no institutional oversight. Our findings speak to the need for systematic review by medical schools and by accrediting organizations to achieve gender equity in academic medicine. PMID:25658907

  7. Inadequate progress for women in academic medicine: findings from the National Faculty Study.

    Science.gov (United States)

    Carr, Phyllis L; Gunn, Christine M; Kaplan, Samantha A; Raj, Anita; Freund, Karen M

    2015-03-01

    Women have entered academic medicine in significant numbers for 4 decades and now comprise 20% of full-time faculty. Despite this, women have not reached senior positions in parity with men. We sought to explore the gender climate in academic medicine as perceived by representatives to the Association of American Medical Colleges (AAMC) Group on Women in Medicine and Science (GWIMS) and Group on Diversity and Inclusion (GDI). We conducted a qualitative analysis of semistructured telephone interviews with GWIMS and GDI representatives and other senior leaders at 24 randomly selected medical schools of the 1995 National Faculty Study. All were in the continental United States, balanced for public/private status and AAMC geographic region. Interviews were audiotaped, transcribed, and organized into content areas before an inductive thematic analysis was conducted. Themes that were expressed by multiple informants were studied for patterns of association. Five themes were identified: (1) a perceived wide spectrum in gender climate; (2) lack of parity in rank and leadership by gender; (3) lack of retention of women in academic medicine (the "leaky pipeline"); (4) lack of gender equity in compensation; and (5) a disproportionate burden of family responsibilities and work-life balance on women's career progression. Key informants described improvements in the climate of academic medicine for women as modest. Medical schools were noted to vary by department in the gender experience of women, often with no institutional oversight. Our findings speak to the need for systematic review by medical schools and by accrediting organizations to achieve gender equity in academic medicine.

  8. Recruitment of Dual-Career Academic Medicine Couples.

    Science.gov (United States)

    Putnam, Charles W; DiMarco, Judy; Cairns, Charles B

    2017-11-28

    Today it is not uncommon to discover that a candidate for a faculty position has a partner or spouse who is also an academician, adding complexity to the recruitment process. Here, the authors address two practical obstacles to the recruitment of faculty who have an academic partner: dual recruitment and conflict-of-interest. The authors have found that tandem recruitment works best when suitable positions for both spouses are first identified so that recruitment can proceed synchronously. This approach decreases misperceptions of favoritism toward either's candidacy. Managing conflict-of-interest, generated by the appointment of one spouse in a supervisory position over the other, requires a proactive, transparent, well-designed plan. After canvassing human resource policies and conducting interviews with national academic leaders, the authors have developed an administrative structure that places "key" decisions (hiring and retention; promotion and tenure; salary, bonuses, and benefits; performance evaluations; and disciplinary matters) regarding the supervised spouse in the jurisdiction of an alternate administrator or committee. The authors also offer suggestions both for mitigating misperceptions of bias in day-to-day decisions and for the support and mentoring of the supervised partner or spouse.

  9. Teaching Quality, Learning Satisfaction, and Academic Performance among Hospitality Students in Taiwan

    Science.gov (United States)

    Ko, Wen-Hwa; Chung, Feng-Ming

    2014-01-01

    The purpose of this study is to examine the effect of the teaching quality of culinary arts teachers and student learning satisfaction on the academic performance of hospitality students. This study surveys the students in hospitality departments at universities in Taiwan. A total of 406 (81.2%) valid questionnaires were received. Research results…

  10. Promoting mobility and reducing length of stay in hospitalized general medicine patients: A quality-improvement project.

    Science.gov (United States)

    Hoyer, Erik H; Friedman, Michael; Lavezza, Annette; Wagner-Kosmakos, Kathleen; Lewis-Cherry, Robin; Skolnik, Judy L; Byers, Sherrie P; Atanelov, Levan; Colantuoni, Elizabeth; Brotman, Daniel J; Needham, Dale M

    2016-05-01

    To determine whether a multidisciplinary mobility promotion quality-improvement (QI) project would increase patient mobility and reduce hospital length of stay (LOS). Implemented using a structured QI model, the project took place between March 1, 2013 and March 1, 2014 on 2 general medicine units in a large academic medical center. There were 3352 patients admitted during the QI project period. The Johns Hopkins Highest Level of Mobility (JH-HLM) scale, an 8-point ordinal scale ranging from bed rest (score = 1) to ambulating ≥250 feet (score = 8), was used to quantify mobility. Changes in JH-HLM scores were compared for the first 4 months of the project (ramp-up phase) versus 4 months after project completion (post-QI phase) using generalized estimating equations. We compared the relative change in median LOS for the project months versus 12 months prior among the QI units, using multivariable linear regression analysis adjusting for 7 demographic and clinically relevant variables. Comparing the ramp-up versus post-QI phases, patients reaching JH-HLM's ambulation status increased from 43% to 70% (P mobility scores between admission and discharge increased from 32% to 45% (P 7 days), were associated with a significantly greater adjusted median reduction in LOS of 1.11 (95% CI: -1.53 to -0.65, P mobility was not associated with an increase in injurious falls compared to 12 months prior on the QI units (P = 0.73). Active prevention of a decline in physical function that commonly occurs during hospitalization may be achieved with a structured QI approach. In an adult medicine population, our QI project was associated with improved mobility, and this may have contributed to a reduction in LOS, particularly for more complex patients with longer expected hospital stay. Journal of Hospital Medicine 2016. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

  11. Rationale and Design of the Women and Inclusion in Academic Medicine Study.

    Science.gov (United States)

    Hill, Emorcia V; Wake, Michael; Carapinha, René; Normand, Sharon-Lise; Wolf, Robert E; Norris, Keith; Reede, Joan Y

    2016-04-21

    Women of color (WOC) (African American, Hispanic, Native American/Alaskan Native, and Asian American) faculty remain disproportionately underrepresented among medical school faculty and especially at senior ranks compared with White female faculty. The barriers or facilitators to the career advancement of WOC are poorly understood. The Women and Inclusion in Academic Medicine (WIAM) study was developed to characterize individual, institutional and sociocultural factors that influence the entry, progression and persistence, and advancement of women faculty in academic medical careers with a focus on WOC. Using a purposive sample of 13 academic medical institutions, we collected qualitative interview data from 21 WOC junior faculty and quantitative data from 3,127 (38.9% of 8,053 eligible women) respondents via an online survey. To gather institutional data, we used an online survey and conducted 23 key administrative informant interviews from the 13 institutions. Grounded theory methodology will be used to analyze qualitative data. Multivariable analysis including hierarchical linear modeling will be used to investigate outcomes, such as the inclusiveness of organizational gender climate and women faculty's intent to stay. We describe the design, methods, rationale and limitations of one of the largest and most comprehensive studies of women faculty in academic medicine with a focus on WOC. This study will enhance our understanding of challenges that face women, and, especially WOC, faculty in academic medicine and will provide solutions at both the individual and institutional levels.

  12. Training for Leadership Roles in Academic Medicine: Opportunities for Psychologists in the AAMC LEAD Program.

    Science.gov (United States)

    LaPaglia, Donna; Thompson, Britta; Hafler, Janet; Chauvin, Sheila

    2017-06-01

    Psychologists' roles within academic medicine have expanded well beyond research and scholarship. They are active as providers of patient care, medical education, and clinical supervision. Although the number of psychologists in academic health centers continues to grow, they represent a small portion of total medical school faculties. However, with the movement toward collaborative care models, emphasis on interprofessional teams, and increased emphasis on psychological science topics in medical curricula, psychologists are well-positioned to make further contributions. Another path through which psychologists can further increase their contributions and value within academic health centers is to aspire to leadership roles. This article describes the first author's reflections on her experiences in a two-year, cohort-based, educational leadership development certificate program in academic medicine. The cohort was comprised largely of physicians and basic scientists, and a small number of non-physician participants of which the first author was the only clinical psychologist. The insights gained from this experience provide recommendations for psychologists interested in leadership opportunities in academic medicine.

  13. The historical development of academic journals in occupational medicine, 1901-2009.

    Science.gov (United States)

    Smith, Derek R

    2009-01-01

    Academic journals in a specialist field provide an interesting historical record of its development and progression over time. This article describes the evolution of some major international journals of occupational medicine, including some historical background on their editorial board. As North America, the United Kingdom, and Northern Europe are known to have the highest contribution to scientific production, it was considered appropriate to investigate the main occupational medicine periodicals in these regions. Given the remarkable improvements in Japanese occupational health following the Second World War, it was also considered worthwhile to investigate the two English-language journals of occupational medicine from this country.

  14. Mid-Career Faculty Development in Academic Medicine: How Does It Impact Faculty and Institutional Vitality?

    Science.gov (United States)

    Campion, MaryAnn W.; Bhasin, Robina M.; Beaudette, Donald J.; Shann, Mary H.; Benjamin, Emelia J.

    2016-01-01

    Purpose: Faculty vitality is integral to the advancement of higher education. Strengthening vitality is particularly important for midcareer faculty, who represent the largest and most dissatisfied segment. The demands of academic medicine appear to be another factor that may put faculty at risk of attrition. To address these issues, we initiated…

  15. 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…

  16. More than just a hobby: building an academic career in global emergency medicine.

    Science.gov (United States)

    Martin, Ian B K; Levine, Adam C; Kayden, Stephanie; Hauswald, Mark

    2014-07-01

    As the specialty of emergency medicine (EM) continues to spread around the world, a growing number of academic emergency physicians have become involved in global EM development, research, and teaching. While academic departments have always found this work laudable, they have only recently begun to accept global EM as a rigorous academic pursuit in its own right. This article describes how emergency physicians can translate their global health work into "academic currency" within both the clinician-educator and clinician-researcher tracks. The authors discuss the impact of various types of additional training, including global EM fellowships, for launching a career in global EM. Clearly delineated clinician-researcher and clinician-educator tracks are important for documenting achievement in global EM. Reflecting a growing interest in global health, more of today's EM faculty members are ascending the academic ranks as global EM specialists. Whether attempting to climb the academic ladder as a clinician-educator or clinician-researcher, advanced planning and the firm support of one's academic chair is crucial to the success of the promotion process. Given the relative youth of the subspecialty of global EM, however, it will take time for the pathways to academic promotion to become well delineated. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. 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.

  18. [Family medicine as a medical specialty and an academic discipline in the medical students' assessment].

    Science.gov (United States)

    Krztoń-Królewiecka, Anna; Jarczewska, Dorota Łucja; Windak, Adam

    2015-01-01

    Family medicine has been recognized as the key element of a good health care system. Despite the significance of the family physician's role the number of medical students choosing to train in family medicine has been declining in recent years. The aim of this study was to describe opinions about family medicine and family medicine teaching among medical students. A cross sectional study with an anonymous questionnaire was carried out. The study population was all sixth-year students in Faculty Medicine of Jagiellonian University Medical College, who completed family medicine course in winter semester of academic year 2012/2013. 111 students filled in the questionnaire. The response rate was 84.1%. Less than one third of respondents (30.6%) considered family medicine as a future career choice. Almost all students recognized responsibility of the family doctor for the health of community. 52% of respondents agreed that the family doctor is competent to provide most of the health care an individual may require. Experience from family medicine course was according to the students the most important factor influencing their opinions. Medical students appreciate the social role of family doctors. Family medicine teachers should not only pass on knowledge, but they also should encourage medical students to family medicine as a future career choice.

  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.

    2010-01-01

    For the first time in history, four generations are working together – Traditionalists, Baby Boomers, Generation 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 (SAEM) 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. PMID:21314779

  20. Medicinal plants used with Thai Traditional Medicine in modern healthcare services: a case study in Kabchoeng Hospital, Surin Province, Thailand.

    Science.gov (United States)

    Chotchoungchatchai, Somtanuek; Saralamp, Promchit; Jenjittikul, Thaya; Pornsiripongse, Saowapa; Prathanturarug, Sompop

    2012-05-07

    Thai Traditional Medicine (TTM) is available in many modern hospitals in Thailand. However, there have been difficulties in integrating TTM, particularly the practices of the use of herbal medicines, into modern healthcare services. Kabchoeng Hospital is one hospital that has been able to overcome these difficulties. Thus, this study aimed to document the successful utilization of herbal medicine at Kabchoeng Hospital. The documentation focused on both the knowledge of medicinal plants and the success factors that facilitated the utilization of herbal medicine in the context of a modern hospital in Thailand. Kabchoeng Hospital was intentionally selected for this case study. Participatory observation was used for the data collection. There were six groups of key informants: three applied Thai Traditional Medicine practitioners (ATTMPs), a pharmacist, two physicians, two folk healers, the head of an herbal cultivation and collection group, and 190 patients. The plant specimens were collected and identified based on the botanical literature and a comparison with authentic specimens; these identifications were assisted by microscopic and thin layer chromatography (TLC) techniques. Eighty-nine medicinal plants were used for the herbal preparations. The ATTMPs used these plants to prepare 29 standard herbal preparations and occasional extemporaneous preparations. Moreover, in this hospital, seven herbal preparations were purchased from herbal medicine manufacturers. In total, 36 preparations were used for 10 groups of symptoms, such as the treatment of respiratory system disorders, musculo-skeletal system disorders, and digestive system disorders. Four success factors that facilitated the utilization of herbal medicine at Kabchoeng Hospital were determined. These factors included a proper understanding of the uses of herbal medicines, the successful integration of the modern and TTM healthcare teams, the support of an herbal cultivation and collection group, and the

  1. Group Peer Mentoring: An Answer to the Faculty Mentoring Problem? A Successful Program at a Large Academic Department of Medicine.

    Science.gov (United States)

    Pololi, Linda H; Evans, Arthur T

    2015-01-01

    To address a dearth of mentoring and to avoid the pitfalls of dyadic mentoring, the authors implemented and evaluated a novel collaborative group peer mentoring program in a large academic department of medicine. The mentoring program aimed to facilitate faculty in their career planning, and targeted either early-career or midcareer faculty in 5 cohorts over 4 years, from 2010 to 2014. Each cohort of 9-12 faculty participated in a yearlong program with foundations in adult learning, relationship formation, mindfulness, and culture change. Participants convened for an entire day, once a month. Sessions incorporated facilitated stepwise and values-based career planning, skill development, and reflective practice. Early-career faculty participated in an integrated writing program and midcareer faculty in leadership development. Overall attendance of the 51 participants was 96%, and only 3 of 51 faculty who completed the program left the medical school during the 4 years. All faculty completed a written detailed structured academic development plan. Participants experienced an enhanced, inclusive, and appreciative culture; clarified their own career goals, values, strengths and priorities; enhanced their enthusiasm for collaboration; and developed skills. The program results highlight the need for faculty to personally experience the power of forming deep relationships with their peers for fostering successful career development and vitality. The outcomes of faculty humanity, vitality, professionalism, relationships, appreciation of diversity, and creativity are essential to the multiple missions of academic medicine. © 2015 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

  2. Passive Dosimetry Of Nuclear Medicine Service Staff, Ibn Sina Hospital

    International Nuclear Information System (INIS)

    Sebihi, R.; Talsmat, K.; Cherkaoui, R.; Ben Rais, N.

    2010-01-01

    Full text: Since the implementation of Law No. 00571 of 21 Chaabane 1391 on protection against ionizing radiation and its decrees 2: 2-97-30 and 2-97-132 28 October 1997, surveillance of workers has the subject of major regulatory developments in Morocco, including individual registration delayed for dosimetry. As part of optimizing the protection of medical personnel, a dosimetric study was performed for the first time at the national level, the Nuclear Medicine Service of the Ibn Sina hospital in collaboration with the National Center for Energy Sciences and Nuclear Techniques (CNESTEN). Dosimetric monitoring was conducted for 2 weeks with the use of passive thermoluminescent dosimeters, (GR200A), covering all categories of staff. The administration of samarium (β emitter with energy substantially higher than the energies encountered in conventional nuclear medicine) has been studied, given his first service. Other cases of people concerned our study: a pregnant woman doctor, whose exposure of the unborn child must be reduced as much as possible, and a woman from a private company, working without dosimeter, handles maintenance of premises. To control the conditions imposed on all activities requiring exposure to ionizing radiation, we evaluated the dose at the extremities of operators with the use of ring dosimeters (GR200A) and the dose on the ambient environment of staff (dosimeters ALNOR). This experiment has shown exposure levels below legal limits, without been negligible for certain post. The evaluation results equivalent doses manipulators justify the wearing of dosimeter rings as a complementary dosimeter in Nuclear Medicine service and a way of controlling the normal working conditions. Finally Monitoring ambient dosimetry showed that the environment is low radiation doses. Lessons learned from this study, for the protection of personnel are as follows: from the simple awareness of staff and means of optimizing radiation can maintain a dosimetry annual

  3. The Medical Academic Advancement Program at the University of Virginia School of Medicine.

    Science.gov (United States)

    Fang, W L; Woode, M K; Carey, R M; Apprey, M; Schuyler, J M; Atkins-Brady, T L

    1999-04-01

    Since 1984 the University of Virginia School of Medicine has conducted the Medical Academic Advancement Program for minority and disadvantaged students interested in careers in medicine. The program is a six-week residential program for approximately 130 undergraduate and post-baccalaureate students per year. It emphasizes academic course work--biology, chemistry, physics, and essay writing--to prepare the participants for the Medical College Admission Test. Non-graded activities, such as a clinical medicine lecture series, clinical experiences, and a special lecture series, and special workshops are also offered. The participants take two simulated MCAT exams. Between 1984 and 1998, 1,497 students have participated in the program, with complete follow-up information available for 690 (46%). Of the 1,487 participants, 80 (5%) have graduated from the University of Virginia School of Medicine and 174 (12%) from other medical schools; 44 (3%) are attending the medical school now, and 237 (16%) are at other medical schools; 44 (3%) have graduated from other health professions schools, and 54 (3%) are attending such schools. The retention rate for participants at the University of Virginia School of Medicine is 91% (that is, all but seven of the 80 who matriculated have been retained past the first year). The Medical Academic Advancement Program has been successful in increasing the number of underrepresented minority students matriculating into and continuing in medical education. Such programs warrant continued support and encouragement.

  4. The Creation of a Pediatric Hospital Medicine Dashboard: Performance Assessment for Improvement.

    Science.gov (United States)

    Fox, Lindsay Anne; Walsh, Kathleen E; Schainker, Elisabeth G

    2016-07-01

    Leaders of pediatric hospital medicine (PHM) recommended a clinical dashboard to monitor clinical practice and make improvements. To date, however, no programs report implementing a dashboard including the proposed broad range of metrics across multiple sites. We sought to (1) develop and populate a clinical dashboard to demonstrate productivity, quality, group sustainability, and value added for an academic division of PHM across 4 inpatient sites; (2) share dashboard data with division members and administrations to improve performance and guide program development; and (3) revise the dashboard to optimize its utility. Division members proposed a dashboard based on PHM recommendations. We assessed feasibility of data collection and defined and modified metrics to enable collection of comparable data across sites. We gathered data and shared the results with division members and administrations. We collected quarterly and annual data from October 2011 to September 2013. We found comparable metrics across all sites for descriptive, productivity, group sustainability, and value-added domains; only 72% of all quality metrics were tracked in a comparable fashion. After sharing the data, we saw increased timeliness of nursery discharges and an increase in hospital committee participation and grant funding. PHM dashboards have the potential to guide program development, mobilize faculty to improve care, and demonstrate program value to stakeholders. Dashboard implementation at other institutions and data sharing across sites may help to better define and strengthen the field of PHM by creating benchmarks and help improve the quality of pediatric hospital care. Copyright © 2016 by the American Academy of Pediatrics.

  5. 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.

  6. Academic career in medicine: requirements and conditions for successful advancement in Switzerland.

    Science.gov (United States)

    Buddeberg-Fischer, Barbara; Stamm, Martina; Buddeberg, Claus

    2009-04-29

    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. 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. 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 models. The conditions for an academic career in

  7. 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

  8. First, keep it safe: Integration of a complementary medicine service within a hospital.

    Science.gov (United States)

    Schiff, Elad; Levy, Ilana; Arnon, Zahi; Ben-Arye, Eran; Attias, Samuel

    2018-05-01

    This paper sought to explore risk/safety considerations associated with the integration of a complementary medicine (CM) service within a public academic medical centre in Israel. We reviewed various sources pertaining to the CM service (interviews with CM staff, patients' electronic charts, service guidelines, correspondence with hospital administration) and conducted a thematic analysis to evaluate safety-related incidents during the 7 years of operation. In addition, we systematically assessed the charts for reports of treatment-associated adverse effects, which were documented in an obligatory field on treatment reports. After reviewing transcripts of interviews with 12 CM practitioners and with the director and vice-director of the CM service as well as transcripts of 8560 consultations that included 7383 treatments, we categorised 3 major domains of CM safety management: (i) prevention of safety-related incidents by appropriate selection of CM practitioners and modalities, (ii) actual adverse incidents and (iii) prevention of their recurrence using both hospital and CM service safety protocols. CM staff reported 5 categories of adverse incidents, most of which were minor. Twenty-nine adverse incidents were documented in the 7383 treatment sessions (0.4%). Safety management needs to be addressed both before introducing CM services in hospitals and throughout their integration. Important considerations for the safe integration of CM practices in the hospital include communication between CM and conventional practitioners, adherence to hospital safety rules, implementing a systematic approach for detecting and reporting safety-related incidents and continuous adaptation of the CM service safety protocols. © 2018 John Wiley & Sons Ltd.

  9. 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. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Association between Internet addiction and depression in Thai medical students at Faculty of Medicine, Ramathibodi Hospital.

    Science.gov (United States)

    Boonvisudhi, Thummaporn; Kuladee, Sanchai

    2017-01-01

    To study the extent of Internet addiction (IA) and its association with depression in Thai medical students. A cross-sectional study was conducted at Faculty of Medicine, Ramathibodi Hospital. Participants were first- to fifth-year medical students who agreed to participate in this study. Demographic characteristics and stress-related factors were derived from self-rated questionnaires. Depression was assessed using the Thai version of Patient Health Questionnaire (PHQ-9). A total score of five or greater derived from the Thai version of Young Diagnostic Questionnaire for Internet Addiction was classified as "possible IA". Then chi-square test and logistic regression were used to evaluate the associations between possible IA, depression and associated factors. From 705 participants, 24.4% had possible IA and 28.8% had depression. There was statistically significant association between possible IA and depression (odds ratio (OR) 1.92, 95% confidence interval (CI): 1.34-2.77, P-value depression in possible IA group was 1.58 times of the group of normal Internet use (95% CI: 1.04-2.38, P-value = 0.031). Academic problems were found to be a significant predictor of both possible IA and depression. IA was likely to be a common psychiatric problem among Thai medical students. The research has also shown that possible IA was associated with depression and academic problems. We suggest that surveillance of IA should be considered in medical schools.

  11. A systematic review of qualitative research on the meaning and characteristics of mentoring in academic medicine.

    Science.gov (United States)

    Sambunjak, Dario; Straus, Sharon E; Marusic, Ana

    2010-01-01

    Mentorship is perceived to play a significant role in the career development and productivity of academic clinicians, but little is known about the characteristics of mentorship. This knowledge would be useful for those developing mentorship programs. To complete a systematic review of the qualitative literature to explore and summarize the development, perceptions and experiences of the mentoring relationship in academic medicine. Medline, PsycINFO, ERIC, Scopus and Current Contents databases from the earliest available date to December 2008. We included studies that used qualitative research methodology to explore the meaning and characteristics of mentoring in academic medicine. Two investigators independently assessed articles for relevance and study quality, and extracted data using standardized forms. No restrictions were placed on the language of articles. A total of 8,487 citations were identified, 114 full text articles were assessed, and 9 articles were selected for review. All studies were conducted in North America, and most focused on the initiation and cultivation phases of the mentoring relationship. Mentoring was described as a complex relationship based on mutual interests, both professional and personal. Mentees should take an active role in the formation and development of mentoring relationships. Good mentors should be sincere in their dealings with mentees, be able to listen actively and understand mentees' needs, and have a well-established position within the academic community. Some of the mentoring functions aim at the mentees' academic growth and others at personal growth. Barriers to mentoring and dysfunctional mentoring can be related to personal factors, relational difficulties and structural/institutional barriers. Successful mentoring requires commitment and interpersonal skills of the mentor and mentee, but also a facilitating environment at academic medicine's institutions.

  12. Women faculty: an analysis of their experiences in academic medicine and their coping strategies.

    Science.gov (United States)

    Pololi, Linda H; Jones, Sandra J

    2010-10-01

    Women represent a persistently low proportion of faculty in senior and leadership roles in medical schools, despite an adequate pipeline. This article highlights women's concerns in the context of the academic medical culture in which they work, and considers the ways in which they cope with and resist marginalizing situations. To explore the experiences of faculty in academic medicine, a multidisciplinary faculty research team conducted 96 open-ended interviews with faculty representing a broad set of disciplines at 4 different career stages (early career, leaders, plateaued, and left academic medicine) in 5 medical schools. Coded data from interview transcripts indicated situations in which women were marginalized. Experiences of marginality were examined through a systematic secondary analysis of a subset of 17 representative cases using qualitative analysis. Women had a sense of "not belonging" in the organization, perceiving themselves as cultural outsiders and feeling isolated and invisible. They described barriers to advancement, including bias and gender role expectations. Faculty from underrepresented minority groups and PhDs perceived a double disadvantage. Four strategies were identified that helped women cope with and resist professional barriers: self-silencing, creating microenvironments, balancing life and work, and simultaneously holding dual identities--being successful in the organization while trying to change the culture. Although the sample size was small, this analysis found that many women faculty perceive themselves as outsiders within academic medicine. Because of their marginalization, minority and non-minority women are more able to see the bias and exclusion that may operate in academic medical centers as well as other problematic dimensions of the culture. As cultural outsiders, women may be better able to advance change to improve academic medical culture. A next step is to leverage women's awareness to develop a broader vision of what

  13. The development of academic family medicine in central and eastern Europe since 1990.

    Science.gov (United States)

    Krztoń-Królewiecka, Anna; Švab, Igor; Oleszczyk, Marek; Seifert, Bohumil; Smithson, W Henry; Windak, Adam

    2013-03-19

    Since the early 1990s former communist countries have been reforming their health care systems, emphasizing the key role of primary care and recognizing family medicine as a specialty and an academic discipline. This study assesses the level of academic development of the discipline characterised by education and research in central and eastern European (CEE) countries. A key informants study, using a questionnaire developed on the basis of a systematic literature review and panel discussions, conducted in 11 central and eastern European countries and Russia. Family medicine in CEE countries is now formally recognized as a medical specialty and successfully introduced into medical training at undergraduate and postgraduate levels. Almost all universities have FM/GP departments, but only a few of them are led by general practitioners. The specialist training programmes in all countries except Russia fulfil the recommendations of the European Parliament. Structured support for research in FM/GP is not always available. However specific scientific organisations function in almost all countries except Russia. Scientific conferences are regularly organised in all the countries, but peer-reviewed journals are published in only half of them. Family medicine has a relatively strong position in medical education in central and eastern Europe, but research in family practice is less developed. Although the position of the discipline at the universities is not very strong, most of the CEE countries can serve as an example of successful academic development for countries southern Europe, where family medicine is still not fully recognised.

  14. 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

    2016-12-30

    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. 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. 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. 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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  15. Stories from early-career women physicians who have left academic medicine: a qualitative study at a single institution.

    Science.gov (United States)

    Levine, Rachel B; Lin, Fenny; Kern, David E; Wright, Scott M; Carrese, Joseph

    2011-06-01

    The number of women in academic medicine has steadily increased, although gender parity still does not exist and women leave academics at somewhat higher rates than men. The authors investigated the reasons why women leave careers in academic medicine. Semistructured, one-on-one interviews were conducted in 2007-2008 with 20 women physicians who had left a single academic institution to explore their reasons for opting out of academic careers. Data analysis was iterative, and an editing analysis style was used to derive themes. A lack of role models for combining career and family responsibilities, frustrations with research (funding difficulties, poor mentorship, competition), work-life balance, and the institutional environment (described as noncollaborative and biased in favor of male faculty) emerged as key factors associated with a decision to leave academic medicine for respondents. Faced with these challenges, respondents reevaluated their priorities and concluded that a discrepancy existed between their own and institutional priorities. Many respondents expressed divergent views with the institutional norms on how to measure success and, as a consequence, felt that they were undervalued at work. Participants report a disconnection between their own priorities and those of the dominant culture in academic medicine. Efforts to retain women faculty in academic medicine may include exploring the aspects of an academic career that they value most and providing support and recognition accordingly.

  16. Promotion of women physicians in academic medicine. Glass ceiling or sticky floor?

    Science.gov (United States)

    Tesch, B J; Wood, H M; Helwig, A L; Nattinger, A B

    1995-04-05

    To assess possible explanations for the finding that the percentage of women medical school faculty members holding associate or full professor rank remains well below the percentage of men. Cross-sectional survey of physician faculty of US medical schools using the Association of American Medical Colleges (AAMC) database. Surveyed were 153 women and 263 men first appointed between 1979 and 1981, matched for institutions of original faculty appointment. Academic rank achieved, career preparation, academic resources at first appointment, familial responsibilities, and academic productivity. After a mean of 11 years on a medical school faculty, 59% of women compared with 83% of men had achieved associate or full professor rank, and 5% of women compared with 23% of men had achieved full professor rank. Women and men reported similar preparation for an academic career, but women began their careers with fewer academic resources. The number of children was not associated with rank achieved. Women worked about 10% fewer hours per week and had authored fewer publications. After adjustment for productivity factors, women remained less likely to be associate or full professors (adjusted odds ratio [OR] = 0.37; 95% confidence interval [CI], 0.21 to 0.66) or to achieve full professor rank (adjusted OR = 0.27; 95% CI, 0.12 to 0.63). Based on the AAMC database, 50% of both women and men originally appointed as faculty members between 1979 and 1981 had left academic medicine by 1991. Women physician medical school faculty are promoted more slowly than men. Gender differences in rank achieved are not explained by productivity or by differential attrition from academic medicine.

  17. Zolpidem prescribing and adverse drug reactions in hospitalized general medicine patients at a Veterans Affairs hospital.

    Science.gov (United States)

    Mahoney, Jane E; Webb, Melissa J; Gray, Shelly L

    2004-03-01

    Zolpidem is prescribed for sleep disruption in hospitalized patients, but data on the incidence of adverse drug reactions (ADRs) are based largely on outpatient studies. Thus, the incidence of ADRs in hospitalized patients may be much higher. The goal of this study was to describe prescribing patterns of zolpidem for hospitalized medical patients aged 50 years, the incidence of ADRs possibly and probably associated with its use, and the factors associated with central nervous system (CNS) ADRs. This case series was conducted in 4 general medicine wards at a Veterans Affairs hospital and was a consecutive sample of patients aged 50 years who were hospitalized between 1993 and 1997 and received zolpidem as a hypnotic during hospitalization, but had not received it in the previous 3 months. Chart review was conducted by 2 evaluators. Data extracted from the medical records included admission demographic characteristics, medications, comorbidities, and levels of function in performing basic and instrumental activities of daily living. The main outcome measure was ADRs possibly or probably related to zolpidem use. The association between zolpidem and the occurrence of CNS ADRs (eg, confusion, dizziness, daytime somnolence) was analyzed separately. The review included 119 medical patients aged > or =50 years who had newly received zolpidem for sleep disruption during hospitalization. The median age of the population was 70 years; 86 (72.3%) patients were aged 65 years. The initial zolpidem dose was 5 mg in 42 patients (35.3%) and 10 mg in 77 patients (64.7%). Twenty-three patients had a respective 16 and 10 ADRs possibly and probably related to zolpidem use (19.3% incidence). Of a total of 26 ADRs, 21 (80.8%) were CNS ADRs, occurring with both zolpidem 5 mg (10.8% of users) and 10 mg (18.3% of users). On univariate analyses, the only factor significantly associated with a CNS ADR was functional impairment at baseline (P = 0.003). Zolpidem was discontinued in 38.8% of

  18. Pseudomonas aeruginosa bacteraemia in an academic hospital in ...

    African Journals Online (AJOL)

    This study aimed at determining the clinical manifestations, outcome and prognostic factors associated with P. aeruginosa bacteraemia at the Chris Hani Baragwanath Hospital during the period 1998-99; to describe and quantify resistance to anti-pseudomonal drugs, and characterization of bacteraemic isolates, investigate ...

  19. Preparing culture change agents for academic medicine in a multi-institutional consortium: the C - change learning action network.

    Science.gov (United States)

    Pololi, Linda H; Krupat, Edward; Schnell, Eugene R; Kern, David E

    2013-01-01

    Research suggests an ongoing need for change in the culture of academic medicine. This article describes the structure, activities and evaluation of a culture change project: the C - Change Learning Action Network (LAN) and its impact on participants. The LAN was developed to create the experience of a culture that would prepare participants to facilitate a culture in academic medicine that would be more collaborative, inclusive, relational, and that supports the humanity and vitality of faculty. Purposefully diverse faculty, leaders, and deans from 5 US medical schools convened in 2 1/2-day meetings biannually over 4 years. LAN meetings employed experiential, cognitive, and affective learning modes; innovative dialogue strategies; and reflective practice aimed at facilitating deep dialogue, relationship formation, collaboration, authenticity, and transformative learning to help members experience the desired culture. Robust aggregated qualitative and quantitative data collected from the 5 schools were used to inform and stimulate culture-change plans. Quantitative and qualitative evaluation methods were used. Participants indicated that a safe, supportive, inclusive, collaborative culture was established in LAN and highly valued. LAN members reported a deepened understanding of organizational change, new and valued interpersonal connections, increased motivation and resilience, new skills and approaches, increased self-awareness and personal growth, emotional connection to the issues of diversity and inclusion, and application of new learnings in their work. A carefully designed multi-institutional learning community can transform the way participants experience and view institutional culture. It can motivate and prepare them to be change agents in their own institutions. Copyright © 2013 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical

  20. Allocation of Internal Medicine Resident Time in a Swiss Hospital: A Time and Motion Study of Day and Evening Shifts.

    Science.gov (United States)

    Wenger, Nathalie; Méan, Marie; Castioni, Julien; Marques-Vidal, Pedro; Waeber, Gérard; Garnier, Antoine

    2017-04-18

    Little current evidence documents how internal medicine residents spend their time at work, particularly with regard to the proportions of time spent in direct patient care versus using computers. To describe how residents allocate their time during day and evening hospital shifts. Time and motion study. Internal medicine residency at a university hospital in Switzerland, May to July 2015. 36 internal medicine residents with an average of 29 months of postgraduate training. Trained observers recorded the residents' activities using a tablet-based application. Twenty-two activities were categorized as directly related to patients, indirectly related to patients, communication, academic, nonmedical tasks, and transition. In addition, the presence of a patient or colleague and use of a computer or telephone during each activity was recorded. Residents were observed for a total of 696.7 hours. Day shifts lasted 11.6 hours (1.6 hours more than scheduled). During these shifts, activities indirectly related to patients accounted for 52.4% of the time, and activities directly related to patients accounted for 28.0%. Residents spent an average of 1.7 hours with patients, 5.2 hours using computers, and 13 minutes doing both. Time spent using a computer was scattered throughout the day, with the heaviest use after 6:00 p.m. The study involved a small sample from 1 institution. At this Swiss teaching hospital, internal medicine residents spent more time at work than scheduled. Activities indirectly related to patients predominated, and about half the workday was spent using a computer. Information Technology Department and Department of Internal Medicine of Lausanne University Hospital.

  1. Current Status of Gender and Racial/Ethnic Disparities Among Academic Emergency Medicine Physicians.

    Science.gov (United States)

    Madsen, Tracy E; Linden, Judith A; Rounds, Kirsten; Hsieh, Yu-Hsiang; Lopez, Bernard L; Boatright, Dowin; Garg, Nidhi; Heron, Sheryl L; Jameson, Amy; Kass, Dara; Lall, Michelle D; Melendez, Ashley M; Scheulen, James J; Sethuraman, Kinjal N; Westafer, Lauren M; Safdar, Basmah

    2017-10-01

    A 2010 survey identified disparities in salaries by gender and underrepresented minorities (URM). With an increase in the emergency medicine (EM) workforce since, we aimed to 1) describe the current status of academic EM workforce by gender, race, and rank and 2) evaluate if disparities still exist in salary or rank by gender. Information on demographics, rank, clinical commitment, and base and total annual salary for full-time faculty members in U.S. academic emergency departments were collected in 2015 via the Academy of Administrators in Academic Emergency Medicine (AAAEM) Salary Survey. Multiple linear regression was used to compare salary by gender while controlling for confounders. Response rate was 47% (47/101), yielding data on 1,371 full-time faculty: 33% women, 78% white, 4% black, 5% Asian, 3% Asian Indian, 4% other, and 7% unknown race. Comparing white race to nonwhite, 62% versus 69% were instructor/assistant, 23% versus 20% were associate, and 15% versus 10% were full professors. Comparing women to men, 74% versus 59% were instructor/assistant, 19% versus 24% were associate, and 7% versus 17% were full professors. Of 113 chair/vice-chair positions, only 15% were women, and 18% were nonwhite. Women were more often fellowship trained (37% vs. 31%), less often core faculty (59% vs. 64%), with fewer administrative roles (47% vs. 57%; all p disparities in salary and rank persist among full-time U.S. academic EM faculty. There were gender and URM disparities in rank and leadership positions. Women earned less than men regardless of rank, clinical hours, or training. Future efforts should focus on evaluating salary data by race and developing systemwide practices to eliminate disparities. © 2017 by the Society for Academic Emergency Medicine.

  2. Leadership Primer for Current and Aspiring Pulmonary, Critical Care, and Sleep Medicine Academic Division Chiefs.

    Science.gov (United States)

    Nguyen, H Bryant; Thomson, Carey C; Kaminski, Naftali; Schnapp, Lynn M; Madison, J Mark; Glenny, Robb W; Dixon, Anne E

    2018-02-27

    An academic medical career traditionally revolves around patient care, teaching, and scholarly projects. Thus, when an opportunity for a leadership role arises, such as Division Chief, the new leader is often unprepared with little or no formal leadership training. In this article, academic leaders of the Association of Pulmonary, Critical Care and Sleep Division Directors reviewed several leadership concepts adapted from the business sector and applied years of their experience to aid new division chiefs with their first day on the job. The first 90 days are highlighted to include accomplishing the early wins, performing a division Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis, establishing division rapport, redefining the division infrastructure, avoiding conflicts, and managing their relationship with the department chair. The five levels of leadership applicable to academic medicine are discussed: position, permission, production, people, and pinnacle. Finally, emotional intelligence and behavior styles crucial to leadership success are reviewed.

  3. Medicine procurement in hospital pharmacies of Nepal: A qualitative study based on the Basel Statements

    Science.gov (United States)

    Ranjit, Eurek

    2018-01-01

    Background Accessibility and affordability of evidence-based medicines are issues of global concern. For low-income countries like Nepal, it is crucial to have easy and reliable access to affordable, good-quality, evidence-based medicines, especially in the aftermath of natural or manmade disasters. Availability of affordable and evidence-based high quality medicines depends on the medicine procurement procedure, which makes it an important aspect of healthcare delivery. In this study, we aimed to investigate medicine procurement practices in hospital pharmacies of Nepal within the framework of International Pharmaceutical Federation [FIP] hospital pharmacy guidelines “the Basel Statements”. Method We conducted semi-structured interviews with hospital pharmacists or procurement officers in hospital pharmacies of four major regions in Nepal to explore procurement practices. Data were collected until saturation of themes, analysed using the framework approach, and organised around the statements within the procurement theme of the Basel Statements. Results Interviews conducted with 53 participants revealed that the procurement guidelines of the Basel Statements were adopted to a certain extent in hospital pharmacies of Nepal. It was found that the majority of hospital pharmacies in Nepal reported using an expensive direct-procurement model for purchasing medicines. Most had no formulary and procured medicines solely based on doctors’ prescriptions, which were heavily influenced by pharmaceutical companies’ marketing strategies. Whilst most procured only registered medicines, a minority reported purchasing unregistered medicines through unauthorised supply-chains. And although the majority of hospital pharmacies had some contingency plans for managing medicine shortages, a few had none. Conclusions Procurement guidelines of the Basel Statements were thus found to be partially adopted; however, there is room for improvement in current procurement practices in

  4. Medicine procurement in hospital pharmacies of Nepal: A qualitative study based on the Basel Statements.

    Directory of Open Access Journals (Sweden)

    Mina Shrestha

    Full Text Available Accessibility and affordability of evidence-based medicines are issues of global concern. For low-income countries like Nepal, it is crucial to have easy and reliable access to affordable, good-quality, evidence-based medicines, especially in the aftermath of natural or manmade disasters. Availability of affordable and evidence-based high quality medicines depends on the medicine procurement procedure, which makes it an important aspect of healthcare delivery. In this study, we aimed to investigate medicine procurement practices in hospital pharmacies of Nepal within the framework of International Pharmaceutical Federation [FIP] hospital pharmacy guidelines "the Basel Statements".We conducted semi-structured interviews with hospital pharmacists or procurement officers in hospital pharmacies of four major regions in Nepal to explore procurement practices. Data were collected until saturation of themes, analysed using the framework approach, and organised around the statements within the procurement theme of the Basel Statements.Interviews conducted with 53 participants revealed that the procurement guidelines of the Basel Statements were adopted to a certain extent in hospital pharmacies of Nepal. It was found that the majority of hospital pharmacies in Nepal reported using an expensive direct-procurement model for purchasing medicines. Most had no formulary and procured medicines solely based on doctors' prescriptions, which were heavily influenced by pharmaceutical companies' marketing strategies. Whilst most procured only registered medicines, a minority reported purchasing unregistered medicines through unauthorised supply-chains. And although the majority of hospital pharmacies had some contingency plans for managing medicine shortages, a few had none.Procurement guidelines of the Basel Statements were thus found to be partially adopted; however, there is room for improvement in current procurement practices in hospital pharmacies of Nepal

  5. Medicine procurement in hospital pharmacies of Nepal: A qualitative study based on the Basel Statements.

    Science.gov (United States)

    Shrestha, Mina; Moles, Rebekah; Ranjit, Eurek; Chaar, Betty

    2018-01-01

    Accessibility and affordability of evidence-based medicines are issues of global concern. For low-income countries like Nepal, it is crucial to have easy and reliable access to affordable, good-quality, evidence-based medicines, especially in the aftermath of natural or manmade disasters. Availability of affordable and evidence-based high quality medicines depends on the medicine procurement procedure, which makes it an important aspect of healthcare delivery. In this study, we aimed to investigate medicine procurement practices in hospital pharmacies of Nepal within the framework of International Pharmaceutical Federation [FIP] hospital pharmacy guidelines "the Basel Statements". We conducted semi-structured interviews with hospital pharmacists or procurement officers in hospital pharmacies of four major regions in Nepal to explore procurement practices. Data were collected until saturation of themes, analysed using the framework approach, and organised around the statements within the procurement theme of the Basel Statements. Interviews conducted with 53 participants revealed that the procurement guidelines of the Basel Statements were adopted to a certain extent in hospital pharmacies of Nepal. It was found that the majority of hospital pharmacies in Nepal reported using an expensive direct-procurement model for purchasing medicines. Most had no formulary and procured medicines solely based on doctors' prescriptions, which were heavily influenced by pharmaceutical companies' marketing strategies. Whilst most procured only registered medicines, a minority reported purchasing unregistered medicines through unauthorised supply-chains. And although the majority of hospital pharmacies had some contingency plans for managing medicine shortages, a few had none. Procurement guidelines of the Basel Statements were thus found to be partially adopted; however, there is room for improvement in current procurement practices in hospital pharmacies of Nepal. Adoption and

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

    Science.gov (United States)

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

    2016-08-01

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

  7. Eliminating Gender-Based Bias in Academic Medicine: More Than Naming the "Elephant in the Room".

    Science.gov (United States)

    Morgan, Anna U; Chaiyachati, Krisda H; Weissman, Gary E; Liao, Joshua M

    2018-06-01

    Gender-based discrimination and bias are widespread in professional settings, including academic medicine. Overt manifestations such as sexual harassment have long been identified but attention is only more recently turning towards subtler forms of bias, including inequity in promotion and compensation. Barriers to progress vary across institutions and include lack of awareness, inadequate training, poor informational transparency, and challenging power dynamics. We propose five solutions that the academic medical community can adopt to not only name, but also address, gender-based bias as the proverbial elephant in the room: definitively identify the systemic nature of the problem, prompt those with influence and power to advance a culture of equity, broadly incorporate evidence-based explicit anti-sexist training, increase transparency of information related to professional development and compensation, and use robust research methods to study the drivers and potential solutions of gender inequity within academic medicine. While implementing these proposals is no small task, doing so is an important step in helping the academic medical community become more just.

  8. Commentary: health care payment reform and academic medicine: threat or opportunity?

    Science.gov (United States)

    Shomaker, T Samuel

    2010-05-01

    Discussion of the flaws of the current fee-for-service health care reimbursement model has become commonplace. Health care costs cannot be reduced without moving away from a system that rewards providers for providing more services regardless of need, effectiveness, or quality. What alternatives are likely under health care reform, and how will they impact the challenged finances of academic medical centers? Bundled payment methodologies, in which all providers rendering services to a patient during an episode of care split a global fee, are gaining popularity. Also under discussion are concepts like the advanced medical home, which would establish primary care practices as a regular source of care for patients, and the accountable care organization, under which providers supply all the health care services needed by a patient population for a defined time period in exchange for a share of the savings resulting from enhanced coordination of care and better patient outcomes or a per-member-per-month payment. The move away from fee-for-service reimbursement will create financial challenges for academic medicine because of the threat to clinical revenue. Yet academic health centers, because they are in many cases integrated health care organizations, may be aptly positioned to benefit from models that emphasize coordinated care. The author also has included a series of recommendations for how academic medicine can prepare for the implementation of new payment models to help ease the transition away from fee-for-service reimbursement.

  9. 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.

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

    Science.gov (United States)

    Morrissey, Claudia; Geller, Stacie E.

    2008-01-01

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

  11. 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.

  12. 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…

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

    Science.gov (United States)

    Morris, D E

    1985-06-01

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

  14. Attitudes and preferences toward the provision of medication abortion in an urban academic internal medicine practice.

    Science.gov (United States)

    Page, Cameron; Stumbar, Sarah; Gold, Marji

    2012-06-01

    Mifepristone offers internal medicine doctors the opportunity to greatly expand access to abortion for their patients. Almost 70% of pregnancy terminations, however, still occur in specialized clinics. No studies have examined the preferences of Internal Medicine patients specifically. Determine whether patient preference is a reason for the limited uptake of medication abortion among internal medicine physicians. Women aged 18-45 recruited from the waiting room in an urban academic internal medicine clinic. A semi-structured questionnaire was used to determine risk of unintended pregnancy and attitudes toward abortion. Support for provision of medication abortion in the internal medicine clinic was assessed with a yes/no question, followed by the open-ended question, "Why do you think this clinic should or should not offer medication abortion?" Subjects were asked whether it was very important, somewhat important, or not important for the internal medicine clinic to provide medication abortion. Of 102 women who met inclusion criteria, 90 completed the survey, yielding a response rate of 88%. Twenty-two percent were at risk of unintended pregnancy. 46.7% had had at least one lifetime abortion. Among those who would consider having an abortion, 67.7% responded yes to the question, "Do you think this clinic should offer medication abortions?" and 83.9% stated that it was "very important" or "somewhat important" to offer this service. Of women open to having an abortion, 87.1% stated that they would be interested in receiving a medication abortion from their primary care doctor. A clinically significant proportion of women in this urban internal medicine clinic were at risk of unintended pregnancy. Among those open to having an abortion, a wide majority would consider receiving it from their internal medicine doctor. The provision of medication abortion by internal medicine physicians has the potential to greatly expand abortion access for women.

  15. 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.

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

    Science.gov (United States)

    Helitzer, Deborah

    2009-10-01

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

  17. Getting it RITE: Impact of a Dedicated Hospital Medicine Curriculum for Residents.

    Science.gov (United States)

    Lin, Doris; Shah, Chirayu; Campbell, Steffanie; Bates, Jeffrey T; Lescinskas, Erica

    2018-01-01

    The goal of this study was to improve resident confidence in inpatient care and knowledge in hospital medicine topics with a newly developed rotation and curriculum called the Resident Inpatient Training Experience. This study was a prospective observational study completed by postgraduate year-2 (PGY-2) internal medicine residents in two affiliated hospitals. Forty-six PGY-2 residents each rotated on the Resident Inpatient Training Experience service for 1 month and completed a pre- and postrotation confidential online survey. Primary outcomes included confidence in managing hospitalized patients, knowledge regarding hospital medicine topics, and interest in pursuing hospital medicine as a career. Thirty-three PGY-2 residents completed both the pre- and postrotation survey (72% response rate). After completing the rotation, the residents' confidence level (measured on a 5-point Likert scale, with 1 = strongly disagree and 5 = strongly agree) rose significantly in managing hospitalized patients, from 3.82 to 4.33 ( P = 0.003) and in leading a ward team, from 3.76 to 4.21 ( P = 0.020). Knowledge level (measured on a 5-point Likert scale with 1 = very poor and 5 = excellent) improved significantly in transitions of care, from 3.45 to 3.79 ( P = 0.023); cost-conscious care, from 3.00 to 3.42 ( P = 0.016); physician billing/coding, from 2.55 to 3.03 ( P = 0.007); hospital metrics, from 2.39 to 2.94 ( P = 0.002); and hospital reimbursement, from 2.48 to 3.09 ( P = 0.001). Interest in pursuing hospital medicine as a career also increased. Resident independence in managing patients and training in hospital medicine topics has not kept up with evolving need. Dedicated hospital medicine rotation and curriculum are effective ways to alleviate the deficiencies in resident education.

  18. The Case of the Suzhou Hospital of National Medicine (1939-41): War, Medicine, and Eastern Civilization.

    Science.gov (United States)

    Daidoji, Keiko; Karchmer, Eric I

    2017-06-01

    This article explores the founding of the Suzhou Hospital of National Medicine in 1939 during the Japanese occupation of Suzhou. We argue that the hospital was the culmination of a period of rich intellectual exchange between traditional Chinese and Japanese physicians in the early twentieth century and provides important insights into the modern development of medicine in both countries. The founding of this hospital was followed closely by leading Japanese Kampo physicians. As the Japanese empire expanded into East Asia, they hoped that they could revitalize their profession at home by disseminating their unique interpretations of the famous Treatise on Cold Damage abroad. The Chinese doctors that founded the Suzhou Hospital of National Medicine were close readers of Japanese scholarship on the Treatise and were inspired to experiment with a Japanese approach to diagnosis, based on new interpretations of the concept of "presentation" ( shō / zheng ). Unfortunately, the Sino-Japanese War cut short this fascinating dialogue on reforming medicine and set the traditional medicine professions in both countries on new nationalist trajectories.

  19. 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

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

    OpenAIRE

    Shou-ping CHEN

    2014-01-01

    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

  1. Combining clinical practice and academic work in nursing: A qualitative study about perceived importance, facilitators and barriers regarding clinical academic careers for nurses in university hospitals.

    Science.gov (United States)

    van Oostveen, Catharina J; Goedhart, Nicole S; Francke, Anneke L; Vermeulen, Hester

    2017-12-01

    To obtain in-depth insight into the perceptions of nurse academics and other stakeholders regarding the importance, facilitators and barriers for nurses combining clinical and academic work in university hospitals. Combining clinical practice and academic work facilitates the use of research findings for high-quality patient care. However, nurse academics move away from the bedside because clinical academic careers for nurses have not yet been established in the Netherlands. This qualitative study was conducted in two Dutch university hospitals and their affiliated medical faculties and universities of applied sciences. Data were collected between May 2015 and August 2016. We used purposive sampling for 24 interviews. We asked 14 participants in two focus groups for their perceptions of importance, facilitators and barriers in nurses' combined clinical and academic work in education and research. We audiotaped, transcribed and thematically analysed the interviews and focus groups. Three themes related to perceived importance, facilitators and barriers: culture, leadership and infrastructure. These themes represent deficiencies in facilitating clinical academic careers for nurses. The current nursing culture emphasises direct patient care, which is perceived as an academic misfit. Leadership is lacking at all levels, resulting in the underuse of nurse academics and the absence of supporting structures for nurses who combine clinical and academic work. The present nursing culture appears to be the root cause of the dearth of academic positions and established clinical academic posts. A culture change would require a show of leadership that would promote and enable combined research, teaching and clinical practice and that would introduce clinical academic career pathways for nurses. Meanwhile, nurse academics should collaborate with established medical academics for whom combined roles are mainstream, and they should take advantage of their established infrastructure

  2. Combining clinical practice and academic work in nursing: a qualitative study about perceived importance, facilitators and barriers regarding clinical academic careers for nurses in university hospitals.

    NARCIS (Netherlands)

    Oostveen, C.J. van; Goedhart, N.S.; Francke, A.L.; Vermeulen, H.

    2017-01-01

    Aims and objectives: To obtain in-depth insight into the perceptions of nurse aca- demics and other stakeholders regarding the importance, facilitators and barriers for nurses combining clinical and academic work in university hospitals. Background: Combining clinical practice and academic work

  3. 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

    OpenAIRE

    Linzer, M; Warde, C; Alexander, RW; DeMarco, DM; Haupt, A; Hicks, L; Kutner, J; Mangione, CM; Mechaber, H; Rentz, M; Riley, J; Schuster, B; Solomon, GD; Volberding, P; Ibrahim, T

    2009-01-01

    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, enhan...

  4. Characterization of Complementary and Alternative Medicine-Related Consultations in an Academic Drug Information Service.

    Science.gov (United States)

    Gregory, Philip J; Jalloh, Mohamed A; Abe, Andrew M; Hu, James; Hein, Darren J

    2016-12-01

    To characterize requests received through an academic drug information consultation service related to complementary and alternative medicines. A retrospective review and descriptive analysis of drug information consultations was conducted. A total of 195 consultations related to complementary and alternative medicine were evaluated. All consultation requests involved questions about dietary supplements. The most common request types were related to safety and tolerability (39%), effectiveness (38%), and therapeutic use (34%). Sixty-eight percent of the requests were from pharmacists. The most frequent consultation requests from pharmacists were questions related to drug interactions (37%), therapeutic use (37%), or stability/compatibility/storage (34%). Nearly 60% of complementary and alternative medicine-related consultation requests were able to be completely addressed using available resources. Among review sources, Natural Medicines Comprehensive Database, Clinical Pharmacology, Micromedex, and Pharmacist's Letter were the most common resources used to address consultations. Utilization of a drug information service may be a viable option for health care professionals to help answer a complementary and alternative medicine-related question. Additionally, pharmacists and other health care professionals may consider acquiring resources identified to consistently answering these questions. © The Author(s) 2015.

  5. [The implementation of strategy of medicinal support in multi-type hospital].

    Science.gov (United States)

    Ludupova, E Yu

    2016-01-01

    The article presents brief review of implementation of strategy of medicinal support of population of the Russian Federation and experience of application of at the level of regional hospital. The necessity and importance of implementation into practice of hospitals of methodology of pharmaco-economical management of medicinal care using modern technologies of XYZ-, ABC and VEN-analysis is demonstrated. The stages of development and implementation of process of medicinal support of multifield hospital applying principles of system of quality management (processing and systemic approaches, risk management) on the basis of standards ISO 9001 are described. The significance of monitoring of results ofprocess of medicinal support of the basis of implementation of priority target programs (prevention of venous thrombo-embolic complications, system od control of anti-bacterial therapy) are demonstrated in relation to multi-field hospital using technique of ATC/DDD-analysis for evaluating indices of effectiveness and efficiency.

  6. Faculty self-reported experience with racial and ethnic discrimination in academic medicine.

    Science.gov (United States)

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

    2004-03-01

    Despite the need to recruit and retain minority faculty in academic medicine, little is known about the experiences of minority faculty, in particular their self-reported experience of racial and ethnic discrimination at their institutions. To determine the frequency of self-reported experience of racial/ethnic discrimination among faculty of U.S. medical schools, as well as associations with outcomes, such as career satisfaction, academic rank, and number of peer-reviewed publications. A 177-item self-administered mailed survey of U.S. medical school faculty. Twenty-four randomly selected medical schools in the contiguous United States. A random sample of 1,979 full-time faculty, stratified by medical school, specialty, graduation cohort, and gender. Frequency of self-reported experiences of racial/ethnic bias and discrimination. The response rate was 60%. Of 1,833 faculty eligible, 82% were non-Hispanic white, 10% underrepresented minority (URM), and 8% non-underrepresented minority (NURM). URM and NURM faculty were substantially more likely than majority faculty to perceive racial/ethnic bias in their academic environment (odds ratio [OR], 5.4; P discrimination by a superior or colleague. Faculty with such reported experiences had lower career satisfaction scores than other faculty (P discrimination achieved academic productivity similar to that of other faculty.

  7. Improving operating room efficiency in academic children's hospital using Lean Six Sigma methodology.

    Science.gov (United States)

    Tagge, Edward P; Thirumoorthi, Arul S; Lenart, John; Garberoglio, Carlos; Mitchell, Kenneth W

    2017-06-01

    Lean Six Sigma (LSS) is a process improvement methodology that utilizes a collaborative team effort to improve performance by systematically identifying root causes of problems. Our objective was to determine whether application of LSS could improve efficiency when applied simultaneously to all services of an academic children's hospital. In our tertiary academic medical center, a multidisciplinary committee was formed, and the entire perioperative process was mapped, using fishbone diagrams, Pareto analysis, and other process improvement tools. Results for Children's Hospital scheduled main operating room (OR) cases were analyzed, where the surgical attending followed themselves. Six hundred twelve cases were included in the seven Children's Hospital operating rooms (OR) over a 6-month period. Turnover Time (interval between patient OR departure and arrival of the subsequent patient) decreased from a median 41min in the baseline period to 32min in the intervention period (p<0.0001). Turnaround Time (interval between surgical dressing application and subsequent surgical incision) decreased from a median 81.5min in the baseline period to 71min in the intervention period (p<0.0001). These results demonstrate that a coordinated multidisciplinary process improvement redesign can significantly improve efficiency in an academic Children's Hospital without preselecting specific services, removing surgical residents, or incorporating new personnel or technology. Prospective comparative study, Level II. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Public Health, Academic Medicine, and the Alcohol Industry’s Corporate Social Responsibility Activities

    Science.gov (United States)

    Robaina, Katherine

    2013-01-01

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

  9. 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.

  10. Characteristics of patients in a ward of Academic Internal Medicine: implications for medical care, training programmes and research.

    Science.gov (United States)

    Becchi, Maria Angela; Pescetelli, Michele; Caiti, Omar; Carulli, Nicola

    2010-06-01

    To describe the characteristics of "delayed discharge patients" and the factors associated with "delayed discharges", we performed a 12-month observational study on patients classified as "delayed discharge patients" admitted to an Academic Internal Medicine ward. We assessed the demographic variables, the number and severity of diseases using the Geriatric Index of Comorbidity (GIC), the cognitive, affective and functional status using, respectively, the Mini Mental Stare Examination, the Geriatric Depression Scale and the Barthel Index. We assessed the total length of stay (T-LHS), the total inappropriate length of stay (T-ILHS), the median length of stays (M-LHS), the median inappropriate length of stay (M-ILHS) and evaluated the factors associated with delayed discharge. "Delayed discharge patients" were 11.9% of all patients. The mean age was 81.9 years, 74.0% were in the IV class of GIC and 33.5% were at the some time totally dependent and affected by severe or non-assessable cognitive impairments. The patients had 2584 T-LHS, of which 1058 (40.9%) were T-ILHS. Their M-LHS was 15 days, and the M-ILHS was 5 days. In general, the greater the LHS, the greater is the ILHS (Spearman's rho + 0.68, P < 0.001). Using a multivariate analysis, only the absence of formal aids before hospitalisation is independently associated with delayed discharge (F = 4.39, P = 0.038). The majority of the delays (69%) resulted from the difficulty in finding beds in long-term hospital wards, but the longest M-ILHS (9 days) was found in patients waiting for the Geriatric Evaluation Unit. The profile of patients and the pattern of hospital utilisation suggest a need to reorient the health care system, and to develop appropriate resources for the academic functions of education, research and patient care.

  11. Geographic mobility advances careers: study of the Executive Leadership in Academic Medicine (ELAM) program for women.

    Science.gov (United States)

    McLean, Marsha R; Morahan, Page S; Dannels, Sharon A; McDade, Sharon A

    2013-11-01

    To explore whether geographic mobility is associated with career advancement of women in U.S. medical schools who are entering mid- to executive-level positions. Using an existing dataset of 351 participants in academic medicine who attended the Executive Leadership in Academic Medicine (ELAM) Program for Women (1996-2005) (adjusted to 345 participants in some analyses because data on initial faculty rank were missing), the authors conducted a quantitative study in 2009 to determine whether geographic mobility was associated with administrative promotion for those who relocated geographically (from employer while attending ELAM to employer at last job of record). Twenty-four percent of women (83/345) relocated geographically (movers) after attending ELAM. Moving had a positive association with career advancement (P = .001); odds for promotion were 168% higher for movers than for stayers [odds ratio Exp(β) = 2.684]. Movers attained higher administrative positions (P = .003), and more movers (60%) were promoted at the most recent job compared with stayers (40%) (P = .0001). Few movers changed city size; 70% already resided in large or urban cities where most medical schools are located. Age was not a barrier to mobility. Career advancement was not related to research reputation (National Institutes of Health grant award ranking) of participants' schools (either at time of attending ELAM or post-ELAM). Similar to findings outside academic medicine, 24% of women classified as geographic "movers" among midcareer faculty in medical schools attained career advantages. Psychosocial and socioeconomic factors underlying women's relocation decisions require additional study.

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

    International Nuclear Information System (INIS)

    Sudbrock, Ferdinand

    2011-01-01

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

  13. Evaluation of the physicians‘ of n hospital opinion on clinical trials of medicinal products

    OpenAIRE

    Videikaitė, Lina

    2014-01-01

    Aim of the research. To evaluate the physicians‘ of N Hospital opinion on clinical trials of medicinal products. Objectives. To evaluate the factors affecting physicians' motivation to perform clinical trials of medicinal products as well as those that prevent the physicians getting involved in the trials. To assess physicians' attitude towards clinical trials of medicinal products. To compare the opinions of physicians who have and have’nt participated in clinical trials. Methods of...

  14. From hospitals to herbalists: Rx herbal medicines | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2011-02-03

    Feb 3, 2011 ... "Equally important, their services are inexpensive — in fact, herbal medicines ... There's also a strong cultural attachment to this form of health care. ... "People and associations of traditional healers now have home gardens of ...

  15. Herbal medicine for hospitalized patients with severe depressive episode: a retrospective controlled study.

    Science.gov (United States)

    Liu, Lan-Ying; Feng, Bin; Chen, Jiong; Tan, Qing-Rong; Chen, Zheng-Xin; Chen, Wen-Song; Wang, Pei-Rong; Zhang, Zhang-Jin

    2015-01-01

    Herbal medicine is increasingly used in depressed patients. The purpose of this retrospective controlled study was to evaluate the efficacy and safety of herbal medicine treatment of severe depressive episode. A total of 146 severely depressed subjects were selected from patients who were admitted to the Department of Psychosomatics of Tongde Hospital at Hangzhou, China between 1st September 2009 and 30th November 2013. While all were medicated with psychotropic drugs, 78 received additional individualized herbal medicine. The severity of depressive symptoms was measured using 24-item Hamilton Rating Scale for Depression (HAMD-24) at admission and thereafter once weekly during hospital stay. The proportion of patients achieving clinical response and remission and incidence of adverse events were compared. The two groups had similar average length of hospital stay for approximately 28 days and were not different in the use of psychotropic medications. Survival analysis revealed that patients with herbal medicine had significantly higher chance of achieving clinical response [relative risk (RR)=2.179, Pherbal medicine. Patients with herbal medicine experienced remarkably fewer incidences of physical tiredness, headache, palpitation, dry mouth and constipation, but had a significantly higher incidence of digestive discomfort compared to patients without herbal medicine. These results indicate that additional treatment with individualized herbal medicine enhances antidepressant response and reduces certain side effects associated with psychotropic medications. Herbal medicine is an effective and relatively safe therapy for severe depressive episode (Trial Registration: ChiCTR-OCH-13003864). Copyright © 2014 Elsevier B.V. All rights reserved.

  16. [Scientific research and academic promotion in occupational medicine: what are the rules of the game?].

    Science.gov (United States)

    Franco, G

    2011-01-01

    Recently, the National University Council (CUN) recognized the importance of bibliometric indicators in assessing scientific output and the Ministry of Education, University and Research established that the selection committees' decision must be guided by internationally recognized metrics including the impact factor (IF). To analyse methods and tools of metrics to assess scientific performance in Occupational Medicine by examining some critical aspects for entry-level positions and academic promotion in the Universities. By means of different databases (Web of Knowledge, Scopus, SCImago), the h-index was studied to assess the scientific output in the field of Occupational Medicine. The h-index was used as an index of both output and quality of overall output of researchers, disciplines, journals, and countries. Italian scientific output in the Public, Environmental & Occupational Health subject category (h-index = 62) was lower than almost the total of other medical disciplines and, at an international level, is ranked at 12th place (other disciplines ranked 3rd to 9th). Output was 32% compared to that of the USA (other disciplines ranged from 42% and 61%). However, it should be noted that most scientific papers of Occupational Medicine researchers are published mainly in journals of different disciplines (with a higher IF) rather than in journals of Public, Environmental & Occupational Health (with a lower IF). Assuming that selection committees' decisions will be guided by metrics and will respect the minimum standard proposed by CUN, Occupational Medicine researchers aiming at academic promotion will have good reason to ask themselves not only which journals are most useful but also which journals have the greatest impact. This fact could have profound implications for the future of the discipline.

  17. New Academic Partnerships in Global Health: Innovations at Mount Sinai School of Medicine

    Science.gov (United States)

    Landrigan, Philip J.; Ripp, Jonathan; Murphy, Ramon J. C.; Claudio, Luz; Jao, Jennifer; Hexom, Braden; Bloom, Harrison G.; Shirazian, Taraneh; Elahi, Ebby; Koplan, Jeffrey P.

    2011-01-01

    Global health has become an increasingly important focus of education, research, and clinical service in North American universities and academic health centers. Today there are at least 49 academically based global health programs in the United States and Canada, as compared with only one in 1999. A new academic society, the Consortium of Universities for Global Health, was established in 2008 and has grown significantly. This sharp expansion reflects convergence of 3 factors: (1) rapidly growing student and faculty interest in global health; (2) growing realization–powerfully catalyzed by the acquired immune deficiency syndrome epidemic, the emergence of other new infections, climate change, and globalization–that health problems are interconnected, cross national borders, and are global in nature; and (3) rapid expansion in resources for global health. This article examines the evolution of the concept of global health and describes the driving forces that have accelerated interest in the field. It traces the development of global health programs in academic health centers in the United States. It presents a blueprint for a new school-wide global health program at Mount Sinai School of Medicine. The mission of that program, Mount Sinai Global Health, is to enhance global health as an academic field of study within the Mount Sinai community and to improve the health of people around the world. Mount Sinai Global Health is uniting and building synergies among strong, existing global health programs within Mount Sinai; it is training the next generation of physicians and health scientists to be leaders in global health; it is making novel discoveries that translate into blueprints for improving health worldwide; and it builds on Mount Sinai’s long and proud tradition of providing medical and surgical care in places where need is great and resources few. PMID:21598272

  18. Prevalence of delirium in hospitalized internal medicine and surgical adult patients in Shohadaye ashayer hospital of Khoram abad

    Directory of Open Access Journals (Sweden)

    raheleh Asaee

    2008-10-01

    Full Text Available Asaee R1, Nasari H2,Hoseini S3 1. Assistant professor, Department of Physiology, Faculty of Medicine, Lorestanl University of Medical Sciences, Khorramabad, Iran 1. Assistant professor, Department of Psychiatry, Faculty of Medicine, Lorestanl University of Medical Sciences, Khorramabad, Iran 2. G.P, Khorramabad, Iran Abstract Background: Delirium is common in elderly persons and in hospitalized patients especially after surgical procedures. But many of them are undetected and don’t receive treatment so they involve with increased mortality and morbidity, adverse outcomes, length of hospital stay and mental disability sequels. Unfortunetly , despite the importance of this syndrom , physicians and staff are able to diagnose only one thirth of the patients. Material and methods: In this cross sectional study, 240 inpatiants (120 from surgery ward and 120 from miernal medicine ward from Shohadaye Ashayer hospital of Khorramabad were selected randomly. The diagnostic criteria for delirium were Mini-Mental state examination (MMSE questionnaire, and patients daily examination for 4 days by MMSE. Results: Delirium was observed in 37 (30.8% of the patients of internal medicine ward and 25 (20.8% of the patients of surgery ward. 27 (22.5% of the patients of internal medicine ward and 37 (30.8% of the patients of surgery ward were suspicious for delirium. In age group of 58-77 years in surgery ward and patients over 77 years in internal medicine ward had the most frequency of delirium. There was significant relationship (p=0.01 between two sex in surgery ward. But there was not significant difference (p=0.92 between two sex in internal medicine ward for delirium. Conclusion: Reading the results of this study and frequency of delirum in surgery and internal medicine wards, presence of a psychiatrist in mentioned wards is necessary of early diagnosis and control of delirium.

  19. Gender and academic medicine: a good pipeline of women graduates is not advancing.

    Science.gov (United States)

    Puljak, Livia; Kojundzic, Sanja Lovric; Sapunar, Damir

    2008-01-01

    Women are underrepresented in the higher levels of appointment in academic medicine, despite the so-called feminization of medicine. A 27-year (1979-2006) retrospective study was conducted regarding the success and advancement of women and men at the University of Split School of Medicine in Croatia. Data were collected from the school's archive, including number of women and men among applicants, enrollees, graduates, teachers, department chairs and the school management: high school grade averages and admission tests scores by applicant gender and gender-based graduation grade averages. The number and gender patterns of all employed and unemployed physicians in the Split-Dalmatia county were also collected. Men represent the minority among applicants, enrollees, and graduates, whereas women were in the minority among faculty, department chairs, and the school management across all 27 years. Graduation grades from high school and medical school showed that women were statistically better students, although the difference was slight. In the same geographic area, women are more often unemployed and less likely to specialize. More women are applying, enrolling and graduating from the University of Split School of Medicine. Women also perform statistically better on entrance exam and have better graduation grades, yet they remain a minority in faculty and leadership positions. A review of county-wise employment statistics revealed that women were more frequently unemployed and less likely to specialize in this study.

  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. Factors Influencing Adoption of Hospital-Acquired Pressure Ulcer Prevention Programs in US Academic Medical Centers.

    Science.gov (United States)

    Padula, William V; Valuck, Robert J; Makic, Mary Beth F; Wald, Heidi L

    2015-01-01

    Recent data show a decrease in hospital-acquired pressure ulcers (PUs) throughout US hospitals; these changes may be associated with increased success in implementing evidence-based practices for PU prevention. The purpose of this study was to identify wound care nurse perceptions of the primary factors that influenced the overall reduction of PUs. Cross-sectional descriptive survey. Surveys were sent to wound care nurses at 98 University HealthSystem Consortium (UHC) hospitals. The UHC consists of more than 120 academic medical centers and affiliated facilities across the United States. Responses solicited from this survey represented a geographically diverse set of hospitals from less than 200 beds to more than 1000 beds. The survey questionnaire used a framework of 7 internal and 5 external influential factors for implementing evidence-based practices for PU prevention. Internal influential factors queried included availability of nurse specialists, high nursing job turnover, high PU rates, and prevention campaigns. External influential factors included data sharing, Medicare nonpayment policy, and applications for Magnet recognition. Hospital-acquired PU prevention experts at UHC hospitals were contacted through the Wound, Ostomy and Continence Nurses Society membership directory to complete the questionnaire. Consenting participants were e-mailed a disclosure and online questionnaire; they were also sent monthly reminders until they either responded to the survey or declined participation. Fifty-five respondents (59% response rate) indicated several internal factors that influenced evidence-based practice: hospital prevention campaigns; the availability of nursing specialists; and the level of preventive knowledge among hospital staff. External influential factors included financial concerns; application for Magnet recognition; data sharing among peer institutions; and regulatory issues. These findings suggest that the Centers for Medicare & Medicaid Services

  3. Reluctance to Retire: A Qualitative Study on Work Identity, Intergenerational Conflict, and Retirement in Academic Medicine.

    Science.gov (United States)

    Silver, Michelle Pannor; Williams, Sarah A

    2018-03-19

    Some professions foster expectations that individuals cultivate their work identity above all other aspects of life. This can be problematic when individuals are confronted with the expectation that they will readily terminate this identity in later-career stages as institutions seek to cycle in new generations. This study examines the relationship between work identity and retirement by examining multiple generations of academic physicians. This study used a multimethod qualitative design that included document analysis, participant observation, focus groups, and in-depth interviews with academic physicians from one of the oldest departments of medicine in North America. This study illustrates how participants were predisposed and then groomed through institutional efforts to embrace a career trajectory that emphasized work above all else and fostered negative sensibilities about retirement. Participants across multiple generations described a lack of work-life balance and a prioritization of their careers above nonwork commitments. Assertions that less experienced physicians were not as dedicated to medicine and implicit assumptions that later-career physicians should retire emerged as key concerns. Strong work identity and tensions between different generations may confound concerns about retirement in ways that complicate institutional succession planning and that demonstrate how traditional understandings of retirement are out of date. Findings support the need to creatively reconsider the ways we examine relations between work identity, age, and retirement in ways that account for the recent extensions in the working lives of professionals.

  4. Experiencing the culture of academic medicine: gender matters, a national study.

    Science.gov (United States)

    Pololi, Linda H; Civian, Janet T; Brennan, Robert T; Dottolo, Andrea L; Krupat, Edward

    2013-02-01

    Energized and productive faculty are critical to academic medicine, yet studies indicate a lack of advancement and senior roles for women. Using measures of key aspects of the culture of academic medicine, this study sought to identify similarity and dissimilarity between perceptions of the culture by male and female faculty. The C - Change Faculty Survey was used to collect data on perceptions of organizational culture. A stratified random sample of 4,578 full-time faculty at 26 nationally representative US medical colleges (response rate 52 %). 1,271 (53 %) of respondents were female. Factor analysis assisted in the creation of scales assessing dimensions of the culture, which served as the key outcomes. Regression analysis identified gender differences while controlling for other demographic characteristics. Compared with men, female faculty reported a lower sense of belonging and relationships within the workplace (T = -3.30, p men to perceive their institution as family-friendly (T = -4.06, p men did not differ significantly on levels of engagement, leadership aspirations, feelings of ethical/moral distress, perception of institutional commitment to faculty advancement, or perception of institutional change efforts to improve support for faculty. Faculty men and women are equally engaged in their work and share similar leadership aspirations. However, medical schools have failed to create and sustain an environment where women feel fully accepted and supported to succeed; how can we ensure that medical schools are fully using the talent pool of a third of its faculty?

  5. Reducing Implicit Gender Leadership Bias in Academic Medicine With an Educational Intervention.

    Science.gov (United States)

    Girod, Sabine; Fassiotto, Magali; Grewal, Daisy; Ku, Manwai Candy; Sriram, Natarajan; Nosek, Brian A; Valantine, Hannah

    2016-08-01

    One challenge academic health centers face is to advance female faculty to leadership positions and retain them there in numbers equal to men, especially given the equal representation of women and men among graduates of medicine and biological sciences over the last 10 years. The purpose of this study is to investigate the explicit and implicit biases favoring men as leaders, among both men and women faculty, and to assess whether these attitudes change following an educational intervention. The authors used a standardized, 20-minute educational intervention to educate faculty about implicit biases and strategies for overcoming them. Next, they assessed the effect of this intervention. From March 2012 through April 2013, 281 faculty members participated in the intervention across 13 of 18 clinical departments. The study assessed faculty members' perceptions of bias as well as their explicit and implicit attitudes toward gender and leadership. Results indicated that the intervention significantly changed all faculty members' perceptions of bias (P leadership of all participants regardless of age or gender (P = .008). These results suggest that providing education on bias and strategies for reducing it can serve as an important step toward reducing gender bias in academic medicine and, ultimately, promoting institutional change, specifically the promoting of women to higher ranks.

  6. 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.

  7. 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

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

    Directory of Open Access Journals (Sweden)

    KIM Nam-il

    2006-06-01

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

  9. Faculty perceptions of gender discrimination and sexual harassment in academic medicine.

    Science.gov (United States)

    Carr, P L; Ash, A S; Friedman, R H; Szalacha, L; Barnett, R C; Palepu, A; Moskowitz, M M

    2000-06-06

    Gender-based discrimination and sexual harassment are common in medical practice and may be even more prevalent in academic medicine. To examine the prevalence of gender-based discrimination and sexual harassment among medical school faculty and the associations of gender-based discrimination with number of publications, career satisfaction, and perceptions of career advancement. A self-administered mailed questionnaire of U.S. medical school faculty that covered a broad range of topics relating to academic life. 24 randomly selected medical schools in the contiguous United States. A random sample of 3332 full-time faculty, stratified by specialty, graduation cohort, and sex. Prevalence of self-reported experiences of discrimination and harassment, number of peer-reviewed publications, career satisfaction, and perception of career advancement. Female faculty were more than 2.5 times more likely than male faculty to perceive gender-based discrimination in the academic environment (P productivity but lower career satisfaction scores than did other women (Padvancement (72% compared with 47%). Publications, career satisfaction, and professional confidence were not affected by sexual harassment, and self-assessed career advancement was only marginally lower for female faculty who had experienced sexual harassment (P = 0.06). Despite substantial increases in the number of female faculty, reports of gender-based discrimination and sexual harassment remain common.

  10. Academic medical centers as innovation ecosystems to address population -omics challenges in precision medicine.

    Science.gov (United States)

    Silva, Patrick J; Schaibley, Valerie M; Ramos, Kenneth S

    2018-02-15

    While the promise of the Human Genome Project provided significant insights into the structure of the human genome, the complexities of disease at the individual level have made it difficult to utilize -omic information in clinical decision making. Some of the existing constraints have been minimized by technological advancements that have reduced the cost of sequencing to a rate far in excess of Moore's Law (a halving in cost per unit output every 18 months). The reduction in sequencing costs has made it economically feasible to create large data commons capturing the diversity of disease across populations. Until recently, these data have primarily been consumed in clinical research, but now increasingly being considered in clinical decision- making. Such advances are disrupting common diagnostic business models around which academic medical centers (AMCs) and molecular diagnostic companies have collaborated over the last decade. Proprietary biomarkers and patents on proprietary diagnostic content are no longer driving biomarker collaborations between industry and AMCs. Increasingly the scope of the data commons and biorepositories that AMCs can assemble through a nexus of academic and pharma collaborations is driving a virtuous cycle of precision medicine capabilities that make an AMC relevant and highly competitive. A rebalancing of proprietary strategies and open innovation strategies is warranted to enable institutional precision medicine asset portfolios. The scope of the AMC's clinical trial and research collaboration portfolios with industry are increasingly dependent on the currency of data, and less on patents. Intrapeneurial support of internal service offerings, clinical trials and clinical laboratory services for example, will be important new points of emphasis at the academic-industry interface. Streamlining these new models of industry collaboration for AMCs are a new area for technology transfer offices to offer partnerships and to add value

  11. Mentor Networks in Academic Medicine: Moving Beyond a Dyadic Conception of Mentoring for Junior Faculty Researchers

    Science.gov (United States)

    DeCastro, Rochelle; Sambuco, Dana; Ubel, Peter A.; Stewart, Abigail; Jagsi, Reshma

    2013-01-01

    Purpose Career development award programs often require formal establishment of mentoring relationships. The authors sought to gain a nuanced understanding of mentoring from the perspective of a diverse national sample of faculty clinician-researchers who were all members of formal mentoring relationships. Method Between February 2010 and August 2011, the authors conducted semi-structured, in-depth telephone interviews with 100 former recipients of National Institutes of Health mentored career development awards and 28 of their mentors. Purposive sampling ensured a diverse range of viewpoints. Multiple analysts thematically coded verbatim transcripts using qualitative data analysis software. Results Three relevant themes emerged: (1) the numerous roles and behaviors associated with mentoring in academic medicine, (2) the improbability of finding a single person who can fulfill the diverse mentoring needs of another individual, and (3) the importance and composition of mentor networks. Many respondents described the need to cultivate more than one mentor. Several participants discussed the utilization of peer mentors, citing benefits such as pooled resources and mutual learning. Female participants generally acknowledged the importance of having at least one female mentor. Some observed that their portfolio of mentors needed to evolve in order to remain effective. Conclusions Those who seek to promote the careers of faculty in academic medicine should focus upon developing mentoring networks, rather than hierarchical mentoring dyads. The members of each faculty member's mentoring team or network should reflect the protégé's individual needs and preferences, with special attention towards ensuring diversity in terms of area of expertise, academic rank, and gender. PMID:23425990

  12. The Practice of Medicine at a District Hospital Emergency Room ...

    African Journals Online (AJOL)

    To remain in touch with the changing environment of medicine, one has to keep on learning and sometimes attend refresher courses far away from the place of work. The rewarding part of the practice is that many junior doctors benefit from the experience of the senior colleagues, who teach them basic skills. A practitioner ...

  13. Treatment of patients with a history of penicillin allergy in a large tertiary-care academic hospital.

    Science.gov (United States)

    Picard, Matthieu; Bégin, Philippe; Bouchard, Hugues; Cloutier, Jonathan; Lacombe-Barrios, Jonathan; Paradis, Jean; Des Roches, Anne; Laufer, Brian; Paradis, Louis

    2013-01-01

    Prescribing antibiotics to patients with a history of penicillin allergy is common in clinical practice. Opting for non-beta-lactam antibiotics has its inconveniences and is often unnecessary, because most of these patients are in fact not allergic. This study aimed to determine how physicians in a large Canadian tertiary-care academic hospital without allergists on staff treat patients with a history of penicillin allergy. A retrospective study was conducted during a 1-year period among all patients hospitalized in the intensive care unit, coronary care unit, and internal medicine wards. Files of patients with a record of penicillin allergy were reviewed to assess the need for antibiotics during their hospitalization and the decision-making process underlying the choice of antibiotic. The additional costs of alternative antibiotics were calculated. The files of 1738 patients admitted over a 1-year period were hand reviewed. A history of penicillin allergy was found in 172 patients (9.9%). The allergic reaction was described in only 30% of cases and left unmentioned in 20.7%. Beta-lactam antibiotics were used on 56 occasions despite a history of penicillin allergy. The use of alternative antibiotics in place of the beta-lactam standard of care carried an additional cost of $15,672 Canadian. Alleged penicillin allergy is common among hospitalized patients and leads to substantial additional costs. Poor documentation of penicillin allergy likely reflects a lack of knowledge on this issue in the medical community, which impairs optimal treatment of these patients. Increased education on this matter is needed, and allergists on staff could be part of the solution. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  14. Gender Differences in Academic Medicine: Retention, Rank, and Leadership Comparisons From the National Faculty Survey.

    Science.gov (United States)

    Carr, Phyllis L; Raj, Anita; Kaplan, Samantha E; Terrin, Norma; Breeze, Janis L; Freund, Karen M

    2018-01-30

    Prior studies have found that women in academic medicine do not advance or remain in their careers in parity with men. The authors examined a national cohort of faculty from the 1995 National Faculty Survey to identify predictors of advancement, retention, and leadership for women faculty. The authors followed 1,273 faculty at 24 medical schools in the continental United States for 17 years to identify predictors of advancement, retention, and leadership for women faculty. Schools were balanced for public or private status and the four Association of American Medical Colleges geographic regions. The authors used regression models to adjust for covariates: seniority, department, academic setting, and race/ethnicity. After adjusting for significant covariates women were less likely than men to achieve the rank of professor (OR = 0.57; 95% CI, 0.43-0.78) or to remain in academic careers (OR = 0.68; 95% CI, 0.49-0.94). When number of refereed publications were added to the model, differences by gender in retention and attainment of senior rank were no longer significant. Male faculty were more likely to hold senior leadership positions after adjusting for publications (OR = 0.49; 95% CI, 0.35-0.69). Gender disparities in rank, retention, and leadership remain across the career trajectories of the faculty cohort in this study. Women were less likely to attain senior-level positions than men, even after adjusting for publication-related productivity. Institutions must examine the climate for women to ensure their academic capital is fully utilized and equal opportunity exists for leadership.

  15. 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.

  16. Changing the Culture of Academic Medicine to Eliminate the Gender Leadership Gap: 50/50 by 2020

    OpenAIRE

    Valantine, Hannah; Sandborg, Christy I.

    2013-01-01

    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 also 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 h...

  17. 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.

  18. 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....

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

    Science.gov (United States)

    Shams, Tarek; El-Masry, Ragaa

    2013-01-01

    Objectives: There is compelling evidence that anaesthesiology is a stressful occupation and, when this stressful occupation is associated with an academic career, the burnout level is high. This study aimed to assess the predictors and prevalence of stress and burnout, associated sociodemographic characteristics, and job-related features. Methods: A cross-sectional survey study was carried out at Mansoura University Hospital in Egypt among 98 anaesthesiologists who had academic careers. The English version of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) scale and the Workplace Stress Scale of the American Institute of Stress were used to measure job stress and burnout. Data were analysed according to the guidelines for data processing and an analysis of the scales used. Results: The participation rate of this study was 73.1%, where 69.4% were encountering job stress, while 62.2% experienced emotional exhaustion, 56.1% depersonalisation, and 58.2% reduced personal capacity. There was a significant positive correlation between job stress and MBI-HSS subscales. Residents and assistant lecturers were the most affected group. The strongest significant single predictor of all burnout dimensions was a lack of job support. Conclusion: Stress and burnout among academic anaesthesiologists were caused by the lack of job support; this was especially true among residents and assistant lecturers. We can conclude that a well-organised institutional strategy to mitigate the heavy professional demands of academic anaesthesiologists’ will relieve their stress and burnout. PMID:23862036

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

    Science.gov (United States)

    Shams, Tarek; El-Masry, Ragaa

    2013-05-01

    There is compelling evidence that anaesthesiology is a stressful occupation and, when this stressful occupation is associated with an academic career, the burnout level is high. This study aimed to assess the predictors and prevalence of stress and burnout, associated sociodemographic characteristics, and job-related features. A cross-sectional survey study was carried out at Mansoura University Hospital in Egypt among 98 anaesthesiologists who had academic careers. The English version of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) scale and the Workplace Stress Scale of the American Institute of Stress were used to measure job stress and burnout. Data were analysed according to the guidelines for data processing and an analysis of the scales used. The participation rate of this study was 73.1%, where 69.4% were encountering job stress, while 62.2% experienced emotional exhaustion, 56.1% depersonalisation, and 58.2% reduced personal capacity. There was a significant positive correlation between job stress and MBI-HSS subscales. Residents and assistant lecturers were the most affected group. The strongest significant single predictor of all burnout dimensions was a lack of job support. Stress and burnout among academic anaesthesiologists were caused by the lack of job support; this was especially true among residents and assistant lecturers. We can conclude that a well-organised institutional strategy to mitigate the heavy professional demands of academic anaesthesiologists' will relieve their stress and burnout.

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

    Directory of Open Access Journals (Sweden)

    Liang Wang

    2017-01-01

    Full Text Available 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.

  2. A nurse-led model at public academic hospitals maintains high adherence to colorectal cancer surveillance guidelines.

    Science.gov (United States)

    Symonds, Erin L; Simpson, Kalindra; Coats, Michelle; Chaplin, Angela; Saxty, Karen; Sandford, Jayne; Young Am, Graeme P; Cock, Charles; Fraser, Robert; Bampton, Peter A

    2018-06-18

    To examine the compliance of colorectal cancer surveillance decisions for individuals at greater risk with current evidence-based guidelines and to determine whether compliance differs between surveillance models. Prospective auditing of compliance of surveillance decisions with evidence-based guidelines (NHMRC) in two decision-making models: nurse coordinator-led decision making in public academic hospitals and physician-led decision making in private non-academic hospitals. Selected South Australian hospitals participating in the Southern Co-operative Program for the Prevention of Colorectal Cancer (SCOOP). Proportions of recall recommendations that matched NHMRC guideline recommendations (March-May 2015); numbers of surveillance colonoscopies undertaken more than 6 months ahead of schedule (January-December 2015); proportions of significant neoplasia findings during the 15 years of SCOOP operation (2000-2015). For the nurse-led/public academic hospital model, the recall interval recommendation following 398 of 410 colonoscopies (97%) with findings covered by NHMRC guidelines corresponded to the guideline recommendations; for the physician-led/private non-academic hospital model, this applied to 257 of 310 colonoscopies (83%) (P < 0.001). During 2015, 27% of colonoscopies in public academic hospitals (mean, 27 months; SD, 13 months) and 20% of those in private non-academic hospitals (mean, 23 months; SD, 12 months) were performed more than 6 months earlier than scheduled, in most cases because of patient-related factors (symptoms, faecal occult blood test results). The ratio of the numbers of high risk adenomas to cancers increased from 6.6:1 during 2001-2005 to 16:1 during 2011-2015. The nurse-led/public academic hospital model for decisions about colorectal cancer surveillance intervals achieves a high degree of compliance with guideline recommendations, which should relieve burdening of colonoscopy resources.

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

    International Nuclear Information System (INIS)

    Causer, D.A.

    2010-01-01

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

  4. Organizational Context and Female Faculty's Perception of the Climate for Women in Academic Medicine.

    Science.gov (United States)

    Carapinha, René; McCracken, Caitlin M; Warner, Erica T; Hill, Emorcia V; Reede, Joan Y

    2017-05-01

    Gender inequalities in the careers of faculty in academic medicine could partially be attributed to an organizational climate that can exclude or be nonsupportive of women faculty. This study explores the climate for women faculty from a systems perspective at the organizational and individual levels based on the perceptions of women faculty. Race differences were also investigated. Cross-sectional survey data from women faculty (N = 3127) at 13 purposively sampled medical schools and an institutional assessment of organizational characteristics were used. Organizational factors related to the climate for women were identified using bivariate statistics. The association between perceived climate for women and organizational characteristics, individual perceptions of the work environment and individual career, and personal characteristics with control variables were investigated using hierarchical linear regression models. Organizational effects by race/ethnicity were estimated using interaction terms. The climate for women faculty varied across institutions and by classification as minority-serving institutions (MSIs). Respondent's report of existence of an office for women's affairs, trust in leadership, and satisfaction with mentoring were positively associated with the climate for women. Perceived workplace discrimination and work-family conflict were inversely associated with a positive climate. No race/ethnicity differences were observed in the multivariable analysis. The climate for women faculty in academic medicine should not be regarded constant across organizations, specifically between MSIs and non-MSIs. Efforts to advance a positive climate for women could focus on improving trust in leadership, increasing support for structures/offices for women, and mitigating perceived discrimination and work-family conflict.

  5. Culture Matters: The Pivotal Role of Culture for Women’s Careers in Academic Medicine

    Science.gov (United States)

    Speck, Rebecca M.; Dupuis Sammel, Mary; Scott, Patricia; Conant, Emily F.; Tuton, Lucy Wolf; Abbuhl, Stephanie B.; Grisso, Jeane Ann

    2014-01-01

    Purpose Women in academic medicine are not achieving the same career advancement as men, and face unique challenges in managing work and family alongside intense work demands. The purpose of this study was to investigate how a supportive department/division culture buffered women from the impact of work demands on work-to-family conflict. Method As part of a larger intervention trial, the authors collected baseline survey data from 133 women assistant professors at the University of Pennsylvania Perelman School of Medicine in 2010. Validated measures of work demands, work-to-family conflict, and a department/division culture were employed. Pearson correlations and general linear mixed modeling were used to analyze the data. Authors investigated whether work culture moderated the association between work demands and work-to-family conflict. Results Heavy work demands were associated with increased levels of work-to-family conflict. There were significant interactions between work demands, work-to-family conflict, and department/division culture. A culture conducive to women’s academic success significantly moderated the effect of work hours on time-based work-to-family conflict and significantly moderated the effect of work overload on strain-based work-to-family conflict. At equivalent levels of work demands, women in more supportive cultures experienced lower levels of work-to-family conflict. Conclusions The culture of the department/division plays a crucial role in women’s work-to-family conflict and can exacerbate or alleviate the impact of extremely high work demands. This finding leads to important insights about strategies for more effectively supporting the careers of women assistant professors. PMID:24556773

  6. Work-life balance in academic medicine: narratives of physician-researchers and their mentors.

    Science.gov (United States)

    Strong, Erin A; De Castro, Rochelle; Sambuco, Dana; Stewart, Abigail; Ubel, Peter A; Griffith, Kent A; Jagsi, Reshma

    2013-12-01

    Leaders in academic medicine are often selected from the ranks of physician-researchers, whose demanding careers involve multiple professional commitments that must also be balanced with demands at home. To gain a more nuanced understanding of work-life balance issues from the perspective of a large and diverse group of faculty clinician-researchers and their mentors. A qualitative study with semi-structured, in-depth interviews conducted from 2010 to 2011, using inductive analysis and purposive sampling. One hundred former recipients of U.S. National Institutes of Health (NIH) K08 or K23 career development awards and 28 of their mentors. Three researchers with graduate training in qualitative methods conducted the interviews and thematically coded verbatim transcripts. Five themes emerged related to work-life balance: (1) the challenge and importance of work-life balance for contemporary physician-researchers, (2) how gender roles and spousal dynamics make these issues more challenging for women, (3) the role of mentoring in this area, (4) the impact of institutional policies and practices intended to improve work-life balance, and (5) perceptions of stereotype and stigma associated with utilization of these programs. In academic medicine, in contrast to other fields in which a lack of affordable childcare may be the principal challenge, barriers to work-life balance appear to be deeply rooted within professional culture. A combination of mentorship, interventions that target institutional and professional culture, and efforts to destigmatize reliance on flexibility (with regard to timing and location of work) are most likely to promote the satisfaction and success of the new generation of clinician-researchers who desire work-life balance.

  7. The role of cultural diversity climate in recruitment, promotion, and retention of faculty in academic medicine.

    Science.gov (United States)

    Price, Eboni G; Gozu, Aysegul; Kern, David E; Powe, Neil R; Wand, Gary S; Golden, Sherita; Cooper, Lisa A

    2005-07-01

    Ethnic diversity among physicians may be linked to improved access and quality of care for minorities. Academic medical institutions are challenged to increase representation of ethnic minorities among health professionals. To explore the perceptions of physician faculty regarding the following: (1) the institution's cultural diversity climate and (2) facilitators and barriers to success and professional satisfaction in academic medicine within this context. Qualitative study using focus groups and semi-structured interviews. Nontenured physicians in the tenure track at the Johns Hopkins University School of Medicine. Focus groups and interviews were audio-taped, transcribed verbatim, and reviewed for thematic content in a 3-stage independent review/adjudication process. Study participants included 29 faculty representing 9 clinical departments, 4 career tracks, and 4 ethnic groups. In defining cultural diversity, faculty noted visible (race/ethnicity, foreign-born status, gender) and invisible (religion, sexual orientation) dimensions. They believe visible dimensions provoke bias and cumulative advantages or disadvantages in the workplace. Minority and foreign-born faculty report ethnicity-based disparities in recruitment and subtle manifestations of bias in the promotion process. Minority and majority faculty agree that ethnic differences in prior educational opportunities lead to disparities in exposure to career options, and qualifications for and subsequent recruitment to training programs and faculty positions. Minority faculty also describe structural barriers (poor retention efforts, lack of mentorship) that hinder their success and professional satisfaction after recruitment. To effectively manage the diversity climate, our faculty recommended 4 strategies for improving the psychological climate and structural diversity of the institution. Soliciting input from faculty provides tangible ideas regarding interventions to improve an institution's diversity

  8. Integrating biomedical and herbal medicine in Ghana - experiences from the Kumasi South Hospital: a qualitative study.

    Science.gov (United States)

    Boateng, Millicent Addai; Danso-Appiah, Anthony; Turkson, Bernard Kofi; Tersbøl, Britt Pinkowski

    2016-07-07

    Over the past decade there has been growing interest in the use of herbal medicine both in developed and developing countries. Given the high proportion of patients using herbal medicine in Ghana, some health facilities have initiated implementation of herbal medicine as a component of their healthcare delivery. However, the extent to which herbal medicine has been integrated in Ghanaian health facilities, how integration is implemented and perceived by different stakeholders has not been documented. The study sought to explore these critical issues at the Kumasi South Hospital (KSH) and outline the challenges and motivations of the integration process. Qualitative phenomenological exploratory study design involving fieldwork observations, focus group discussion, in-depth interviews and key informants' interviews was employed to collect data. Policies and protocols outlining the definition, process and goals of integration were lacking, with respondents sharing different views about the purpose and value of integration of herbal medicine within public health facilities. Key informants were supportive of the initiative. Whilst biomedical health workers perceived the system to be parallel than integrated, health personnel providing herbal medicine perceived the system as integrated. Most patients were not aware of the herbal clinic in the hospital but those who had utilized services of the herbal clinic viewed the clinic as part of the hospital. The lack of a regulatory policy and protocol for the integration seemed to have led to the different perception of the integration. Policy and protocol to guide the integration are key recommendations.

  9. 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...

  10. 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. PMID:26807394

  11. Quantifying federal funding and scholarly output related to the academic emergency medicine consensus conferences.

    Science.gov (United States)

    Nishijima, Daniel K; Dinh, Tu; May, Larissa; Yadav, Kabir; Gaddis, Gary M; Cone, David C

    2014-01-01

    Every year since 2000, Academic Emergency Medicine (AEM) has presented a one-day consensus conference to generate a research agenda for advancement of a scientific topic. One of the 12 annual issues of AEM is reserved for the proceedings of these conferences. The purpose of this study was to measure academic productivity of these conferences by evaluating subsequent federal research funding received by authors of conference manuscripts and calculating citation counts of conference papers. This was a cross-sectional study. In 2012, the NIH RePORTER system was searched to identify subsequent federal funding obtained by authors of the consensus conference issues from 2000 to 2010. Funded projects were coded as related or unrelated to conference topic. Citation counts for all conference manuscripts were quantified using Scopus and Google Scholar. Simple descriptive statistics were reported. Eight hundred fifty-two individual authors contributed to 280 papers published in the 11 consensus conference issues. One hundred thirty-seven authors (16%) obtained funding for 318 projects. A median of 22 topic-related projects per conference (range 10-97) accounted for a median of $20,488,331 per conference (range $7,779,512 to $122,918,205). The average (± SD) number of citations per paper was 15.7 ± 20.5 in Scopus and 23.7 ± 32.6 in Google Scholar. The authors of consensus conference manuscripts obtained significant federal grant support for follow-up research related to conference themes. In addition, the manuscripts generated by these conferences were frequently cited. Conferences devoted to research agenda development appear to be an academically worthwhile endeavor.

  12. [What is new in 2016 for the specialist in hospital internal medicine?

    Science.gov (United States)

    Mraihi, Hamza; Chevaux, Fabienne; Castoni, Julien; Aebischer, Oriane; Christou, Foetini; Jaccard, Evrim; Benmachiche, Malik; Tasheva, Plamena; Giroud, Sabine; Kraege, Vanessa; Lamy, Olivier

    2017-01-18

    The year 2016 was rich in significant advances in all areas of internal medicine. Many of them have an impact on our daily practice in general internal medicine. From the treatment of NSTEMI in population older than 80, to new sepsis and septic shock criteria to antidotes of new oral anticoagulants, this selection offers to the readers a brief overview of the major advances. The chief residents in the Service of internal medicine of the Lausanne University hospital are pleased to share their readings.

  13. Implementing managed alcohol programs in hospital settings: A review of academic and grey literature.

    Science.gov (United States)

    Brooks, Hannah L; Kassam, Shehzad; Salvalaggio, Ginetta; Hyshka, Elaine

    2018-04-01

    People with severe alcohol use disorders are at increased risk of poor acute-care outcomes, in part due to difficulties maintaining abstinence from alcohol while hospitalised. Managed alcohol programs (MAP), which administer controlled doses of beverage alcohol to prevent withdrawal and stabilise drinking patterns, are one strategy for increasing adherence to treatment, and improving health outcomes for hospital inpatients with severe alcohol use disorders. Minimal research has examined the implementation of MAPs in hospital settings. We conducted a scoping review to describe extant literature on MAPs in community settings, as well as the therapeutic provision of alcohol to hospital inpatients, to assess the feasibility of implementing formal MAPs in hospital settings and identify knowledge gaps requiring further study. Four academic and 10 grey literature databases were searched. Evidence was synthesised using quantitative and qualitative approaches. Forty-two studies met review inclusion criteria. Twenty-eight examined the administration of alcohol to hospital inpatients, with most reporting positive outcomes related to prevention or treatment of alcohol withdrawal. Fourteen studies examined MAPs in the community and reported that they help stabilise drinking patterns, reduce alcohol-related harms and facilitate non-judgemental health and social care. MAPs in the community have been well described and research has documented effective provision of alcohol in hospital settings for addressing withdrawal. Implementing MAPs as a harm reduction approach in hospital settings is potentially feasible. However, there remains a need to build off extant literature and develop and evaluate standardised MAP protocols tailored to acute-care settings. © 2018 Australasian Professional Society on Alcohol and other Drugs.

  14. Academic profile of students who transferred to Zagreb School of Medicine from other medical schools in Croatia.

    Science.gov (United States)

    Dusek, Davorka; Dolovcak, Svjetlana; Kljaković-Gaspić, Marko

    2004-02-01

    To assess the academic performance of students who transferred to the Zagreb School of Medicine from other three medical schools in Croatia. Academic performance of medical students who moved from Rijeka, Osijek, or Split University Medical Schools to the Zagreb University School of Medicine at the second or third year was compared with academic performance of students enrolled at the Zagreb University School of Medicine. Using the Zagreb Medical School's registry, we made a list of 57 transfer students to Zagreb Medical School in the 1985-1994 period. Control group was formed of students enrolled at the Zagreb School of Medicine in the same period, whose names followed in alphabetical order after the names of transfer students. Students' performance was analyzed according to their grade average before transfer, grade average in the first year after transfer, total grade average after transfer, overall grade average, and duration of studies. We also analyzed the proportion of students in each group who did not pass the admission test at the Zagreb School of Medicine in the year before the enrollment in Zagreb, Osijek, Rijeka, and Split Medical Schools. Nineteen transfer students, transferred between 1985 and 1988, and their controls were excluded from the analysis because of incomplete data. Transfer students had significantly lower grade average before transfer (3.2-/+0.6 vs 3.5-/+0.7, p=0.03, Student t-test), lower grade average in the first year after transfer (3.2-/+0.6 vs 3.5-/+0.7, p=0.03), lower total grade average after transfer (3.6-/+0.5 vs 4.0-/+0.6, pZagreb School of Medicine in the year before the final enrollment than their controls (15/38 vs 4/38, p=0.009, chi-square test). Transfer students had poorer academic performance than students who passed the admission test and were enrolled at the Zagreb School of Medicine from the first year of studies.

  15. Modifying the Toyota Production System for continuous performance improvement in an academic children's hospital.

    Science.gov (United States)

    Stapleton, F Bruder; Hendricks, James; Hagan, Patrick; DelBeccaro, Mark

    2009-08-01

    The Toyota Production System (TPS) has become a successful model for improving efficiency and eliminating errors in manufacturing processes. In an effort to provide patients and families with the highest quality clinical care, our academic children's hospital has modified the techniques of the TPS for a program in continuous performance improvement (CPI) and has expanded its application to educational and research programs. Over a period of years, physicians, nurses, residents, administrators, and hospital staff have become actively engaged in a culture of continuous performance improvement. This article provides background into the methods of CPI and describes examples of how we have applied these methods for improvement in clinical care, resident teaching, and research administration.

  16. Auditing Safety of Compounding and Reconstituting of Intravenous Medicines on Hospital Wards in Finland.

    Science.gov (United States)

    Suvikas-Peltonen, Eeva; Palmgren, Joni; Häggman, Verner; Celikkayalar, Ercan; Manninen, Raija; Airaksinen, Marja

    2017-01-01

    On the hospital wards in Finland, nurses generally reconstitute intravenous medicines, such as antibiotics, analgesics, and antiemetics prescribed by doctors. Medicine reconstitution is prone to many errors. Therefore, it is important to identify incorrect practices in the reconstitution of medicine to improve patient safety in hospitals. The aim of this study was to audit the compounding and reconstituting of intravenous medicines on hospital wards in a secondary-care hospital in Finland by using an assessment tool and microbiological testing for identifying issues posing patient safety risks. A hospital pharmacist conducted an external audit by using a validated 65-item assessment tool for safe-medicine compounding practices on 20 wards of the selected hospital. Also, three different microbiological samples were collected to assure the aseptics. Practices were evaluated using a four-point rating scale of "never performed," "rarely performed," "often performed," and "always performed," and were based on observation and interviews with nurses or ward pharmacists. In addition, glove-, settle plate-, and media fill-tests were collected. Associations between microbial sample results and audit-tool results were discussed. Altogether, only six out of the 65 items were fully implemented in all wards; these were related to logistic practices and quality assurance. More than half of the wards used incorrect practices ("rarely performed" or "never performed") for five items. Most of these obviated practices related to aseptic practices. All media-fill tests were clean but the number of colony forming units in glove samples and settle- plate samples varied from 0 to >100. More contamination was found in wards where environmental conditions were inadequate or the use of gloves was incorrect. Compounding practices were [mostly] quite well adapted, but the aseptic practices needed improvement. Attention should have been directed particularly to good aseptic techniques and

  17. Barriers towards the publication of academic drug trials. Follow-up of trials approved by the Danish Medicines Agency

    DEFF Research Database (Denmark)

    Berendt, Louise; Petersen, Lene Grejs; Bach, Karin Friis

    2017-01-01

    OBJECTIVE: To characterize and quantify barriers towards the publication of academic drug trials. STUDY DESIGN: We identified academic drug trials approved during a 3-year period (2004-2007) by the Danish Medicines Agency. We conducted a survey among the trial sponsors to describe the rates...... of initiation, completion, and publication, and the reasons for the failure to reach each of these milestones. Information on size and methodological characteristics of the trials was extracted from the EudraCT database, a prospective register of all approved clinical drug trials submitted to European medicines...... agencies since 2004. RESULTS: A total of 181 academic drug trials were eligible for inclusion, 139 of which participated in our survey (response rate: 77%). Follow-up time ranged from 5.1 to 7.9 years. Most trials were randomized controlled trials (73%, 95% CI 65-81%). Initiation and completion rates were...

  18. IAIMS and JCAHO: implications for hospital librarians. Integrated Academic Information Management Systems. Joint Commission on Accreditation of Healthcare Organizations.

    OpenAIRE

    Doyle, J D

    1999-01-01

    The roles of hospital librarians have evolved from keeping print materials to serving as a focal point for information services and structures within the hospital. Concepts that emerged from the Integrated Academic Information Management Systems (IAIMS) as described in the Matheson Report and the 1994 Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards have combined to propel hospital libraries into many new roles and functions. This paper will review the relations...

  19. Antimicrobial resistance patterns of Staphylococcus species isolated from cats presented at a veterinary academic hospital in South Africa.

    Science.gov (United States)

    Qekwana, Daniel Nenene; Sebola, Dikeledi; Oguttu, James Wabwire; Odoi, Agricola

    2017-09-15

    Antimicrobial resistance is becoming increasingly important in both human and veterinary medicine. This study investigated the proportion of antimicrobial resistant samples and resistance patterns of Staphylococcus isolates from cats presented at a veterinary teaching hospital in South Africa. Records of 216 samples from cats that were submitted to the bacteriology laboratory of the University of Pretoria academic veterinary hospital between 2007 and 2012 were evaluated. Isolates were subjected to antimicrobial susceptibility testing against a panel of 15 drugs using the disc diffusion method. Chi square and Fisher's exact tests were used to assess simple associations between antimicrobial resistance and age group, sex, breed and specimen type. Additionally, associations between Staphylococcus infection and age group, breed, sex and specimen type were assessed using logistic regression. Staphylococcus spp. isolates were identified in 17.6% (38/216) of the samples submitted and 4.6% (10/216) of these were unspeciated. The majority (61.1%,11/18) of the isolates were from skin samples, followed by otitis media (34.5%, 10/29). Coagulase Positive Staphylococcus (CoPS) comprised 11.1% (24/216) of the samples of which 7.9% (17/216) were S. intermedius group and 3.2% (7/216) were S. aureus. Among the Coagulase Negative Staphylococcus (CoNS) (1.9%, 4/216), S. felis and S. simulans each constituted 0.9% (2/216). There was a significant association between Staphylococcus spp. infection and specimen type with odds of infection being higher for ear canal and skin compared to urine specimens. There were higher proportions of samples resistant to clindamycin 34.2% (13/25), ampicillin 32.4% (2/26), lincospectin 31.6% (12/26) and penicillin-G 29.0% (11/27). Sixty three percent (24/38) of Staphylococcus spp. were resistant to one antimicrobial agent and 15.8% were multidrug resistant (MDR). MDR was more common among S. aureus 28.6% (2/7) than S. intermedius group isolates 11.8% (2

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

    Science.gov (United States)

    2011-01-01

    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 health care system. PMID

  1. 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

  2. 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

  3. Giving Medicine Through Intravenous Towards Incident of Phlebitis to Hospitalized Patient in Hospital

    OpenAIRE

    Iradiyanti, Winda Pratama; Kurnia, Erlin

    2013-01-01

    Phlebitis incident is a reflection of the character of health care. The sign of phlebitis include an increase of skin temperature on the veins, pain, and some cases of redness in the site of insertion or along the vein line. The purpose of this research to study the phlebitis caused. The design used was cross sectional. Population of this research was all patients hospitalized at inpatient ward Kediri Baptist Hospital and all the nurses who provided medication through an intravenous tube a...

  4. When Reducing Low-Value Care in Hospital Medicine Saves Money, Who Benefits ?

    Science.gov (United States)

    Liao, Joshua M; Navathe, Amol S; Schapira, Marilyn M; Weissman, Arlene; Mitra, Nandita; Asch, David A

    2018-01-01

    One emerging policy solution for deterring low-value care is to financially penalize physicians who prescribe it. However, physicians' willingness to support such policies may depend on whether they perceive that benefits accrue to patients or to insurers and hospitals. We surveyed physicians practicing hospital medicine to evaluate the association between policy support and physician beliefs about who benefits from the money saved through reducing low-value services in hospital medicine. Overall, physicians believed that more of any money saved would go to profits and leadership salaries for insurance companies and hospitals and/or health systems rather than to patients. These beliefs were associated with policy support: 66% of those supporting physician penalties were more likely to believe that benefits accrue to patients or physicians, compared to 39% of those not supporting policies (P benefits accrue to corporate or organizational interests. Effective physician penalties will likely need to address the belief that insurers and provider organizations stand to gain more than patients when low-value care services are reduced. © 2017 Society of Hospital Medicine.

  5. Forensic medicine experts' opinion on medico-legal autopsies in hospital deaths: a questionnaire survey.

    Science.gov (United States)

    D'Souza, Deepak Herald; Pant, Sadip; Menezes, Ritesh George

    2013-10-01

    Medico-legal autopsy is conducted routinely in some countries and selectively in others in hospital deaths. This study was conducted to evaluate the views of the forensic medicine experts regarding this matter. A questionnaire pro forma was sent to sixty-five forensic medicine experts practicing in different medical institutions all around India. Designations and experiences of the participants were noted by requests in the same questionnaire. Their specific experience in conducting medico-legal autopsy in hospital deaths was also requested for. Responses were charted in frequency distribution tables and analyzed using SPSS, version 17.0. One-third of the participants felt that a medico-legal autopsy was necessary in all the hospital death cases as defined in the present study. Ten percent of the participants opined that a medico-legal autopsy was unnecessary in hospital deaths. The majority of the experts mentioned finding the cause of death, followed by finding the manner of death and collecting the evidentiary materials, as the reasons for medico-legal autopsy in hospital deaths. Twenty percent of the participants felt that internal findings at autopsy poorly matched with the case records. All the experts agreed that external autopsy findings matched with the hospital case records. Nearly two-third of the participants felt that it was difficult in some cases to interpret the autopsy findings without case records from the hospital where the deceased was treated. Our findings suggest that the exercise of carrying out medico-legal autopsy routinely in every hospital death as evident in the Indian framework is often unnecessary as per the experts' opinion. Autopsy findings in hospital deaths often correlate with hospital case records.

  6. 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.

  7. Knowledge and perceptions of family leave policies among female faculty in academic medicine.

    Science.gov (United States)

    Gunn, Christine M; Freund, Karen M; Kaplan, Samantha A; Raj, Anita; Carr, Phyllis L

    2014-01-01

    The purpose of this research was to examine the knowledge and perceptions of family leave policies and practices among senior leaders including American Association of Medical College members of the Group on Women in Medicine and Science (GWIMS) to identify perceived barriers to career success and satisfaction among female faculty. In 2011 and 2012, GWIMS representatives and senior leaders at 24 medical schools were invited to participate in an interview about faculty perceptions of gender equity and overall institutional climate. An inductive, thematic analysis of the qualitative data was conducted to identify themes represented in participant responses. The research team read and reviewed institutional family leave policies for concordance with key informant descriptions. There were 22 GWIMS representatives and senior leaders in the final sample. Participants were all female; 18 (82%) were full professors with the remainder being associate professors. Compared with publicly available policies at each institution, the knowledge of nine participants was consistent with policies, was discrepant for six, with the remaining seven acknowledging a lack of knowledge of policies. Four major themes were identified from the interview data: 1) Framing family leave as a personal issue undermines its effect on female faculty success; 2) poor communication of policies impairs access and affects organizational climate; 3) discrepancies in leave implementation disadvantage certain faculty in terms of time and pay; and 4) leave policies are valued and directly related to academic productivity. Family leave policies are an important aspect of faculty satisfaction and academic success, yet policy awareness among senior leaders is lacking. Further organizational support is needed to promote equitable policy creation and implementation to support women in medical academia. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  8. Clostridial collagenase ointment and medicinal honey utilization for pressure ulcers in US hospitals.

    Science.gov (United States)

    Dreyfus, Jill; Delhougne, Gary; James, Roberta; Gayle, Julie; Waycaster, Curtis

    2018-04-01

    To describe the utilization of clostridial collagenase ointment (CCO) and medicinal honey debridement methods in real-world inpatient and outpatient hospital settings among pressure ulcer (PU) patients and compare the frequency of healthcare re-encounters between CCO- and medicinal honey-treated patients. De-identified hospital discharge records for patients receiving CCO or medicinal honey methods of debridement and having an ICD-9 code for PU were extracted from the US Premier Healthcare Database. Multivariable analysis was used to compare the frequency of inpatient and outpatient revisits up to 6 months after an index encounter for CCO- vs medicinal honey-treated PUs. The study identified 48,267 inpatients and 2,599 outpatients with PUs treated with CCO or medicinal honeys. Among study inpatients, n = 44,725 (93%) were treated with CCO, and n = 3,542 (7%) with medicinal honeys. CCO and medicinal honeys accounted for 1,826 (70%) and 773 (30%), respectively, of study outpatients. In adjusted models, those treated with CCO had lower odds for inpatient readmissions (OR = 0.86, 95% CI = 0.80-0.94) after inpatient index visits, and outpatient re-encounters both after inpatient (OR = 0.73, 95% CI = 0.67-0.79) and outpatient (OR = 0.78, 95% CI = 0.64-0.95) index visits in 6 months of follow-up. The study was observational in nature, and did not adjust for reasons why patients were hospitalized initially, or why they returned to the facility. Although the study adjusted for differences in a variety of demographic, clinical, and hospital characteristics between the treatments, we are not able to rule out selection bias. Patients with CCO-treated PUs returned to inpatient and outpatient hospital settings less often compared with medicinal honey-treated PUs. These results from real-world administrative data help to gain a better understanding of the clinical characteristics of patients with PUs treated with these two debridement methods and

  9. Implementing a comprehensive relative-value-based incentive plan in an academic family medicine department.

    Science.gov (United States)

    Cramer, J S; Ramalingam, S; Rosenthal, T C; Fox, C H

    2000-12-01

    The authors describe the implementation and first three years (1997-1999) of a department-wide incentive plan of the Department of Family Medicine at the State University of New York at Buffalo School of Medicine and Biomedical Sciences. By using a consensus approach, a representative elected committee designed a clinical relative value unit (explained in detail) that could be translated to equally value and reward faculty efforts in patient care, education, and research and which allowed the department to avoid the imposition of a model that could have undervalued scholarship and teaching. By 1999, the plan's goal of eight patient-care-equivalent points per four-hour session had been exceeded for pure clinical care. Clearly, only a small financial incentive was necessary (in 1999, an incentive pool of 4% of providers' gross salary) to motivate the faculty to be more productive and to self-report their efforts. Long-term productivity for pure clinical care rose from 9.8 points per session in 1997 to 10.4 in 1999. Of the mean total of 3,980 points for the year 1999, the contribution from teaching was 1,146, or 29%, compared with 25% in 1997. For scholarship, the number of points was 775, or 20%, in 1999, compared with 11% in 1997. The authors describe modifications to the original plan (e.g., integration of quality measures) that the department's experience has fostered. Problems encountered included the lack of accurate and timely billing information from the associated teaching hospitals, the inherent problems of self-reported information, difficulties of gaining buy-in from the faculty, and inherent risks of a pay-for-performance approach. But the authors conclude that the plan is fulfilling its goal of effectively and fairly quantifying all areas of faculty effort, and is also helping the department to more effectively demonstrate clinical productivity in negotiations with teaching hospitals.

  10. CAEP 2016 Academic Symposium: How to have an impact as an emergency medicine educator and scholar.

    Science.gov (United States)

    Frank, Jason R; Cheung, Warren J; Sherbino, Jonathan; Primavesi, Robert; Woods, Robert A; Bandiera, Glen; LeBlanc, Constance

    2017-05-01

    In a time of major medical education transformation, emergency medicine (EM) needs to nurture education scholars who will influence EM education practice. However, the essential ingredients to ensure a career with impact in EM education are not clear. To describe how to prepare EM educators for a high-impact career. The Canadian Association of Emergency Physicians (CAEP) Academic Section commissioned an "Education Impact" working group (IWG) to guide the creation of consensus recommendations from the EM community. EM educators from across Canada were initially recruited from the networks of the IWG members, and additional educators were recruited via snowball sampling. "High impact educators" were nominated by this network. The high impact educators were then interviewed using a structured question guide. These interviews were transcribed and coded for themes using qualitative methods. The process continued until no new themes were identified. Proposed themes and recommendations were presented to the EM community at the CAEP 2016 Academic Symposium. Feedback was then incorporated into a final set of recommendations. Fifty-five (71%) of 77 of identified Canadian EM educators participated, and 170 names of high impact educators were submitted and ranked by frequency. The IWG achieved sufficiency of themes after nine interviews. Five recommendations were made: 1) EM educators can pursue a high impact career by leveraging either traditional or innovative career pathways; 2) EM educators starting their education careers should have multiple senior mentors; 3) Early-career EM educators should immerse themselves in their area of interest and cultivate a community of practice, not limited to EM; 4) Every academic EM department and EM teaching site should have access to an EM educator with protected time and recognition for their EM education scholarship; and 5) Educators at all stages should continuously compile an impact portfolio. We describe a unique set of

  11. Women in hospital medicine in the United Kingdom: glass ceiling, preference, prejudice or cohort effect?

    Science.gov (United States)

    McManus, I C; Sproston, K A

    2000-01-01

    To assess from official statistics whether there is evidence that the careers of women doctors in hospitals do not progress in the same way as those of men. The proportions of female hospital doctors overall (1963-96), and in the specialties of medicine, surgery, obstetrics and gynaecology, pathology, radiology/radiotherapy, anaesthetics and psychiatry (1974-1996) were examined. Additionally data were examined on career preferences and intentions from pre-registration house officers, final year medical students, and medical school applicants (1966-1991). Data were analysed according to cohort of entry to medical school to assess the extent of disproportionate promotion. The proportion of women in hospital career posts was largely explained by the rapidly increasing proportion of women entering medical school during the past three decades. In general there was little evidence for disproportionate promotion of women in hospital careers, although in surgery, hospital medicine and obstetrics and gynaecology, fewer women seemed to progress beyond the SHO grade, and in anaesthetics there were deficits of women at each career stage. Analyses of career preferences and intentions suggest that disproportionate promotion cannot readily be explained as differential choice by women. Although there is no evidence as such of a "glass ceiling" for women doctors in hospital careers, and the current paucity of women consultants primarily reflects historical trends in the numbers of women entering medical school, there is evidence in some cases of disproportionate promotion that is best interpreted as direct or indirect discrimination.

  12. Improving the diversity climate in academic medicine: faculty perceptions as a catalyst for institutional change.

    Science.gov (United States)

    Price, Eboni G; Powe, Neil R; Kern, David E; Golden, Sherita Hill; Wand, Gary S; Cooper, Lisa A

    2009-01-01

    To assess perceptions of underrepresented minority (URM) and majority faculty physicians regarding an institution's diversity climate, and to identify potential improvement strategies. The authors conducted a cross-sectional survey of tenure-track physicians at the Johns Hopkins University School of Medicine from June 1, 2004 to September 30, 2005; they measured faculty perceptions of bias in department/division operational activities, professional satisfaction, career networking, mentorship, and intentions to stay in academia, and they examined associations between race/ethnicity and faculty perceptions using multivariate logistic regression. Among 703 eligible faculty, 352 (50.1%) returned surveys. Fewer than one third of respondents reported experiences of bias in department/division activities; however, URM faculty were less likely than majority faculty to believe faculty recruitment is unbiased (21.1% versus 50.6%, P = .006). A minority of respondents were satisfied with institutional support for professional development. URM faculty were nearly four times less likely than majority faculty to report satisfaction with racial/ethnic diversity (12% versus 47.1%, P = .001) and three times less likely to believe networking included minorities (9.3% versus 32.6%, P = .014). There were no racial/ethnic differences in the quality of mentorship. More than 80% of respondents believed they would be in academic medicine in five years. However, URM faculty were less likely to report they would be at their current institution in five years (42.6% versus 70.5%, P = .004). Perceptions of the institution's diversity climate were poor for most physician faculty and were worse for URM faculty, highlighting the need for more transparent and diversity-sensitive recruitment, promotion, and networking policies/practices.

  13. State of the field survey: spinal cord stimulator use by academic pain medicine practices.

    Science.gov (United States)

    Gharibo, Christopher; Laux, Gary; Forzani, Brian R; Sellars, Christopher; Kim, Eric; Zou, Shengping

    2014-02-01

    The concept of neuromodulation via the use of spinal cord stimulators (SCS) was first established over forty years ago. Since then, its popularity has grown as numerous studies have demonstrated its utility to reduce chronic pain, improve patient function, and reduce long-term health care costs. The aim of this study was to update the pain medicine community on the evolution of SCS practice trends in academic centers. Ninety-three pain medicine fellowship programs in the United States were identified from the Accreditation Council for Graduate Medical Education Website and were contacted to participate in an internet survey. A 37-item questionnaire was inspired by a previous study performed by Fanciullo et al. Questions focused on three main themes regarding SCS clinical application, namely demographics, education, and technical matters. Completed surveys were received from 50 institutions, all of which reported performing SCS interventions. Annual implants ranged from 0 to 150. Fellowship training was cited as the most valuable modality for learning implantation. Nearly all programs reported manufacturer representative participation during SCS procedures, with a minority of program directors discouraging their involvement in fellow education. SCS trials were performed exclusively on an outpatient basis. The average length for trials was 4-7 days. The most common indication for SCS implantation was failed back surgery syndrome, which also had the highest 2-year success rate. Post procedure, patients generally were followed up every 2-4 weeks for device reprogramming, which was performed by company representatives 92% of the time. Standardized SCS training is imperative as the implementation of neuromodulation therapy continues to increase. Wiley Periodicals, Inc.

  14. 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

    2016-06-07

    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. 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. 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. 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. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  15. Initial Results of the Master's Degree Programme in "Leadership in Medicine" – Impact on hospital-based follow-on training of doctors

    Directory of Open Access Journals (Sweden)

    Wulfert, Chris-Henrik

    2017-11-01

    Full Text Available Objective: This pilot project, which was jointly conducted by a hospital and a university, describes the development of the Master's Degree Programme in Leadership in Medicine, a course designed to supplement medical specialty training. The aim of the pilot project is to demonstrate how hospital-based projects on personnel and organisational development undertaken under academic supervision can be used to increase leadership responsibility among doctors whose duties include providing initial and follow-on training and to professionalise medical specialty training as a leadership task. This need arose from the nationwide requirements and an internal audit regarding follow-on training. The version of the degree programme described below aims to further the personnel development of the participants in the field of didactics. Method: Each of the nine modules is made up of two classroom-based phases and one distance learning phase. The distance learning phase involves undertaking hospital-based projects on personnel and organisational development under academic supervision. The pilot phase participants were hospital doctors who, as part of their duties, hold leadership responsibility or are involved in the follow-on training of doctors.Results: The 17 participants successfully implemented more than 30 hospital-based projects during the distance learning phases of the nine modules. These projects included the development of medical specialty curricula, relevant didactic methods and evaluation design and were subsequently presented and subjected to reflection in interdisciplinary groups. The project presentation together with the project report were regarded as proof of competency. Conclusion: In addition to enhancing participant competency, the degree model described, which interlinks theory and practice, promotes organisational development through the implementation of projects undertaken under academic supervision. This has a double impact on the

  16. Plastic surgeons' self-reported operative infection rates at a Canadian academic hospital.

    Science.gov (United States)

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

    2014-01-01

    Surgical site infection rates are of great interest to patients, surgeons, hospitals and third-party payers. While previous studies have reported hospital-acquired infection rates that are nonspecific to all surgical services, there remain no overall reported infection rates focusing specifically on plastic surgery in the literature. To estimate the reported surgical site infection rate in plastic surgery procedures over a 10-year period at an academic hospital in Canada. A review was conducted on reported plastic surgery surgical site infection rates from 2003 to 2013, based on procedures performed in the main operating room. For comparison, prospective infection surveillance data over an eight-year period (2005 to 2013) for nonplastic surgery procedures were reviewed to estimate the overall operative surgical site infection rates. A total of 12,183 plastic surgery operations were performed from 2003 to 2013, with 96 surgical site infections reported, corresponding to a net operative infection rate of 0.79%. There was a 0.49% surgeon-reported infection rate for implant-based procedures. For non-plastic surgery procedures, surgical site infection rates ranged from 0.04% for cataract surgery to 13.36% for high-risk abdominal hysterectomies. The plastic surgery infection rate at the study institution was found to be site infection rates. However, these results do not report patterns of infection rates germane to procedures, season, age groups or sex. To provide more in-depth knowledge of this topic, multicentre studies should be conducted.

  17. Narratives of Participants in National Career Development Programs for Women in Academic Medicine: Identifying the Opportunities for Strategic Investment.

    Science.gov (United States)

    Helitzer, Deborah L; Newbill, Sharon L; Cardinali, Gina; Morahan, Page S; Chang, Shine; Magrane, Diane

    2016-04-01

    Academic medicine has initiated changes in policy, practice, and programs over the past several decades to address persistent gender disparity and other issues pertinent to its sociocultural context. Three career development programs were implemented to prepare women faculty to succeed in academic medicine: two sponsored by the Association of American Medical Colleges, which began a professional development program for early career women faculty in 1988. By 1995, it had evolved into two programs one for early career women and another for mid-career women. By 2012, more than 4000 women faculty from medical schools across the U.S and Canada had participated in these intensive 3-day programs. The third national program, the Hedwig van Ameringen Executive Leadership in Academic Medicine(®) (ELAM) program for women, was developed in 1995 at the Drexel University College of Medicine. Narratives from telephone interviews representing reflections on 78 career development seminars between 1988 and 2010 describe the dynamic relationships between individual, institutional, and sociocultural influences on participants' career advancement. The narratives illuminate the pathway from participating in a career development program to self-defined success in academic medicine in revealing a host of influences that promoted and/or hindered program attendance and participants' ability to benefit after the program in both individual and institutional systems. The context for understanding the importance of these career development programs to women's advancement is nestled in the sociocultural environment, which includes both the gender-related influences and the current status of institutional practices that support women faculty. The findings contribute to the growing evidence that career development programs, concurrent with strategic, intentional support of institutional leaders, are necessary to achieve gender equity and diversity inclusion.

  18. [Susceptibility of yeasts to antifungal agents in Kaunas University of Medicine Hospital].

    Science.gov (United States)

    Skrodeniene, Erika; Dambrauskiene, Asta; Vitkauskiene, Astra

    2006-01-01

    The aim of this study was to determine the species of yeast and their susceptibility to antifungal agents isolated from clinical specimens of patients treated in Kaunas University of Medicine Hospital. A total of 142 yeasts isolated from various clinical specimens of patients hospitalized in Kaunas University of Medicine Hospital were included in this study. All yeasts were cultivated on Sabouraud dextrose agar and identified using either CHROM agar or API 20C AUX system. The minimum inhibitory concentrations of fluconazole, itraconazole, and amphotericin B were determined by the ATB FUNGUS 2 agar microdilution test. In all clinical specimens except blood, Candida albicans was the most frequently isolated yeast (65.5%, pyeast strains showed resistance to fluconazole. Nearly one-fourth of Candida albicans strains (24.7%) and 23.2% of all isolated yeast strains showed resistance to itraconazole. Almost all of fluconazole-resistant (93.3%) and 12.6% of fluconazole-susceptible yeast were found to be resistant to itraconazole (pyeast strains were susceptible to amphotericin B. Candida albicans strains were significantly frequently resistant to fluconazole than non-albicans Candida species (15.1% and 4.1%, respectively, pyeast isolated in Kaunas University of Medicine Hospital. There was determined that yeasts resistant to fluconazole were commonly resistant to itraconazole too. All isolated yeast strains were susceptible to amphotericin B.

  19. Diversity in academic medicine no. 1 case for minority faculty development today.

    Science.gov (United States)

    Nivet, Marc A; Taylor, Vera S; Butts, Gary C; Strelnick, A Hal; Herbert-Carter, Janice; Fry-Johnson, Yvonne W; Smith, Quentin T; Rust, George; Kondwani, Kofi

    2008-12-01

    For the past 20 years, the percentage of the American population consisting of nonwhite minorities has been steadily increasing. By 2050, these nonwhite minorities, taken together, are expected to become the majority. Meanwhile, despite almost 50 years of efforts to increase the representation of minorities in the healthcare professions, such representation remains grossly deficient. Among the underrepresented minorities are African and Hispanic Americans; Native Americans, Alaskans, and Pacific Islanders (including Hawaiians); and certain Asians (including Hmong, Vietnamese, and Cambodians). The underrepresentation of underrepresented minorities in the healthcare professions has a profoundly negative effect on public health, including serious racial and ethnic health disparities. These can be reduced only by increased recruitment and development of both underrepresented minority medical students and underrepresented minority medical school administrators and faculty. Underrepresented minority faculty development is deterred by barriers resulting from years of systematic segregation, discrimination, tradition, culture, and elitism in academic medicine. If these barriers can be overcome, the rewards will be great: improvements in public health, an expansion of the contemporary medical research agenda, and improvements in the teaching of both underrepresented minority and non-underrepresented minority students.

  20. Analysis of research ethics board approval times in an academic department of medicine.

    Science.gov (United States)

    Tsang, Teresa S M; Jones, Meaghan; Meneilly, Graydon S

    2015-04-01

    As part of an ongoing effort to better understand barriers to academic research, we reviewed and analyzed the process of research ethics applications, focusing on ethics approval time, within the Department of Medicine from 2006 to 2011. A total of 1,268 applications for approval to use human subjects in research were included in our analysis. Three variables, risk category (minimal vs. non-minimal risk), type of funding, and year of submission, were statistically significant for prediction of ethics approval time, with risk status being the most important of these. The covariate-adjusted mean time for approval for minimal risk studies (35.7 days) was less than half that of non-minimal risk protocols (76.5 days). Studies funded through a for-profit sponsor had significantly longer approval times than those funded through other means but were also predominantly (87%) non-minimal risk protocols. Further investigations of the reasons underlying the observed differences are needed to determine whether improved training for research ethics board (REB) members and/or greater dialogue with investigators may reduce the lengthy approval times associated with non-minimal risk protocols. © The Author(s) 2015.

  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. Factors affecting nurse retention at an academic Magnet® hospital.

    Science.gov (United States)

    Buffington, Annsley; Zwink, Jennifer; Fink, Regina; Devine, Deborah; Sanders, Carolyn

    2012-05-01

    : The aim of this study was to examine the factors affecting the retention of registered nurses (RNs) and validate the revised Casey-Fink Nurse Retention Survey (2009). : Creating an organizational culture of retention may reduce nurse turnover. Focusing on why nurses leave and identifying factors why nurses stay are essential. : A descriptive survey design gathered data from RNs with 1 or more years of experience providing direct patient care and employed in inpatient/ambulatory settings in an acute care, academic, Magnet hospital. : There were no statistically significant relationships between nurse respondents' perceptions of work environment/support/encouragement and age or years of experience. However, there were significant differences between inpatient and ambulatory nurse responses in several key areas including job satisfaction, mentorship, and educational support. Overall, nurses reported feeling a lack of support and recognition from managers. Results provide evidence to support improved strategies to foster nurse retention.

  3. Cost-Analysis of Seven Nosocomial Outbreaks in an Academic Hospital.

    Science.gov (United States)

    Dik, Jan-Willem H; Dinkelacker, Ariane G; Vemer, Pepijn; Lo-Ten-Foe, Jerome R; Lokate, Mariëtte; Sinha, Bhanu; Friedrich, Alex W; Postma, Maarten J

    2016-01-01

    Nosocomial outbreaks, especially with (multi-)resistant microorganisms, are a major problem for health care institutions. They can cause morbidity and mortality for patients and controlling these costs substantial amounts of funds and resources. However, how much is unclear. This study sets out to provide a comparable overview of the costs of multiple outbreaks in a single academic hospital in the Netherlands. Based on interviews with the involved staff, multiple databases and stored records from the Infection Prevention Division all actions undertaken, extra staff employment, use of resources, bed-occupancy rates, and other miscellaneous cost drivers during different outbreaks were scored and quantified into Euros. This led to total costs per outbreak and an estimated average cost per positive patient per outbreak day. Seven outbreaks that occurred between 2012 and 2014 in the hospital were evaluated. Total costs for the hospital ranged between €10,778 and €356,754. Costs per positive patient per outbreak day, ranged between €10 and €1,369 (95% CI: €49-€1,042), with a mean of €546 and a median of €519. Majority of the costs (50%) were made because of closed beds. This analysis is the first to give a comparable overview of various outbreaks, caused by different microorganisms, in the same hospital and all analyzed with the same method. It shows a large variation within the average costs due to different factors (e.g. closure of wards, type of ward). All outbreaks however cost considerable amounts of efforts and money (up to €356,754), including missed revenue and control measures.

  4. Cost-Analysis of Seven Nosocomial Outbreaks in an Academic Hospital.

    Directory of Open Access Journals (Sweden)

    Jan-Willem H Dik

    Full Text Available Nosocomial outbreaks, especially with (multi-resistant microorganisms, are a major problem for health care institutions. They can cause morbidity and mortality for patients and controlling these costs substantial amounts of funds and resources. However, how much is unclear. This study sets out to provide a comparable overview of the costs of multiple outbreaks in a single academic hospital in the Netherlands.Based on interviews with the involved staff, multiple databases and stored records from the Infection Prevention Division all actions undertaken, extra staff employment, use of resources, bed-occupancy rates, and other miscellaneous cost drivers during different outbreaks were scored and quantified into Euros. This led to total costs per outbreak and an estimated average cost per positive patient per outbreak day.Seven outbreaks that occurred between 2012 and 2014 in the hospital were evaluated. Total costs for the hospital ranged between €10,778 and €356,754. Costs per positive patient per outbreak day, ranged between €10 and €1,369 (95% CI: €49-€1,042, with a mean of €546 and a median of €519. Majority of the costs (50% were made because of closed beds.This analysis is the first to give a comparable overview of various outbreaks, caused by different microorganisms, in the same hospital and all analyzed with the same method. It shows a large variation within the average costs due to different factors (e.g. closure of wards, type of ward. All outbreaks however cost considerable amounts of efforts and money (up to €356,754, including missed revenue and control measures.

  5. Consultation clinics for complementary and alternative medicine at Japanese university hospitals: An analysis at Tokushima University Hospital

    Science.gov (United States)

    YANAGAWA, HIROAKI; TERAO, JUNJI; TAKEDA, EIJI; TAKAISHI, YOSHIHISA; KASHIWADA, YOSHIKI; KAWAZOE, KAZUYOSHI; FUSHITANI, SHUJI; TSUCHIYA, KOICHIRO; YAMAUCHI, AIKO; SATO, CHIHO; IRAHARA, MINORU

    2010-01-01

    Here, we report on a Consultation Clinic for Complementary and Alternative Medicine (CAM) which we established at Tokushima University Hospital in July of 2007 with the aim of providing person-to-person information on CAM, though not CAM therapy itself. In December of 2008, we received 55 applications for consultation, 37% concerning health foods, 37% Japanese herbal medicine (Kampo), and 26% various other topics. The consultants (nutritionists and pharmacists) communicated individually with 38 applicants; malignancies (26%) and cardiovascular disease (24%) were the main underlying concerns. To promote the quality of consultation, data was collected by means of focus group interviews concerning the perspective of the consultants. Safe and effective use of CAM requires a network of communication linking individuals, consultation teams, physicians, primary care institutions and university hospitals. To advance this goal, we plan to broaden the efforts described herein. Our findings indicate that the specific role of the consultation clinic in promoting the scientific use of CAM merits further study. PMID:22993564

  6. Quality of communication about medicines in United States hospitals: A national retrospective study.

    Science.gov (United States)

    Mullings, Lauren; Sankaranarayanan, Jayashri

    Despite the benefits of improving transitions across care, literature is very limited on inpatient "Communication about Medicines" (ComMed) by staff across United States (U.S.) hospitals. To evaluate ComMed quality variations by hospital characteristics. In a cross-sectional, retrospective study of publicly available U.S. Medicare's Hospital Consumer Assessment of Health Care Plans Survey (HCAHPS) data (January 2013-September 2014), ComMed quality (high = above average/excellent vs. low = average/below average/poor star ratings) of 3125 hospitals were compared across region, rural-urban location, and health information technology (HIT) infrastructure giving providers access to patients' electronic medical records. Multivariate logistic regression analysis was conducted with adjusting for confounders (hospital - bed size, ownership, type, ED services, the number of completed HCAHPS surveys). After adjusting for other characteristics, Midwest versus Western region hospitals (OR = 1.55, 95% CI: 1.21-1.98, p=quality. Hospitals' small bed-size, physician/non-profit ownership, critical-access type, absent ED services, and 100-299 HCAHPS completed surveys were more likely to be associated with high ComMed quality. One of the first national studies found significant variations in ComMed quality across U.S. hospitals by location (high in Midwest and low in Northeast regions and urban areas) and by access to HIT infrastructure (high) after controlling for other hospital characteristics. With this baseline data, hospital providers and policymakers can design, implement, and evaluate service programs with pharmacists and HIT to enhance ComMed quality in the future delivery of patient-centered care. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Perspective: Adopting an Asset Bundle Model to Support and Advance Minority Students’ Careers in Academic Medicine and the Scientific Pipeline

    OpenAIRE

    Johnson, Japera; Bozeman, Barry

    2012-01-01

    The authors contend that increasing diversity in the scientific pipeline (e.g., academic medicine, science, technology, engineering and mathematics) requires a systematic approach to retain minority high school and college students. 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 continge...

  8. Multidisciplinary education in geriatric medicine. Continuing experience at the Middlesex Hospital.

    Science.gov (United States)

    Beynon, G P; Croker, J

    1983-01-01

    The unique feature about the course in teaching geriatric medicine to undergraduates at the Middlesex Hospital is its multidisciplinary nature. The course lasts for three weeks during the first or second clinical year and involves medical students together with student physiotherapists, nurses and occupational therapists. All take part in seminars, ward rounds and multidisciplinary case presentations. A full-time course organizer funded by the School of Nursing manages the course. Assessment includes MCQ and course evaluation questionnaire and an essay.

  9. Barriers towards the publication of academic drug trials. Follow-up of trials approved by the Danish Medicines Agency.

    Science.gov (United States)

    Berendt, Louise; Petersen, Lene Grejs; Bach, Karin Friis; Poulsen, Henrik Enghusen; Dalhoff, Kim

    2017-01-01

    To characterize and quantify barriers towards the publication of academic drug trials. We identified academic drug trials approved during a 3-year period (2004-2007) by the Danish Medicines Agency. We conducted a survey among the trial sponsors to describe the rates of initiation, completion, and publication, and the reasons for the failure to reach each of these milestones. Information on size and methodological characteristics of the trials was extracted from the EudraCT database, a prospective register of all approved clinical drug trials submitted to European medicines agencies since 2004. A total of 181 academic drug trials were eligible for inclusion, 139 of which participated in our survey (response rate: 77%). Follow-up time ranged from 5.1 to 7.9 years. Most trials were randomized controlled trials (73%, 95% CI 65-81%). Initiation and completion rates were 92% (95% CI: 88-97%) and 93% (95% CI: 89-97%) respectively. The publication rate of completed trials was 73% (95% CI: 62-79%). RCTs were published faster than non-RCTs (quartile time to publication 2.9 vs. 3.1 years, p = 0.0412). Many academic drug trials are left unpublished. Main barriers towards publication were related to the process from completion to publication. Hence, there is much to gain by facilitating the process from analysis to publication. Research institutions and funders should actively influence this process, e.g. by requiring the publication of trial results within a given time after completion.

  10. A modified Elixhauser score for predicting in-hospital mortality in internal medicine admissions.

    Science.gov (United States)

    Fabbian, Fabio; De Giorgi, Alfredo; Maietti, Elisa; Gallerani, Massimo; Pala, Marco; Cappadona, Rosaria; Manfredini, Roberto; Fedeli, Ugo

    2017-05-01

    In-hospital mortality (IHM) is an indicator of the quality of care provided. The two most widely used scores for predicting IHM by International Classification of Diseases (ICD) codes are the Elixhauser (EI) and the Charlson Comorbidity indexes. Our aim was to obtain new measures based on internal medicine ICD codes for the original EI, to detect risk for IHM. This single-center retrospective study included hospital admissions for any cause in the department of internal medicine between January 1, 2000, and December 31, 2013, recorded in the hospital database. The EI was calculated for evaluation of comorbidity, then we added age, gender and diagnosis of ischemic heart disease. IHM was our outcome. Only predictors positively associated with IHM were taken into consideration and the Sullivan's method was applied in order to modify the parameter estimates of the regression model into an index. We analyzed 75,586 admissions (53.4% females) and mean age was 72.7±16.3years. IHM was 7.9% and mean score was 12.1±7.6. The points assigned to each condition ranged from 0 to 16, and the possible range of the score varied between 0 and 89. In our population the score ranged from 0 to 54, and it was higher in the deceased group. Receiver operating characteristic curve of the new score was 0.721 (95% CI 0.714-0.727, pInternal Medicine. Published by Elsevier B.V. All rights reserved.

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

    International Nuclear Information System (INIS)

    Wilson, G.W.

    1976-01-01

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

  12. Results of an academic promotion and career path survey of faculty at the Johns Hopkins University School of Medicine.

    Science.gov (United States)

    Thomas, Patricia A; Diener-West, Marie; Canto, Marcia I; Martin, Don R; Post, Wendy S; Streiff, Michael B

    2004-03-01

    Clinician-educator faculty are increasing in numbers in academic medical centers, but their academic advancement is slower than that of research faculty. The authors sought to quantify the magnitude of this difference in career advancement and to explore the characteristics of faculty that might explain the difference. In 1999, a questionnaire was administered to all MD faculty at the rank of instructor and above (259) in the Department of Medicine at the Johns Hopkins University School of Medicine. A total of 180 (69%) faculty returned questionnaires. Of these, 178 identified with one of four career paths: basic researcher (46), clinical researcher (69), academic clinician (38), or teacher-clinician (25). Career path did not differ by age, gender, rank, years on faculty, hours worked per week, family responsibility, or global work satisfaction. After adjusting for age, gender, time at rank, and work satisfaction, the odds of being at a higher rank were 85% less for academic clinicians (odds ratio,.15; 95% confidence interval, 0.06-0.40) and 69% less for teacher-clinicians (odds ratio,.31; 95% confidence interval, 0.11-0.88) than for basic researchers. Clinical researchers did not differ from basic researchers in the likelihood of being at higher rank. Similarly, compared with basic research faculty, the adjusted odds of being more satisfied with progress towards academic promotion were 92% lower for academic clinicians and 87% lower for teacher-clinicians. Clinician-educator faculty were less likely to be at higher rank at this institution than were faculty in research paths. Differences in rank may be explained by lower rank at hire for faculty in these career paths, time available for scholarly activities, or other resources available to support scholarship. Retaining clinician-educators will require further exploration of barriers to promotion inherent to these career paths and methods of modifying these barriers.

  13. Paramedics' experiences of financial medicine practices in the pre-hospital environment. A pilot study

    Directory of Open Access Journals (Sweden)

    Craig Vincent-Lambert

    2016-10-01

    Objectives: This qualitative pilot study explored and described the experiences of South African Paramedics with regard to the practicing of financial medicine in the local pre-hospital emergency care environment. Method: A sample of South African Paramedics were interviewed either face-to-face or telephonically. The interviews were audio recorded and transcripts produced. Content analysis was conducted to explore, document and describe the participants' experiences with regard to financial medicine practices in the local pre-hospital environment. Results: It emerged that all of the participants had experienced a number of financial medicine practices and associated unethical conduct. Examples included Over-servicing, Selective Patient Treatment, Fraudulent Billing Practices, Eliciting of kickbacks, incentives or benefits and Deliberate Time Wasting. Conclusion: The results of this study are concerning as the actions of service providers described by the participants constitute gross violations of the ethical and professional guidelines for health care professionals. The authors recommend additional studies be conducted to further explore these findings and to establish the reasons for, and ways of, limiting financial medicine practices in the South African emergency care environment.

  14. Gender equity programmes in academic medicine: a realist evaluation approach to Athena SWAN processes.

    Science.gov (United States)

    Caffrey, Louise; Wyatt, David; Fudge, Nina; Mattingley, Helena; Williamson, Catherine; McKevitt, Christopher

    2016-09-08

    Gender inequity has persisted in academic medicine. Yet equity is vital for countries to achieve their full potential in terms of translational research and patient benefit. This study sought to understand how the gender equity programme, Athena SWAN, can be enabled and constrained by interactions between the programme and the context it is implemented into, and whether these interactions might produce unintended consequences. Multimethod qualitative case studies using a realist evaluation approach. 5 departments from a university medical school hosting a Translational Research Organisation. 25 hours of observations of gender equality committee meetings, 16 in-depth interviews with Heads of Departments, Committee Leads and key personnel involved in the initiative. 4 focus groups with 15 postdoctoral researchers, lecturers and senior lecturers. The implementation of Athena SWAN principles was reported to have created social space to address gender inequity and to have highlighted problematic practices to staff. However, a number of factors reduced the programme's potential to impact gender inequity. Gender inequity was reproduced in the programme's enactment as female staff was undertaking a disproportionate amount of Athena SWAN work, with potential negative impacts on individual women's career progression. Early career researchers experienced problems accessing Athena SWAN initiatives. Furthermore, the impact of the programme was perceived to be undermined by wider institutional practices, national policies and societal norms, which are beyond the programme's remit. Gender equity programmes have the potential to address inequity. However, paradoxically, they can also unintentionally reproduce and reinforce gender inequity through their enactment. Potential programme impacts may be undermined by barriers to staff availing of career development and training initiatives, and by wider institutional practices, national policies and societal norms. Published by the

  15. Evaluation of and Feedback for Academic Medicine Leaders: Developing and Implementing the Memorial Method.

    Science.gov (United States)

    Rourke, James; Bornstein, Stephen; Vardy, Cathy; Speed, David; White, Tyrone; Corbett, Paula

    2017-11-01

    Giving and receiving honest and helpful feedback for leadership development is a common challenge in all types of organizations but particularly in academic medicine. At Memorial University of Newfoundland, in 2014, a consensus emerged to develop a new method for evaluating the leadership performance of the discipline chairs, dean, and vice dean, and to provide these leaders with the evaluation results to help them improve their performance. The leaders responsible for developing and implementing this method (called the Memorial Method) decided to use a survey to obtain faculty members' perceptions about their leader's performance. Beginning in October 2014, a portion of several regular meetings of the discipline chairs with the dean and vice dean was used to develop the survey, by first discussing the broad dimensions of leadership performance, then discussing these dimensions in more detail and drafting specific questions. The resulting survey included 44 quantitative questions addressing eight leadership dimensions. In March-April 2015, the survey was administered electronically to full-time faculty members on a confidential basis. The results were compiled and reported to each discipline chair and to the dean and vice dean. In total, 144/249 faculty responded to the survey (response rate: 58%). For the various dimensions, individual chairs' mean scores ranged from 2.82 to 4.70, and overall mean scores ranged from 3.57 to 4.24. Psychometric properties of the survey suggested it was both reliable and valid. The survey will be repeated, this time with part-time as well as full-time faculty included.

  16. Worklife and Wellness in Academic General Internal Medicine: Results from a National Survey.

    Science.gov (United States)

    Linzer, Mark; Poplau, Sara; Babbott, Stewart; Collins, Tracie; Guzman-Corrales, Laura; Menk, Jeremiah; Murphy, Mary Lou; Ovington, Kay

    2016-09-01

    General internal medicine (GIM) careers are increasingly viewed as challenging and unsustainable. We aimed to assess academic GIM worklife and determine remediable predictors of stress and burnout. We conducted an email survey. Physicians, nurse practitioners, and physician assistants in 15 GIM divisions participated. A ten-item survey queried stress, burnout, and work conditions such as electronic medical record (EMR) challenges. An open-ended question assessed stressors and solutions. Results were categorized into burnout, high stress, high control, chaos, good teamwork, high values alignment, documentation time pressure, and excessive home EMR use. Frequencies were determined for national data, Veterans Affairs (VA) versus civilian populations, and hospitalist versus ambulatory roles. A General Linear Mixed Model (GLMM) evaluated associations with burnout. A formal content analysis was performed for open-ended question responses. Of 1235 clinicians sampled, 579 responded (47 %). High stress was present in 67 %, with 38 % burned out (burnout range 10-56 % by division). Half of respondents had low work control, 60 % reported high documentation time pressure, half described too much home EMR time, and most reported very busy or chaotic workplaces. Two-thirds felt aligned with departmental leaders' values, and three-quarters were satisfied with teamwork. Burnout was associated with high stress, low work control, and low values alignment with leaders (all p less burnout than civilian counterparts (17 % vs. 40 %, p stress and burnout, division rates vary widely. Sustainability efforts within GIM could focus on visit length, staff support, schedule control, clinic chaos, and EMR stress.

  17. Stenotrophomonas maltophilia in a university hospital of traditional Chinese medicine: molecular epidemiology and antimicrobial resistance.

    Science.gov (United States)

    Zhao, S; Yang, L; Liu, H; Gao, F

    2017-07-01

    Stenotrophomona maltophilia has emerged as an important opportunistic pathogen that is highly antibiotic resistant. Analysis of antibiotic susceptibilities, drug-resistant gene profiles and molecular typing of S. maltophilia was undertaken in a university hospital of traditional Chinese medicine in East China. Resistance to sulphamethoxazole (SXT) was found to be an indicator of multi-drug resistance. SXT resistance was mediated by sul and dfrA genes in integrons, especially class 1. Some evidence of clonal dissemination was found, indicating the occurrence of cross-transmission of antibiotic-resistant strains within the hospital. This underscores the need for effective control and prevention measures in hospitals. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  18. Mentorship perceptions and experiences among academic family medicine faculty: Findings from a quantitative, comprehensive work-life and leadership survey.

    Science.gov (United States)

    Stubbs, Barbara; Krueger, Paul; White, David; Meaney, Christopher; Kwong, Jeffrey; Antao, Viola

    2016-09-01

    To collect information about the types, frequency, importance, and quality of mentorship received among academic family medicine faculty, and to identify variables associated with receiving high-quality mentorship. Web-based survey of all faculty members of an academic department of family medicine. The Department of Family and Community Medicine of the University of Toronto in Ontario. All 1029 faculty members were invited to complete the survey. Receiving mentorship rated as very good or excellent in 1 or more of 6 content areas relevant to respondents' professional lives, and information about demographic and practice characteristics, faculty ratings of their local departments and main practice settings, teaching activities, professional development, leadership, job satisfaction, and health. Bivariate and multivariate analyses identified variables associated with receiving high-quality mentorship. The response rate was 66.8%. Almost all (95.0%) respondents had received mentorship in several areas, with informal mentorship being the most prevalent mode. Approximately 60% of respondents rated at least 1 area of mentoring as very good or excellent. Multivariate logistic regression identified 5 factors associated with an increased likelihood of rating mentorship quality as very good or excellent: positive perceptions of their local department (odds ratio [OR] = 4.02, 95% CI 2.47 to 6.54, P teachers, family medicine faculties will need to develop strategies to support effective mentorship across a range of settings and career stages. Copyright© the College of Family Physicians of Canada.

  19. 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.

  20. Systems of Career Influences: A Conceptual Model for Evaluating the Professional Development of Women in Academic Medicine

    Science.gov (United States)

    Helitzer, Deborah; Morahan, Page; Chang, Shine; Gleason, Katharine; Cardinali, Gina; Wu, Chih-Chieh

    2012-01-01

    Abstract Background Surprisingly little research is available to explain the well-documented organizational and societal influences on persistent inequities in advancement of women faculty. Methods The Systems of Career Influences Model is a framework for exploring factors influencing women's progression to advanced academic rank, executive positions, and informal leadership roles in academic medicine. The model situates faculty as agents within a complex adaptive system consisting of a trajectory of career advancement with opportunities for formal professional development programming; a dynamic system of influences of organizational policies, practices, and culture; and a dynamic system of individual choices and decisions. These systems of influence may promote or inhibit career advancement. Within this system, women weigh competing influences to make career advancement decisions, and leaders of academic health centers prioritize limited resources to support the school's mission. Results and Conclusions The Systems of Career Influences Model proved useful to identify key research questions. We used the model to probe how research in academic career development might be applied to content and methods of formal professional development programs. We generated a series of questions and hypotheses about how professional development programs might influence professional development of health science faculty members. Using the model as a guide, we developed a study using a quantitative and qualitative design. These analyses should provide insight into what works in recruiting and supporting productive men and women faculty in academic medical centers. PMID:23101486

  1. Effect of obesity on academic grades among Saudi female medical students at College of Medicine, King Saud University: Pilot study.

    Science.gov (United States)

    Suraya, Faryal; Meo, Sultan Ayoub; Almubarak, Zaid; Alqaseem, Yazeed Abdullah

    2017-08-01

    The aim was to investigate the effect of obesity on academic grades among Saudi female medical students. This cross sectional study was conducted in the Department of Plastic Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia during the period November 2014 to June 2015. In all 191 second and third year female medical students with an average age of 21.31 years and body mass indices 15-40 were included. An English language questionnaire was established to obtain the information about age, gender, body mass index, level of study and the academic grades [Grade Point Average-GPA]. Female medical students with BMI 21-25 and 26-30 achieved high GPA while female medical students with higher BMI 31-35 and greater than 36 obtained low GPA. High BMI in female medical students impair the academic performance. The academic institutes must establish extra-curricular physical fitness policies to minimize the obesity and achieve better health and academic outcomes.

  2. Systems of career influences: a conceptual model for evaluating the professional development of women in academic medicine.

    Science.gov (United States)

    Magrane, Diane; Helitzer, Deborah; Morahan, Page; Chang, Shine; Gleason, Katharine; Cardinali, Gina; Wu, Chih-Chieh

    2012-12-01

    Surprisingly little research is available to explain the well-documented organizational and societal influences on persistent inequities in advancement of women faculty. The Systems of Career Influences Model is a framework for exploring factors influencing women's progression to advanced academic rank, executive positions, and informal leadership roles in academic medicine. The model situates faculty as agents within a complex adaptive system consisting of a trajectory of career advancement with opportunities for formal professional development programming; a dynamic system of influences of organizational policies, practices, and culture; and a dynamic system of individual choices and decisions. These systems of influence may promote or inhibit career advancement. Within this system, women weigh competing influences to make career advancement decisions, and leaders of academic health centers prioritize limited resources to support the school's mission. The Systems of Career Influences Model proved useful to identify key research questions. We used the model to probe how research in academic career development might be applied to content and methods of formal professional development programs. We generated a series of questions and hypotheses about how professional development programs might influence professional development of health science faculty members. Using the model as a guide, we developed a study using a quantitative and qualitative design. These analyses should provide insight into what works in recruiting and supporting productive men and women faculty in academic medical centers.

  3. [Assessing research productivity in Department of Internal Medicine, University of Zagreb, School of Medicine and University Hospital Centre Zagreb].

    Science.gov (United States)

    Petrak, Jelka; Sember, Marijan; Granić, Davorka

    2012-01-01

    Bibliometric analysis may give an objective information about publishing activity, citation rate and collaboration patterns of individuals, groups and institutions. The publication productivity of the present medical staff (79 with specialist degree and 22 residents) in Department of Internal Medicine, University of Zagreb School of Medicine in University Hospital Centre Zagreb was measured by the number of papers indexed by Medline, their impact was measured by the number of times these papers had subsequently been cited in the medical literature, while the collaboration pattern was estimated by the authors' addresses listed in the papers. PubMed database was a source for verifying the bibliographic data, and the citation data were searched via Thomson Web of Scence (WoS) platform. There were a total of 1182 papers, published from 1974 to date. The number of papers per author ranged from 0 to 252. Sixty of papers were published in English, and 39% in Croatian language. The roughly equal share was published in local and foreign journals. The RCT studies and practice guidelines were among the most cited papers and were at the same time published by the highly ranked journals. The collaboration analysis confirmed the extensive involment in the international multicentric clinical trials as well as in the development of international/local practice guidelines.

  4. Use of herbal medicine among pregnant women on antenatal care at nekemte hospital, Western ethiopia.

    Science.gov (United States)

    Bayisa, Bodena; Tatiparthi, Ramanjireddy; Mulisa, Eshetu

    2014-11-01

    Investigations across the world confirm dramatic increment in the use of complementary and alternative medicine in pregnant women. The most important aspect is lack of awareness of pregnant women about potential effects of using traditional medicine on fetus; some herbal products may be teratogenic in human and animal models. In this area, so far, no research has been conducted in Ethiopia to assess traditional medicine use in pregnant women. Therefore, the main objective of this study was to investigate the prevalence and use of herbal drugs among pregnant women attending Nekemte Hospital to provide baseline information for future studies. A cross-sectional descriptive study was conducted by quantitative and qualitative approaches to identify the prevalence of using herbal medicines among pregnant women. About 50.4% of study participants used herbal drugs during their pregnancy. The proportion of herbal drug usage was gradually decreased along with the first, second and third trimesters of pregnancy. The most and least commonly used herbs were ginger (44.36%) and tenaadam (9.15 %), respectively. The common indications of herbal remedies use during pregnancy were nausea (23.90%) and morning sickness (21.05%). The result of the present study confirmed wide use of herbal drugs use during pregnancy that need to report the safety concerns of these drugs during pregnancy. To achieve the requirements of pregnant women, it is vital for health care workers to be familiar with the effect of herbal medicine in pregnancy.

  5. Women in hospital medicine in the United Kingdom: glass ceiling, preference, prejudice or cohort effect?

    Science.gov (United States)

    McManus, I; Sproston, K

    2000-01-01

    OBJECTIVE—To assess from official statistics whether there is evidence that the careers of women doctors in hospitals do not progress in the same way as those of men.
DESIGN—The proportions of female hospital doctors overall (1963-96), and in the specialties of medicine, surgery, obstetrics and gynaecology, pathology, radiology/radiotherapy, anaesthetics and psychiatry (1974-1996) were examined. Additionally data were examined on career preferences and intentions from pre-registration house officers, final year medical students, and medical school applicants (1966-1991).
ANALYSIS—Data were analysed according to cohort of entry to medical school to assess the extent of disproportionate promotion.
RESULTS—The proportion of women in hospital career posts was largely explained by the rapidly increasing proportion of women entering medical school during the past three decades. In general there was little evidence for disproportionate promotion of women in hospital careers, although in surgery, hospital medicine and obstetrics and gynaecology, fewer women seemed to progress beyond the SHO grade, and in anaesthetics there were deficits of women at each career stage. Analyses of career preferences and intentions suggest that disproportionate promotion cannot readily be explained as differential choice by women.
CONCLUSIONS—Although there is no evidence as such of a "glass ceiling" for women doctors in hospital careers, and the current paucity of women consultants primarily reflects historical trends in the numbers of women entering medical school, there is evidence in some cases of disproportionate promotion that is best interpreted as direct or indirect discrimination.

 PMID:10692956

  6. Assessment of academic/non-academic factors and extracurricular activities influencing performance of medical students of faculty of medicine, Universiti Sultan Zainal Abidin, Malaysia

    Directory of Open Access Journals (Sweden)

    Mainul Haque

    2018-01-01

    Full Text Available Background: Physical and mental comfort is known to have a crucial influence on health and performance amongst medical students. Very often, medical students suffer from poor quality of life (QOL related to the work-life balance due to the lack of sleep, nutritional and dietary disorders and low physical activity, resulting in a negative impact on their academic performance. This study aims to determine the potential academic/non-academic factors and extra-curricular activities influencing the performance of medical students in Universiti Sultan Zainal Abidin (UniSZA. Materials and Methods: This was a cross-sectional study conducted on medical students at the Faculty of Medicine, UniSZA, Terengganu, Malaysia. A sample size of 300 respondents were recruited from Year I to V medical students. The questionnaire was adopted, modified and validated from a similar study in Saudi Arabia. Results: Majority of the students enjoy medical education are self-motivated, have a good command of English, non-smokers and have a sufficient sleep. Conclusion: University medical students possess good QOL within the optimum educational environment.

  7. Pharmacovigilance study of Ayurvedic medicine in Ayurvedic Teaching Hospital: A prospective survey study.

    Science.gov (United States)

    Ajanal, Manjunath N; Nayak, Shradda U; Kadam, Avinash P; Prasad, B S

    2015-01-01

    Though Ayurveda is practiced in the Indian subcontinent since centuries, there is a paucity of systematic documentation related to the occurrence of adverse drug reactions (ADR) and other issues regarding the safety of Ayurveda medicines. To monitor and analyze the pattern and frequency of ADR to Ayurvedic medicines in an Ayurvedic hospital setup. In this prospective study, ADR monitoring was done in KLE Ayurveda Secondary Care Hospital, Belgaum, Karnataka, India by spontaneous and intensive monitoring technique for a span of 1-year (June 2010 to May 2011). Data pertaining to patient demography, drug and reaction characteristics, organ system involved and reaction outcomes were collected and evaluated. The reaction severity and predisposing factors were also assessed. In a span of one year, 84 adverse drug events were reported out of which 52 confirmed as ADR. The overall incidence of ADR in the patient population was 1.14%, out of which 23 (44.23%) were related to Panchakarma (detoxification process), 13 (25.00%) related to the herbal formulations and 06 (11.53%) were of Rasa Aushadhi (mineral or herbo-mineral formulations). The commonly affected organ systems were gastrointestinal system 24 (46.15%) and skin 15 (28.84%). The majority of the reactions were moderate 30 (57.69%) to mild 20 (38.46%) in severity. Most patients recovered from the incidence. The present work has documented the incidence and characteristic of ADR to Ayurvedic medicine in a typical Ayurveda hospital setup. This will help in developing various strategies for boosting pharmacovigilance in Ayurveda, thereby ensuring safer use of Ayurveda medicines.

  8. Drug utilization pattern of Chinese herbal medicines in a general hospital in Taiwan.

    Science.gov (United States)

    Chen, L C; Wang, B R; Chou, Y C; Tien, J H

    2005-09-01

    Drug utilization studies are important for the optimization of drug therapy and have received a great attention in recent years. Most of the information on drug use patterns has been derived from studies in modern Western medicines; however, studies regarding the drug utilization of traditional Chinese medicine (CM) are few. The present study was the first clinical research to evaluate the drug utilization patterns of Chinese herbal medicines in a general hospital in Taiwan. Data were collected prospectively from the patients attending the Traditional Medicine Center of Taipei Veteran General Hospital under CM drug treatments. The study was carried out over a period of 1 year, from January 2002 to December 2002. Core drug use indicators, such as the average number of drugs per prescriptions, the dosing frequency of prescriptions, and the most common prescribed CM herbs and formulae were evaluated. The primary diagnosis and the CM drugs prescribed for were also revealed. All data were analyzed by descriptive statistics. A total of 10 737 patients, representing 52 255 CM drugs, were screened during the study period. Regarding the prescriptions, the average number of drugs per prescription was 4.87 and 37.21% of prescriptions were composed by five drugs. Most of prescriptions (91.38%) were prescribed for three times a day. The most often prescribed Chinese herb was Hong-Hwa (5.76%) and the most common Chinese herbal formula was Jia-Wey-Shiau-Yau-San (3.80%). The most frequent main diagnosis was insomnia (15.58%), followed by menopause (5.22%) and constipation (5.09%). The survey revealed the drug use pattern of CMs in a general hospital. The majority of CM prescriptions were composed by 3-6 drugs and often prescribed for three times a day. Generally, the rational drug uses of CM drugs were provided with respect to the various diagnoses. (c) 2005 John Wiley & Sons, Ltd.

  9. Road map to a patient-centered research agenda at the intersection of hospital medicine and geriatric medicine.

    Science.gov (United States)

    Wald, Heidi L; Leykum, Luci K; Mattison, Melissa L P; Vasilevskis, Eduard E; Meltzer, David O

    2014-06-01

    As the United States ages, the patient population in acute care hospitals is increasingly older and more medically complex. Despite evidence of a high burden of disease, high costs, and often poor outcomes of care, there is limited understanding of the presentation, diagnostic strategies, and management of acute illness in older adults. In this paper, we present a strategy for the development of a research agenda at the intersection of hospital and geriatric medicine. This approach is informed by the Patient-Centered Outcomes Research Institute (PCORI) framework for identification and prioritization of research areas, emphasizing input from patients and caregivers. The framework's four components are: 1) Topic generation, 2) Gap Analysis in Systematic Review, 3) Value of information (VOI) analysis, and 4) Peer Review. An inclusive process for topic generation requiring the systematic engagement of multiple stakeholders, especially patients, is emphasized. In subsequent steps, researchers and stakeholders prioritize research topics in order to identify areas that optimize patient-centeredness, population impact, impact on clinical decision making, ease of implementation, and durability. Finally, next steps for dissemination of the research agenda and evaluation of the impact of the patient-centered research prioritization process are described.

  10. Auditing of clinical research ethics in a children's and women's academic hospital.

    Science.gov (United States)

    Bortolussi, Robert; Nicholson, Diann

    2002-06-01

    Canadian and international guidelines for research ethics practices have advocated that research ethics boards (REBs) should implement mechanisms to review and monitor human research. Despite this, few Canadian REBs fulfil this expectation. The objective of this report is to summarize the results of 6 audits of clinical research ethics conducted between 1992 and 2000 in a children's and women's academic hospital in Canada in an effort to guide other academic centres planning a similar process. Research audits were conducted by members of a research audit review committee made up of REB volunteers. With use of random and selective processes, approximately 10% of research protocols were audited through interviews with research investigators and research coordinators and by sampling research records. Predetermined criteria were used to assess evidence of good record keeping, data monitoring, adherence to protocol, consents and the recording of adverse events during the research study. An estimate of time required to undertake an audit was made by recall of participants and records. Thirty-five research studies were reviewed including 16 multicentre clinical trials and 19 single-site clinical studies. Review of record keeping and research practice revealed some deficiencies: researchers failed to maintain original authorization (7%) or renewal documentation (9%); there was 1 instance of improper storage of medication; in 5% of 174 participants for whom consent was reviewed, an outdated consent form had been used, and in 4% the signature of the enrolee was not properly shown. Other deficiencies in consent documentation occurred in less than 2% of cases. Nineteen recommendations were made with respect to deficiencies and process issues. A total of 9 to 20 person-hours are required to review each protocol in a typical audit of this type. Information from research audits has been useful to develop educational programs to correct deficiencies identified through the audits

  11. Good practice or positive action? Using Q methodology to identify competing views on improving gender equality in academic medicine.

    Science.gov (United States)

    Bryant, Louise D; Burkinshaw, Paula; House, Allan O; West, Robert M; Ward, Vicky

    2017-08-22

    The number of women entering medicine has increased significantly, yet women are still under-represented at senior levels in academic medicine. To support the gender equality action plan at one School of Medicine, this study sought to (1) identify the range of viewpoints held by staff on how to address gender inequality and (2) identify attitudinal barriers to change. Q methodology. 50 potential interventions representing good practice or positive action, and addressing cultural, organisational and individual barriers to gender equality, were ranked by participants according to their perception of priority. The School of Medicine at the University of Leeds, UK. Fifty-five staff members were purposively sampled to represent gender and academic pay grade. Principal components analysis identified six competing viewpoints on how to address gender inequality. Four viewpoints favoured positive action interventions: (1) support careers of women with childcare commitments, (2) support progression of women into leadership roles rather than focus on women with children, (3) support careers of all women rather than just those aiming for leadership, and (4) drive change via high-level financial and strategic initiatives. Two viewpoints favoured good practice with no specific focus on women by (5) recognising merit irrespective of gender and (6) improving existing career development practice. No viewpoint was strongly associated with gender, pay grade or role; however, latent class analysis identified that female staff were more likely than male to prioritise the setting of equality targets. Attitudinal barriers to the setting of targets and other positive action initiatives were identified, and it was clear that not all staff supported positive action approaches. The findings and the approach have utility for those involved in gender equality work in other medical and academic institutions. However, the impact of such initiatives needs to be evaluated in the longer term.

  12. Development of pediatric emergency medicine at Addis Ababa University/Tikuranbessa Specialized Hospital, Ethiopia.

    Science.gov (United States)

    Tefera, Muluwork; Bacha, Tigist; Butteris, Sabrina; Teshome, Getachew; Ross, Joshua; Hagen, Scott; Svenson, Jim; Busse, Heidi; Tefera, Girma

    2014-07-01

    In the world emergencies occur everywhere, and each day they consume ressources regardless of whether there are systems capable of achieving good outcomes. Low-income countries suffer the most highest rates of every category of injury--from traffic and the highest rates of acute complications of communicable diseases including tuberculosis, malaria and HIV. To describe the development of pediatrics emergency medicine at Tikur Anbesa Specialized Hospital A twinning partnership model was used in developing a pediatric emergency medicine training program helps in development of pediatrics emergency system. Strengthening the capacity of Addis Ababa University (AAU), Tikur Anbessa Hospital (TASH) to provide pediatric emergency medical services through improved organization of the pediatrics emergency department and strengthening of continuing education opportunities for faculty and staff capacity building by this improving quality of care in pediatrics patients in the country. The Addis Ababa University, University of Wiscosin and People to People partners intend to continue working together to strengthening and developing effetive systems to deliver quality pediatrics emergency medicine care troughout all regions of Ethiopia.

  13. Patient awareness of breast density and interest in supplemental screening tests: comparison of an academic facility and a county hospital.

    Science.gov (United States)

    Trinh, Long; Ikeda, Debra M; Miyake, Kanae K; Trinh, Jennifer; Lee, Kevin K; Dave, Haatal; Hanafusa, Kei; Lipson, Jafi

    2015-03-01

    The aim of this study was to measure women's knowledge of breast density and their attitudes toward supplemental screening tests in the setting of the California Breast Density Notification Law at an academic facility and a county hospital, serving women with higher and lower socioeconomic status, respectively. Institutional review board exemptions were obtained. A survey was administered during screening mammography at two facilities, assessing women's awareness of and interest in knowing their breast density and interest in and willingness to pay for supplemental whole breast ultrasound and contrast-enhanced spectral mammography (CEMG). The results were compared by using Fisher exact tests between groups. A total of 105 of 130 and 132 of 153 women responded to the survey at the academic and county facilities, respectively. Among respondents at the academic and county facilities, 23% and 5% were aware of their breast density, and 94% and 79% wanted to know their density. A majority were interested in supplemental ultrasonography and CEMG at both sites; however, fewer women had a willingness to pay for the supplemental tests at the county hospital compared with those at the academic facility (22% and 70%, respectively, for ultrasound, P women were interested in knowing their breast density and in supplemental screening tests. However, women at the county hospital were less willing to incur out-of-pocket expenses, suggesting a potential for a disparity in health care access for women of lower socioeconomic status after the enactment of breast density notification legislation. Published by Elsevier Inc.

  14. Attitudes toward integration of complementary and alternative medicine with hospital-based care.

    Science.gov (United States)

    Lewis, D; Paterson, M; Beckerman, S; Sandilands, C

    2001-12-01

    To characterize those who have used, expect to use, or are opposed to the use of holistic therapies, especially in a conventional medical (hospital) setting. SAMPLE DESCRIPTION AND METHODS: Cross-sectional survey of a random sample of Hamilton-Wentworth residents between March and June 1998 (n = 416; response rate, 63%); analysis used logistic regression. Thirty-seven percent (37%) used at least one holistic therapy in the previous year: the three most common were chiropractic, massage, and herbal/phytology. The three most common reasons for use were general health, fatigue, and arthritis. Thirty-three percent (33%) would use holistic therapy in the future. Barriers to use were lack of information, perceived ineffectiveness, and cost; approximately 40% agreed they would only use holistic therapies with medical advice. Approximately 13% were opposed to holistic therapy and objected to its use in hospitals. Younger age, preference for holistic therapy over conventional medicine, and prior use of holism independently predicted high likelihood for future use. Lower income and high self-perceived health were associated with negative attitude toward use of holistic therapies in hospital. Most respondents would accept integration of holistic techniques into a hospital; therapies would be more acceptable if there were clear evidence of their efficacy. A few might find their opinion of a sponsoring hospital lowered by such integration.

  15. Medicine and management: looking inside the box of changing hospital governance.

    Science.gov (United States)

    Kuhlmann, Ellen; Rangnitt, Ylva; von Knorring, Mia

    2016-05-24

    Health policy has strengthened the demand for coordination between clinicians and managers and introduced new medical manager roles in hospitals to better connect medicine and management. These developments have created a scholarly debate of concepts and an increasing 'hybridization' of tasks and roles, yet the organizational effects are not well researched. This research introduces a multi-level governance approach and aims to explore the organizational needs of doctors using Sweden as a case study. We apply an assessment framework focusing on macro-meso levels and managerial-professional modes of hospital governance (using document analysis, secondary sources, and expert information) and expand the analysis towards the micro-level. Qualitative explorative empirical material gathered in two different studies in Swedish hospitals serves to pilot research into actor-centred perceptions of clinical management from the viewpoint of the 'managed' and the 'managing' doctors in an organization. Sweden has developed a model of integrated hospital governance with complex structural coordination between medicine and management on the level of the organization. In terms of formal requirements, the professional background is less relevant for many management positions but in everyday work, medical managers are perceived primarily as colleagues and not as experts advising on managerial problems. The managers themselves seem to rely more on personal strength and medical knowledge than on management tools. Bringing doctors into management may hybridize formal roles and concepts, but it does not necessarily change the perceptions of doctors and improve managerial-professional coordination at the micro-level of the organization. This study brings gaps in hospital governance into view that may create organizational weaknesses and unmet management needs, thereby constraining more coordinated and integrated medical management.

  16. Peripartum hysterectomy: two years experience at Nelson Mandela Academic hospital, Mthatha, Eastern Cape South Africa.

    Science.gov (United States)

    Wandabwa, J N; Businge, C; Longo-Mbenza, B; Mdaka, M L; Kiondo, P

    2013-06-01

    Obstetric haemorrhage is the leading direct cause of maternal mortality in South Africa. To determine the incidence, indications, associations and maternal outcomes of emergency peripartum hysterectomies. A descriptive and retrospective analysis of patients who had peripartum hysterectomy between 1(st) February 2007 and 31(st) January 2009 in Nelson Mandela Academic Hospital at Mthatha city. The incidence of 0.95% of peripartum hysterectomies (n=63 or 9.5/1000 births) increased with the increasing maternal age from 0.121% at age of less than 20 years to 0.5% at age more or equal to 30 years. Similarly the incidence increased with parity from 0.332% for Primiparity to 0.468% at parity of four or more. The indications for the operation were uterine atony 19/63 (30.2%), secondary haemorrhage/puerperal sepsis 17/63 (27%) and ruptured uterus 16/63 (23.4%). The main intra operative complication was haemorrhage 13/63 (20.6%). Repeat laparotomy was done in 10/63 (15%) of patients due to haemorrhage. Admission to intensive care unit was 25/63 (39.7%). The case specific mortality rate was of 19 % (n=12). The main causes of death were hypovolaemic shock and septicemia. The incidence of peripartum hysterectomies was high and was associated with ruptured uterus and puerperal sepsis which are preventable.

  17. #Me_Who: Anatomy of Scholastic, Leadership, and Social Isolation of Underrepresented Minority Women in Academic Medicine.

    Science.gov (United States)

    Albert, Michelle A

    2018-05-22

    In academic medicine, under-represented minority women physician-scientists (URMWP)* are uncommon, particularly in leadership positions. Data from the American Association of Medical Colleges (AAMC) show that among internal medicine chairs, there are 12 Asian males, 10 African/American (blacks; 9 men), 7 Hispanics (2 females) and 137 whites (21 females). In the top 40 ranked cardiology programs, there are no female cardiology chiefs, whereas there are at least 10, 2, 1 and 24 Asian, black, Hispanic and white males respectively. There are more URMWP than URM males, yet URMWP are less likely to be professors and occupy leadership positions in academia. Specifically, among United States medical school faculty, relative proportions at assistant, associate and full professor levels according to race/ethnicity and gender have remained essentially unchanged over the past 20 years. AAMC information demonstrates that only 11%, 9%, 11% and 24% of Asian, black, Hispanic and white women are full professors compared with 21%, 18%, 19% and 36% of Asian, black, Hispanic and white men. Additionally, while there are representative proportions of women and Asians at the lowest faculty levels, they have not equitably progressed in academic medicine, likely reflecting discrimination and structural/organizational barriers that are also applicable to black and Hispanic females 1 .

  18. Consensus in Guidelines for Evaluation of DSD by the Texas Children's Hospital Multidisciplinary Gender Medicine Team

    Directory of Open Access Journals (Sweden)

    Macias CharlesG

    2010-08-01

    Full Text Available The Gender Medicine Team (GMT, comprised of members with expertise in endocrinology, ethics, genetics, gynecology, pediatric surgery, psychology, and urology, at Texas Children's Hospital and Baylor College of Medicine formed a task force to formulate a consensus statement on practice guidelines for managing disorders of sexual differentiation (DSD and for making sex assignments. The GMT task force reviewed published evidence and incorporated findings from clinical experience. Grading of Recommendations, Assessment, Development, and Evaluation (GRADE was used to assess the quality of evidence presented in the literature for establishing evidence-based guidelines. The task force presents a consensus statement regarding specific diagnostic and therapeutic issues in the management of individuals who present with DSD. The consensus statement includes recommendations for (1 laboratory workup, (2 acute management, (3 sex assignment in an ethical framework that includes education and involvement of the parents, and (4 surgical management.

  19. Will there be room for the teaching of internal medicine in a university hospital?

    Science.gov (United States)

    Junod, Alain F

    2002-01-12

    To answer the question addressed, two working groups, one made of the staff of a University clinic, the other one composed of practising general internists, have discussed the assets and weaknesses of a University service of Internal Medicine for postgraduate training. The groups agreed on a number of points: patients' characteristics (complexity and co-morbidities), quality of teaching, method acquisition for clinical reasoning, as well as absence of exposure to ambulatory patients and of follow-up. The groups differed in their views related to the lack of training in psychiatry and psychosocial problems or to hospital dysfunctions. Opening of internal medicine to primary care appears to be necessary at the same time as individual qualities among the senior staff are to be developed, such as critical analysis and self-questioning.

  20. 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.

  1. Causes of prolonged hospitalization among general internal medicine patients of a tertiary care center.

    Science.gov (United States)

    Ruangkriengsin, Darat; Phisalprapa, Pochamana

    2014-03-01

    Unnecessary days of prolonged hospitalization may lead to the increase in hospital-related complications and costs, especially in tertiary care center Currently, there have not been many studies about the causes of prolonged hospitalization. Some identified causes could, however, be prevented and improved. To identify the prevalence, causes, predictive factors, prognosis, and economic burden of prolonged hospitalization in patients who had been in general internal medicine wards of the tertiary care center for 7 days or more. Retrospective chart review study was conducted among all patients who were admitted for 7 days or more in general internal medicine wards of Siriraj Hospital, the largest tertiary care center in Thailand. The period of this study was from 1 August 2012 to 30 September 2012. Demographic data, principle diagnosis, comorbid diseases, complications, discharge status, total costs of admission and percentage of reimbursement were collected. The causes of prolonged hospitalization at day 7, 14, 30, and 90 were assessed. Five hundred and sixty-two charts were reviewed. The average length of stay was 25.9 days. The two most common causes of prolonged admission at day 7 were treatment of main diagnosed disease with stable condition (27.6%) and waiting for completion of intravenous antibiotics administration with stable condition (19.5%). The causes of prolonged hospitalization at day 14 were unstable condition from complications (22.6%) and those waiting for completion of intravenous antibiotics administration with stable condition (15.8%). The causes of prolonged admission at day 30 were unstable conditions from complications (25.6%), difficulty weaning or ventilator dependence (17.6%), and caregiver problems (15.2%). The causes of prolonged hospitalization at day 90 were unstable condition from complications (30.0%), caregiver problems (30.0%), and palliative care (25.0%). Poor outcomes were shown in the patients admitted more than 90 days. Percentage

  2. Impact of Family Medicine Implementation in outpatient admissions in an Education and Research Hospital

    Directory of Open Access Journals (Sweden)

    Abdülkadir Aydın

    2017-12-01

    Full Text Available Aim: With the health transformation program in Turkey, the Family Medicine Implementation (FMI was started across the nation in the end of 2010. This study attempted to assess the influence of the FMI on outpatient applications to a third level state hospital.Methods: The number of outpatient applications from 2007 to 2014 was screened through an automation system. Eight clinics were examined including the clinics which Ministry of Health, the Board of Medical Specialties assigned as a part of obligatory rotation within the scope of Family Medicine assistant training, and emergency service. The year 2011 was taken as beginning year of the Family Medicine system. The period from 2007 to 2010 was taken as the pre-FMI period while the term from 2010 to 2014 was taken as the post-FMI period. The outpatient application rates of the selected clinics were compared by periods in correlation with population changes in the Anatolian site of İstanbul. In the analysis of the data, descriptive statistics, mean and standard deviation for continuous variables, Mann Whitney U Test for abnormal distribution comparisons of measured values were used. Significance was assessed at p<0,01 and p<0,05 levels.Results: It was found that no significant increase occurred in the number of patients who applied to the clinics of chest diseases and cardiology in parallel to population growth. In other clinics, the number of applications increased in correlation with population growth.Conclusion: The family medicine implementation made positive effects on the third level hospital in the beginning phase. We are of the opinion that, in order for these positive effects to be improved further, patients should be encouraged to apply to family physicians, and a health referral chain should be implemented with sufficient numbers of primary care personnel.

  3. Is the admission test for a course in medicine a good predictor of academic performance? A case-control experience at the school of medicine of Turin.

    Science.gov (United States)

    Migliaretti, Giuseppe; Bozzaro, Salvatore; Siliquini, Roberta; Stura, Ilaria; Costa, Giuseppe; Cavallo, Franco

    2017-12-01

    The usefulness of university admission tests to medical schools has been discussed in recent years. In the academic year 2014-15 in Italy, several students who failed the admission test appealed to the regional administrative court ('Tribunale Amministrativo Regionale'-TAR) requesting to be included, despite their test results, and all were admitted to their respective courses. The existence of this population of students generated a control group, in order to evaluate the predictive capacity of the admission test. The aim of the present work is to discuss the ability of university admission tests to predict subsequent academic success. The study involved 683 students who enrolled onto the first year of the degree course in medicine in the academic year 2014-15 at the University of Turin (Molinette and San Luigi Gonzaga colleges). The students were separated into two categories: those who passed the admission test (n1=531) and those who did not pass the admission test but won their appeal in the TAR (n2=152). The validity of the admission test was analysed using specificity, sensitivity, positive and negative likelihood ratios (LH+, LH-), receiver operating characteristic (ROC) curves, area under the ROC curve (AUC), and relative (95% CI). The results showed that the admission test appeared to be a good tool for predicting the academic performances in the first year of the course (AUC=0.70, 95% CI 0.64 to 0.76). Moreover, some subject areas seemed to have a greater discriminating capacity than others. In general, students who obtained a high score in scientific questions were more likely to obtain the required standards during the first year (LH+ 1.22, 95% CI 1.14 to 1.25). Based on a consistent statistical approach, our study seems to confirm the ability of the admission test to predict academic success in the first year at the school of medicine of Turin. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All

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

    International Nuclear Information System (INIS)

    Asawarattanapakdee, J.; Sritongkul, N.; Chaudakshetrin, P.; Kanchanaphiboon, P.; Tuntawiroon, M.

    2012-01-01

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

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

    Science.gov (United States)

    Perkins, Barbara Bridgman

    2010-02-01

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

  6. [Undesirable effects of medicine in the Internal Medicine Service of the University Hospital Center du Point G].

    Science.gov (United States)

    Soukho-Kaya, A; Minta, D K; Diarra, M T; Konaté, A; Diallo, B; Sidibé, A T; Dembélé, M; Bah, M; Doumbia, A A; Dao, K; Tolo, N; Camara, B D; Sy, D; Maiga, M Y; Traoré, H A

    2010-01-01

    The aim of this study was to determine the frequency of adverse reactions to drugs, the WHO grade, describe the clinical features and identify the drug responsible. This was a descriptive cross-sectional study which took place from February 2005 to January 2006 in the Internal Medicine Department at the hospital point G. Were included in this study, all patients hospitalized during the study period, which presented adverse drug reactions (ADRs) that the relation of cause and effect was certain or likely. Thus, 47 ADRs were identified in 39 patients of 426 admitted during the same period a frequency of 9.2%. The average age of our patients was 48.5 ± 16.5 years. The sex-ratio was 1.6 for women. Eighty-two percent of our patients had an ADR and 18% more than one. The WHO grade 1 was the most met or 36.2%, followed by grades 4 and 2 respectively 27.7% and 25.5%. Antidiabetics were responsible for adverse reactions in 46.8% and 21.3% in TB. Adverse events were neurological in 53.2% and type of manifestations of hypoglycemia 46.8% (22/47 cases), polyneuritis 6.4% (3 / 47 cases) and 29.8% in digestive cases dominated by vomiting 12.8% (6 / 47 cases), the epigastria pain 6.4% (3 / 47 cases). The outcome was favorable in 87.2% of cases, however, 3 cases of death among those over 60 years all grade 4 WHO. ADRs deserve special attention to this high death rate (6.4% 3/47 cases) where the interest to search systematically for all patients under medical treatment with a good clinical examination and questioning some thoroughly.

  7. Perceptions of Personalized Medicine in an Academic Health System: Educational Findings.

    Science.gov (United States)

    Vorderstrasse, Allison; Katsanis, Sara Huston; Minear, Mollie A; Yang, Nancy; Rakhra-Burris, Tejinder; Reeves, Jason W; Cook-Deegan, Robert; Ginsburg, Geoffrey S; Ann Simmons, Leigh

    Prior reports demonstrate that personalized medicine implementation in clinical care is lacking. Given the program focus at Duke University on personalized medicine, we assessed health care providers' perspectives on their preparation and educational needs to effectively integrate personalized medicine tools and applications into their clinical practices. Data from 78 health care providers who participated in a larger study of personalized and precision medicine at Duke University were analyzed using Qualtrics (descriptive statistics). Individuals age 18 years and older were recruited for the larger study through broad email contacts across the university and health system. All participants completed an online 35-question survey that was developed, pilot-tested, and administered by a team of interdisciplinary researchers and clinicians at the Center for Applied Genomics and Precision Medicine. Overall, providers reported being ill-equipped to implement personalized medicine in clinical practice. Many respondents identified educational resources as critical for strengthening personalized medicine implementation in both research and clinical practice. Responses did not differ significantly between specialists and primary providers or by years since completion of the medical degree. Survey findings support prior calls for provider and patient education in personalized medicine. Respondents identified focus areas in training, education, and research for improving personalized medicine uptake. Given respondents' emphasis on educational needs, now may be an ideal time to address these needs in clinical training and public education programs.

  8. Caregivers’ knowledge and acceptance of complementary and alternative medicine in a tertiary care pediatric hospital

    Directory of Open Access Journals (Sweden)

    Trifa M

    2018-03-01

    Full Text Available Mehdi Trifa,1,2 Dmitry Tumin,1,3 Hina Walia,1 Kathleen L Lemanek,4 Joseph D Tobias,1,3 Tarun Bhalla1,3 1Department of Anesthesiology and Pain Medicine, Nationwide Children’s Hospital, Columbus, OH, USA; 2Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia; 3Department of Anesthesiology and Pain Medicine, The Ohio State University College of Medicine, Columbus, OH, USA; 4Department of Pediatric Psychology and Neuropsychology, Nationwide Children’s Hospital, Columbus, OH, USA Background: The use of complementary and alternative medicine (CAM therapies has increased in children, especially in those with chronic health conditions. However, this increase may not translate into acceptance of CAM in the perioperative setting. We surveyed caregivers of patients undergoing surgery to determine their knowledge and acceptance of hypnotherapy, acupuncture, and music therapy as alternatives to standard medication in the perioperative period. Materials and methods: An anonymous, 12-question survey was administered to caregivers of children undergoing procedures under general anesthesia. Caregivers reported their knowledge about hypnotherapy, music therapy, and acupuncture and interest in one of these methods during the perioperative period. CAM acceptance was defined as interest in one or more CAM methods.Results: Data from 164 caregivers were analyzed. The majority of caregivers were 20–40 years of age (68% and mothers of the patient (82%. Caregivers were most familiar with acupuncture (70%, followed by music therapy (60% and hypnotherapy (38%. Overall CAM acceptance was 51%. The acceptance of specific CAM modalities was highest for music therapy (50%, followed by hypnotherapy (17% and acupuncture (13%. In multivariable logistic regression, familiarity with music therapy was associated with greater odds of CAM acceptance (odds ratio=3.36; 95% CI: 1.46, 7.74; P=0.004.Conclusion: Overall CAM acceptance among caregivers of children

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

    OpenAIRE

    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...

  10. On the first occupational medicine initiatives in Mexico: The Real del Monte miners’ hospital.

    Science.gov (United States)

    Gómez, José Luis; Rodríguez-Paz, Carlos Agustín

    2018-01-01

    Despite the legislation of Otto von Bismarck (1815-1898) on social security rights formulated in 1883 in Germany where it is stated that it is the duty of the State to promote the welfare of all members of society, particularly the weakest and most needy, using the means available to them, and the proposals of laws against accidents issued on April 30, 1904 in the State of Mexico in 1904, in the Mexico of the Porfirio Díaz era, providing workers with formal medical care was not contemplated, except in the case of some railway companies, hospitals for the care of patients with occupational diseases were not built. One of these exceptions was the Hospital del Mineral del Real del Monte de Pachuca, founded in the late nineteenth century and after the mining company passed to the Americans in 1906, it was agreed that the company acquired the hospital and equated it with the medical and surgical advances of the time for immediate care of injuries, especially of the orthopedic type, which enabled not only the healing of wounds, but also rehabilitation. This hospital is one of the oldest in Mexico with regard to three disciplines: orthopedics, occupational medicine and rehabilitation. It ceased to operate in 1982, and currently it is a museum with a rich collection of documents and instruments related to the aforementioned disciplines. Copyright: © 2018 SecretarÍa de Salud.

  11. Does medicine still show an unresolved discrimination against women? Experience in two European university hospitals.

    Science.gov (United States)

    Santamaría, A; Merino, A; Viñas, O; Arrizabalaga, P

    2009-02-01

    Have invisible barriers for women been broken in 2007, or do we still have to break through medicine's glass ceiling? Data from two of the most prestigious university hospitals in Barcelona with 700-800 beds, Hospital Clínic (HC) and Hospital de la Santa Creu i Sant Pau (HSCSP) address this issue. In the HSCSP, 87% of the department chairs are men and 85% of the department unit chiefs are also men. With respect to women, only 5 (13%) are in the top position (department chair) and 4 (15%) are department unit chiefs. Similar statistics are also found at the HC: 87% of the department chairs and 89% of the department unit chiefs are men. Currently, only 6 women (13%) are in the top position and 6 (11%) are department unit chiefs. Analysis of the 2002 data of internal promotions in HC showed that for the first level (senior specialist) sex distribution was similar. Nevertheless, for the second level (consultant) only 25% were women, and for the top level (senior consultant) only 8% were women. These proportions have not changed in 2007 in spite of a 10% increase in leadership positions during this period. Similar proportions were found in HSCSP where 68% of the top promotions were held by men. The data obtained from these two different medical institutions in Barcelona are probably representative of other hospitals in Spain. It would be ethically desirable to have males and females in leadership positions in the medical profession.

  12. 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.

  13. [History of the 4th Department of Internal Medicine of the First Faculty of Medicine at Charles University and the General University Hospital in Prague].

    Science.gov (United States)

    Bartůněk, Petr

    In 2015, the doctors and nurses of the 4th Department of Internal Medicine of the First Faculty of Medicine, Charles University and the General University Hospital in Prague celebrated the 70th anniversary of its founding. The article summarizes the clinics contribution to the field of internal medicine, and particularly to angiology, hepatogastroenterology and lipidology. It comments the clinics current activities and the possibilities of its further development. Attention is also paid to the tradition of high ethical and professional standards of medical care in accordance with the norms established by the clinic's founder, prof. MUDr. Bohumil Prusík.

  14. Mentoring perception, scientific collaboration and research performance: is there a 'gender gap' in academic medicine? An Academic Health Science Centre perspective.

    Science.gov (United States)

    Athanasiou, Thanos; Patel, Vanash; Garas, George; Ashrafian, Hutan; Hull, Louise; Sevdalis, Nick; Harding, Sian; Darzi, Ara; Paroutis, Sotirios

    2016-10-01

    The 'gender gap' in academic medicine remains significant and predominantly favours males. This study investigates gender disparities in research performance in an Academic Health Science Centre, while considering factors such as mentoring and scientific collaboration. Professorial registry-based electronic survey (n=215) using bibliometric data, a mentoring perception survey and social network analysis. Survey outcomes were aggregated with measures of research performance (publications, citations and h-index) and measures of scientific collaboration (authorship position, centrality and social capital). Univariate and multivariate regression models were constructed to evaluate inter-relationships and identify gender differences. One hundred and four professors responded (48% response rate). Males had a significantly higher number of previous publications than females (mean 131.07 (111.13) vs 79.60 (66.52), p=0.049). The distribution of mentoring survey scores between males and females was similar for the quality and frequency of shared core, mentor-specific and mentee-specific skills. In multivariate analysis including gender as a variable, the quality of managing the relationship, frequency of providing corrective feedback and frequency of building trust had a statistically significant positive influence on number of publications (all presearch to investigate the relationship between mentoring perception, scientific collaboration and research performance in the context of gender. It presents a series of initiatives that proved effective in marginalising the gender gap. These include the Athena Scientific Women's Academic Network charter, new recruitment and advertisement strategies, setting up a 'Research and Family Life' forum, establishing mentoring circles for women and projecting female role models. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  15. Cross-sectional survey of patients' need for information and support with medicines after discharge from hospital.

    Science.gov (United States)

    Mackridge, Adam J; Rodgers, Ruth; Lee, Dan; Morecroft, Charles W; Krska, Janet

    2017-11-20

    Most patients experience changes to prescribed medicines during a hospital stay. Ensuring they understand such changes is important for preventing adverse events post-discharge and optimising patient understanding. However, little work has explored the information that patients receive about medicines or their perceived needs for information and support after discharge. To determine information that hospital inpatients who experience medicine changes receive about their medicines during admission and their needs and preferences for, and use of, post-discharge support. Cross-sectional survey with adult medical inpatients experiencing medicine changes in six English hospitals, with telephone follow-up 2-3 weeks post-discharge. A total of 444 inpatients completed surveys, and 99 of these were followed up post-discharge. Of the 444, 44 (10%) were unaware of changes to medicines and 65 (16%) did not recall discussing them with a health professional, but 305 (77%) reported understanding the changes. Type of information provided and patients' perceived need for post-discharge support differed between hospitals. Information about changes was most frequently provided by consultant medical staff (157; 39%) with pharmacists providing information least often (71; 17%). One third of patients surveyed considered community pharmacists as potential sources of information about medicines and associated support post-discharge. Post-discharge, just 5% had spoken to a pharmacist, although 35% reported medicine-related problems. In north-west England, patient inclusion in treatment decisions could be improved, but provision of information prior to discharge is reasonable. There is scope to develop hospital and community pharmacists' role in medicine optimisation to maximise safety and effectiveness of care. © 2017 Royal Pharmaceutical Society.

  16. Patient characteristics, resource use and outcomes associated with general internal medicine hospital care: the General Medicine Inpatient Initiative (GEMINI) retrospective cohort study.

    Science.gov (United States)

    Verma, Amol A; Guo, Yishan; Kwan, Janice L; Lapointe-Shaw, Lauren; Rawal, Shail; Tang, Terence; Weinerman, Adina; Cram, Peter; Dhalla, Irfan A; Hwang, Stephen W; Laupacis, Andreas; Mamdani, Muhammad M; Shadowitz, Steven; Upshur, Ross; Reid, Robert J; Razak, Fahad

    2017-12-11

    The precise scope of hospital care delivered under general internal medicine services remains poorly quantified. The purpose of this study was to describe the demographic characteristics, medical conditions, health outcomes and resource use of patients admitted to general internal medicine at 7 hospital sites in the Greater Toronto Area. This was a retrospective cohort study involving all patients who were admitted to or discharged from general internal medicine at the study sites between Apr. 1, 2010, and Mar. 31, 2015. Clinical data from hospital electronic information systems were linked to administrative data from each hospital. We examined trends in resource use and patient characteristics over the study period. There were 136 208 admissions to general internal medicine involving 88 121 unique patients over the study period. General internal medicine admissions accounted for 38.8% of all admissions from the emergency department and 23.7% of all hospital bed-days. Over the study period, the number of admissions to general internal medicine increased by 32.4%; there was no meaningful change in the median length of stay or cost per hospital stay. The median patient age was 73 (interquartile range [IQR] 57-84) years, and the median number of coexisting conditions was 6 (IQR 3-9). The median acute length of stay was 4.6 (IQR 2.5-8.6) days, and the median total cost per hospital stay was $5850 (IQR $3915-$10 061). Patients received at least 1 computed tomography scan in 52.2% of admissions. The most common primary discharge diagnoses were pneumonia (5.0% of admissions), heart failure (4.7%), chronic obstructive pulmonary disease (4.1%), urinary tract infection (4.0%) and stroke (3.6%). Patients admitted to general internal medicine services represent a large, heterogeneous, resource-intensive and growing population. Understanding and improving general internal medicine care is essential to promote a high-quality, sustainable health care system. Copyright 2017

  17. [Supply prescription filling and out-of-pocket expenditures on medicines in public hospitals in Mexico in 2009].

    Science.gov (United States)

    Sesma-Vázquez, Sergio; Gómez-Dantés, Octavio; Wirtz, Veronika J; Castro-Tinoco, Manuel

    2011-01-01

    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. 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 day of visit, the proportion of prescriptions completely filled for patients when they are discharged and their out-of-pocket expenditure during their hospitalization were analyzed. A total of 26 271 patients in 160 public hospitals were interviewed. The mean availability of drugs was 82% for all hospitals, with the lowest availability for the Ministry of Health (SESA) hospitals (77%, with a range of 30 to 96%). Patients discharged at social security hospitals received in 97% of cases a complete prescription filling, while in SESA hospitals the average was only 56.2%, with a large variance among states (13 to 94%). The median inpatient spending was 150 pesos in national currency (1% spent over 10 000 pesos). The lack of medicines in public hospitals may increase in-patient morbidity and mortality and has an economic impact on household spending, particularly in those with scarce resources.

  18. Associations between teaching effectiveness scores and characteristics of presentations in hospital medicine continuing education.

    Science.gov (United States)

    Ratelle, John T; Wittich, Christopher M; Yu, Roger C; Newman, James S; Jenkins, Sarah M; Beckman, Thomas J

    2015-09-01

    There is little research regarding characteristics of effective continuing medical education (CME) presentations in hospital medicine (HM). Therefore, we sought to identify associations between validated CME teaching effectiveness scores and characteristics of CME presentations in the field of HM. This was a cross-sectional study of participants and didactic presentations from a national HM CME course in 2014. Participants provided CME teaching effectiveness (CMETE) ratings using an instrument with known validity evidence. Overall CMETE scores (5-point scale: 1 = strongly disagree; 5 = strongly agree) were averaged for each presentation, and associations between scores and presentation characteristics were determined using the Kruskal-Wallis test. The threshold for statistical significance was set at P teaching effectiveness scores and characteristics of effective CME presentations in HM. Our findings, which support previous research in other fields, indicate that CME presentations may be improved by increasing interactivity through the use of audience response systems and allowing longer presentations. © 2015 Society of Hospital Medicine.

  19. Measuring Value in Internal Medicine Residency Training Hospitals Using Publicly Reported Measures.

    Science.gov (United States)

    Schickedanz, Adam; Gupta, Reshma; Arora, Vineet M; Braddock, Clarence H

    2018-03-01

    Graduate medical education (GME) lacks measures of resident preparation for high-quality, cost-conscious practice. The authors used publicly reported teaching hospital value measures to compare internal medicine residency programs on high-value care training and to validate these measures against program director perceptions of value. Program-level value training scores were constructed using Centers for Medicare & Medicaid Services Value-Based Purchasing (VBP) Program hospital quality and cost-efficiency data. Correlations with Association of Program Directors in Internal Medicine Annual Survey high-value care training measures were examined using logistic regression. For every point increase in program-level VBP score, residency directors were more likely to agree that GME programs have a responsibility to contain health care costs (adjusted odds ratio [aOR] 1.18, P = .04), their faculty model high-value care (aOR 1.07, P = .03), and residents are prepared to make high-value medical decisions (aOR 1.07, P = .09). Publicly reported clinical data offer valid measures of GME value training.

  20. Variations in survival after cardiac arrest among academic medical center-affiliated hospitals.

    Directory of Open Access Journals (Sweden)

    Michael Christopher Kurz

    Full Text Available Variation exists in cardiac arrest (CA survival among institutions. We sought to determine institutional-level characteristics of academic medical centers (AMCs associated with CA survival.We examined discharge data from AMCs participating with Vizient clinical database-resource manager. We identified cases using ICD-9 diagnosis code 427.5 (CA or procedure code 99.60 (CPR. We estimated hospital-specific risk-standardized survival rates (RSSRs using mixed effects logistic regression, adjusting for individual mortality risk. Institutional and community characteristics of AMCs with higher than average survival were compared with those with lower survival.We analyzed data on 3,686,296 discharges in 2012, of which 33,700 (0.91% included a CA diagnosis. Overall survival was 42.3% (95% CI 41.8-42.9 with median institutional RSSR of 42.6% (IQR 35.7-51.0; Min-Max 19.4-101.6. We identified 28 AMCs with above average survival (median RSSR 61.8% and 20 AMCs with below average survival (median RSSR 26.8%. Compared to AMCs with below average survival, those with high CA survival had higher CA volume (median 262 vs.119 discharges, p = 0.002, total beds (722 vs. 452, p = 0.02, and annual surgical volume (24,939 vs. 13,109, p<0.001, more likely to offer cardiac catheterization (100% vs. 72%, p = 0.007 or cardiac surgery (93% vs. 61%, p = 0.02 and cared for catchment areas with higher household income ($61,922 vs. $49,104, p = 0.004 and lower poverty rates (14.6% vs. 17.3%, p = 0.03.Using discharge data from Vizient, we showed AMCs with higher CA and surgical case volume, cardiac catheterization and cardiac surgery facilities, and catchment areas with higher socioeconomic status had higher risk-standardized CA survival.

  1. Medicines

    Science.gov (United States)

    Medicines can treat diseases and improve your health. If you are like most people, you need to take medicine at some point in your life. You may need to take medicine every day, or you may only need to ...

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

    International Nuclear Information System (INIS)

    Kamiya, Kenji; Tanigawa, Koichi; Hosoi, Yoshio

    2011-01-01

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

  3. Restorative Justice as the Rx for Mistreatment in Academic Medicine: Applications to Consider for Learners, Faculty, and Staff.

    Science.gov (United States)

    Acosta, David; Karp, David R

    2018-03-01

    The mistreatment of learners is an ongoing issue at U.S. medical schools. According to responses to the 2017 Association of American Medical Colleges Graduation Questionnaire, 39.3% of medical students nationally reported being mistreated. Many articles have been published on the topic of mistreatment at medical schools over the last 20 years. These articles have focused primarily on the definition of mistreatment, the impact of mistreatment, and initiatives put into place to help mitigate the problem. To date, very little attention has been paid to repairing the harm caused by mistreatment and rebuilding community trust. Academic medicine is in need of new forums of interaction to achieve more positive learning and workplace environments.The authors discuss restorative justice practices and the potential applications that they may have in academic medicine learning and workplace environments to serve vulnerable students, faculty, and staff who are targets of mistreatment. Restorative justice practices are used to convene groups of people to engage in substantive dialogue about consequential issues that impede community functioning. This process can help a group identify and gain mutual understanding of the personal and collective harm that has occurred, create the conditions that incentivize offenders to admit responsibility rather than deny or minimize the harm, and explore and define a set of problem-solving steps to address the harm and rebuild community trust.

  4. Use of a Hands Free, Instantaneous, Closed-Loop Communication Device Improves Perception of Communication and Workflow Integration in an Academic Teaching Hospital: A Pilot Study.

    Science.gov (United States)

    Fang, Daniel Z; Patil, Teja; Belitskaya-Levy, Ilana; Yeung, Marianne; Posley, Keith; Allaudeen, Nazima

    2017-11-17

    Efficient and effective communication between providers is critical to quality patient care within a hospital system. Hands free communication devices (HFCD) allow instantaneous, closed-loop communication between physicians and other members of a multidisciplinary team, providing a communication advantage over traditional pager systems. HFCD have been shown to decrease emergency room interruptions, improve nursing communication, improve speed of information flow, and eliminate health care waste. We evaluated the integration of an HFCD with an existing alphanumeric paging system on an acute inpatient medicine service. We conducted a prospective, observational, survey-based study over twenty-four weeks in an academic tertiary care center with attending physicians and residents. Our intervention involved the implementation of an HFCD alongside the existing paging system. Fifty-six pre and post surveys evaluated the perception of improvement in communication and the integration of the HFCD into existing workflow. We saw significant improvements in the ability of an HFCD to help physicians communicate thoughts clearly, communicate thoughts effectively, reach team members, reach ancillary staff, and stay informed about patients. Physicians also reported better workflow integration during admissions, rounds, discharge, and teaching sessions. Qualitative data from post surveys demonstrated that the greatest strengths of the HFCD included the ability to reach colleagues and staff quickly, provide instant access to individuals of the care team, and improve overall communication. Integration of an instantaneous, hands free, closed loop communication system alongside the existing pager system can provide improvements in the perceptions of communication and workflow integration in an academic medicine service. Future studies are needed to correlate these subjective findings with objective measures of quality and safety.

  5. [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.

  6. Nurses Caring and Patient’s Satisfaction at Internal Medicine Unit of Dr. Soetomo Hospital, Surabaya

    Directory of Open Access Journals (Sweden)

    Nur Hasanah

    2017-06-01

    Full Text Available Patient’s satisfaction is crucial for a hospital, and nursing as an integral part of health care in hospitals also determine the level of patient’s satisfaction. At the order of the clinic nurses deal directly with the public as their client. A direct relationship between the nurse and the client need a behaviour that can be accepted by the whole society. Caring as one of the basic values of nursing, is a phenomenon that affects the way to think, feel and relate to others. This study aimed to analyze the relationship between the nurses caring with patient’s satisfaction by using cross sectional design. Population of this study was patients who were treated in Internal Medicine Unit of Dr. Soetomo Hospital in November 2015. The sample size was 75 people, who were selected  by simple random sampling technique. Data collection was done by filling out the questionnaire, then anayzed by using Chi-square test. Results showed 57.33% of the patients gave judgment of satisfactory to nurse caring behaviour and 42.67% gave a good assessment. 62.67% of the patients said they were satisfied with the caring services. There was a significant relationship between nurses caring with patient satisfaction.

  7. A Novel Service-Oriented Professional Development Program for Research Assistants at an Academic Hospital: A Web-Based Survey.

    Science.gov (United States)

    Kitts, Robert Li; Koleoglou, Kyle John; Holland, Jennifer Elysia; Hutchinson, Eliza Haapaniemi; Nang, Quincy Georgdie; Mehta, Clare Marie; Tran, Chau Minh; Fishman, Laurie Newman

    2015-11-02

    Research assistants (RAs) are hired at academic centers to staff the research and quality improvement projects that advance evidence-based medical practice. Considered a transient population, these young professionals may view their positions as stepping-stones along their path to graduate programs in medicine or public health. To address the needs of these future health professionals, a novel program-Program for Research Assistant Development and Achievement (PRADA)-was developed to facilitate the development of desirable professional skill sets (ie, leadership, teamwork, communication) through participation in peer-driven service and advocacy initiatives directed toward the hospital and surrounding communities. The authors hope that by reporting on the low-cost benefits of the program that other institutions might consider the utility of implementing such a program and recognize the importance of acknowledging the professional needs of the next generation of health care professionals. In 2011, an anonymous, Web-based satisfaction survey was distributed to the program membership through a pre-established email distribution list. The survey was used to evaluate demographics, level of participation and satisfaction with the various programming, career trajectory, and whether the program's goals were being met. Upon the completion of the survey cycle, a 69.8% (125/179) response rate was achieved with the majority of respondents (94/119, 79.0%) reporting their 3-year goal to be in medical school (52/119, 43.7%) or nonmedical graduate school (42/119, 35.3%). Additionally, most respondents agreed or strongly agreed that PRADA had made them feel more a part of a research community (88/117, 75.2%), enhanced their job satisfaction (66/118, 55.9%), and provided career guidance (63/117, 53.8%). Overall, 85.6% of respondents (101/118) agreed or strongly agreed with recommending PRADA to other research assistants. High response rate and favorable outlook among respondents

  8. Changing the culture of academic medicine: the C-Change learning action network and its impact at participating medical schools.

    Science.gov (United States)

    Krupat, Edward; Pololi, Linda; Schnell, Eugene R; Kern, David E

    2013-09-01

    The culture of academic medicine has been described as hierarchical, competitive, and not highly supportive of female or minority faculty. In response to this, the authors designed the Learning Action Network (LAN), which was part of the National Initiative on Gender, Culture and Leadership in Medicine (C-Change). The LAN is a five-school consortium aimed at changing the organizational culture of its constituent institutions. The authors selected LAN schools to be geographically diverse and representative of U.S. medical schools. Institutional leaders and faculty representatives from constituent schools met twice yearly for four years (2006-2010), forming a cross-institutional learning community. Through their quarterly listing of institutional activities, schools reported a wide array of actions. Most common were increased faculty development and/or mentoring, new approaches to communication, and adoption of new policies and procedures. Other categories included data collection/management, engagement of key stakeholders, education regarding gender/diversity, and new/expanded leadership positions. Through exit interviews, most participants reported feeling optimistic about maintaining the momentum of change. However, some, especially in schools with leadership changes, expressed uncertainty. Participants reported that they felt that the LAN enabled, empowered, facilitated, and/or caused the reported actions.For others who might want to work toward changing the culture of academic medicine, the authors offer several lessons learned from their experiences with C-Change. Most notably, people, structures, policies, and reward systems must be put into place to support cultural values, and broad-based support should be created in order for changes to persist when inevitable transitions in leadership occur.

  9. Internal Medicine Residents' Perceived Responsibility for Patients at Hospital Discharge: A National Survey.

    Science.gov (United States)

    Young, Eric; Stickrath, Chad; McNulty, Monica C; Calderon, Aaron J; Chapman, Elizabeth; Gonzalo, Jed D; Kuperman, Ethan F; Lopez, Max; Smith, Christopher J; Sweigart, Joseph R; Theobald, Cecelia N; Burke, Robert E

    2016-12-01

    Medical residents are routinely entrusted with transitions of care, yet little is known about the duration or content of their perceived responsibility for patients they discharge from the hospital. To examine the duration and content of internal medicine residents' perceived responsibility for patients they discharge from the hospital. The secondary objective was to determine whether specific individual experiences and characteristics correlate with perceived responsibility. Multi-site, cross-sectional 24-question survey delivered via email or paper-based form. Internal medicine residents (post-graduate years 1-3) at nine university and community-based internal medicine training programs in the United States. Perceived responsibility for patients after discharge as measured by a previously developed single-item tool for duration of responsibility and novel domain-specific questions assessing attitudes towards specific transition of care behaviors. Of 817 residents surveyed, 469 responded (57.4 %). One quarter of residents (26.1 %) indicated that their responsibility for patients ended at discharge, while 19.3 % reported perceived responsibility extending beyond 2 weeks. Perceived duration of responsibility did not correlate with level of training (P = 0.57), program type (P = 0.28), career path (P = 0.12), or presence of burnout (P = 0.59). The majority of residents indicated they were responsible for six of eight transitional care tasks (85.1-99.3 % strongly agree or agree). Approximately half of residents (57 %) indicated that it was their responsibility to directly contact patients' primary care providers at discharge. and 21.6 % indicated that it was their responsibility to ensure that patients attended their follow-up appointments. Internal medicine residents demonstrate variability in perceived duration of responsibility for recently discharged patients. Neither the duration nor the content of residents' perceived responsibility was

  10. 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…

  11. 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

  12. Review of monograph of Doctor of Medicine, Professor Prokopov V.O. «Drinking water of Ukraine: medical-ecologic and sanitary-hygiene aspects» edited by Doctor of Medicine, Academician of NAMS of Ukraine A.M. Serdiuk. – K.: Academic Press «Medicine», 2016.

    OpenAIRE

    Shevchenko, O. A.

    2017-01-01

    Review of monograph of Doctor ofMedicine, Professor Prokopov V.O. «Drinking water ofUkraine: medical-ecologic and sanitary-hygiene aspects»edited by Doctor of Medicine, Academician of NAMS ofUkraine A.M. Serdiuk. – K.: Academic Press «Medicine»,2016. – 400 p.

  13. Modified Early Warning System improves patient safety and clinical outcomes in an academic community hospital

    Directory of Open Access Journals (Sweden)

    Chirag Mathukia

    2015-04-01

    Full Text Available Background and objective: Severe adverse events such as cardiac arrest and death are often heralded by abnormal vital signs hours before the event. This necessitates an organized track and trigger approach of early recognition and response to subtle changes in a patient's condition. The Modified Early Warning System (MEWS is one of such systems that use temperature, blood pressure, pulse, respiratory rate, and level of consciousness with each progressive higher score triggering an action. Root cause analysis for mortalities in our institute has led to the implementation of MEWS in an effort to improve patient outcomes. Here we discuss our experience and the impact of MEWS implementation on patient care at our community academic hospital. Methods: MEWS was implemented in a protocolized manner in June 2013. The following data were collected from non-ICU wards on a monthly basis from January 2010 to June 2014: 1 number of rapid response teams (RRTs per 100 patient-days (100PD; 2 number of cardiopulmonary arrests ‘Code Blue’ per 100PD; and 3 result of each RRT and Code Blue (RRT progressed to Code Blue, higher level of care, ICU transfer, etc.. Overall inpatient mortality data were also analyzed. Results: Since the implementation of MEWS, the number of RRT has increased from 0.24 per 100PD in 2011 to 0.38 per 100PD in 2013, and 0.48 per 100PD in 2014. The percentage of RRTs that progressed to Code Blue, an indicator of poor outcome of RRT, has been decreasing. In contrast, the numbers of Code Blue in non-ICU floors has been progressively decreasing from 0.05 per 100PD in 2011 to 0.02 per 100PD in 2013 and 2014. These improved clinical outcomes are associated with a decline of overall inpatient mortality rate from 2.3% in 2011 to 1.5% in 2013 and 1.2% in 2014. Conclusions: Implementation of MEWS in our institute has led to higher rapid response system utilization but lower cardiopulmonary arrest events; this is associated with a lower mortality

  14. Prognostic importance of glycaemic variability on hospital mortality in patients hospitalised in Internal Medicine Departments.

    Science.gov (United States)

    Sáenz-Abad, D; Gimeno-Orna, J A; Pérez-Calvo, J I

    2015-12-01

    The objective was to assess the prognostic importance of various glycaemic control measures on hospital mortality. Retrospective, analytical cohort study that included patients hospitalised in internal medicine departments with a diagnosis related to diabetes mellitus (DM), excluding acute decompensations. The clinical endpoint was hospital mortality. We recorded clinical, analytical and glycaemic control-related variables (scheduled insulin administration, plasma glycaemia at admission, HbA1c, mean glycaemia (MG) and in-hospital glycaemic variability and hypoglycaemia). The measurement of hospital mortality predictors was performed using univariate and multivariate logistic regression. A total of 384 patients (50.3% men) were included. The mean age was 78.5 (SD, 10.3) years. The DM-related diagnoses were type 2 diabetes (83.6%) and stress hyperglycaemia (6.8%). Thirty-one (8.1%) patients died while in hospital. In the multivariate analysis, the best model for predicting mortality (R(2)=0.326; P<.0001) consisted, in order of importance, of age (χ(2)=8.19; OR=1.094; 95% CI 1.020-1.174; P=.004), Charlson index (χ(2)=7.28; OR=1.48; 95% CI 1.11-1.99; P=.007), initial glycaemia (χ(2)=6.05; OR=1.007; 95% CI 1.001-1.014; P=.014), HbA1c (χ(2)=5.76; OR=0.59; 95% CI 0.33-1; P=.016), glycaemic variability (χ(2)=4.41; OR=1.031; 95% CI 1-1.062; P=.036), need for corticosteroid treatment (χ(2)=4.03; OR=3.1; 95% CI 1-9.64; P=.045), administration of scheduled insulin (χ(2)=3.98; OR=0.26; 95% CI 0.066-1; P=.046) and systolic blood pressure (χ(2)=2.92; OR=0.985; 95% CI 0.97-1.003; P=.088). An increase in initial glycaemia and in-hospital glycaemic variability predict the risk of mortality for hospitalised patients with DM. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

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

    OpenAIRE

    Ahmed Tawfeeq Alahmar

    2016-01-01

    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...

  16. Experience of an eating disorders out-patient program in an internal medicine hospital.

    Science.gov (United States)

    García-García, Eduardo; Rocha-Velis, Ingrid; Vázquez-Velázquez, Verónica; Kaufer-Horwitz, Martha; Reynoso, Ricardo; Méndez, Juan Pablo

    2013-12-01

    The aim of this study was to develop a successful low budget out-patient program, in an internal medicine hospital, for patients presenting eating disorders in an emerging nation. A total of 144 patients were included in a 6 month intervention centered in medical support, with fortnightly medical consultations, monthly counseling by a nutritionist and by a psychiatrist and three psycho-educational courses. The Three Factor Eating Questionnaire and the Eating Disorders Inventory-2 were performed at the beginning and at the end of the study. After 6 months, more than half of the patients who completed the intervention were on remission. Substantial improvement was observed regarding the scores of both instruments after completion of the program. The outcome of this study compares favorably to previous published data of more intensive programs. These results were obtained having little infrastructure, a low budget and limited human resources, making this a suitable eating disorders program for emerging nations.

  17. Physiatrie and German maternal feminism: Dr. Anna Fischer-Dückelmann critiques academic medicine.

    Science.gov (United States)

    Meyer, Paulette

    2006-01-01

    Alternative medicine and reform strategies made Anna Fischer-Dückelmann a most controversial, notorious, and widely read women doctor before World War I. She published a dozen titles in 13 languages asserting that national well-being depended on maternal prowess. To her critics, Fischer-Dückelmann's commitment to medical self-help and practices of Physiatrie amounted to medical quackery. Her career has been largely unexamined, yet her feminist critiques and social concerns are not far removed from modern social medicine. For this pioneering doctor, treating physical and emotional ills and promoting the health of families were first steps toward healing the divisions of a world at war.

  18. Concurrent Use of Herbal and Orthodox Medicines among Residents of Tamale, Northern Ghana, Who Patronize Hospitals and Herbal Clinics

    Science.gov (United States)

    Ibrahim, Mohammed; Ibrahim, Halimatu-Sadia; Habib, Rabiatu Hamisu; Gbedema, Stephen Yao

    2018-01-01

    Despite the development of more researched and formulated orthodox medicines, herbal medicines continue to be well patronized for persons across the world with some patrons concurrently using both forms, oblivious of the unwanted effects that may occur. Using a multistage sampling procedure, a semistructured questionnaire was used to collect data in April 2016 from 240 informants from three selected hospitals and three herbal clinics in Tamale, a city in northern Ghana. Using Statistical Package for the Social Sciences, binary logistic regression was used to determine sociodemographic predictors of concurrent use of herbal and orthodox medicines. Orthodox medicines were the drug of choice for 54.2% and 49.2% of patrons of hospitals and herbal clinics, respectively. Also, 67.5% of herbal clinic patrons used orthodox medicines, while 25.0% of hospital attendees used herbal medications prior to their visit to the health facilities. Up to 17.9% of respondents concurrently used herbal and orthodox medicines for their prevailing ailment with age, less than 30 years being the only predictor of this habit (p = 0.015; 95% CI, 1.183–4.793; cOR = 2.4). All health professionals including those in herbal clinics should therefore be interested in the drug history of their clients. PMID:29743917

  19. Advancing women and closing the leadership gap: the Executive Leadership in Academic Medicine (ELAM) program experience.

    Science.gov (United States)

    Richman, R C; Morahan, P S; Cohen, D W; McDade, S A

    2001-04-01

    Women are persistently underrepresented in the higher levels of academic administration despite the fact that they have been entering the medical profession in increasing numbers for at least 20 years and now make up a large proportion of the medical student body and fill a similar proportion of entry level positions in medical schools. Although there are no easy remedies for gender inequities in medical schools, strategies have been proposed and implemented both within academic institutions and more broadly to achieve and sustain the advancement of women faculty to senior level positions. Substantial, sustained efforts to increase programs and activities addressing the major obstacles to advancement of women must be put in place so that the contributions of women can be fully realized and their skills fittingly applied in meeting the medical education and healthcare needs of all people in the 21st century.

  20. Comparison of Patient Costs in Internal Medicine and Anaesthesiology Intensive Care Units in a Tertiary University Hospital.

    Science.gov (United States)

    Kara, İskender; Yıldırım, Fatma; Başak, Dilek Yumuş; Küçük, Hamit; Türkoğlu, Melda; Aygencel, Gülbin; Katı, İsmail; Karabıyık, Lale

    2015-06-01

    The allocation of the Gross Domestic Product (GDP) to health is limited, therefore it has made a need for professional management of health business. Hospital managers as well as employees are required to have sufficient knowledge about the hospital costs. Hospital facilities like intensive care units that require specialization and advanced technology have an important part in costs. For this purpose, cost analysis studies should be done in the general health business and special units separately. In this study we aimed to compare the costs of anaesthesiology and internal medicine intensive care units (ICU) roughly. After approval of this study by Gazi University Faculty of Medicine Ethics Committee, the costs of 855 patients that were hospitalized, examined and treated for at least 24 hours in internal medicine and anaesthesiology ICUs between January 2012-August 2013 (20 months period) were taken and analyzed from chief staff of the Department of Information Technology, Gazi University Hospital. At the end of the study, we observed clear differences between internal medicine and anaesthesiology ICUs arising from transactions and patient characteristics of units. We stated that these differences should be considered by Social Security Institution (SSI) for the reimbursement of the services. Further, we revealed that SSI payments do not meet the intensive care expenditure.

  1. Residents examine factors associated with 30-day, same-cause hospital readmissions on an internal medicine service.

    Science.gov (United States)

    Moran, Jennifer; Colbert, Colleen Y; Song, Juhee; Hull, Joshua; Rajan, Sabitha; Varghees, Sunita; Arroliga, Alejandro C; Reddy, Santosh P

    2013-01-01

    In recent years, there has been increased interest in stemming the tide of hospital readmissions in an attempt to improve quality of care. This study presents the Phase I results of a resident-led quality improvement initiative to determine the percentage of and risk factors for same-cause readmissions (SCRs; defined as hospital readmission within 30 days of hospital discharge for treatment of the same condition) to the internal medicine service of a multispecialty teaching hospital in central Texas. Results indicate that patients diagnosed with chronic obstructive pulmonary disease/asthma or anemia may be at increased risk for SCRs. Those patients who are insured by Medicaid and those who require assistance from social services also demonstrated an increased risk for SCRs. This study appears to be the first resident-led initiative in the field to examine 30-day SCRs to an internal medicine service for demographic and clinical risk factors.

  2. If At First You Don't Succeed: The Fate of Manuscripts Rejected by Academic Emergency Medicine.

    Science.gov (United States)

    Grant, William D; Cone, David C

    2015-10-01

    The purpose of this study was to characterize the publication fate of a recent 2-year sample of manuscripts declined by Academic Emergency Medicine (AEM), the journal of the Society for Academic Emergency Medicine. This was a retrospective analysis of manuscripts submitted to AEM in 2010 and 2011 that were declined by the AEM editorial review process. An online search was conducted for each declined paper, to determine whether or not it was published in another clinical/scientific journal after being declined by AEM. The investigators used Scopus and Google Scholar, using the submitting author's name, the verbatim title, and key words and phrases from the title, to search for subsequent publication of each paper. Of 1,542 manuscript submissions to the journal in 2010 and 2011, 1,052 papers were declined. Of these, 693 (65.9%) were subsequently published elsewhere, in a total of 229 journals: 362 papers in 22 different EM journals, 81 in 14 EM subspecialty journals, 237 in 185 non-EM journals, and 13 in eight nursing journals. Papers were published a median of 16.7 months (interquartile range [IQR] = 11.8 to 22.0 months) after being declined at AEM. Of the 229 journals, 19 do not have h-indices. The median h-index of the remaining 210 journals is 36 (IQR = 17 to 64; maximum = 229; AEM's h-index is 78). Thirty of these 210 journals, publishing 43 papers, have higher h-indices than AEM; the other 650 papers were published in journals either with lower h-indices than AEM's (n = 180 journals) or in journals without h-indices (n = 19 journals). U.S. and non-U.S. authors had similar rates of subsequent publication (65.3% vs 66.6%, p = 0.69) for papers initially declined by AEM. Papers in the educational advances category were less likely to be subsequently published than those in the original contributions (p journal are eventually published elsewhere, in a large number and wide variety of both EM and non-EM journals, in a median of 16.7 months. Authors of manuscripts

  3. Changing the Culture of Academic Medicine: Critical Mass or Critical Actors?

    Science.gov (United States)

    Newbill, Sharon L.; Cardinali, Gina; Morahan, Page S.; Chang, Shine; Magrane, Diane

    2017-01-01

    Abstract Purpose: By 2006, women constituted 34% of academic medical faculty, reaching a critical mass. Theoretically, with critical mass, culture and policy supportive of gender equity should be evident. We explore whether having a critical mass of women transforms institutional culture and organizational change. Methods: Career development program participants were interviewed to elucidate their experiences in academic health centers (AHCs). Focus group discussions were held with institutional leaders to explore their perceptions about contemporary challenges related to gender and leadership. Content analysis of both data sources revealed points of convergence. Findings were interpreted using the theory of critical mass. Results: Two nested domains emerged: the individual domain included the rewards and personal satisfaction of meaningful work, personal agency, tensions between cultural expectations of family and academic roles, and women's efforts to work for gender equity. The institutional domain depicted the sociocultural environment of AHCs that shaped women's experience, both personally and professionally, lack of institutional strategies to engage women in organizational initiatives, and the influence of one leader on women's ascent to leadership. Conclusions: The predominant evidence from this research demonstrates that the institutional barriers and sociocultural environment continue to be formidable obstacles confronting women, stalling the transformational effects expected from achieving a critical mass of women faculty. We conclude that the promise of critical mass as a turning point for women should be abandoned in favor of “critical actor” leaders, both women and men, who individually and collectively have the commitment and power to create gender-equitable cultures in AHCs. PMID:28092473

  4. The influence of academic projects on the professional socialization of family medicine faculty.

    Science.gov (United States)

    Morzinski, Jeffrey A

    2005-05-01

    Successful academic physicians acquire and maintain productive colleague relationships, understand unwritten rules of academe, and effectively manage their careers. Developing these professional socialization skills are goals of some faculty development programs (FDPs), but there is scant evidence about whether such programs are effective. A nationwide retrospective, cross-sectional written survey was conducted in two phases: (1) FDP directors who received US Department of Health and Human Services, Health Resources and Services Administration support between 1994 and 1997 described program activities and provided enrollee rosters and (2) enrollees reported socialization and colleague outcomes. Instruments were developed, pilot tested, and administered for this study. Analysis utilized descriptive statistics, factor analysis, and ANOVA. Of 52 eligible directors, 37 (71%) provided FDP activity details and rosters. Of 543 eligible enrollees, 351 (65%) returned surveys. A key result of factor analysis was a seven-item scale related to academic project activities. FDPs with greater emphasis on these activities were associated with enrollees reporting higher levels of colleague relationships and professional socialization skills. This study's factor analysis indicates that certain FDP project activities are positively associated with enrollees' professional socialization outcomes.

  5. Changing the Culture of Academic Medicine: Critical Mass or Critical Actors?

    Science.gov (United States)

    Helitzer, Deborah L; Newbill, Sharon L; Cardinali, Gina; Morahan, Page S; Chang, Shine; Magrane, Diane

    2017-05-01

    By 2006, women constituted 34% of academic medical faculty, reaching a critical mass. Theoretically, with critical mass, culture and policy supportive of gender equity should be evident. We explore whether having a critical mass of women transforms institutional culture and organizational change. Career development program participants were interviewed to elucidate their experiences in academic health centers (AHCs). Focus group discussions were held with institutional leaders to explore their perceptions about contemporary challenges related to gender and leadership. Content analysis of both data sources revealed points of convergence. Findings were interpreted using the theory of critical mass. Two nested domains emerged: the individual domain included the rewards and personal satisfaction of meaningful work, personal agency, tensions between cultural expectations of family and academic roles, and women's efforts to work for gender equity. The institutional domain depicted the sociocultural environment of AHCs that shaped women's experience, both personally and professionally, lack of institutional strategies to engage women in organizational initiatives, and the influence of one leader on women's ascent to leadership. The predominant evidence from this research demonstrates that the institutional barriers and sociocultural environment continue to be formidable obstacles confronting women, stalling the transformational effects expected from achieving a critical mass of women faculty. We conclude that the promise of critical mass as a turning point for women should be abandoned in favor of "critical actor" leaders, both women and men, who individually and collectively have the commitment and power to create gender-equitable cultures in AHCs.

  6. Measuring Diversity and Inclusion in Academic Medicine: The Diversity Engagement Survey (DES)

    Science.gov (United States)

    Person, Sharina D.; Jordan, C. Greer; Allison, Jeroan J.; Fink Ogawa, Lisa M.; Castillo-Page, Laura; Conrad, Sarah; Nivet, Marc A.; Plummer, Deborah L.

    2018-01-01

    Purpose To produce a physician and scientific workforce capable of delivering high quality, culturally competent health care and research, academic medical centers must assess their capacity for diversity and inclusion and respond to identified opportunities. Thus, the Diversity Engagement Survey (DES) is presented as a diagnostic and benchmarking tool. Method The 22-item DES connects workforce engagement theory with inclusion and diversity constructs. Face and content validity were established based on decades of previous work to promote institutional diversity. The survey was pilot tested at a single academic medical center and subsequently administered at 13 additional academic medical centers. Cronbach alphas assessed internal consistency and Confirmatory Factor Analysis (CFA) established construct validity. Criterion validity was assessed by observed separation in scores for groups traditionally recognized to have less workforce engagement. Results The sample consisted of 13,694 individuals at 14 medical schools from across the U.S. who responded to the survey administered between 2011– 2012. The Cronbach alphas for inclusion and engagement factors (range: 0.68 to 0.85), CFA fit indices, and item correlations with latent constructs, indicated an acceptable model fit and that questions measured the intended concepts. DES scores clearly distinguished higher and lower performing institutions. The DES detected important disparities for black, women, and those who did not have heterosexual orientation. Conclusions This study demonstrated that the DES is a reliable and valid instrument for internal assessment and evaluation or external benchmarking of institutional progress in building inclusion and engagement. PMID:26466376

  7. Negotiation in academic medicine: narratives of faculty researchers and their mentors.

    Science.gov (United States)

    Sambuco, Dana; Dabrowska, Agata; Decastro, Rochelle; Stewart, Abigail; Ubel, Peter A; Jagsi, Reshma

    2013-04-01

    Few researchers have explored the negotiation experiences of academic medical faculty even though negotiation is crucial to their career success. The authors sought to understand medical faculty researchers' experiences with and perceptions of negotiation. Between February 2010 and August 2011, the authors conducted semistructured, in-depth telephone interviews with 100 former recipients of National Institutes of Health mentored career development awards and 28 of their mentors. Purposive sampling ensured a diverse range of viewpoints. Multiple analysts thematically coded verbatim transcripts using qualitative data analysis software. Participants described the importance of negotiation in academic medical careers but also expressed feeling naïve and unprepared for these negotiations, particularly as junior faculty. Award recipients focused on power, leverage, and strategy, and they expressed a need for training and mentorship to learn successful negotiation skills. Mentors, by contrast, emphasized the importance of flexibility and shared interests in creating win-win situations for both the individual faculty member and the institution. When faculty construed negotiation as adversarial and/or zero-sum, participants believed it required traditionally masculine traits and perceived women to be at a disadvantage. Academic medical faculty often lack the skills and knowledge necessary for successful negotiation, especially early in their careers. Many view negotiation as an adversarial process of the sort that experts call "hard positional bargaining." Increasing awareness of alternative negotiation techniques (e.g., "principled negotiation," in which shared interests, mutually satisfying options, and fair standards are emphasized) may encourage the success of medical faculty, particularly women.

  8. Race/Ethnicity and Success in Academic Medicine: Findings From a Longitudinal Multi-Institutional Study.

    Science.gov (United States)

    Kaplan, Samantha E; Raj, Anita; Carr, Phyllis L; Terrin, Norma; Breeze, Janis L; Freund, Karen M

    2017-10-24

    To understand differences in productivity, advancement, retention, satisfaction, and compensation comparing underrepresented medical (URM) faculty with other faculty at multiple institutions. A 17-year follow-up was conducted of the National Faculty Survey, a random sample from 24 U.S. medical schools, oversampled for URM faculty. The authors examined academic productivity, advancement, retention, satisfaction, and compensation, comparing white, URM, and non-URM faculty. Retention, productivity, and advancement data were obtained from public sources for nonrespondents. Covariates included gender, specialty, time distribution, and years in academia. Negative binomial regression was used for count data, logistic regression for binary outcomes, and linear regression for continuous outcomes. In productivity analyses, advancement, and retention, 1,270 participants were included; 604 participants responded to the compensation and satisfaction survey. Response rates were lower for African American (26%) and Hispanic faculty (39%) than white faculty (52%, P career satisfaction, or compensation between URM and white faculty. URM and white faculty had similar career satisfaction, grant support, leadership, and compensation; URM faculty had fewer publications and were less likely to be promoted and retained in academic careers. Successful retention of URM faculty requires comprehensive institutional commitment to changing the academic climate and deliberative programming to support productivity and advancement.

  9. The evolution of academic performance in emergency medicine journals: viewpoint from 2000 to 2009 journal citation reports.

    Science.gov (United States)

    Lee, Ching-Hsing; Shih, Chia-Pang; Chang, Yu-Che; Chaou, Chung-Hsien

    2011-08-01

    Emergency medicine (EM) is a young but rapidly growing field. An evaluation of academic performance and the growing impact of EM journals would help to elucidate the increase in the number of EM scientific studies. The authors used the Journal Citation Reports (JCR) database to investigate the scientific achievements of EM journals in the past 10 years. This was a literature review study. All data were collected from the JCR database. Journals listed in the EM category from 2000 to 2009 were included. Eleven categories that were considered most closely related to EM by a consensus of the authors were chosen for comparison, including cardiac and cardiovascular systems, clinical neurology, critical care medicine, gastroenterology and hepatology, infectious diseases, general and internal medicine, pediatrics, respiratory system, surgery, toxicology, and urology and nephrology. Data on journals in the EM category were collected, including journal title, language, journal country or territory, impact factor for each year, total number of EM journals for each year, and the EM category aggregate impact factor (available from 2003 to 2009). The variables in the comparison group included the number of journals in each of the 11 clinical medicine categories from 2000 to 2009 and the aggregate impact factors for 2003 to 2009. The category aggregate impact factor and journal impact factor were adopted as representative of category and journal academic performance. Linear regression was used to assess the trend of aggregate impact factor and journal impact factor. The slope (β) of the linear regression was used to represent the evolution of performance. The relationship between the 2000 EM journal impact factor and the impact factor trend of EM journals between 2000 and 2009 was measured by Pearson correlation coefficient to evaluate the evolution difference between journals with different initial impact factors. In 2000, all 12 EM journals were published in the United States

  10. Year-End Clinic Handoffs: A National Survey of Academic Internal Medicine Programs.

    Science.gov (United States)

    Phillips, Erica; Harris, Christina; Lee, Wei Wei; Pincavage, Amber T; Ouchida, Karin; Miller, Rachel K; Chaudhry, Saima; Arora, Vineet M

    2017-06-01

    While there has been increasing emphasis and innovation nationwide in training residents in inpatient handoffs, very little is known about the practice and preparation for year-end clinic handoffs of residency outpatient continuity practices. Thus, the latter remains an identified, yet nationally unaddressed, patient safety concern. The 2014 annual Association of Program Directors in Internal Medicine (APDIM) survey included seven items for assessing the current year-end clinic handoff practices of internal medicine residency programs throughout the country. Nationwide survey. All internal medicine program directors registered with APDIM. Descriptive statistics of programs and tools used to formulate a year-end handoff in the ambulatory setting, methods for evaluating the process, patient safety and quality measures incorporated within the process, and barriers to conducting year-end handoffs. Of the 361 APDIM member programs, 214 (59%) completed the Transitions of Care Year-End Clinic Handoffs section of the survey. Only 34% of respondent programs reported having a year-end ambulatory handoff system, and 4% reported assessing residents for competency in this area. The top three barriers to developing a year-end handoff system were insufficient overlap between graduating and incoming residents, inability to schedule patients with new residents in advance, and time constraints for residents, attendings, and support staff. Most internal medicine programs do not have a year-end clinic handoff system in place. Greater attention to clinic handoffs and resident assessment of this care transition is needed.

  11. [Current Research Activities on Person-Centered Medicine in Academic Institutes of General Practice in Germany and Austria].

    Science.gov (United States)

    Weber, Annemarie; Schelling, Jörg; Kohls, Niko; van Dyck, Marcus; Poggenburg, Stephanie; Vajda, Christian; Hirsch, Jameson; Sirois, Fuschia; Toussaint, Loren; Offenbächer, Martin

    2017-10-11

    Aim of study Person-centered medicine (PCM) with its focus on humanistic-biographical-oriented medicine and integrated, positive-salutogenic health is a central aspect in the patient-physician relationship in general practice. The objective of this analysis is to assess the prevalence and type of research project in academic institutions of general practice in Germany (Ger) and Austria (At) and the thematic priorities of the projects in the areas PCM, health promotion (HP), prevention (PRE) and conventional medicine (CM). Methods A search was conducted (September-December 2015) on the websites of 30 institutes and divisions of general medicine for their current research projects. The retrieved projects were assigned to five categories: PCM, HP, PRE, CM and others. Subsequently, we identified the targeted patient groups of the projects as well as the thematic focus in the categories PCM, HP, PRE and CM with focus on PCM and HP. Results 541 research projects were identified, 452 in Germany and 89 in Austria. Research projects were only included if they were explicitly indicated as research-oriented. Seventy projects addressed PCM aspects, 15 projects HP aspects, 32 projects PRE aspects and 396 projects CM aspects. The most frequently target groups in the categories PCM (24 of 70) and HP (7 of 15) were chronically ill patients. The most common thematic focus in PCM was communication (13 of 70) and in HP, physical activity (6 of 15). Conclusion The vast majority of research projects investigated conventional medical topics. The percentage of research activities in the field of PCM (13%) or PCM including HP (16%) in Ger and At is below the European average of 20%. From our point of view, PCM and HP need to be implemented to a greater extent in general practice. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Corporate and Hospital Profiteering in Emergency Medicine: Problems of the Past, Present, and Future.

    Science.gov (United States)

    Derlet, Robert W; McNamara, Robert M; Plantz, Scott H; Organ, Matthew K; Richards, John R

    2016-06-01

    Health care delivery in the United States has evolved in many ways over the past century, including the development of the specialty of Emergency Medicine (EM). With the creation of this specialty, many positive changes have occurred within hospital emergency departments (EDs) to improve access and quality of care of the nation's de facto "safety net." The specialty of EM has been further defined and held to high standards with regard to board certification, sub-specialization, maintenance of skills, and research. Despite these advances, problems remain. This review discusses the history and evolution of for-profit corporate influence on EM, emergency physicians, finance, and demise of democratic group practice. The review also explores federal and state health care financing issues pertinent to EM and discusses potential solutions. The monopolistic growth of large corporate contract management groups and hospital ownership of vertically integrated physician groups has resulted in the elimination of many local democratic emergency physician groups. Potential downsides of this trend include unfair or unlawful termination of emergency physicians, restrictive covenants, quotas for productivity, admissions, testing, patient satisfaction, and the rising cost of health care. Other problems impact the financial outlook for EM and include falling federal, state, and private insurance reimbursement for emergency care, balance-billing, up-coding, unnecessary testing, and admissions. Emergency physicians should be aware of the many changes happening to the specialty and practice of EM resulting from corporate control, influence, and changing federal and state health care financing issues. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Acinetobacter baumannii: Epidemiological and Beta-Lactamase Data From Two Tertiary Academic Hospitals in Tshwane, South Africa

    Directory of Open Access Journals (Sweden)

    Michelle Lowe

    2018-06-01

    Full Text Available Acinetobacter baumannii is an opportunistic pathogen that is increasingly responsible for hospital-acquired infections. The increasing prevalence of carbapenem resistant A. baumannii has left clinicians with limited treatment options. Last line antimicrobials (i.e., polymyxins and glycylcyclines are often used as treatment options. The aim of this study was to determine the prevalence of selected β-lactamase genes from A. baumannii isolates obtained from patients with hospital-acquired infections and to determine the genetic relationship and epidemiological profiles among clinical A. baumannii isolates collected from two tertiary academic hospitals in the Tshwane region, South Africa (SA. Multiplex-PCR (M-PCR assays were performed to detect selected resistance genes. The collected isolates’ genetic relatedness was determined by using pulsed field gel electrophoresis (PFGE and multilocus sequence typing (MLST. The acquired oxacillinase (OXA genes, notably blaOXA-23-like were prevalent in the A. baumannii isolates. The M-PCR assays showed that the isolates collected from hospital A contained the OXA-23-like (96%; n = 69/72 genes and the isolates collected from hospital B contained the OXA-23-like (91%; n = 63/69 and OXA-58-like (4%; n = 3/69 genes. Colistin resistance was found in 1% of the isolates (n = 2/141 and tigecycline intermediate resistance was found in 6% of the isolates (n = 8/141. The A. baumannii isolates were genetically diverse. Molecular epidemiological data showed that specific sequence types (STs (ST106, ST229, ST258 and ST208 were established in both hospitals, while ST848 was established in hospital A and ST502, ST339 and the novel ST1552 were established in hospital B. ST848 (established in hospital A was predominately detected in ICU wards whereas ST208, ST339 and the novel ST1552 (established in hospital B were detected in ICUs and the general wards. The origin of the A. baumannii isolates in the hospitals may be due to

  14. A qualitative study of patient involvement in medicines management after hospital discharge: an under-recognised source of systems resilience.

    Science.gov (United States)

    Fylan, Beth; Armitage, Gerry; Naylor, Deirdre; Blenkinsopp, Alison

    2017-11-16

    There are risks to the safety of medicines management when patient care is transferred between healthcare organisations, for example, when a patient is discharged from hospital. Using the theoretical concept of resilience in healthcare, this study aimed to better understand the proactive role that patients can play in creating safer, resilient medicines management at a common transition of care. Qualitative interviews with 60 cardiology patients 6 weeks after their discharge from 2 UK hospitals explored patients' experiences with their discharge medicines. Data were initially subjected to an inductive thematic analysis and a subsequent theory-guided deductive analysis. During interviews 23 patients described medicines management resilience strategies in two main themes: identifying system vulnerabilities; and establishing self-management strategies. Patients could anticipate problems in the system that supplied them with medicines and took specific actions to prevent them. They also identified when errors had occurred both before and after medicines had been supplied and took corrective action to avoid harm. Some reported how they had not foreseen problems or experienced patient safety incidents. Patients recounted how they ensured information about medicines changes was correctly communicated and acted upon, and described their strategies to enhance their own reliability in adherence and resource management. Patients experience the impact of vulnerabilities in the medicines management system across the secondary-primary care transition but many are able to enhance system resilience through developing strategies to reduce the risk of medicines errors occurring. Consequently, there are opportunities-with caveats-to elicit, develop and formalise patients' capabilities which would contribute to safer patient care and more effective medicines management. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights

  15. HIV and infectious disease care in jails and prisons: breaking down the walls with the help of academic medicine.

    Science.gov (United States)

    Flanigan, Timothy P; Zaller, Nickolas; Taylor, Lynn; Beckwith, Curt; Kuester, Landon; Rich, Josiah; Carpenter, Charles C J

    2009-01-01

    Health care within correctional facilities has traditionally been marginalized from excellence in academic medicine. The armamentarium of a medical school, which includes excellence in research, teaching and clinical care, can be successfully applied to the correctional setting both in the United States and internationally. At any one time, there are over 2 million people incarcerated in the US who are disproportionately poor and from communities of color. Rates of human immunodeficiency virus (HIV) and hepatitis C virus infection (HCV) in prisons are 5 and 17-28-times higher than in the general population, respectively. The correctional setting provides an excellent opportunity to screen for and treat sexually transmitted infections (STIs), HIV, HCV, chronic hepatitis B virus (HBV) infections and tuberculosis (TB) and to develop effective prevention programs.

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

    Science.gov (United States)

    Cameron, Christian Blake; Nair, Vinay; Varma, Manu; Adams, Martha; Jhaveri, Kenar D; Sparks, Matthew A

    2016-06-23

    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. We sought to understand whether chairs of medicine and pediatric departments acknowledge blog authorship as academic achievement. 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). 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). Our findings demonstrate that although the majority of department chairs value educational scholarship, only a minority perceive value in faculty blogging effort.

  17. Variability in Women Faculty’s Preferences Regarding Mentor Similarity: A Multi-Institution Study in Academic Medicine

    Science.gov (United States)

    Carapinha, René; Ortiz-Walters, Rowena; McCracken, Caitlin M.; Hill, Emorcia V.; Reede, Joan Y.

    2016-01-01

    Purpose To investigate which mentor similarity characteristics women faculty in academic medicine rate most important and to determine whether the importance of similarity differs among women faculty based on current and prior mentoring, demographic and personal factors, and career factors. Method Cross-sectional survey data from 3,100 women faculty at 13 purposively sampled U.S. medical schools were collected in 2012. The preferences of participants regarding the importance of mentor similarity in terms of race/ethnicity, gender, personal and career interests, and department and institution were studied. Analysis entailed chi square tests and multivariable ordered logistic models. Results Overall, respondents ranked having a mentor in the same department and institution as most important. Same department and institution were less important for those without a current mentor and for senior faculty, and were more important for Asian faculty. Same career and personal interests were less important for older faculty and more important for those with a doctorate only. Same gender was more important for Black faculty, faculty at the rank of instructor, and those without current mentoring. Overall, same race/ethnicity was rated least important; however, it was more important for racial/ethnic minorities, foreign-born faculty, and those who had never had a mentor. Conclusions Mentor preferences, as indicated by level of importance assigned to types of mentor similarity, varied among women faculty. To advance effective mentoring, characterized by high degree of mentor-mentee fit, the authors provide recommendations on matching strategies to be used in academic medicine when considering the diverse mentor preferences of women faculty. PMID:27332871

  18. The Culture of Academic Medicine: Faculty Behaviors Impacting the Learning Environment.

    Science.gov (United States)

    Moutier, Christine; Wingard, Deborah; Gudea, Monica; Jeste, Dilip; Goodman, Seneca; Reznik, Vivian

    2016-12-01

    The culture of academic medical institutions impacts trainee education, among many other faculty and patient outcomes. Disrespectful behavior by faculty is one of the most challenging and common problems that, left unattended, disrupts healthy work and learning environments. Conversely, a respectful environment facilitates learning, creates a sense of safety, and rewards professionalism. The authors developed surveys and an intervention in an effort to better understand and improve climate concerns among health sciences faculty at the University of California, San Diego (UCSD), a research-intense, public, academic medical center. An online "climate survey" of all UC San Diego health sciences faculty was conducted in 2011-2012. A strategic campaign to address the behavioral issues identified in the initial survey was subsequently launched. In 2015, the climate was re-evaluated in order to assess the effectiveness of the intervention. A total of 478 faculty members (223 women, 235 men, 35 % of faculty) completed the baseline survey, reporting relatively low levels of observed sexual harassment (7 %). However, faculty reported concerning rates of other disruptive behaviors: derogatory comments (29 %), anger outbursts (25 %), and hostile communication (25 %). Women and mid-level faculty were more likely to report these behavioral concerns than men and junior or senior colleagues. Three years after an institutional strategy was initiated, 729 faculty members (50 % of the faculty) completed a follow-up survey. The 2015 survey results indicate significant improvement in numerous climate factors, including overall respectful behaviors, as well as behaviors related to gender. In order to enhance a culture of respect in the learning environment, institutions can effectively engage academic leaders and faculty at all levels to address disruptive behavior and enhance positive climate factors.

  19. Negotiation in Academic Medicine: Narratives of Faculty Researchers and Their Mentors

    Science.gov (United States)

    Sambuco, Dana; Dabrowska, Agata; DeCastro, Rochelle; Stewart, Abigail; Ubel, Peter A.; Jagsi, Reshma

    2013-01-01

    Purpose Few researchers have explored the negotiation experiences of academic medical faculty even though negotiation is crucial to their career success. The authors sought to understand medical faculty researchers' experiences with and perceptions of negotiation. Method Between February 2010 and August 2011, the authors conducted semi-structured, in-depth telephone interviews with 100 former recipients of National Institutes of Health mentored career development awards and 28 of their mentors. Purposive sampling ensured a diverse range of viewpoints. Multiple analysts thematically coded verbatim transcripts using qualitative data analysis software. Results Participants described the importance of negotiation in academic medical careers but also expressed feeling naïve and unprepared for these negotiations, particularly as junior faculty. Award recipients focused on power, leverage, and strategy, and they expressed a need for training and mentorship to learn successful negotiation skills. Mentors, by contrast, emphasized the importance of flexibility and shared interests in creating win-win situations for both the individual faculty member and the institution. When faculty construed negotiation as adversarial and/or zero-sum, participants believed it required traditionally masculine traits and perceived women to be at a disadvantage. Conclusions Academic medical faculty often lack the skills and knowledge necessary for successful negotiation, especially early in their careers. Many view negotiation as an adversarial process of the sort that experts call “hard positional bargaining.” Increasing awareness of alternative negotiation techniques (e.g., “principled negotiation,” in which shared interests, mutually satisfying options, and fair standards are emphasized), may encourage the success of medical faculty, particularly women. PMID:23425992

  20. 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.

  1. The culture of academic medicine: faculty perceptions of the lack of alignment between individual and institutional values.

    Science.gov (United States)

    Pololi, Linda; Kern, David E; Carr, Phyllis; Conrad, Peter; Knight, Sharon

    2009-12-01

    Energized, talented faculty are essential to achieving the missions of academic medical centers (AMCs) in education, research and health care. The alignment of individuals' values with workplace experiences are linked to meaningfulness of work and productivity. To determine faculty values and their alignment with institutional values. A qualitative hypothesis-generating interview study to understand the professional experiences of faculty and organizational approach in five AMCs that were nationally representative in regional and organizational characteristics. Analysis was inductive and data driven. Using stratified, purposeful sampling, we interviewed 96 male and female faculty at different career stages (early career, plateaued, senior faculty and those who had left academic medicine) and diverse specialties (generalists, medical and surgical subspecialists, and research scientists). Dominant themes that emerged from the data. Faculty described values relating to excellence in clinical care, community service (including care for the underserved and disadvantaged), teaching, intellectual rigor/freedom and discovery, all values that mirror the stated missions of AMCs. However, many faculty also described behaviors that led them to conclude that their AMCs, in practice, undervalued excellence in clinical care, and their social and educational missions. Themes were seen across gender, career stage, race and discipline, except that female leaders appeared more likely than male leaders to identify incongruence of individual values and organizational practices. In this study of five diverse medical schools, faculty values were well aligned with stated institutional missions; however, many perceived that institutional behaviors were not always aligned with individual faculty values.

  2. Who would become a successful Dean of Faculty of Medicine: academic or clinician or administrator?

    Science.gov (United States)

    Lee, Albert; Hoyle, Eric

    2002-11-01

    It has been a long tradition that the medical school dean is an expert in a specialist field with a well-established reputation in research and clinical services. Medical education is no longer simply disease orientated; it is required to put an emphasis on prevention, the need for better management of the health care system, and the need for a better understanding of the sociopolitical aspects of medical care. The deans of medical schools must appreciate the social role of medical education, and the social contract with the community. Although doctors might have difficulties with leadership because they are trained to work as individuals and to value highly their independence and autonomy, good communication skills are an asset for clinicians in management roles. It does not matter whether the background of the dean is academic, clinical or administrative; the most important thing is to possess the managerial skills to tackle the three-way tension between management, academic leadership and professional leadership. The job should be open to people with a good knowledge of and background in health and fiscal expertise, and also a high degree of management, diplomatic and interpersonal skills. Those skills should also be emphasized in the medical curriculum.

  3. 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.

  4. 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...

  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. 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

    OpenAIRE

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

    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...

  7. Supporting 'medicine at a distance' for delivery of hospital services in war-torn Somalia: how well are we doing?

    Science.gov (United States)

    Maalim, Abdisalan M; Zachariah, Rony; Khogali, Mohamed; Van Griensven, Johan; Van den Bergh, Rafael; Tayler-Smith, Katherine; Kizito, Walter; Baruani, Bienvenu; Osoble, Abdirahman; Abdirahman, Faiza; Ayada, Latifa; Mohamed, Abdinoor H

    2014-03-01

    We describe an innovative strategy implemented to support national staff at Istarlin Hospital in the conflict setting of Somalia; and report on inpatient morbidities, mortality and adverse hospital exit outcomes. This was a retrospective analysis of hospital data for 2011. Of 8584 admitted patients, the largest numbers were for lower respiratory tract infections (LRTI) (2114; 25%), normal deliveries (1355; 16%) and diarrhoeal diseases (715; 8%). The highest contributors to mortality were gunshot wounds in surgery (18/30; 60%), LRTIs in internal medicine (6/32; 19%) and malnutrition in paediatrics (30/81; 37%). Adverse hospital exit outcomes (deaths and absconded) were well within thresholds set by Médecins Sans Frontières. With a support package, satisfactory standards of care were met for hospital care in Somalia.

  8. Science communication in regenerative medicine: Implications for the role of academic society and science policy

    Directory of Open Access Journals (Sweden)

    Ryuma Shineha

    2017-12-01

    Full Text Available It is essential to understand the hurdles, motivation, and other issues affecting scientists' active participation in science communication to bridge the gap between science and society. This study analyzed 1115 responses of Japanese scientists regarding their attitudes toward science communication through a questionnaire focusing on the field of stem cell and regenerative medicine. As a result, we found that scientists face systemic issues such as lack of funding, time, opportunities, and evaluation systems for science communication. At the same time, there is a disparity of attitudes toward media discourse between scientists and the public.

  9. Surveillance of psychosomatic disorders in internal medicine in Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

    Science.gov (United States)

    Shatri, Hamzah; Mudjaddid, E; Lapau, Buchari

    2004-01-01

    to examine certain characteristics of patients who suffer from psychosomatic disorders. We called data through medical report outpatient clinic of the Psychosomatic Division, Department of internal medicine, Cipto Mangunkusumo Central General Hospital/Faculty of Medicine of the University of Indonesia (FKUI/RSUPN-CM), Jakarta, Indonesia, in 1996. The data was processed manually and by computer from which table and graphic were obtained. The descriptive analysis was performed to the objective the study. the FPD patients consisted of those with vegetative imbalance (multiple psychosomatic syndrome) (30.2%), dyspepsia (20.8%), functional heart disease (11.3%) and others 1%-6%. All of SPD consisted of chronic disease, such as hypertension (38.3%), diabetes mellitus (29.8%), bronchial asthma (10.6%), coronary artery disease (6.4%), and others 2%-5%. According to DSM IV, among the psychosomatic patients, 52.7% met the criteria for anxiety, 29.3% for depression, 14.2% for mixed anxiety and depression, and 3.8% unclear. The psychosocial stressor groups were family problems (38%), physical conditions (16%), work-related problems (13.4%), marriage problems (8.4%) and others (1%-4%). The most common physical symptoms of psychosomatic disorders were functional. Common functional psychosomatic disorders were multiple psychosomatic syndrome, dyspepsia and functional heart disease. Structural disorders found were chronic diseases. There was no difference in prevalence between males and females. The most frequent functional disorders were more commonly found among those under 40 years of age, while those with structural disorders were more common among patients 40 years of age or more. The psychological diagnoses were anxiety and depression. The most frequent psychological stressors were family problems, medical conditions, work-related problems and marriage problems.

  10. Pulmonary tuberculosis among diabetic patients in internal medicine at point g hospital, bamako - mali.

    Science.gov (United States)

    Sidibé, At; Dembélé, M; Diarra, As; Cissé, I; Bocoum, A; Traoré, Ak; Traoré, Ha

    2005-01-01

    Summary The depression of cellular immunity among diabetic patients exposes them to tuberculosis considered as one of the major diseases of immune-depressive people. The purpose of our study was to evaluate the frequency, gravity, treatment and evolution of pulmonary tuberculosis among our patients affected with diabetes. For that purpose, two descriptive retrospective and prospective studies were undertaken from January 1982 to December 1992 in the Internal Medicine (Internal medicine) department of Hospital of Point G, the national hospital. Thus, 54 diabetics patients hospitalised out of 1 365 had tuberculosis at a frequency rate of 3,95%. The average age of our patients was 49 years +/- 12 and the sex ratio was 2,18 in favour of men. The infection was also more frequent in diabetes type 1 (51,9%) then in type 2 (48,1%), and concerned mainly men (68.51%) who were more than 37 years old (57.41%). Clinically, the common signs to both affections were prevalent namely asthenia: 85,2%, anorexia: 53,7%, weight loss: 66,7%, associated to cough: 81,5% and to dyspnea: 29,6%. However, for a third of the patients (22,2%), tuberculosis was discovered during a systematic check up. All the patients had a glycemia higher than 8mmol/l, with extremes up to 8mmol/l and 32mmol/l, 63% of patient had a febricula. The intradermo cutaneous reaction to tuberculosis (IDR) was negative in 44,4%. The bacilloscopy during direct testing or through the liquid obtained by casing was positive in 64,82%. Tubercular lesions were localised at the top: 91,8%, with an equal attack of the two lungs. During the treatment six products were mainly used comprising Rifampicine (R) isoniazid (INH or H), Streptomycine (S), Ethambutol (E), Thiacetazone (T), and Pyrazinamide (Z). Insulin treatment was done on all patients until tuberculosis was cured. The evolution was favourable after 2 to 3 months of treatment for 48 patients (88,88%) among whom 4: (8,33%) fell sick again. Six patients out of 54 died, i

  11. Hospital Audit as a Useful Tool in the Process of Introducing Falsified Medicines Directive (FMD into Hospital Pharmacy Settings—A Pilot Study

    Directory of Open Access Journals (Sweden)

    Urszula Religioni

    2017-11-01

    Full Text Available Background: Recently, the European Union has introduced the Falsified Medicines Directive (FMD. Additionally, in early 2016, a Delegated Act (DA related to the FMD was published. The main objective of this study was to evaluate the usefulness of external audits in the context of implementing new regulations provided by the FMD in the secondary care environment. Methods: The external, in-person workflow audits were performed by an authentication company in three Polish hospital pharmacies. Each audit consisted of a combination of supervision (non-participant observation, secondary data analysis, and expert interviews with the use of an independently designed authorial Diagnostic Questionnaire. The questionnaire included information about hospital drug distribution procedures, data concerning drug usage, IT systems, medication order systems, the processes of medication dispensing, and the preparation and administration of hazardous drugs. Data analysis included a thorough examination of hospital documentation in regard to drug management. All data were subjected to qualitative analysis, with the aim of generating meaningful information through inductive inference. Results: Only one dispensing location in the Polish hospitals studied has the potential to be a primary authentication area. In the audited hospitals, an Automated Drug Dispensing System and unit dose were not identified during the study. Hospital wards contained an enclosed place within the department dedicated to drug storage under the direct supervision of senior nursing staff. An electronic order system was not available. In the largest center, unused medications are re-dispensed to different hospital departments, or may be sold to various institutions. Additionally, in one hospital pharmacy, pharmacists prepared parenteral nutrition and chemotherapeutic drugs for patients admitted to the hospital. Conclusions: External audits might prove beneficial in the course of introducing new

  12. Hospitability of ornamental and medicinal plants to root-knot nematode (Meloidogyne incognita race 2

    Directory of Open Access Journals (Sweden)

    Francisco José Carvalho Moreira

    2017-10-01

    Full Text Available The correct identification of species and genus of nematodes that affect a particular culture is of great importance to form a quantity of information that will be useful to laboratories for diagnosis and control of these pathogens. Because of the increase in the production of ornamental and medicinal plants in the of Cear. á State, the agricultural importance of the genus Meloidogyne and the scarcity of information on the hospitability this pathogen in these species, in that it was to evaluate the susceptibility testing of 30 species, and 20 ornamental (Antirrhimum majus, Gazania ringens, Carthamus tinctorius, Bryophyllum cayicinum, Ceasalpinia pulcherrima, Thumbergia alata, Petunia hibryda, Exacum affine, Catharanthus roseus, Opuntia sp., Sansevieria trifasciata, Asparagus densiflorus, Hibiscus mutabilis-roreus, Impatiens balsamiana, Celosia spicata, Antirrhimum sp., Dianthus chinensis, Zinnia elegans, Tagetes patula, Capsicum annuum and 10 medicinal (Peumus boldus, Ocimum gratissimum, Mentha arvensis var. piperascens, Mentha x Vilosa, Plectranthus amboinicus, Ocimum bassilicum, Rosmarinus officinalis, Cymbopogon citratus, Lippia alba, Cymbopogon winterianus. The test was conducted in a greenhouse, of the Phytosanitary Sector, Department of Plant Science, Federal University of Ceará. The inoculation was conducted with 4,000 eggs/J2 for pot. Evaluation of the plants gave to 60 days after inoculation. Evaluated is the reaction of the plants, measuring up: number of galls and eggs, egg mass index, reproduction factor and reduce the reproduction factor. From these variables it was classified the reaction of plants to the nematode by means of five criterions. Of ownership of the results, it was verified that of the ornamental plants only species T. patula didn’t presented galls in your root system. Concerning medicinal species M. vilosa, C. citrates, L. alba, C. winterianus and P. boldus showed no galls in their root systems. Thus, concluded

  13. 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.

  14. [Laboratory medicine in the obligatory postgraduate clinical training system--common clinical training program in the department of laboratory medicine in our prefectural medical university hospital].

    Science.gov (United States)

    Okamoto, Yasuyuki

    2003-04-01

    I propose a postgraduate common clinical training program to be provided by the department of laboratory medicine in our prefectural medical university hospital. The program has three purposes: first, mastering basic laboratory tests; second, developing the skills necessary to accurately interpret laboratory data; third, learning specific techniques in the field of laboratory medicine. For the first purpose, it is important that medical trainees perform testing of their own patients at bedside or in the central clinical laboratory. When testing at the central clinical laboratory, instruction by expert laboratory technicians is helpful. The teaching doctors in the department of laboratory medicine are asked to advise the trainees on the interpretation of data. Consultation will be received via interview or e-mail. In addition, the trainees can participate in various conferences, seminars, and meetings held at the central clinical laboratory. Finally, in order to learn specific techniques in the field of laboratory medicine, several special courses lasting a few months will be prepared. I think this program should be closely linked to the training program in internal medicine.

  15. Overspecialized and undertrained? Patient diversity encountered by medical students during their internal medicine clerkship at a university hospital.

    Science.gov (United States)

    Melderis, Simon; Gutowski, Jan-Philipp; Harendza, Sigrid

    2015-03-31

    During the four-month internal medicine clerkship in their final year, undergraduate medical students are closely involved in patient care. Little is known about what constitutes their typical learning experiences with respect to patient diversity within the different subspecialties of internal medicine and during on call hours. 25 final year medical students (16 female, 9 male) on their internal medicine clerkship participated in this observational single-center study. To detail the patient diversity encountered by medical students at a university hospital during their 16-week internal medicine clerkship, all participants self-reported their patient contacts in the different subspecialties and during on call hours on patient encounter cards. Patients' chief complaint, suspected main diagnosis, planned diagnostic investigations, and therapy in seven different internal medicine subspecialties and the on call medicine service were documented. 496 PECs were analysed in total. The greatest diversity of chief complaints (CC) and suspected main diagnoses (SMD) was observed in patients encountered on call, with the combined frequencies of the three most common CCs or SMDs accounting for only 23% and 25%, respectively. Combined, the three most commonly encountered CC/SMD accounted for high percentages (82%/63%), i.e. less diversity, in oncology and low percentages (37%/32%), i.e. high diversity, in nephrology. The percentage of all diagnostic investigations and therapies that were classified as "basic" differed between the subspecialties from 82%/94% (on call) to 37%/50% (pulmonology/oncology). The only subspecialty with no significant difference compared with on call was nephrology for diagnostic investigations. With respect to therapy, nephrology and infectious diseases showed no significant differences compared with on call. Internal medicine clerkships at a university hospital provide students with a very limited patient diversity in most internal medicine

  16. 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.

  17. Social deprivation, population dependency ratio and an extended hospital episode - Insights from acute medicine.

    Science.gov (United States)

    Cournane, Seán; Dalton, Ann; Byrne, Declan; Conway, Richard; O'Riordan, Deirdre; Coveney, Seamus; Silke, Bernard

    2015-11-01

    Patients from deprived backgrounds have a higher in-patient mortality following an emergency medical admission; this study aimed to investigate the extent to which Deprivation status and the population Dependency Ratio influenced extended hospital episodes. All Emergency Medical admissions (75,018 episodes of 41,728 patients) over 12 years (2002-2013) categorized by quintile of Deprivation Index and Population Dependency Rates (proportion of non-working/working) were evaluated against length of stay (LOS). Patients with an Extended LOS (ELOS), >30 days, were investigated, by Deprivation status, Illness Severity and Co-morbidity status. Univariate and multi-variable risk estimates (Odds Rates or Incidence Rate Ratios) were calculated, using truncated Poisson regression. Hospital episodes with ELOS had a frequency of 11.5%; their median LOS (IQR) was 55.0 (38.8, 97.6) days utilizing 57.6% of all bed days by all 75,018 emergency medical admissions. The Deprivation Index independently predicted the rate of such ELOS admissions; these increased approximately five-fold (rate/1000 population) over the Deprivation Quintiles with model adjusted predicted admission rates of for Q1 0.93 (95% CI: 0.86, 0.99), Q22.63 (95% CI: 2.55, 2.71), Q3 3.84 (95% CI: 3.77, 3.91), Q4 3.42 (95% CI: 3.37, 3.48) and Q5 4.38 (95% CI: 4.22, 4.54). Similarly the Population Dependency Ratio Quintiles (dependent to working structure of the population by small area units) independently predicted extended LOS admissions. The admission of patients with an ELOS is strongly influenced by the Deprivation status and the population Dependency Ratio of the catchment area. These factors interact, with both high deprivation and Dependency cohorts having a major influence on the numbers of emergency medical admission patients with an extended hospital episode. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  18. Environmental iodine intake and pattern of thyroid diseases: experience at nuclear medicine centre, Mayo Hospital (abstract)

    International Nuclear Information System (INIS)

    Elahi, S.; Khan, M.; Rasool, S.; Khalid, A.; Tasneem, A.

    2011-01-01

    To know level of iodine intake in women residing in Lahore and correlate it with pattern of thyroid diseases found in women referred to Centre for Nuclear Medicine (CENUM), Mayo Hospital. Iodine intake status was determined by urinary iodine (UI) excretion by Sandell-Kolthoff reaction. Thyroid related hormones (FT4, FT3 and TSH) were measured by radioimmunoassay. In 110 non-pregnant euthyroid women (age 20-36 year) average iodine intake was 66.3 +- 14.4 mu g/L (range: 30-98 mu g/dL). All women were iodine deficient (UI 22.0 pmol/L and TSH greater or equal to 0.1mIU/L) was detected in 580(10.8%) women and hypothyroidism (FT4 0.4mIU/L) was found in 271(5.1%) women. Thus incidence of hyperthyroidism was almost double than that of hypothyroidism. Low iodine intake is manifested as increased incidence of hyperthyroidism. (author)

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

    International Nuclear Information System (INIS)

    Richards, P.A.C.

    1998-01-01

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

  20. A matter of priorities? Exploring the persistent gender pay gap in hospital medicine.

    Science.gov (United States)

    Weaver, A Charlotta; Wetterneck, Tosha B; Whelan, Chad T; Hinami, Keiki

    2015-08-01

    Gender earnings disparities among physicians exist even after considering differences in specialty, part-time status, and practice type. Little is known about the role of job satisfaction priorities on earnings differences. To examine gender differences in work characteristics and job satisfaction priorities, and their relationship with gender earnings disparities among hospitalists. Observational cross-sectional survey study. US hospitalists in 2010. Self-reported income, work characteristics, and priorities among job satisfaction domains. On average, women compared to men hospitalists were younger, less likely to be leaders, worked fewer full-time equivalents, worked more nights, reported fewer daily billable encounters, more were pediatricians, worked in university settings, worked in the Western United States, and were divorced. More hospitalists of both genders prioritized optimal workload among the satisfaction domains. However, substantial pay ranked second in prevalence by men and fourth by women. Women hospitalists earned $14,581 less than their male peers in an analysis adjusting for these differences. The gender earnings gap persists among hospitalists. A portion of the disparity is explained by the fewer women hospitalists compared to men who prioritize pay. © 2015 Society of Hospital Medicine.

  1. 50th Year Anniversary of Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University.

    Science.gov (United States)

    Lertakyamanee, Jariya

    2016-05-01

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

  2. Impact of a Dedicated Emergency Medicine Teaching Resident Rotation at a Large Urban Academic Center.

    Science.gov (United States)

    Ahn, James; Golden, Andrew; Bryant, Alyssa; Babcock, Christine

    2016-03-01

    In the face of declining bedside teaching and increasing emergency department (ED) crowding, balancing education and patient care is a challenge. Dedicated shifts by teaching residents (TRs) in the ED represent an educational intervention to mitigate these difficulties. We aimed to measure the perceived learning and departmental impact created by having TR. TRs were present in the ED from 12 pm-10 pm daily, and their primary roles were to provide the following: assist in teaching procedures, give brief "chalk talks," instruct junior trainees on interesting cases, and answer clinical questions in an evidence-based manner. This observational study included a survey of fourth-year medical students (MSs), residents and faculty at an academic ED. Surveys measured the perceived effect of the TR on teaching, patient flow, ease of procedures, and clinical care. Survey response rates for medical students, residents, and faculty are 56%, 77%, and 75%, respectively. MSs perceived improved procedure performance with TR presence and the majority agreed that the TR was a valuable educational experience. Residents perceived increased patient flow, procedure performance, and MS learning with TR presence. The majority agreed that the TR improved patient care. Faculty agreed that the TR increased resident and MS learning, as well as improved patient care and procedure performance. The presence of a TR increased MS and resident learning, improved patient care and procedure performance as perceived by MSs, residents and faculty. A dedicated TR program can provide a valuable resource in achieving a balance of clinical education and high quality healthcare.

  3. The intended and unintended consequences of communication systems on general internal medicine inpatient care delivery: a prospective observational case study of five teaching hospitals.

    Science.gov (United States)

    Wu, Robert C; Lo, Vivian; Morra, Dante; Wong, Brian M; Sargeant, Robert; Locke, Ken; Cavalcanti, Rodrigo; Quan, Sherman D; Rossos, Peter; Tran, Kim; Cheung, Mark

    2013-01-01

    Effective clinical communication is critical to providing high-quality patient care. Hospitals have used different types of interventions to improve communication between care teams, but there have been few studies of their effectiveness. To describe the effects of different communication interventions and their problems. Prospective observational case study using a mixed methods approach of quantitative and qualitative methods. General internal medicine (GIM) inpatient wards at five tertiary care academic teaching hospitals. Clinicians consisting of residents, attending physicians, nurses, and allied health (AH) staff working on the GIM wards. Ethnographic methods and interviews with clinical staff (doctors, nurses, medical students, and AH professionals) were conducted over a 16-month period from 2009 to 2010. We identified four categories that described the intended and unintended consequences of communication interventions: impacts on senders, receivers, interprofessional collaboration, and the use of informal communication processes. The use of alphanumeric pagers, smartphones, and web-based communication systems had positive effects for senders and receivers, but unintended consequences were seen with all interventions in all four categories. Interventions that aimed to improve clinical communications solved some but not all problems, and unintended effects were seen with all systems.

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

    Science.gov (United States)

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

    2015-03-01

    Massage therapy is offered increasingly in US medical facilities. Although the United States has many massage schools, their education differs, along with licensure and standards. As massage therapy in hospitals expands and proves its value, massage therapists need increased training and skills in working with patients who have various complex medical concerns, to provide safe and effective treatment. These services for hospitalized patients can impact patient experience substantially and provide additional treatment options for pain and anxiety, among other symptoms. The present article summarizes the initial development and description of a hospital-based massage therapy course at a Midwest medical center. A hospital-based massage therapy course was developed on the basis of clinical experience and knowledge from massage therapists working in the complex medical environment. This massage therapy course had three components in its educational experience: online learning, classroom study, and a 25-hr shadowing experience. The in-classroom study portion included an entire day in the simulation center. The hospital-based massage therapy course addressed the educational needs of therapists transitioning to work with interdisciplinary medical teams and with patients who have complicated medical conditions. Feedback from students in the course indicated key learning opportunities and additional content that are needed to address the knowledge and skills necessary when providing massage therapy in a complex medical environment. The complexity of care in medical settings is increasing while the length of hospital stay is decreasing. For this reason, massage provided in the hospital requires more specialized training to work in these environments. This course provides an example initial step in how to address some of the educational needs of therapists who are transitioning to working in the complex medical environment.

  5. Assessment of academic/non-academic factors and extracurricular activities influencing performance of medical students of faculty of medicine, Universiti Sultan Zainal Abidin, Malaysia

    OpenAIRE

    Mainul Haque; Nor Azlina A Rahman; Md. Anwarul Azim Majumder; Nor Iza A Rahman; Seraj Zohurul Haque; Zainal Zulkifli; Halyna Lugova; Rabiu Muazu Musa; Ahmed Ghazi Alattraqchi

    2018-01-01

    Background: Physical and mental comfort is known to have a crucial influence on health and performance amongst medical students. Very often, medical students suffer from poor quality of life (QOL) related to the work-life balance due to the lack of sleep, nutritional and dietary disorders and low physical activity, resulting in a negative impact on their academic performance. This study aims to determine the potential academic/non-academic factors and extra-curricular activities influencing t...

  6. Peri-operative morbidity associated with radical cystectomy in a multicenter database of community and academic hospitals.

    Directory of Open Access Journals (Sweden)

    Luke T Lavallée

    Full Text Available OBJECTIVE: To characterize the frequency and timing of complications following radical cystectomy in a cohort of patients treated at community and academic hospitals. PATIENTS AND METHODS: Radical cystectomy patients captured from NSQIP hospitals from January 1 2006 to December 31 2012 were included. Baseline information and complications were abstracted by study surgical clinical reviewers through a validated process of medical record review and direct patient contact. We determined the incidence and timing of each complication and calculated their associations with patient and operative characteristics. RESULTS: 2303 radical cystectomy patients met inclusion criteria. 1115 (48% patients were over 70 years old and 1819 (79% were male. Median hospital stay was 8 days (IQR 7-13 days. 1273 (55.3% patients experienced at least 1 post-operative complication of which 191 (15.6% occurred after hospital discharge. The most common complication was blood transfusion (n = 875; 38.0%, followed by infectious complications with 218 (9.5% urinary tract infections, 193 (8.4% surgical site infections, and 223 (9.7% sepsis events. 73 (3.2% patients had fascial dehiscence, 82 (4.0% developed a deep vein thrombosis, and 67 (2.9% died. Factors independently associated with the occurrence of any post-operative complication included: age, female gender, ASA class, pre-operative sepsis, COPD, low serum albumin concentration, pre-operative radiotherapy, pre-operative transfusion >4 units, and operative time >6 hours (all p<0.05. CONCLUSION: Complications remain common following radical cystectomy and a considerable proportion occur after discharge from hospital. This study identifies risk factors for complications and quality improvement needs.

  7. Relationship Between Academic Performance and Student Self-Assessment of Clinical Performance in the College of Podiatric Medicine and Surgery.

    Science.gov (United States)

    Yoho, Robert M; Vardaxis, Vassilios; Millonig, Kelsey

    2016-05-01

    Student self-assessment is viewed as an important tool in medical education. We sought to identify the relationship between student academic performance and third-year clinical performance self-assessment. No such study exists in podiatric medical education. Third-year podiatric medical students from the classes of 2012 through 2014 completed a self-assessment of their performance for each of five broad clinical podiatric medical domains (Professionalism, Medicine, Radiology, Surgery, and Biomechanics/Orthopedics). The assessment was completed after students finished the first 12 weeks of their third-year clinical rotations (PRE) and a second time at the conclusion of the third year (POST). The mean self-assessment score for PRE and POST surveys for all combined domains was determined for each student. This mean was compared with the student's 3-year cumulative grade point average (GPA). Students' clinical experiences for the year were essentially identical. No statistically significant correlation was identified between cumulative GPA and the PRE and POST clinical self-assessments or with the change between PRE and POST assessments based on the Pearson correlation test for each class separately or on the pooled data. Published studies in allopathic medical education have shown that students with lower GPAs tend to rate their clinical performance higher in initial clinical performance self-assessment. Our results show that student academic performance was not correlated with clinical performance self-assessment. These findings may be due to the explicit description of successful clinical competency completion, the orientation students receive before the start of clinical training, and the continuous feedback received from clinical preceptors.

  8. Current Understandings of the Research-Practice Gap From the Viewpoint of Complementary Medicine Academics: A Mixed-Method Investigation.

    Science.gov (United States)

    Leach, Matthew J; Tucker, Basil

    Research plays an important role in advancing health and healthcare. However, much research evidence is not reflected in contemporary complementary and alternative medicine (CAM) practice. Understanding and addressing the reasons for this research-practice gap may have positive implications for quality of care. To shed light on the gap between research and CAM practice. Descriptive cross-sectional, mixed-method study. A total of 126 senior CAM academics across Australasia, Europe, UK, and North America. Participants completed a 30-item online survey and a semi-structured interview; both of which explored the research-practice gap in CAM. A total of 43 (34%) academics completed the survey, with 29 (67%) respondents undergoing an interview. There was general agreement among respondents that CAM research should be informed by practice, and practice informed by research; however, most agreed that this did not reflect the current situation. Translational issues were perceived to be the primary reason for the research-practice gap in CAM. Suggested strategies for closing the gap focussed mostly around improving CAM student/practitioner education and training, and researcher-practitioner engagement and collaboration. Study findings point toward the presence of a research-practice gap in CAM, with several factors likely to be instrumental in sustaining this gap. Attention now needs to focus on understanding the views of CAM clinicians on this issue. Insights gained from this research will help inform the development of a multi-modal strategy that will effectively target the barriers to change in order to bring CAM research and practice closer together. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Effects of participation in the Executive Leadership in Academic Medicine (ELAM) program on women faculty's perceived leadership capabilities.

    Science.gov (United States)

    McDade, Sharon A; Richman, Rosalyn C; Jackson, Gregg B; Morahan, Page S

    2004-04-01

    This study measured the impact of participation by women academics in the Executive Leadership in Academic Medicine (ELAM) program as part of a robust evaluation agenda. The design is a classic pre/post, within-group, self-report study. The survey elicits self-perception about leadership in ten constructs: knowledge of leadership, management, and organizational theory; environmental scanning; financial management; communication; networking and coalition building; conflict management; general leadership; assessment of strengths and weaknesses; acceptance of leadership demands; and career advancement sophistication. The post surveys inquire additionally about perceived program usefulness. Data were collected from 79 participants (1997-98, 1998-99, and 2000-01 classes). Response rates were nearly 100% (pre) and 69% to 76% (post). Statistically significant increases (p leadership capabilities were identified across all ten leadership constructs. Gains were large in knowledge of leadership and organizational theory, environmental scanning, financial management, and general leadership. Gains in career building knowledge were large to moderate. More modest were gains in communication, networking, and conflict management. There were significant correlations between each leadership construct and perceived usefulness of the program. Significant improvements were reported on all leadership constructs, even when participants viewed themselves as already skilled. While it cannot be concluded that participation in ELAM directly and solely caused all improvements, it seems unlikely that midcareer women faculty would improve on all ten constructs in 11 months after program completion by natural maturation alone. Future research will investigate whether the changes are due to ELAM or other factors, and assess whether participants show more rapid advancement into leadership than comparable women not participating in ELAM.

  10. The gender imbalance in academic medicine: a study of female authorship in the United Kingdom.

    Science.gov (United States)

    Sidhu, Reena; Rajashekhar, Praveen; Lavin, Victoria L; Parry, Joanne; Attwood, James; Holdcroft, Anita; Sanders, David S

    2009-08-01

    A shortfall exists of female doctors in senior academic posts in the United Kingdom. Career progression depends on measures of esteem, including publication in prestigious journals. This study investigates gender differences in first and senior authorship in six peer-reviewed British journals and factors that are associated with publication rates. Data was collected on United Kingdom first and senior authors who had published in the British Medical Journal, Lancet, British Journal of Surgery, Gut, British Journal of Obstetrics and Gynaecology and the Archives of Diseases in Childhood. Authorship and gender were quantified for 1970, 1980, 1990, 2000 and 2004 (n=6457). In addition, selected questions from the Athena Survey of Science Engineering and Technology (ASSET2006), web-based doctor's self-report of publications were also analysed (n=1162). Female first authors increased from 10.5% in 1970 to 36.5% in 2004 (p<0.001) while female senior authors only increased from 12.3% to 16.5% (p=0.046). Within individual journals, the largest rise was in British Journal of Obstetric and Gynaecology with 4.5- and 3-fold increases for first and senior authors, respectively. In contrast, female senior authors marginally declined in Gut and Lancet by 2.8% and 2.2%, respectively. ASSET2006 identified that female respondents who were parents were less likely to have publications as sole (p=0.02) and joint authors (p<0.001) compared to male respondents. Female respondents with care responsibilities for parents/partner also had less publications as lead authors compared to those without carer responsibilities (p<0.001). The increase in UK female first authors is encouraging. In contrast, there is considerable lag and in some specialties a decline in female senior authors. Factors that could narrow the gender gap in authorship should be sought and addressed.

  11. Impact of a Dedicated Emergency Medicine Teaching Resident Rotation at a Large Urban Academic Center

    Directory of Open Access Journals (Sweden)

    James Ahn, MD

    2016-03-01

    Full Text Available Introduction: In the face of declining bedside teaching and increasing emergency department (ED crowding, balancing education and patient care is a challenge. Dedicated shifts by teaching residents (TRs in the ED represent an educational intervention to mitigate these difficulties. We aimed to measure the perceived learning and departmental impact created by having TR. Methods: TRs were present in the ED from 12pm-10pm daily, and their primary roles were to provide the following: assist in teaching procedures, give brief “chalk talks,” instruct junior trainees on interesting cases, and answer clinical questions in an evidence-based manner. This observational study included a survey of fourth-year medical students (MSs, residents and faculty at an academic ED. Surveys measured the perceived effect of the TR on teaching, patient flow, ease of procedures, and clinical care. Results: Survey response rates for medical students, residents, and faculty are 56%, 77%, and 75%, respectively. MSs perceived improved procedure performance with TR presence and the majority agreed that the TR was a valuable educational experience. Residents perceived increased patient flow, procedure performance, and MS learning with TR presence. The majority agreed that the TR improved patient care. Faculty agreed that the TR increased resident and MS learning, as well as improved patient care and procedure performance. Conclusion: The presence of a TR increased MS and resident learning, improved patient care and procedure performance as perceived by MSs, residents and faculty. A dedicated TR program can provide a valuable resource in achieving a balance of clinical education and high quality healthcare.

  12. Reasons given by hypertensive patients for concurrently using traditional and Western medicine at Natalspruit Hospital in the Gauteng Province, South Africa

    Science.gov (United States)

    Mabuza, Langalibalele H.; Okonta, Henry I.

    2013-01-01

    Abstract Background In 2007, a large number of hypertensive patients seen at Natalspruit Hospital had poor adherent to their anti-hypertension treatment which manifested itself through poor blood pressure control. On enquiry, they revealed that they were also taking traditional medicines. Objectives To explore the reasons given by hypertensive patients for concurrently using traditional and Western medicine. Methods A qualitative study was conducted amongst nine purposefully selected participants attending treatment at the hospital. Interviews were conducted in the Southern Sotho and IsiZulu languages and were audio-taped. The exploratory question was: ‘Would you tell us why you are taking traditional medicine together with the antihypertensive medicine your are receiving at this hospital?’ The transcribed and translated transcriptions were analysed using the ‘cut and paste’ method to identify themes. Results Themes that emerged were that traditional medicine was readily accessible; traditional healers displayed knowledge and confidence in their medicine; traditional medicine was perceived to counteract the side-effects of western medicine; the two streams were perceived to complement each other and both streams could lead to a ‘cure’. Patients were disappointed at the perceived bad attitude of the hospital staff. Conclusion The reasons given by hypertensive patients for their concurrent use of traditional and Western medicine centred around patients’ relatively favourable perception of traditional medicine and its practitioners. Western medicine health care practitioners should continue health education on antihypertensive medication in a manner acceptable to patients.

  13. A computerized faculty time-management system in an academic family medicine department.

    Science.gov (United States)

    Daugird, Allen J; Arndt, Jane E; Olson, P Richard

    2003-02-01

    The authors describe the development, implementation, and evaluation of a computerized faculty time-management system (FTMS) in the Department of Family Medicine at the University of North Carolina-Chapel Hill. The FTMS is presented as an integrated set of computerized spreadsheets used annually to allocate faculty time across all mission activities of the department. It was first implemented in 1996 and has been continuously developed since then. An iterative approach has been used to gain consensus among faculty about time resources needed for various tasks of all missions of the department. These time-resource assumptions are used in the computerized system. Faculty time is allocated annually by the department vice chair in negotiation with individual faculty, making sure that the activities planned do not exceed the work time each faculty member has available for the year. During this process, faculty preferences are balanced against department aggregate needs to meet mission commitments and obligations. The authors describe how the computerized FTMS is used for faculty time management and career development, department planning, budget planning, clinical scheduling, and mission cost accounting. They also describe barriers and potential abuses and the challenge of building an organizational culture willing to discuss faculty time openly and committed to developing a system perceived as fair and accurate. The spreadsheet file is available free from the authors for use in other departments.

  14. The subjectively perceived quality of postgraduate medical training in integrative medicine within the public healthcare systems of Germany and Switzerland: the example of anthroposophic hospitals

    OpenAIRE

    Heusser, Peter; Eberhard, Sabine; Berger, Bettina; Weinzirl, Johannes; Orlow, Pascale

    2014-01-01

    Background Integrative medicine (IM) integrates evidence-based Complementary and Alternative Medicine (CAM) with conventional medicine (CON). Medical schools offer basic CAM electives but in postgraduate medical training (PGMT) little has been done for the integration of CAM. An exception to this is anthroposophic medicine (AM), a western form of CAM based on CON, offering an individualized holistic IM approach. AM hospitals are part of the public healthcare systems in Germany and Switzerland...

  15. Importance of intellectual property generated by biomedical research at universities and academic hospitals.

    Science.gov (United States)

    Heus, Joris J; de Pauw, Elmar S; Leloux, Mirjam; Morpurgo, Margherita; Hamblin, Michael R; Heger, Michal

    2017-01-01

    Biomedical research has many different facets. Researchers and clinicians study disease biology and biochemistry to discover novel therapeutic targets, unravel biochemical pathways and identify biomarkers to improve diagnosis, or devise new approaches to clinically manage diseases more effectively. In all instances, the overall goal of biomedical research is to ensure that results thereof (such as a therapy, a device, or a method which may be broadly referred to as "inventions") are clinically implemented. Most of the researchers' efforts are centered on the advance of technical and scientific aspects of an invention. The development and implementation of an invention can be arduous and very costly. Historically, it has proven to be crucial to protect intellectual property rights (IPR) to an invention (i.e., a patent) to ensure that companies can obtain a fair return on their investment that is needed to develop an academic invention into a product for the benefit of patients. However, the importance of IPR is not generally acknowledged among researchers at academic institutions active in biomedical research. Therefore this paper aims to (1) raise IP awareness amongst clinical and translational researchers; (2) provide a concise overview of what the patenting trajectory entails; and (3) highlight the importance of patenting for research and the researcher. Adequate patent protection of inventions generated through biomedical research at academic institutions increases the probability that patients will benefit from these inventions, and indirectly enables the financing of clinical studies, mainly by opening up funding opportunities (e.g. specific grants aimed at start-ups, pre-seed and seed capital) that otherwise would not be accessible. As a consequence, patented inventions are more likely to become clinically tested and reach the market, providing patients with more treatment options.

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

    International Nuclear Information System (INIS)

    Eiselen, T.; Ellmann, A.

    2004-01-01

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

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

    Science.gov (United States)

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

    2013-09-01

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

  18. Analysis of Smartphone Interruptions on Academic General Internal Medicine Wards. Frequent Interruptions may cause a 'Crisis Mode' Work Climate.

    Science.gov (United States)

    Vaisman, Alon; Wu, Robert C

    2017-01-04

    Hospital-based medical services are increasingly utilizing team-based pagers and smartphones to streamline communications. However, an unintended consequence may be higher volumes of interruptions potentially leading to medical error. There is likely a level at which interruptions are excessive and cause a 'crisis mode' climate. We retrospectively collected phone, text messaging, and email interruptions directed to hospital-assigned smartphones on eight General Internal Medicine (GIM) teams at two tertiary care centres in Toronto, Ontario from April 2013 to September 2014. We also calculated the number of times these interruptions exceeded a pre-specified threshold per hour, termed 'crisis mode', defined as at least five interruptions in 30 minutes. We analyzed the correlation between interruptions and date, site, and patient volumes. A total of 187,049 interruptions were collected over an 18-month period. Daily weekday interruptions rose sharply in the morning, peaking between 11 AM to 12 PM and measuring 4.8 and 3.7 mean interruptions/hour at each site, respectively. Mean daily interruptions per team totaled 46.2 ± 3.6 at Site 1 and 39.2 ± 4.2 at Site 2. The 'crisis mode' threshold was exceeded, on average, 2.3 times/day per GIM team during weekdays. In a multivariable linear regression analysis, site (β6.43 CI95% 5.44 - 7.42, ptime.

  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. 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. Perspective: Adopting an Asset Bundle Model to Support and Advance Minority Students’ Careers in Academic Medicine and the Scientific Pipeline

    Science.gov (United States)

    Johnson, Japera; Bozeman, Barry

    2012-01-01

    The authors contend that increasing diversity in the scientific pipeline (e.g., academic medicine, science, technology, engineering and mathematics) requires a systematic approach to retain minority high school and college students. 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 in order to continue toward a career 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, or 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. PMID:23018329

  2. Relating mentor type and mentoring behaviors to academic medicine faculty satisfaction and productivity at one medical school.

    Science.gov (United States)

    Shollen, S Lynn; Bland, Carole J; Center, Bruce A; Finstad, Deborah A; Taylor, Anne L

    2014-09-01

    To examine relationships among having formal and informal mentors, mentoring behaviors, and satisfaction and productivity for academic medicine faculty. In 2005, the authors surveyed full-time faculty at the University of Minnesota Medical School to assess their perceptions of variables associated with job satisfaction and productivity. This analysis focused on perceptions of mentoring as related to satisfaction with current position and productivity (articles published in peer-reviewed journals [article production] and role as a primary investigator [PI] or a co-PI on a grant/contract). Of 615 faculty, 354 (58%) responded. Satisfied faculty were not necessarily productive, and vice versa. Outcomes differed somewhat for mentor types: Informal mentoring was more important for satisfaction, and formal mentoring was more important for productivity. Regardless of mentor type, the 14 mentoring behaviors examined related more to satisfaction than productivity. Only one behavior-serves as a role model-was significantly, positively related to article production. Although participants reported that formal and informal mentors performed the same mentoring behaviors, mentees were more satisfied or productive when some behaviors were performed by formal mentors. The results emphasize the importance of having both formal and informal mentors who perform mentoring behaviors associated with satisfaction and productivity. The results provide a preliminary indication that mentor types and specific mentoring behaviors may have different effects on satisfaction and productivity. Despite the differences found for some behaviors, it seems that it is more essential that mentoring behaviors be performed by any mentor than by a specific type of mentor.

  3. Clinical holistic medicine: factors influencing the therapeutic decision-making. From academic knowledge to emotional intelligence and spiritual "crazy" wisdom.

    Science.gov (United States)

    Ventegodt, Søren; Kandel, Isack; Merrick, Joav

    2007-12-10

    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.

  4. Why aren't there more women leaders in academic medicine? the views of clinical department chairs.

    Science.gov (United States)

    Yedidia, M J; Bickel, J

    2001-05-01

    A scarcity of women in leadership positions in academic medicine has persisted despite their increasing numbers in medical training. To understand the barriers confronting women and potential remedies, clinical department chairs with extensive leadership experience were interviewed. In 1998-99, open-ended interviews averaging 80 minutes in length were conducted with 34 chairs and two division chiefs in five specialties. Individuals were selected to achieve a balance for gender, geographic locale, longevity in their positions, and sponsorship and research intensity of their institutions. The interviews were audiotaped and fully transcribed, and the themes reported emerged from inductive analysis of the responses using standard qualitative techniques. The chairs' responses centered on the constraints of traditional gender roles, manifestations of sexism in the medical environment, and lack of effective mentors. Their strategies for addressing these barriers ranged from individual or one-on-one interventions (e.g., counseling, confronting instances of bias, and arranging for appropriate mentors) to institutional changes (e.g., extending tenure probationary periods, instituting mechanisms for responding to unprofessional behavior, establishing mentoring networks across the university). The chairs universally acknowledged the existence of barriers to the advancement of women and proposed a spectrum of approaches to address them. Individual interventions, while adapting faculty to requirements, also tend to preserve existing institutional arrangements, including those that may have adverse effects on all faculty. Departmental or school-level changes address these shortcomings and have a greater likelihood of achieving enduring impact.

  5. The Pipeline From Abstract Presentation to Publication in Pediatric Hospital Medicine.

    Science.gov (United States)

    Herrmann, Lisa E; Hall, Matthew; Kyler, Kathryn; Cochran, Joseph; Andrews, Annie L; Williams, Derek J; Wilson, Karen M; Shah, Samir S

    2018-02-01

    The annual Pediatric Hospital Medicine (PHM) conference serves as a venue for the dissemination of research in this rapidly growing discipline. A measure of research validity is subsequent publication in peer-reviewed journals. To identify the publication rate of abstracts submitted to the 2014 PHM conference and determine whether presentation format was associated with subsequent journal publication or time to publication. We identified abstracts submitted to the 2014 PHM conference. Presentation formats included rejected abstracts and poster and oral presentations. Abstracts subsequently published in journals were identified by searching the author and abstract title in PubMed, MedEdPORTAL, and Google Scholar. We used logistic regression and Cox proportional hazards models to determine if presentation format was associated with publication, time to publication, and publishing journal impact factor. Of 226 submitted abstracts, 19.0% were rejected, 68.0% were selected for posters, and 12.8% were selected for oral presentations; 36.3% were subsequently published within 30 months after the conference. Abstracts accepted for oral presentation had more than 7-fold greater odds of publication (adjusted odds ratio 7.8; 95% confidence interval [CI], 2.6-23.5) and a 4-fold greater likelihood of publication at each month (adjusted hazard ratio 4.5; 95% CI, 2.1-9.7) compared with rejected abstracts. Median journal impact factor was significantly higher for oral presentations than other presentation formats (P presentation; however, the low overall publication rate may indicate that presented results are preliminary or signify a need for increased mentorship and resources for research development in PHM.

  6. Positive impact of infection prevention on the management of nosocomial outbreaks at an academic hospital.

    Science.gov (United States)

    Dik, Jan-Willem H; Sinha, Bhanu; Lokate, Mariëtte; Lo-Ten-Foe, Jerome R; Dinkelacker, Ariane G; Postma, Maarten J; Friedrich, Alexander W

    2016-10-01

    Infection prevention (IP) measures are vital to prevent (nosocomial) outbreaks. Financial evaluations of these are scarce. An incremental cost analysis for an academic IP unit was performed. On a yearly basis, we evaluated: IP measures; costs thereof; numbers of patients at risk for causing nosocomial outbreaks; predicted outbreak patients; and actual outbreak patients. IP costs rose on average yearly with €150,000; however, more IP actions were undertaken. Numbers of patients colonized with high-risk microorganisms increased. The trend of actual outbreak patients remained stable. Predicted prevented outbreak patients saved costs, leading to a positive return on investment of 1.94. This study shows that investments in IP can prevent outbreak cases, thereby saving enough money to earn back these investments.

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

    International Nuclear Information System (INIS)

    Coleman, C. Norman; Govern, Frank S.; Svensson, Goran; Mitchell, Ronald; Chaffey, John T.

    2000-01-01

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

  8. Tradition Meets Innovation: Transforming Academic Medical Culture at the University of Pennsylvania’s Perelman School of Medicine

    OpenAIRE

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

    2013-01-01

    Traditional performance expectations and career advancement paths for academic physicians persist despite dramatic transformations in the academic workflow, workload, and workforce over the past twenty years. While the academic physician’s triple role as clinician, researcher, and educator has been lauded as the ideal by academic medical centers, current standards of excellence for promotion and tenure are based on outdated models. These models fail to reward collaboration and center around r...

  9. Use of Herbal Medicine Among Pregnant Women on Antenatal Care at Nekemte Hospital, Western Ethiopia

    OpenAIRE

    Bayisa, Bodena; Tatiparthi, Ramanjireddy; Mulisa, Eshetu

    2014-01-01

    Background: Investigations across the world confirm dramatic increment in the use of complementary and alternative medicine in pregnant women. The most important aspect is lack of awareness of pregnant women about potential effects of using traditional medicine on fetus; some herbal products may be teratogenic in human and animal models. In this area, so far, no research has been conducted in Ethiopia to assess traditional medicine use in pregnant women. Objectives: Therefore, the main object...

  10. Quality Control and Complication Screening Programme of Chinese Medicinal Drugs at the First German Hospital of Traditional Chinese Medicine - A Retrospective Analysis.

    Science.gov (United States)

    Melchart, Dieter; Hager, Stefan; Dai, Jingzhang; Weidenhammer, Wolfgang

    2016-01-01

    The use of drugs derived from plants is a cornerstone of Traditional Chinese Medicine (TCM). Yet, too little is known about risk and safety of Chinese medicinal drugs (CMD). Therefore, the TCM hospital Bad Kötzting has developed a quality control and complication screening programme in order to ensure a safe administration of TCM drugs to their patients. All Chinese medicinal drugs delivered to the hospital between September 1, 2012 and December 31, 2013 entered the quality control program and were screened for microbial contamination, aflatoxin, pesticides and heavy metals. A routinely applied complication screening programme monitored liver enzymes in all patients. Case causality assessment by CIOMS scale and identification of admitted herbs were conducted. Additionally, side effects of patients were identified by a routinely performed web-based documentation system. In 5 of 23 investigated samples (21.7%) the initial testing showed microbial contamination (2), pesticide (2) and heavy metals (1). The drugs were tested for authenticity and adulterations, respectively. All 994 patients (mean age 52.6 years; 72.6% female) admitted were available for analysis. 448 (45.1%) of all patients reported having perceived at least one side effect of treatment. They experienced mainly gastrointestinal symptoms (13.6%), neurovegetative symptoms (10.8 %), temporary deteriorations of pain (8.8%), diarrhoea (5.9%), nausea (1.6%) and vomiting (0.5%). Further, 6 patients with a more than 2-fold elevation (compared to maximum normal value or elevated admission values) of ALT were found in the systematic laboratory control with a non-conclusive causality assessment for TCM-drugs. Approximate incidence rates and analysed drugs associated with liver damage revealed a low rate of liver injury. Patients should be informed of the gastrointestinal symptoms caused by and potential hepatotoxicity of TCM herbs. © 2016 S. Karger GmbH, Freiburg.

  11. Intracranial suppuration: Review of an 8-year experience at Umtata General Hospital and Nelson Mandela Academic Hospital, Eastern Cape, South Africa.

    Science.gov (United States)

    Anwary, M A

    2015-09-21

    Intracranial suppuration (ICS) is a life-threatening condition caused by various disease processes and consisting of brain abscess and extradural and subdural empyema. The major causes have changed over the decades. To the author's knowledge, the incidence of ICS in South Africa (SA) has not been established. To determine the incidence of ICS, overall and according to age and gender, and to identify the source and distribution of ICS. The archive of the radiology departments at Umtata General Hospital and Nelson Mandela Academic Hospital in the Transkei region, Eastern Cape Province, SA, was searched retrospectively for computed tomography (CT) reports of patients diagnosed with ICS. Cases in which the CT images, patients' clinical information and CT reports were available for an uninterrupted period of at least 1 year were included. Five time frames were established, encompassing 8 years of data. The first time frame established an incidence of ICS of 1/100,000/year for the Transkei region. All the time frames were utilised to determine the incidence according to gender and age, and the source and distribution of ICS. The incidence of ICS was higher among males than females, and highest in the age groups 0-10 and 11-20 years. A seasonal variation in the incidence of sinusitis- and meningitis-related ICS was noted. Numbers of cases declined during the last 3 years of the study period. Sinusitis, head trauma, ear infection and meningitis were the major sources of ICS. A pulmonary source was not a major feature. In the last 4 years, trauma became the commonest source of ICS. A steady decline in ear infection- and meningitis-related ICS was noted.

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

    Science.gov (United States)

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

    2016-08-01

    Continuous increase of elderly patients with multimorbidity and Emergency Department (ED) overcrowding are great challenges for modern medicine. Traditional hospital organizations are often too rigid to solve them without consistently rising healthcare costs. In this paper we present a new organizational model achieved at Internal Medicine and Critical Subacute Care Unit of Parma University Hospital, Italy, a 106-bed internal medicine area organized by intensity of care and specifically dedicated to such patients. The unit is partitioned into smaller wards, each with a specific intensity level of care, including a rapid-turnover ward (mean length of stay model, compared with other peer units of the hospital and of other teaching hospitals of the region, showed a better performance, efficacy and effectiveness indexes calculated on Regional Hospital Discharge Records database system, allowing a capacity to face a massive (+22 %) rise in medical admissions from the ED. Further studies are needed to validate this model from a patient outcome point of view.

  13. Complementary Medicine and the Role of Oncology Nurses in an Acute Care Hospital: The Gap Between Attitudes and Practice.

    Science.gov (United States)

    Admi, Hanna; Eilon-Moshe, Yael; Ben-Arye, Eran

    2017-09-01

    To describe hospital nurses' knowledge, attitudes, and practices regarding complementary medicine (CM); to compare the knowledge and attitudes of nurse managers to staff nurses with diverse oncology experience; and to assess attitudes toward integrating CM into the role of the hospital oncology nurse. 
. Descriptive, cross-sectional study.
. Rambam Health Care Campus in northern Israel.
. A convenience sample of 434 hospital nurses with varied oncology experience.
. Nurses completed a knowledge and attitude questionnaire developed for the current study. Data were analyzed using parametric and nonparametric statistical tests. 
. Hospital nurses' knowledge of and attitudes toward CM, and attitudes toward integrating CM into the role of the hospital oncology nurse.
. Nurses lack knowledge and are unaware of the risks associated with CM. However, they believe this approach can improve the quality of life of patients with cancer; 51% expressed an interest in receiving training. Oncology nurses were ambivalent about the feasibility of applying an integrative approach, whereas nurse managers expressed significantly more positive attitudes toward integrating CM within the scope of nursing practices.
. A large discrepancy remains between nurses' strong interest in CM and awareness of associated benefits, and their ambivalence toward its integration in their nursing practice. 
. Although improving nurses' knowledge should be mandatory, it remains insufficient; a shift in the approach to integrating CM into conventional health care is needed, from practitioners' responsibility to healthcare policymakers' responsibility. Legislations and policies are necessary, along with providing respectable infrastructures.

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

    Directory of Open Access Journals (Sweden)

    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.

  15. The impact of ED nurse manager leadership style on staff nurse turnover and patient satisfaction in academic health center hospitals.

    Science.gov (United States)

    Raup, Glenn H

    2008-10-01

    Nurse managers with effective leadership skills are an essential component to the solution for ending the nursing shortage. Empirical studies of existing ED nurse manager leadership styles and their impact on key nurse management outcomes such as staff nurse turnover and patient satisfaction have not been performed. The specific aims of this study were to determine what types of leadership styles were used by ED nurse managers in academic health center hospitals and examine their influence on staff nurse turnover and patient satisfaction. ED nurse managers were asked to complete the Multifactor Leadership Questionnaire and a 10-item researcher defined nurse manager role and practice demographics survey. Completed surveys (15 managers and 30 staff nurses) representing 15 out of 98 possible U.S. academic health centers were obtained. Fisher's exact test with 95% confidence intervals were used to analyze the data. The sample percentage of managers who exhibited Transformational leadership styles and demographic findings of nurse manager age, total years experience and length of time in current position matched current reports in the literature. A trend of lower staff nurse turnover with Transformational leadership style compared to non-Trasformational leadership styles was identified. However, the type of leadership style did not appear to have an effect on patient satisfaction. The ED is an ever-changing, highly regulated, critical-care environment. Effective ED nurse manager leadership strategies are vital to maintaining the standards of professional emergency nursing practice to create an environment that can produce management outcomes of decreased staff nurse turnover, thereby enhancing staff nurse retention and potentially impacting patient satisfaction.

  16. Internal medicine network: a new way of thinking hospital-territory integration and public-private partnership

    Directory of Open Access Journals (Sweden)

    Filomena Pietrantonio

    2016-10-01

    Full Text Available This working proposal aims to establish an Internal Medicine Network (IMN model for the appropriate management of the poly-pathological complex patient in the different phases of his illness natural hystory. The IMN is based on an organization recalling the Hub and Spoke system already used for existing specialized networks. The Internal Medicine Unit (IMU is the natural destination of acutely ill patients suffering from systemic or multi-organ diseases. Three are the IMU specific tasks: i to stabilize acute, severe, poly-pathologic and complex patients; ii to develop difficult etiological diagnosis in these patients and in those who should necessarily be admitted to the hospital, not being possible, for different reasons, alternative routes; iii to select the acute poly-pathological complex patient’s priorities. The expected results of a new model of integration system inside the IMN are: i reduction and rationalization of expenditure in the medical area, increasing effectiveness, quality and safety guaranteeing patient centrality; ii patients stratification based on characteristics of gravity, acute illness, estimated duration of hospitalization; iii reduction of inappropriate hospital admissions ensuring connections between hospital and primary care units; iv definition of different care pathways for patients hospitalized due to non-communicable diseases; v implementation of new common medical records. The public-private partnership inside the IMN could be able to increase appropriateness reducing health costs. Patient-centered problems assessment, together with integration, cooperation, coordination and effective communication are some simple rules useful to achieve tangible results in a complex system and the IMN model represents its practical application.

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

    Science.gov (United States)

    Aggarwal, Praveen; Galwankar, Sagar; Kalra, Om Prakash; Bhalla, Ashish; Bhoi, Sanjeev; Sundarakumar, Sundarajan

    2014-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Praveen Aggarwal

    2014-01-01

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

  19. CAEP 2014 Academic Symposium: "How to make research succeed in your emergency department: How to develop and train career researchers in emergency medicine".

    Science.gov (United States)

    Perry, Jeffrey J; Snider, Carolyn E; Artz, Jennifer D; Stiell, Ian G; Shaeri, Sedigheh; McLeod, Shelley; Le Sage, Natalie; Hohl, Corinne; Calder, Lisa A; Vaillancourt, Christian; Holroyd, Brian; Hollander, Judd E; Morrison, Laurie J

    2015-05-01

    We sought to 1) identify best practices for training and mentoring clinician researchers, 2) characterize facilitators and barriers for Canadian emergency medicine researchers, and 3) develop pragmatic recommendations to improve and standardize emergency medicine postgraduate research training programs to build research capacity. We performed a systematic review of MEDLINE and Embase using search terms relevant to emergency medicine research fellowship/graduate training. We conducted an email survey of all Canadian emergency physician researchers. The Society for Academic Emergency Medicine (SAEM) research fellowship program was analysed, and other similar international programs were sought. An expert panel reviewed these data and presented recommendations at the Canadian Association of Emergency Physicians (CAEP) 2014 Academic Symposium. We refined our recommendations based on feedback received. Of 1,246 potentially relevant citations, we included 10 articles. We identified five key themes: 1) creating training opportunities; 2) ensuring adequate protected time; 3) salary support; 4) infrastructure; and 5) mentorship. Our survey achieved a 72% (67/93) response rate. From these responses, 42 (63%) consider themselves clinical researchers (i.e., spend a significant proportion of their career conducting research). The single largest constraint to conducting research was funding. Factors felt to be positive contributors to a clinical research career included salary support, research training (including an advanced graduate degree), mentorship, and infrastructure. The SAEM research fellowship was the only emergency medicine research fellowship program identified. This 2-year program requires approval of both the teaching centre and each applying fellow. This program requires training in 15 core competencies, manuscript preparation, and submission of a large grant to a national peer-review funding organization. We recommend that the CAEP Academic Section create a

  20. Association Between Treatment by Locum Tenens Internal Medicine Physicians and 30-Day Mortality Among Hospitalized Medicare Beneficiaries.

    Science.gov (United States)

    Blumenthal, Daniel M; Olenski, Andrew R; Tsugawa, Yusuke; Jena, Anupam B

    2017-12-05

    Use of locum tenens physicians has increased in the United States, but information about their quality and costs of care is lacking. To evaluate quality and costs of care among hospitalized Medicare beneficiaries treated by locum tenens vs non-locum tenens physicians. A random sample of Medicare fee-for-service beneficiaries hospitalized during 2009-2014 was used to compare quality and costs of hospital care delivered by locum tenens and non-locum tenens internal medicine physicians. Treatment by locum tenens general internal medicine physicians. The primary outcome was 30-day mortality. Secondary outcomes included inpatient Medicare Part B spending, length of stay, and 30-day readmissions. Differences between locum tenens and non-locum tenens physicians were estimated using multivariable logistic regression models adjusted for beneficiary clinical and demographic characteristics and hospital fixed effects, which enabled comparisons of clinical outcomes between physicians practicing within the same hospital. In prespecified subgroup analyses, outcomes were reevaluated among hospitals with different levels of intensity of locum tenens physician use. Of 1 818 873 Medicare admissions treated by general internists, 38 475 (2.1%) received care from a locum tenens physician; 9.3% (4123/44 520) of general internists were temporarily covered by a locum tenens physician at some point. Differences in patient characteristics, demographics, comorbidities, and reason for admission between locum tenens and non-locum tenens physicians were not clinically relevant. Treatment by locum tenens physicians, compared with treatment by non-locum tenens physicians (n = 44 520 physicians), was not associated with a significant difference in 30-day mortality (8.83% vs 8.70%; adjusted difference, 0.14%; 95% CI, -0.18% to 0.45%). Patients treated by locum tenens physicians had significantly higher Part B spending ($1836 vs $1712; adjusted difference, $124; 95% CI, $93 to $154

  1. NEONATAL SURGERY, A STUDY OF TWO YEARS AT NELSON MANDELA ACADEMIC HOSPITAL, MTHATHA, EASTERN CAPE.

    Science.gov (United States)

    Delgado, A; Cejas, A; Bangasa, D

    2017-09-01

    Advances in diagnostic techniques and perioperative care have greatly improved the outcome of neonatal surgery. Despite this, disparity still exists in the outcome of neonatal surgery between developed and developing countries. We performed a prospective study of neonates admitted and treated due to surgical congenital diseases and other conditions in our hospital from April 2015 to April 2017. There were 19 (28,7%) females and 47 (70,3%) males in this group. It was found that 41 neonates had 7 days after birth or less by a 62% and 25 with more than 7 days by 38%. The Anorectal malformations (ARM) were the most frequent congenital anomaly in 21 patients (47%), followed by Gastroquises with 7 neonates (10,6%), Omphalocele with 8 (12%), and Oesophagus Atresia in 5 neonates (7,5%). Intestinal Malrotation with midgut volvulus, Pyloric Stenoses and Duodenal Atresia in 4 neonates (6,2 % each). Others alterations such as, Ileal Atresia, Strangulated Inguinal Hernia, Limb Gangrene, Necrotizing Enterocolitis, Sacro Coxigeal Theratoma, Megacolon Aganglionic, Colon perforation, Gastric perforation and Hydromethrocolpus accounted in 13 neonates by 19,7% from the total of patients. Ten babies died (15%). We conclude that Anorectal Malformations, Gastroquises and Omphalocele were the most frequent malformations. Considering the mortality is above the average of developed countries this could be improved by increasing the knowledge about the neonatal surgery characteristics among medical doctors and improving the necessary facilities and back up.

  2. A Growing Opportunity: Community Gardens Affiliated with US Hospitals and Academic Health Centers.

    Science.gov (United States)

    George, Daniel R; Rovniak, Liza S; Kraschnewski, Jennifer L; Hanson, Ryan; Sciamanna, Christopher N

    Community gardens can reduce public health disparities through promoting physical activity and healthy eating, growing food for underserved populations, and accelerating healing from injury or disease. Despite their potential to contribute to comprehensive patient care, no prior studies have investigated the prevalence of community gardens affiliated with US healthcare institutions, and the demographic characteristics of communities served by these gardens. In 2013, national community garden databases, scientific abstracts, and public search engines (e.g., Google Scholar) were used to identify gardens. Outcomes included the prevalence of hospital-based community gardens by US regions, and demographic characteristics (age, race/ethnicity, education, household income, and obesity rates) of communities served by gardens. There were 110 healthcare-based gardens, with 39 in the Midwest, 25 in the South, 24 in the Northeast, and 22 in the West. Compared to US population averages, communities served by healthcare-based gardens had similar demographic characteristics, but significantly lower rates of obesity (27% versus 34%, p gardens are located in regions that are demographically representative of the US population, and are associated with lower rates of obesity in communities they serve.

  3. Needs of relatives of critically ill patients in an academic hospital in Chile.

    Science.gov (United States)

    Padilla-Fortunatti, C; Rojas-Silva, N; Amthauer-Rojas, M; Molina-Muñoz, Y

    To identify the importance of the needs of family members of patients in an intensive care unit (ICU). Descriptive, comparative and cross-sectional study based on a secondary data analysis of 251 relatives of ICU patients at a university hospital in Santiago, Chile. Using non-random sampling, the 'Critical Care Family Needs Inventory' was used to establish the family needs, as well as a sociodemographic questionnaire that included: age, gender, educational level, patient relationship and previous ICU experience. A descriptive statistical analysis, Student's T test and ANOVA were performed. The most important family needs related to the dimensions of 'security' (mean=3.90) and 'information' (mean=3.76), while those of minor importance with 'support' (mean=3.09). In the latter, differences were observed at an older age (P<.05), an educational level (P<.001) and relationship with the patient (P<.05). The most relevant needs for family members in the ICU are related to safety and information. Less important needs are influenced by certain sociodemographic variables. Identifying the degree of importance of family needs will allow the health team to improve its relationship with families in ICUs. Copyright © 2017 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Readability of pediatric otolaryngology information by children's hospitals and academic institutions.

    Science.gov (United States)

    Wong, Kevin; Levi, Jessica R

    2017-04-01

    Evaluate the readability of pediatric otolaryngology-related patient education materials from leading online sources. Cross-sectional analysis. All pediatric otolaryngology-related articles from the online patient health libraries of the top 10 US News & World Report-ranked children's hospitals, top 5 Doximity-ranked pediatric otolaryngology fellowships, and the American Academy of Otolaryngology-Head and Neck Surgery were collected. Each article was copied in plain text format into a blank document. Web page navigation, appointment information, references, author information, appointment information, acknowledgements, and disclaimers were removed. Follow-up editing was also performed to remove paragraph breaks, colons, semicolons, numbers, percentages, and bullets. Readability grade was calculated using the Flesch-Kincaid Grade Level, Flesch Reading Ease Score, Gunning-Fog Index, Coleman-Liau Index, Automated Readability Index, and Simple Measure of Gobbledygook. Intraobserver and interobserver reliability were assessed. A total of 502 articles were analyzed. Intraobserver and interobserver reliability were both excellent, with an intraclass correlation coefficient of 0.99 and 0.96, respectively. The average readability grade across all authorships and readability assessments exceeded the reading ability of the average American adult. Only 142 articles (28.3%) were written at or below the reading ability of the average American adult, whereas the remaining 360 articles (71.7%) were written above the reading level of the average adult. Current online health information related to pediatric otolaryngology may be too difficult for the average reader to understand. Revisions may be necessary for current materials to benefit a larger readership. NA Laryngoscope, 127:E138-E144, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

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

    Directory of Open Access Journals (Sweden)

    Langalibalele H. Mabuza

    2014-03-01

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Barcode Technology Acceptance and Utilization in Health Information Management Department at Academic Hospitals According to Technology Acceptance Model.

    Science.gov (United States)

    Ehteshami, Asghar

    2017-03-01

    Nowdays, due to the increasing importance of quality care, organizations focuse on the improving provision, management and distribution of health. On one hand, incremental costs of the new technologies and on the other hand, increased knowledge of health care recipients and their expectations for high quality services have doubled the need to make changes in order to respond to resource constraints (financial, human, material). For this purpose, several technologies, such as barcode, have been used in hospitals to improve services and staff productivity; but various factors effect on the adoption of new technologies and despite good implementation of a technology and its benefits, sometimes personnel don't accept and don't use it. This is an applied descriptive cross-sectional study in which all the barcode users in health information management department of the three academic hospitals (Feiz, Al-Zahra, Ayatollah Kashani) affiliated to Isfahan University of Medical Sciences were surveyed by the barcode technology acceptance questionnaire, in six areas as following: barcode ease of learning, capabilities, perception of its usefulness and its ease of use, users attitudes towards its using, and users intention. The finding showed that barcode technology total acceptance was relatively desirable (%76.9); the most compliance with TAM model was related to the user perceptions about the ease of use of barcode technology and the least compliance was related to the ease of learning barcode technology (respectively %83.7 and %71.5). Ease of learning and barcode capability effect of usefulness and perceived ease of barcode technology. Users perceptions effect their attitudes toward greater use of technology and their attitudes have an effect on their intention to use the technology and finally, their intention makes actual use of the technology (acceptance). Therefore, considering the six elements related to technology implementation can be important in the barcode

  8. A Retrospective Analysis of Thyroid Disease in Pregnancy at Chris Hani Baragwanath Academic Hospital Soweto South Africa

    Directory of Open Access Journals (Sweden)

    V Nicolaou

    2017-12-01

    Full Text Available BackgroundThyroid diseases in pregnancy are associated with adverse outcomes for mother and fetus.No studies have been reported examining the spectrum and nature of such disorders in the Black population of South Africa.AimsTo examine thyroid disorders in pregnancy at Chris Hani Baragwanath Academic Hospital in Soweto, by assessing the causes, management and outcomes.MethodsA retrospective review of thyroid disorders was undertaken in 88 patients, attending the Antenatal Endocrine Clinic over a four-year period. All underwent initial and follow-up clinical and biochemical assessments.Maternal delivery records and thyroid function tests of the neonates 48 hours or later following delivery were reviewed.ResultsFifty-eight (66% were hyperthyroid, 23(26% hypothyroid, and 7(8% had euthyroid colloid goiters. Forty-eight (83% hyperthyroid patients had Graves’ disease, whilst had gestational hyperthyroidism. Regarding the hypothyroid patients, more than half followed I131 ablation for Graves’ disease. Eighty-seven percent of the hyperthyroid and 83% of the hypothyroid patients were euthyroid prior to delivery. One fatal maternal outcome, due to uterine rupture and six intra-partum fetal losses occurred. Amongst neonates, there was one case of a tracheo-esophageal fistula and one of neonatal thyrotoxicosis.ConclusionThis is the first report in sub-Saharan Africa detailing thyroid diseases in pregnancy.

  9. An investigation of diverticular disease among black patients undergoing colonoscopy at Dr George Mukhari Academic Hospital, Pretoria, South Africa.

    Science.gov (United States)

    Vally, M; Koto, M Z; Govender, M

    2017-01-30

    Diverticular disease was previously thought to be non-existent in the black African population. Studies over the past four decades, however, have shown a steady increase in the prevalence of the disease. To report on the profile and current prevalence of diverticular disease in the black South African (SA) population at Dr George Mukhari Academic Hospital, Pretoria, SA. A retrospective descriptive study was performed in black SA patients who were diagnosed with diverticular disease by colonoscopy between 1 January and 31 December 2015. Of 348 patients who had undergone colonoscopies and who were eligible for inclusion in this study, 47 were diagnosed with diverticular disease - a prevalence of 13.50% (95% confidence interval 10.30 - 17.50). The greatest number of patients diagnosed were in their 7th and 8th decades, with an age range of 46 - 86 (mean 67) years. There was a female predominance of 57.45%. Lower gastrointestinal bleeding was the most common (65.96%) indication for colonoscopy. The left colon was most commonly involved (72.34%), followed by the right colon (55.31%). A substantial number of patients had pancolonic involvement (27.65%). This retrospective study suggests that there has been a considerable increase in the prevalence of diverticular disease among black South Africans, possibly owing to changes in dietary habits and socioeconomic status.

  10. An investigation of diverticular disease among black patients undergoing colonoscopy at Dr George Mukhari Academic Hospital, Pretoria, South Africa

    Directory of Open Access Journals (Sweden)

    M Vally

    2017-02-01

    Full Text Available Background. Diverticular disease was previously thought to be non-existent in the black African population. Studies over the past four decades, however, have shown a steady increase in the prevalence of the disease. Objective. To report on the profile and current prevalence of diverticular disease in the black South African (SA population at Dr George Mukhari Academic Hospital, Pretoria, SA. Methods. A retrospective descriptive study was performed in black SA patients who were diagnosed with diverticular disease by colonoscopy between 1 January and 31 December 2015. Results. Of 348 patients who had undergone colonoscopies and who were eligible for inclusion in this study, 47 were diagnosed with diverticular disease – a prevalence of 13.50% (95% confidence interval 10.30 - 17.50. The greatest number of patients diagnosed were in their 7th and 8th decades, with an age range of 46 - 86 (mean 67 years. There was a female predominance of 57.45%. Lower gastrointestinal bleeding was the most common (65.96% indication for colonoscopy. The left colon was most commonly involved (72.34%, followed by the right colon (55.31%. A substantial number of patients had pancolonic involvement (27.65%. Conclusion. This retrospective study suggests that there has been a considerable increase in the prevalence of diverticular disease among black South Africans, possibly owing to changes in dietary habits and socioeconomic status.

  11. 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.

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

    International Nuclear Information System (INIS)

    Ruiz C, M.A.; Rivero G, T.; Celis del Angel, L.; Sainz M, E.; Molina, G.

    2006-01-01

    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

  13. 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 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. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Discharge Processes and 30-Day Readmission Rates of Patients Hospitalized for Heart Failure on General Medicine and Cardiology Services.

    Science.gov (United States)

    Salata, Brian M; Sterling, Madeline R; Beecy, Ashley N; Ullal, Ajayram V; Jones, Erica C; Horn, Evelyn M; Goyal, Parag

    2018-05-01

    Given high rates of heart failure (HF) hospitalizations and widespread adoption of the hospitalist model, patients with HF are often cared for on General Medicine (GM) services. Differences in discharge processes and 30-day readmission rates between patients on GM and those on Cardiology during the contemporary hospitalist era are unknown. The present study compared discharge processes and 30-day readmission rates of patients with HF admitted on GM services and those on Cardiology services. We retrospectively studied 926 patients discharged home after HF hospitalization. The primary outcome was 30-day all-cause readmission after discharge from index hospitalization. Although 60% of patients with HF were admitted to Cardiology services, 40% were admitted to GM services. Prevalence of cardiovascular and noncardiovascular co-morbidities were similar between patients admitted to GM services and Cardiology services. Discharge summaries for patients on GM services were less likely to have reassessments of ejection fraction, new study results, weights, discharge vital signs, discharge physical examinations, and scheduled follow-up cardiologist appointments. In a multivariable regression analysis, patients on GM services were more likely to experience 30-day readmissions compared with those on Cardiology services (odds ratio 1.43 95% confidence interval [1.05 to 1.96], p = 0.02). In conclusion, outcomes are better among those admitted to Cardiology services, signaling the need for studies and interventions focusing on noncardiology hospital providers that care for patients with HF. Copyright © 2018 Elsevier Inc. All rights reserved.

  15. [Clinical and economic analysis of an internal medicine-infectious disease department at a university general hospital (2005-2006)].

    Science.gov (United States)

    Gómez, Joaquín; García-Vázquez, Elisa; Antonio Puertas, José; Ródenas, Julio; Herrero, José Antonio; Albaladejo, Carmen; Baños, Víctor; Canteras, Manuel; Alcaraz, Manolo

    2009-02-01

    Comparative study in patients with infectious diseases admitted to a specialized Internal Medicine-Infectious Diseases Department (IMID) versus those admitted to other medical departments in a university general hospital, investigating quality and cost-effectiveness. Analysis of patients in 10 principle diagnosis-related groups (DRGs) of infectious diseases admitted to the IMID were compared to those admitted to other medical departments (2005-2006). The DRG were divided in 4 main groups: respiratory infections (DGR 88, 89, 90, 540), urinary infections (DRG 320, 321), sepsis (DRG 416, 584), and skin infections (DRG 277, 278). For each group, quality variables (mortality and readmission rate), efficacy variables (mean hospital stay and mean DRG-based cost per patient) and complexity variables (case mix, relative weight, and functional index) were analyzed. 542 patients included in the 10 main infectious disease DRGs were admitted to IMID and 2404 to other medical departments. After adjusting for DRG case mix (case mix 0.99 for IMID and 0.89 for others), mean hospital stay (5.11 days vs. 7.65 days), mortality (3.5% vs. 7.9%) and mean DRG-based economic cost per patient (1521euro/patient vs. 2952euro/patient) was significantly lower in the group of patients hospitalized in IMID than the group in other medical departments (peconomic cost per patient. Creation and development of IMID departments should be an essential objective to improve healthcare quality and respond to social demands.

  16. Vulnerabilities and rupture risk in the supply of materials and medicine on the supply chain in the Public Hospital

    Directory of Open Access Journals (Sweden)

    Lilian de Fátima Silva

    2018-06-01

    Full Text Available Constant disruptions in the hospital supply chain caused by various sources of risk and vulnerability have been identified. This article aims to identify and analyze the main vulnerabilities that cause rupture risk in the supply of materials and medicines, on the supply chain in a public hospital in the city of Belo Horizonte. From qualitative research, we interviewed ten employees of the hospital and five suppliers. The interview script used was adapted from the model proposed by Mason-Jones and Towill (1988 and adapted by Bastos Junior (2007. As part of the results, it is possible to mention the risks of supply and the processes risk as being among those which were of more concern to the employees and the supply risks and control risk of more concern in the suppliers vision. It is inferred that more investment is necessary in the hospital supply chain management, given that the processes are based on the reaction to the risks rather than their prevention.

  17. 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...

  18. Nigerian Quarterly Journal of Hospital Medicine - Vol 13, No 1 (2003)

    African Journals Online (AJOL)

    Appropriateness of removal of impacted lower third molars: a 2-year audit at the Lagos ... Optimizing directly observed treatment, short course strategy in Nigeria ... patients in Lagos University Teaching Hospital - a preliminary report · EMAIL ...

  19. Nigerian Quarterly Journal of Hospital Medicine - Vol 24, No 2 (2014)

    African Journals Online (AJOL)

    Pattern of tooth replacement and colour choice among patients in a Nigerian teaching hospital · EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. OA Oremosu, DC Umesi, OH Savage, 169-174 ...

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

    International Nuclear Information System (INIS)

    Velazquez Cruz, R.A.; Pupo Palma, C.

    1998-01-01

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