WorldWideScience

Sample records for academic hospital medicine

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

    OpenAIRE

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

    2009-01-01

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

  2. Academic Hospitality

    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…

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

    Science.gov (United States)

    Modanlou, H D

    2011-04-01

    Historical progression and the development of current teaching hospitals, medical schools and biomedical research originated from the people of many civilizations and cultures. Greeks, Indians, Syriacs, Persians and Jews, assembled first in Gondi-Shapur during the Sasanian empire in Persia, and later in Baghdad during the Golden Age of Islam, ushering the birth of current academic medicine. PMID:21233794

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

    Science.gov (United States)

    Modanlou, H D

    2011-04-01

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

  5. [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

  6. [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

  7. Women in Academic Medicine.

    Science.gov (United States)

    Thibault, George E

    2016-08-01

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

  8. Women in Academic Medicine.

    Science.gov (United States)

    Thibault, George E

    2016-08-01

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

  9. 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

    Developments in "-omics" are creating a paradigm shift in laboratory medicine leading to personalized medicine. This allows the increase in diagnostics and therapeutics focused on individuals rather than populations. In order to investigate whether laboratory medicine is ready to play a key role...... in the integration of personalized medicine in routine health care and set the state-of-the-art -knowledge about personalized medicine and laboratory medicine in Europe, a questionnaire was constructed under the auspices of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and the European...... Society of Pharmacogenomics and Personalised Therapy (ESPT). The answers of the participating laboratory medicine professionals indicate that they are aware that personalized medicine can represent a new and promising health model, and that laboratory medicine should play a key role in supporting...

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

    Science.gov (United States)

    Maaroos, Heidi-Ingrid

    2004-10-01

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

  11. 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.

  12. Pre-hospital emergency medicine.

    Science.gov (United States)

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

    2015-12-19

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

  13. Career Choice in Academic Medicine: Systematic Review

    OpenAIRE

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

    2006-01-01

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

  14. The fault lines of academic medicine.

    Science.gov (United States)

    Schafer, Andrew I

    2002-01-01

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

  15. The fault lines of academic medicine.

    Science.gov (United States)

    Schafer, Andrew I

    2002-01-01

    Unprecedented advances in biomedical research and the upheaval in health care economics have converged to cause seismic changes in the traditional organization of medical schools and academic health centers. This process is particularly evident in departments of internal medicine. The activities and functions of academic medicine are in the midst of separation and realignment along lines that do not honor historical departmental and divisional boundaries. The organization of a successful medical school or department must be dynamic, constantly serving its constituents to accommodate progress and change and to promote optimal structure for academic productivity. PMID:12114834

  16. 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 h...... 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....... 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...

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

    Science.gov (United States)

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

    2015-06-01

    Acute heart failure is a fatal syndrome. Emergency physicians, cardiologists, intensivists, nurses and other health care providers have to cooperate to provide optimal benefit. However, many treatment decisions are opinion-based and few are evidenced-based. This consensus paper provides guidance to practicing physicians and nurses to manage acute heart failure in the pre-hospital and hospital setting. Criteria of hospitalization and of discharge are described. Gaps in knowledge and perspectives in the management of acute heart failure are also detailed. This consensus paper on acute heart failure might help enable contiguous practice.

  18. Effective organizational control: implications for academic medicine.

    Science.gov (United States)

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

    2005-11-01

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

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

    Science.gov (United States)

    Witt, Claudia M; Holmberg, Christine

    2012-01-01

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

  20. 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.

  1. The Priority of Intersectionality in Academic Medicine.

    Science.gov (United States)

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

    2016-07-01

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

  2. 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. PMID:27166867

  3. ACADEMIC TRAINING Physics Technologies in Medicine

    CERN Multimedia

    Françoise Benz

    2002-01-01

    10, 11, 12, 13, 14 June LECTURE SERIES from 11.00 to 12.00 hrs - Auditorium, bldg. 500 Physics Technologies in Medicine by G. K. Von Schulthess / Univ. of 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...

  4. 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...

  5. Facilitating scholarly writing in academic medicine.

    Science.gov (United States)

    Pololi, Linda; Knight, Sharon; Dunn, Kathleen

    2004-01-01

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

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

    OpenAIRE

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

    2007-01-01

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

  7. Implementing Personalized Medicine in the Academic Health Center

    OpenAIRE

    Weiss, Scott T

    2016-01-01

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

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

    OpenAIRE

    Claudia M Witt; Christine Holmberg

    2012-01-01

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

  9. 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...

  10. A second career in academic medicine.

    Science.gov (United States)

    Saunders, D E

    1984-03-01

    Career changes in all vocations are relatively common in the forties age group due to a variety of factors which include a crisis period caused by polarities of Generativity versus Stagnation as conceptualized by Erik H. Erikson. Generativity is served not only by procreativity but also by guiding the next generation through teaching. The result can be the strength of Care. Stagnation can result in unhappiness, irrational and destructive behavior, or withdrawal. Concepts of young, old and mortality also come into focus. A successful career change from private practice to academic medicine depends upon a combination of power, opportunity, and character. To be successful, the change should be made for positive reasons and be based upon youthful concepts in the cold reality of the financial and intellectual challenges of a new and competitive career. If properly done, both the personal rewards and the contribution to future medical care can be quite positive. PMID:6706448

  11. Academic Training: Physics technologies in medicine

    CERN Multimedia

    Françoise Benz

    2005-01-01

    24, 25, 26, 27 January 2004-2005 ACADEMIC TRAINING PROGRAMME LECTURE SERIES from 11.00 to 12.00 hrs - Main Auditorium, bldg. 500 Physics technologies in medicine M. GILARDI / Univ. of Milano, I. - U. AMALDI / Univ. of Milano Bicocca and TERA Foundation - M. SCHOLZ / GSI, Darmstadt, D. - O. JÄKEL / Deutsches Krebsforschungszentrum, Heidelberg, D Monday 24 January The frontiers of medical imaging M. GILARDI / Univ. of Milano, I. 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...

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

    Directory of Open Access Journals (Sweden)

    Ackerman Michael

    2007-02-01

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

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

    Science.gov (United States)

    Iglehart, J

    2000-03-01

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

  14. 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. PMID:22361794

  15. 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.

  16. 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. PMID:24977676

  17. 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.

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

    Science.gov (United States)

    Naylor, C David

    2006-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Claudia M. Witt

    2012-01-01

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

  20. 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…

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

    OpenAIRE

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

    2015-01-01

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

  2. 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.

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

    Science.gov (United States)

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

    2009-11-01

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

  4. 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. PMID:27061556

  5. 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.

  6. Academic Emergency Medicine Physicians’ Knowledge of Mechanical Ventilation

    OpenAIRE

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

    2016-01-01

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

  7. Academic Emergency Medicine Physicians’ Knowledge of Mechanical Ventilation

    OpenAIRE

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

    2016-01-01

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

  8. [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. PMID:10907162

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

    Science.gov (United States)

    Iglehart, J

    1997-09-01

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

  10. 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

  11. Importance of international networking in academic family medicine

    Directory of Open Access Journals (Sweden)

    Zalika Klemenc-Ketiš

    2014-05-01

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

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

    Science.gov (United States)

    Lindfors, Sara; Eintrei, Christina; Alexanderson, Kristina

    2009-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Gian Franco Gensini

    2007-01-01

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

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

    Directory of Open Access Journals (Sweden)

    R. Gcaba

    1992-09-01

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

  15. 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.

  16. 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.

  17. 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.

  18. 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. PMID:27276008

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

    OpenAIRE

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

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Kholiwe Shabangu

    2015-02-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  2. Mentorship perceptions and experiences among academic family medicine faculty

    Science.gov (United States)

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

    2016-01-01

    Abstract Objective 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. Design Web-based survey of all faculty members of an academic department of family medicine. Setting The Department of Family and Community Medicine of the University of Toronto in Ontario. Participants All 1029 faculty members were invited to complete the survey. Main outcome measures 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. Results 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 < .001); positive ratings of practice infrastructure (OR = 1.86, 95% CI 1.23 to 2.80, P = .003); increased frequency of receiving mentorship (OR = 2.78, 95% CI 1.59 to 4.89, P < .001); fewer years in practice (OR = 1.93, 95% CI 1.19 to 3.12, P = .007); and practising in a family practice teaching unit (OR = 1.51, 95% CI 1.01 to 2.27, P = .040). Conclusion With increasing emphasis on distributed education and community-based teachers, family medicine faculties will need to develop strategies to support

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

    Science.gov (United States)

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

    2004-03-01

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

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

    Science.gov (United States)

    Rich, Eugene C; Reschovsky, James D

    2016-07-01

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

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

    Science.gov (United States)

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

    2004-03-01

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

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

    Science.gov (United States)

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

    2014-11-01

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

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

    Science.gov (United States)

    Weigel, Charlene; Suen, Winnie; Gupte, Gouri

    2013-01-01

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

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

    LENUS (Irish Health Repository)

    Kellett, John

    2009-09-01

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

  9. 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.

  10. 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. PMID:27306972

  11. 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.

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

    Science.gov (United States)

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

    2014-03-01

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

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

    Science.gov (United States)

    Carter, Mary

    2016-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  15. An Expanded Model of Faculty Vitality in Academic Medicine

    Science.gov (United States)

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Afshin Amini

    2014-08-01

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

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

    Science.gov (United States)

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

    2011-02-01

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

  18. [Changes of career of traditional Chinese medicine in Hong Kong Donghua Hospital in modern times].

    Science.gov (United States)

    Zheng, H

    2016-05-01

    Founded in 1872, the Hong Kong Donghua Hospital (Tung Wah Group of Hospitals later) was the earliest traditional Chinese hospital in modern times, which has made positive contributions in exploring the shape and structure of TCM hospital and promoting science of TCM in Hong Kong. Unfortunately, TCM didn't acquire a legal status in Hong Kong, the practice of TCM in Donghua Hospital was thus restricted by the government, and ultimately, it changed into a comprehensive hospital mainly use western medicine. The change of TCM business in Hong Kong Donghua Hospital reflected the problems and situation of traditional Chinese medicine encountered in modern times. PMID:27485869

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

    Science.gov (United States)

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

    2013-10-01

    Despite increases in the percentages of women medical school graduates and faculty over the past decade, women physicians and scientists remain underrepresented in academic medicine's highest-level executive positions, known as the "C-suite." The challenges of today and the future require novel approaches and solutions that depend on having diverse leaders. Such diversity has been widely shown to be critical to creating initiatives and solving complex problems such as those facing academic medicine and science. However, neither formal mentoring programs focused on individual career development nor executive coaching programs focused on individual job performance have led to substantial increases in the proportion of women in academic medicine's top leadership positions.Faced with a similar dilemma, the corporate world has initiated sponsorship programs designed to accelerate the careers of women as leaders. Sponsors differ from mentors and coaches in one key area: They have the position and power to advocate publicly for the advancement of nascent talent, including women, in the organization. Although academic medicine differs from the corporate world, the strong sponsorship programs that have advanced women into corporations' upper levels of leadership can serve as models for sponsorship programs to launch new leaders in academic medicine. PMID:23969365

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

    Science.gov (United States)

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

    2015-08-01

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

  1. Academic Medicine Becomes a Target for Labor Organizing.

    Science.gov (United States)

    Mangan, Katherine S.

    1999-01-01

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

  2. 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…

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

    OpenAIRE

    Newton, Warren P.; DuBard, C Annette

    2006-01-01

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

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

    OpenAIRE

    Mohammad Mehdi Movahedi; Alireza Mehdizadeh

    2013-01-01

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

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

    Science.gov (United States)

    Fischer Zellers, Darlene

    2013-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  7. 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. PMID:23425986

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

    Science.gov (United States)

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

    1996-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Selma Siahaan

    2014-08-01

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

  10. 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.

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

    Science.gov (United States)

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

    2016-08-01

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

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

    Science.gov (United States)

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

    2016-08-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  14. 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

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

    Science.gov (United States)

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

    2012-10-01

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

  17. 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. 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…

  19. 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. PMID:26760060

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

    Science.gov (United States)

    Just, Melissa L

    2003-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

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

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

    Science.gov (United States)

    Buss, Daryl D

    2015-01-01

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

  3. 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......’ 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.......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...... follow-on drugs and their incumbent therapeutic competitors were identified from Danish sales and product registration data on hospital pharmaceuticals using medically relevant criteria. We examined whether follow-on drugs adopt lower prices than their incumbent competitors, and whether incumbent...

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

    Science.gov (United States)

    Tweardy, David J; Belmont, John W

    2009-12-01

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

  5. Integration of an academic medical center and a community hospital: the Brigham and Women's/Faulkner hospital experience.

    Science.gov (United States)

    Sussman, Andrew J; Otten, Jeffrey R; Goldszer, Robert C; Hanson, Margaret; Trull, David J; Paulus, Kenneth; Brown, Monte; Dzau, Victor; Brennan, Troyen A

    2005-03-01

    Brigham and Women's Hospital (BWH), a major academic tertiary medical center, and Faulkner Hospital (Faulkner), a nearby community teaching hospital, both in the Boston, Massachusetts area, have established a close affiliation relationship under a common corporate parent that achieves a variety of synergistic benefits. Formed under the pressures of limited capacity at BWH and excess capacity at Faulkner, and the need for lower-cost clinical space in an era of provider risk-sharing, BWH and Faulkner entered into a comprehensive affiliation agreement. Over the past seven years, the relationship has enhanced overall volume, broadened training programs, lowered the cost of resources for secondary care, and improved financial performance for both institutions. The lessons of this relationship, both in terms of success factors and ongoing challenges for the hospitals, medical staffs, and a large multispecialty referring physician group, are reviewed. The key factors for success of the relationship have been integration of training programs and some clinical services, provision of complementary clinical capabilities, geographic proximity, clear role definition of each institution, commitment and flexibility of leadership and medical staff, active and responsive communication, and the support of a large referring physician group that embraced the affiliation concept. Principal challenges have been maintaining the community hospital's cost structure, addressing cultural differences, avoiding competition among professional staff, anticipating the pace of patient migration, choosing a name for the new affiliation, and adapting to a changing payer environment. PMID:15734807

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

    OpenAIRE

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

    2014-01-01

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

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

    Science.gov (United States)

    Porter, Katie; Lampson, Sarah

    2011-01-01

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

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

    Science.gov (United States)

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

    2014-12-01

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

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  10. 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. PMID:27332868

  11. 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. PMID:27332165

  12. 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. PMID:10271804

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

    Science.gov (United States)

    Zhang, Ying-Nan; Xu, Wen

    2014-03-01

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

  14. 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

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

    Science.gov (United States)

    Tanabe, Seizan

    2016-02-01

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

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

    Science.gov (United States)

    Paz, Harold L

    2016-05-01

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

  17. 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. PMID:23237151

  18. 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.

  19. 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...

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2014-09-01

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

  2. 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.

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

    Vidale, Claudia

    2014-01-01

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

  5. 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

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

    Science.gov (United States)

    Lao, Lixing; Ning, Zhipeng

    2015-11-01

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

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

    Science.gov (United States)

    Lao, Lixing; Ning, Zhipeng

    2015-11-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Lixing Lao; Zhipeng Ning

    2015-01-01

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

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

    Science.gov (United States)

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

    2013-10-01

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

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

    OpenAIRE

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

    2015-01-01

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

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

    Science.gov (United States)

    Lander, Bryn; Atkinson-Grosjean, Janet

    2011-02-01

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

  12. 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. PMID:23969359

  13. 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.

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

    Science.gov (United States)

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

    2015-12-01

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

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

    Science.gov (United States)

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

    2016-09-01

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

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

    Science.gov (United States)

    Morgen, Evelyn Breck

    2003-01-01

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

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

    Science.gov (United States)

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

    2015-11-01

    Given the discrepancy between men and women's equal rates of medical school matriculation and their rates of academic promotion and leadership role acquisition, the need to provide mentorship and education to women in academic medicine is becoming increasingly recognized. Numerous large-scale programs have been developed to provide support and resources for women's enrichment and retention in academic medicine. Analyses of contributory factors to the aforementioned discrepancy commonly cite insufficient mentoring and role modeling as well as challenges with organizational navigation. Since residency training has been shown to be a critical juncture for making the decision to pursue an academic career, there is a need for innovative and tailored educational and mentorship programs targeting residents. Acknowledging residents' competing demands, we designed a program to provide easily accessible mentorship and contact with role models for our trainees at the departmental and institutional levels. We believe that this is an important step towards encouraging women's pursuit of academic careers. Our model may be useful to other emergency medicine residencies looking to provide such opportunities for their women residents. PMID:25915003

  18. [Prescription of high-cost medicines in French Hospitals: Regulation and procedures of reimbursement].

    Science.gov (United States)

    Wilkowsky, Cécile; Lenain, Adélaïde; Benbekhaled, Khaled; Le Gall, Marie-José; Vignot, Stéphane

    2016-04-01

    The high cost of several drugs or medical devices involves specific reimbursement procedures in French hospitals. Specific prescription rules have been developed and a regular survey by regional health authorities is performed. These particular funding procedures allow patients to access to innovative drugs. Some questions have recently been raised in France about the list of cancer drugs that could be concerned by an additional funding by health insurance. In this setting, this article proposes to summarize the current modalities of reimbursement of high-cost medicines in French Hospitals to enlighten the current debate. PMID:27017057

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

    Directory of Open Access Journals (Sweden)

    Cohen M

    2010-01-01

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

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

    Science.gov (United States)

    Snyderman, Ralph; Yoediono, Ziggy

    2008-08-01

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

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

    OpenAIRE

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    M. Süsskind

    2012-01-01

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

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

    Science.gov (United States)

    Zajączkowski, Tadeusz

    2014-01-01

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

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

    Science.gov (United States)

    Zajączkowski, Tadeusz

    2014-01-01

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

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

    Science.gov (United States)

    Mallon, William T

    2003-11-01

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

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

    Science.gov (United States)

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

    2002-01-01

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

  7. 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. PMID:26535867

  8. 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.

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

    Science.gov (United States)

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

    2014-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Kyung-Jin Yun

    2015-01-01

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

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  12. Perspective: Paying physicians to be on call: a challenge for academic medicine.

    Science.gov (United States)

    Krueger, Kristine J; Halperin, Edward C

    2010-12-01

    Paying physicians for on-call services is an emerging national trend. It is fueled by the growing demand for specialty services during nighttime, weekend, and holiday hours, coupled with the changing attitude of physicians, many of whom no longer view being on call as an obligation. Academic health centers (AHCs) serve as stewards of the public's health and are the primary educators for most health care workers. AHCs' policies, including their on-call practices, have significant influence on health care trends and the practice of medicine, but AHC leaders have not reached consensus on whether being on call should be a voluntary or paid responsibility. Graduate medical education programs at AHCs, which insist that trainees adhere to work hours restrictions, are teaching tomorrow's physicians that working fewer hours and getting enough sleep will help reduce medical errors. The unintended consequence is an increasing shortage of physicians who are willing to be on call. Faculty at AHCs need to critically evaluate the multiple factors creating on-call shortages, then formulate and implement practical solutions. Simply offering payment as an incentive for on-call services has not guaranteed the availability of specialty care around the clock and has not addressed the on-call burden for physicians. PMID:20978431

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

    Science.gov (United States)

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

    2015-01-01

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

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

    OpenAIRE

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

    2016-01-01

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

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

    Science.gov (United States)

    Voravuthikunchai, S P; Kitpipit, L

    2005-06-01

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

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

    OpenAIRE

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

    2009-01-01

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

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

    Science.gov (United States)

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

    2011-09-27

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

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

    Directory of Open Access Journals (Sweden)

    Veronique C. Bailey

    2010-03-01

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

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

    Caffrey, Louise; Mattingley, Helena; Williamson, Catherine; McKevitt, Christopher

    2016-01-01

    Objectives 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. Design Multimethod qualitative case studies using a realist evaluation approach. Setting 5 departments from a university medical school hosting a Translational Research Organisation. Participants 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. Results 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. Conclusions 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

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

    Directory of Open Access Journals (Sweden)

    Hussain A

    2009-01-01

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

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

    Science.gov (United States)

    Slater, James M

    2007-08-01

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

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

    International Nuclear Information System (INIS)

    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

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

    Science.gov (United States)

    Nomura, Fumio

    2008-12-01

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

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

    Science.gov (United States)

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

    2014-08-01

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

  6. 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

  7. 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…

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

    Directory of Open Access Journals (Sweden)

    Jeremy J. Hess

    2015-10-01

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

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

    Institute of Scientific and Technical Information of China (English)

    成美

    2014-01-01

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

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

    International Nuclear Information System (INIS)

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

  11. 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

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

    Directory of Open Access Journals (Sweden)

    Roberto Nardi

    2013-09-01

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

  13. 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

    2015-01-01

    Objective 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. Methods 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. Results 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. Conclusions 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. PMID:26236542

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

    Directory of Open Access Journals (Sweden)

    Carlo Nozzoli

    2015-05-01

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

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

    OpenAIRE

    Stamm Martina; Buddeberg-Fischer Barbara; Buddeberg Claus

    2009-01-01

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

  16. 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.

  17. 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.

  18. 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...

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

    Science.gov (United States)

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

    2012-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Filomena Pietrantonio

    2016-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Roberto Nardi

    2013-04-01

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

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

    Institute of Scientific and Technical Information of China (English)

    庞国丽

    2015-01-01

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

  3. 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. PMID:27501620

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

    International Nuclear Information System (INIS)

    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

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

    Science.gov (United States)

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

    2016-04-01

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

  6. 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. PMID:11389787

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

    OpenAIRE

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

    2016-01-01

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

  8. 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.

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

    Institute of Scientific and Technical Information of China (English)

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

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Igbiks Tamuno

    2011-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

    Hunter, Cecily

    2006-04-01

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

  14. 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...

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

    OpenAIRE

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2012-01-01

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

  17. 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.

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

    Science.gov (United States)

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

    2016-04-01

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

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

    Science.gov (United States)

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

    2016-06-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  4. 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.

  5. 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.

  6. 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

    2007-01-01

    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. PMID:18167609

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

    Science.gov (United States)

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

    2006-01-01

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

  8. Hospitals

    DEFF Research Database (Denmark)

    Mullins, Michael

    2013-01-01

    The challenge could be briefly seen in these terms: hospitals as places for treatment where there’s a technology focus and hospitals for healing where there’s a human focus. In the 60s - 70s wave of new hospital building, an emphasis on technology can be seen. It’s time to move from the technology...... is to minimize the negative effects of stress inducing environments based on research results. Which stress inducing factors? We can look around at some old hospitals and see they are noisy, confusing, ugly, monotonous, hard, cold, artificial, and dark; qualitative terms which can indicate what we shouldn......’t be doing in hospitals. Design factors which should be carefully considered include: Light, as in daylight, artificial light, its color, its temperature, the level and quality of lighting and the effects of light on circadian rhythms. There is documented evidence in: users’ satisfaction, orientation, 24...

  9. 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. PMID:23887000

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

    DEFF Research Database (Denmark)

    Rasmussen, Søren; Abildstrøm, Steen Zabell; Rasmussen, Jeppe Nørgaard;

    2008-01-01

    OBJECTIVE: To examine temporal trends in hospital use of secondary preventive medicine after discharge for first acute myocardial infarction (AMI) in Denmark. DESIGN: Observational study from national administrative databases of 60,339 patients who survived a first AMI at 73 acute-care hospitals...... during 1995-2004. OUTCOME MEASURES: At least 1 prescription claim for angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, or statins within 90 days of discharge for AMI. FINDINGS: The odds ratios between hospitals in the highest and lowest deciles, adjusted for age, gender, period, income......, comorbidity, concomitant, and prior pharmaceutical therapy, in 1995 were 8.5 [95% confidence interval (CI), 5.5-12.2] for beta-blockers, 3.0 (2.3-3.7) for ACE inhibitors, and 6.2 (4.1-8.8) for statins. By 2004, the hospital variation had decreased for beta-blockers (3.2; 2.3-4.0) and statins (4.2; 3...

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

    Directory of Open Access Journals (Sweden)

    Zornoff Leonardo A. M.

    2002-01-01

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

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

    OpenAIRE

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

    2015-01-01

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

  13. 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. PMID:27033085

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

    Science.gov (United States)

    Guenther, Katja

    2014-01-01

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

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

    OpenAIRE

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

    2016-01-01

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

  16. 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.

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

    Directory of Open Access Journals (Sweden)

    Swapna R. Nayaka

    2015-06-01

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

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

    Science.gov (United States)

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

    2004-09-01

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

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

    NARCIS (Netherlands)

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

    2002-01-01

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

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

    Science.gov (United States)

    Huff, C

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

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

    Directory of Open Access Journals (Sweden)

    Shimizu T

    2013-07-01

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

  2. Alternative models for academic family practices

    Directory of Open Access Journals (Sweden)

    Yarnall Kimberly SH

    2006-03-01

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

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

    Science.gov (United States)

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

    2014-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Paulo Fernando Burlamaqui

    2008-07-01

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

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

    Science.gov (United States)

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

    2014-12-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  7. Painful medicine: managed care and the fate of America's major teaching hospitals.

    Science.gov (United States)

    Levey, S; Anderson, L

    1999-01-01

    Healthcare spending in the United States has risen steadily throughout the post-World War II period as the American healthcare system has been transformed from cottage industry to big business. The increasing rate of social investment in healthcare also transformed America's major teaching hospitals. As a case in point, the University of Iowa Hospitals and Clinics saw annual operating revenues rise from $1 million in 1945 to more than $350 million in 1995, which was accompanied by an extraordinary expansion in its physical facilities and in its multifaceted operations. In the 1970s and even more so in the 1980s, however, the unceasing climb in healthcare spending fueled concern among policy experts, politicians, employers, and insurers alike. In turn, the search for effective cost controls led to the current managed care revolution. While the end of that revolution is not yet in sight, managed care has, it appears, effected significant cost savings, but at no small cost to America's major teaching hospitals and their social missions of teaching, research, and patient care. Whether those missions can survive--and, if so, in what form--in a healthcare system dominated by the managed care ethos is an increasingly important concern. PMID:10539198

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

    Science.gov (United States)

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

    2016-08-01

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

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

    Science.gov (United States)

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

    2016-08-01

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

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

    Science.gov (United States)

    Shearer, Barbara S; Nagy, Suzanne P

    2003-07-01

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

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

    Science.gov (United States)

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

    2012-09-01

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

  12. National Health and Hospital Network for Australia's future: implications for Emergency Medicine.

    Science.gov (United States)

    FitzGerald, Gerry; Ashby, Richard

    2010-10-01

    The proposals arising from the agreement reached between the Rudd government and the States and Territories (except Western Australia) in April 2010 represent the most fundamental realignment of health responsibilities since the creation of Medicare in 1984. They will change the health system, and the structures that will craft its future direction and design. These proposals will have a significant impact on Emergency Medicine; an impact from not only the system-wide effects of the proposals but also those that derive from the specific recommendations to create an activity-based funding mechanism for EDs, to implement the four hour rule and to develop a performance indicator framework for EDs. The present paper will examine the potential impact of the proposals on Emergency Medicine to inform those who work within the system and to help guide further developments. More work is required to better evaluate the proposals and to guide the design and development of specific reform instruments. Any such efforts should be based upon a proper analysis of the available evidence, and a structured approach to research and development so as to deliver on improved services to the community, and on improved quality and safety of emergency medical care.

  13. National Health and Hospital Network for Australia's future: implications for Emergency Medicine.

    Science.gov (United States)

    FitzGerald, Gerry; Ashby, Richard

    2010-10-01

    The proposals arising from the agreement reached between the Rudd government and the States and Territories (except Western Australia) in April 2010 represent the most fundamental realignment of health responsibilities since the creation of Medicare in 1984. They will change the health system, and the structures that will craft its future direction and design. These proposals will have a significant impact on Emergency Medicine; an impact from not only the system-wide effects of the proposals but also those that derive from the specific recommendations to create an activity-based funding mechanism for EDs, to implement the four hour rule and to develop a performance indicator framework for EDs. The present paper will examine the potential impact of the proposals on Emergency Medicine to inform those who work within the system and to help guide further developments. More work is required to better evaluate the proposals and to guide the design and development of specific reform instruments. Any such efforts should be based upon a proper analysis of the available evidence, and a structured approach to research and development so as to deliver on improved services to the community, and on improved quality and safety of emergency medical care. PMID:21040482

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

    Science.gov (United States)

    Hominick, Kathryn; McLeod, Victoria; Rockwood, Kenneth

    2016-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    张海霞; 高颖

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    徐升阳

    1997-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2016-05-01

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

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

    OpenAIRE

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

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    卢凤玲; 吴小萍; 鲁菊香

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ana Carolina González Pezoa

    2015-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Anarado Agnes N

    2007-09-01

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

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

    Institute of Scientific and Technical Information of China (English)

    汪姣

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ni Made Sintia Anggia Sari

    2013-05-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE One of the complications that can occur in microvaskular diabetes mellitus is diabetic retinopathy. This research was carried out to know the prevalence of diabetic retinopathy in patients type 2 diabetes mellitus at internal divison of Sanglah Hospital. The method used is cross sectional by collecting data from the questionnaire and secondary data of medical record patient's type 2 DM. On this research acquired 111 patients (35.1% with diabetic retinopathy and (64,9% nonretinopathy. In the group with good level of HbA1c (<6.5% the prevalence of diabetic retinopathy obtained 53.2%, in the group of patients with moderate level of HbA1c (6.5-8% as much as 22.5%, and in the group of patients with HbA1c bad level (>8% as much as 24.3%. The prevalence of the occurrence of DM complications in the diabetic retinopathy is still high, and a good level of HbA1c does not guarantee a person can’t have complication because the complication can also happens are affected by hypertension, dyslipidemia, age, and duration of DM. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

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

    Institute of Scientific and Technical Information of China (English)

    黄培艳

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Tatjana Magi

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

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

    Science.gov (United States)

    Cant, Sarah; Watts, Peter; Ruston, Annmarie

    2011-02-01

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

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

    Science.gov (United States)

    Marin, Jennifer R; Mills, Angela M

    2015-12-01

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

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

    Institute of Scientific and Technical Information of China (English)

    翟忠美; 杨友谊; 鲜于丽

    2014-01-01

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

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

    OpenAIRE

    Naveen Kumar D; Sudhakar TP

    2013-01-01

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

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

    OpenAIRE

    Subramaniam, BS; Hande, S; Komattil, R

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Stephan Curtis

    2011-01-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

  15. 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 <4 days) admitting acutely ill patients from the ED, a subacute care ward for chronic critically ill subjects and a nurse-managed ward for stable patients who have socio-economic trouble preventing discharge. A very-rapid-turnover ("come'n'go") ward has also been instituted to manage sudden ED overflows. Continuity, effectiveness, safety and appropriateness of care are guaranteed by an innovative figure called "flow manager," with skilled clinical experience and managerial attitude, and by elaboration of an early personalized discharge plan anticipating every patient's needs according to lean methodology principles. In 2012-2014, this organizational model, compared with other peer units of the hospital and of other teaching hospitals of the region, showed a better performance, efficacy and effectiveness indexes calculated on Regional Hospital Discharge Records database system, allowing a capacity to face a massive (+22 %) rise in medical admissions from the ED. Further studies are needed to validate this model from a patient outcome point of view. PMID:26846233

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

    Directory of Open Access Journals (Sweden)

    Dawie Du Plessis

    2016-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Mohammad S. Alyahya

    2016-08-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2011-01-01

    In this paper, we describe: 1) the environmental forces driving performance measurement and management in the University of California San Diego Department of Medicine; 2) the systematic process used by the department to implement a Balanced Scorecard; 3) the initial direct and indirect outcomes of this effort; 4) the opportunities and challenges to the Balanced Scorecard as a management directive; and 5) future directions. PMID:21815545

  1. Transposed Markov Matrix as a New Decision Tool of How to Choose among Competing Investment Options in Academic Medicine

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    Amnon Sonnenberg

    2009-01-01

    Full Text Available Medical institutions face the challenge of promoting excellence in a variety of competing focus areas, such as grants, publications, income, research, faculty, variety, patient care and teaching. A transposed Markov chain is used analyse the interactions between the various focus areas and their transition towards steady-state. In contradistinction with a regular Markov chain, in the transposed chain used for the present analysis, the sum of inputs (rather than outputs of each individual state is 100%, whereas the outputs are left to assume any possible value. The mathematics of calculating the steady state conditions of a transposed Markov matrix are similar to those of a regular Markov matrix. The analysis shows that a focus area more dependent on other areas is also more likely to lose its investment, whereas largely self-reliant areas will generate the largest return. Full strength of all academic focus areas can be achieved only by investments in all areas. In academic systems with one or several exclusively self-reliant focus areas, only investment in these particular areas will invigorate the system, as all other investments are bound to dissipate over time. The newly developed decision tool of a transposed Markov matrix could be helpful in stochastic modelling of medical phenomena.

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

    Science.gov (United States)

    Grabois, M

    1992-04-01

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

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

    OpenAIRE

    Tema, Matsepo Aniva

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    贺小靖; 贺伯汉

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Karpa Kelly

    2011-10-01

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

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

    Institute of Scientific and Technical Information of China (English)

    苏玉纯; 沈紧治; 王政

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Roberta Mullini

    2013-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Woodhams Victoria

    2012-06-01

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

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

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    Kendall Emily A

    2012-10-01

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

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

    Science.gov (United States)

    Iglehart, J

    1999-07-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-12-15

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

  12. 基于中医医院制剂处方的中药创新药处方优化模式的探讨%Optimization Mode of Innovative Chinese Medicine Formulations Based on Traditional Chinese Medicine Hospital Preparations

    Institute of Scientific and Technical Information of China (English)

    田元祥; 雷燕; 曹洪欣; 翁维良

    2012-01-01

    This study was aimed to investigate the optimization model of innovative Chinese medicine formulations based on traditional Chinese medicine (TCM) hospital preparations. A literature review was conducted to analyze the importance and characteristics of TCM hospital preparations. And then the optimization process and methods of hospital preparations were summarized and explored. The results showed that hospital preparation is an important and fundamental resource of new drug development, with characteristics of abundant clinical experience, multiple formulations, multiple dosage forms, well-established efficacy and reliable safety. Thus, hospital preparations may provide a rich material foundation for the screening of new drug development, which can shorten the development cycle and reduce the research cost. However, there is still a gap between hospital preparations and innovative drugs. Based on our optimization work experiences, the optimization of hospital preparations should comply with general principles and process of optimizing innovative Chinese medicine formulations, which can be divided into three parts, i.e. optimization of component formulation, optimization of clinical trial protocols and assessment before and after clinical trials. The optimization process should be well—focused, so as to facilitate comprehensive optimization. Before optimization, the investigational prescription should undergo qualitative and quantitative evaluation for the first time. Based on sponsor's final revision, the second qualitative and quantitative evaluation should be performed before the initiation of clinical trials. After clinical trials, the prescription should undergo qualitative and quantitative evaluation for the third time according to the findings of clinical trials. It was concluded that it is possible to provide an optimization model of innovative Chinese medicine formulations based on TCM hospital preparations.%目的:探讨基于中医医院制剂处方的

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

    Directory of Open Access Journals (Sweden)

    Biljana Lakić

    2016-05-01

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

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

    Science.gov (United States)

    Abraham, J

    1995-06-01

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

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

    OpenAIRE

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

    2012-01-01

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

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

    Science.gov (United States)

    Marin, Jennifer R; Mills, Angela M

    2015-12-01

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

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

    Institute of Scientific and Technical Information of China (English)

    张真全

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    何广宏; 董然

    2014-01-01

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

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

    Science.gov (United States)

    Pellegrini, V D

    2001-10-01

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

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

    Science.gov (United States)

    Ong, B K C

    2002-11-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Lim Alissa

    2006-05-01

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

  3. Academics explore humidity's benefits.

    Science.gov (United States)

    Mortimer, Dave

    2008-11-01

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

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

    OpenAIRE

    Sawchuk, Victor N.

    1980-01-01

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

  5. Medication safety during your hospital stay

    Science.gov (United States)

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

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

    Science.gov (United States)

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

    2008-09-01

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

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

    OpenAIRE

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

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    顾晓玲; 朱江; 陈丽华

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Mauro Campanini

    2015-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Violet N Pinto

    2014-01-01

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

  11. Hospital marketing.

    Science.gov (United States)

    Carter, Tony

    2003-01-01

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

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

    Science.gov (United States)

    Schmidt, C M; Eckerman, N L

    2001-04-01

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

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

    International Nuclear Information System (INIS)

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

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

    Institute of Scientific and Technical Information of China (English)

    俞培敏

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Gladys Oblitas

    2013-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Søren Ventegodt

    2007-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Emilio Scotti

    2013-12-01

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

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

    OpenAIRE

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

    2004-01-01

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

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

    OpenAIRE

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2011-12-01

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

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

    Science.gov (United States)

    Grujić, M

    1994-01-01

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

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

    OpenAIRE

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Adem Diken

    2014-03-01

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

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

    OpenAIRE

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

    2007-01-01

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

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Marcela Mercado

    2012-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Jennifer L. McQuade

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Bhavik S.

    2015-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Luigi Lusiani

    2013-04-01

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

  10. Pediatric integrative medicine: pediatrics' newest subspecialty?

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    Vohra Sunita

    2012-08-01

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Domhnall MacAuley

    2012-02-01

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

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

    Institute of Scientific and Technical Information of China (English)

    张燕舞; 唐小利; 夏杰峰

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    张小会; 李宗友; 谢春娥; 曾俊杰

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-05-01

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

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

    Institute of Scientific and Technical Information of China (English)

    徐洪

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Hee Seung Choi

    2014-01-01

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

  18. Hypoglycemia in the hospital

    OpenAIRE

    Shomali, Mansur

    2011-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Gloria Paulina Pulido Acuña

    2012-12-01

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

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

    Institute of Scientific and Technical Information of China (English)

    陈玮; 费健; 俞郁萍; 杨伟国; 李国红

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Dipanjan Bandyopadhyay

    2011-01-01

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

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

    Science.gov (United States)

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Mai Duong

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

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

    Science.gov (United States)

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

    2016-03-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    高红燕; 陈迎平

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Jatin Patel

    2015-06-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  10. Analysis on the Demand of Human Resources in County Hospitals of Chinese Medicine Based on the Health Service Industry in Baoding%基于健康服务的保定市县中医医院人力资源需求分析

    Institute of Scientific and Technical Information of China (English)

    司建平

    2015-01-01

    -sources. As for demands from job, the top 10 were internal medicine(thirteen), medicine surgery(eleven), gynecology(eight), orthopedics ( seven) , rehabilitation( seven) ,pediatric medicine( six) ,nursing( five) ,emergency( five) ,treating disease( five) ,and massage( four) . As for de-mands from academic needs,doctoral students are 12, graduate students are 116, undergraduate are 930, and specialist and below are 502. As for demands from title, senior titles are 184, intermediate grade are 640, junior are 653, and others are 83. As for demands from professional, clini-cal medicine of TCM are 364, acupuncture and massage are 95,pharmacy are 78, integrative medicine are 155, and western medicine are 132, Western pharmacy are 56, and nursing of TCM are 444, medical technology are 150. Conclusion:The suggestions to explore ways to enhance the county hospital of TCM service capacity and service levels, and boost the development of health services industry are to create a good environ-ment, and to build human resources development platform of county hospital of TCM;change employment concept, and to encourage graduates to the county hospital of TCM for employment;strengthen continuing education, and to improve staff enthusiasm in county hospital of TCM;improve the pay system, and to perfect human resources development security system in county hospital of TCM;balanced supporting resources, and to es-tablish human resources benefits long-term mechanism in county hospital of TCM.

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

    Directory of Open Access Journals (Sweden)

    Jan A Graw

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

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

    Institute of Scientific and Technical Information of China (English)

    杨继红

    2008-01-01

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

  13. Nuclear medicine

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

    Pandey, Nishant Raj

    2016-12-01

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

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

    Institute of Scientific and Technical Information of China (English)

    郭玉霞; 张磊; 齐伟; 吴志恒

    2012-01-01

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

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

    Science.gov (United States)

    Pillar, Giora; Shapira, Chen

    2015-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Paolo Biagi

    2014-03-01

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

  18. An analysis on 5828 cases of pre-hospital care of a traditional Chinese medicine hospital%中医院5828例院前急救病例分析

    Institute of Scientific and Technical Information of China (English)

    蒋文钧

    2011-01-01

    Objective To analyze various types of pre-hospital emergency disease spectrum and the amount of visits and their visit correlations to various months and different day times to provide a theoretical basis for specifying the construction of reasonable salvage and treatments in an emergency department. Methods A retrospective analysis of 5 828 cases undergoing pre-hospital emergency treatment in Emergency Department in Guilin Traditional Chinese Medicine Hospital from 0 h on January 1st 2008 to 24 h on December 31st 2010 was made. The patient's age and sex distribution, the amount of visits, their visit correlations to various months and different daytimes, and the situation of the common disease spectrum were analyzed. Results The number of patient visits for pre-hospital emergency treatment had a tendency of increase year by year;the ratio of men to women was 1. 37 :1,and the number of cases with 19-49 years of age was the greatest; the peak of the first-aid consultation was in November, December, January and February; the daily visits in 0 - 6 h period were accounted for 17. 48% , in the morning session 7 - 12 h, 27. 30% , in the afternoon session 13 - 18 h, 34. 63%, and in the evening or night time 19 - 24 h, 20. 59%. The diseases occupied the first 3 positions were trauma, intoxication, etc. Various external causes, being accounted for 48. 20% , and the diseases of nervous system and cardiovascular diseases were respectively 13. 74% and 11. 05%. Conclusion According to the pre-hospital emergency disease spectrum, the technology emphasized and the direction of personnel cultivation in emergency medicine can be established. In this department, the knowledge and training of emergency treatment and salvage of cases with trauma, intoxication and cardiocerebrovascular diseases should be particularly enhanced. The salvage scheme and service process for green channel of critical patients should be formulated, and the plans for responding to sudden occurrences of various

  19. Academic Blogging: Academic Practice and Academic Identity

    Science.gov (United States)

    Kirkup, Gill

    2010-01-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

  1. Historical perspectives on health. Early Arabic medicine.

    Science.gov (United States)

    Brewer, Harry

    2004-07-01

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

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

    International Nuclear Information System (INIS)

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

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

    Institute of Scientific and Technical Information of China (English)

    戴柏华; 陈良乾; 杨鸿洋

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    范玲玲

    2001-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    张华锋; 彭桂清; 李丽; 许静; 陈绪龙

    2012-01-01

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

  6. [A phase-out model: the practice of a rural healer practice at a time of increasing academic hegemony in medicine].

    Science.gov (United States)

    Weikl, Katharina; Ritzmann, Iris

    2012-01-01

    This article deals with a healer's practice in a rural Swiss region during the first half of the 19th century. The lay-healer Gottfried Wachter (1776-1861) learned his therapeutic knowledge from his father in the late 18th century as was typical for the period. With the rise to power of the academic physicians during the first decades of the 19th century the number of non-academic healers decreased. Until the end of his working life, Wachter resisted this trend as one of the last healers in his region. The medical records of Wachter's and other sources allow us to enter into the question how this healer's practice tried to persist on the medical market. PMID:23320374

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

    Institute of Scientific and Technical Information of China (English)

    宗志勇; 贾鹰珏; 刘小鹏; 张瑞丽; 苏爽; 刘权

    2015-01-01

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

  8. Structure and Activities of Nuclear Medicine in Kuwait.

    Science.gov (United States)

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

    2016-07-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    张碧华; 穆林; 金鹏飞; 蔡小兵

    2012-01-01

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

  11. Strategic business planning for internal medicine.

    Science.gov (United States)

    Ervin, F R

    1996-07-01

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

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

    NARCIS (Netherlands)

    Smit Sibinga, Cornelis; Escudeiro, P

    2010-01-01

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  14. Academics respond

    DEFF Research Database (Denmark)

    Hazel, Spencer

    2015-01-01

    Contribution to the article "Academics respond: Brexit would weaken UK university research and funding", Guardian Witness, The Guardian, UK......Contribution to the article "Academics respond: Brexit would weaken UK university research and funding", Guardian Witness, The Guardian, UK...

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

    Directory of Open Access Journals (Sweden)

    Roberto Manfredi

    2010-12-01

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

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

    Science.gov (United States)

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

    2012-01-01

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

  17. 平衡记分卡理论与综合性医院行为医学学科建设%The balanced scorecard and behavioral medicine discipline development in general hospitals

    Institute of Scientific and Technical Information of China (English)

    高天; 马效恩; 王晋; 宋雨潇; 李晓红

    2014-01-01

    This study run through the process of developing behavioral medicine discipline in a general hospital with action research method,based on the balanced scorecard (BSC) framework.The four perspectives of the behavioral medicine BSC covered the main areas in hospital discipline development,including patients and community,healthy financial disciplines,clinical service process and efficiency,and research,innovation and growth.By the implementation of the discipline BSC,this hospital clarified its discipline development strategy,provided a communication platform,determined the objective and monitored the discipline effectively,and provided a mode which can integrate the discipline development and providing clinical services.The hospital set up the first neurology behavioral medicine clinic in Jinan Region though the exploration of the path and methods for developing behavioral medicine discipline,which had practical guiding significance for behavioral medicine development and services.%研究基于平衡记分卡理论,采用行动研究,贯穿一家综合性医院发展行为医学学科的全过程.行为医学学科平衡记分卡的四个层面包括患者与社会,健康的学科财务,临床服务流程与效率,研究、创新与成长,涵盖了医院学科建设的主要关键领域.通过实施学科平衡计分卡,理清了学科发展战略,搭建了学科发展沟通平台,明确了学科发展目标导向,并为学科发展提供有效监控,使学科建设与临床服务融为一体.研究探索综合性医院发展行为医学学科的路径与方法,开设了济南地区第一家神经行为医学门诊,对综合性医院建设行为医学科及开展行为医学服务具有重要指导意义.

  18. Haptic medicine.

    Science.gov (United States)

    Mason, Cindy; Mason, Earl

    2009-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Gamal M. H. Rakha

    2015-03-01

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

  20. Academic writing

    Science.gov (United States)

    Eremina, Svetlana V.

    2003-10-01

    The series of workshops on academic writing have been developed by academic writing instructors from Language Teaching Centre, Central European University and presented at the Samara Academic Writing Workshops in November 2001. This paper presents only the part dealing with strucutre of an argumentative essay.

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

    Institute of Scientific and Technical Information of China (English)

    王进臣

    2011-01-01

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

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

    Science.gov (United States)

    Kastor, John A

    2013-07-01

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

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

    OpenAIRE

    Søren Ventegodt; Isack Kandel; Joav Merrick

    2007-01-01

    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 ...

  4. Development of a medical academic degree system in China

    Directory of Open Access Journals (Sweden)

    Lijuan Wu

    2014-01-01

    Full Text Available Context: The Chinese government launched a comprehensive healthcare reform to tackle challenges to health equities. Medical education will become the key for successful healthcare reform. Purpose: We describe the current status of the Chinese medical degree system and its evolution over the last 80 years. Content: Progress has been uneven, historically punctuated most dramatically by the Cultural Revolution. There is a great regional disparity. Doctors with limited tertiary education may be licensed to practice, whereas medical graduates with advanced doctorates may have limited clinical skills. There are undefined relationships between competing tertiary training streams, the academic professional degree, and the clinical residency training programme (RTP. The perceived quality of training in both streams varies widely across China. As the degrees of master or doctor of academic medicine is seen as instrumental in career advancement, including employability in urban hospitals, attainment of this degree is sought after, yet is often unrelated to a role in health care, or is seen as superior to clinical experience. Meanwhile, the practical experience gained in some prestigious academic institutions is deprecated by the RTP and must be repeated before accreditation for clinical practice. This complexity is confusing both for students seeking the most appropriate training, and also for clinics, hospitals and universities seeking to recruit the most appropriate applicants. Conclusion: The future education reforms might include: 1 a domestic system of ‘credits’ that gives weight to quality clinical experience vs. academic publications in career advancement, enhanced harmonisation between the competing streams of the professional degree and the RTP, and promotion of mobility of staff between areas of excellence and areas of need; 2 International – a mutual professional and academic recognition between China and other countries by reference to

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

    Science.gov (United States)

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

    2013-07-01

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

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

    Science.gov (United States)

    Botvin, Judith D

    2005-01-01

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

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

    Science.gov (United States)

    Botvin, Judith D

    2005-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Dijkgraaf Marcel G

    2011-05-01

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

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

    Institute of Scientific and Technical Information of China (English)

    刘彦雪; 邓伟生

    2011-01-01

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

  10. [Disaster medicine].

    Science.gov (United States)

    Carli, Pierre; Telionri, Caroline

    2015-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-07-01

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

  12. A Strategic Vision for NSF Investments in Antarctic and Southern Ocean Research: Recommendations of a New Study from the National Academes of Sciences, Engineering, and Medicine.

    Science.gov (United States)

    Weller, R. A.; Bell, R. E.; Geller, L.

    2015-12-01

    A Committee convened by the National Academies of Sciences, Engineering, and Medicine carried out a study (at the request of NSF's Division of Polar Programs) to develop a strategic vision for the coming decade of NSF's investments in Antarctic and Southern Ocean research. The study was informed by extensive efforts to gather ideas from researchers across the United States. This presentation will provide an overview of the Committee's recommendations—regarding an overall strategic framework for a robust U.S. Antarctic program, regarding the specific areas of research recommended as highest priority for NSF support, and regarding the types of infrastructure, logistical support, data management, and other critical foundations for enabling and adding lasting value to the proposed research .

  13. Nuclear Medicine

    Science.gov (United States)

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

  14. Commentary: Personalized health planning and the Patient Protection and Affordable Care Act: an opportunity for academic medicine to lead health care reform.

    Science.gov (United States)

    Dinan, Michaela A; Simmons, Leigh Ann; Snyderman, Ralph

    2010-11-01

    The Patient Protection and Affordable Care Act of 2010 (PPACA) mandates the exploration of new approaches to coordinated health care delivery--such as patient-centered medical homes, accountable care organizations, and disease management programs--in which reimbursement is aligned with desired outcomes. PPACA does not, however, delineate a standardized approach to improve the delivery process or a specific means to quantify performance for value-based reimbursement; these details are left to administrative agencies to develop and implement. The authors propose that coordinated care can be implemented more effectively and performance quantified more accurately by using personalized health planning, which employs individualized strategic health planning and care relevant to the patient's specific needs. Personalized health plans, developed by providers in collaboration with their patients, quantify patients' health and health risks over time, identify strategies to mitigate risks and/or treat disease, deliver personalized care, engage patients in their care, and measure outcomes. Personalized health planning is a core clinical process that can standardize coordinated care approaches while providing the data needed for performance-based reimbursement. The authors argue that academic health centers have a significant opportunity to lead true health care reform by adopting personalized health planning to coordinate care delivery while conducting the research and education necessary to enable its broad clinical application. PMID:20844424

  15. The crucial factor of hospital readmissions: a retrospective cohort study of patients evaluated in the emergency department and admitted to the department of medicine of a general hospital in Italy

    OpenAIRE

    Fabbian, Fabio; Boccafogli, Arrigo; De Giorgi, Alfredo; Pala, Marco; Salmi, Raffaella; Melandri, Roberto; Gallerani, Massimo; Gardini, Andrea; Rinaldi, Gabriele; Manfredini, Roberto

    2015-01-01

    Background Early hospital readmissions, defined as rehospitalization within 30 days from a previous discharge, represent an economic and social burden for public health management. As data about early readmission in Italy are scarce, we aimed to relate the phenomenon of 30-day readmission to factors identified at the time of emergency department (ED) visits in subjects admitted to medical wards of a general hospital in Italy. Methods We performed a retrospective 30-month observational study, ...

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

    Directory of Open Access Journals (Sweden)

    Sergio Sesma-Vázquez

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    徐静晗; 陈越; 蒋艳; 张舜瑞; 程薇

    2014-01-01

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

  18. Latex allergies - for hospital patients

    Science.gov (United States)

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

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

    Institute of Scientific and Technical Information of China (English)

    汪劲

    2015-01-01

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

  20. Risco de hospitalizações repetidas em idosos usuários de um centro de saúde escola Risk of repeated hospitalizations in elderly users of an academic health center

    Directory of Open Access Journals (Sweden)

    Isabel Casale Guerra

    2007-03-01

    Full Text Available O objetivo deste trabalho foi estratificar 305 idosos com 65 anos ou mais, atendidos em um Centro de Saúde Escola (Botucatu, São Paulo, Brasil, quanto à probabilidade de admissão hospitalar repetida. Os dados foram coletados por meio de um instrumento de avaliação do risco de admissão hospitalar repetida, constituído por oito indicadores de saúde: autopercepção da saúde, hospitalização, consultas médicas, diabetes, doença cardiovascular, sexo, apoio social e idade. Verificou-se que 56,4% dos entrevistados apresentaram baixa probabilidade de admissão hospitalar repetida; 26,9%, média; 10,5%, média-alta; e 6,2%, alta. Na associação dos indicadores de saúde com a probabilidade de admissão hospitalar repetida, observou-se que, para idosos classificados como sendo de riscos médio, médio-alto e alto, em relação àqueles com baixo, os riscos relativos foram significativos: saúde média ou ruim (2,31; hospitalização (2,38; mais de três consultas médicas (1,75; diabetes (2,10; doença cardiovascular (2,76; homens (1,68; e 75 anos ou mais (1,62. Constatou-se que o instrumento utilizado possibilitou a estratificação dos idosos quanto ao risco de serem hospitalizados repetidas vezes, o que pode contribuir para propostas de reorganização dos serviços de saúde.The aim of this study was to stratify 305 elderly (> 65 years treated at an academic health center (Botucatu, São Paulo, Brazil according to risk of repeated hospitalization. Data collection used an instrument to evaluate risk of repeated hospital admissions, including eight health indicators: self-rated health, hospitalizations, doctor visits, diabetes, cardiovascular disease, gender, social support, and age. 56.4% of interviewees presented low probability of repeated hospitalization, as compared to 26.9% medium, 10.5% medium-high, and 6.2% high probability. Combining health indicators with the probability of repeated hospitalization, for elderly classified as

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

    International Nuclear Information System (INIS)

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

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

    Institute of Scientific and Technical Information of China (English)

    杨珊珊; 张晓丽

    2016-01-01

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

  3. Finn Bøe--war, medicine, music.

    Science.gov (United States)

    Hem, Erlend; Natvig, Jacob B; Børdahl, Per E

    2016-03-15

    In January 1944 the Norwegian Resistance Movement placed a radio transmitter in the attic of the Department of Obstetrics and Gynaecology, the National Hospital (Rikshospitalet), Oslo. Knut Haugland (1917-2009) used this to send messages to the Norwegian government-in-exile in London. The transmitter was discovered by the Gestapo, and German troops surrounded the building on 1 April 1944. Haugland survived a dramatic escape. While the transmitter was in operation, Haugland lived with senior registrar Finn Bøe (1906-70) and his family in a hospital apartment. Bøe risked his own life and that of his family to assist during a dramatic phase of the resistance struggle. Bøe had completed a focused and purposeful clinical and academic training when he was appointed senior registrar at the Department of Obstetrics and Gynaecology, the National Hospital, in 1943. He was professionally ambitious. His thesis from 1938 was disqualified, but four years later he submitted a new, experimental thesis which he successfully defended in 1945. In 1955, Bøe became the first senior consultant at the Department of Obstetrics and Gynaecology at Aker hospital. Under his leadership, it became the largest in the Oslo area, and one of the most active in Norway with regard to science. Several of Bøe's own academic works on placental morphology and blood circulation have become classics. Outside of medicine, his great interest was music, and not only as a piano player. He also wrote a book about his fellow townsman Edvard Grieg. PMID:26983150

  4. 2010-2013年某院门诊中成药应用分析%Utilization of Chinese Patient Medicine in Outpatient of One Hospital during 2010-2013

    Institute of Scientific and Technical Information of China (English)

    王锦芳

    2014-01-01

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

  5. Academic Decathlon.

    Science.gov (United States)

    Association of California School Administrators.

    This position paper from the Research, Evaluation, and Accreditation Committee of the Association of California School Administrators (ACSA) presents a description of the Academic Decathlon program and offers recommendations for improving the program and ways that ACSA can assist the program. The description of the Academic Decathlon, a ten-event…

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

    Institute of Scientific and Technical Information of China (English)

    鲍冬旭; 杨涛; 栾奕

    2016-01-01

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

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

    Science.gov (United States)

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

    2001-10-01

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

  8. The Chinese Association of the Integration of Traditional and Western Medicine (CAIM) 2002 National Congresses (Call for Papers)

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@September Beijing The Year Working Meeting of CAIM, 2002 Information: No call for paperSeptember Beijing The 2nd World Integrative Medicine Congress (WIMCO 2002) Information: The Academic Department of CAIM, 18 Beixincang,Dongzhimennei, Beijing (100700), Email: secretary@wimco-2002.com Deadline: April 1, 2002March Beijing The National Conference of Integration Medical for Young and Mid-aged Doctors Information: Dr. Songjun, Xiyuan Hospital,1 Caochang, Haidian District, Beijing (100091), Email: junsong-tcm@sina.com.cn Deadline: December 31, 2001 March Suzhou, Jiangsu Province The National Conference of ITWM Dermatology and Venereology Information: Dr. Zhu Lifen, Department of Dermatology, Zhongshan Hospital,

  9. 高等院校开展院前急救技能培训必要性与可行性的探讨%The approach of feasibility and necessity of pre-hospital emergency medicine education in colleges

    Institute of Scientific and Technical Information of China (English)

    吴向辉; 周树生

    2009-01-01

    院前急救的及时性、院前急救的水平和质量对挽救生命和降低致残率至关重要,而急救知识、急救技能的推广和普及是院前急救成功与否的基础.高校大学生在时间、精力、学习能力等方面都优于其他人群,因此,对他们进行急救知识和急救技能的培训,可以带动全民急救水平的提高.%"People-orientated" is the Chinese Communist Party's philosophy. "life comes before everything else" can be demonstrated obviously in some situations including various natural disasters, pub- lie health emergencies and accidents. The pre-hospital emergency care in good time plays an important role in rescuing lives and reducing disabled rate. Public education of emergency first-aid knowledge and skills is the comer-stone of the successful pre-hospital aid. Compared to other groups in the society, undergraduates have enough time and energy as well as the ability to acquire new information and skills. So, it may im- prove the level of first-aid in public to perform the education program on pre-hospital emergency medicine a- mong college students.

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

    Institute of Scientific and Technical Information of China (English)

    CHEN Ke-ji; LU Ai-ping

    2006-01-01

    Integrative medicine (IM) usually called integrated traditional and Western medicine in China, which came into being in the 1950s as a new form of medicine, although is now developing quickly, little is known about its status and existing problems. So a national survey in China was conducted through questionnaire in 2004 by Chinese Association of Integrative Medicine with the support of State Administration of Traditional Chinese Medicine (SATCM). The results show that, of all the medical professionals investigated in this survey, 91.21% and 93.52% respondents respectively favored IM as the best diagnostic and therapeutic method. Of all the patients who once went through TCM, Western medicine (WM) and IM therapies,68.85%, 65.45% and 71.2% respondents respectively most appreciated IM, IM hospitals and IM therapeutic treatments. Most of the 6 595 respondents held that the optimal scientific research strategy in TCM should be integrating modern medical research method (n = 2 380) or modern scientific method (n = 2 920). However, many hospitals exposed the problems in the aspects of governmental supports and funding supports, human resources, and domestic or international academic activities. These results indicated that IM is the patients' social needs and doctors' aspiration in China. For further development of IM, the enhancement of scientific research construction and assistance by policies and finance from the government and other institutions are urgently needed in China.

  11. Risks of Academic Underachievement in Epilepsy

    OpenAIRE

    J Gordon Millichap

    2004-01-01

    The relation between neuropsychological functioning and academic achievement and the role of family environment, seizures, and psychosocial variables were examined in 173 children with chronic epilepsy, ages 8 to 15 years, at Purdue School of Science; Indiana University School of Medicine, Indianapolis; and University of Wisconsin-Madison School of Medicine, WI.

  12. Project ASPIRE: Incorporating Integrative Medicine Into Residency Training

    OpenAIRE

    Nawaz, Haq; Via, Christina M.; Ali, Ather; Rosenberger, Lisa D.

    2015-01-01

    Griffin Hospital, a community hospital affiliated with Yale School of Public Health and Yale School of Medicine, received Health Resources and Services Administration funding to strengthen and improve its combined internal medicine and general preventive medicine residency program by incorporating an integrative medicine curriculum. The purpose of project ASPIRE (Advancing Skills of Preventive medicine residents through Integrative medicine Education, Research and Evaluation) was to create, i...

  13. 基层医院2011年至2012年中药注射剂使用分析%Use Situation of Chinese Medicine Injections in Our Hospital from 2011 to 2012

    Institute of Scientific and Technical Information of China (English)

    杨作英

    2014-01-01

    Objective To understand the status quo of the use of Chinese medicine injections in our hospital for promoting their clinical rational use and management. Methods The amount of sales,medication frequency,average daily cost of traditional Chinese medicine injections from 2011 to 2012 were statistically analyzed. Results The use of Chinese medicine injections involved in 5 major categories of 13 varieties,which was dominated by the blood - regulating agents,followed by tonic and clearing heat agents;Xuesaitong Injection was in the top 2 of the amount of sales and DDDs. Conclusion The rational use and management of Chinese medicine injections should be strengthened.%目的:了解医院中药注射剂的使用现状,促进临床合理使用及管理。方法对2011年至2012年中药注射剂的销售金额、用药频度(DDDs)、日均费用等进行统计。结果中药注射剂使用涉及5大类13个品种,以理血剂为主,其次是补益剂和清热剂;销售金额和DDDs排序前2位的均有注射用血塞通。结论临床应加强中药注射剂的合理使用及管理。

  14. Extreme, expedition, and wilderness medicine.

    Science.gov (United States)

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

    2015-12-19

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

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

    Directory of Open Access Journals (Sweden)

    Wang HF

    2015-03-01

    Full Text Available Hua-fen Wang,1 Jing-fen Jin,1 Xiu-qin Feng,1 Xin Huang,1 Ling-ling Zhu,2 Xiao-ying Zhao,3 Quan Zhou4 1Division of Nursing, 2Geriatric VIP Ward, Division of Nursing, 3Office of Quality Administration, 4Department of Pharmacy, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of China Background: Medication errors may occur during prescribing, transcribing, prescription auditing, preparing, dispensing, administration, and monitoring. Medication administration errors (MAEs are those that actually reach patients and remain a threat to patient safety. The Joint Commission International (JCI advocates medication error prevention, but experience in reducing MAEs during the period of before and after JCI accreditation has not been reported. Methods: An intervention study, aimed at reducing MAEs in hospitalized patients, was performed in the Second Affiliated Hospital of Zhejiang University, Hangzhou, People’s Republic of China, during the journey to JCI accreditation and in the post-JCI accreditation era (first half-year of 2011 to first half-year of 2014. Comprehensive interventions included organizational, information technology, educational, and process optimization-based measures. Data mining was performed on MAEs derived from a compulsory electronic reporting system. Results: The number of MAEs continuously decreased from 143 (first half-year of 2012 to 64 (first half-year of 2014, with a decrease in occurrence rate by 60.9% (0.338% versus 0.132%, P<0.05. The number of MAEs related to high-alert medications decreased from 32 (the second half-year of 2011 to 16 (the first half-year of 2014, with a decrease in occurrence rate by 57.9% (0.0787% versus 0.0331%, P<0.05. Omission was the top type of MAE during the first half-year of 2011 to the first half-year of 2014, with a decrease by 50% (40 cases versus 20 cases. Intravenous administration error was the

  16. Challenges in contemporary academic neurosurgery.

    Science.gov (United States)

    Black, Peter M

    2006-03-01

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

  17. Performance evaluation of the activity meters of nuclear medicine services of the hospitals Rafael Angel Calderon, San Juan de Dios and Mexico during the period from July 1, 2008 to December 31, 2008

    International Nuclear Information System (INIS)

    Nuclear medicine has used radioisotopes associated to drugs in order to get them to an organ of interest. The radioisotope has the quality to emit radiation, which passes through the body, after being admitted to it, and this is perceived by equipment such as a gamma camera to study the behavior of the organ under study. The radiation is a energy emission able to boot electrons from atoms and produce ions, thus the chemical composition may be altered, resulting in alterations in the cells. Conditions such as: a onreproductive of the cells, causing a tumor; or alterations in geminal cells, causing genetic alterations, which may occur in the offspring of an individual. For the above reason is that the use of radiopharmaceuticals should be as careful as possible, doing as little radiation exposure, without compromising the quality of the study, these should be applied with more important in more radiosensitive population such as children and older adults. The doses used in nuclear medicine are quantified using a device called activity meters and the proper functioning of the overexposures shall impose or low-quality studies doses outside the range of usefulness. The operation of these machines based on the quality control logs have been studied to discover if there are alterations in dosages of nuclear medicine departments of hospitals Calderon Guardia, San Juan de Dios and Mexico. Tests of zero settings, display, physical monitoring, high voltage, linearity test, stability, background radiation, precision, accuracy and consistency have been performed as quality control. This research is classified as non-experimental longitudinal quantitative. The study population was the record set and the realization of quality control tests made to the hospital activity meters above. The collection of data was performed by two steps, the first taking records concerning quality control of the different hospitals, completed tabulation, gratification and analysis of the same. The

  18. Emergency preparedness of Research Center for Radiation medicine and its hospital to admit and treat the patients with signs of acute radiation sickness

    International Nuclear Information System (INIS)

    After the Chernobyl accident, the Research Center for Radiation Medicine (RCRM) was established in Kiev (Ukraine). Its main task was to maintain a high level of emergency preparedness and be ready to examine and treat patients who suffer as a result of hypothetical radiation accident. Based on the previous experience, this institution's specialists worked out new diagnostic criteria and drug treatment schemata for acute radiation sickness, created a database on 75 patients with this diagnosis and improved educational programmes for medical students and physicians working in the field of radiation medicine. RCRM collaborates fruitfully with western partners through the joint research projects and connects with the World Health Organisation's Radiation Emergency Medical Preparedness and Assistance Network centre. Collaboration with Kiev Center for Bone Marrow Transplantation allows RCRM to use aseptic wards having highly filtered air for the treatment of most severely irradiated patients. (authors)

  19. On the development and strategy of translational medicine at hospitals%医院转化医学发展方向与策略的思考

    Institute of Scientific and Technical Information of China (English)

    刘亮; 吴晓松; 刘广东; 孔越

    2014-01-01

    Translational medicine has been on the rise for 20 years as a new model of biomedical research,which plays a positive role in narrowing the gap between basic research and clinical medicine and in development of medical sciences.This paper traced back the milestones of translational medicine,and analyzed the hurdles for China to develop translational medicine,namely the organization system,management model and benefit sharing.On such basis,the authors recommended on the development and strategy,especially in clinical medical institutions in China.%转化医学作为近20年来在世界范围内兴起的生物医学研究新模式,在推进基础医学与临床医学结合,促进医学科技发展方面发挥了重要作用.本研究通过回溯转化医学发展的历史,分析我国转化医学在具体组织与实施中面临的关于组织体制、管理模式、效益分享等诸多难题,并在此基础上提出未来转化医学发展,特别是在临床医疗机构中的发展的一些方向和策略方面的建议和参考.

  20. Personality, academic majors and performance

    DEFF Research Database (Denmark)

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

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    崔晋涛; 刘萍; 曹媛媛; 柴栋

    2014-01-01

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

  2. 2012-2014年上海长征医院抗肿瘤中药注射剂使用情况分析%Utilization of Antitumor Traditional Chinese Medicine Injections in Shanghai Changzheng Hospital during 2012-2014

    Institute of Scientific and Technical Information of China (English)

    刘震; 葛卫青; 陈万生; 陶霞

    2015-01-01

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

  3. FacilitiesHospitals_HOSPITAL

    Data.gov (United States)

    Vermont Center for Geographic Information — This datalayer contains point locations of all major community, regional, comprehensive health, and healthcare provider hospitals in the state of Vermont. The...

  4. Exploration of the articulation of African traditional medicine and Western biomedicine in hospital spaces in the town of Barberton, South Africa

    OpenAIRE

    Andreadis, Petros Isidoros

    2015-01-01

    Whilst hospitals are the dominant institutions through which Western biomedical treatment is delivered, it is also argued that these institutions do not reproduce a distinct notion of a biomedical model, but instead assume different configurations, reflecting and replicating wider socio-cultural processes. In South Africa, this includes a reflection and replication of challenges arising from an eclectic therapeutic landscape in which biomedicine is but one avenue. The challe...

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

    Institute of Scientific and Technical Information of China (English)

    韦健

    2013-01-01

      新的《医院财务制度》和《医院会计制度》对于药品的核算进行了改革,要求药品由按零售价核算改为按进价核算,明确规定应当根据实际情况采用个别计价法、先进先出法或者加权平均法来确定发出物资的实际成本,文章结合我院药品管理与核算存在的问题进行深入分析与探讨,提出切实可行的解决方案,加强药品的规范化管理和药品的成本核算。%The new current versions of Hospital Finance System and Hospital Accounting System promote the reform of medicine accounting. It requires the method of the drugs cost accounting to change the retailing price accounting to the purchasing price accounting. It clearly defines individual valuation method, “first-in, first-out” method or weighted average method should be used to determine the actual cost of the materials based on the actual situation. It analyzes the problems of medical management and cost accounting, and proposes the practical solutions to strengthen the standard management of medicine and the medical cost accounting.

  6. The evaluation of the distribution and antimicrobal susceptibility of the strains isolated from war wound specimens of the Libyan patients at Izmir University School of Medicine Medicalpark Hospital in Turkey

    Directory of Open Access Journals (Sweden)

    Mürşide Tunçel Başoğlu

    2013-12-01

    Full Text Available OBJECTIVE[|]Skin and soft tissue infections are important due to the clinical picture they create and the varying microorganisms that cause infection.Wound culture helps by reducing treatment cost and monitorizing resistant strains and their spread. The aim of our study is to evaluate the distribution and antimicrobial susceptibility of strains isolated from wound specimens of the patients after the Libya conflict and compare to Turkish patients at Izmir University School of Medicine Medicalpark Hospital. [¤]METHODS[|]Fourty wound specimens of Libyan patients admitted to Izmir University School of Medicine Medicalpark Hospital between October 2011 - April 2012 after the Libya conflict and 154 wound specimens of Turkish patients treated during the same interval were retrospectively evaluated. The strains were isolated by conventional methods and automatized Vitek 2.0 (Biomerieux, France system. The antibiotic susceptibility was studied by automatized Vitek 2.0 system.[¤]RESULTS[|]Seventeen (42.5% of the fourty specimens were culture positive. Ten (58.8% of them were Gram negative, and seven (41.2% were Gram positive. The mostly isolated strains were Enterobacter cloacae (23.5%, coagulase negative Staphylococci (CoNS (23.5%, Stapylococcus aureus (17.6% and Proteus mirabilis (11.7%. Enterobacter cloacae was susceptible to meropenem and amikacin.[¤]CONCLUSION[|]We evaluated the distribution and antimicrobial susceptibility of wound specimens after the Libya conflict. The mostly isolated strains were E. cloacae and CoNS. Meanwhile Turkish patients had P. mirabilis as Gram negative bacteria and methicillin susceptible S. aureus as Gram positive bacteria isolated in wound specimens. We could not compare this data to our country due to a lack of similar studies. Further studies with a greater number of patients are necessary to obtain reasonable data. [¤

  7. From the High Energy Physics Laboratory to the hospital -some experiences of the application of MWPC [multiwire proportional counter] technology to medicine

    International Nuclear Information System (INIS)

    In this talk I wish to briefly review the experience we have obtained at the Rutherford Appleton Laboratory over the past decade in the adaptation of MWPC (multiwire proportional counter) technology to diagnostic imaging applications in medicine. A cursory glance at the history of science and technology quickly shows the often intimate and mutually beneficial relationship between ''pure'' science (and scientists) and practical applications. The following talk traces some of the principal features of the situation which have been brought to my attention in the course of the last decade. (author)

  8. Reflection on medical ethics and professionalism training of the hospital postgraduates in the medicine-education collaboration situation%医教协同医院研究生医德和职业素养培养的思考

    Institute of Scientific and Technical Information of China (English)

    龙丽; 顾兴智

    2015-01-01

    医教协同深化临床医学人才培养改革形势下,医院需要重新审视思考研究生医德和职业素养培养的必要性,采取灵活多样的教育方式,重点培养研究生的医德医风、临床实践、人文沟通和团队合作精神,使研究生成长为德才兼备的医学人才。%In the Medicine-education collaboration situation of deepening the reform of clinical medicine talents, the necessity of medical ethics and professionalism training of the hospital postgraduates needs to be reexamined. Medical ethics, clinical practice, humanity communication and team-work spirit can be focused on through various of channels. Thus, postgraduates can be brought up clinical talents with political integrity and ability.

  9. The application of hospitality elements in hospitals.

    Science.gov (United States)

    Wu, Ziqi; Robson, Stephani; Hollis, Brooke

    2013-01-01

    In the last decade, many hospital designs have taken inspiration from hotels, spurred by factors such as increased patient and family expectations and regulatory or financial incentives. Increasingly, research evidence suggests the value of enhancing the physical environment to foster healing and drive consumer decisions and perceptions of service quality. Although interest is increasing in the broader applicability of numerous hospitality concepts to the healthcare field, the focus of this article is design innovations, and the services that such innovations support, from the hospitality industry. To identify physical hotel design elements and associated operational features that have been used in the healthcare arena, a series of interviews with hospital and hotel design experts were conducted. Current examples and suggestions for future hospitality elements were also sought from the experts, academic journals, and news articles. Hospitality elements applied in existing hospitals that are addressed in this article include hotel-like rooms and decor; actual hotels incorporated into medical centers; hotel-quality food, room service, and dining facilities for families; welcoming lobbies and common spaces; hospitality-oriented customer service training; enhanced service offerings, including concierges; spas or therapy centers; hotel-style signage and way-finding tools; and entertainment features. Selected elements that have potential for future incorporation include executive lounges and/or communal lobbies with complimentary wireless Internet and refreshments, centralized controls for patients, and flexible furniture. Although the findings from this study underscore the need for more hospitality-like environments in hospitals, the investment decisions made by healthcare executives must be balanced with cost-effectiveness and the assurance that clinical excellence remains the top priority. PMID:23424818

  10. The application of hospitality elements in hospitals.

    Science.gov (United States)

    Wu, Ziqi; Robson, Stephani; Hollis, Brooke

    2013-01-01

    In the last decade, many hospital designs have taken inspiration from hotels, spurred by factors such as increased patient and family expectations and regulatory or financial incentives. Increasingly, research evidence suggests the value of enhancing the physical environment to foster healing and drive consumer decisions and perceptions of service quality. Although interest is increasing in the broader applicability of numerous hospitality concepts to the healthcare field, the focus of this article is design innovations, and the services that such innovations support, from the hospitality industry. To identify physical hotel design elements and associated operational features that have been used in the healthcare arena, a series of interviews with hospital and hotel design experts were conducted. Current examples and suggestions for future hospitality elements were also sought from the experts, academic journals, and news articles. Hospitality elements applied in existing hospitals that are addressed in this article include hotel-like rooms and decor; actual hotels incorporated into medical centers; hotel-quality food, room service, and dining facilities for families; welcoming lobbies and common spaces; hospitality-oriented customer service training; enhanced service offerings, including concierges; spas or therapy centers; hotel-style signage and way-finding tools; and entertainment features. Selected elements that have potential for future incorporation include executive lounges and/or communal lobbies with complimentary wireless Internet and refreshments, centralized controls for patients, and flexible furniture. Although the findings from this study underscore the need for more hospitality-like environments in hospitals, the investment decisions made by healthcare executives must be balanced with cost-effectiveness and the assurance that clinical excellence remains the top priority.

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

    Institute of Scientific and Technical Information of China (English)

    杨伟吉

    2013-01-01

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

  12. Study of regenerative medicine in China: demands and clinical translation

    Directory of Open Access Journals (Sweden)

    Xiao-bing FU

    2012-03-01

    Full Text Available The repair and regeneration of tissue is a well-discussed topic. Over the past 20 years, with the development of genetics, auxology, stem cell biology, and tissue engineering, tissue repair and regeneration have rapidly developed as emerging "Regenerative Medicine". Regenerative medicine has significant market demand in China. Based on national statistics, injury and poisoning patients rank third in afflictions in city hospitals (accounting for 9.13% and rank second in afflictions in county hospitals (accounting for 14.07%. Totally, approximately one hundred million patients suffered from traumatic, genetic and metabolic diseases in China and demand reparative and regenerative medical treatment each year. The Chinese government and its related departments have always attached great importance and support to the development of regenerative medicine, and the Chinese academic circle is involved in a very wide range of diseases and injuries including regenerative medical theory and technology. Stem cell biology, organ engineering and duplication, tissue engineering research and production have developed rapidly, and great portion of these studies have started to appear in applications, which have aroused extensive concerns in international professional circle. In the next 10 years, the Chinese regenerative medical system will be further improved, in both statute and rules, clinical translation will be further accelerated. Breakthroughs are expected in induced differentiation of stem cells and synchronous repair and regeneration of multiple organs, construction of major organs by tissue engineering, large-scale applications of tissue engineering products, and other aspects.

  13. Utilization of Compounded Medications in an Oral Medicine Practice.

    Science.gov (United States)

    Stock, Shannon; Rubino, Katie; Woo, Sook-Bin; Margolis, Arthur; Thomas, Irena; Aboalela, Ali; thomas Ali; Treister, Nathaniel

    2016-01-01

    For many oral medicine conditions, the use of compounded topical therapies that are locally absorbed and act directly at the affected site can provide greater efficacy compared with systemically delivered medications while minimizing systemic side effects. The objective of this study was to characterize the utilization and costs associated with the use of compounded medications in an academic, hospital-based oral medicine practice. This was a retrospective analysis of outpatients treated at the Center for Oral Disease at Brigham and Women's Hospital (Boston, Massachusetts) during the five-year period from November 2006 through November 2011. Patient prescription and payment information were obtained from the pharmacy's patient database. Variables included prescription compound, number of prescriptions refilled, prescription cost, and payment contributions from insurance and patients. An electronic medical record review was conducted to obtain patient demographics and diagnoses. There were 510 unique perscriptions corresponding to 423 patients filled during the study period. Four distinct medications comprised the majority (479/510; 94%) of prescriptions filled. The vast majority (94%) of prescriptions filled were at least partially paid for by insurance, with median patient co-pays ranging from $21 (clonazepam solution) to $34 (ketoprofen cream). Compound medications provide an affordable, flexible therapeutic option for patients being treated for a variety of oral medicine conditions. PMID:27323426

  14. Evaluation of an academic service partnership using a strategic alliance framework.

    Science.gov (United States)

    Murray, Teri A; James, Dorothy C

    2012-01-01

    Strategic alliances involve the sharing of resources to achieve mutually relevant benefits and they are flexible ways to access resources outside of one's own institution. The recent landmark report from the Institute of Medicine, The Future of Nursing: Leading Change, Advancing Health, called for academic and health care organizations to strategically align around the future registered nurse workforce to improve the quality and safety of patient care. The dedicated education unit (DEU) is one practical way for 2 entities to align so that students can learn to administer safe, quality care. Because DEUs have great potential, it is critical to evaluate the alignment between the academic and service partner for appropriate fit, mutual benefit, and long-term success. In this article, we analyze the effectiveness of the Saint Louis University School of Nursing (SLUSON) and Mercy Hospital, St. Louis (MHSL) DEU project, an alliance between a medical center and school of nursing, using the Single Alliance Key Success Model. PMID:22177471

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

    Institute of Scientific and Technical Information of China (English)

    史文川; 丁政; 赵宁; 朱佩枫; 魏鲁霞; 申俊龙

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Jastria Pusmarani

    2015-12-01

    Full Text Available In order to improve warfarin medication adherence in patient with Acute Coronary Syndrome (ACS and Atrial Fibrillation (AF, giving education with leaflet administration is one of the solutions. This study was aim to know the impact of pharmacist education with using prepared leaflet on the adherence to warfarin in ACS and AF patients. This study used pre test and post test with control group design. Data were collected prospectively during 8 weeks in June–July 2014 at the ambulatory ACS and AF patients at PKU Muhammadiyah Yogyakarta hospital, Indonesia. Data were collected by medical record and the questionnaire using Morisky Medication Adherence Scale (MMAS. Wilcoxon test was used for statistical analysis. The results shows pre test and post test value in the control group was p=0.194 and pre and post test value in the test group was p=0.058. There was no significant difference (p>0.05 after giving education with leaflet. The education with leaflet had no effect to adherence in warfarin in ACS and AF patients at PKU Muhammadiyah Yogyakarta hospital.

  17. Expatriate academics

    DEFF Research Database (Denmark)

    Selmer, Jan; Lauring, Jakob

    2011-01-01

    relationships with all of the five investigated work outcome variables, work adjustment, work performance, work effectiveness, job satisfaction, and time to proficiency. Job conflict and job freedom had an association with some of the work outcome variables but not with all of them. Neither workload nor job...... novelty had a relationship with any of the work outcome variables of the expatriate academics. Originality/value – The paper shows that the findings are only partly consistent with previous research results concerning business expatriates, suggesting that the work situation for expatriate academics could...

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

    Institute of Scientific and Technical Information of China (English)

    谢云; 诸兰艳; 范杜

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    张碧华; 高素强; 金鹏飞

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    徐玉燕; 吴春明; 赖冬红

    2013-01-01

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

  1. FacilitiesHospitals_HOSPITAL

    Data.gov (United States)

    Vermont Center for Geographic Information — This data layer contains point locations of all major community, regional, comprehensive health, and healthcare provider hospitals in the state of Vermont. The...

  2. Hospitals; hospitals13

    Data.gov (United States)

    University of Rhode Island Geospatial Extension Program — Hospital Facilities information was compiled from several various sources. Main source was the RI Department of Health Facilities Regulation database, License 2000....

  3. Aerospace Medicine

    Science.gov (United States)

    Michaud, Vince

    2015-01-01

    NASA Aerospace Medicine overview - Aerospace Medicine is that specialty area of medicine concerned with the determination and maintenance of the health, safety, and performance of those who fly in the air or in space.

  4. Brief hospitalizations of elderly patients

    DEFF Research Database (Denmark)

    Strømgaard, Sofie; Rasmussen, Søren Wistisen; Schmidt, Thomas Andersen

    2014-01-01

    BACKGROUND: Crowded departments are a common problem in Danish hospitals, especially in departments of internal medicine, where a large proportion of the patients are elderly. We therefore chose to investigate the number and character of hospitalizations of elderly patients with a duration of less...

  5. Academic Practice

    DEFF Research Database (Denmark)

    Nielsen, Sandro; Heine, Carmen

    Vejledning i at undgå plagiering ved at følge de normer, der gælder for good academic practice. Dette indebærer at man angiver kilder korrekt, og når det er nødvendigt, og at man har en korrekt udformet fortegnelse over referencer. Vejledningen indeholder konkrete eksempler på korrekt kildeangive...

  6. The Laboratory Medicine and the care of patients infected by the Ebola virus. Experience in a reference hospital of Madrid, Spain.

    Science.gov (United States)

    Fernandez-Puntero, Belen; Gomez-Rioja, Ruben; Alcaide, Maria Jose; Oliver, Paloma; Fernandez-Calle, Pilar; Iturzaeta, Jose Manuel; Buno, Antonio

    2015-11-01

    The ongoing Ebola virus outbreak in several countries in West Africa was considered by the World Health Organisation (WHO) as a public health emergency of international concern. Healthcare providers must be prepared by organising specific procedures in our hospitals based on recommendations from national and international healthcare organisations. Two aims should be considered: appropriate medical care for patients with suspected or confirmed disease must be ensured, as must measures to prevent transmission to healthcare workers. The clinical laboratory plays an important role and must define and establish its own procedures in accordance with clinicians and integrated into those of the institution, starting with the definition of the organisation model in the laboratory to achieve those goals. In this review we present our experience based on the care of three patients with confirmed cases. We hope it will help other colleagues to plan for Ebola. PMID:26053009

  7. [Opening medicine containers].

    Science.gov (United States)

    Glerup, E; Dengsø, H

    1990-07-01

    In connection with self-administration of medicine for patients with rheumatoid arthritis, patients with weak hands and elderly patients in general, the design of many medicine containers makes them awkward to handle for the patients. In this investigation 12 different medicine containers were tested. The 12 containers represent the antirheumatic medicine containers available on the market in Denmark in 1988. Sixty patients participated in the investigation. Thirty had rheumatoid arthritis and 30 had normal hand function. The age range was 40-85 years The patients had the choice between five possible answers concerning each container. In all patients, grip strength was measured. The patients with rheumatoid arthritis were classified in four functional classes, and pulpa-vola distance end thumb--5th MCP point distance were measured. The opening mechanisms of 29% of the antirheumatic medicine containers are unacceptable; these are plastic containers with a "push-off" top and suppository packs. 46%--(containers with screw cap or pressure dispensing) are considered acceptable. For 25% (tablet and capsule blister packs) the patients' estimate varied. It is important that medicine containers can be opened by the patients without difficulty, so that they do not present a hindrance to a correct intake of medicine or result in an unnecessary admission to hospital. The results of this investigation show that it is of continuous importance to encourage the production of medicine containers that comply with the requirements of the patients. PMID:2142351

  8. ANTIBACTERIAL ACTIVITY OF THREE PLANT EXTRACTS USED IN NIGERIA FOLKLORIC MEDICINE AGAINST HOSPITAL ISOLATES OF METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA AND METHICILLIN-SENSITIVE STAPHYLOCOCCUS AUREUS (MSSA

    Directory of Open Access Journals (Sweden)

    Daniyan SY

    2011-03-01

    Full Text Available Staphylococcus aureus is a species of bacterium commonly found on the skin and/or in the noses of healthy people. Although it is usually harmless at these sites, it may occasionally get into the body (eg through breaks in the skin such as abrasions, cuts, wounds, surgical incisions or indwelling catheters and cause infections. These infections may be mild (eg pimples or boils or serious (eg infection of the bloodstream, bones or joints. It is one of the important bacteria as a potential pathogen specifically for nosocomial infections. Interest in plants with antimicrobial properties has revived as a result of current problems associated with the use of antibiotics.Hexane, ethylacetate, methanol and water extracts from 3 different plant species, Jatropha curcas, Piliostigma thonningii and Hyptis suaveolens used in Nigeria as popular medicine for the treatment of several ailments of microbial and non-microbial origin were evaluated for potential antimicrobial activity against methicillin-resistant Staphylococcus aureus (MRSA and methicillin-sensitive Staphylococcus aureus (MSSA using agar dilution method. Results revealed that there were no significant differences in the % susceptibility to MRSA and MSSA between the standard drugs and the different plant extracts using different extracting solvents (P>0.05. All the extracts of the 3 plants were effective on MRSA except water extract of Jatropha curcas and Piliostigma thonningii. Hexane extract from P. thonningii was inhibitory to 100% of both MRSA and MSSA isolates followed by ethyl acetate extract of J. curcas 61% of MSSA, ethyl acetate extract of P. thonningii on 38% of MRSA, methanol extract of J. curcas on 33% of both MSSA and MRSA and the least activity was with water extract of H. suaveolens on 17% of both MSSA and MRSA; no activity was observed with water extract of J. curcas. Hexane extract of P.thonningii was the only extract found in this study to inhibit the growth of both MRSA and MSSA

  9. European regulatory tools for advanced therapy medicinal products.

    Science.gov (United States)

    Flory, Egbert; Reinhardt, Jens

    2013-12-01

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

  10. Emergency medicine in Dubai, UAE

    OpenAIRE

    Partridge, Robert; Abbo, Michael; Virk, Alamjit

    2009-01-01

    Dubai has rapidly risen to prominence in the Persian Gulf region as a center of global commerce and tourism and as a cultural crossroad between East and West. The health-care infrastructure has undergone rapid development. Collaborations with academic medical centers now exist to advance clinical care, teaching and research. Emergency medicine has also advanced and is undergoing dynamic change. Dubai may soon emerge as a regional leader in emergency medicine training and practice.

  11. Emergency medicine in Dubai, UAE.

    Science.gov (United States)

    Partridge, Robert; Abbo, Michael; Virk, Alamjit

    2009-01-01

    Dubai has rapidly risen to prominence in the Persian Gulf region as a center of global commerce and tourism and as a cultural crossroad between East and West. The health-care infrastructure has undergone rapid development. Collaborations with academic medical centers now exist to advance clinical care, teaching and research. Emergency medicine has also advanced and is undergoing dynamic change. Dubai may soon emerge as a regional leader in emergency medicine training and practice.

  12. Survey on the use of essential medicines at all levels of hospitals in Huizhou in 2013%2013年惠州市各级医院基本药物品种使用情况调查

    Institute of Scientific and Technical Information of China (English)

    陈浩; 黄雷; 郭林

    2016-01-01

    Objective Investigation and analysis of 2013,Huizhou tertiary hospitals,secondary hospitals and grassroots medical and health institutions essential medicines procurement of equipment,and use of,as national, provincial and formulate implementation system of essential drugs policy and adjust the varieties of essential drugs to provide a basis.Methods Using random sampling method,extraction of Huizhou two tertiary hospitals,secondary hospitals and 27 grassroots medical and health institutions and the basic situation of drug use,the basic drugs with the variety,sales amount and the number of beds,outpatient,inpatient volume,common diseases for statistical analysis on national and provincial essential drugs and supplementary medicines Varieties Screening and selection.Results In Huizhou,tertiary hospital basic drugs can gain of around 35%;basic medical and health institutions is not 100%implementation of essential drug system and equipped with basic drugs;current national essential drugs,and added to the species,about 1/3 is not included in al levels of hospital drug list,mainly is proprietary Chinese medicines.About 50% secondary hospitals and basic medical and health institutions in the presence of but for 3 consecutive months is more than 50 kinds of basic drug varieties.In addition,78% of the basic medical and health institutions needs to supplement the needs of drug varieties.Conclusion By "zero slip sales,providing Medicare reimbursement,including in the performance appraisal,etc,to further promote the national system for basic drugs expanding the scope of implementation.National essential drugs and the addition of species which can not fuly meets the after the reform of basic medical and health institutions and the need for medication needs to formulate rational drug selection and update mechanism and guarantee the production,procurement and supply of basic drugs and the addition of the species.%目的:调查分析2013年,惠州市三级医院、二级医

  13. Analysis of epidemiological and clinical characteristics of patients admitted diagnosed with acute ischemic cerebrovascular event in internal medicine services and neurology of the Hospital Mexico in March 2013 to March 2014

    International Nuclear Information System (INIS)

    Records of 100 patients were revised with diagnosis of ischemic cerebrovascular event in the neurology and internal medicine at the Hospital Mexico since March 2013 to March 2014. A total of 46 patients were men and 54 were women. The overall mean age was 69 years, for men have been 66 years and for women from 71. Patients of all provinces were entered main of San Jose with 56% followed by 19% Alajuela. The hospital management by specialty was distributed 60% to internal medicine and 40% neurology. The risk factors most frequently found were: hypertension 85%, diabetes mellitus 40%, smoking 35%, and dyslipidemia 35%. Overweight was observed in 23% of patients and 22% obese. As for the initial clinical manifestations documented in the first physical examination, the 6 most frequently found have been: faciobrachiocrural hemiparesis 60%, delirium 22%, dysarthria 22%, headache 20%, nausea and/or vomiting 17% and aphasia 15%. A total of 13% of patients have altered the consciousness and 5% have required ventilatory support for first 24 hours of evolution. 27% of patients have arrived within the first 3 hours of onset of symptoms, 11% between 3 to 4.5 hours and the remaining 62% beyond 4.5 hours of duration. 70% of patients have had 1 or more comorbidities prior to the event, the top 5 have been: ischemic heart disease 31%, 29% atrial fibrillation, cerebrovascular disease 19%, 16% chronic kidney disease and congestive heart failure by 12%. Regarding the topographic classification of stokes, 16% were TACI, PACI 46%, 27% LACI and POCI only 11%. The average NIHSS scale has been 9 points to admission, 10 to 48 hours and 6 points at the time of discharge. Regarding brain scan on admission to 98% of the patients were performed while that between 48-72 hours alone to 74%. The most common initial tomographic CT findings have been: 49% lucency of more than 1/3 of middle cerebral artery territory, without alteration 46%, 8% cerebral edema data and 8% midline deviation. Hemorrhagic

  14. Challenges Facing Early Career Academic Cardiologists

    OpenAIRE

    Tong, Carl W.; Ahmad, Tariq; Brittain, Evan L.; Bunch, T. Jared; Damp, Julie B.; Dardas, Todd; Hijar, Amalea; Hill, Joseph A.; Hilliard, Anthony A.; Houser, Steven R.; Jahangir, Eiman; Kates, Andrew M.; Kim, Darlene; Lindman, Brian R.; Ryan, John J.

    2014-01-01

    Early-career academic cardiologists currently face unprecedented challenges that threaten a highly valued career path. A team consisting of early career professionals and senior leadership members of American College of Cardiology (ACC) completed this white paper to inform the cardiovascular medicine profession regarding the plight of early career cardiologists and to suggest possible solutions. This paper includes: (1) definition of categories of early career academic cardiologists, (2) gene...

  15. Engineering in translational medicine

    CERN Document Server

    2014-01-01

    This book covers a broad area of engineering research in translational medicine. Leaders in academic institutions around the world contributed focused chapters on a broad array of topics such as: cell and tissue engineering (6 chapters), genetic and protein engineering (10 chapters), nanoengineering (10 chapters), biomedical instrumentation (4 chapters), and theranostics and other novel approaches (4 chapters). Each chapter is a stand-alone review that summarizes the state-of-the-art of the specific research area. Engineering in Translational Medicine gives readers a comprehensive and in-depth overview of a broad array of related research areas, making this an excellent reference book for scientists and students both new to engineering/translational medicine and currently working in this area.

  16. Academic entrepreneurship

    OpenAIRE

    Sass, Enrico

    2013-01-01

    Research on entrepreneurial motivation of university scientists is often determined by quantitative methods without taking into account context-related influences. According to different studies, entrepreneurial scientists found a spin-off company due to motives like independency, market opportunity, money or risk of unemployment (short-term contracts). To give a comprehensive explanation, it is important to use a qualitative research view that considers academic rank, norms and values of uni...

  17. 中医院规范化培训护士工作压力的质性研究%Qualitative research on the pressure of nurses′ standardized training in traditional Chinese medicine hospital

    Institute of Scientific and Technical Information of China (English)

    梁曼; 周平; 余晓云; 周芳

    2016-01-01

    目的:了解中医院规范化培训护士工作的主要压力并提出解决建议。方法采用现象学研究法,以深入访谈的方式对12名规范化培训护士进行资料收集并将资料整理归纳分析,最后提炼出主题。结果工作性质、专业知识技能、考核考试及人际交往是中医院规范化培训护士主要的压力来源。结论规范化培训护士在工作中存在着较大的压力,需护士和医院管理者共同探索合理的方式减轻其工作压力,以促进规范化培训护士身心健康,为患者提供更好的护理服务。%Objective To explore the main pressure sources of standardized training nurses in traditional Chinese medicine hospital and propose some solutions. Methods Phenomenological method with in-depth interview was used to explore the experience of the stress in 12 standardized training nurses and the information was collected, induced, analyzed, finally refined topics. Results Nature of work, Professional knowledge and skills, examination, interpersonal relationship were the main pressure sources of standardized training nurses. Conclusions Standardized training nurses have great pressure at work, so nurses and hospital managers should explore the rational way to relieve the pressure of work together to promote physical and mental health of standardized training nurses, in order to provide better service for patients.

  18. [Laboratory medicine in Taiwan].

    Science.gov (United States)

    Chen, J S

    1998-07-01

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

  19. HCAHPS - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...

  20. Hospital Compare

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Compare has information about the quality of care at over 4,000 Medicare-certified hospitals across the country. You can use Hospital Compare to find...

  1. Future directions for academic practice plans: thoughts on organization and management from Johns Hopkins University and the University of Pennsylvania.

    Science.gov (United States)

    Longnecker, David E; Henson, Douglas E; Wilczek, Kenneth; Wray, Janet L; Miller, Edward D

    2003-11-01

    Academic practice plans have been challenged in recent years by increasing pressures for productivity and financial performance. Most practice plans began as relatively loose affiliations among the clinical departments associated with their respective medical schools, and such approaches were adequate in an earlier era. However, this model is not well suited to deal with the current and future challenges that face the practice plans, hospitals, and medical schools that comprise our academic medical centers. The current clinical, financial, and regulatory environment requires highly effective business management, a shared commitment to common goals, and meticulous attention to regulatory compliance. In turn, the organizational structures, daily management, and overall governance of academic practice plans must be revised to address these new expectations. The business, clinical, and academic performance of the individual practices must be aligned to meet the diverse, and sometimes conflicting, needs of the academic health center. Both Johns Hopkins Medicine and the University of Pennsylvania (Penn Medicine) have been addressing these issues independently, but their approaches share many common principles. Among others, these principles include (a) organizational alignment, (b) strong practice plan business management, (c) shared resources and strategies, (d) accountability for performance in each practice based on credible data generated by the practice plan, (e) uniform audit and compliance standards, and (f) application of market strategy principles to assure the right mix of primary and specialist physicians, and appropriate incentive-based compensation for physicians. The application of these approaches at two academic health centers, and the rationale for these approaches, are discussed in detail. PMID:14604872

  2. Institutionalizing the academic health department within the context of the 3-fold academic mission.

    Science.gov (United States)

    Livingood, William C; Goldhagen, Jeffrey; Bryant, Thomas; Harmon, Robert G; Wood, David L

    2014-01-01

    A mature model of an academic health department (AHD) that has been institutionalized over 2 decades is described within the context of the 3-fold traditional mission of academics (teaching, research, and service/practice). This adaptive model for AHDs, based on mutual benefits that can be viewed through the lenses of both the academic health center mission and the public health functions and services, has important implications for AHD sustainability. Continued collaboration in any academic-public health partnership will depend in part on the commitments of the changing leadership. However, institutionalizing support for the academic mission enables this collaboration to transcend changing leadership styles and priorities. The collaboration of Duval County Health Department and University of Florida College of Medicine-Jacksonville is an example of a model of AHD that has endured major changes in leadership within both the academic center and the Duval County Health Department. PMID:24667196

  3. The evolution of sports medicine in Singapore.

    Science.gov (United States)

    Tan, Benedict

    2013-10-01

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

  4. ACADEMIC TRAINING

    CERN Multimedia

    Françoise Benz

    2002-01-01

    6, 7 May LECTURE SERIES from 11.00 to 12.00 hrs - Auditorium, bldg. 500 Decoding the Human Genome, Scientific basis and ethic and social aspects by S.E. Antonarakis and A. Mauron / Univ. of Geneva Decoding the Human genome is a very up-to-date topic, raising several questions besides purely scientific, in view of the two competing teams (public and private), the ethics of using the results, and the fact that the project went apparently faster and easier than expected. The lecture series will address the following chapters: Scientific basis and challenges, Ethical and social aspects of genomics. Academic Training Françoise Benz Tel. 73127

  5. Possible adverse drug events leading to hospital admission in a Brazilian teaching hospital

    OpenAIRE

    Fabiana Rossi Varallo; Helaine Carneiro Capucho; Cleópatra da Silva Planeta; Patrícia de Carvalho Mastroianni

    2014-01-01

    OBJECTIVES: Drug safety problems can lead to hospital admission. In Brazil, the prevalence of hospitalization due to adverse drug events is unknown. This study aims to estimate the prevalence of hospitalization due to adverse drug events and to identify the drugs, the adverse drug events, and the risk factors associated with hospital admissions. METHOD: A cross-sectional study was performed in the internal medicine ward of a teaching hospital in São Paulo State, Brazil, from August to Decemb...

  6. Ancient medicine--a review.

    Science.gov (United States)

    Zuskin, Eugenija; Lipozencić, Jasna; Pucarin-Cvetković, Jasna; Mustajbegović, Jadranka; Schachter, Neil; Mucić-Pucić, Branka; Neralić-Meniga, Inja

    2008-01-01

    Different aspects of medicine and/or healing in several societies are presented. In the ancient times as well as today medicine has been closely related to magic, science and religion. Various ancient societies and cultures had developed different views of medicine. It was believed that a human being has two bodies: a visible body that belongs to the earth and an invisible body of heaven. In the earliest prehistoric days, a different kind of medicine was practiced in countries such as Egypt, Greece, Rome, Mesopotamia, India, Tibet, China, and others. In those countries, "medicine people" practiced medicine from the magic to modern physical practices. Medicine was magical and mythological, and diseases were attributed mostly to the supernatural forces. The foundation of modern medicine can be traced back to ancient Greeks. Tibetan culture, for instance, even today, combines spiritual and practical medicine. Chinese medicine developed as a concept of yin and yang, acupuncture and acupressure, and it has even been used in the modern medicine. During medieval Europe, major universities and medical schools were established. In the ancient time, before hospitals had developed, patients were treated mostly in temples. PMID:18812066

  7. 42 CFR 482.53 - Condition of participation: Nuclear medicine services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Nuclear medicine... HOSPITALS Optional Hospital Services § 482.53 Condition of participation: Nuclear medicine services. If the hospital provides nuclear medicine services, those services must meet the needs of the patients...

  8. Musings on genome medicine: the Obama effect redux

    OpenAIRE

    Nathan, David G.; Orkin, Stuart H.

    2009-01-01

    From the point of view of genome medicine, Barack Obama has made two vital policy decisions: he has chosen a new director of the National Institutes of Health, and his proposed change in United States healthcare policy will have profound effects on genome medicine and, indeed, all of academic medicine.

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

    Science.gov (United States)

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

    2010-08-01

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

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

    Institute of Scientific and Technical Information of China (English)

    吴大嵘; 赖世隆; 杨显荣

    2009-01-01

    The 2008 Evidence-based Chinese Medicine (EBCM) Workshop,jointly organized by the International Society for Chinese Medicine/Editorial Board of Chinese Medicine(Macao) and the Guangdong Provincial Hospital of Chinese Medicine/ Second Affiliated Hospital of Guangzhou University of

  11. The relationship of psychosomatic medicine to consultation-liaison psychiatry.

    Science.gov (United States)

    Rosenbaum, M; McCarty, T

    1994-01-01

    Consultation-liaison psychiatry arose in the mid-1960s from the matrix of psychoanalytically oriented psychosomatic medicine. The influence of psychoanalysis and psychoanalytically trained academic psychiatrists gradually waned. The liaison aspect of consultation-liaison psychiatry faded in the early 1980s, and most consultation-liaison services are now primarily high-quality consultation services that contribute much to university teaching hospitals. The consultation-liaison service at the University of New Mexico (UNM) and several others have eliminated the term "liaison." The consultation service at UNM sees relatively few patients with classic psychosomatic disorders. The majority of requests to UNM's consultation service relate to suicide attempts, delirium, complicated medical problems with psychiatric illness, substance abuse, burns, trauma, and competency evaluations. PMID:7809359

  12. Herbal Medicine

    Science.gov (United States)

    ... for its scent, flavor, or therapeutic properties. Herbal medicines are one type of dietary supplement. They are ... and fresh or dried plants. People use herbal medicines to try to maintain or improve their health. ...

  13. Diabetes Medicines

    Science.gov (United States)

    Diabetes means your blood glucose, or blood sugar, levels are too high. If you can't control your diabetes with wise food choices and physical activity, you may need diabetes medicines. The kind of medicine you take depends ...

  14. Analysis of Anesthetic Drugs Application in the Internal Medicine Pharmacy of Our Hospital during 2008-2009%我院2008年和2009年内科药房麻醉药品应用分析

    Institute of Scientific and Technical Information of China (English)

    韩毅音; 裴保香; 马培琴

    2011-01-01

    Objective To investigate the anesthetic drugs application in the inpatients in the Internal Medicine Pharmacy of our hospital to offer reference for rational drug use. Methods To retrieve the related data from January to November, 2008-2009 from HIS of our hospital for statistically analyzing the drug name, specification, usage and dosage. Results There were totally 13 kinds of anesthetic drugs including 5 dosage forms. The top 5 places in total consumptions from January to November, 2008 were Romifentanil Hydrochloride for Injection, Sufantanil Citrate Injection, Fantanil Citrate Injection, Morphine Hydrochloride Injection and Pethidine Hydrochloride Injection. The top 5 places in total consumptions used from January to November, 2009 were Remifentanil Hydrochloride for Injection, Fentanyl Transdermal Patches, Fentanyl Citrate Injection, Sufentanil Citrate Injection and Oxycodone Hydrocloride Controlled Release Tablets. Conclusion Remifentanil Hydrochloride Injection is a new member in fentanyl category with quick action and efficacy quickly disappearing, which is widely used in the operative patients in our hospital. The application of anesthetic drugs in our hospital is basically rational but some problems exist. The medication supervision should be enhanced and the medication should be strictly abided the cancer pain three-ladder analgesic therapeutic principles.%目的 了解中国人民解放军总医院内科药房麻醉药品的应用情况,为合理用药提供参考.方法 调取该院2008年和2009年两年1月至11月医院信息系统中相关数据,统计药品名称、规格、用法用量等.结果 该院内科药房两年供应的麻醉药品有13个品种、5种剂型,2008年1月至11月DDDs排前5位的是注射用盐酸瑞芬太尼、枸橼酸舒芬太尼注射液、枸橼酸芬太尼注射液、盐酸吗啡注射液和盐酸哌替啶注射液,2009年1月至11月DDDs排前5位的是注射用盐酸瑞芬太尼、芬太尼透皮贴、枸橼酸芬

  15. Wittgenstein, medicine and neuropsychiatry.

    Science.gov (United States)

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

    2011-08-01

    A historical review is presented of the link between Ludwig Wittgenstein, considered the most important philosopher of the 20th century, and medicine, particularly neurology and psychiatry. Wittgenstein worked as a porter at Guy's Hospital in London, and then as a technician at the Royal Victoria Infirmary in Newcastle. He wrote about his important insights into language, and neuroscience. It has been suggested that he had Asperger syndrome and a possible movement disorder (mannerisms).

  16. Wittgenstein, medicine and neuropsychiatry

    Directory of Open Access Journals (Sweden)

    Hélio A.G. Teive

    2011-08-01

    Full Text Available A historical review is presented of the link between Ludwig Wittgenstein, considered the most important philosopher of the 20th century, and medicine, particularly neurology and psychiatry. Wittgenstein worked as a porter at Guy's Hospital in London, and then as a technician at the Royal Victoria Infirmary in Newcastle. He wrote about his important insights into language, and neuroscience. It has been suggested that he had Asperger syndrome and a possible movement disorder (mannerisms.

  17. Nuclear medicine therapy

    CERN Document Server

    Eary, Janet F

    2013-01-01

    One in three of the 30 million Americans who are hospitalized are diagnosed or treated with nuclear medicine techniques. This text provides a succinct overview and detailed set of procedures and considerations for patient therapy with unsealed radioactivity sources.  Serving as a complete literature reference for therapy with radiopharmaceuticals currently utilized in practice, this source covers the role of the physician in radionuclide therapy, and essential procedures and protocols required by health care personnel.

  18. The future of general medicine.

    Science.gov (United States)

    Firth, John

    2014-08-01

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

  19. Check-up and follow-up of papillary and follicular thyroid carcinoma in the department of nuclear medicine at Ibn Sina hospital Rabat; Bilan et surveillance des carcinomes papillaire et vesiculaire de la thyroide dans le service de medecine nucleaire de l'hopital Ibn Sina de Rabat

    Energy Technology Data Exchange (ETDEWEB)

    Ben Rais Aouad, N.; Ghfir, I.; Guerrouj, H.; Fellah, S.; Rahali, J.; Ksyar, R.; Missoum, F.; Bssis, A.; Azrak, S. [CHU Ibn Sina, Service de Medecine Nucleaire, Rabat (Morocco)

    2009-10-15

    In the department of nuclear medicine at Ibn Sina university hospital. Thyroid carcinoma follow-up strategy has been modified and includes cervical ultrasonography and thyroglobulin measurement. The role of radio-iodine scanning in the management of differentiated thyroid carcinoma is decreasing. Papillary and follicular carcinoma have good prognosis but late metastases exist and can lead to death. A lifelong follow-up is therefore mandatory. The main goal of follow-up is to detect earlier persistent or recurrent disease. (authors)

  20. Medicine Women.

    Science.gov (United States)

    Beiswenger, James N., Ed.; Jeanotte, Holly, Ed.

    Described as a survival manual for Indian women in medicine, this collected work contains diverse pieces offering inspiration and practical advice for Indian women pursuing or considering careers in medicine. Introductory material includes two legends symbolizing the Medicine or Spirit Woman's role in Indian culture and an overview of Indians Into…

  1. [SPORT MEDICINE].

    Science.gov (United States)

    Constantini, Naama; Mann, Gideon

    2016-06-01

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

  2. ACADEMIC TRAINING

    CERN Multimedia

    Françoise Benz

    2002-01-01

    25, 26, 27, 28 February and 1st March from 11.00 to 12.00 hrs - Auditorium, bldg. 500 LECTURE SERIES Neutrino masses and oscillations by A. de Rujula / CERN-TH This course will not cover its subject in the customary way. The emphasis will be on the simple theoretical concepts (helicity, handedness, chirality, Majorana masses) which are obscure in most of the literature, and on the quantum mechanics of oscillations, that ALL books get wrong. Which, hopefully, will not deter me from discussing some of the most interesting results from the labs and from the cosmos. Academic Training Françoise Benz Secretariat Tel. 73127 francoise.benz@cern.ch

  3. Veterinary Teaching Hospital introduces radioactive iodine therapy for feline hyperthyroidism

    OpenAIRE

    Douglas, Jeffrey S.

    2008-01-01

    The Virginia-Maryland Regional College of Veterinary Medicine's Veterinary Teaching Hospital has introduced a new radioactive iodine therapy for an endocrine disorder that commonly affects older cats.

  4. Assessment of preclinical students’ academic motivation before and after a three-day academic affair program

    OpenAIRE

    Aung MN; Somboonwong J; Jaroonvanichkul V; Wannakrairot P

    2015-01-01

    Myo Nyein Aung,1 Juraiporn Somboonwong,2 Vorapol Jaroonvanichkul,1 Pongsak Wannakrairot3 1Medical Education Unit, 2Quality Management Division and Department of Physiology, 3Academic Affairs Division, Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandBackground: Medical students’ motivation is an important driving factor for academic performance, and therefore medical teachers and educators are often highly interested in this topic. This study evaluated the impact of an ac...

  5. O brinquedo no hospital: uma análise da produção acadêmica dos enfermeiros brasileiros El juguete en el hospital: un análisis de la producción Académica de los Enfermeros Brasileños The toy in the hospital: an analysis of the Brazilian Nurses' academic production

    Directory of Open Access Journals (Sweden)

    Tânia Maria Coelho Leite

    2007-06-01

    Full Text Available Este estudo teve como objetivo analisar o conteúdo das teses e dissertações de enfermeiros brasileiros sobre a utilização do brinquedo no hospital. O levantamento dos dados foi realizado por meio de uma busca no Portal Capes, Cepen, Ibict e consulta às referências dos trabalhos, que foram analisados qualitativamente. Os objetivos mais freqüentemente encontrados referem-se à vivência da criança durante a hospitalização, ao significado e importância do brinquedo e dificuldades para sua implantação. O brinquedo foi utilizado com maior freqüência no pré e pós-operatório. A análise dos resultados obtidos nos trabalhos pautou-se nos efeitos do brinquedo sobre as crianças. Ficou evidente que, para os enfermeiros, o brinquedo é ferramenta indispensável no cuidado à criança. Portanto, recomenda-se que a prática do brinquedo / brinquedo terapêutico seja utilizada no plano de assistência de enfermagem pediátrica.Este estudio tuvo como objetivo analizar el contenido de las tesis y disertaciones de enfermeros brasileños sobre la utilización del juguete en el hospital. Los datos fueron levantados a traves de una búsqueda en el Portal Capes, Cepen, Ibict, consultando las referencias de los trabajos y analizándolos de manera cualitativa. Los objetivos encontrados con más frecuencia se refieren a la vivencia del niño durante la hospitalización, al significado y a la importancia del juguete y a las dificultades para implantar su presencia en el ámbito hospitalar. El juguete fue usado con más frecuencia en el pré y en el post-operatorio. El análisis de los resultados obtenidos en los trabajos fué pautado en el efecto que los juguetes tienen sobre los niños. Quedó evidente que para los enfermeros, el juguete es una herramienta indispensable en el cuidado de los niños. Por lo tanto, recomiendase que la práctica del juguete / juguete terapéutico sea usado en el plano de asistencia de enfermería pediátrica.The purpose

  6. Academic Engagement and Commercialisation

    DEFF Research Database (Denmark)

    Perkmann, Markus; Tartari, Valentina; McKelvey, Maureen;

    2013-01-01

    as ‘academic engagement’. Apart from extracting findings that are generalisable across studies, we ask how academic engagement differs from commercialisation, defined as intellectual property creation and academic entrepreneurship. We identify the individual, organisational and institutional antecedents...... and consequences of academic engagement, and then compare these findings with the antecedents and consequences of commercialisation. Apart from being more widely practiced, academic engagement is distinct from commercialisation in that it is closely aligned with traditional academic research activities...

  7. 中医医院护士组织公民行为与组织公平感相关性研究%The relationship between organizational citizenship behavior and organizational justice among nurses in traditional Chinese medicine hospitals

    Institute of Scientific and Technical Information of China (English)

    曹秋茹; 郭玲玉; 刘根莉

    2011-01-01

    Objective: To explore the relationship between organizational justice and organizational citizenship behavior among clinical nurses. Methods: A total of 316 nurses from 4 large traditional Chinese medicine hospitals were investigated by Organizational Justice Questionnaire and Chinese Organizational Citizenship Behavior Scale. Results:There was a positive relationship between organizational justice and organizational citizenship behaviors among clinical nurse after controlling their demographic variables. Conclusion:This study confirms that organizational justice can significantly predict organizational citizenship behaviors. Nursing managers must attach more importance to organizational justice to eliminate nurse's unfair feeling which could negatively impact the nurses' working enthusiasm.%目的:通过实证研究验证中医医院临床护士的组织公平感与组织公民行为的关系.方法:采用横断面问卷调查法对来自4 家大型中医医院的316 名护士进行组织公平感和组织公民行为的测量.结果:在控制了人口统计学变量后,组织公平感与中医护士的组织公民行为显著相关.结论:中医医院护士的组织公平感会对其组织公民行为具有积极的正向影响,所以护理管理者必须给予高度重视,尽力消除不公平感对护士工作积极性的消极影响.

  8. 中医院校护理本科生学习适应性的调查研究%Academic adjustment of undergraduate nursing students in the University of Traditional Chinese Medicine

    Institute of Scientific and Technical Information of China (English)

    王惠婷; 李壮苗

    2014-01-01

    目的:调查护理本科生学习适应性,为护理教育者指导护理专业学生改善学习适应性提供依据。方法采用学习适应性量表对251名在校护理本科生进行调查。结果护理本科生学习适应性为(3.52±0.44)分,各维度得分不均衡。高年级、家庭教育类型为放任型的护理专业学生学习能力高(P<0.05)。低年级护理本科生学习态度端正(P<0.05),专业满意度为学生学习动机、教学模式、学习能力、学习态度及学习适应总分的重要影响因素(P<0.05)。结论护理本科生学习态度端正,但学习动机和环境得分较低。护理教育者应针对护理学专业学生的学习适应问题引导其寻找内在的学习动力,形成良好的学习态度,为其提供良好的学习环境。%Objective To investigate the level of academic adjustment among undergraduate nursing students,and provide a basis for nursing educators to improve students' academic adjustment. Methods Totally 251 undergraduate nursing students were investigated using Undergraduate Academic Adjustment Scale (UAAS). Results The score of academic adjustment among undergraduate nursing students was(3.52±0.44).The scores of academic ability were different among students in different family education styles(P<0.05) and grades(P<0.05);the scores of learning attitudes were different among students in different grades(P<0.05). Moreover,professional satisfaction was related to the scores of learning motivation,teaching mode,academic ability,learing attitudes and the total score of academic adjustment (P<0.05). Conclusion Undergraduate nursing students have right learning attitudes,but lower level of learning motivation and academic environment. Nursing educators should guide nursing students looking for intrinsic motivation,forming good academic attitude,and provide well academic environment for them aiming at different adjustment problems.

  9. 结合JCI标准加强我院病区科室药品管理%Enhancement of Ward Departments Management of Medicines in Our Hospital Based on JCI Standard

    Institute of Scientific and Technical Information of China (English)

    刘世林; 杨晓蓉; 黄亮; 张伶俐

    2012-01-01

    目的:加强病区药品管理,保证患者用药安全.方法:结合《美国医疗机构评审国际联合委员会医院评审标准》(下简称JCI标准)药品管理原则,从普通药品基数管理、药品贮存与养护、高危药品管理、麻醉药品和一类精神药品以及急救药品管理进行行政和技术干预,制订持续改进的方法和流程.12个月后评价干预效果,并与干预前进行比较.结果:12个月后,普通药品未按要求贮存(8 vs.19)、未规范放置(11 vs.78)和药品基数不符(0vs.1)等均较干预前减少,差异有统计学意义(P<0.05);各病区高危药品、麻醉和一类精神药品、急救药品管理合格率达到100%.结论:结合JCI标准后,加强了我院病区药品管理的制度化、规范化及多部门协作,促进了药品管理和用药安全的持续改进与提高.%OBJECTIVE: To enhance ward management of medicines, and to gurantee the safety of drag use. METHODS: Based on American Joint Commission on the Accreditation of Healthcare Organizations International Accreditation Standards for Hospitals (called JCI for short), the standard, system and work flow of ward management of medicines were established, and index for performance check were all determined, such as base of drug management, drag storage and conservation, the management of high-risk drugs, narcotics and class I psychotropic substances and emergency drugs. 12 months later, the effects of JCI standard were compared before and after the implementation. RESULTS: 12 months later, the number of drags which were not stored in accordance with standard (8 vs. 19), not placed in right place (11 vs. 78) or drug base not imcompatible (0 vs. 1) were decreased, there was statistical significance (P<0.05); the qualified rate of the management of high-risk drugs, narcotics and class I psycho-tropic substances and emergency drugs all reached 100%. CONCLUSION: The use of JCI standard enhances the systemization and standardization

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

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    @@ Chinese Academic Journal(CAJ-CD) is a series of integrated full text database of current electronic academic journals in China. The subject areas of CAJ-CD are included in the humanities, social science,natural. science, engineering, agriculture, medicine, technology, and so on. All these journals reflect the progresses and the most recent dynamic developing information in China's academic researches.

  11. Painting the Bigger Picture: Academic Literacy in Postgraduate Vocational Education

    Science.gov (United States)

    Strauss, Pat; Mooney, Shelagh

    2011-01-01

    Currently postgraduate hospitality courses are attracting large numbers of international students, many of whom do not speak English as a first language. In addition, these programmes are also popular with first language students drawn from non-traditional academic backgrounds. Both cohorts experience difficulties with the academic genre…

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

    Directory of Open Access Journals (Sweden)

    Andrzejewski Jr C

    2014-07-01

    Full Text Available Chester Andrzejewski Jr,1 Darlene Cloutier,1 David Unold,2 Richard C Friedberg1 1Transfusion Medicine Services, Department of Pathology, Baystate Medical Center, Baystate Health, Springfield, MA, 2Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, USA Abstract: Throughout the history of hemotherapy (HT, various challenges and concerns have been encountered in its practical application. When viewed using a prismatic lens of history, recurrent themes regarding adverse HT sequelae separate and become apparent. These can be broadly classified into three categories: infectious, noninfectious, and administrative/logistical. Using the HT care map as a frame of reference along with its associated rites, we examine the contemporary spectrum of HT adverse events and concerns, and some approaches as to how these may be addressed from bedside and laboratory medicine biovigilance perspectives enhancing patient care and blood transfusion safety. Although our vantage point is from an academic community hospital venue, the issues and concerns identified are germane to many if not all transfusion-medicine practice environments. Included among the subjects we explore are patient/specimen identification issues, blood-management initiatives, unrecognized and/or unreported suspected transfusion reactions, transfusion-associated adverse pulmonary sequelae (including transfusion-related acute lung injury and transfusion-associated circulatory overload, expanded applications of electronic health records and issues regarding their “meaningful use” and interinstitutional “digital compatibilities”, biovigilance integration of electronic data networks within and between health care entities, and anticipated workforce contractions secondary to projected declines in the availability of qualified laboratory professionals. Cooperative initiatives between accreditation and regulatory entities, blood collectors and suppliers, hospital

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

    Science.gov (United States)

    Nixon, L James; Ryder, Hilary F; Alexandraki, Irene; Lyons, Maureen D; McEwen, Kelsey Angell; DeWaay, Deborah J; Warrier, Sarita; Lang, Valerie J; LaRochelle, Jeffrey

    2016-01-01

    Since its inception in 1989, Clerkship Directors in Internal Medicine (CDIM) has promoted excellence in medical student education. CDIM members move medical education forward by sharing innovations in curriculum and assessment and discoveries related to educating our students and administering our programs. The Alliance for Academic Internal Medicine, of which CDIM is a founding member, broadens the umbrella beyond student education to include five academically focused specialty organizations representing departments of medicine, teaching hospitals, and medical schools working together to advance learning, discovery, and caring. CDIM held its 2015 annual meeting at Academic Internal Medicine Week in Atlanta, Georgia. This year 36 innovation and research submissions were selected for either oral abstract or poster presentation. The quality of the presentations was outstanding this year and included many of the most important issues in medical education. The CDIM research committee selected the following seven abstracts as being of the highest quality, the most generalizable, and relevant to the readership of Teaching and Learning in Medicine. Two abstracts include information from the CDIM annual survey, which remains a rich source for answering questions about student education on a national level. Looking at trends in medical education, three of the seven selected abstracts mention entrustable professional activities. Three of the abstracts address how we assess student skill and provide them with appropriate feedback. These include two schools' approach to bringing milestones into the medical student realm, use of objective structured clinical exam for assessing clinical skill in clerkship, and what students want in terms of feedback. Four articles deal with curricular innovation. These include interprofessional education, high-value care, transitions of care, and internship preparation. We are pleased to share these abstracts, which represent the breadth and

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

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Rafiaa Valji

    2013-01-01

    Full Text Available Background. The use of complementary and alternative medicine (CAM is high among children and youths with chronic illnesses, including cancer. The objective of this study was to assess prevalence and patterns of CAM use among pediatric oncology outpatients in two academic clinics in Canada. Procedure. A survey was developed to ask patients (or their parents/guardians presenting to oncology clinics at the Stollery Children’s Hospital in Edmonton and the Children’s Hospital of Eastern Ontario (CHEO in Ottawa about current or previous use of CAM products and practices. Results. Of the 137 families approached, 129 completed the survey. Overall CAM use was 60.5% and was not significantly different between the two hospitals. The most commonly reported reason for not using CAM was lack of knowledge about it. The most common CAM products ever used were multivitamins (86.5%, vitamin C (43.2%, cold remedies (28.4%, teething remedies (27.5%, and calcium (23.0%. The most common CAM practices ever used were faith healing (51.0%, massage (46.8%, chiropractic (27.7%, and relaxation (25.5%. Many patients (40.8% used CAM products at the same time as prescription drugs. Conclusion. CAM use was high among patients at two academic pediatric oncology clinics. Although most respondents felt that their CAM use was helpful, many were not discussing it with their physicians.

  16. COPD Medicine

    Science.gov (United States)

    ... AerobiKa® Cardiology Medications Anticoagulant Medicine Anticoagulants and Drug-Food Interactions COPD Medications Bronchodilators Anti-Inflammatories Antibiotics Managing Your Medications Devices ...

  17. Emergency Medicine in Guyana: Lessons from Developing the Country's First Degree-conferring Residency Program

    Directory of Open Access Journals (Sweden)

    Nicolas P Forget

    2013-09-01

    Full Text Available Introduction: Academic departments of emergency medicine are becoming increasingly involved in assisting with the development of long-term emergency medicine training programs in low and middle-income countries. This article presents our 10-year experience working with local partners to improve emergency medical care education in Guyana.Methods: The Vanderbilt Department of Emergency Medicine has collaborated with the Georgetown Public Hospital Corporation on the development of Emergency Medicine skills followed by the implementation of an emergency medicine residency training program. Residency development included a needs assessment, proposed curriculum, internal and external partnerships, University of Guyana and Ministry of Health approval, and funding.Results: In our experience, we have found that our successful program initiation was due in large part to the pre-existing interest of several local partners and followed by long-term involvement within the country. As a newer specialty without significant local expertise, resident educational needs mandated a locally present full time EM trained attending to serve as the program director. Both external and internal funding was required to achieve this goal. Local educational efforts were best supplemented by robust distance learning. The program was developed to conform to local academic standards and to train the residents to the level of consultant physicians. Despite the best preparations, future challenges remain.Conclusion: While every program has unique challenges, it is likely many of the issues we havefaced are generalizable to other settings and will be useful to other programs considering or currentlyconducting this type of collaborative project. [West J Emerg Med. 2013;14(5:477–481.

  18. Tratamento de hidrocefalia com derivação ventrículo-peritoneal: análise de 150 casos consecutivos no Hospital das Clínicas de Ribeirão Preto Treatment of hydrocephalus by ventriculoperitoneal shunt: analysis of 150 consecutive cases in the Hospital of the Faculty of Medicine of Ribeirão Preto

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo Barros Jucá

    2002-01-01

    Full Text Available INTRODUÇÃO: O presente trabalho analisou 150 casos consecutivos de tratamento da hidrocefalia com DVP no Hospital das Clínicas de Ribeirão Preto entre março de 1997 e julho de 2000. OBJETIVO: Traçar as principais características dos pacientes e dos procedimentos, com ênfase nas etiologias, diagnóstico, complicações, seqüelas e fatores associados. MÉTODOS: Prontuários médicos como fonte para quantificar as variáveis selecionadas. RESULTADOS: As etiologias congênitas e adquiridas tiveram a mesma incidência, destacando-se a mielomeningocele no primeiro grupo e a prematuridade e a meningite no segundo. As principais complicações foram o mal funcionamento da válvula (33% e a infecção (15%. Incluídas as cirurgias devido às complicações, houve 2,5 procedimentos por paciente em média. No último retorno, 40% dos pacientes apresentavam algum grau de retardo do desenvolvimento neuro-psico-motor (RDNPM. As principais etiologias relacionadas a RDNPM foram prematuridade, meningite e malformações complexas. Discussão: O trabalho serviu como ferramenta para ajudar a caracterizar a história natural da hidrocefalia e de seu tratamento em nosso meio, fornecendo base para uma melhor compreensão da mesma e para comparação com a literatura e com outros serviços. A taxa de RDNPM está condizente com a literatura. A taxa de infecção está mais elevada, podendo haver relação com o fato de ser este um hospital-escola. Maior tempo de seguimento seria necessário para comparação da incidência de complicações mecânicas.INTRODUCTION/OBJECTIVES: This study has analyzed 150 consecutive cases of treatment of hydrocephalus by ventriculoperitoneal shunt in the Faculty of Medicine of Ribeirão Preto's Hospital between May 1997 and July 2000, in order to stablish the main characteristics of the patients and proceedings , in particular the etiologies, diagnosis, complications, final outcome and associated factors. METHODS: Medica

  19. A RANDOMIZED CONTROLLED TRIAL ON THE EFFICACY OF MEDHYA RASAYANA TABLET ON ACADEMIC STRESS AND PERFORMANCE IN SCHOOL CHILDREN

    Directory of Open Access Journals (Sweden)

    Abhimanyu Kumar

    2013-08-01

    Full Text Available Background:School children and academics are not exempted from stress. In Indian context, especially for high school children, the demands to be placed high, parental pressures, the future career option and time bound targets along with inherent biological variations of adolescence create paramount stress. Such stress can be detrimental if not well managed. Despite of loss of lives consequent upon stress and poor performance, academic stress is less researched. Psychotherapy is the current gold standard. Hence this trial aims to evolve the risk factors, common manifestations and adaptations with the academic stress, remedial measures with herbal medicine.Objectives: Evaluation of efficacy and safety of oral administration of Medhya Rasayana (MR on manifestations of academic stress and to improve the academic performance. Setting and design: Study was carried out in Sri Dharmasthala Manjunatheshwara College of Ayurveda and Hospital (SDMCA&H, Hassan, Karnataka, South India, from December, 2010- December, 2012. Interventional, single blinded, randomized psychotherapy-placebo controlled efficacy trial.Materials and methods:164 children of either sex, studying in tenth standard with normal intelligent quotient (IQ, average and above average stress as indicated from the scores on academic anxiety scale (AASC and Sarason’s Test anxiety scale (TASC, consciously willing to participate in the trial were randomized in to three groups (GP–medhya (M and medhya with psychotherapy (MP and control – Placebo with psychotherapy (PP group. M-group received MR, MP-group with MR and psychotherapy while PP-group given placebo with psychotherapy over 3 months. Stress identified by test anxiety and academic anxiety scores, clinical manifestations and performances were evaluated before, after therapy and after exams. Children suffering from chronic systemic illnesses, developmental disorders, psychiatric illness, post traumatic stress disorder and not

  20. Programa de Triagem Neonatal do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Brasil Neonatal Screening Program at the University Hospital of the Ribeirao Preto School of Medicine, São Paulo University, Brazil

    Directory of Open Access Journals (Sweden)

    Patrícia Künzle Ribeiro Magalhães

    2009-02-01

    Full Text Available O Programa de Triagem Neonatal do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Brasil, instituído em 1994 diagnosticou, até 2005, 76 crianças com hipotireoidismo congênito, 10 com fenilcetonúria e 25 com hemoglobinopatias, o que representou uma incidência de 1:2.595, 1:19.409, 1:4.120, respectivamente. Foram diagnosticadas 2.747 crianças com traço falciforme (1:37,5 nascidos vivos. A cobertura média do programa foi de 94,5%. Houve uma considerável melhora nos parâmetros de avaliação da qualidade do programa no período, porém, sem atingir os índices ideais. Campanhas visando à maior divulgação da importância da triagem neonatal são necessárias para aumentar a cobertura e a instituição do 3º dia de vida do recém-nascido como sendo o Dia do Teste do Pezinho poderia contribuir para que idades mais precoces de tratamento fossem atingidas, melhorando o prognóstico das crianças acometidas.The Neonatal Screening Program at the University Hospital of the Ribeirao Preto School of Medicine, São Paulo University, Brazil, was introduced in 1994. As of December 2005, congenital hypothyroidism had been diagnosed in 76 infants, phenylketonuria in 10, and hemoglobinopathies in 25, representing incidence rates of 1:2,595, 1:19,409, and 1:4,120, respectively. A total of 2,747 newborns had the sickle cell trait, i.e., were heterozygous for the sickle mutation (1:37.5 live births. The program's mean coverage during this period was 94.5%. There was major improvement in the parameters for evaluating the program's quality, although they were still far from ideal. Public-awareness campaigns on the importance of neonatal screening are needed to increase the program's coverage. Setting postnatal day 3 as the standard Day for the Heel Stick Test would help ensure treatment at earlier ages, thus improving prognosis for affected infants.

  1. Vacinação dos viajantes: experiência do Ambulatório dos Viajantes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo Travelers' vaccinations: experience from the Travelers' Clinic of Hospital das Clínicas, University of São Paulo School of Medicine

    Directory of Open Access Journals (Sweden)

    Simone Chinwa Lo

    2008-10-01

    Full Text Available O perfil dos indivíduos, a situação vacinal e as vacinas recomendadas aos viajantes que procuram o serviço médico de orientação pré-viagem do Ambulatório dos Viajantes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo foram analisados no presente estudo. Dos 445 viajantes estudados, 51% eram mulheres; a mediana de idade foi de 33,5 anos; 51% viajavam a trabalho e 39,5% por lazer. Destinos mais procurados: África (47%; Ásia (31,7%; América do Sul (21,4%. Trezentos e oitenta e cinco (86,5% viajantes tiveram indicação de vacinação para viagem. Principais vacinas recomendadas: febre tifóide (55,7%, difteria-tétano (54,1%, hepatite A (46,1%, hepatite B (44,2%, febre amarela (24,7%. A orientação pré-viagem mostrou-se importante não só para indicar as vacinas recomendadas para a viagem, mas também como oportunidade para atualização das vacinas de rotina.TThe profile and vaccination status of travelers seeking pre-travel medical advice at the Travelers' Clinic of Hospital das Clínicas, University of São Paulo School of Medicine, and the vaccines recommended for them, were analyzed in the present study. Among the 445 travelers who were studied, 51% were women, the median age was 33.5 years, 51% were traveling on business and 39.5% were traveling for leisure purposes. The destinations most sought were Africa (47%, Asia (31.7% and South America (21.4%. Vaccination before traveling was recommended for 385 (86.5% of the travelers. The main vaccines recommended were against typhoid fever (55.7%, diphtheria-tetanus (54.1%, hepatitis A (46.1%, hepatitis B (44.2% and yellow fever (24.7%. The pre-travel guidance was shown to be important not only for indicating the vaccines recommended for the trip, but also as an opportunity to update routine vaccinations.

  2. Emergency medicine in the United Arab Emirates

    OpenAIRE

    Fares, Saleh; Irfan, Furqan B; Corder, Robert F; Al Marzouqi, Μuneer Abdulla; Al Zaabi, Ahmad Hasan; Idrees, Marwa Mubarak; Abbo, Michael

    2014-01-01

    It has been a decade since emergency medicine was recognized as a specialty in the United Arab Emirates (UAE). In this short time, emergency medicine has established itself and developed rapidly in the UAE. Large, well-equipped emergency departments (EDs) are usually located in government hospitals, some of which function as regional trauma centers. Most of the larger EDs are staffed with medically or surgically trained physicians, with board-certified emergency medicine physicians serving as...

  3. Monitoring of multi-resistant bacteria hospitalized patients with respiratory medicine and risk factor analysis%呼吸内科住院患者多重耐药菌监测与危险因素分析

    Institute of Scientific and Technical Information of China (English)

    费君; 赵大海; 陆友金

    2016-01-01

    Objective To investigate the distribution and risk factors caused by respiratory medicine of mul-tiple drug-resistant bacteria ( MDRB) and to provide evidence for prevention and controlling measure of MDRB infec-tion. Methods 124 cases infected in lower respiratory tract from January 2012 to December 2013 was performed, and divided into MDRB infections group (70 cases) and the non-MDRB infections group (54 cases). Several statisti-cally significant risk factors were screened out with single factor analysis, thereafter independent risk factors of MDRB infections were determined with multivariate logistic regression analysis. Results A total of 84 pathogens were detec-ted, the pathogens successively were Escherichia coil, acinetobacter baumannii, Klebsiella pneumoniae, and pseudo-monas aeruginosa. In the multi-variable logistic analysis results of MDRB infections, the related factors included du-ration of hospital stay, use of multiple antimicrobial drug, cardiovascular and cerebrovascular diseases, tracheotomy/trachea cannula and indwelling catheter. Conclusion E. coli bacterium is the main pathogen causing MDRB in lower respiratory tract infection of gram-negative bacilli primary pathogenic bacteria. The independent risk factors of MDRB infection include duration of hospital stay, basic chronic diseases, the use of antibiotics and invasive ventilation.%目的 分析呼吸内科多重耐药菌(MDRB)的分布及其危险因素,从而采取相应措施预防及控制多重耐药菌感染.方法 回顾性调查2012年1月至2013年12月呼吸内科确诊下呼吸道感染患者124例,分为多重耐药组(70例)和非多重耐药组(54例),分析其多重耐药菌的分布,以单因素分析筛选出有统计学意义的相关危险因素,再通过多因素logistic回归分析方法分析多重耐药菌的独立危险因素.结果 共检出多重耐药致病菌84株,多重耐药菌依次为大肠埃希氏菌、鲍曼溶血不动杆菌、肺炎克雷伯菌、铜绿假

  4. 2011-2013年我院治疗心脑血管疾病中成药的用药合理性%Rational Use of Traditional Chinese Medicines for the Treatment of Cardiovascular and Cerebrovascular Diseases in Our Hospital in 2011 - 2013

    Institute of Scientific and Technical Information of China (English)

    张丝雨

    2015-01-01

    Objective: To analyze the usage of 20 kinds of traditional Chinese medicines for the treatment of cardiovascular and cerebrovascular diseases in our hospital from 2011 to 2013 , and to provide a reference for ratio-nal use of traditional Chinese medicines . Methods: The traditional Chinese medicines used in the three years in our hospital for cardiovascular and cerebrovascular diseases were analyzed statistically in respect of consumption sum of medication and DDDs . Results: The DDDs of traditional Chinese medicines used for cardiovascular and cere-brovascular diseases increased year by year . Compound Danshen dripping pills ranked the first over the three years , which was followed by Ginkgo biloba extract dropping pills and Suxiaojiuxin pills . Conclusion: The application of 20 kinds of traditional Chinese medicines for the treatment of cardiovascular and cerebrovascular diseases in our hospital was generally reasonable . Clinicians should follow the principle of syndrome differentiation and use medicines reasonably .%目的:分析2011-2013年我院治疗心脑血管疾病的20种中成药的使用情况,为临床合理用药提供参考。方法:对我院3年来治疗心脑血管疾病的中成药用药金额、用药频度进行统计分析。结果:3年来我院治疗心脑血管疾病的中成药用药频度呈逐年递增趋势,复方丹参滴丸一直位列第1,2013年银杏酮酯滴丸和速效救心丸有明显增长,位居第2、3位。结论:2011-2013年我院治疗心脑血管疾病的20种中成药使用基本合理,临床医生应根据辨证施治原则合理用药。

  5. Integrative Medicine in a Preventive Medicine Residency: A Program for the Urban Underserved.

    Science.gov (United States)

    Berz, Jonathan P B; Gergen Barnett, Katherine A; Gardiner, Paula; Saper, Robert B

    2015-11-01

    The Preventive Medicine Residency Program collaborated with the Department of Family Medicine's Program for Integrative Medicine and Health Disparities at Boston Medical Center to create a new rotation for preventive medicine residents starting in autumn 2012. Residents participated in integrative medicine group visits and consults, completed an online curriculum in dietary supplements, and participated in seminars all in the context of an urban safety net hospital. This collaboration was made possible by a federal Health Resources and Services Administration grant for integrative medicine in preventive medicine residencies and helped meet a need of the program to increase residents' exposure to clinical preventive medicine and integrative health clinical skills and principles. The collaboration has resulted in a required rotation for all residents that continues after the grant period and has fostered additional collaborations related to integrative medicine across the programs.

  6. Implementing a global integrative rehabilitation medicine rotation: a physical medicine and rehabilitation residency program's experience.

    Science.gov (United States)

    Kosasih, Judith B; Jurisic, Daniela H; Gandini, Cristiano; Sauter, Carley N; Braza, Diane W

    2013-06-01

    An innovative international rotation in integrative rehabilitation medicine was implemented as part of the physical medicine and rehabilitation residency program at the Medical College of Wisconsin. Rotation objectives were to introduce medical knowledge of integrative medicine treatments into physical medicine and rehabilitation practice and to initiate collaboration with international academic partners. Residents were approved based on their academic record, completion of prerequisites, and personal statement. During a 4-wk rotation located in Italy, residents developed an integrative treatment strategy for each patient using conventional medical care and other therapeutic options, including acupuncture, biofeedback, aquatic therapy, yoga, and others. Postrotation assessment included evaluations by Italian team and patients, residents' evidence-based presentations, and postrotation self-reflection. Participating residents reported high achievement in clinical performance, improved application of integrative medicine, broader appreciation of cultural diversity in patient care, and increased personal and professional development. This reciprocal program model serves as an example for other programs interested in implementing similar international rotations. PMID:23291603

  7. Competency Modeling for Academic Leaders in Hospital An Integrated Approach%临床医学学科带头人胜任特征模型建构——量化与质化结合的方法

    Institute of Scientific and Technical Information of China (English)

    王桢; 苏景宽; 罗正学; 时勘

    2011-01-01

    Research on competency model is one of the frontier issues of HRM research. This study is conducted to obtain the competency model of clinical academic leaders by ways of structured job analysis questionnaires and Behavioral Event Interview (BEI). Questionnaires of Occupational Information Network (O*NET) are administered to 494 clinical workers, on the results of which, further Behavioral Event Interviews (BEI) are carried out with 20 clinical academic leaders. Moreover, subject matter experts are invited to confirm the primary competency construct along with the process. The results of this study show that a combined method to establish the competency model of clinical academic leaders is effective. The findings also demonstrate the competency model of clinical academic leaders is composed of eighteen competencies, divided into three levels, and with seven distinctive competencies. The findings also indicate three new competencies: individual consideration, outer resource seeking and business sense.%胜任特征模型研究是人力资源管理理论和实践的前沿问题,然而目前研究多采用单一的方法.本研究首先使用0*NET问卷对494位医院工作人员进行工作分析,然后对20位学科带头人进行行为事件访谈,结合进行专家小组访谈,构建临床医学学科带头人的胜任特征模型.研究发现多方法构建模型具有较好的效果.该职位胜任特征模型包括18项特征,可以分为个性特征,认知技能,管理能力三个理论层次.此外,本研究发现了个性化关怀等三项较新的素质要求.

  8. Treatment of cholecystitis with Chinese herbal medicines: A systematic review of the literature

    Institute of Scientific and Technical Information of China (English)

    Zhi-Yong Dong; Guan-Liang Wang; Xing Liu; Jia Liu; De-Zeng Zhu; Chang-Quan Ling

    2012-01-01

    AIM:To analyze the literature on the use of Chinese herbal medicines for the treatment of cholecystitis.METHODS:The literature on treatment of cholecystitis with traditional Chinese medicines (TCM) was analyzed based on the principles and methods described by evidence-based medicine (EBM).Eight databases including MEDLINE,EMbase,Cochrane Central (CCTR),four Chinese databases (China Biological Medicine Database,Chinese National Knowledge Infrastructure Database,Database of Chinese Science and Technology Periodicals,Database of Chinese Ministry of Science and Technology) and Chinese Clinical Registry Center,were searched.Full text articles or abstracts concerning TCM treatment of cholecystitis were selected,categorized according to study design,the strength of evidence,the first author's hospital type,and analyzed statistically.RESULTS:A search of the literature published from 1977 through 2009 yielded 1468 articles in Chinese and 9 in other languages; and 93.92% of the articles focused on clinical studies.No article was of level I evidence,and 9.26% were of level Ⅱ evidence.The literature cited by Science Citation Index (SCI),MEDLINE and core Chinese medical journals accounted for 0.41%,0.68% and 7.29%,respectively.Typically,the articles featured in case reports of illness,examined from the perspective of EBM,were weak in both quality and evidence level,which inconsistently conflicted with the fact that most of the papers were by authors from Level-3 hospitals,the highest possible level evaluated based on their comprehensive quality and academic authenticity in China.CONCLUSION:The published literature on TCM treatment of cholecystitis is of low quality and based on low evidence,and cognitive medicine may functions as a useful supplementary framework for the evaluation.

  9. American academic headache specialists in neurology: practice characteristics and culture.

    Science.gov (United States)

    Finkel, A G

    2004-07-01

    Headache diagnosis and treatment is the most important focus or concentration area for practising neurologists in America. The American Headache Society, formerly the American Association for the Study of Headache, is made up predominantly of neurologists. Recognition of the importance of the teaching and practice of headache medicine, especially migraine, is still incomplete at many academic teaching institutions. Suggestions that this results from inadequate academic hierarchies and education at graduate and post-graduate levels have been made. We therefore undertook a survey of academic practitioners of headache medicine in departments of neurology with membership of the American Headache Society. Subjects and addresses were identified using the 1999-2000 membership directory of the American Headache Society. Practice characteristics and time distribution were assessed. Teaching in undergraduate and resident programmes was also assessed. Fifty-five surveys from 46 institutions in 25 states were judged as adequate for this report. Academic neurologists with interest in headache medicine spent most of their time in clinic, with less than 25% spent doing either research or teaching. Medical schools had an average of 1 h of preclinical and 2 h of clinical teaching in headache. Neurology residents received an average of 3 h of didactic instruction in headache. This report is the first of its kind to review the practice characteristics and culture of headache medicine in the setting of academic departments of neurology. It describes a clinical practice similar to those of other non-academic American neurologists.

  10. Surviving Hurricane Katrina: reconstructing the educational enterprise of Tulane University School of Medicine.

    Science.gov (United States)

    Krane, N Kevin; Kahn, Marc J; Markert, Ronald J; Whelton, Paul K; Traber, Peter G; Taylor, Ian L

    2007-08-01

    Hurricane Katrina was one of the greatest natural disasters to ever strike the United States. Tulane University School of Medicine, located in downtown New Orleans, and its three major teaching hospitals were flooded in the aftermath of the storm and forced to close. Faculty, students, residents, and staff evacuated to locations throughout the country. All critical infrastructure that normally maintained the school, including information technology, network communication servers, registration systems, and e-mail, became nonoperational. However, on the basis of experiences learned when Tropical Storm Allison flooded the Texas Medical Center in 2001, Baylor College of Medicine, University of Texas-Houston, University of Texas Medical Branch in Galveston, and Texas A&M School of Medicine created the South Texas Alliance of Academic Health Centers, which allowed Tulane to move its education programs to Houston. Using Baylor's facilities, Tulane faculty rebuilt and delivered the preclinical curriculum, and clinical rotations were made available at the Alliance schools. Remarkably, the Tulane School of Medicine was able to resume all educational activities within a month after the storm. Educational reconstruction approaches, procedures employed, and lessons in institutional recovery learned are discussed so that other schools can prepare effectively for either natural or man-made disasters. Key disaster-response measures include designating an evacuation/command site in advance; backing up technology, communication, financial, registration, and credentialing systems; and establishing partnership with other institutions and leaders. PMID:17762249

  11. Reinventing the academic health center.

    Science.gov (United States)

    Kirch, Darrell G; Grigsby, R Kevin; Zolko, Wayne W; Moskowitz, Jay; Hefner, David S; Souba, Wiley W; Carubia, Josephine M; Baron, Steven D

    2005-11-01

    Academic health centers have faced well-documented internal and external challenges over the last decade, putting pressure on organizational leaders to develop new strategies to improve performance while simultaneously addressing employee morale, patient satisfaction, educational outcomes, and research growth. In the aftermath of a failed merger, new leaders of The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center encountered a climate of readiness for a transformational change. In a case study of this process, nine critical success factors are described that contributed to significant performance improvement: performing a campus-wide cultural assessment and acting decisively on the results; making values explicit and active in everyday decisions; aligning corporate structure and governance to unify the academic enterprise and health system; aligning the next tier of administrative structure and function; fostering collaboration and accountability-the creation of unified campus teams; articulating a succinct, highly focused, and compelling vision and strategic plan; using the tools of mission-based management to realign resources; focusing leadership recruitment on organizational fit; and "growing your own" through broad-based leadership development. Outcomes assessment data for academic, research, and clinical performance showed significant gains between 2000 and 2004. Organizational transformation as a result of the nine factors is possible in other institutional settings and can facilitate a focus on crucial quality initiatives. PMID:16249294

  12. Reinventing the academic health center.

    Science.gov (United States)

    Kirch, Darrell G; Grigsby, R Kevin; Zolko, Wayne W; Moskowitz, Jay; Hefner, David S; Souba, Wiley W; Carubia, Josephine M; Baron, Steven D

    2005-11-01

    Academic health centers have faced well-documented internal and external challenges over the last decade, putting pressure on organizational leaders to develop new strategies to improve performance while simultaneously addressing employee morale, patient satisfaction, educational outcomes, and research growth. In the aftermath of a failed merger, new leaders of The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center encountered a climate of readiness for a transformational change. In a case study of this process, nine critical success factors are described that contributed to significant performance improvement: performing a campus-wide cultural assessment and acting decisively on the results; making values explicit and active in everyday decisions; aligning corporate structure and governance to unify the academic enterprise and health system; aligning the next tier of administrative structure and function; fostering collaboration and accountability-the creation of unified campus teams; articulating a succinct, highly focused, and compelling vision and strategic plan; using the tools of mission-based management to realign resources; focusing leadership recruitment on organizational fit; and "growing your own" through broad-based leadership development. Outcomes assessment data for academic, research, and clinical performance showed significant gains between 2000 and 2004. Organizational transformation as a result of the nine factors is possible in other institutional settings and can facilitate a focus on crucial quality initiatives.

  13. 品管圈用于提高门诊西药房药品质量管理实践%Application of Quality Control Circle for Improving Drug Quality Management in Outpatient Western Medicine Pharmacy of Our Hospital

    Institute of Scientific and Technical Information of China (English)

    李杨华; 周祖萍

    2015-01-01

    quality management ) and intangible results ( circle ability ) were evaluated and the standardized work flow was formulated. Results The drug deliquescence was mainly due to the cipher prescriptions and scattered tablets;drug invali-dation was mainly due to the poor working responsibility of pharmacists and the backlog of drugs;refrigerated drugs mainly due to many varieties of cold medicines, large quantity and few refrigerating cabinets. In view of the above reasons, a series of measures were adopted including the standardized packing of cipher prescriptions, standardization of applying receiving drugs, the refrigerated drugs taking the method of small amount and multiple batches of receiving and increasing the refrigerating cabinets, and enhancing the responsibility sense of pharmacists. After the activity, the deliquescence drugs were dropped from 13 times before the activity to 5 times, the drug in-validation was dropped from 5 times before the activity to twice, the drugs of cold storage management were dropped from 16 times be-fore the activity to 6 times;at the same time the circle staffs were greatly improved in the aspects of the work enthusiasm, team cohe-sion and ability to solve problems. Conclusion The application of QCC management model is feasible to improve the quality manage-ment of the outpatient Western medicine pharmacy in our hospital.

  14. Lasers in veterinary medicine: a review

    Science.gov (United States)

    Bartels, Kenneth E.

    1994-09-01

    As in other facets of medical science, the use of lasers in veterinary medicine is a relatively new phenomenon. Economic aspects of the profession as well as questionable returns on investment have limited laser applications primarily to the academic community, research institutions, and specialty practices. As technology improves and efficacy is proven, costs should decrease and allow further introduction of laser surgical and diagnostic devices into the mainstream of clinical veterinary medicine.

  15. Celebrating Leadership in Public Health and Medicine Friends of the National Library of Medicine (FNLM) | NIH ...

    Science.gov (United States)

    ... of this page please turn Javascript on. Celebrating Leadership in Public Health and Medicine Friends of the ... Hospital Dr. Braunwald was honored for his outstanding leadership and contributions to the world of cardiology as ...

  16. Early management of patients with acute heart failure: state of the art and future directions. A consensus document from the society for academic emergency medicine/heart failure society of America acute heart failure working group.

    Science.gov (United States)

    Collins, Sean; Storrow, Alan B; Albert, Nancy M; Butler, Javed; Ezekowitz, Justin; Felker, G Michael; Fermann, Gregory J; Fonarow, Gregg C; Givertz, Michael M; Hiestand, Brian; Hollander, Judd E; Lanfear, David E; Levy, Phillip D; Pang, Peter S; Peacock, W Frank; Sawyer, Douglas B; Teerlink, John R; Lenihan, Daniel J

    2015-01-01

    Heart failure (HF) afflicts nearly 6 million Americans, resulting in one million emergency department (ED) visits and over one million annual hospital discharges. An aging population and improved survival from cardiovascular diseases is expected to further increase HF prevalence. Emergency providers play a significant role in the management of patients with acute heart failure (AHF). It is crucial that emergency physicians and other providers involved in early management understand the latest developments in diagnostic testing, therapeutics and alternatives to hospitalization. Further, clinical trials must be conducted in the ED in order to improve the evidence base and drive optimal initial therapy for AHF. Should ongoing and future studies suggest early phenotype-driven therapy improves in-hospital and post-discharge outcomes, ED treatment decisions will need to evolve accordingly. The potential impact of future studies which incorporate risk-stratification into ED disposition decisions cannot be underestimated. Predictive instruments that identify a cohort of patients safe for ED discharge, while simultaneously addressing barriers to successful outpatient management, have the potential to significantly impact quality of life and resource expenditures.

  17. Academic Entitlement and Academic Performance in Graduating Pharmacy Students

    OpenAIRE

    Jeffres, Meghan N.; Barclay, Sean M.; Stolte, Scott K.

    2014-01-01

    Objectives. To determine a measurable definition of academic entitlement, measure academic entitlement in graduating doctor of pharmacy (PharmD) students, and compare the academic performance between students identified as more or less academically entitled.

  18. Starting a new residency program: a step-by-step guide for institutions, hospitals, and program directors

    Directory of Open Access Journals (Sweden)

    Michelle Barajaz

    2016-08-01

    Full Text Available Although our country faces a looming shortage of doctors, constraints of space, funding, and patient volume in many existing residency programs limit training opportunities for medical graduates. New residency programs need to be created for the expansion of graduate medical education training positions. Partnerships between existing academic institutions and community hospitals with a need for physicians can be a very successful means toward this end. Baylor College of Medicine and The Children's Hospital of San Antonio were affiliated in 2012, and subsequently, we developed and received accreditation for a new categorical pediatric residency program at that site in 2014. We share below a step-by-step guide through the process that includes building of the infrastructure, educational development, accreditation, marketing, and recruitment. It is our hope that the description of this process will help others to spur growth in graduate medical training positions.

  19. Starting a new residency program: a step-by-step guide for institutions, hospitals, and program directors.

    Science.gov (United States)

    Barajaz, Michelle; Turner, Teri

    2016-01-01

    Although our country faces a looming shortage of doctors, constraints of space, funding, and patient volume in many existing residency programs limit training opportunities for medical graduates. New residency programs need to be created for the expansion of graduate medical education training positions. Partnerships between existing academic institutions and community hospitals with a need for physicians can be a very successful means toward this end. Baylor College of Medicine and The Children's Hospital of San Antonio were affiliated in 2012, and subsequently, we developed and received accreditation for a new categorical pediatric residency program at that site in 2014. We share below a step-by-step guide through the process that includes building of the infrastructure, educational development, accreditation, marketing, and recruitment. It is our hope that the description of this process will help others to spur growth in graduate medical training positions.

  20. Starting a new residency program: a step-by-step guide for institutions, hospitals, and program directors.

    Science.gov (United States)

    Barajaz, Michelle; Turner, Teri

    2016-01-01

    Although our country faces a looming shortage of doctors, constraints of space, funding, and patient volume in many existing residency programs limit training opportunities for medical graduates. New residency programs need to be created for the expansion of graduate medical education training positions. Partnerships between existing academic institutions and community hospitals with a need for physicians can be a very successful means toward this end. Baylor College of Medicine and The Children's Hospital of San Antonio were affiliated in 2012, and subsequently, we developed and received accreditation for a new categorical pediatric residency program at that site in 2014. We share below a step-by-step guide through the process that includes building of the infrastructure, educational development, accreditation, marketing, and recruitment. It is our hope that the description of this process will help others to spur growth in graduate medical training positions. PMID:27507541