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Sample records for aggressive medical management

  1. Medical Management

    Science.gov (United States)

    ... email share facebook twitter google plus linkedin Medical Management Although there’s no cure for CMT, there are ... individualized physical therapy program. For more on medical management of CMT, see Surgery Sometimes, Bracing Often, Caution ...

  2. Individualizing management of aggressive fibromatoses

    International Nuclear Information System (INIS)

    Purpose: To examine prognostic indicators in aggressive fibromatoses that may be used to optimize case-specific management strategy. Methods and Materials: One hundred and seven fibromatoses presenting between 1971 and 1992 were analyzed. The following treatment modalities were utilized: (a) surgery alone for 51 tumors; (b) radiation alone for 15 tumors; and (c) radiation and surgery (combined modality) for 41 tumors. Outcome analysis was based on 5-year actuarial local control rates. Results: Control rates among surgery, radiation therapy, and combined modality groups were 69%, 93%, and 72%. Multivariate analysis identified age 60 Gy was seen in patients with unresected or gross residual disease. Of the patients, 23 with disease involving the plantar region had a control rate of 62%, with significantly worse outcomes in children. Conclusions: These results are consistent with those found in the relevent literature. They support primary resection with negative margins when feasible. Radiation is a highly effective alternative in situations where surgery would result in major functional or cosmetic defects. When negative surgical margins are not achieved in recurrent tumors, radiation is recommended. Perioperative radiation should be considered in other high-risk groups (recurrent disease, positive margins, and plantar tumors in young patients). Doses of 60-65 Gy for gross disease and 50-60 Gy for microscopic residual are recommended. Observation may be considered for primary tumors with disease remaining in situ when they are located such that progression would not cause significant morbidity. Although plantar lesions in children may represent a group at high risk for recurrence or aggressive behavior, the greater potential for radiation-induced morbidity in this group must also temper its use. Given the inconsistent nature and treatment response of this tumor, it is fundamental that treatment recommendations should be made based on the risk:benefit analysis for

  3. Management compensation, monitoring and aggressive corporate tax planning

    OpenAIRE

    Steinhoff, Melanie

    2015-01-01

    The empirical literature shows that management incentives often reduce corporate tax aggressiveness. Focussing on the riskiness of tax aggressiveness this paper offers one explanation for the observed negative relation. Using an agency framework, I analyze the manager's choice of effort dedication in other tasks and her explicit choice of the firm's tax risk. I show that corporate tax aggressiveness may decrease with compensation incentives. By choosing the tax risk, the manager (partly) dete...

  4. Medical waste management plan.

    Energy Technology Data Exchange (ETDEWEB)

    Lane, Todd W.; VanderNoot, Victoria A.

    2004-12-01

    This plan describes the process for managing research generated medical waste at Sandia National Laboratories/California. It applies to operations at the Chemical and Radiation Detection Laboratory (CRDL), Building 968, and other biosafety level 1 or 2 activities at the site. It addresses the accumulation, storage, treatment and disposal of medical waste and sharps waste. It also describes the procedures to comply with regulatory requirements and SNL policies applicable to medical waste.

  5. Medical and Health Services Managers

    Science.gov (United States)

    ... SITE MAP | EN ESPAÑOL Management > Medical and Health Services Managers PRINTER-FRIENDLY EN ESPAÑOL Summary What They ... occupations. What They Do -> What Medical and Health Services Managers Do About this section In group medical ...

  6. Managing Your COPD Medications

    Science.gov (United States)

    ... Lookup > COPD > Diagnosing and Treating COPD Managing Your COPD Medications There are a variety of medicines available ... are the types of medicines usually prescribed for COPD: Bronchodilators Bronchodilators relax the muscles around your airways, ...

  7. Management Strategies for Aggressive Cushing's Syndrome: From Macroadenomas to Ectopics

    Directory of Open Access Journals (Sweden)

    Carlotta Pozza

    2012-01-01

    Full Text Available Cushing’s syndrome (CS is a rare but severe clinical condition represented by an excessive endogenous cortisol secretion and hence excess circulating free cortisol, characterized by loss of the normal feedback regulation and circadian rhythm of the hypothalamic-pituitary axis due to inappropriate secretion of ACTH from a pituitary tumor (Cushing’s disease, CD or an ectopic source (ectopic ACTH secretion, EAS. The remaining causes (20% are ACTH independent. As soon as the diagnosis is established, the therapeutic goal is the removal of the tumor. Whenever surgery is not curative, management of patients with CS requires a major effort to control hypercortisolemia and associated symptoms. A multidisciplinary approach that includes endocrinologists, neurosurgeons, oncologists, and radiotherapists should be adopted. This paper will focus on traditional and novel medical therapy for aggressive ACTH-dependent CS. Several drugs are able to reduce cortisol levels. Their mechanism of action involves blocking adrenal steroidogenesis (ketoconazole, metyrapone, aminoglutethimide, mitotane, etomidate or inhibiting the peripheral action of cortisol through blocking its receptors (mifepristone “RU-486”. Other drugs include centrally acting agents (dopamine agonists, somatostatin receptor agonists, retinoic acid, peroxisome proliferator-activated receptor γ “PPAR-γ” ligands and novel chemotherapeutic agents (temozolomide and tyrosine kinase inhibitors which have a significant activity against aggressive pituitary or ectopic tumors.

  8. Radio nuclear aggression. Psychological impact and management

    International Nuclear Information System (INIS)

    Long before possible organic effects, exposure to ionizing radiations can provoke anxiety. In front of invisibility, the imagination quickly ignites. The terrorists have perfectly understood it. They are ready to use ionizing radiations as a weapon to remind traumatic images deeply rooted in people's memory. These images induce anxiety with all the clinical expressions connected to it. These symptoms require to be treated because of a possible anarchic development. For that purpose, plans have been elaborated to coordinate the different professional's actions. The coherence of medical management and communication aims to allow the most implicated people to find the way to face the events. When it is not possible, medico-psychological cells permit a specialized care. (author)

  9. Medical Information Management System

    Science.gov (United States)

    Alterescu, S.; Hipkins, K. R.; Friedman, C. A.

    1979-01-01

    On-line interactive information processing system easily and rapidly handles all aspects of data management related to patient care. General purpose system is flexible enough to be applied to other data management situations found in areas such as occupational safety data, judicial information, or personnel records.

  10. [Quality management in medical laboratories].

    Science.gov (United States)

    Fritzer-Szekeres, M

    2010-05-01

    During the 20th century understanding for quality has changed and international and national requirements for quality have been published. Therefore also medical branches started to establish quality management systems. Quality assurance has always been important for medical laboratories. Certification according to the standard ISO 9001 and accreditation according to the standard ISO 17025 have been the proof of fulfilling quality requirements. The relatively new standard ISO 15189 is the first standard for medical laboratories. This standard includes technical and management requirements for the medical laboratory. The main focus is the proof of competence within the personnel. As this standard is accepted throughout the European Union an increase in accreditations of medical laboratories is predictable. PMID:20454753

  11. Medical-Information-Management System

    Science.gov (United States)

    Alterescu, Sidney; Friedman, Carl A.; Frankowski, James W.

    1989-01-01

    Medical Information Management System (MIMS) computer program interactive, general-purpose software system for storage and retrieval of information. Offers immediate assistance where manipulation of large data bases required. User quickly and efficiently extracts, displays, and analyzes data. Used in management of medical data and handling all aspects of data related to care of patients. Other applications include management of data on occupational safety in public and private sectors, handling judicial information, systemizing purchasing and procurement systems, and analyses of cost structures of organizations. Written in Microsoft FORTRAN 77.

  12. Medication management in the making

    DEFF Research Database (Denmark)

    Andersen, Tariq Osman

    2013-01-01

    show this by the case of how the concept of 'medication management' has been performed differently on a combined CSCW and participatory design project in healthcare. It is suggested that through design interventions with working prototypes; prospective analysis and participatory design can be...

  13. Accounting for Medication Particularities: Designing for Everyday Medication Management

    DEFF Research Database (Denmark)

    Dalgaard, Lea Gulstav; Grönvall, Erik; Verdezoto, Nervo

    2013-01-01

    Several projects have shown that self-management of medication in private homes can be challenging. Many projects focused on specific illness-related approaches (e.g. diabetes) or practical issues such as how to handle medication while travelling. However, designing for everyday medication...... management involves more than just specific illness-related strategies and should take into account the broad set of activities conforming people’s everyday life. This study investigates how older adults manage their medication in everyday life. To inform the design of pervasive healthcare medication...... management systems (PHMMS), the study calls for attention to medication-specific particularities that account for: according to need medication, the heterogeneous care network, the substitute medication, the medication informational order, the shared responsibility and the adjustment of medication intake...

  14. Medical management of radiation emergencies

    International Nuclear Information System (INIS)

    This review deals specifically with the medical management of victims, such as, the triage of exposed individuals on the basis of preliminary observations and investigations, planning priority of treatment to different groups, emergency care, and definitive care. The infrastructure for appropriate management involves first aid posts, decontamination centre, Site Hospital and Specialized Central Hospital. Medical management of life threatening radiation doses involve haematological examinations, blood component therapy, treatment with growth factors and if necessary, bone marrow transplantation as the last option. Most of the radiation accidents involving partial body and localized exposures are associated with industrial radiography sources. Such exposures are generally not life threatening but may involve serious skin injury, such as, ulceration, necrosis and gangrene. Methods have been developed to carry out decontamination of skin and decorporation of internally deposited radio nuclides. This article also provides information on the Radiation Emergency Medical Preparedness and Assistance Network and also outlines the role of media in reducing the human suffering in the event of an accident

  15. Mindfulness-based program for management of aggression among youth: A follow-up study

    Directory of Open Access Journals (Sweden)

    Manoj Kumar Sharma

    2016-01-01

    Full Text Available Background: Youth have shown indulgence in various high-risk behaviors and violent activities. Yoga-based approaches have been used for the management of psychological problems. The present work explores the role of mindfulness-based program in the management of aggression among youth. Materials and Methods: Sociodemographic information schedule, Buss-Perry Aggression Questionnaire, and World Health Organization quality of life were administered on 50 subjects in the age range of 18-25 years at pre- and post-mindfulness-based program level. Results: It revealed the presence of feeling of well-being and ability to relax themselves; changes in score of anger, hostility, physical, and verbal aggression; and enhancement of quality of life in the physical and environment domains at 1 month follow-up. Conclusions: Mindfulness-based program has shown changes in aggression expression/control and implies integration of it in available program for the management of aggression among youth.

  16. The management of adult aggressive non-Hodgkin's lymphomas.

    Science.gov (United States)

    Couderc, B; Dujols, J P; Mokhtari, F; Norkowski, J L; Slawinski, J C; Schlaifer, D

    2000-07-01

    Aggressive non-Hodgkin's lymphona include diffuse large B-cell lymphoma, anaplastic large cell lymphona, and different peripheral T-cell lymphomas. An international prognostic index has been developed including age, serum LDH, performance status, and extranodal involvement. For localized aggressive lymphoma, the preferred treatment is 3-4 CHOP and radiation therapy, with a cure rate of 70-80%. For disseminated aggressive lymphoma, current regimens have a cure rate of less than 40%. Innovative strategies, including dose escalation, autologus stem cell support, new drugs, and immunotherapy are being explored to improve these results. PMID:10863150

  17. Effectiveness of an Afterschool-Based Aggression Management Program for Elementary Students

    Science.gov (United States)

    Staecker, Emma; Puett, Eli; Afrassiab, Shayda; Ketcherside, Miranda; Azim, Sabiya; Rhodes, Darson; Wang, Anna

    2016-01-01

    A school-community partnership team implemented an aggression management curriculum in an afterschool program as an early-intervention strategy at the upper elementary level. Although statistically significant differences in physical or psychological aggression were not found, the partnership team gained a better understanding of evidence-based…

  18. MIMS - MEDICAL INFORMATION MANAGEMENT SYSTEM

    Science.gov (United States)

    Frankowski, J. W.

    1994-01-01

    MIMS, Medical Information Management System is an interactive, general purpose information storage and retrieval system. It was first designed to be used in medical data management, and can be used to handle all aspects of data related to patient care. Other areas of application for MIMS include: managing occupational safety data in the public and private sectors; handling judicial information where speed and accuracy are high priorities; systemizing purchasing and procurement systems; and analyzing organizational cost structures. Because of its free format design, MIMS can offer immediate assistance where manipulation of large data bases is required. File structures, data categories, field lengths and formats, including alphabetic and/or numeric, are all user defined. The user can quickly and efficiently extract, display, and analyze the data. Three means of extracting data are provided: certain short items of information, such as social security numbers, can be used to uniquely identify each record for quick access; records can be selected which match conditions defined by the user; and specific categories of data can be selected. Data may be displayed and analyzed in several ways which include: generating tabular information assembled from comparison of all the records on the system; generating statistical information on numeric data such as means, standard deviations and standard errors; and displaying formatted listings of output data. The MIMS program is written in Microsoft FORTRAN-77. It was designed to operate on IBM Personal Computers and compatibles running under PC or MS DOS 2.00 or higher. MIMS was developed in 1987.

  19. A multistage mechanism for managing aggressive flows in the next generation internet

    OpenAIRE

    D. Lanzi

    2001-01-01

    In this note, we provide a multistage game form which may be used for managing aggressive flows which may cause network congestion or monopolisation. The mechanism here presented attains economic efficiency, technical efficiency and other desirable properties.

  20. Medical management of venous ulcers.

    Science.gov (United States)

    Pascarella, Luigi; Shortell, Cynthia K

    2015-03-01

    Venous disease is the most common cause of chronic leg ulceration and represents an advanced clinical manifestation of venous insufficiency. Due to their frequency and chronicity, venous ulcers have a high socioeconomic impact, with treatment costs accounting for 1% of the health care budget in Western countries. The evaluation of patients with venous ulcers should include a thorough medical history for prior deep venous thrombosis, assessment for an hypercoagulable state, and a physical examination. Use of the CEAP (clinical, etiology, anatomy, pathophysiology) Classification System and the revised Venous Clinical Severity Scoring System is strongly recommended to characterize disease severity and assess response to treatment. This venous condition requires lifestyle modification, with affected individuals performing daily intervals of leg elevation to control edema; use of elastic compression garments; and moderate physical activity, such as walking wearing below-knee elastic stockings. Meticulous skin care, treatment of dermatitis, and prompt treatment of cellulitis are important aspects of medical management. The pharmacology of chronic venous insufficiency and venous ulcers include essentially two medications: pentoxifylline and phlebotropic agents. The micronized purified flavonoid fraction is an effective adjunct to compression therapy in patients with large, chronic ulceration. PMID:26358306

  1. The use of liquid nitrogen cryotherapy in the management of locally aggressive bone lesions.

    Science.gov (United States)

    Pogrel, M A

    1993-03-01

    Cryosurgery has a unique role in the management of locally aggressive osseous lesions. By using a combination of enucleation and cryosurgery to devitalize the surrounding bone, the need for segmental mandibular resection is decreased. This article reviews 37 cases managed successfully in this manner. PMID:8445469

  2. Subtypes of Aggression in Children with Attention Deficit Hyperactivity Disorder: Medication Effects and Comparison with Typical Children

    Science.gov (United States)

    King, Sara; Waschbusch, Daniel A.; Pelham, William E.; Frankland, Bradley W.; Corkum, Penny V.; Jacques, Sophie

    2009-01-01

    We examined aggressive behavior in 6- to 12-year-old children, including 20 children with attention deficit hyperactivity disorder (ADHD) on stimulant medication, 19 children with ADHD on placebo (n = 19), and 32 controls. Children completed a laboratory provocation task designed to measure hostile, instrumental, reactive, and proactive…

  3. Medical response and management of radiation accidents

    International Nuclear Information System (INIS)

    An overview is provided of educational programs and principles essential to the appropriate medical management of radiation accident victims. Such an education program will provide details of the physical properties of radiation, of the sources of radiation exposure, of radiation protection standards and of biological radiation effects. The medical management of individuals involved in radiation accidents is discussed. Such management includes emergency medical stabilization, locating and quantitating the level and degree of internal and/or external contamination, wound decontamination, medical surveillance and the evaluation and treatment of local radiation injuries

  4. Intraoperative Electron Radiotherapy for the Management of Aggressive Fibromatosis

    International Nuclear Information System (INIS)

    Purpose: We analyzed our experience with intraoperative electron radiotherapy (IOERT) followed by moderate doses of external beam radiotherapy (EBRT) after organ-sparing surgery in patients with primary or recurrent aggressive fibromatosis. Methods and Materials: Indication for IOERT and postoperative EBRT as an individual treatment approach to avoid mutilating surgical procedures was seen when complete surgical removal seemed to be unlikely or impossible. A total of 31 lesions in 30 patients were treated by surgery and IOERT with a median dose of 12 Gy. Median age was 31 years (range, 13-59 years). Resection status was close margin in six lesions, microscopically positive in 13, and macroscopically positive in 12. Median tumor size was 9 cm. In all, 25 patients received additional EBRT, with a median dose of 45 Gy (range, 36-54 Gy). Results: After a median follow-up of 32 months (range, 3-139 months), no disease-related deaths occurred. A total of five local recurrences were seen, resulting in actuarial 3-year local control rates of 82% overall and 91% inside the IOERT areas. Trends to improved local control were seen for older age (>31 years) and negative margins, but none of these factors reached significance. Perioperative complications were found in six patients, in particular as wound healing disturbances in five patients and venous thrombosis in one patient. Late toxicity was seen in five patients. Conclusion: Introduction of IOERT into a multimodal treatment approach in patients with aggressive fibromatosis is feasible with low toxicity and yielded good local control rates even in patients with microscopical or gross residual disease.

  5. Aggression on inpatient units: Clinical characteristics and consequences.

    Science.gov (United States)

    Renwick, Laoise; Stewart, Duncan; Richardson, Michelle; Lavelle, Mary; James, Karen; Hardy, Claire; Price, Owen; Bowers, Len

    2016-08-01

    Aggression and violence are widespread in UK Mental Health Trusts, and are accompanied by negative psychological and physiological consequences for both staff and other patients. Patients who are younger, male, and have a history of substance use and psychosis diagnoses are more likely to display aggression; however, patient factors are not solely responsible for violence, and there are complex circumstances that lead to aggression. Indeed, patient-staff interactions lead to a sizeable portion of aggression and violence on inpatient units, thus they cannot be viewed without considering other forms of conflict and containment that occur before, during, and after the aggressive incident. For this reason, we examined sequences of aggressive incidents in conjunction with other conflict and containment methods used to explore whether there were particular profiles to aggressive incidents. In the present study, 522 adult psychiatric inpatients from 84 acute wards were recruited, and there were 1422 incidents of aggression (verbal, physical against objects, and physical). Cluster analysis revealed that aggressive incident sequences could be classified into four separate groups: solo aggression, aggression-rule breaking, aggression-medication, and aggression-containment. Contrary to our expectations, we did not find physical aggression dominant in the aggression-containment cluster, and while verbal aggression occurred primarily in solo aggression, physical aggression also occurred here. This indicates that the management of aggression is variable, and although some patient factors are linked with different clusters, these do not entirely explain the variation. PMID:26892149

  6. Successful medical management of neutropenic enterocolitis

    Energy Technology Data Exchange (ETDEWEB)

    Gandy, W.; Greenberg, B.R.

    1983-04-15

    The medical management of neutropenic enterocolitis has been associated with a 100% mortality rate according to recent reports. This report describes two cases which were successfully managed without colonic resection. In one case, /sup 67/Ga radionuclide scanning was utilized as an aid in the diagnosis. The incidence, pathogenesis, diagnosis, and previously reported cases of medical management of neutropenic enterocolitis are reviewed, and the role of granulocyte transfusions and /sup 67/Ga scanning are discussed.

  7. Should I fight or should I flight? How studying insect aggression can help integrated pest management.

    Science.gov (United States)

    Benelli, Giovanni

    2015-07-01

    Aggression plays a key role all across the animal kingdom, as it allows the acquisition and/or defence of limited resources (food, mates and territories) in a huge number of species. A large part of our knowledge on aggressive behaviour has been developed on insects of economic importance. How can this knowledge be exploited to enhance integrated pest management? Here, I highlight how knowledge on intraspecific aggression can help IPM both in terms of insect pests (with a focus on the enhancement of the sterile insect technique) and in terms of biological control agents (with a focus on mass-rearing optimisation). Then, I examine what implications for IPM can be outlined from knowledge about interspecific aggressive behaviour. Besides predator-pest aggressive interactions predicted by classic biological control, I focus on what IPM can learn from (i) interspecific aggression among pest species (with special reference to competitive displacement), (ii) defensive behaviour exhibited by prey against predaceous insects and (iii) conflicts among predaceous arthropods sharing the same trophic niche (with special reference to learning/sensitisation practices and artificial manipulation of chemically mediated interactions). PMID:25582991

  8. Medication management during electroconvulsant therapy

    Directory of Open Access Journals (Sweden)

    Zolezzi M

    2016-04-01

    Full Text Available Monica Zolezzi Clinical Pharmacy and Practice, College of Pharmacy, Qatar University, Doha, Qatar Abstract: Electroconvulsive therapy (ECT has demonstrated to be highly effective and safe, even life saving for many psychiatric disorders such as major depression, bipolar disorder and schizophrenia. Most patients who require ECT are also on concurrent pharmacotherapy. As such, the objective of this article is to provide a review of the most recent literature focusing on the medications used during an ECT procedure and on the effects of concurrent psychiatric and non-psychiatric medications on the effectiveness and safety of ECT. The review also attempts to summarize the recommendations derived from existing documents to guide pharmacotherapy decisions for patients undergoing ECT. For this purpose, using electronic databases, an extensive search of the current literature was made using ECT and medications or drug classes as keywords. Keywords: ECT, medications, drug interactions

  9. The Best Friendships of Aggressive Boys: Relationship Quality, Conflict Management, and Rule-Breaking Behavior

    Science.gov (United States)

    Bagwell, Catherine L.; Coie, John D.

    2004-01-01

    The current study examined the best friendships of aggressive and nonaggressive boys (N=96 boys, 48 dyads, mean age=10.6 years). Friends completed self-report measures of friendship quality, and their interactions were observed in situations that required conflict management and provided opportunities for rule-breaking behavior. Although there…

  10. Medication management during electroconvulsant therapy.

    Science.gov (United States)

    Zolezzi, Monica

    2016-01-01

    Electroconvulsive therapy (ECT) has demonstrated to be highly effective and safe, even life saving for many psychiatric disorders such as major depression, bipolar disorder and schizophrenia. Most patients who require ECT are also on concurrent pharmacotherapy. As such, the objective of this article is to provide a review of the most recent literature focusing on the medications used during an ECT procedure and on the effects of concurrent psychiatric and non-psychiatric medications on the effectiveness and safety of ECT. The review also attempts to summarize the recommendations derived from existing documents to guide pharmacotherapy decisions for patients undergoing ECT. For this purpose, using electronic databases, an extensive search of the current literature was made using ECT and medications or drug classes as keywords. PMID:27143894

  11. Medication management during electroconvulsant therapy

    Science.gov (United States)

    Zolezzi, Monica

    2016-01-01

    Electroconvulsive therapy (ECT) has demonstrated to be highly effective and safe, even life saving for many psychiatric disorders such as major depression, bipolar disorder and schizophrenia. Most patients who require ECT are also on concurrent pharmacotherapy. As such, the objective of this article is to provide a review of the most recent literature focusing on the medications used during an ECT procedure and on the effects of concurrent psychiatric and non-psychiatric medications on the effectiveness and safety of ECT. The review also attempts to summarize the recommendations derived from existing documents to guide pharmacotherapy decisions for patients undergoing ECT. For this purpose, using electronic databases, an extensive search of the current literature was made using ECT and medications or drug classes as keywords. PMID:27143894

  12. Medical management of mass radiological casualties

    International Nuclear Information System (INIS)

    Full text: Radiation accidents, are extreme situations involving one or many individuals. The general public and also emergency workers could be overexposed to radiation or be contaminated as a consequence of malicious acts involving radioactive material. The international view is that the likelihood of use of radiological and nuclear terrorism is low, but the impact could be high. This represents a new challenge for emergency responders and medical community. Without adequate preparedness for radiation emergencies, medical management of situation could be ineffective. Experience has shown that in many radiation emergencies, the severity and extent of the health consequences could be restricted by general response and, in particular medical triage. This article looks at the medical management of radiation accidents to derive principles for organizing and acting the medical community in cases of mass radiation accidents

  13. [The Traceability Management for Qualification Documents of Medical Instruments].

    Science.gov (United States)

    Tang, Guoping; Hu, Liang; Xu, Xia; Fang, Zhiqiang; Hu, Juan

    2016-01-01

    The management for qualification documents of medical instruments is very important work to management department of medical instruments. Because the number of qualification documents of medical instruments is very large and they have an expiry date, it is difficult to manage them. This article discussed how to manage qualification documents of medical instruments, and an information management system that has a function of traceability management has been developed. This information management system standardizes management for qualification documents of medical instruments, and ensures that qualification documents of medical instruments are available and can be traced. Besides, it can reduce the amount of work for medical instruments management. PMID:27197505

  14. Medical management of nuclear disaster

    International Nuclear Information System (INIS)

    This report briefly describes the measures to be taken other than ordinary duties when an accident happens in nuclear facilities such as atomic power plant, reprocessing plant, etc. Such nuclear disasters are assigned into four groups; (1) accidents in industrial levels, (2) accidents in which the workers are implicated, (3) accidents of which influence to environments should be taken into consideration and (4) accidents to which measures for inhabitants should be taken. Therefore, the measures to be taken at an emergency were also grouped in the following four; (1) treatments for the accident, itself, (2) measures to minimize the effects on the environment, (3) rescues of the victims and emergency cares for them and (4) measures and medical cares to protect the inhabitants from radiation exposure. Presently, medical professionals, especially doctors, nurses etc. are not accustomed to control nuclear contaminations. Therefore, it is needed for radiological professionals to actively provide appropriate advises about the control and measurement of contamination. (M.N.)

  15. Medical management of nuclear disaster

    Energy Technology Data Exchange (ETDEWEB)

    Kinugasa, Tatsuya [Mitsubishi Heavy Industries Ltd., Tokyo (Japan)

    1996-12-01

    This report briefly describes the measures to be taken other than ordinary duties when an accident happens in nuclear facilities such as atomic power plant, reprocessing plant, etc. Such nuclear disasters are assigned into four groups; (1) accidents in industrial levels, (2) accidents in which the workers are implicated, (3) accidents of which influence to environments should be taken into consideration and (4) accidents to which measures for inhabitants should be taken. Therefore, the measures to be taken at an emergency were also grouped in the following four; (1) treatments for the accident, itself, (2) measures to minimize the effects on the environment, (3) rescues of the victims and emergency cares for them and (4) measures and medical cares to protect the inhabitants from radiation exposure. Presently, medical professionals, especially doctors, nurses etc. are not accustomed to control nuclear contaminations. Therefore, it is needed for radiological professionals to actively provide appropriate advises about the control and measurement of contamination. (M.N.)

  16. Medical management of paraquat ingestion

    OpenAIRE

    Gawarammana, Indika B; Buckley, Nicholas A.

    2011-01-01

    Poisoning by paraquat herbicide is a major medical problem in parts of Asia while sporadic cases occur elsewhere. The very high case fatality of paraquat is due to inherent toxicity and lack of effective treatments. We conducted a systematic search for human studies that report toxicokinetics, mechanisms, clinical features, prognosis and treatment. Paraquat is rapidly but incompletely absorbed and then largely eliminated unchanged in urine within 12–24 h. Clinical features are largely due to ...

  17. Medication management during electroconvulsant therapy

    OpenAIRE

    Zolezzi M

    2016-01-01

    Monica Zolezzi Clinical Pharmacy and Practice, College of Pharmacy, Qatar University, Doha, Qatar Abstract: Electroconvulsive therapy (ECT) has demonstrated to be highly effective and safe, even life saving for many psychiatric disorders such as major depression, bipolar disorder and schizophrenia. Most patients who require ECT are also on concurrent pharmacotherapy. As such, the objective of this article is to provide a review of the most recent literature focusing on the medication...

  18. Stress Management Training in Medical School.

    Science.gov (United States)

    Kelly, Jeffrey A.; And Others

    1982-01-01

    An effort to teach medical students practical stress management skills is discussed. A group of students volunteered to participate in a six-session program that taught them personal stress management techniques including self-relaxation training, schedule-planning, priority-setting, leisure time-planning, and cognitive modification techniques.…

  19. Medical equipment maintenance management and oversight

    CERN Document Server

    Wang, Binseng

    2012-01-01

    In addition to being essential for safe and effective patient care, medical equipment also has significant impact on the income and, thus, vitality of healthcare organizations. For this reason, its maintenance and management requires careful supervision by healthcare administrators, many of whom may not have the technical background to understand all of the relevant factors. This book presents the basic elements of medical equipment maintenance and management required of healthcare leaders responsible for managing or overseeing this function. It will enable these individuals to understand thei

  20. Medical leadership and management: An international revolution

    Directory of Open Access Journals (Sweden)

    Alex Till

    2015-01-01

    Full Text Available Medical leadership and management are increasingly receiving widespread attention internationally. Significant focus has been paid as to the style of leadership within healthcare and how to develop both leadership and management skills and competencies (the two are inseparable yet distinct throughout the careers of all healthcare professionals. This article discusses how leadership and management development is being considered internationally, both at an organisational and personal level, helpful models and frameworks and challenges and opportunities.

  1. Testing Effectiveness of a Community-Based Aggression Management Program for Children 7 to 11 Years Old and Their Families.

    Science.gov (United States)

    Lipman, Ellen L.; Boyle, Michael H.; Cunningham, Charles; Kenny, Meghan; Sniderman, Carrie; Duku, Eric; Mills, Brenda; Evans, Peter; Waymouth, Marjorie

    2006-01-01

    Objective: There are few well-evaluated uncomplicated community-based interventions for childhood aggression. The authors assess the impact of a community-based anger management group on child aggressive behaviors, using a randomized, controlled trial (RCT). Method: Families with children 7 to 11 years old were recruited through advertisements and…

  2. Management accounting versus medical profession discourse

    DEFF Research Database (Denmark)

    Malmmose, Margit

    2015-01-01

    This study uses discourse, ideology and hegemony as a theoretical foundation to investigate the development of the polarised discourses of management accounting and the medical profession during the introduction of a NPM reform in the public health care debate, using Denmark as a case study. 194...... newspaper articles and 73 medical profession articles from 2002 to 2008 are analysed, using critical discourse analysis. The analysis shows that the management accounting discourse becomes the dominating ideology which is embedded in the public rhetorical debate. There are three peculiar outcomes of this...... perspective of a patient oriented focus to a quantitative focus through strong rationalised arguments. This puts the medical profession in a dilemma concerning their ideological Hippocratic Oath versus the NPM efficiency focus. However, they choose to gradually adopt management accounting terms in their own...

  3. Aggression in Tephritidae Flies: Where, When, Why? Future Directions for Research in Integrated Pest Management.

    Science.gov (United States)

    Benelli, Giovanni

    2014-01-01

    True fruit flies (Diptera: Tephritidae) include over 4000 species, many of which constitute enormous threats to fruit and vegetable production worldwide. A number of Tephritidae are lekking species, forming aggregations in which males fight to defend a small territory where they court females and mate. Male-male contests also occur in non-lekking species, characterized by resource defense polygyny. Tephritidae females display agonistic behavior to maintain single oviposition sites and reduce larval competition for food. Here, how, where, when and why aggressive interactions occur in Tephritidae flies is reviewed. A number of neglected issues deserving further research are highlighted, with a special focus on diel periodicity of aggression, cues evoking aggressive behavior, the role of previous experience on fighting success and the evolution of behavioral lateralization of aggressive displays. In the final section, future directions to exploit this knowledge in Integrated Pest Management, with particular emphasis on enhancement of Sterile Insect Technique and interspecific competitive displacement in the field are suggested. PMID:26463064

  4. Aggression in Tephritidae Flies: Where, When, Why? Future Directions for Research in Integrated Pest Management

    Directory of Open Access Journals (Sweden)

    Giovanni Benelli

    2014-12-01

    Full Text Available True fruit flies (Diptera: Tephritidae include over 4000 species, many of which constitute enormous threats to fruit and vegetable production worldwide. A number of Tephritidae are lekking species, forming aggregations in which males fight to defend a small territory where they court females and mate. Male-male contests also occur in non-lekking species, characterized by resource defense polygyny. Tephritidae females display agonistic behavior to maintain single oviposition sites and reduce larval competition for food. Here, how, where, when and why aggressive interactions occur in Tephritidae flies is reviewed. A number of neglected issues deserving further research are highlighted, with a special focus on diel periodicity of aggression, cues evoking aggressive behavior, the role of previous experience on fighting success and the evolution of behavioral lateralization of aggressive displays. In the final section, future directions to exploit this knowledge in Integrated Pest Management, with particular emphasis on enhancement of Sterile Insect Technique and interspecific competitive displacement in the field are suggested.

  5. Medical management of radioactive contamination

    International Nuclear Information System (INIS)

    With increasing use of radiation in agriculture, medicine, industry and power generation, the chances of coming across radiation injury, though remote, is not impossible. It is, therefore prudent to gain an insight into the field of management of conditions arising out of radiation exposures. The injuries can occur as a result of exposure to radiation (irradiation) or as a result of contamination. Contamination may be external (deposition of radioactive material on clothing, skin or hair) or internal (internal deposition through inhalation, ingestion or through intact skin or wound)

  6. Medical management of chronic pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Dhiraj Yadav; Jonathan E. Clain

    2003-01-01

    慢性胰腺炎的临床表现包括疼痛、脂肪泻和糖尿病.在西方国家,慢性胰腺炎最常见的病因是酗酒.70%以上的病人在就诊时有疼痛的临床表现,而且,这些患者中又有75%以上会在几年之后出现疼痛减轻或完全消失.对于所有的慢性胰腺炎的病人来说,均应排除非胰源性疼痛和胆道梗阻、胰腺假性囊肿等胰腺局部并发症.应建议所有慢性胰腺炎病人戒烟、戒酒.阿片类镇痛剂仅应用于治疗疼痛严重的病人.尽管有报道认为胰酶替代治疗有助于止痛,但是,对于已经确诊的慢性胰腺炎病人来说,该疗法无效.激素类药物进行腹腔神经丛阻滞术可能有助于病人度过剧烈疼痛期.顽固性疼痛是进行胰液引流或胰腺切除的适应证.建议应用适量胰酶替代联合(或不联合)制酸剂治疗营养不良.慢性胰腺炎导致的糖尿病与原发性糖尿病的治疗原则相似.%The clinical presentation of chronic pancreatitis includes pain, steatorrhea and diabetes. The most common etiology in the western world is excess alcohol use. Pain is present in >70% patients at presentation and decreases in intensity or resolves over several years in up to 75% of patients. Non-pancreatic causes of pain and local complications, chiefly pseudocysts and biliary obstruction should be excluded in all patients. All patients should be advised to abstain from alcohol and smoking and opiates should be used only to control severe exacerbations of pain. Although pancreatic enzyme replacement is reported to be useful in the management of pancreatic pain, it is of little or no benefit in patients with established chronic pancreatitis. Celiac plexus block using steroids may be helpful to tide patients over an episode of severe pain. Intractable pain is an indication for surgery that includes pancreatic drainage procedure or pancreatic resection. For control of malabsorption, adequate pancreatic enzyme replacement with or

  7. Medical technology management: from planning to application.

    Science.gov (United States)

    David, Y; Jahnke, E

    2005-01-01

    Appropriate deployment of technological innovation contributes to improvement in the quality of healthcare delivered, the containment of cost, and access to the healthcare system. Hospitals have been allocating a significant portion of their resources to procuring and managing capital assets; they are continuously faced with demands for new medical equipment and are asked to manage existing inventory for which they are not well prepared. To objectively manage their investment, hospitals are developing medical technology management programs that need pertinent information and planning methodology for integrating new equipment into existing operations as well as for optimizing costs of ownership of all equipment. Clinical engineers can identify technological solutions based on the matching of new medical equipment with hospital's objectives. They can review their institution's overall technological position, determine strengths and weaknesses, develop equipment-selection criteria, supervise installations, train users and monitor post procurement performance to assure meeting of goals. This program, together with cost accounting analysis, will objectively guide the capital assets decision-making process. Cost accounting analysis is a multivariate function that includes determining the amount, based upon a strategic plan and financial resources, of funding to be allocated annually for medical equipment acquisition and replacement. Often this function works closely with clinical engineering to establish equipment useful life and prioritization of acquisition, upgrade, and replacement of inventory within budget confines and without conducting time consuming, individual financial capital project evaluations. PMID:17282142

  8. 21 CFR 880.6315 - Remote Medication Management System.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Remote Medication Management System. 880.6315... Miscellaneous Devices § 880.6315 Remote Medication Management System. (a) Identification. A remote medication management system is a device composed of clinical and communications software, a medication delivery...

  9. Medical management of chronic rhinosinusitis - an update.

    Science.gov (United States)

    Schwartz, Joseph S; Tajudeen, Bobby A; Cohen, Noam A

    2016-05-01

    Chronic rhinosinusitis (CRS) is an epidemiologically important, chronic inflammatory disease process affecting the paranasal sinuses with significant and extensively reported economic implications. Despite an elusive pathophysiologic mechanism underlying this disease process, treatment outcomes are encouraging with the employment of an array of medical and surgical therapies. The goal of this paper is to provide a comprehensive, up to date analysis of the literature concerning the medical management of CRS by highlighting the most recent evidence based recommendations addressing this ongoing field of research. PMID:26849215

  10. In-Flight Personalized Medication Management

    Science.gov (United States)

    Peletskaya, E.; Griko, Y. V.

    2016-01-01

    , technologies capable of predicting and managing medication side effects, interactions, and toxicity of drugs during spaceflight are needed. We propose to develop and customize for NASAs applications available on the market Personalized Prescribing System (PPS) that would provide a comprehensive, non-invasive solution for safer, targeted medication management for every crew member resulting in safer and more effective treatment and, consequently, better performance. PPS will function as both decision support and record-keeping tool for flight surgeons and astronauts in applying the recommended medications for situations arising in flight. The information on individual drug sensitivity will translate into personalized risk assessment for adverse drug reactions and treatment failures for each drug from the medication kit as well as predefined outcome of any combination of them. Dosage recommendations will also be made individually. The mobile app will facilitate ease of use by crew and medical professionals during training and flight missions.

  11. Assessment of obesity management in medical examination

    Directory of Open Access Journals (Sweden)

    Treyzon Leo

    2005-03-01

    Full Text Available Abstract Obesity is a growing international health problem that has already reached epidemic proportions, particularly within the United States where a majority of the population is overweight or obese. Effective methods of treatment are needed, and should be taught to physicians by efficient means. There exists a disconnect between the rising obesity prevalence with its high toll on medical resources, and the lack of obesity education provided to practitioners in the course of their training. One particular shortfall is the lack of representation of obesity on standardized medical examinations. Physician attitudes toward obesity are influenced by their lack of familiarity with the management of the disease. This may include dietary restriction, increasing physical activity, behavior modification, pharmacotherapy, and surgical interventions. Thus, curricular changes in the medical education of obesity could help reduce morbidity and mortality associated with this disease.

  12. Thru-life impacts of driver aggression, climate, cabin thermal management, and battery thermal management on battery electric vehicle utility

    Science.gov (United States)

    Neubauer, Jeremy; Wood, Eric

    2014-08-01

    Battery electric vehicles (BEVs) offer the potential to reduce both oil imports and greenhouse gas emissions, but have a limited utility that is affected by driver aggression and effects of climate-both directly on battery temperature and indirectly through the loads of cabin and battery thermal management systems. Utility is further affected as the battery wears through life in response to travel patterns, climate, and other factors. In this paper we apply the National Renewable Energy Laboratory's Battery Lifetime Analysis and Simulation Tool for Vehicles (BLAST-V) to examine the sensitivity of BEV utility to driver aggression and climate effects over the life of the vehicle. We find the primary challenge to cold-climate BEV operation to be inefficient cabin heating systems, and to hot-climate BEV operation to be high peak on-road battery temperatures and excessive battery degradation. Active cooling systems appear necessary to manage peak battery temperatures of aggressive, hot-climate drivers, which can then be employed to maximize thru-life vehicle utility.

  13. Medical management and planning for radiation emergencies

    International Nuclear Information System (INIS)

    Radiation Emergencies which result as a consequence of nuclear or radiological accidents can produce a spectrum of different types of radiation injuries which could include cases of whole body irradiation causing Acute Radiation Syndrome, partial body irradiation, radiation burns (localized irradiation), radioactive contamination and combined injuries having component of conventional injuries. General principles of managing these cases entail doing triage, offering immediate emergency care and instituting definitive treatment. Infra-structural facilities which are required to facilitate their management include first aid post at plant site, personnel decontamination centre, site clinic and specialized hospital which can offer comprehensive investigational and treatment modalities. Training of medical and paramedical personnel is crucial as part of emergency preparedness programme and if needed, help can be sought from WHO's Radiation Emergency Medical Preparedness and Assistance Network Centres. (author)

  14. Medical management of radioactively contaminated wounds

    International Nuclear Information System (INIS)

    In addition to the usual measures involved in the medical management of wounds, the presence of radioactivity requires further considerations. In brief, these involve the decontamination of the surface area surrounding the wound, evaluation of the radioactivity contained in the wound, excision of the contaminated tissue, treatment with a regimen utilizing the intravenous administration of a suitable chelating agent, followed by urinary or faecel assay for a period of time. (author)

  15. 78 FR 57159 - Scientific Information Request on Medication Therapy Management

    Science.gov (United States)

    2013-09-17

    ... scientific information submissions from the public on medication therapy management Scientific information is... published and unpublished pertinent scientific information on medication therapy management will improve the... HUMAN SERVICES Agency for Healthcare Research and Quality Scientific Information Request on...

  16. Reliability and validity of the Management of Aggression and Violence Attitude Scale (MAVAS-BR) for use in Brazil

    OpenAIRE

    Divane de Vargas; Margarita Antônia Villar Luis; Janaina Soares; Marcos Hirata Soares

    2015-01-01

    Abstract Background Aggression and violent behavior against health care professionals is a serious problem today and has aroused the interest of researchers and authorities. Objective: The purpose of this study was to examine the reliability and validity of the Management of Aggression and Violence Attitude Scale – Brazil (MAVAS-BR) for use with Brazilian nurses. Method The MAVAS-BR was applied in a convenience sample of 262 nurses, the data were submitted to an exploratory factor analysi...

  17. Medical and dental management of Alagille syndrome: A review

    Science.gov (United States)

    Berniczei-Royko, Adam; Chałas, Renata; Mitura, Iwona; Nagy, Katalin; Prussak, Elżbieta

    2014-01-01

    Alagille syndrome is a rare, autosomal, complex, dominant disorder associated with dysfunction of the liver, heart, skeleton, and eyes, as well as characteristic facial appearance. It is associated with the defect in component of the Notch signalling pathway. Here, we review the main features of Alagille syndrome with special focus on oro-facial manifestations like prominent forehead, moderate hypertelorism with deep-set eyes, a saddle or straight nose with a flattened, bulbous tip, and large ears. The article is based on the most recent and significant literature available from the Medline database. Contrary to healthy children, patients with Alagille syndrome have many problems, depending on several factors like the severity of cholestasis and scarring in the liver, heart or lung problems, presence of infections, or other problems related to poor nutrition that can manifest in their oral cavity in the dental and periodontal tissues, as well as oral mucosa. From the dentist’s view, the most important elements are careful observation, accurate diagnosis, and planned management of such patients, especially during the patient’s formative years, to prevent complications. Aggressive preventive oral care and consultations with medical specialists before any invasive procedure are obligatory. All this can improve quality of life in patients with Alagille syndrome. PMID:24658020

  18. Invasive pulmonary aspergillosis in acute leukemia: Contribution of CT to early diagnosis and aggressive management

    International Nuclear Information System (INIS)

    More than 80% of patients with invasive pulmonary aspergillosis (IPA) who received antileukemic chemotherapy survived the infection as a result of early diagnosis and aggressive therapy. CT helped to establish the early diagnosis of IPA in these patients. Since first describing the CT findings of IPA, the authors have added ten new cases, each subsequently confirmed. The CT ''halo sign,'' a zone of lower attenuation surrounding a pulmonary mass, was seen in eight of nine patients on early scans obtained during aplasia. A characteristic progression from multiple fluffy masses to cavitation suggested IPA in five of seven patients. CT findings affected patient management in seven of ten patients and were one criterion for increasing antifungal therapy. The CT appearance of healing IPA resembled that of resolving pulmonary infarcts, and was used to monitor disease activity in the long term

  19. Medical image information system 2001. Development of the medical image information system to risk management- Medical exposure management

    International Nuclear Information System (INIS)

    This paper discusses the methods and systems for optimizing the following supplements 10 and 17 for national health and medical care. The supplements 10 and 17 of DICOM (digital imaging and communications in medicine) system, which is now under progress for the purpose to keep compatibility within medical image information system as an international standard, are important for making the cooperation between HIS (hospital information system)/RIS (radiation information system) and modality (imaging instruments). Supplement 10 concerns the system to send the information of patients and their orders through HIS/RIS to modality and 17, the information of modality performed procedure step (MPPS) to HIS/RIS. The latter defines to document patients' exposure, a part of which has not been recognized in Japan. Thus the medical information system can be useful for risk-management of medical exposure in future. (K.H.)

  20. Medical image information system 2001. Development of the medical image information system to risk management- Medical exposure management

    Energy Technology Data Exchange (ETDEWEB)

    Kuranishi, Makoto; Kumagai, Michitomo; Shintani, Mitsuo [Toyama Medical and Pharmaceutical Univ. (Japan). Hospital

    2000-12-01

    This paper discusses the methods and systems for optimizing the following supplements 10 and 17 for national health and medical care. The supplements 10 and 17 of DICOM (digital imaging and communications in medicine) system, which is now under progress for the purpose to keep compatibility within medical image information system as an international standard, are important for making the cooperation between HIS (hospital information system)/RIS (radiation information system) and modality (imaging instruments). Supplement 10 concerns the system to send the information of patients and their orders through HIS/RIS to modality and 17, the information of modality performed procedure step (MPPS) to HIS/RIS. The latter defines to document patients' exposure, a part of which has not been recognized in Japan. Thus the medical information system can be useful for risk-management of medical exposure in future. (K.H.)

  1. An evaluation of an aggression management training program to cope with workplace violence in the healthcare sector

    NARCIS (Netherlands)

    J.K. Oostrom (Janneke); H. van Mierlo (Heleen)

    2008-01-01

    textabstractAbstract Workplace violence is a major occupational hazard for healthcare workers, generating a need for effective intervention programs. The purpose of this study was to evaluate the effectiveness of an aggression management training program. The evaluation design was based on the inter

  2. Aggressive Fibromatosis in Neck.

    OpenAIRE

    Namita Kabdwal; Sanjeev Bhagat; Saurabh Varshney; Sampan Singh Bist; Sarita Mishra; Bhavna Singh

    2013-01-01

    Aggressive fibromatosis (AF) is a locally aggressive infiltrative low-grade benign tumor that accounts for approximately less than 3% of all soft tissue tumors. In the head and neck region this tumor tends to be more aggressive and associated with significant morbidity. Aggressive surgery is a viable management option and may be successfully used as a single modality treatment, or in combination with radiotherapy. We report a rare case of AF in a 38 year old female, who presented with a painl...

  3. Managing bipolar moods without medication:a qualitative investigation

    OpenAIRE

    Cappleman, Reed; Smith, Ian; Lobban, Fiona

    2015-01-01

    Objectives Although many diagnosed with Bipolar Disorder (BD) choose to manage their moods without medication at some point, their experiences of doing so are not well understood. This paper aims to explore the processes by which people manage bipolar moods without medication. Methods Ten people diagnosed with BD who do not use medication were interviewed. Analysing their accounts using grounded theory methods led to developing a model of how they perceive the processes involved in managing m...

  4. Sodium Valproate Withdrawal Correlates with Reduced Aggression

    Science.gov (United States)

    Pritchard, Duncan; Hoerger, Marguerite; Dyer, Tim; Graham, Nicola; Penney, Heather; Mace, F. Charles

    2014-01-01

    People with learning disabilities are sometimes prescribed psychotropic medication to help manage their challenging behaviour. This case study describes how a multicomponent behavioural intervention in conjunction with the systematic withdrawal of sodium valproate was strongly correlated with reduced aggression. No symptoms of bipolar disorder or…

  5. Managing Aggression Using Cognitive-Behavioral Interventions: State of the Practice and Future Directions

    Science.gov (United States)

    Smith, Stephen W.; Lochman, John E.; Daunic, Ann P.

    2005-01-01

    Education professionals consistently rank disruptive/aggressive student behavior as persistent and troubling, reporting various types of maladaptive behaviors ranging from talking out in class to assault. Researchers suggest that childhood aggression accounts for a high proportion of the referrals to special education for emotional and behavioral…

  6. Medical Management of Metastatic Medullary Thyroid Cancer

    OpenAIRE

    Maxwell, Jessica E; Sherman, Scott K.; O’Dorisio, Thomas M.; Howe, James R.

    2014-01-01

    Medullary thyroid cancer (MTC) is an aggressive form of thyroid cancer, which occurs in both heritable and sporadic forms. Discovery that mutations in the RET protooncogene predispose to familial cases of this disease has allowed for presymptomatic identification of gene carriers and prophylactic surgery to improve the prognosis of these patients. A significant number of patients with the sporadic type of MTC and even with familial disease, still present with nodal or distant metastases, maki...

  7. Medical foods: products for the management of chronic diseases.

    Science.gov (United States)

    Morgan, Sarah L; Baggott, Joseph E

    2006-11-01

    Medical foods are a specific category of therapeutic agents created under the Orphan Drug Act of 1988, which separated medical foods from drugs for regulatory purposes. Products in this category share the requirements that they are intended for the nutritional management of a specific disease, are used under the guidance of a physician, and contain ingredients that are generally recognized as safe (GRAS). An example of medical foods are formulations intended to manage patients with inborn errors in amino acid metabolism. Newer medical foods are designed to manage hyperhomocysteinemia, pancreatic exocrine insufficiency, inflammatory conditions, cancer cachexia, and other diseases. PMID:17131945

  8. Medical management of accidentally exposed individuals

    International Nuclear Information System (INIS)

    Bone marrow aplasia is one of the main syndromes following a high dose accidental radiation exposure. Whilst transfusion and bone marrow transplantation have been used with some success starting with the first treatments of accident victims, other therapeutic strategies are needed. With the development of experimental and clinical haematology, promising new approaches to the treatment of aplasia have appeared. New trends for the treatment of haemopoietic injury based on bone marrow transplantation rely on new sources of compatible donor cells, such as cord blood, on the selection of immature haemopoietic cells and on new transplant regimens. Haemopoietic growth factors stimulate the proliferation and/or differentiation of haemopoietic progenitors and, possibly, stem cells. Furthermore, they act on the functions of mature cells. Currently, they have specific uses in haematology related to their role in the regulation of growth and in the differentiation of haemopoietic progenitor cells. Growth factors have already been used for the treatment of accidental radiation induced aplasia and lessons have been learned from their medical management and followup. (author)

  9. Medical management of accidentally exposed individuals

    International Nuclear Information System (INIS)

    Bone marrow aplasia is one of the main syndromes following a high dose accidental radiation exposure. Although both transfusion and bone marrow transplantation have been used with some success since the first treatments of patients, other therapeutic strategies are needed. New promising approaches of the treatment of aplasia have appeared with the development of experimental and clinical hematology. Some new trends for the treatment of the hematopoietic injury based on bone marrow transplantation rely on new sources of compatible donor cells, such as cord blood, on the selection of immature haemopoietic cells and on new transplant regimens. The hematopoietic growth factors stimulate proliferation and/or differentiation of hematopoietic progenitors and possibly stem cells. Furthermore, they act on the functions of mature cells. They have now specific uses in hematology, related to their role in the regulation of growth and differentiation of hematopoietic progenitor cells. Some growth factors have already been used for the treatment of accidental radiation-induced aplasia and lessons have been learned from their medical management and follow-up. (author)

  10. Medical management of radiation burns - some experiences

    International Nuclear Information System (INIS)

    Localized exposure resulting in radiation burns are serious injuries, seen not only in this country but all over the world. All of these injuries have resulted from accidents in Industrial Radiography (non-destructive testing). In our country all these injuries have occurred in the private sectors who handle these radiography sources. These sources can be of Iridium-192 or Cobalt-60. Some of these accidents have occurred involving trained radiographers but sometimes casual workers have been exposed. Skin is highly vulnerable to the external radiation exposure. Damage of varying extent can be seen following radiotherapy and accidents involving X- and gamma-ray sources. The reaction is related to the absorbed dose, which in turn is dependent upon the energy of radiation and weather it is particulate or electromagnetic radiation. Beta particles give up their energy within a short range and hence are more hazardous. Radiation burns develop slowly and blister formation occurs usually after 4 weeks. After exposure the skin response occurs in the form of transient erythema, fixed erythema, transepidermal burns, full thickness radiation burns and epilation. In radiation accidents, particularly those involving X-ray machines, the patients may not be aware of the time of accident and the dose may not be known in those circumstances. The medical management and treatment of such patients, therefore, has its own challenges. This talk will share some experiences on treatment of radiation injuries. (author)

  11. [Medical management of cholangiocarcinomas in 2015].

    Science.gov (United States)

    Marret, Grégoire; Neuzillet, Cindy; Rousseau, Benoît; Tournigand, Christophe

    2016-04-01

    Cholangiocarcinoma is a rare malignancy carrying a poor prognosis. Most patients are diagnosed with advanced-stage disease and are then ineligible for surgical resection, which is the only potentially curative therapeutic modality. The aim of this article is to provide an up-to-date review of medical management of patients with cholangiocarcinoma. The benefit of adjuvant therapy in patients undergoing curative-intent surgery is under evaluation. Combination chemotherapy with gemcitabine and platinum is the standard first-line treatment for patients with advanced cholangiocarcinoma. Targeted agents are not currently recommended due to limited data on use in this setting. The role of second-line chemotherapy is not established in advanced cholangiocarcinoma. Identification of predictive and prognostic markers to select patients who could benefit from second-line therapy is a major issue. A better understanding of the biological and molecular mechanisms underlying the carcinogenesis and the phenotypic heterogeneity of cholangiocarcinoma may path the way of new therapeutic strategies. PMID:26922666

  12. Discussion on Management Model of Medical Equipment Maintenance in Hospital

    Institute of Scientific and Technical Information of China (English)

    ZHOU Qiang; DENG Wen-yan; CAI Kui

    2016-01-01

    With the development of technology, medical equipment plays a more important role in the modern hospital. Medical equipment provides images, physiological results or other schematics of the patients to help doctors deal with the routines. It is also the major tool to the lab assistant in the clinical teaching and studies. It becomes one of a symbol of the technological level in modern hospital. The director of the hospital should establish an efficacious management pattern to manage the medical equipment, so that it will be operated in good condition to insure the safety of the patients. Since the maintenance is an important part of medical equipment management, it is significant that the hospital should establish a system to fit for itself. The study reviews the issues in hospital medical equipment maintenance management, the development of the maintenance management model and the characteristics, as well as the status at home and abroad. The research has been finished by using literature research method, questionnaire survey method and data analysis method. Then we analyze the current status of hospital medical equipment maintenance management model to find the problems. Based on the authentic and effective data from the survey, we can deduce the overview about the maintenance model in Beijing. The paper discusses the advantages and the disadvantages between the different model, and it makes suggestions on the follow aspects, such as system management, quality management, personnel management, cost management, information management perspective.

  13. The power of management in medical services. Can we manage better for higher quality and more productive medical services?

    Directory of Open Access Journals (Sweden)

    Magdalena BARBU

    2010-06-01

    Full Text Available Medical services are the most important services of all since we all depend on them. Their quality and productivity can assure a wealthy nation and therefore good economical results. The offer of medical services depends on medical personnel and more than this, on the management in the medical field since any resource not managed well or not managed at all is only a lost one, regardless its value. Management is therefore the key, the “how to” method of obtaining the desired result. The same approach can be applied into our study in order to reach more productive medical services which to prove high quality to all patients. We need to use and to squeeze the entire force of management tools in order to reach our goal: accessible medical services full of quality. The current worldwide crisis situation makes us think that after job and food, even medical services (also a basic thing after all can become a “luxury” although this should never happen. Therefore we must do whatever needed to improve the way medical organizations are driven so that the quality of their medical services will be better and better and the productivity will be at a higher level. Medical management should have as a goal making it possible for patients to be able to solve their health problems as soon as possible and as good as possible.

  14. Managed care and medical education: hard cases and hard choices.

    Science.gov (United States)

    Friedman, E

    1997-05-01

    As managed care becomes more and more dominant in U.S. health care, it is coming into conflict with medical education. There are historical reasons for this: medical education traditionally excluded physicians who chose to work in health plans, and for profit managed care has tended to avoid subsidizing medical education. In order to improve the climate, three changes are necessary: medical education must understand the tense history of discord between the two; distinctions must be made between responsible and irresponsible managed care plans; and medical educators should not assume they own the moral high ground. Arrogance, a gross oversupply of physicians and especially specialists, scandals and fraud, an often callous attitude toward the poor, and other sins can be laid at medical education's door. The worse threat for both sides is that the public and payers could simply abandon both, leading to underfunding for health professions education, a society that does not trust its health care system, and the loss of superb teaching organizations. To prevent this, managed care and medical education should work together to solve several difficult problems: how to shrink the medical education infrastructure; how to report honestly the uses to which medical education funds are put; and how to identify and end irresponsible behavior on the part of health plans and medical education entities alike. If the two sides can exercise leadership in these areas, they will be able to protect and enhance the singular place of honor that medical education holds in this society. PMID:9159575

  15. Case management for long-term and acute medical care

    OpenAIRE

    Capitman, John A.

    1988-01-01

    Case management has developed as an administrative service for controlling costs and improving the quality of health and social service delivery. Long-term care case management combined with service expansion has been examined in some detail with varied results. Less research has focused on case management for users of high-cost medical care. This overview highlights five programs and patient groups where integrated delivery and/or financing of medical and long-term care services are being de...

  16. Handbook for medical management of persons exposed in radiation accidents

    International Nuclear Information System (INIS)

    The document is intended as a rapid reference handbook for the use of physicians who may be called upon to handle the cases of radiation emergency. It deals mainly with the diagnosis and treatment procedures which should be followed by medical officers. The handbook has following sections : basic radiobiology, classification of radiation accidents and preparedness for medical intervention, management of external radiation exposure, management of radioactive contamination, and action plan for handling radiation facilities. It is advisable to have a separate medical unit for proper management of persons exposed in radiation accidents. Infrastructure and facilities required in such a set-up are described. Names and addresses of : (1) physicians in India who have specialized in medical management of radiation injuries, and (2)medical doctors trained in radiation protection and occupational health in different states of India are listed in an appendix. (M.G.B.). 10 refs., figs., tabs

  17. Self-management of medical abortion: a qualitative evidence synthesis.

    Science.gov (United States)

    Wainwright, Megan; Colvin, Christopher J; Swartz, Alison; Leon, Natalie

    2016-05-01

    Medical abortion is a method of pregnancy termination that by its nature enables more active involvement of women in the process of managing, and sometimes even administering the medications for, their abortions. This qualitative evidence synthesis reviewed the global evidence on experiences with, preferences for, and concerns about greater self-management of medical abortion with lesser health professional involvement. We focused on qualitative research from multiple perspectives on women's experiences of self-management of first trimester medical abortion (administration of medical abortion. We highlight particular considerations when offering self-management options, and identify key areas for future research. Further qualitative research is needed to strengthen this important evidence base. PMID:27578349

  18. [Evidence-based management of medical disposable materials].

    Science.gov (United States)

    Yang, Hai

    2009-03-01

    Evidence-based management of medical disposable materials pays attention to collect evidence comprehensively and systematically, accumulate and create evidence through its own work and also evaluate evidence strictly. This can be used as a function to guide out job. Medical disposable materials evidence system contains product register qualification, product quality certification, supplier's behavior, internal and external communication evidence. Managers can find different ways in creating and using evidence referring to specific inside and outside condition. Evidence-based management can help accelerating the development of management of medical disposable materials from traditional experience pattern to a systematic and scientific pattern. It also has the very important meaning to improve medical quality, control the unreasonable growth of medical expense and make purchase and supply chain be more efficient. PMID:19565800

  19. Prevalence of aggressive behaviours among inpatients with psychiatric disorders: A case study analysis from Jordan.

    Science.gov (United States)

    Al-Sagarat, Ahmad Y; Hamdan-Mansour, Ayman M; Al-Sarayreh, Faris; Nawafleh, Hani; Moxham, Lorna

    2016-06-01

    In this study, we investigated the correlates of aggression among consumers with mental illness within two psychiatric hospitals in Jordan. This was a descriptive, cross sectional study carried out by auditing consumers' medical records in regards to incidents of aggression before and during admission. Approval was gained from 203 next of kins to review the consumers' medical records. Results from this case analysis, found the prevalence of aggressive behaviours among psychiatric inpatient's in Jordan to be 23.6%, the most common form of aggression was consumer to consumer and that the aggressive act was more likely to be perpetrated by younger consumers. Such findings contribute to the discourse about aggression and understanding who and what causes aggression can go toward identify strategies for early intervention and management. After all, mental health units should be places of safety, that is, an asylum, and everyone who enters that environment deserves to be safe. PMID:26538486

  20. Strategic management of Public Hospitals' medical services.

    Science.gov (United States)

    Hao, Aimin; Yi, Tao; Li, Xia; Wei, Lei; Huang, Pei; Xu, Xinzhou; Yi, Lihua

    2016-01-01

    Purpose: The quality of medical services provided by competing public hospitals is the primary consideration of the public in determining the selection of a specific hospital for treatment. The main objective of strategic planning is to improve the quality of public hospital medical services. This paper provides an introduction to the history, significance, principles and practices of public hospital medical service strategy, as well as advancing the opinion that public hospital service strategy must not merely aim to produce but actually result in the highest possible level of quality, convenience, efficiency and patient satisfaction. PMID:27273960

  1. Evaluation of Bio-Medical Waste Management Practices in a Government Medical College and Hospital

    Directory of Open Access Journals (Sweden)

    Srivastav Shalini, Mahajan Harsh, Mathur B P

    2012-01-01

    Full Text Available Background: Biomedical waste (BMW collection and proper disposal has become a significant concern for both the medical and the general community as improper management poses risks to the health care workers, waste handlers, patients, community in general and largely the environment. Objectives: (i Assessment of current Bio-medical waste management practices including collection, segregation, transportation, storage, treatment and disposal technologies in tertiary health care center. (ii Assessment of health and safety practices for the health care personnel involved in Bio-Medical Waste Management. Materials and Methods: Waste management practices in the Government Hospital was studied during March 2009 – May 2009.The information / data regarding Bio-Medical Waste Management practices and safety was collected by way of semi- structured interview. Results: M.L.B Medical College generates 0.52Kgs waste per bed per day and maximum waste is generated in wards. The institute has got separate color coded bins in wards for collection of waste but segregation practices needs to be more refined. The safety measures taken by health care workers was not satisfactory, it was basically due to un-awareness of health hazards which may occur because of improper waste management practices. Conclusion: Thus it is concluded that there should be strict implementation of a waste management policy set up in the institute; training and motivation must be given paramount importance to meet the current needs and standards of bio-medical waste management.

  2. Dietary and medical management of recurrent nephrolithiasis.

    Science.gov (United States)

    Shah, Silvi; Calle, Juan Camilo

    2016-06-01

    Dietary approaches and medical treatment can prevent recurrence of urinary stones. Some interventions are appropriate for all types of stones, but there are particular risk factors that may need directed therapy. PMID:27281259

  3. Retrospective Analysis of Medication Adherence and Cost Following Medication Therapy Management

    Directory of Open Access Journals (Sweden)

    Ashley Branham, PharmD

    2010-01-01

    Full Text Available Objective: To determine if pharmacist-provided medication therapy management (MTM improves medication adherence in Medicare patients. A secondary objective is to compare the total monthly cost of a patient’s prescription medication regimen 6 months before and 6 months following a comprehensive medication review (CMR. Design: Retrospective analysis of medication adherence, pre-post comparison. Setting: Three independent pharmacies in North Carolina. Patients: 97 Medicare Part D beneficiaries with one or more chronic disease states who participated in a comprehensive medication review (CMR. Intervention: MTM services provided by community pharmacists. Main outcome measure: Change in adherence as measured by the proportion of days covered (PDC and change in medication costs for patients and third party payers. Results: Patients were adherent to chronic disease-state medications before and after MTM (PDC≥ 0.8. Overall, change in mean adherence before and after MTM did not change significantly (0.87 and 0.88, respectively; p = 0.43. However, patients taking medications for cholesterol management, GERD, thyroid and BPH demonstrated improved adherence following a CMR. No change in adherence was noted for patients using antihypertensives and antidiabetic agents. Average total chronic disease-state medication costs for participants were reduced from $210.74 to $193.63 (p=0.08 following the comprehensive medication review. Total costs for patient and third party payers decreased from patients prescribed antilipemics, antihypertensives, GERD and thyroid disorders following a CMR. Conclusions: Pharmacist-provided MTM services were effective at improving medication adherence for some patients managed with chronic medications. Pharmacist-provided MTM services also were effective in decreasing total medication costs.

  4. Aggressive nonsurgical management of acute coronary artery occlusions developing immediately after percutaneous transluminal coronary angioplasty (PTCA)

    International Nuclear Information System (INIS)

    In 368 consecutive percutaneous transluminal coronary angiography (PTCA) procedures, acute occlusion of the dilated artery developed within the first hour after the procedure in 24 cases (6.5%). Four patients underwent emergency bypass surgery. In 17 of the remaining 20 patients, repeat balloon dilation was immediately attempted, and was successful in 11 instances (65%). Five of the six cases in which repeat balloon dilation was not successful responded well to surgical or medical therapy. The author conclude that acute occlusions of dilated coronary arteries shortly after PTCA do not automatically necessitate emergency bypass. Approximately two thirds of such cases can be managed by repeat dilation, converting a potential complication into a successful outcome

  5. Regulations and legal aspects in management of medical waste

    OpenAIRE

    Sikovska, Biljana; Dimova, Cena; Sumanov, Gorgi; Apostoloski, Pavle

    2015-01-01

    Medical waste, according to the law of waste management is waste generated in medical and health institutions (dispensaries, hospitals, polyclinics and outpatient clinics, dental clinics, veterinary stations etc.), originated as a product of used items and materials during diagnosis, convalescence, treatment and prevention in humans and animals. Medical waste is a risk to those who produce, package, store, transport, treat and perform disposition. The possibility of infection of some disea...

  6. Decision Support System for Tele-Medical Transportation Management

    OpenAIRE

    M. Gupta; Yadav, S.; Mittal, V; Singh, P.; Saxena, P.

    2011-01-01

    In this paper, a Decision Support System for Management of Tele-Medical Transportation Services has been designed and developed. The system is developed with symbiotic approach to achieve the aim of providing the necessary Quality based Information Resources for real life interaction among Decision Members of Tele-Medical Transportation System to enable speedy decision management by scanning the future. The salient features of the System are: quick and interactive communication, instant conte...

  7. Medical group management: a marketing orientation.

    Science.gov (United States)

    Bopp, K D; Allcorn, S

    1986-09-01

    This article considers the pragmatic aspects of conducting a situation/marketing audit for group medical practices. This audit is a key component in the formulation of a competitive strategy and the development of a marketing program. Given are a series of questions that may be used by medical groups to guide assessment of the opportunities and threats present in the environment as well as the strengths and weaknesses of the organization in meeting the environmental challenges. Furthermore, the article provides a framework for thinking about strategy and the variables that should be considered and aligned to achieve effective implementation of strategy. Finally, the parameters are outlined for deciding on a marketing program: the mix of marketing tools (service design, distribution channels, pricing and promotion) that should be employed to offensively and/or defensively position the medical group in the competitive marketplace. PMID:10301113

  8. Flexible medical image management using service-oriented architecture.

    Science.gov (United States)

    Shaham, Oded; Melament, Alex; Barak-Corren, Yuval; Kostirev, Igor; Shmueli, Noam; Peres, Yardena

    2012-01-01

    Management of medical images increasingly involves the need for integration with a variety of information systems. To address this need, we developed Content Management Offering (CMO), a platform for medical image management supporting interoperability through compliance with standards. CMO is based on the principles of service-oriented architecture, implemented with emphasis on three areas: clarity of business process definition, consolidation of service configuration management, and system scalability. Owing to the flexibility of this platform, a small team is able to accommodate requirements of customers varying in scale and in business needs. We describe two deployments of CMO, highlighting the platform's value to customers. CMO represents a flexible approach to medical image management, which can be applied to a variety of information technology challenges in healthcare and life sciences organizations. PMID:22874344

  9. Medical management of obesity in Scandinavia 2016

    DEFF Research Database (Denmark)

    Tonstad, Serena; Rössner, Stephan; Rissanen, Aila;

    2016-01-01

    Background: Preventive efforts with improved diet and more exercise have at best decelerated increasing prevalence of overweight and obesity in Scandinavia, and the complications call for more effective treatments. This review is an overview of dietary supplements, medical devices (for oral use),...

  10. Medical management of metabolic dysfunction in PCOS

    OpenAIRE

    Duleba, Antoni J.

    2011-01-01

    Polycystic ovary syndrome (PCOS) is associated with metabolic derangements including insulin resistance, dyslipidemia, systemic inflammation and endothelial dysfunction. There is a growing need to develop pharmacologic interventions to improve metabolic function in women with PCOS. Medications that have been tested in patients with PCOS include metformin, thiazolidinediones, acarbose, naltrexone, orlistat, vitamin D and statins.

  11. Movement Disorders: A Brief Guide in Medication Management.

    Science.gov (United States)

    Julius, Anthony; Longfellow, Katelan

    2016-07-01

    Movement disorders can be challenging to manage and often use a specific set of medications. Because it is a complex and broad field within neurology, many providers are unfamiliar with the classes of medications. This paper details medications used for specific conditions, explains why these medications are helpful, and shares pearls and pitfalls related to each agent, focusing on parameters such as dose titration, side effect profiles, and specific drug-drug interactions and challenges. We focus on the most commonly encountered movement disorders, including essential tremor, Parkinson's disease, rapid eye movement sleep behavior disorder, and restless leg syndrome. PMID:27235613

  12. 某医学院大学生攻击行为现状分析%Status analysis of aggressive behavior among college students in a medical college

    Institute of Scientific and Technical Information of China (English)

    谭兴秀; 程欢; 陈兰; 黄苹; 庞佳; 罗秀

    2014-01-01

    Objective To explore the current situation of aggressive behavior among undergraduates ,in order to provide reference for college students′psychological health intervention. A total of 1 105 questionnaires were issued ,and 983 effective questionnaires were returnet. Methods Aggressive behavior questionnaire (AQ) was adopted among students from 13 classes in three years of freshmen,sophomore and junior in a medical college to investigate the current status of aggressive behavior by strat-ified sampling. Results All the students in this survey had a certain degree of aggression,and 83.93%(825/983) of the students showed aggressive behavior of medium level and above;among college students with different attack dimension or midium-level a-gression and above,the students chose verbal aggression accounted for 88.61%(871/983),and the students with physical aggres-sion account for 59.61%(589/983);there were gender differences and grade differences of college students′aggressive behavior on the total average and dimensionality with statistical significance (P<0.05),and it still had to make further study of whether there were major differences. Conclusion Gender and grade are predictive variables of aggressive behavior ,so the intervention of ag-gressive behavior should combine gender and grade systematically.%目的:探讨大学生攻击行为的现状,为大学生心理卫生干预提供参考。方法采用攻击行为问卷(AQ),按照分层抽样的方法,在某医学院校大一、大二、大三3个年级分别随机抽取13个班级的学生进行攻击行为现状调查,共发放调查问卷1105份,回收有效问卷983份。结果被调查的所有大学生均呈现出一定程度的攻击倾向,且83.93%(825/983)的大学生表现出中度及以上的攻击行为;在不同攻击维度、中度及以上攻击倾向的大学生中,选择言语攻击的大学生88.61%(871/983),选择身体攻击的大学生59.61%(586/983);大

  13. Reliability and validity of the Management of Aggression and Violence Attitude Scale (MAVAS-BR for use in Brazil

    Directory of Open Access Journals (Sweden)

    Divane de Vargas

    2015-12-01

    Full Text Available Abstract Background Aggression and violent behavior against health care professionals is a serious problem today and has aroused the interest of researchers and authorities. Objective: The purpose of this study was to examine the reliability and validity of the Management of Aggression and Violence Attitude Scale – Brazil (MAVAS-BR for use with Brazilian nurses. Method The MAVAS-BR was applied in a convenience sample of 262 nurses, the data were submitted to an exploratory factor analysis, and reliability was estimated using Cronbach’s alpha. Results The MAVAS-BR is composed of 23 items distributed among four factors, and the Cronbach’s alpha was σ = 0.75. Discussion The MAVAS-BR is a reliable instrument for measuring the attitudes of Brazilian nurses facing aggression and violent behavior. The scale has shown to possess validity and the recommended reliability criteria; however, additional studies using this scale should be performed to offer further evidence of its validity in the context of Brazilian nursing.

  14. Assessment of obesity management in medical examination

    OpenAIRE

    Treyzon Leo

    2005-01-01

    Abstract Obesity is a growing international health problem that has already reached epidemic proportions, particularly within the United States where a majority of the population is overweight or obese. Effective methods of treatment are needed, and should be taught to physicians by efficient means. There exists a disconnect between the rising obesity prevalence with its high toll on medical resources, and the lack of obesity education provided to practitioners in the course of their training...

  15. [Compassionate care and management in the medical-social sector].

    Science.gov (United States)

    Lambert Barraquier, Arièle

    2016-05-01

    Compassionate care can appear ambiguous when subject to critical examination. The spotlight falls on the responsibility and activity of management with regard to policy guidance and the management of activities in the medical-social field. Discussion around this subject enables an assessment of current standards and ethical progress to be carried out. PMID:27157562

  16. Persistent medical management of chylopericardium following orthotopic heart transplant

    OpenAIRE

    Jackson, E; Khan, A.; N Yonan

    2010-01-01

    We describe a case of chylopericardium post orthotopic heart transplant, having had previous cardiac surgeries. This was managed conservatively for a prolonged period after which the patient recovered. We emphasise the fact that medical management works although the recovery time may be prolonged.

  17. Attitudes of medical students to medical leadership and management: a systematic review to inform curriculum development

    Directory of Open Access Journals (Sweden)

    Abbas Mark R

    2011-11-01

    Full Text Available Abstract Background There is a growing acknowledgement that doctors need to develop leadership and management competences to become more actively involved in the planning, delivery and transformation of patient services. We undertook a systematic review of what is known concerning the knowledge, skills and attitudes of medical students regarding leadership and management. Here we report the results pertaining to the attitudes of students to provide evidence to inform curriculum development in this developing field of medical education. Methods We searched major electronic databases and citation indexes within the disciplines of medicine, education, social science and management. We undertook hand searching of major journals, and reference and citation tracking. We accessed websites of UK medical institutions and contacted individuals working within the field. Results 26 studies were included. Most were conducted in the USA, using mainly quantitative methods. We used inductive analysis of the topics addressed by each study to identity five main content areas: Quality Improvement; Managed Care, Use of Resources and Costs; General Leadership and Management; Role of the Doctor, and Patient Safety. Students have positive attitudes to clinical practice guidelines, quality improvement techniques and multidisciplinary teamwork, but mixed attitudes to managed care, cost containment and medical error. Education interventions had variable effects on students' attitudes. Medical students perceive a need for leadership and management education but identified lack of curriculum time and disinterest in some activities as potential barriers to implementation. Conclusions The findings from our review may reflect the relatively little emphasis given to leadership and management in medical curricula. However, students recognise a need to develop leadership and management competences. Although further work needs to be undertaken, using rigorous methods, to identify

  18. Management factors affecting aggression in dynamic group housing systems with electronic sow feeding - a field trial

    DEFF Research Database (Denmark)

    Sørensen, L S; Bertelsen, D; Jensen, K H;

    1999-01-01

    frequency of introduction/removal of animals, space allowance in the lying area, group size and number of feeding stations, and starting times for the feeding cycle. All herds had one feeding cycle per 24 h. Six 24-h video recordings in the most settled period with respect to rank relationships (2 to 12...... days after the last introduction) were collected from each herd and analysed according to activity and aggressive interactions. In two of the four herds recordings were collected in two separate periods with different starting times for the feeding cycle. In all herds peaks of activity in the morning...... and in the afternoon were evident. Furthermore, the diurnal variation was overlaid by an increase in activity at the start of the feeding cycle. The activity and aggression in the feeding area as well as the duration per sow of the period with high feeder occupation were lowest in herds where a layer...

  19. Occurrence of lactational mastitis and medical management

    DEFF Research Database (Denmark)

    Scott, Jane A.; Robertson, Michele; Fitzpatrick, Julie;

    2008-01-01

    questionnaire before discharge from hospital. Cases of mastitis were reported either directly to the researchers or were detected during regular follow-up telephone interviews at weeks 3, 8, 18 and 26. Women experiencing mastitis provided further information of their symptoms and the management and advice they......BACKGROUND: Lactational mastitis is a painful, debilitating condition that if inappropriately managed, may lead women to discontinue breastfeeding prematurely. The aim of this paper is to report the incidence of mastitis in the first six months postpartum in a Scottish population, its impact on...... breastfeeding duration and to describe the type and appropriateness of the support and management received by affected women from health professionals. METHODS: A longitudinal study of 420 breastfeeding women was undertaken in Glasgow in 2004/05. Participants were recruited and completed a baseline...

  20. Feline aggression toward family members: a guide for practitioners.

    Science.gov (United States)

    Bain, Melissa; Stelow, Elizabeth

    2014-05-01

    Feline aggression toward people is a common and potentially dangerous problem. Proper diagnosis of the underlying cause of the aggression is key in effective treatment. A complete history, including information on the people in the home, other pets, and specific incidents, is necessary to make this diagnosis. A comprehensive treatment plan typically includes management, enhancement of the cat's living environment, techniques for replacing the aggressive behavior with more appropriate behaviors, and, potentially, medication. The treatment plan must reflect the abilities and commitment of the owner. PMID:24766701

  1. Prescriptions for medical research. I--Management within the Medical Research Council.

    OpenAIRE

    Gillett, R.; Harrow, J.

    1993-01-01

    In their submission to the government in advance of the white paper on science policy in the United Kingdom the Medical Research Council commends the MRC's own approach to managing directly funded research. But a series of semi-structured interviews with the directors of some of the MRC's units suggests a gap between the MRC's model of managed research and the reality. Although such units are theoretically managed from MRC head office (and units are charged an overhead for this), in practice ...

  2. Forty project management strategies for the medical practice staff.

    Science.gov (United States)

    Hills, Laura Sachs

    2010-01-01

    Most every medical practice will embark at one time or another on a large and complex new project. The practice may, for instance, undertake a project in office construction or renovation, practice expansion, new technology, or a new large-scale event. The medical practice staff may find itself creating the project plan, overseeing its execution, and working through the plan day to day until its completion. In short, the staff may find itself responsible for project management. This article contains 40 specific, easy-to-implement project management strategies medical practice employees can use to manage both the large and small projects they undertake on behalf of the practice. It suggests effective project management strategies the staff can use before the onset of a new project as well as strategies to help define the project, to deliver the project, and to close and review the project. This article also describes five reasons medical practices often fail at project management and suggests more effective approaches that will ensure that the projects the medical practice undertakes are completed well, on time, and within budget. PMID:20480774

  3. Quality assurance in military medical research and medical radiation accident management.

    Science.gov (United States)

    Hotz, Mark E; Meineke, Viktor

    2012-08-01

    The provision of quality radiation-related medical diagnostic and therapeutic treatments cannot occur without the presence of robust quality assurance and standardization programs. Medical laboratory services are essential in patient treatment and must be able to meet the needs of all patients and the clinical personnel responsible for the medical care of these patients. Clinical personnel involved in patient care must embody the quality assurance process in daily work to ensure program sustainability. In conformance with the German Federal Government's concept for modern departmental research, the international standard ISO 9001, one of the relevant standards of the International Organization for Standardization (ISO), is applied in quality assurance in military medical research. By its holistic approach, this internationally accepted standard provides an excellent basis for establishing a modern quality management system in line with international standards. Furthermore, this standard can serve as a sound basis for the further development of an already established quality management system when additional standards shall apply, as for instance in reference laboratories or medical laboratories. Besides quality assurance, a military medical facility must manage additional risk events in the context of early recognition/detection of health risks of military personnel on deployment in order to be able to take appropriate preventive and protective measures; for instance, with medical radiation accident management. The international standard ISO 31000:2009 can serve as a guideline for establishing risk management. Clear organizational structures and defined work processes are required when individual laboratory units seek accreditation according to specific laboratory standards. Furthermore, international efforts to develop health laboratory standards must be reinforced that support sustainable quality assurance, as in the exchange and comparison of test results within

  4. Aggressive Behavior

    Science.gov (United States)

    ... Stages Listen Español Text Size Email Print Share Aggressive Behavior Page Content Article Body My child is sometimes ... type of behavior? The best way to prevent aggressive behavior is to give your child a stable, secure ...

  5. [A Medical Devices Management Information System Supporting Full Life-Cycle Process Management].

    Science.gov (United States)

    Tang, Guoping; Hu, Liang

    2015-07-01

    Medical equipments are essential supplies to carry out medical work. How to ensure the safety and reliability of the medical equipments in diagnosis, and reduce procurement and maintenance costs is a topic of concern to everyone. In this paper, product lifecycle management (PLM) and enterprise resource planning (ERP) are cited to establish a lifecycle management information system. Through integrative and analysis of the various stages of the relevant data in life-cycle, it can ensure safety and reliability of medical equipments in the operation and provide the convincing data for meticulous management. PMID:26665958

  6. 42 CFR 423.153 - Drug utilization management, quality assurance, and medication therapy management programs (MTMPs).

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Drug utilization management, quality assurance, and... management, quality assurance, and medication therapy management programs (MTMPs). (a) General rule. Each... utilization management program, quality assurance measures and systems, and an MTMP as described in...

  7. Systemic Medical Management of Diabetic Retinopathy

    OpenAIRE

    Gopal Lingam; Tien Yin Wong

    2013-01-01

    Diabetes mellitus (DM) has assumed epidemic proportions and as a consequence, diabetic retinopathy is expected to be a major societal problem across the world. Diabetic retinopathy (DR) affects the vision by way of proliferative disease that results in vitreous hemorrhage and traction retinal detachment or by way of diabetic maculopathy (DME). The present-day management of diabetic retinopathy revolves around screening the diabetics for evidence of retinopathy and treating the retinopathy wit...

  8. Evaluation of Medical Faculty Students's Time Management Skills

    Directory of Open Access Journals (Sweden)

    Umit Yavas

    2012-02-01

    Full Text Available SUMMARY AIM: This study was carried out in order to determine medical faculty students� time management skills. METHOD: This is a cross sectional study and was carried out between 13 -31 May 2010. The universe of the study comprised 513 medical faculty students and data collection was performed by using the Time Management Inventory (TMI from 420 students (%81,9 of the universe. For statistical analyses of data percentage, Kruskal-Wallis, One-way Anova, Mann-Whitney U, Student-t test and Pearson correlation analysis were used. RESULTS: Students� total time management points were minimum 44 and maximum 122. Total points� mean was 79,06±14,07 and also the median was 78 of Time Management Inventory. Total time management points of the fifth class students were higher than the others. There was no correlation between total time management points and ages of the students. Also there is no statistically significant difference between the males and females at the TMI points. CONCLUSION: According to the other studies the medical faculty students� total TMI mean points are low. The reason of this situation may be the pension school that someone else is planning most of students� time and inadequacy of awareness, knowledge and skills about time management. Enhancing awareness with useful knowledge and being full of resource about time management is essential. [TAF Prev Med Bull 2012; 11(1.000: 5-10

  9. Opinions of disease management programs among medical directors of managed care organizations.

    Science.gov (United States)

    Algozzine, T; Pannone, R; Kozma, C M

    1998-05-15

    Medical directors of managed care organizations (MCOs) were surveyed about their views on disease management programs in their facilities. A survey was mailed to 600 MCO medical directors. The survey consisted of 14 Likert-type items related to disease management programs, 4 demographic items, and 1 item related to satisfaction. Seventy-nine usable surveys were received, for a net response rate of 14%. There were 48 medical directors (61%) with disease management programs at their MCO; 25 (52%) were working independently. A majority (71%) of programs were targeted at asthma. Seventy percent of the 48 medical directors were completely to somewhat satisfied and 13% dissatisfied to some extent with their disease management programs. Satisfaction was significantly related to the MCO's partnerships for these programs. A majority of medical directors agreed or strongly agreed that disease management programs could improve outcomes and decrease health care costs at their MCO, that an independent consultant could help analyze their MCO's prescription and medical data, and that they would be willing to accept grants or funds from pharmaceutical companies to initiate and support an independent disease management program at their MCO. MCO medical directors who responded to a national survey indicated that their organization could benefit from disease management programs, that internal resources might be insufficient to manage these programs, and that their MCO might be willing to contract with external organizations for support. PMID:9606454

  10. Medical Leadership and Management in the United Kingdom

    OpenAIRE

    Kyratsis, Y.; Armit, K.; Zyada, A; Lees, P.

    2016-01-01

    Objective: This article aims to outline the historical development of medical leadership in the United Kingdom (UK), present recent advances, discuss professional development and future prospects. Conclusions: With increasing involvement of medical professionals in top managerial roles in the UK over the last 30 years, leadership development initiatives have been growing steadily and there is increasing recognition of the need for leadership and management skills for doctors. Such skills ...

  11. Experiences of Emotion Management in Medical Care (Case Study: Toronto)

    OpenAIRE

    Masoud Kianpour

    2013-01-01

    Introduction   This study lies at the intersection of the sociology of emotions and medical sociology, investigating emotion management among a rather unknown category of medical personnel –Hospital Chaplains. Sociologists of emotions seek to understand how emotions can be socially influenced in terms of both experience and expression. They believe emotions can be influenced by such institutions as culture and religion. As a result, not only do societies and subcultures have different pattern...

  12. Bio Medical Waste Management- ‘An Emerging Problem’

    OpenAIRE

    Mohd Inayatulla Khan; Prasant MC; Fareedi Mukram Ali; Vinit Aher; Sanjay Kar; Imran Khalid; Mahesh Ahire

    2012-01-01

    As per Bio-Medical Waste (Management and Handling) Rules, 1998 and amendments, any waste, which is generated during the diagnosis, treatment or immunization of human beings or animals or in research activities pertaining there to or in the production of testing of biological and including categories mentioned in schedule 1 of the Rule, is the bio-medical waste The private sector accounts for more than 80% of total healthcare spending in India. Unless there is a decline in the combined federal...

  13. The problem mastoid cavity: medical and surgical management.

    Science.gov (United States)

    Kinney, S E

    1977-11-01

    The patient with persistent foul drainage from a previously operated-on mastoid cavity has a serious problem that requires aggressive attention from the otologic surgeon. The ear must be carefully evaluated in the office. Careful cleaning of the cavity and effective application of medication will dry up many of these cavities. Revision surgery of the ear requires a systematic approach using all the techniques of modern otologic surgery. This means the use of a post-auricular incision and wide bone removal combined with bone removal combined with obliteration techniques and grafting of the middle ear. This approach was used in 29 ears in 27 patients. Rapid healing and a trouble-free, dry ear was obtained in 26 patients or 90% of the operated-on cases. PMID:916779

  14. Medical wastes management in the south of Brazil

    International Nuclear Information System (INIS)

    In developing countries, solid wastes have not received sufficient attention. In many countries, hazardous and medical wastes are still handled and disposed together with domestic wastes, thus creating a great health risk to municipal workers, the public and the environment. Medical waste management has been evaluated at the Vacacai river basin in the State of Rio Grande do Sul, Brazil. A total of 91 healthcare facilities, including hospitals (21), health centers (48) and clinical laboratories (22) were surveyed to provide information about the management, segregation, generation, storage and disposal of medical wastes. The results about management aspects indicate that practices in most healthcare facilities do not comply with the principles stated in Brazilian legislation. All facilities demonstrated a priority on segregation of infectious-biological wastes. Average generation rates of total and infectious-biological wastes in the hospitals were estimated to be 3.245 and 0.570 kg/bed-day, respectively

  15. Evaluating an interprofessional disease state and medication management review model.

    Science.gov (United States)

    Hoti, Kreshnik; Forman, Dawn; Hughes, Jeffery

    2014-03-01

    There is lack of literature data reporting an incorporation of medication management reviews in students' interprofessional education (IPE) and practice programs in aged care settings. This pilot study reports how an interprofessional disease state and medication management review program (DSMMR) was established in a residential aged care facility in Perth, Western Australia. Students from the professions of nursing, pharmacy and physiotherapy focused on a wellness check in the areas of cognition, falls and continence while integrating a medication management review. Students' attitudes were explored using a pre- and post-placement questionnaire. Students indicated positive experience with the IPE DSMMR program which also resulted in their positive attitudinal shift towards IPE and practice. These findings indicated that aged care can be a suitable setting for student interprofessional programs focusing on DSMMR. PMID:24246025

  16. Landscape of Medication Management in the Minnesota Patient-Centered Medical Home (PCMH)

    OpenAIRE

    Donald L. Uden, PharmD, FCCP; Jody L. Lounsbery, PharmD, BCPS; Jean Moon, PharmD, BCACP; Margaret L. Wallace, PharmD, BCACP

    2013-01-01

    Purpose: To describe the landscape of medication management within the patient-centered medical homes (PCMH) in the state of Minnesota. Methods: An electronic survey of care coordinators within PCMHs certified with the Department of Health in state of Minnesota was conducted. The survey and follow up were distributed by the Minnesota Department of Health. At the time the survey was distributed, there were 161 certified PCMHs in the state. Results: The final analysis included 21 respondents. S...

  17. Content-based management service for medical videos.

    Science.gov (United States)

    Mendi, Engin; Bayrak, Coskun; Cecen, Songul; Ermisoglu, Emre

    2013-01-01

    Development of health information technology has had a dramatic impact to improve the efficiency and quality of medical care. Developing interoperable health information systems for healthcare providers has the potential to improve the quality and equitability of patient-centered healthcare. In this article, we describe an automated content-based medical video analysis and management service that provides convenience and ease in accessing the relevant medical video content without sequential scanning. The system facilitates effective temporal video segmentation and content-based visual information retrieval that enable a more reliable understanding of medical video content. The system is implemented as a Web- and mobile-based service and has the potential to offer a knowledge-sharing platform for the purpose of efficient medical video content access. PMID:23270313

  18. Guidelines on the medical management of tritiated water overexposures

    International Nuclear Information System (INIS)

    The Medical Advisers to the Atomic Energy Control Board provide advice to occupational and family physicians treating overexposed workers. GMA-7 provides information and guidance to medical practitioners on the medical management of individuals who have been overexposed to tritiated water. Various treatment principles are presented with special emphasis on techniques for facilitating removal of tritiated water from the body so as to reduce the total radiation dose. Risks and biological effects from exposures to tritiated water and various radiation protection precautions are also discussed. 32 refs., 1 tab

  19. Medical management of radiation/nuclear emergencies

    International Nuclear Information System (INIS)

    The medical issues in a radioactive fallout eventuality include radioprotectors, radioactivity de corporators, hemopoietic system regenerators, community and individual dosage issues, logistic and scale-up issues, regulatory issues. These issues are further compounded by the fact that published literature is (and will be) sparse and outdated, and pharma majors are unlikely to involve themselves in the R and D as well as in the supply chain. Self-developed out-of-box solutions are therefore needed. INMAS, DRDO has recently made progress on all these fronts. Many of these products have already been approved by DCGI and others are in an advanced development stage. Radioprotector has been and is an Achilles heals for the concerned scientists and a number of state agencies for a long time. However, it is a difficult area to work in for a number of reasons. New research in this area shall be highlighted. Finally, clinical trials, which are considered a norm and the final step before introduction of new drugs, are not strictly possible in case of decorporating agents and radioprotectors. Ways and means to collect safety-efficacy data shall be discussed

  20. Legislative Framework and Objectives of Medical Waste Management

    Directory of Open Access Journals (Sweden)

    BRAŞOVEAN I.

    2010-12-01

    Full Text Available Waste regime is governed by the Government Emergency Ordinance no. 78/2000 transposing into nationallegislation EC Directive no. EC Directive 75/442 on waste and no. 91/689 on hazardous waste.Waste management operations involving the collection, transport, recovery and disposal, including surveillanceof these operations and care of their storage areas after closing. Waste management are priority objectives: to prevent orreduce waste production and the degree of their dangerousness and reuse and recovery of waste by recycling orrecovery or any other process to obtain secondary raw materials or the use of waste as energy source. The main legalrules concerning the management of medical waste, is how regulation is collected, packaged, is temporarily stored,transported and disposed of such waste. Compliance with legislative requirements and obligations by producers,transporters, and the authorities dealing with the recovery, treatment and disposal of medical waste, converge to theobjectives set out in the integrated waste management system.

  1. Attitudes of medical students to medical leadership and management: a systematic review to inform curriculum development

    OpenAIRE

    Abbas Mark R; Quince Thelma A; Wood Diana F; Benson John A

    2011-01-01

    Abstract Background There is a growing acknowledgement that doctors need to develop leadership and management competences to become more actively involved in the planning, delivery and transformation of patient services. We undertook a systematic review of what is known concerning the knowledge, skills and attitudes of medical students regarding leadership and management. Here we report the results pertaining to the attitudes of students to provide evidence to inform curriculum development in...

  2. Medical management of the patient with cardiovascular disease.

    Science.gov (United States)

    Mask, A G

    2000-06-01

    Cigarette smoking, hypertension, hypercholesterolemia, and periodontal disease have been established as major risk factors for cardiovascular disease. Dentists and physicians should work aggressively to educate periodontitis patients about this relationship in an effort to improve the quality of health and contribute to their long-term survival. Blood pressure should be checked at the initial dental visit and at each subsequent visit in patients whose blood pressure is found to be high and/or has a history of hypertension. Dental and medical assistants should receive in-service training to assure competency in measuring blood pressures. All staff should be certified in basic cardiopulmonary resuscitation. Emergency protocol procedures should be in writing and rehearsed regularly. Patients should take their blood pressure medication as usual on the day of the dental procedure. It is helpful for the patients to bring all medications to the office for review at the time of the dental procedure. Good communication should be established between the dentist and physician to maximize good dental and physical health. Because the patient with periodontal disease is at an increased risk for cardiovascular disease, a standardized form should be developed for the convenient exchange of vital information, including but not limited to: blood pressure, medications, allergies, medical conditions and pertinent highlights of dental procedures. Minimize stress in patients with coronary artery disease. This includes providing solid local anesthesia, avoidance of intravascular medication injections, and encouraging relaxation techniques. Antibiotic prophylaxis is indicated in patients with valvular heart disease but does not guarantee the prevention of endocarditis. These patients should be alerted to monitor any symptoms such as fever, chills or shortness of breath. It has also been documented that toothbrushing, flossing and home plaque removers can cause transient bacteremia in

  3. Challenging the Cost Effectiveness of Medi-Cal Managed Care

    Directory of Open Access Journals (Sweden)

    Riner, R. Myles

    2009-01-01

    Full Text Available Some researchers and consulting groups have promoted managed care as a way to provide cost-effective quality care to Medicaid patients, based on assertions that are often poorly substantiated. Unfortunately, politicians and policy makers in California and other states have adopted the presumption of the cost-effectiveness of Medicaid Managed Care as a rationale for expanding the use of managed care programs to include a larger share of more Medicaid eligible enrollees, and expand coverage and services to the currently uninsured. This paper challenges the assertion that Medi-Cal Managed Care is cost effective, by demonstrating that the unique and idiosyncratic manner in which Medi-Cal managed care has been implemented in California (and other states creates perverse incentives leading to cost-shifting and selective enrollment and dis-enrollment of costly beneficiaries. This places an unfair burden on fee-for-service Medi-Cal providers, who are expected to provide more services for less reimbursement. Administrators of Medicaid Managed Care programs need to consider risk adjusted rates for beneficiaries enrolled in plans in order to align incentives with program objectives. [WestJEM. 2009;10:124-129.

  4. Patterns of intracranial glioblastoma recurrence after aggressive surgical resection and adjuvant management. Retrospective analysis of 43 cases

    International Nuclear Information System (INIS)

    The present retrospective study evaluated the recurrence patterns after aggressive surgical removal of intracranial glioblastomas in 43 consecutive adult patients. The resection rate of the enhanced lesion on magnetic resonance imaging was 100% and 95-99% in 22 and 21 cases, respectively. All patients received postoperative fractionated radiotherapy (60 Gy in 30 fractions) with additional chemotherapy (25 cases) or vaccine therapy (18 cases). During follow-up (median 17 months), tumor recurrence was identified in 33 patients, most frequently regional within the wall of the resection cavity (20 cases). No clinical factor differed significantly between the groups of patients with regional or marginal tumor progression (N=22) and patients with distant or multiple recurrences (N=8). Progression-free survival did not differ significantly between these two groups (p=0.27). However, overall survival was significantly longer (p=0.04) in patients with regional or marginal tumor progression, and constituted 90% and 54% at 1 and 2 years after surgery, respectively, compared to 75% and 0% in patients with distant or multiple recurrences. Aggressive surgical resection and adjuvant management of intracranial glioblastoma may change its recurrence pattern. Tumor progression appears in the wall of the resection cavity or within 2 cm from its margin in approximately half of patients. (author)

  5. Getting Personal: Harvard Medical School's Approach to Debt Management.

    Science.gov (United States)

    Gibbons, Kathleen

    2000-01-01

    Describes a program of the financial aid office at Harvard University Medical School (Massachusetts) that helps students with debt management and personal financial planning through presentations to seniors by professionals in insurance and financial planning and by offering two individual consultations with a physician financial planning…

  6. Stress Management in Medical Education: A Review of the Literature.

    Science.gov (United States)

    Shapiro, Shauna L.; Shapiro, Daniel E.; Schwartz, Gary E. R.

    2000-01-01

    Review of clinical studies providing empirical data on stress management programs in medical education found that student participants in such programs demonstrated improved immunologic functioning, decreased depression and anxiety, increased spirituality and empathy, enhanced knowledge of alternative therapies, improved knowledge of stress…

  7. Ohio Medical Office Management. Technical Competency Profile (TCP).

    Science.gov (United States)

    Ray, Gayl M.; Wilson, Nick; Mangini, Rick

    This document provides a framework for a broad-based secondary and postsecondary curriculum to prepare students for employment in medical office management. The first part of the technical competency profile (TCP) contains the following items: an explanation of the purpose and scope of Ohio's TCPs; college tech prep program standards; an overview…

  8. Intravenous immunoglobulin use in managing severe, perioperative peristomal pyoderma gangrenosum following subtotal colectomy with end ileostomy for medically refractory chronic ulcerative colitis

    OpenAIRE

    Behm, Kevin; Larson, David W; Colibaseanu, Dorin

    2015-01-01

    Peristomal pyoderma gangrenosum (PPG) is a rare subtype of pyoderma gangrenosum that is characterized by painful, necrotic ulcerations occurring in the area surrounding an abdominal stoma. PPG is typically seen in younger patients with active inflammatory bowel disease. The etiology and pathogenesis is largely unknown and risk factors are not well defined. Therapy typically involves a combination of aggressive local wound care and systemic medications. Diagnosis and management of PPG can be d...

  9. Healthcare managers' construction of the manager role in relation to the medical profession.

    Science.gov (United States)

    von Knorring, Mia; Alexanderson, Kristina; Eliasson, Miriam A

    2016-05-16

    Purpose - The purpose of this paper is to explore how healthcare managers construct the manager role in relation to the medical profession in their organisations. Design/methodology/approach - In total, 18 of Sweden's 20 healthcare chief executive officers (CEOs) and 20 clinical department managers (CDMs) were interviewed about their views on management of physicians. Interviews were performed in the context of one aspect of healthcare management; i.e., management of physicians' sickness certification practice. A discourse analysis approach was used for data analysis. Findings - Few managers used a management-based discourse to construct the manager role. Instead, a profession-based discourse dominated and managers frequently used the attributes "physician" or "non-physician" to categorise themselves or other managers in their managerial roles. Some managers, both CEOs and CDMs, shifted between the management- and profession-based discourses, resulting in a kind of "yes, but […]" approach to management in the organisations. The dominating profession-based discourse served to reproduce the power and status of physicians within the organisation, thereby rendering the manager role weaker than the medical profession for both physician and non-physician managers. Research limitations/implications - Further studies are needed to explore the impact of gender, managerial level, and basic profession on how managers construct the manager role in relation to physicians. Practical implications - The results suggest that there is a need to address the organisational conditions for managers' role taking in healthcare organisations. Originality/value - Despite the general strengthening of the manager position in healthcare through political reforms during the last decades, this study shows that a profession-based discourse clearly dominated in how the managers constructed the manager role in relation to the medical profession on the workplace level in their organisations. PMID

  10. Medication therapy management clinic: perception of healthcare professionals in a University medical center setting

    Directory of Open Access Journals (Sweden)

    Shah M

    2013-09-01

    Full Text Available Objective: To determine the overall perception and utilization of the pharmacist managed medication therapy management (MTM clinic services, by healthcare professionals in a large, urban, university medical care setting.Methods: This was a cross-sectional, anonymous survey sent to 195 healthcare professionals, including physicians, nurses, and pharmacists at The University of Illinois Outpatient Care Center to determine their perception and utilization of the MTM clinic. The survey consisted of 12 questions and was delivered through a secure online application. Results: Sixty-two healthcare professionals (32% completed the survey. 82% were familiar with the MTM clinic, and 63% had referred patients to the clinic. Medication adherence and disease state management was the most common reason for referral. Lack of knowledge on the appropriate referral procedure was the prominent reason for not referring patients to the MTM clinic. Of the providers that were aware of MTM services, 44% rated care as ‘excellent’, 44% as ‘good’, 5% as ‘fair’, and 0% stated ‘poor’. Strengths of MTM clinic identified by healthcare providers included in-depth education to patients, close follow-up, and detailed medication reconciliation provided by MTM clinic pharmacists. Of those familiar with MTM clinic, recommendations included; increase marketing efforts to raise awareness of the MTM clinic service, create collaborative practice agreements between MTM pharmacists and physicians, and ensure that progress notes are more concise.Conclusion: In a large, urban, academic institution MTM clinic is perceived as a valuable resource to optimize patient care by providing patients with in-depth education as it relates to their prescribed medications and disease states. These identified benefits of MTM clinic lead to frequent patient referrals specifically for aid with medication adherence and disease state management.

  11. Aggression: peculiarities of manifestation and coping strategies in adolescence

    OpenAIRE

    Budykin A.V.; Budykin S.V.; Zhigachev A.S.

    2014-01-01

    Aggression management is becoming increasingly important task in modern society, as the number of situations that provoke aggression increases. Particular attention should be paid to aggression in adolescence. The world economic crisis contributes to the increase in the level of aggressiveness. The incidence of auto-aggression also increases. Suppressed aggression leads to the development of psychosomatic disorders. Experts agree that aggression is bad, but just suppressing aggressive reactio...

  12. Medical Data Manager an Interface between PACS and the gLite Data Management System

    CERN Document Server

    Montagnat, Johan; Texier, Romain; Nienartowicz, Krzysztof; Baud, Jean-Philippe

    2008-01-01

    The medical imaging community uses the DICOM image format and protocol to store and exchange data. The Medical Data Manager (MDM) is an interface between DICOM compliant systems such as PACS and the EGEE Data Management System. It opens hospital imaging networks to the world scale Grid while protecting sensitive medical data. It can be accessed transparently from any gLite service. It is an important milestone towards adoption of Grid technologies in the medical imaging community. Hospitals continuously produce tremendous amounts of image data that is managed by local PACS (Picture Archiving and Communication Systems). These systems are often limited to a local network access although the community experiences a growing interest for data sharing and remote processing. Indeed, patient data is often spread out different medical data acquisition centers. Furthermore, researchers in the area often need to analyze large populations whose data can be gathered through federations of PACS. Opening PACS to the outer I...

  13. Medical waste management in Ibadan, Nigeria: Obstacles and prospects

    International Nuclear Information System (INIS)

    Quantification and characterization of medical waste generated in healthcare facilities (HCFs) in a developing African nation has been conducted to provide insights into existing waste collection and disposal approaches, so as to provide sustainable avenues for institutional policy improvement. The study, in Ibadan city, Nigeria, entailed a representative classification of nearly 400 healthcare facilities, from 11 local government areas (LGA) of Ibadan, into tertiary, secondary, primary, and diagnostic HCFs, of which, 52 HCFs were strategically selected. Primary data sources included field measurements, waste sampling and analysis and a questionnaire, while secondary information sources included public and private records from hospitals and government ministries. Results indicate secondary HCFs generate the greatest amounts of medical waste (mean of 10,238 kg/day per facility) followed by tertiary, primary and diagnostic HCFs, respectively. Characterised waste revealed that only ∼3% was deemed infectious and highlights opportunities for composting, reuse and recycling. Furthermore, the management practices in most facilities expose patients, staff, waste handlers and the populace to unnecessary health risks. This study proffers recommendations to include (i) a need for sustained cooperation among all key actors (government, hospitals and waste managers) in implementing a safe and reliable medical waste management strategy, not only in legislation and policy formation but also particularly in its monitoring and enforcement and (ii) an obligation for each HCF to ensure a safe and hygienic system of medical waste handling, segregation, collection, storage, transportation, treatment and disposal, with minimal risk to handlers, public health and the environment

  14. Medical waste management in Jordan: A study at the King Hussein Medical Center

    International Nuclear Information System (INIS)

    As in many other developing countries, the generation of regulated medical waste (RMW) in Jordan has increased significantly over the last few decades. Despite the serious impacts of RMW on humans and the environment, only minor attention has been directed to its proper handling and disposal. This study was conducted in the form of a case study at one of Jordan's leading medical centers, namely, the King Hussein Medical Center (KHMC). Its purpose was to report on the current status of medical waste management at KHMC and propose possible measures to improve it. In general, it was found that the center's administration was reasonably aware of the importance of medical waste management and practiced some of the measures to adequately handle waste generated at the center. However, it was also found that significant voids were present that need to be addressed in the future including efficient segregation, the use of coded and colored bags, better handling and transfer means, and better monitoring and tracking techniques, as well as the need for training and awareness programs for the personnel

  15. Medication Treatment

    Science.gov (United States)

    ... behavior, such as to reduce self-injury or aggression. Once a symptom is no longer a problem, ... of repetitive behaviors; decrease anxiety, irritability, tantrums, and aggressive behavior; and improve eye contact. Tricyclics These medications are ...

  16. Teacher Classroom Management Practices: Effects on Disruptive or Aggressive Student Behavior

    Science.gov (United States)

    Oliver, Regina M.; Wehby, Joseph H.; Reschly, Daniel J.

    2011-01-01

    Despite the large research base grounded in behavioral theory for strategies to increase appropriate behavior and prevent or decrease inappropriate behavior in the classroom, a systematic review of multi-component universal classroom management research is necessary to establish the effects of teachers' universal classroom management approaches.…

  17. Understanding and managing dental caries: a medical approach.

    Science.gov (United States)

    Steinberg, Steve

    2007-01-01

    This article has taken a medical approach toward the understanding and managing of dental caries. Caries has been defined as a point in a person's life when there is an imbalance between protective and pathologic factors such that the process of demineralization of tooth structure by acid from bacteria in the tooth biofilm exceeds the patient's ability to remineralized tooth structure. The patient diagnosed with caries is out of balance. Caries is a diagnosis of a person. People have caries, teeth have lesions. Caries lesion detection, classification, and analysis are done at the level of the tooth surface. Caries is a process in time. Today we establish a diagnosis. For the future we establish a prediction. Patients can be diagnosed as caries active, caries balanced, or caries undetermined. For an improved treatment plan, future risk and prognosis assessments are accomplished by classifying all patients as either low, moderate, or high risk. A combination of diagnosis and risk or prognosis assessment leads to five treatment groups, each with an appropriate protocol for managing the disease process. The five protocols follow from the use of the four-step medical model for caries management. In the end, there are two treatment plans for these patients: a restorative therapy plan that treats the holes and a disease management plan that treats the disease. Surgical treatment does not manage the disease. Today we are managing tooth decay with medicine instead of a drill. PMID:18051341

  18. Aggressive Angiomyxoma

    OpenAIRE

    Padmavathy, L.; L Lakshmana Rao; M Dhana Lakshmi; N Sylvester

    2014-01-01

    Myxoid tumors are a heterogeneous group of lesions characterized by a marked abundance of extra cellular mucoid (myxoid) matrix. [1] The term aggressive emphasizes the often infiltrative nature of the tumor and its frequent association with recurrence. [2] A case of aggressive angiomyxoma arising from the vagina in a 55-year-old woman is reported for its rarity.

  19. Aggressive angiomyxoma.

    Science.gov (United States)

    Padmavathy, L; Rao, L Lakshmana; Lakshmi, M Dhana; Sylvester, N

    2014-04-01

    Myxoid tumors are a heterogeneous group of lesions characterized by a marked abundance of extra cellular mucoid (myxoid) matrix.[1] The term aggressive emphasizes the often infiltrative nature of the tumor and its frequent association with recurrence.[2] A case of aggressive angiomyxoma arising from the vagina in a 55-year-old woman is reported for its rarity. PMID:24860748

  20. Aggressive Angiomyxoma

    Directory of Open Access Journals (Sweden)

    L Padmavathy

    2014-01-01

    Full Text Available Myxoid tumors are a heterogeneous group of lesions characterized by a marked abundance of extra cellular mucoid (myxoid matrix. [1] The term aggressive emphasizes the often infiltrative nature of the tumor and its frequent association with recurrence. [2] A case of aggressive angiomyxoma arising from the vagina in a 55-year-old woman is reported for its rarity.

  1. Medical management of suspected Paecilomyces sp. deep keratitis.

    Science.gov (United States)

    Holland, Lee; Lee, Graham A

    2015-01-01

    A 74-year-old woman developed a deep keratitis presenting with an endothelial plaque without overlying stromal involvement. Owing to the characteristic clinical appearance, she was provisionally diagnosed with a Paecilomyces sp. keratitis. Corneal scrapings and aqueous humour samples were culture negative. The difficulties in diagnosing Paecilomyces sp. keratitis are discussed. The patient's keratitis was managed with a combination of topical, oral and intracameral injections of voriconazole. This medical management strategy was successful in achieving good infection control and visual outcome. We report a rarely encountered presentation of keratitis in which the clinical appearance and response to voriconazole are highly suggestive evidence of a Paecilomyces sp. keratitis. We believe the combination of topical, oral and intracameral injections of voriconazole represents a novel treatment approach for Paecilomyces sp. keratitis. Our case supports the potential for a medical approach as initial treatment in this otherwise devastating form of oculomycosis. PMID:26135494

  2. Anger as a Train and State, Anger Management Methods, and People\\\\\\'s Tendency towards Collective Aggression

    Directory of Open Access Journals (Sweden)

    Fariborz Nikdel

    2015-09-01

    Full Text Available Introduction   Ethnic disputes and collective aggressions are observable in each period of history and are more evident in traditional and nomadic communities. This issue has had many life and property damages in the past and present times and it has also prevented social development to flourish. Based on the damages of collective aggression, the researchers attempt to study the fundamental causes of this problem. It is assumed that state-trait anger and anger control methods are effective variables on people's tendency toward collective aggression. Therefore, determining the effective factors on collective aggression is of great importance from social, family and individual aspects. The theoretical framework of the present study is the combination of psychological and social- psychological theories regarding collective aggression. According the theories regarding collective aggression and relevant researches, collective aggression stems from different factors and reasons as a multi-dimensional social phenomenon. In a general classification, these factors are divided into individual and social factors. Based on various researches regarding social reasons of tendency to collective aggression, only the individual and psychological causes have been investigated. Indeed, this study evaluated state-trait anger and anger control method variables as individual and psychological factors related to tendency to collective aggression.     Materials & Methods   The study method is non-experimental -anger ationneral BB Asianasurest time and it also and it is a survey in terms of type and cross section in terms of time. The study population is all citizens of the Kohgiluye and Buyerahmad province whose age is between 14 and 50 years old. Based on the latest census, they include 325204 individuals. The sample size is 400 based on Cochran’s formula. The sampling method is stratified random. Two questionnaires were used to measure the variables: a

  3. AN INTRODUCTION TO ESSENTIALS OF BIO-MEDICAL WASTE MANAGEMENT

    OpenAIRE

    Singh, Zile; Bhalwar, R; Jayaram, J; Tilak, VW

    2001-01-01

    The issue of biomedical waste management has assumed great significance in recent times particularly in view of the rapid upsurge of HIV infection. Government of India has made proper handling and disposal of this category of waste a statutory requirement with the publication of gazette notification no 460 dated 27 July 1998. The provisions are equally applicable to our service hospitals and hence there is a need for all the service medical, dental, nursing officers, other paramedical staff a...

  4. The medical management of renal artery stenosis in transplant recipients.

    Science.gov (United States)

    Jachuck, S J; Wilkinson, R; Uldall, P R; Elliott, R W; Taylor, R M; Hacking, P M

    1979-01-01

    The investigation, management and clinical course of 12 patients developing stenosis of the renal artery following transplantation are described. The possible aetiology of the three arteriographic patterns of stenosis is discussed. Surgical correction of graft arterial stenosis is difficult and may lead to graft loss, whereas the outcome with antihypertensive drug treatment with or without anticoagulants is good. Surgery should only be contemplated if medical treatment is failing or if renal function is deteriorating. PMID:369641

  5. A proposed approach for safety management in medical software design.

    Science.gov (United States)

    Rafeh, Reza

    2013-02-01

    Safe behavior of modern medical systems is the most important issue in this industry. Software has to follow safety instructions to keep the system away from any error situation. This paper proposes a new approach for safety management which can be used in different phases of software development before implementation and disposal phase. In the proposed approach safety begins from requirements as the infrastructure of design and continues through other phases of software production. PMID:23321965

  6. Incorporating medical leadership and management into the UK undergraduate medical curriculum

    OpenAIRE

    Ah-kee EY; Khan AA

    2015-01-01

    Elliott Yann Ah-kee,1 Aamir Asif Khan21Monklands Hospital, Airdrie, 2Glasgow Royal Infirmary, Glasgow, UKWe read with high interest the letter by Singh et al1 which advocates a mandatory year studying for a BSc in management, within the UK undergraduate medical curriculum. The authors have supported their proposition with compelling figures from a recent National Health Service (NHS) report, which is expecting a £30 billion funding gap by 2020/2021.We strongly believe that nowadays, lea...

  7. MEDICAL MANAGEMENT OF DENTAL CARIES: A CHANGE IN THERAPEUTIC APPROACH

    Directory of Open Access Journals (Sweden)

    Amit Malhotra

    2013-01-01

    Full Text Available Dental caries is an infectious, communicable disease, which causes destruction of teeth by acid-forming bacteria found in dental plaque. Caries progression or reversal is determined by the balance between protective and pathological factors in the mouth. There have been revolutions in every field and dentistry is no exception to it, these changes have led to a change in concept from the conventional surgical approach of removing dental decay and cutting of tooth structure to the medical model which deals with interception of disease at different stages and possible reversal of the disease process. The key to medical paradigm is determination of caries risk in an individual and effective early detection of initial carious lesions. There are various equipments available in market which uses different principles for diagnosing caries susceptibility in an individual. In the years of thorough research different agents have been investigated for their role in caries prevention and reversal. There is a separate treatment plan for managing patients falling in different risk category. This article outlines the need for the medical management of dental caries and how it can be a viable option in dental decay management.

  8. Understanding patient management: the need for medication adherence and persistence.

    Science.gov (United States)

    Chia, Yc

    2008-01-01

    Poor patient adherence to medication is one of the major factors contributing to poor disease control, in particular in asymptomatic chronic diseases like hypertension and dyslipidaemia. The physical and economic burden on patients and the health care system as a result of non-adherence is great. It is estimated that poor adherence to hypertension medication accounts for as many as 7.1 million preventable deaths annually. Hence recognising and identifying non-adherence is the first step to addressing this problem. Medication adherence can be measured in various ways including self-report to electronic monitoring. In order to be more successful in managing non-adherence, attention must be paid to barriers to adherence, namely the interplay of patient factors, the health care providers themselves and the health care system itself. Taking these into account will probably have the greatest impact on improving medication adherence. Consequently strategies to help overcome these barriers are of paramount importance. Some of these strategies will include education of patients, improving communication between patients and health care providers, improving dose scheduling, providing drugs with less adverse effects, and improving accessibility to health care. Poor mediation adherence continues to be a huge challenge. While the patient is ultimately responsible for the taking of medication, good communication, involving the patient in decision making about their care and simplifying drug regimens go a long way in improving it. PMID:25606104

  9. Aggressive fibromatosis: optimisation of local management with a retrospective failure analysis

    International Nuclear Information System (INIS)

    The records of 40 consecutive patients treated at the Princess Margaret Hospital (PMH) between 1979 and 1988 for aggressive fibromatosis were reviewed. The median follow-up was 86 months (range 21-167 months). All surgery was performed at the referring hospitals. Thirty-six underwent an attempt at excision, four were biopsied. Thirty-one had no overt disease after surgery and 26 of these received adjuvant irradiation. Eight were treated with radiotherapy alone, and another was treated with azathioprine and prednisone. Twenty-four (60%) presented with recurrent disease. The overall relapse free rate was 63% at 5 and 10 years. Combined surgery and irradiation had a higher relapse rate than irradiation alone (46% vs. 25%), and a high proportion of failures in the combined group were marginal failures (36%). Relapses following surgery alone were (1(5)) (20%), and chemotherapy(0(1)) . Tumour size greater than 8 cm predicted for relapse (p 0.002), but tumour site, status of surgical margins, and presence or absence of a history of relapse were not statistically significant. Twelve with subsequent treatment failure underwent successful salvage surgery, and (37(40)) (92%) were disease free at last follow-up. A functional assessment (modified Johnstone scale) revealed(11(24)) patients (46%) with poor functional outcomes (grade 2 or less) after all treatment compared with (6(24)) (25%) at referral. Ten of 11 (91%) with grade of 2 or less had a history of recurrence, and (4(5)) amputations were for treatment of a painful recurrence. Treatment planning in this study was hampered by inadequate information on tumour location since few patients had clinically apparent disease when seen by the radiation oncologist (only 35% of cases) and fewer had preoperative cross-sectional imaging available (12% of cases). Relapse was also associated with a poor functional outcome. Attaining high rates of local control with good functional outcomes requires a thorough pretreatment assessment of

  10. Aggression and Withdrawal Related Behavior within Conflict Management Progression in Preschool Boys with Language Impairment

    Science.gov (United States)

    Horowitz, Laura; Westlund, Karolina; Ljungberg, Tomas

    2007-01-01

    Objective: This study examined conflict behavior in naturalistic preschool settings to better understand the role of non-affiliative behavior and language in conflict management. Method: Free-play at preschool was filmed among 20 boys with typically developing language (TL) and among 11 boys with Language Impairment (LI); the boys 4-7 years old.…

  11. Incorporating medical leadership and management into the UK undergraduate medical curriculum

    Directory of Open Access Journals (Sweden)

    Ah-kee EY

    2015-08-01

    Full Text Available Elliott Yann Ah-kee,1 Aamir Asif Khan21Monklands Hospital, Airdrie, 2Glasgow Royal Infirmary, Glasgow, UKWe read with high interest the letter by Singh et al1 which advocates a mandatory year studying for a BSc in management, within the UK undergraduate medical curriculum. The authors have supported their proposition with compelling figures from a recent National Health Service (NHS report, which is expecting a £30 billion funding gap by 2020/2021.We strongly believe that nowadays, leadership and management skills are crucial within the NHS and have been shown to positively impact the overall performance of doctors appointed to hospital boards of directors and clinical outcomes.2 Furthermore, we agree with the authors that a lack of knowledge of the NHS structure can be efficiently addressed by incorporating medical leadership and management (MLM early during undergraduate training.However, we believe that a mandatory year studying management within an already overcrowded undergraduate curriculum is not realistic and feasible. Moreover, several identified barriers to the implementation of such education, including negative attitudes held by both doctors and students toward MLM still need to be addressed.2Previous letter has been published 

  12. Diabetes: Christian worldview, medical distrust and self-management.

    Science.gov (United States)

    Newlin Lew, Kelley; Arbauh, Nancy; Banach, Paul; Melkus, Gail

    2015-06-01

    To inform the development of a combined diabetes prevention and self-management intervention in partnership with church communities, this study sampled African American church leaders and members (N = 44) to qualitatively study religious beliefs and practices, diabetes prevention and self-management behaviors, and related community actions. Prior to commencing the study, internal review board approval was obtained. Although not required, community consent was officially provided by the church pastors. Individual consent was subsequently obtained from eligible community members who expressed an interest in participating in the study. Following a participatory action research approach, the inquiry group method was used. Qualitative data were analyzed with content analysis. Findings revealed Christian worldview, medical distrust and self-management as prominent themes. Findings suggest that diabetes providers address religious orientation in the provision of care with attention to rebuilding trust with the African-American community to improve health outcomes. PMID:25735754

  13. Medication management concerns of ethnic minority family caregivers of people living with dementia.

    Science.gov (United States)

    Gillespie, Robyn J; Harrison, Lindsey; Mullan, Judy

    2015-01-01

    This qualitative study explored the medication management experiences of Australian ethnic minority family caregivers of people living with dementia. From the perspective of this group of caregivers, medication management was a source of stress resulting from the progressive loss of ability of care recipients to manage their own medications; the complexity of the medication regime and the caregiver's lack of trust of the care recipient to safely and effectively manage medications. Caregivers used various strategies to manage medications and avoid conflict with care recipients including being watchful and involving other family members in medication management tasks. Family caregivers indicated that a lack of information and access to support to inform their medication management role added to their stress, which was exacerbated in some cases by limited English proficiency. Supportive factors noted by caregivers included a well-established relationship with a community pharmacist, involvement of a geriatrician, family support and caregiver support group participation. PMID:24339089

  14. Medical management of patients after bariatric surgery: Principles and guidelines

    Institute of Scientific and Technical Information of China (English)

    Abd; Elrazek; Mohammad; Ali; Abd; Elrazek; Abduh; Elsayed; Mohamed; Elbanna; Shymaa; E; Bilasy

    2014-01-01

    Obesity is a major and growing health care concern. Large epidemiologic studies that evaluated the relationship between obesity and mortality, observed that a higher body-mass index(BMI) is associated with increased rate of death from several causes, among them cardiovascular disease; which is particularly true for those with morbid obesity. Being overweight was also associated with decreased survival in several studies. Unfortunately, obese subjects are often exposed to public disapproval because of their fatness which significantly affects their psychosocial behavior. All obese patients(BMI ≥ 30 kg/m2) should receive counseling on diet, lifestyle, exercise and goals for weight management. Individuals with BMI ≥ 40 kg/m2 and those with BMI > 35 kg/m2 with obesity-related comorbidities; who failed diet, exercise, and drug therapy, should be considered for bariatric surgery. In current review article, we will shed light on important medical principles that each surgeon/gastroenterologist needs to know about bariatric surgical procedure, with special concern to the early post operative period. Additionally, we will explain the common complications that usually follow bariatric surgery and elucidate medical guidelines in their management. For the first 24 h after the bariatric surgery, the postoperative priorities include pain management, leakage, nausea and vomiting, intravenous fluid management, pulmonary hygiene, and ambulation. Patients maintain a low calorie liquid diet for the first few postoperative days that is gradually changed to soft solid food diet within two or three weeks following the bariatric surgery. Later, patients should be monitored for postoperative complications. Hypertension, diabetes, dumping syndrome, gastrointestinal and psychosomatic disorders are among the most important medical conditions discussed in this review.

  15. A personalized framework for medication treatment management in chronic care.

    Science.gov (United States)

    Koutkias, Vassilis G; Chouvarda, Ioanna; Triantafyllidis, Andreas; Malousi, Andigoni; Giaglis, Georgios D; Maglaveras, Nicos

    2010-03-01

    The ongoing efforts toward continuity of care and the recent advances in information and communication technologies have led to a number of successful personal health systems for the management of chronic care. These systems are mostly focused on monitoring efficiently the patient's medical status at home. This paper aims at extending home care services delivery by introducing a novel framework for monitoring the patient's condition and safety with respect to the medication treatment administered. For this purpose, considering a body area network (BAN) with advanced sensors and a mobile base unit as the central communication hub from the one side, and the clinical environment from the other side, an architecture was developed, offering monitoring patterns definition for the detection of possible adverse drug events and the assessment of medication response, supported by mechanisms enabling bidirectional communication between the BAN and the clinical site. Particular emphasis was given on communication and information flow aspects that have been addressed by defining/adopting appropriate formal information structures as well as the service-oriented architecture paradigm. The proposed framework is illustrated via an application scenario concerning hypertension management. PMID:20007042

  16. Individuals with Mental Illness Can Control Their Aggressive Behavior through Mindfulness Training

    Science.gov (United States)

    Singh, Nirbhay N.; Lancioni, Giulio E.; Winton, Alan S. W.; Adkins, Angela D.; Wahler, Robert G.; Sabaawi, Mohamed; Singh, Judy

    2007-01-01

    Verbal and physical aggression are risk factors for community placement of individuals with serious and persistent mental illness. Depending on the motivations involved, treatment typically consists of psychotropic medications and psychosocial interventions, including contingency management procedures and anger management training. Effects of a…

  17. Exposure management systems in emergencies as comprehensive medical care

    International Nuclear Information System (INIS)

    The emergency management of nuclear hazards relies on a comprehensive medical care system that includes accident prevention administration, environmental monitoring, a health physics organization, and a medical institution. In this paper, the care organization involved in the criticality accident at Tokai-mura is described, and the problems that need to be examined are pointed out. In that incident, even the expert was initially utterly confused and was unable to take appropriate measures. The author concluded that the members of the care organization were all untrained for dealing with nuclear hazards and radiation accidents. The education and training of personnel at the job site are important, and they are even more so for the leaders. Revisions of the regional disaster prevention plans and care manual are needed. (K.H.)

  18. [The realization way and lean management about medical consumable material in clinical use].

    Science.gov (United States)

    Shang, Changhao; Cheng, Junpei; Xu, Hailin; Wang, Xiaoguang

    2015-01-01

    The medical consumable material management is an important part of logistic support in the management of hospital, but the hospital has many weak links in the management of supplies. This paper aims to explore the common problems (especially in clinical use) existing in the management of medical consumables and years of management experience in Changhai hospital's practice, then discusses lean management from the perspective of lean management PMID:26027302

  19. A Description of Medication Therapy Management Services in Minnesota

    OpenAIRE

    Amie Jo Digatono, Pharm.D. Candidat

    2011-01-01

    Objective:  To describe Medication Therapy Management (MTM) services in Minnesota, quantifying how many patient encountersoccur per week and compiling provider and practice site characteristics.Design:  Cross‐sectional study.Setting:  Minnesota practice sites surveyed in June and July 2010.Participants:  MTM providers in Minnesota who are registered users of the Assurance®documentation system or are members of theMinnesota Pharmacists Association MTM Academy.  Intervention:  Self‐administered...

  20. Norethindrone Acetate in the Medical Management of Adenomyosis

    Directory of Open Access Journals (Sweden)

    Siddhi Mankame

    2012-10-01

    Full Text Available The role of norethindrone acetate (NA in the management of adenomyosis was evaluated with a retrospective chart review of 28 premenopausal women between 27–49 years of age presenting with moderate to severe pelvic pain and bleeding. Bleeding and dysmenorrhea scores were analyzed using paired T-tests. There was significant improvement of both dysmenorrhea and bleeding after treatment. Age showed no correlation with dysmenorrhea or bleeding. Low dose NA could be considered an effective, well-tolerated and inexpensive medical alternative to surgery for treating symptomatic adenomyosis. Large multicentric studies may help validate our findings.

  1. Unnatural birth? : medical pain management technology and the naturalness of birth

    OpenAIRE

    2008-01-01

    The aim of this thesis is to explore how medical pain management technology affects the concept of natural birth.The relationship between medical pain management technology and natural birth is discussed in a structural framework in which medicalization, risk, and identity are acknowledged as important issues within the current childbirth paradigm. The analysis is based on thirteen in-depth interviews with Norwegian midwives and mothers on their perceptions of medical pain management technolo...

  2. Can managed care reduce employers' retiree medical liability?

    Science.gov (United States)

    Taylor, R S; Newton, B

    1991-01-01

    The Financial Accounting Standards Board (FASB) has forced U.S. companies to look squarely at their current retiree health obligations and their future commitments. Accounting Statement No. 106 (FAS 106) requires employers to accrue liabilities for retiree health benefits during employees' active service, rather than record the costs as benefits are paid. Employers are scrambling to find ways to reduce the statement's effect on corporate balance sheets. While managed health care has been increasingly employed to control benefit costs in active employee health plans, it has not been as popular in retiree plans. This article reviews important demographic and health trends in the retiree population and summarizes employers' early responses to FAS 106. It explores why managed health care has thus far played a limited role in reducing employers' postretirement medical liability, and offers insight into how that role could be increased in the future. PMID:10116958

  3. Infectious waste management in Japan: A revised regulation and a management process in medical institutions

    International Nuclear Information System (INIS)

    In Japan, the waste management practice is carried out in accordance with the Waste Disposal Law of 1970. The first rule of infectious waste management was regulated in 1992, and infectious wastes are defined as the waste materials generated in medical institutions as a result of medical care or research which contain pathogens that have the potential to transmit infectious diseases. Revised criteria for infectious waste management were promulgated by the Ministry of Environment in 2004. Infectious waste materials are divided into three categories: the form of waste; the place of waste generation; the kind of infectious diseases. A reduction of infectious waste is expected. We introduce a summary of the revised regulation of infectious waste management in this article

  4. Bio Medical Waste Management- ‘An Emerging Problem’

    Directory of Open Access Journals (Sweden)

    Mohd Inayatulla Khan

    2012-01-01

    Full Text Available As per Bio-Medical Waste (Management and Handling Rules, 1998 and amendments, any waste, which is generated during the diagnosis, treatment or immunization of human beings or animals or in research activities pertaining there to or in the production of testing of biological and including categories mentioned in schedule 1 of the Rule, is the bio-medical waste The private sector accounts for more than 80% of total healthcare spending in India. Unless there is a decline in the combined federal and state government deficit, which currently stands at roughly 9%, the opportunity for significantly higher public health spending will be limited. The growth of this sector has not only increased the quality of patient care but also put a tremendous strain on the environment due to generation of huge amounts of Bio-Medical waste. It is estimated that quantity of waste generated from hospitals in our country ranges from 0.5-2 kg/bed/day and annually 0.33 million tons of waste is generated in India [2]. The waste generated in the hospitals and institutions essentially consists of solids and liquid, which may be hazardous, infectious and non-infectious. According to a WHO report, around 85% of the hospital wastes are actually nonhazardous, 10% are infectious and 5% are non-infectious but hazardous.

  5. 78 FR 35940 - Content of Premarket Submissions for Management of Cybersecurity in Medical Devices; Draft...

    Science.gov (United States)

    2013-06-14

    ... premarket submissions to provide effective cybersecurity management and to reduce the risk that device... Submissions for Management of Cybersecurity in Medical Devices.'' This guidance identifies cybersecurity... draft guidance document entitled ``Content of Premarket Submissions for Management of Cybersecurity...

  6. Medical management of three workers following a radiation exposure incident

    Energy Technology Data Exchange (ETDEWEB)

    House, R.A.; Sax, S.E.; Rumack, E.R.; Holness, D.L. (Department of Occupational and Environmental Health, St. Michael' s Hospital, Toronto, Ontario (Canada))

    1992-01-01

    The medical management of three individuals involved in an exposure incident to whole-body radiation at a nuclear generating plant of a Canadian electrical utility is described. The exposure incident resulted in the two highest whole-body radiation doses ever received in a single event by workers in a Canadian nuclear power plant. The individual whole-body doses (127.4 mSv, 92.0 mSv, 22.4 mSv) were below the threshold for acute radiation sickness but the exposures still presented medical management problems related to assessment and counseling. Serial blood counting and lymphocyte cytogenetic analysis to corroborate the physical dosimetry were performed. All three employees experienced somatic symptoms due to stress and one employee developed post-traumatic stress disorder. This incident indicates that there is a need in such radiation exposure accidents for early and continued counseling of exposed employees to minimize the risk of development of stress-related symptoms.

  7. Medical management of three workers following a radiation exposure incident

    International Nuclear Information System (INIS)

    The medical management of three individuals involved in an exposure incident to whole-body radiation at a nuclear generating plant of a Canadian electrical utility is described. The exposure incident resulted in the two highest whole-body radiation doses ever received in a single event by workers in a Canadian nuclear power plant. The individual whole-body doses (127.4 mSv, 92.0 mSv, 22.4 mSv) were below the threshold for acute radiation sickness but the exposures still presented medical management problems related to assessment and counseling. Serial blood counting and lymphocyte cytogenetic analysis to corroborate the physical dosimetry were performed. All three employees experienced somatic symptoms due to stress and one employee developed post-traumatic stress disorder. This incident indicates that there is a need in such radiation exposure accidents for early and continued counseling of exposed employees to minimize the risk of development of stress-related symptoms

  8. Preventing and managing unprofessionalism in medical school faculties.

    Science.gov (United States)

    Binder, Renee; Friedli, Amy; Fuentes-Afflick, Elena

    2015-04-01

    Professionalism is a required competency for medical students, residents, practicing physicians, and academic faculty. Faculty members must adhere to codes of conduct or risk discipline. The authors describe issues of unprofessionalism that culminate in allegations of faculty misconduct or filing of grievances in academic medicine and outline strategies for early intervention and prevention. The authors, vice and associate deans and executive director of the office of faculty affairs at a large U.S. medical school, have handled many allegations of unprofessional conduct over the past decade. They present case examples based on behaviors such as lack of respect, inappropriate language and behavior, failure to cooperate with members of the health care team, and sexual harassment/discrimination. They discuss factors complicating evaluation of these behaviors, including variable definitions of respect, different cultural norms, and false allegations. The authors make recommendations for prevention and intervention, including early identification, performance management, education about sexual harassment, and referrals to professional coaches, anger management classes, and faculty-staff assistance programs. PMID:25470311

  9. Understanding Aggressive Behavior Across the Life Span

    OpenAIRE

    Liu, Jianghong; Lewis, Gary; Evans, Lois

    2012-01-01

    Aggressive behavior is the observable manifestation of aggression and is often associated with developmental transitions and a range of medical and psychiatric diagnoses across the lifespan. As healthcare professionals involved in the medical and psychosocial care of patients from birth through death, nurses frequently encounter—and may serve as—both victims and perpetrators of aggressive behavior in the workplace. While the nursing literature has continually reported research on prevention a...

  10. Nonadherence with antipsychotic medication in schizophrenia: challenges and management strategies

    Directory of Open Access Journals (Sweden)

    Haddad PM

    2014-06-01

    and monitoring systems to enhance adherence, eg, Short Message Service text messaging and real-time medication monitoring linked to smart pill containers or an electronic ingestible event marker. Financial incentives to enhance antipsychotic adherence raise ethical issues, and their place in practice remains unclear. Simple pragmatic strategies to improve medication adherence include shared decision-making, regular assessment of adherence, simplification of the medication regimen, ensuring that treatment is effective and that side effects are managed, and promoting a positive therapeutic alliance and good communication between the clinician and patient. These elements remain essential for all patients, not least for the small minority where vulnerability and risk issue dictate that compulsory treatment is necessary to ensure adherence.Keywords: adherence, nonadherence, antipsychotics, schizophrenia, long-acting injections, relapse, risk factors

  11. Improvised explosive devices: pathophysiology, injury profiles and current medical management.

    Science.gov (United States)

    Ramasamy, A; Hill, A M; Clasper, J C

    2009-12-01

    The improvised explosive device (IED), in all its forms, has become the most significant threat to troops operating in Afghanistan and Iraq. These devices range from rudimentary home made explosives to sophisticated weapon systems containing high-grade explosives. Within this broad definition they may be classified as roadside explosives and blast mines, explosive formed pojectile (EFP) devices and suicide bombings. Each of these groups causeinjury through a number of different mechanisms and can result in vastly different injury profiles. The "Global War on Terror" has meant that incidents which were previously exclusively seen in conflict areas, can occur anywhere, and clinicians who are involved in emergency trauma care may be required to manage casualties from similar terrorist attacks. An understanding of the types of devices and their pathophysiological effects is necessary to allow proper planning of mass casualty events and to allow appropriate management of the complex poly-trauma casualties they invariably cause. The aim of this review article is to firstly describe the physics and injury profile from these different devices and secondly to present the current clinical evidence that underpins their medical management. PMID:20397601

  12. Children with medically unexplained pain symptoms: Categorization and effective management

    Directory of Open Access Journals (Sweden)

    Sharmishtha S Deshpande

    2011-01-01

    Full Text Available Context: Medically unexplained pain symptoms are common in children, and their incidence is on the rise. There is often a lack of clearly articulated pathophysiology in these patients. There is need to improve understanding about varied causes and presentations of these patients which would generate further insight in management of these patients. Documentation and detailed assessment of such children in Indian setting is not seen in literature. Materials and Methods: A series of 17 cases, 10 boys and 7 girls referred from pediatrics department is discussed, so as to categorize them in three different subgroups for management. Result and Discussion: Although there were often no overt anxiety or depressive features, some psychosocial stress which was mostly unnoticed by the child, the parents and the doctor, preceded such a pain. It was often an academic stress, familial separation or parental psychiatric illness. They were at times not able to verbalize their distress, which was revealed with the help of Children′s Apperception Test (C.A.T.. They mainly had anxieties about loss of love or disapproval by parents and also fear of harm or injury. They used defence mechanisms like denial, reaction formation and repression, which were ineffective in handling the overwhelming anxiety. Most of these children had either above average or borderline intelligence. Somatic expression of emotional needs and fears in these children was managed effectively by supportive therapy and antidepressant drugs.

  13. Resistance to medical educational change: management and communication.

    Science.gov (United States)

    Tsai, Tsuen-Chiuan

    2007-01-01

    Medical education in Taiwan is currently undergoing active renovation. Reform and changes always bring resistance from the levels of individuals, institution and even the society. As an educational leader, to be able to manage resistance is a key to successful reform. This review article provides management strategies and communication skills to solve the resistance problem. The best solution to the problem is "to prevent" resistance from happening through identifying those who may be reluctant to change, and the reasons behind the potential resistance. Some of the reasons for resistance are threatening of self-interest and a loss of face, excess uncertainty, conservatism, fear of personal-worth declination in the organization, and different assessment or perception. The management and communication strategies are suggested to adjust to fit reform process, i.e., recognizing the needs for change, planning process, implementation, and institutionalization innovation. Finally, it is only with respect, empathy, sincerity and support that the resistance to changes can be resolved and difficulties can be overcome. PMID:19653408

  14. Managing the Learning Environment in Undergraduate Medical Education: The Sheffield Approach.

    Science.gov (United States)

    Roberts, Chris; Lawson, Mary; Newble, David; Self, Ashley

    2003-01-01

    Describes one possible model for e-learning in undergraduate medical education with an emphasis on supporting and managing curriculum development. The Sheffield Networked Learning Environment (NLE) was developed in collaboration with other medical schools. (Author/SOE)

  15. [The management of implantable medical device and the application of the internet of things in hospitals].

    Science.gov (United States)

    Zhou, Li; Xu, Liang

    2011-11-01

    Implantable medical device is a special product which belongs to medical devices. It not only possesses product characteristics in common, but also has specificity for safety and effectiveness. Implantable medical device must be managed by the relevant laws and regulations of the State Food and Drug Administration. In this paper, we have used cardiac pacemakers as an example to describe the significance of the management of implantable medical device products and the application of the internet of things in hospitals. PMID:22379772

  16. Effects of a "Brief Stress Management Training Program" from Medical Students’ Viewpoints: A Qualitative Study

    OpenAIRE

    Sepideh Herizchi; Jaafar Sadegh Tabrizi; Fatemeh Ranjbar

    2015-01-01

    Introduction: Medical students undergo many stressors during various stages of medical education and must learn to cope with their new situation. Some studies have reported that stress management training methods have significant effects on decreasing stress in medical students. The aim of this study was to evaluate the efficacy of a "Stress Management Training Session" from medical students’ viewpoints. Methods: This study design employed a qualitative phenomenological research method. U...

  17. Improving medication management for patients: the effect of a pharmacist on post-admission ward rounds

    OpenAIRE

    Fertleman, M; Barnett, N; Patel, T.

    2005-01-01

    

Problem: Medication management in the NHS has been highlighted by the UK Department of Health as an area for improvement. Pharmacist participation on post-take (post-admission) ward rounds was shown to reduce medication errors and reduced prescribing costs in the USA and in UK teaching hospitals, which can contribute to improved medication management. We sought to demonstrate the problem in our hospital by collecting data on prescribing practice from three consecutive general medical post-t...

  18. Integrating Medication Therapy Management Education into a Core Pharmacy Curriculum

    Science.gov (United States)

    Kodali, Leela; Pace, Adam C.

    2016-01-01

    Objective. To describe the design of a core course directed at improving confidence and competence of students to perform medication therapy management (MTM) services. Design. Using the American Pharmacists Association (APhA) certificate training program framework, a core course was developed to teach MTM concepts to third-year student pharmacists. Using deep learning and authentic assignments, course instructors attempted to improve student confidence and readiness to provide MTM services. Assessment. Student ability to meet course objectives was evaluated by examinations and the APhA MTM program self-assessment. Students had an overall success rate of 93% on all three assessments. Student perceptions of confidence, competence, and importance of performing MTM services were measured using a survey instrument with 56 Likert-type items. Students completing both surveys reported significantly increased confidence and competence. Conclusion. Integrating MTM-specific education into the core curriculum increased student pharmacists’ perceived competence and confidence to perform MTM services.

  19. Integrating Medication Therapy Management Education into a Core Pharmacy Curriculum.

    Science.gov (United States)

    Poole, Traci M; Kodali, Leela; Pace, Adam C

    2016-05-25

    Objective. To describe the design of a core course directed at improving confidence and competence of students to perform medication therapy management (MTM) services. Design. Using the American Pharmacists Association (APhA) certificate training program framework, a core course was developed to teach MTM concepts to third-year student pharmacists. Using deep learning and authentic assignments, course instructors attempted to improve student confidence and readiness to provide MTM services. Assessment. Student ability to meet course objectives was evaluated by examinations and the APhA MTM program self-assessment. Students had an overall success rate of 93% on all three assessments. Student perceptions of confidence, competence, and importance of performing MTM services were measured using a survey instrument with 56 Likert-type items. Students completing both surveys reported significantly increased confidence and competence. Conclusion. Integrating MTM-specific education into the core curriculum increased student pharmacists' perceived competence and confidence to perform MTM services. PMID:27293237

  20. Which medication do I need to manage dizzy patients?

    Science.gov (United States)

    Huppert, Doreen; Strupp, Michael; Mückter, Harald; Brandt, Thomas

    2011-03-01

    Vertigo and dizziness are not independent disease entities, but instead symptoms of various diseases. Accordingly, a variety of treatment approaches are required. Here we review the most relevant drugs for managing dizziness, vertigo, and nystagmus syndromes. It is important to differentiate symptomatic treatment of nausea and vomiting with, for example, dimenhydrinate and benzodiazepines, and prophylactic treatment of motion sickness with scopolamine from a causal therapy of the underlying disorders. Examples of such causal therapy include aminopyridines for downbeat nystagmus and episodic ataxia type 2; carbamazepine for vestibular paroxysmia, paroxsymal dysarthria and ataxia in multiple sclerosis, and superior oblique myokymia; betahistine, dexamethasone, and gentamicin for Menière's disease; gabapentin and memantine for different forms of acquired and congenital nystagmus; corticosteroids for acute vestibular neuritis and Cogan's syndrome; metoprolol and topiramate for vestibular migraine; and selective serotonin reuptake inhibitors such as paroxetine for phobic postural vertigo. The clinical entities are briefly described, the various medications are discussed in alphabetical order, and dosage, major side effects, contraindications, and alternative medications of each drug are displayed in boxes for easy reference. PMID:21142898

  1. Medical Approach to the Management of Traumatized Refugees.

    Science.gov (United States)

    Kinzie, J David

    2016-03-01

    Refugees are a highly traumatized and culturally diverse group of patients who present many clinical challenges. Refugees have a high prevalence of traumas from torture, ethnic cleansing, and the effects of long civil wars. The most common diagnoses associated with the effects of such traumas are posttraumatic stress disorder (PTSD) or PTSD with comorbid depression; however, psychosis and neurocognitive disorders are also common. For those with PTSD, a suggested treatment approach is long-term supportive psychotherapy with drug treatment directed at reducing the most disruptive symptoms, such as insomnia, nightmares, and irritability or psychosis. The author recommends a sedative tricyclic antidepressant, clonidine or prazosin, and aripiprazole as a useful combination of medications to provide rapid relief. In addition to PTSD, long-term studies indicate a high prevalence of diabetes and hypertension in traumatized refugees. It is therefore important to perform a thorough evaluation for these disorders that includes the measurement of blood pressure and a blood test for diabetes. When managed with such a medical approach, refugees are generally accepting of psychiatric treatment and can obtain relief from the symptoms associated with the massive trauma and losses they have experienced. PMID:27138076

  2. Can we widen the scope of medical management in ectopic pregnancy?

    Directory of Open Access Journals (Sweden)

    Usha Kiran TS

    2016-04-01

    Full Text Available The objective of the study was to Safe Medical management of ectopic pregnancy in those where surgical management was indicated. Patients with one or more criteria not suitable for medical treatment but refusing surgical management were included. Exclusion criteria were those who were not haemodynamically stable. They were managed with close monitoring as inpatient to assess resolution of ectopic with Methotrexate. All five cases have been managed successfully by medical method. There is a possible role for medical management in patients who might not satisfy the criteria fully, however further research is needed. Ectopic pregnancy is life threatening disorder. With advances in diagnostic approaches such as ultrasound coupled with hormone markers diagnosis of ectopic has become easier in cases having first trimester bleeding per vaginum. Ectopic can be managed expectantly, medically and surgically. Medical management includes Inj. Methotrexate (MTX. In this case series we have studied five cases which are managed successfully with hundred percent successful results by medical management despite not satisfying criteria. It is a retrospective study. So from this study we can conclude that we can manage ectopic pregnancies medically based upon clinical judgment. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000: 1257-1259

  3. Electronic Aggression

    Centers for Disease Control (CDC) Podcasts

    2007-11-20

    Aggression is no longer limited to the school yard. New forms of electronic media, such as blogs, instant messaging, chat rooms, email, text messaging, and the internet are providing new arenas for youth violence to occur.  Created: 11/20/2007 by National Center for Injury Prevention and Control, Division of Violence Prevention.   Date Released: 11/28/2007.

  4. [Management of acute intoxication with paracetamol--Polish Medical Society, Section of Clinical Toxicology position statement].

    Science.gov (United States)

    Waldman, Wojciech; Groszek, Barbara; Burda, Piotr; Wiśniewski, Marek; Sein Anand, Jacek

    2012-01-01

    Paper presents Polish Medical Society, Section of Clinical Toxicology position statement on the prehospital and hospital management in case of suspicion of intoxication with paracetamol. PMID:23243910

  5. [Structured medication management in primary care - a tool to promote medication safety

    NARCIS (Netherlands)

    Mahler, C.; Freund, T.; Baldauf, A.; Jank, S.; Ludt, S.; Peters-Klimm, F.; Haefeli, W.E.; Szecsenyi, J.

    2014-01-01

    Patients with chronic disease usually need to take multiple medications. Drug-related interactions, adverse events, suboptimal adherence, and self-medication are components that can affect medication safety and lead to serious consequences for the patient. At present, regular medication reviews to c

  6. MEDICATION MANAGEMENT CAPACITY IN RELATION TO COGNITION AND SELF-MANAGEMENT SKILLS IN OLDER PEOPLE ON POLYPHARMACY

    NARCIS (Netherlands)

    Sino, C. G. M.; Sietzema, M.; Egberts, T. C. G.; Schuurmans, M. J.

    2014-01-01

    Objective: to determine the medication management capacity of independently living older people (>= 75 years) on polypharmacy (>= 5 medications) in relation to their cognitive- and self-management skills. Design: Cross-sectional study. Setting: two homecare organizations in the Netherlands. Particip

  7. Further insights into the roles of the medical educator: the importance of scholarly management.

    Science.gov (United States)

    Bligh, John; Brice, Julie

    2009-08-01

    Medical educators need to be able to define excellence within the various roles they occupy so that they can demonstrate internationally recognized, high-quality scholarship. Previous definitions of scholarship have focused on research and teaching but have been unable to integrate other roles such as leadership, management, and administration. Clearer definition of the various roles of the medical educator, coupled with a broader understanding of medical education scholarship that is able to encompass management, as well as teaching and research, will help institutions to evaluate and reward faculty members appropriately. We propose that management should now be introduced as a third "priority of the professoriate." We outline the concept of the scholarly manager, particularly as it applies to management in medical education. We offer a new conceptual model which situates the role of the academic manager within the scholarship of medical education and shows it to be an essential part of the skills and competences of the excellent medical educator. We emphasize that at the heart of all scholarly activity in medical education lie the core skills, values, and behaviors shared by all involved in the education of doctors and medical students. Future research is needed to explore and, where possible, achieve consensus on the core skills, values, and behaviors of an excellent medical educator. In addition, work should commence to define and categorize the various stages in the development of a significant management portfolio in medical education teaching and research. PMID:19638788

  8. 病案管理中医疗纠纷的防范%Prevention Medical Disputes of Medical Records Management

    Institute of Scientific and Technical Information of China (English)

    何颖芝

    2011-01-01

    Medical records are important evidence in medical disputes and law suits. In medical records management, we should standardize writing, improve the quality and ensure filing integrity and safekeeping . We must learn business and law publicity and education regularly to streng then the law consciousness and establish and perfect the effective medical records management mechanism.Only controlling and managing from writing to filing medical records strictly,can we reduce and prevent medical disputes to greatest extent and ensure medical work in normal operation .%病案是涉及医疗纠纷及诉讼的重要证据,在病案管理中,必须规范病案书写提高病案质量,确保病案的完整归档和妥善保管;医务人员和病案管理人员应定期的进行业务学习和法制教育,强化法律意识,建立完善有效的病案管理机制.只有从病案书写到病案归档全过程进行严格控制管理,才能最大限度地减少和防范医疗纠纷,确保医院医疗工作正常运行.

  9. Experiences of Emotion Management in Medical Care (Case Study: Toronto

    Directory of Open Access Journals (Sweden)

    Masoud Kianpour

    2013-02-01

    Full Text Available Introduction   This study lies at the intersection of the sociology of emotions and medical sociology, investigating emotion management among a rather unknown category of medical personnel –Hospital Chaplains. Sociologists of emotions seek to understand how emotions can be socially influenced in terms of both experience and expression. They believe emotions can be influenced by such institutions as culture and religion. As a result, not only do societies and subcultures have different patterns of expressing emotions according to their own norms and characteristics, but there are also different ways of managing emotions in social institutions. For example, in North American healthcare system, hospital chaplaincy is institutionalized, like other members of the medical team, to provide spiritual and religious care, which is often accompanied with emotional support, requiring therefore emotion management. In order to explore emotional experiences that chaplains undergo as a result of working in hospital and dealing with people who are emotionally overwhelmed, the author utilized insights from interactional and symbolic interactionist, phenomenological, and ethnomethodological approaches within the sociology of emotions and spoke with different chaplains from five faith traditions. The aim was to understand how chaplains perform interpersonal emotion management, what techniques, strategies and skills are involved in dealing with people’s emotions, and how performing emotion management in healthcare institutions brings religion and spirituality at the forefront of a secular society.       Material and Methods   This is a qualitative study based on in-depth interviewing with hospital chaplains working in different hospitals in the Toronto area. Toronto has a large number of hospitals and medical/healthcare institutions, most of which have a spiritual care department in which a number of full-time and part-time chaplains work to provide

  10. The medical device industry developments in software risk management

    CERN Document Server

    Burton, John; McCaffery, Fergal; hAodha, Micheal O

    2009-01-01

    The Medical Device industry is one of the fastest growing industries in the world. Device manufacturers are producing increasingly sophisticated and complex medical device software to differentiate themselves in the battle for dominance in this sector.

  11. DM2: A Distributed Medical Data Manager for Grids

    OpenAIRE

    Duque, Hector; Montagnat, Johan; Pierson, Jean-Marc; Brunie, Lionel; Magnin, Isabelle

    2003-01-01

    International audience Medical data represent tremendous amount of data for which automatic analysis is increasingly needed. Grids are very promising to face today challenging health issues such as epidemiological studies through large image data sets. However, the sensitive nature of medical data makes it difficult to widely distribute medical applications over computational grids. In this paper, we review fundamental medical data manipulation requirements and then propose a distributed d...

  12. Evaluation of a hybrid paper-electronic medication management system at a residential aged care facility.

    Science.gov (United States)

    Elliott, Rohan A; Lee, Cik Yin; Hussainy, Safeera Y

    2016-06-01

    Objectives The aims of the study were to investigate discrepancies between general practitioners' paper medication orders and pharmacy-prepared electronic medication administration charts, back-up paper charts and dose-administration aids, as well as delays between prescribing, charting and administration, at a 90-bed residential aged care facility that used a hybrid paper-electronic medication management system. Methods A cross-sectional audit of medication orders, medication charts and dose-administration aids was performed to identify discrepancies. In addition, a retrospective audit was performed of delays between prescribing and availability of an updated electronic medication administration chart. Medication administration records were reviewed retrospectively to determine whether discrepancies and delays led to medication administration errors. Results Medication records for 88 residents (mean age 86 years) were audited. Residents were prescribed a median of eight regular medicines (interquartile range 5-12). One hundred and twenty-five discrepancies were identified. Forty-seven discrepancies, affecting 21 (24%) residents, led to a medication administration error. The most common discrepancies were medicine omission (44.0%) and extra medicine (19.2%). Delays from when medicines were prescribed to when they appeared on the electronic medication administration chart ranged from 18min to 98h. On nine occasions (for 10% of residents) the delay contributed to missed doses, usually antibiotics. Conclusion Medication discrepancies and delays were common. Improved systems for managing medication orders and charts are needed. What is known about the topic? Hybrid paper-electronic medication management systems, in which prescribers' orders are transcribed into an electronic system by pharmacy technicians and pharmacists to create medication administration charts, are increasingly replacing paper-based medication management systems in Australian residential aged care

  13. Implementation of a Medical Data Manager on top of gLite services

    CERN Document Server

    Montagnat, J; Pera, C; Frohner, Á; Kunszt, Peter Z; Koblitz, B; Santos, N; Loomis, C

    2006-01-01

    This report describes the effort to deploy a Medical Data Management service on top of the EGEE grid infrastructure. The most widely accepted medical image standard, DICOM, was developed for fulfilling clinical practice. It is implemented in most medical image acquisition and analysis devices. The EGEE middleware is using the SRM standard for handling grid files. Our prototype is exposing an SRM compliant interface to the grid middleware, transforming on the fly SRM requests into DICOM transactions. The prototype ensures user identification, strict file access control and data protection through the use of relevant grid services. This Medical Data Manager is easing the access to medical databases needed for many medical data analysis applications deployed today. It offers a high level data management service, compatible with clinical practices, which encourages the migration of medical applications towards grid infrastructures. A limited scale testbed has been deployed as a proof of concept of this new servic...

  14. An Exploration of Healthcare Inventory and Lean Management in Minimizing Medical Supply Waste in Healthcare Organizations

    Science.gov (United States)

    Hicks, Rodney

    2013-01-01

    The purpose of this study was to understand how lean thinking and inventory management technology minimize expired medical supply waste in healthcare organizations. This study was guided by Toyota's theory of lean and Mintzberg's theory of management development to explain why the problem of medical supply waste exists. Government…

  15. Medication management strategy for older people with polypharmacy: the GP's perspective.

    NARCIS (Netherlands)

    Sinnige, J.; Korevaar, J.C.; Lieshout, J. van; Westert, G.P.; Schellevis, F.G.; Braspenning, J.C.C.

    2016-01-01

    Background & Aim: for older patients with polypharmacy medication management is a process of careful deliberation that needs periodic adjustment based on treatment effects and changing conditions. The aim of this study is to gain insight into the GP's medication management strategy for patients with

  16. A Systematic Review of Stress-Management Programs for Medical Students

    Science.gov (United States)

    Shiralkar, Malan T.; Harris, Toi B.; Eddins-Folensbee, Florence F.; Coverdale, John H.

    2013-01-01

    Objective: Because medical students experience a considerable amount of stress during training, academic leaders have recognized the importance of developing stress-management programs for medical students. The authors set out to identify all controlled trials of stress-management interventions and determine the efficacy of those interventions.…

  17. An OGSA Middleware for managing medical images using ontologies.

    Science.gov (United States)

    Espert, Ignacio Blanquer; Garcáa, Vicente Hernández; Quilis, J Damià Segrelles

    2005-10-01

    This article presents a Middleware based on Grid Technologies that addresses the problem of sharing, transferring and processing DICOM medical images in a distributed environment using an ontological schema to create virtual communities and to define common targets. It defines a distributed storage that builds-up virtual repositories integrating different individual image repositories providing global searching, progressive transmission, automatic encryption and pseudo-anonimisation and a link to remote processing services. Users from a Virtual Organisation can share the cases that are relevant for their communities or research areas, epidemiological studies or even deeper analysis of complex individual cases. Software architecture has been defined for solving the problems that has been exposed before. Briefly, the architecture comprises five layers (from the more physical layer to the more logical layer) based in Grid Technologies. The lowest level layers (Core Middleware Layer and Server Services sc layer) are composed of Grid Services that implement the global managing of resources. The Middleware Components Layer provides a transparent view of the Grid environment and it has been the main objective of this work. Finally, the highest layer (the Application Layer) comprises the applications, and a simple application has been implemented for testing the components developed in the Components Middleware Layer. Other side-results of this work are the services developed in the Middleware Components Layer for managing DICOM images, creating virtual DICOM storages, progressive transmission, automatic encryption and pseudo-anonimisation depending on the ontologies. Other results, such as the Grid Services developed in the lowest layers, are also described in this article. Finally a brief performance analysis and several snapshots from the applications developed are shown. The performance analysis proves that the components developed in this work provide image processing

  18. Next Generation of Weight Management Medications: Implications for Diabetes and CVD Risk

    OpenAIRE

    Wharton, S; Serodio, K. J.

    2015-01-01

    Since the 1980s, the prevalence of obesity has almost doubled worldwide. Treatments for obesity include lifestyle modification, medications and surgery. Newer anti-obesity medications have been shown to be effective at inducing initial weight management in addition to successful long-term weight maintenance. Historically, weight management medications have been associated with public safety concerns that have resulted in the majority being withdrawn from the market or never receiving medicina...

  19. Comprehensive Medical Management of Rosacea: An Interim Study Report and Literature Review

    OpenAIRE

    Del Rosso, James Q.; Baum, Eric W.

    2008-01-01

    Rosacea is a common inflammatory facial dermatosis seen in adults that exhibits considerable variety in clinical presentation. Multiple medical therapeutic options are available including topical and oral treatments. Optimal medical management of rosacea includes assessment of subtype and disease severity and use of appropriate skin care to reduce epidermal barrier dysfunction. This article provides an overall discussion of the medical management of rosacea and reviews interim results from a ...

  20. The effectiveness of risk management program on pediatric nurses’ medication error

    OpenAIRE

    Dehghan-Nayeri, Nahid; Bayat, Fariba; Salehi, Tahmineh; Faghihzadeh, Soghrat

    2013-01-01

    Background: Medication therapy is one of the most complex and high-risk clinical processes that nurses deal with. Medication error is the most common type of error that brings about damage and death to patients, especially pediatric ones. However, these errors are preventable. Identifying and preventing undesirable events leading to medication errors are the main risk management activities. The aim of this study was to investigate the effectiveness of a risk management program on the pediatri...

  1. Impact of information technology on the role of medical libraries in information managment: normative background

    OpenAIRE

    Anamarija Rožić-Hristovski; Sonja Pogačnik

    1998-01-01

    Exponential growth of biomedical knowledge and information technology development is changing the infrastructure of health care systems, education and research. So medical libraries roles have shifted from managing containers of information toward influencing biomedical information resource content and education. These new tasks are formalised in modem American standards for medical libraries, stressing information management role in evolving environment.In Slovenia medical libraries also are...

  2. Strategic management of medical tourism in Iran based on SWOT model

    OpenAIRE

    Majid Daeichini; Rasool Abedini; Siavash DanaeiMehr

    2014-01-01

    Medicine and related services worldwide, branches of tourism as medical tourism, have created. Every year, thousands of tourists have access to modern medical services, and of course reasonably priced way to Iran, the more they attract and develop medical tourism, a comprehensive review is necessary. This study, based on an analytical method - a description, and utilization of available resources in the field of tourism management, tourism, and its role in the development of medical tourism i...

  3. Relationship between Emotional Intelligence and the Success of Educational Managers at Golestan University of Medical Sciences

    OpenAIRE

    Einollah Mollaei; Ladan Heravi; Reza Eftekharaldyn; Hamid Asayesh

    2012-01-01

    Introduction: Emotional intelligence is a new evolution in the field of thought – excitement relationship, which has a major effect on the success of managers. Therefore, the aim of this study was to assess the relationship between emotional intelligence and the success of educational managers at Golestan University of medical sciences. Methods: This study was conducted with all (n=96) educational managers (45 females and 51 males) at Golestan University of Medical Sciences who were selected ...

  4. Assessment of medical waste management in seven hospitals in Lagos, Nigeria

    OpenAIRE

    Awodele, Olufunsho; Adewoye, Aishat Abiodun; Oparah, Azuka Cyril

    2016-01-01

    Background Medical waste (MW) can be generated in hospitals, clinics and places where diagnosis and treatment are conducted. The management of these wastes is an issue of great concern and importance in view of potential public health risks associated with such wastes. The study assessed the medical waste management practices in selected hospitals and also determined the impact of Lagos Waste Management Authority (LAWMA) intervention programs. A descriptive cross-sectional survey method was u...

  5. Effective management of medical information through ROI-lossless fragile image watermarking technique.

    Science.gov (United States)

    Das, Sudeb; Kundu, Malay Kumar

    2013-09-01

    In this article, we have proposed a blind, fragile and Region of Interest (ROI) lossless medical image watermarking (MIW) technique, providing an all-in-one solution tool to various medical data distribution and management issues like security, content authentication, safe archiving, controlled access retrieval, and captioning. The proposed scheme combines lossless data compression and encryption technique to embed electronic health record (EHR)/DICOM metadata, image hash, indexing keyword, doctor identification code and tamper localization information in the medical images. Extensive experiments (both subjective and objective) were carried out to evaluate performance of the proposed MIW technique. The findings offer suggestive evidence that the proposed MIW scheme is an effective all-in-one solution tool to various issues of medical information management domain. Moreover, given its relative simplicity, the proposed scheme can be applied to the medical images to serve in many medical applications concerned with privacy protection, safety, and management. PMID:23816251

  6. Radiotherapy for aggressive fibromatosis

    International Nuclear Information System (INIS)

    Purpose/Objective: To evaluate local control with radiotherapy for aggressive fibromatosis. Materials and Methods: Fifty-three patients with histologically confirmed aggressive fibromatosis were treated with radiotherapy at the University of Florida between March 1975 and June 1992. The minimum length of follow-up was 2 years; 88% of patients had follow-up for at least 5 years. Thirty-nine patients had lesions in an extremity and 14 patients had lesions in the trunk. Twenty-nine patients were treated for gross disease. Patients were treated with total doses between 35 Gy and 70 Gy; 83% of patients received 50 Gy to 60 Gy. Results: Local control was achieved in 23 of 29 patients (79%) treated for postoperative microscopic residual disease. Local control was achieved in 21 of 24 patients (88%) treated for gross disease; gross disease was controlled in 8 of 8 patients with previously untreated lesions, and in 13 of 16 patients treated for postoperative gross residual and recurrent disease. Overall, aggressive fibromatosis was locally controlled in 83% of treated patients. All 9 treatment failures occurred with extremity lesions 4 to 68 months after initiation of treatment. Of the 9 recurrences, 4 were out-of-field, 3 were in-field, and 4 occurred at the margin of the irradiated field. Salvage was successful in 8 of 9 patients in whom salvage was attempted with surgery alone or combined with postoperative radiotherapy. A functional limb was maintained in 38 of 39 patients with extremity or limb girdle lesions. The most serious complication of treatment was pathologic fracture, which occurred in 3 of 53 treated patients; all 3 fractures healed with conservative management. Conclusion: Radiotherapy is a valuable adjunct to surgery in the management of aggressive fibromatosis and can be used alone in patients with unresectable or inoperable disease

  7. Personalized Medication Management: Towards a Design of Individualized Support for Elderly Citizens at Home

    DEFF Research Database (Denmark)

    Verdezoto, Nervo; Olsen, Jesper Wolff

    2012-01-01

    Several technologies have been developed to support people's medication management, including pillboxes, specialized software applications, reminders and paper-based medication lists. Several of these technologies were discovered in older adults' homes during user studies carried out with the main...... purpose to help them to manage their medications and recall challenges. We confirm that a considerable number of older adults integrate their medication treatments into their daily life routines, and that the lack of knowledge, caregiver's support, medicine outside the home, forgetting medication intake......, complexity of medication regimen were equally important challenges. One of the major findings was the issue related to substitutions, as older adults get confused due to the volatile information that they receive regarding their medications. We define basic requirements in order to address these issues...

  8. Financial-Ratio Analysis and Medical School Management.

    Science.gov (United States)

    Eastaugh, Steven R.

    1980-01-01

    The value of a uniform program of financial assistance to medical education and research is questioned. Medical schools have an uneven ability to compensate for declining federal capitation and research grants. Financial-ratio analysis and cluster analysis are utilized to suggest four adaptive responses to future financial pressures. (Author/MLW)

  9. [Confrontation with aggression - psychopathological patterns of behavior].

    Science.gov (United States)

    Pauchard, J P

    1981-01-01

    Man in our society is less and less able to manage his own aggression or aggression of others. Psychopathologic patterns of reaction appearing thereby are demonstrated on the example of the soldier, and relations to stress theories are discussed. Conditions of formation and consequences of suppression of aggression are shown on the example of the recruit with fear of shooting or failure in basic training; similar manifestations in non-military life are referred to. The necessity of an education to adequate management of aggression is stressed. PMID:7313590

  10. Effects of a "Brief Stress Management Training Program" from Medical Students’ Viewpoints: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Sepideh Herizchi

    2015-12-01

    Full Text Available Introduction: Medical students undergo many stressors during various stages of medical education and must learn to cope with their new situation. Some studies have reported that stress management training methods have significant effects on decreasing stress in medical students. The aim of this study was to evaluate the efficacy of a "Stress Management Training Session" from medical students’ viewpoints. Methods: This study design employed a qualitative phenomenological research method. Using a goal-directed sampling method, medical students in the psychiatry ward during 3 months, participated in a "Stress Management Training Session". In this section, the nature of stress and some simple techniques for stress management were taught practically. After 1 month, participants cooperated in 3 focus group discussions. In the FGDs students explained their experiences in the stress management session and its effectiveness. After recording and writing discussions, subjects’ content was analyzed. Results: In total, 6 themes and 2:10 subthemes materialized from data analysis. In the students’ opinions, learning and using stress management techniques had good effects on their stress, sleep and headaches. Although some students didn’t notice to the efficacy on concentration, others believed stress management techniques were useful for learning and concentration. Conclusion: Based on the medical students’ opinions, learning and using stress management techniques had good effects on their stress, sleep and headaches and may improve concentration and learning quality.

  11. Loneliness at the Top: Ten Ways Medical Practice Administrators Can Manage the Isolation of Leadership.

    Science.gov (United States)

    Hills, Laura

    2016-01-01

    Medical practice.managers spend their days surrounded by people, so the last thing they may expect to feel is lonely. Yet for many, being the manager of a medical practice can lead to feelings of isolation from the rest of the staff, and loneliness. This article explores the many reasons that managing a medical practice can be a lonely business. It considers the risks when a practice manager's loneliness goes unchecked, both to the individual and to the practice. It suggests 10 effective and healthy strategies for preventing and managing the leadership loneliness that medical practice managers sometimes experience. Next, this article argues that acceptance is the first step in overcoming loneliness in the workplace. It offers guidance for medical practice managers who wish to help lonely members of their teams. It describes the benefits of having a confidant to help support the medical practice manager, and the characteristics of an ideal confidant. Finally, this article suggests a strategy for combatting loneliness by interacting with the staff more frequently. PMID:27249880

  12. Surgical treatment of aggressive vertebral hemangiomas.

    Science.gov (United States)

    Vasudeva, Viren S; Chi, John H; Groff, Michael W

    2016-08-01

    OBJECTIVE Vertebral hemangiomas are common tumors that are benign and generally asymptomatic. Occasionally these lesions can exhibit aggressive features such as bony expansion and erosion into the epidural space resulting in neurological symptoms. Surgery is often recommended in these cases, especially if symptoms are severe or rapidly progressive. Some surgeons perform decompression alone, others perform gross-total resection, while others perform en bloc resection. Radiation, embolization, vertebroplasty, and ethanol injection have also been used in combination with surgery. Despite the variety of available treatment options, the optimal management strategy is unclear because aggressive vertebral hemangiomas are uncommon lesions, making it difficult to perform large trials. For this reason, the authors chose instead to report their institutional experience along with a comprehensive review of the literature. METHODS A departmental database was searched for patients with a pathological diagnosis of "hemangioma" between 2008 and 2015. Medical records were reviewed to identify patients with aggressive vertebral hemangiomas, and these cases were reviewed in detail. RESULTS Five patients were identified who underwent surgery for treatment of aggressive vertebral hemangiomas during the specified time period. There were 2 lumbar and 3 thoracic lesions. One patient underwent en bloc spondylectomy, 2 patients had piecemeal gross-total resection, and the remaining 2 had subtotal tumor resection. Intraoperative vertebroplasty was used in 3 cases to augment the anterior column or to obliterate residual tumor. Adjuvant radiation was used in 1 case where there was residual tumor as well. The patient who underwent en bloc spondylectomy experienced several postoperative complications requiring additional medical care and reoperation. At an average follow-up of 31 months (range 3-65 months), no patient had any recurrence of disease and all were clinically asymptomatic, except the

  13. Understanding Patient Management: the Need for Medication Adherence and Persistence

    OpenAIRE

    2008-01-01

    Poor patient adherence to medication is one of the major factors contributing to poor disease control, in particular in asymptomatic chronic diseases like hypertension and dyslipidaemia. The physical and economic burden on patients and the health care system as a result of non-adherence is great. It is estimated that poor adherence to hypertension medication accounts for as many as 7.1 million preventable deaths annually. Hence recognising and identifying non-adherence is the first step to ad...

  14. Medication supply chain management through implementation of a hospital pharmacy computerized inventory program in Haiti

    Directory of Open Access Journals (Sweden)

    Michelle R. Holm

    2015-01-01

    Full Text Available Background: In the aftermath of the 2010 earthquake in Haiti, St. Luke Hospital was built to help manage the mass casualties and subsequent cholera epidemic. A major problem faced by the hospital system was the lack of an available and sustainable supply of medications. Long-term viability of the hospital system depended largely on developing an uninterrupted medication supply chain. Objective: We hypothesized that the implementation of a new Pharmacy Computerized Inventory Program (PCIP would optimize medication availability and decrease medication shortages. Design: We conducted the research by examining how medications were being utilized and distributed before and after the implementation of PCIP. We measured the number of documented medication transactions in both Phase 1 and Phase 2 as well as user logins to determine if a computerized inventory system would be beneficial in providing a sustainable, long-term solution to their medication management needs. Results: The PCIP incorporated drug ordering, filling the drug requests, distribution, and dispensing of the medications in multiple settings; inventory of currently shelved medications; and graphic reporting of ‘real-time’ medication usage. During the PCIP initiation and establishment periods, the number of medication transactions increased from 219.6 to 359.5 (p=0.055, respectively, and the mean logins per day increased from 24.3 to 31.5, p<0.0001, respectively. The PCIP allows the hospital staff to identify and order medications with a critically low supply as well as track usage for future medication needs. The pharmacy and nursing staff found the PCIP to be efficient and a significant improvement in their medication utilization. Conclusions: An efficient, customizable, and cost-sensitive PCIP can improve drug inventory management in a simplified and sustainable manner within a resource-constrained hospital.

  15. Deprescribing: An Application to Medication Management in Older Adults.

    Science.gov (United States)

    Bemben, Nina M

    2016-07-01

    Polypharmacy has been found to have potentially negative consequences for patients due to use of potentially inappropriate medications, as well as increased risk of drug interactions and adverse effects. Deprescribing has been proposed as a method of improving medication use throughout a patient's course of care. This article reviews the process of deprescribing and applies the process to medication classes commonly encountered by clinical pharmacists. This review of therapeutics included studies identified through a PubMed search and by review of the reference list of included studies. Relevant studies known to the author were also included. Previous studies have identified several classes of medications as a high priority for construction of evidence-based deprescribing guidelines. In the absence of currently available evidence-based clinical practice guidelines, this articles reviews applicable evidence and applies the deprescribing process to three high-priority medication classes: statins, cholinesterase inhibitors and bisphosphonates. Available evidence can be used to apply the deprescribing process to preventive medications for chronic diseases commonly encountered by clinical pharmacists. PMID:27263530

  16. Front office staff as medical educators, risk creators, and risk managers.

    Science.gov (United States)

    Kapp, Marshall B

    2016-03-16

    The author describes his own negative series of encounters with the front office staff of a large specialty medical practice during a recent lengthy episode of significant medical distress. The author suggests several reasons, including legal risk management, that medical students should be exposed as part of their education to the interactions of patients with front office staffs (not just physicians) to get a fuller picture of patients' actual experiences with the health care system. PMID:27176757

  17. Rethinking Adherence: A Health Literacy–Informed Model of Medication Self-Management

    OpenAIRE

    Bailey, Stacy C.; Oramasionwu, Christine U.; Wolf, Michael S

    2013-01-01

    Medication adherence has received a great deal of attention over the past several decades; however, its definition and measurement remain elusive. The authors propose a new definition of medication self-management that is guided by evidence from the field of health literacy. Specifically, a new conceptual model is introduced that deconstructs the tasks associated with taking prescription drugs; including the knowledge, skills and behaviors necessary for patients to correctly take medications ...

  18. Management of death, dying and euthanasia: attitudes and practices of medical practitioners in South Australia.

    OpenAIRE

    Stevens, C. A.; Hassan, R

    1994-01-01

    This article presents the first results of a study of the decisions made by health professionals in South Australia concerning the management of death, dying, and euthanasia, and focuses on the findings concerning the attitudes and practices of medical practitioners. Mail-back, self-administered questionnaires were posted in August 1991 to a ten per cent sample of 494 medical practitioners in South Australia randomly selected from the list published by the Medical Board of South Australia. A ...

  19. 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...

  20. Changing Care Staff Approaches to the Prevention and Management of Aggressive Behaviour in a Residential Treatment Unit for Persons with Mental Retardation and Challenging Behaviour.

    Science.gov (United States)

    Allen, David; And Others

    1997-01-01

    Evaluation of a training procedure to improve staff skills in the preventative and reactive management of severely challenging behaviors in a small residential treatment unit found reduced (though not statistically significant) behavioral incidents, use of major reactive strategies (restraint and emergency medication), and staff and resident…

  1. 75 FR 391 - Medical Device Quality System Regulation Educational Forum on Risk Management Through the Product...

    Science.gov (United States)

    2010-01-05

    ...The Food and Drug Administration (FDA), Office of Regulatory Affairs (ORA), Southwest Region (SWR), Dallas District Office (DALDO), in collaboration with the FDA Medical Device Industry Coalition (FMDIC), is announcing a public workshop entitled ``Medical Device Quality System Regulation Educational Forum on Risk Management through the Product Life Cycle.'' This public workshop is intended to......

  2. Task analysis of information technology-mediated medication management in outpatient care

    NARCIS (Netherlands)

    van Stiphout, F.; Zwart-van Rijkom, J. E. F.; Maggio, L. A.; Aarts, J. E. C. M.; Bates, D. W.; van Gelder, T.; Jansen, P. A. F.; Schraagen, J. M. C.; Egberts, A. C. G.; ter Braak, E. W. M. T.

    2015-01-01

    Aims Educating physicians in the procedural as well as cognitive skills of information technology (IT)-mediated medication management could be one of the missing links for the improvement of patient safety. We aimed to compose a framework of tasks that need to be addressed to optimize medication man

  3. Towards an integrated management of health physics and medical physics

    Energy Technology Data Exchange (ETDEWEB)

    Mommaert, Chantal; Rogge, Frank; Cortenbosch, Geert; Schmitz, Frederic [Association Vincotte Nuclear (AVN), Brussels (Belgium)

    2007-07-01

    AVN is a licensed body that performs health physics control in different types of installations, from large nuclear facilities to small dentist cabinets. AVN can also provide medical physics services for the quality control of, for instance, medical devices used in a radiology or nuclear medicine department. Radiation protection for personnel and environment (health physics) and radiation protection for the patient (medical physics) are usually treated separately, using different referential documents, such as the European Directives 96/29/Euratom for health physics and 97/43/Euratom for medical physics. This difference is also clearly reflected in the Belgium legislation (two types of accreditation/licence for inspectors, different chapters in the law,..) From a practical point of view it is sometimes rather difficult to split the task 'on site' during an inspection. An RX system not complying with radiation protection criteria can definitively affect the patient as well as the workers. On the other hand, the hospitals, cannot easily differentiate these two tasks because they are not fully aware of the legislation and they are mixing both. Taking into account the health physics guidelines as well as medical physics guidelines, we have decided to move to an integrated approach of these two concepts. (orig.)

  4. Supporting practice learning time for non-medical prescribing students: managers' views.

    Science.gov (United States)

    Unwin, Rachel; Redman, Susan; Bain, Heather; Macphee, Michael; McElhinney, Evelyn; Downer, Frances; Paterson, Ruth

    2016-06-01

    Managers in healthcare services have ever-increasing demands to consider in relation to front line care, including the continuing professional education needs of qualified practitioners who are advancing their roles. One advancement is non-medical prescribing, and this article reports part of the findings from a survey undertaken in Scotland which explored managers' views of the clinical support of staff enrolled on a non-medical prescribing programme. The article discusses how managers have an important role to play in supporting these learners in practice, and suggests all stakeholders should be aware of the pressure this adds to managers, and seek creative solutions to support the process of learning. PMID:27246432

  5. A preliminary study of medical waste management in Lagos metropolis, Nigeria

    OpenAIRE

    E. O. Longe, A. Williams

    2006-01-01

    A survey of medical waste management (MWM) practices and their implications to health and environment was carried out in metropolitan Lagos. Lagos is currently the most populous and urbanized city in the country with an estimated population of over 13 million people. The study assessed management practices in four (2 privates and 2 publics) hospitals ranging in capacity from 40 to 600 beds. Empirical data was obtained on medical waste generation, segregation, storage, collection, transportati...

  6. A Healthcare Project: Managing Knowledge through Electronic Medical Record -Empirical Cases

    OpenAIRE

    Rocco Reina; Teresa Cetani; Assunta Lacroce; Marzia Ventura

    2012-01-01

    The paper aims at analysing the complex relations between knowledge management and project management on an empirical case in healthcare system represented by Electronic Medical Record (EMR); the effective goal is to underline the approach and the practical methods used by the project teams to maximize the level of knowledge plugged in EMR in two selected Italian hospitals. First, the research analyzes the main references about knowledge management and project management; then, it shows the j...

  7. Co-occurrence of Calcifying Odontogenic Cyst, Aggressive Central Giant Cell Granuloma and Central Odontogenic Fibroma: Report of a Very Rare Entity and Its Surgical Management

    Directory of Open Access Journals (Sweden)

    Touraj Vaezi

    2016-09-01

    Full Text Available Calcifying odontogenic cyst (COC, Central odontogenic fibroma (COF and aggressive central giant cell granuloma (CGCG are rare pathologic diseases affecting the jaws. While the Co-existence of two of them is reported in the literature, existence of all three conditions in one patient is an extremely rare entity. In the present report, initial biopsy revealed fibrosarcoma, therefore mandibular resection was performed for the subject. Sectional Histopathologic evaluation revealed the co-existence of three conditions through histopathologic evaluation. This report emphasizes the importance of precise microscopical evaluation of jaw lesions and thorough sectional examination of the lesions to reach the precise diagnosis. Treatment modalities and follow-up radiographs are also provided to help clinicians manage these entities.

  8. Standardised assessment of patients' capacity to manage medications: a systematic review of published instruments

    Directory of Open Access Journals (Sweden)

    Elliott Rohan A

    2009-07-01

    Full Text Available Abstract Background Older people are commonly prescribed complex multi-drug regimens while also experiencing declines in the cognitive and physical abilities required for medication management, leading to increased risk of medication errors and need for assisted living. The purpose of this study was to review published instruments designed to assess patients' capacity to self-administer medications. Methods Searches of Medline, EMBASE, CINAHL, PsycINFO, International Pharmaceutical Abstracts, Health and Psychosocial Instruments, Google, and reference lists of identified publications were conducted to identify English-language articles describing development and validation of instruments designed to assess patients' capacity to self-administer medications. Methodological quality of validation studies was rated independently against published criteria by two reviewers and reliability and validity data were reviewed. Results Thirty-two instruments were identified, of which 14 met pre-defined inclusion criteria. Instruments fell into two categories: those that used patients' own medications as the basis for assessment and those that used a simulated medication regimen. The quality of validation studies was generally low to moderate and few instruments were subjected to reliability testing. Most instruments had some evidence of construct validity, through associations with tests of cognitive function, health literacy, activities of daily living or measures of medication management or adherence. Only one instrument had sensitivity and specificity data with respect to prediction of medication-related outcomes such as adherence to therapy. Only three instruments had validity data from more than one independent research group. Conclusion A number of performance-based instruments exist to assess patients' capacity to manage their own medications. These may be useful for identifying physical and cognitive barriers to successful medication management, but

  9. Medication overuse headache: history, features, prevention and management strategies.

    Science.gov (United States)

    Saper, Joel R; Da Silva, Arnaldo Neves

    2013-11-01

    Medication overuse headache (MOH) is a daily, or almost daily, headache form that arises from overuse of one or more classes of migraine-abortive or analgesic medication. The main classes of drugs that cause MOH are opioids, butalbital-containing mixed analgesics, triptans, ergotamine tartrate derivatives, simple analgesics (except for plain aspirin), and perhaps non-steroidal anti-inflammatory drugs. MOH can be debilitating and results from biochemical and functional brain changes induced by certain medications taken too frequently. At this time, migraine and other primary headache disorders in which migraine or migraine-like elements occur seem exclusively vulnerable to the development of MOH. Other primary headache disorders are not currently believed to be vulnerable. The treatment of MOH consists of discontinuation of the offending drug(s), acute treatment of the withdrawal symptoms and escalating pain, establishing a preventive treatment when necessary, and the implementation of educational and behavioral programs to prevent recidivism. In most patients, MOH can be treated in the outpatient setting but, for the most difficult cases, including those with opioid or butalbital overuse, or in patients with serious medical or behavioral disturbances, effective treatment requires a multidisciplinary, comprehensive headache program, either day-hospital with infusion or an inpatient hospital setting. PMID:23925669

  10. Assessing and Managing Medically Fragile Children: Tracheostomy and Ventilatory Support

    Science.gov (United States)

    Woodnorth, Geralyn Harvey

    2004-01-01

    Over the past decade, there has been an increase in premature births. Children born prematurely often present with complex medical conditions; some require a tracheostomy. Although many children with tracheostomies require assistance to achieve effective communication, speech-language pathologists may have limited information with respect to the…

  11. Medical Information Management System (MIMS): A generalized interactive information system

    Science.gov (United States)

    Alterescu, S.; Friedman, C. A.; Hipkins, K. R.

    1975-01-01

    An interactive information system is described. It is a general purpose, free format system which offers immediate assistance where manipulation of large data bases is required. The medical area is a prime area of application. Examples of the system's operation, commentary on the examples, and a complete listing of the system program are included.

  12. CONCEPT ANALYSIS: AGGRESSION

    OpenAIRE

    Liu, Jianghong

    2004-01-01

    The concept of aggression is important to nursing because further knowledge of aggression can help generate a better theoretical model to drive more effective intervention and prevention approaches. This paper outlines a conceptual analysis of aggression. First, the different forms of aggression are reviewed, including the clinical classification and the stimulus-based classification. Then the manifestations and measurement of aggression are described. Finally, the causes and consequences of ...

  13. Medical device development: managing conflicts of interest encountered by physicians.

    Science.gov (United States)

    Baim, Donald S; Donovan, Aine; Smith, John J; Briefs, Nancy; Geoffrion, Richard; Feigal, David; Kaplan, Aaron V

    2007-04-01

    New technologies introduced over the past three decades have transformed medical diagnosis and treatment, and significantly improved patient outcomes. These changes have been mediated by the introduction of new medical devices, particularly for the treatment of cardiovascular, orthopedic, and ophthalmic disorders. These devices, in turn, have created large markets and spawned a burgeoning medical device industry, including six Fortune 500 companies whose combined market capitalization now exceeds 400 billion dollars. This success story, which has unquestionably benefited patients and society alike, has been dependent upon an intense collaboration among industry, clinicians, and regulatory authorities. However, when physicians actively involved in patient care participate in such collaborations, they are increasingly vulnerable to creating potential conflicts between these two (clinical and device development) roles. Such conflicts, which may ultimately erode public trust, have important consequences not only for the individual physicians, but also for their parent institutions, their patients, sponsoring companies, and the entire clinical research enterprise that makes the development and introduction of new devices possible. The third Dartmouth Device Development Symposium held in October 2005 brought together thought leaders within the medical device community, including academicians, clinical investigators, regulators from the Food and Drug Administration and Centers for Medicare and Medicaid Services (CMS), large and small device manufacturers and the financial (venture capital and investment banks) community. The Symposium examined the conflicts of interest encountered during the early development and commercialization of a medical device. The goal of these discussions was to (1) identify and characterize the conflicts that arise and (2) provide strategies to address these conflicts. This manuscript was prepared by a writing committee to provide a summary

  14. The practice and effect of combined duty of administrative management, medical treatment and nursing

    Directory of Open Access Journals (Sweden)

    Min HU

    2014-09-01

    Full Text Available Objective: To explore the effect of combined duty mode on discovery and control of medical nursing hidden trouble. Method: In order to make sure that patients are in the first place, we should take the mode of combined duty of administrative management, medical treatment and nursing. Results:The incidence of nursing errors and defects reduced, and patients’ satisfaction improved. the differences were statistically significant (P<0.01 or P<0.05.Results: Combined duty can the reduce medical nursing defects, improve the efficiency of quality health care services and the management efficiency.

  15. Assessment of Medical Risks and Optimization of their Management using Integrated Medical Model

    Science.gov (United States)

    Fitts, Mary A.; Madurai, Siram; Butler, Doug; Kerstman, Eric; Risin, Diana

    2008-01-01

    The Integrated Medical Model (IMM) Project is a software-based technique that will identify and quantify the medical needs and health risks of exploration crew members during space flight and evaluate the effectiveness of potential mitigation strategies. The IMM Project employs an evidence-based approach that will quantify probability and consequences of defined in-flight medical risks, mitigation strategies, and tactics to optimize crew member health. Using stochastic techniques, the IMM will ultimately inform decision makers at both programmatic and institutional levels and will enable objective assessment of crew health and optimization of mission success using data from relevant cohort populations and from the astronaut population. The objectives of the project include: 1) identification and documentation of conditions that may occur during exploration missions (Baseline Medical Conditions List [BMCL), 2) assessment of the likelihood of conditions in the BMCL occurring during exploration missions (incidence rate), 3) determination of the risk associated with these conditions and quantify in terms of end states (Loss of Crew, Loss of Mission, Evacuation), 4) optimization of in-flight hardware mass, volume, power, bandwidth and cost for a given level of risk or uncertainty, and .. validation of the methodologies used.

  16. A preliminary study of medical waste management in Lagos metropolis, Nigeria

    Directory of Open Access Journals (Sweden)

    E. O. Longe, A. Williams

    2006-04-01

    Full Text Available A survey of medical waste management (MWM practices and their implications to health and environment was carried out in metropolitan Lagos. Lagos is currently the most populous and urbanized city in the country with an estimated population of over 13 million people. The study assessed management practices in four (2 privates and 2 publics hospitals ranging in capacity from 40 to 600 beds. Empirical data was obtained on medical waste generation, segregation, storage, collection, transportation and disposal. The observed MWM practices in all hospitals indicate absence of full compliance with the protocol for handling medical waste as stipulated in the relevant sections of the guidelines and standards for environmental pollution control in Nigeria. Three hospitals demonstrated high priority for segregation of infectious medical waste. Average generation rate of medical waste in the investigated hospitals ranged from 0.562 kg/bed.day to 0.670 kg/bed.day. Infectious waste accounts for between 26 to 37% of this volume. Only two of the hospitals investigated carry out treatment of their infectious and sharp waste types by incineration before final disposal. Burning and burial of medical waste is an unusual but common practice among the hospitals. All the hospitals employ the services of the state owned solid waste management company, the Lagos State Waste Management Authority (LAWMA for final collection, and disposal of their medical waste at government approved sites.

  17. Redefining accountability in health care: managing the plurality of medical interests.

    Science.gov (United States)

    Sorensen, Roslyn; Iedema, Rick

    2008-01-01

    Conflict in health service delivery is common. It is often attributed to disputes between clinicians and patients or their families about treatment decisions and is particularly common in intensive care units (ICUs), in the form of ;futility disputes' between families and medical clinicians about decisions to terminate the active treatment of a dying family member. More common, but less prominent in the literature, is conflict within the medical profession about patient care goals and treatment. We contend that managing the plurality of medical interests is essential in achieving a more managed and positive experience for patients and families of the care they receive, and for achieving standards of quality and resource use. From an ethnographic study undertaken in a large ICU in Sydney, Australia, we found that the knowledge and practice differences of multiple medical decision-makers generated conflict, inconsistency of practice and subjectivity of decision-making that impeded coherent clinical decision-making and integrated patient care planning, coordination and care review. Improving patients' and families' experience of care requires medical clinicians and medical managers to accept responsibility for institutionalizing effective communication and decision-making processes within clinical networks and between clinical and managerial domains. Thus, strategies to improve patient care will need to extend beyond the medical profession to incorporate administrative management. We conclude that restructuring communication and decision-making processes is imperative to achieve clinical accountability in the workplace and systems accountability in the organization. PMID:18073248

  18. Medical management of radiological accidents in non-specialized clinics: mistakes and lessons

    International Nuclear Information System (INIS)

    In 1996-2002 three radiological accidents were developed in Georgia. There were some people injured in those accidents. During medical management of the injured some mistakes and errors were revealed both in diagnostics and scheme of the treatment. The goal of this article is to summarize medical management of the mentioned radiological accidents, to estimate reasons of mistakes and errors, to present the lessons drawn in result of Georgia radiological accidents. There was no clinic with specialized profile and experience. Accordingly due to having no relevant experience late diagnosis can be considered as the main error. It had direct influence on the patients' health and results of treatment. Lessons to be drawn after analyzing Georgian radiological accidents: 1. informing medical staff about radiological injuries (pathogenesis, types, symptoms, clinical course, principles of treatment and etc.); 2. organization of training and meetings in non-specialized clinics or medical institutions for medical staff; 3. preparation of informational booklets and guidelines.(author)

  19. Medical management of first trimester miscarriage according to ultrasonographic findings

    DEFF Research Database (Denmark)

    Vejborg, Thomas; Nilas, Lisbeth; Rørbye, Christina

    2007-01-01

    BACKGROUND: The efficacy of medical treatment of first trimester miscarriages may depend on the regimen used, the definition of success, clinical symptoms, and, possibly, on the ultrasonographic findings. Our primary aim was to assess if a single dose of misoprostol could reduce the number of...... surgical interventions in early pregnancy failure, and to compare efficacy in different ultrasonographically-defined subgroups. METHODS: A retrospective review of 355 consecutive patients treated for a first trimester miscarriage with a single dose of vaginal misoprostol (400 microg), followed by vaginal...... and 3 (43.6%; p<0.05), and the difference was largest in Group B1 (12.9 versus 35.4%; p<0.05). CONCLUSIONS: Single dose misoprostol reduced the number of surgical interventions. The success rates of medically-treated first trimester miscarriages varied according to the ultrasonographic definitions of...

  20. Medical management of first trimester miscarriage according to ultrasonographic findings

    DEFF Research Database (Denmark)

    Vejborg, Thomas; Nilas, Lisbeth; Rørbye, Christina

    2007-01-01

    BACKGROUND: The efficacy of medical treatment of first trimester miscarriages may depend on the regimen used, the definition of success, clinical symptoms, and, possibly, on the ultrasonographic findings. Our primary aim was to assess if a single dose of misoprostol could reduce the number of...... and 3 (43.6%; p<0.05), and the difference was largest in Group B1 (12.9 versus 35.4%; p<0.05). CONCLUSIONS: Single dose misoprostol reduced the number of surgical interventions. The success rates of medically-treated first trimester miscarriages varied according to the ultrasonographic definitions of...... surgical interventions in early pregnancy failure, and to compare efficacy in different ultrasonographically-defined subgroups. METHODS: A retrospective review of 355 consecutive patients treated for a first trimester miscarriage with a single dose of vaginal misoprostol (400 microg), followed by vaginal...

  1. Best practice in unbilled account management: one medical center's story.

    Science.gov (United States)

    Menaker, Debra; Miller, Joshua

    2016-02-01

    After implementing its new electronic health record, a large metropolitan academic medical center (AMC) decided to optimize its supporting business systems, beginning with billing. By identifying problems and taking the following corrective actions immediately, the AMC significantly reduced the number and average age of its unbilled accounts: Realigning system automation to improve routing efficiency. Facilitating interdisciplinary collaboration to better identify and correct the root causes of issues. Ensuring transparent data reporting by setting up different ways of viewing the underlying information. PMID:26999975

  2. MEDICAL MANAGEMENT OF DENTAL CARIES: A CHANGE IN THERAPEUTIC APPROACH

    OpenAIRE

    Amit Malhotra; Hegde, Mithra N

    2013-01-01

    Dental caries is an infectious, communicable disease, which causes destruction of teeth by acid-forming bacteria found in dental plaque. Caries progression or reversal is determined by the balance between protective and pathological factors in the mouth. There have been revolutions in every field and dentistry is no exception to it, these changes have led to a change in concept from the conventional surgical approach of removing dental decay and cutting of tooth structure to the medical model...

  3. Major incident medical management and support the practical approach at the scene

    CERN Document Server

    Advanced Life Support Group

    2012-01-01

    Major Incident Medical Management and Support (MIMMS) is the coursebook for the Advanced Life Support Group's internationally taught training for health care professionals responding to major incidents. The practical approach employed in MIMMS has proved an invaluable aid to both civilian and military doctors, nurses and paramedics working in disaster management worldwide.

  4. Effectiveness of an interprofessional workshop on pain management for medical and nursing students.

    Science.gov (United States)

    Erickson, Jeanne M; Brashers, Valentina; Owen, John; Marks, Jennifer R; Thomas, Shannon M

    2016-07-01

    Interprofessional (IP) care is critical for effective pain management, but evidence is lacking about the best way to teach pain management skills to medical and nursing students using IP strategies. In 2013 and 2014, 307 medical and 169 nursing students participated in an IP case-based pain management workshop. The aims of this study were to determine (1) if students who participate in IP case-based learning groups will have improved pain management skills compared to students who participate in uniprofessional case-based learning groups, and (2) if students mentored by faculty with IP training will have improved pain management skills compared to students who are not mentored by IP-trained faculty. Student learning was assessed and compared using scored checklists for each group's pain management plans. Findings show that IP mentorship and IP group participation improved medical students' pain management skills but did not have the same effect on nursing student performance. Continued work is needed to develop, refine, and integrate innovative and tailored IP strategies into the curricula of medical and nursing schools to advance the pain management competencies of students before they enter clinical practice. PMID:27268513

  5. Medical residents' perceptions of their competencies and training needs in health care management

    DEFF Research Database (Denmark)

    Berkenbosch, Lizanne; Schoenmaker, Suzanne Gerdien; Ahern, Susannah;

    2013-01-01

    Previous research has shown that Dutch medical residents feel inadequate in certain management areas: 85% had a need for management training and reported preferences on the format of such training. Our objective was to explore if the perceived deficiencies and needs among Dutch residents were...

  6. Legislative Framework and Objectives of Medical Waste Management

    OpenAIRE

    I. BRAŞOVEAN; I. OROIAN; C. IEDERAN; C. OROIAN - MIHAI; FLEŞERIU A.; P. BURDUHOS

    2010-01-01

    Waste regime is governed by the Government Emergency Ordinance no. 78/2000 transposing into nationallegislation EC Directive no. EC Directive 75/442 on waste and no. 91/689 on hazardous waste.Waste management operations involving the collection, transport, recovery and disposal, including surveillanceof these operations and care of their storage areas after closing. Waste management are priority objectives: to prevent orreduce waste production and the degree of their dangerousness and reuse a...

  7. INFORMATION AND KNOWLEDGE MANAGEMENT – A STRATEGY FOR PERFORMING MEDICAL SERVICES IN THE INFORMATIONAL ERA

    Directory of Open Access Journals (Sweden)

    Adina BĂLAN

    2009-01-01

    Full Text Available The unprecedented incertitude existing in the health system in Romaniaimplies menaces for the system managers. The improvement of theperformance of the medical system has never been more adequate, so thatthe health system needs specific managerial strategies. Romania needs acomplete solution which could assure a performant management of themedical information in the system, and in their plans, the managers of thehealthcare organizations must include investments for the application of theinformational technologies, like the administration of medical information, ofthe health electronic file, the medical information exchange, so that themedical service be continuous and permanent from the birth until the death ofany individual. But the piece of information is only valuable to the one whoknows how to use it, where to search for it, how to choose it and finally howto use it, so that we can say the main instrument to which the manager fromthe health system may resort rapidly in order to find new solutions isinformation.

  8. [Establishment and management of documentation within QMS of medical device enterprises].

    Science.gov (United States)

    Tian, Shaolei

    2013-09-01

    The objectives of QMS for quality assurance of products are achieved by formulation, implement, and management of document system. Document (includes record) system is important constituent part of QMS. In this paper, the important issues and relative requirements of GMP on the establishment and management of documentation within quality management system (QMS) of medical device enterprises are discussed with the aim of providing reference for relative enterprises to build and improve their QMS and to implement GMP. PMID:24409796

  9. Medical residents perceptions of the need for management education in the postgraduate curriculum: a preliminary study

    OpenAIRE

    Judith W. Brouns; Lizanne Berkenbosch; Fraukje D. Ploemen-Suijker; Ide Heyligers; Busari, Jamiu O

    2010-01-01

    Objectives: The curriculum of the new post-graduate medical training program in the Netherlands is comprised of seven competencies that residents should possess upon graduation. In this new curriculum however, the competency as manager receives relatively little attention. In this preliminary study we investigated the residents' need for management training and tried to identify the preferred form of intervention to develop these management skills. Methods: A survey was designed to investigat...

  10. Medical residents' perceptions of their competencies and training needs in health care management

    DEFF Research Database (Denmark)

    Berkenbosch, Lizanne; Schoenmaker, Suzanne Gerdien; Ahern, Susannah;

    2013-01-01

    Previous research has shown that Dutch medical residents feel inadequate in certain management areas: 85% had a need for management training and reported preferences on the format of such training. Our objective was to explore if the perceived deficiencies and needs among Dutch residents were...... similar to those of their peers in other countries, and if a longer duration of the incorporation of the CanMEDS competency framework into curricula as well as management training had an influence on these perceptions....

  11. Managing medical images and clinical information: InCor's experience.

    Science.gov (United States)

    Furuie, Sergio S; Rebelo, Marina S; Moreno, Ramon A; Santos, Marcelo; Bertozzo, Nivaldo; Motta, Gustavo H M B; Pires, Fabio A; Gutierrez, Marco A

    2007-01-01

    Patients usually get medical assistance in several clinics and hospitals during their lifetime, archiving vital information in a dispersed way. Clearly, a proper patient care should take into account that information in order to check for incompatibilities, avoid unnecessary exams, and get relevant clinical history. The Heart Institute (InCor) of São Paulo, Brazil, has been committed to the goal of integrating all exams and clinical information within the institution and other hospitals. Since InCor is one of the six institutes of the University of São Paulo Medical School and each institute has its own information system, exchanging information among the institutes is also a very important aspect that has been considered. In the last few years, a system for transmission, archiving, retrieval, processing, and visualization of medical images integrated with a hospital information system has been successfully created and constitutes the InCor's electronic patient record (EPR). This work describes the experience in the effort to develop a functional and comprehensive EPR, which includes laboratory exams, images (static, dynamic, and three dimensional), clinical reports, documents, and even real-time vital signals. A security policy based on a contextual role-based access control model was implemented to regulate user's access to EPR. Currently, more than 10 TB of digital imaging and communications in medicine (DICOM) images have been stored using the proposed architecture and the EPR stores daily more than 11 GB of integrated data. The proposed storage subsystem allows 6 months of visibility for rapid retrieval and more than two years for automatic retrieval using a jukebox. This paper addresses also a prototype for the integration of distributed and heterogeneous EPR. PMID:17249400

  12. Using evidence-based management in a medical practice.

    Science.gov (United States)

    Solomon, Robert J

    2010-01-01

    Evidence-based management (EBMa) is the application of the evidence-based medicine process to making management decisions. EBMa has been described in a number of publications, which note the advantages of utilizing EBMa and offer generic guidance on the nature of EBMa evidence. This paper provides a specific EBMa pathway for physician practice and health system mangers to use to conduct EBMa database searches. It provides an example of conducting an EBMa search for a practice-based management problem. It describes how to do database searches using Advance Google Scholar, PubMed, and other data sources. It discusses challenges to conducting quality searches, including access to paid subscription databases, and offers suggestions to improve searches. Finally, the paper discusses the importance of establishing a culture of inquiry and using rapid cycle improvement methods to develop organizational EBMa support so health systems will devote adequate resources to information acquisition. PMID:20222263

  13. Organization and Management of the International Space Station (ISS) Multilateral Medical Operations

    Science.gov (United States)

    Duncan, J. M.; Bogomolov, V. V.; Castrucci, F.; Koike, Y.; Comtois, J. M.; Sargsyan, A. E.

    2007-01-01

    The goal of this work is to review the principles, design, and function of the ISS multilateral medical authority and the medical support system of the ISS Program. Multilateral boards and panels provide operational framework, direct, and supervise the ISS joint medical operational activities. The Integrated Medical Group (IMG) provides front-line medical support of the crews. Results of ongoing activities are reviewed weekly by physician managers. A broader status review is conducted monthly to project the state of crew health and medical support for the following month. All boards, panels, and groups function effectively and without interruptions. Consensus prevails as the primary nature of decisions made by all ISS medical groups, including the ISS medical certification board. The sustained efforts of all partners have resulted in favorable medical outcomes of the initial fourteen long-duration expeditions. The medical support system appears to be mature and ready for further expansion of the roles of all Partners, and for the anticipated increase in the size of ISS crews.

  14. 医院医用压力容器的管理%Management of medical pressure vessel in medical institution

    Institute of Scientific and Technical Information of China (English)

    冯俊佳

    2015-01-01

    医用压力容器是有危险性的特种设备,加强压力容器的安全管理,确保其安全运行,防止和减少事故发生,提高医疗服务质量。本文依据现行的《特种设备安全监察条例》《固定式压力容器安全技术监察规程》等法律法规和技术规范,结合本院的实际工作情况,对医用压力容器安全管理进行归纳和总结,供同行借鉴、参考。%Objective:Medical pressure vessel is a dangerous special equipment, strengthen the safety management of the pressure vessel, ensure its safe operation, prevent and reduce the accident, improve medical service quality. The according to the current "special equipment safety supervision regulations", the fixed pressure vessels safety and Technical Supervision Regulations"and so on laws and regulations and technical standards, combined with the actual working condition of the hospital, to conclude and summarize medical pressure vessel safety management, to peers to use for reference and reference.

  15. Application of Medical Internet of Things in the Medical Waste Management%医疗物联网在医疗垃圾管理中的应用

    Institute of Scientific and Technical Information of China (English)

    骆荦

    2014-01-01

    随着近年来不断出现新的大型突发性公共卫生事件,医疗废物处理问题备受到了社会的广泛关注。医疗废物管理不仅是医院管理的难题,而且也是一个重要的公共卫生问题。随着信息技术尤其是医疗物联网的发展,基于RFID的物联网医疗垃圾处理管理系统采用射频识别技术、网络技术,对医疗垃圾产生、回收、运输、处理等全过程进行监控追踪。我院通过实施医疗物联网在医疗垃圾管理中的应用,实现了垃圾的电子标签化管理、电子监控和在线监测等,对医疗垃圾处理进行全程监管。%In recent years, the continuous emergence of new large public health emergencies, medical waste disposal problem preparation has been widespread concern in society. Medical waste management is not only the problem of hospital management, but also an important public health problem. Along with the information technology, especial y the development of medical Internet of things, RFID Internet of things based on medical waste management system uses a network of radio frequency identification technology, technology, the whole process of medical waste generation, recycling, transportation, processing, monitoring and tracking. Our hospital through the implementation of medical Internet of things applications in medical waste management, realize the electronic label management, waste electronic monitoring and online monitoring, process monitoring of medical waste disposal.In recent years, the continuous emergence of new large public health emergencies, medical waste disposal problem preparation has been widespread concern in society. Medical waste management is not only the problem of hospital management, but also an important public health problem. Along with the information technology, especially the development of medical Internet of things, RFID Internet of things based on medical waste management system uses a network of radio

  16. A Comparison of Management Conditions in Japan's Dental Clinics and Medical Clinics

    Directory of Open Access Journals (Sweden)

    Koichi Kawabuchi

    2015-08-01

    Full Text Available In recent years, national medical expenditures have continued to increase in Japan, and have now reached 39 trillion yen. In contrast, dental clinic expenditures have been slow to grow over the past few years, totaling 2.7132 trillion yen. At the same time, the number of dentists continues to increase, with a total of 102,551 dentists in 2012, surpassing the 100,544 physicians at medical clinics. Objective: Given this, we compared management conditions at dental clinics and medical clinics over time to determine whether management conditions of dental clinics are really as harsh as often claimed. Methods: we used the relevant data provided in the Central Social Insurance Medical Council's Survey on Economic Conditions in Health Care for statistics, which depicts management conditions at clinics, and analyzed the causes. Results: Annual fluctuations in the revenue/expense gap (revenue less expense show that the gap for dentists far undercut that for physicians at medical clinics. The main reason for this decline in revenue is that the number of dental patients declined more that the unit price rose compared to the medical clinic. Conclusion: We determined that management conditions are harsh for dental clinics.DOI: 10.14693/jdi.v22i2.507

  17. Inhaled medication for asthma management: evaluation of how asthma patients, medical students, and doctors use the different devices

    Directory of Open Access Journals (Sweden)

    Muniz Janaína Barbosa

    2003-01-01

    Full Text Available Asthma results from a combination of three essential features: airflow obstruction, hyperresponsiveness of airways to endogenous or exogenous stimuli and inflammation. Inadequacy of the techniques to use different inhalation devices is one of the causes of therapeutic failure. The main purpose of this study was to evaluate how 20 medical students, 36 resident physicians of Internal Medicine/Pediatrics, and 40 asthma patients used three devices for inhalation therapy containing placebo. All patients were followed at the Pulmonary Outpatient Service of Botucatu Medical School and had been using inhaled medication for at least six months. The following devices were evaluated: metered dose inhalers (MDI, dry powder inhalers (DPI, and MDI attached to a spacer device. A single observer applied a protocol containing the main steps necessary to obtain a good inhaler technique to follow and grade the use of different devices. Health care professionals tested all three devices and patients tested only the device being used on their management. MDI was the device best known by doctors and patients. MDI use was associated with errors related to the coordination between inspiration and device activation. Failure to exhale completely before inhalation of the powder was the most frequent error observed with DPI use. In summary, patients did not receive precise instruction on how to use inhaled medication and health care professionals were not well prepared to adequately teach their patients.

  18. Incident and Emergency Medical Services Management from a Regional Perspective

    Directory of Open Access Journals (Sweden)

    Ozge Cavusoglu

    2012-06-01

    Full Text Available Traffic crashes and other emergencies have impacts on traffic operations in transportation networks, often resulting in non-recurring congestion. Congestion, in turn, may impede the ability of Emergency Medical Services (EMS to provide timely response to those in need of medical attention. The work in this paper investigated the impact of incidents of varying severity and duration on transportation network performance in the Birmingham (AL, USA area. The intensity and extent of the impact over space and time were assessed on the basis of average speeds. The analysis of incident scenarios was performed using the Visual Interactive System for Transport Algorithms (VISTA platform. Moreover, first responders’ travel times to the scene of the incident were collected to identify best units for responding, in an effort to improve current dispatching practices. Finally, a secondary incident on the EMS to the hospital was considered to further demonstrate the superiority of Dynamic Traffic Assignment (DTA over traditional static assignment methods in capturing dynamically changing traffic conditions. The study findings are expected to benefit local transportation planners, traffic engineers, emergency responders, and policy makers by allowing them to assess various response strategies to major incidents and emergencies and select the ones that minimize their potential impacts.

  19. Psychotherapy and medication management strategies for obsessive-compulsive disorder

    Directory of Open Access Journals (Sweden)

    McDougle CJ

    2011-08-01

    Full Text Available Kelda H Walsh, Christopher J McDougleDepartment of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USAAbstract: Obsessive-compulsive disorder (OCD is a chronic anxiety disorder. While medication and psychotherapy advances have been very helpful to patients, many patients do not respond adequately to initial trials of serotonergic medication or cognitive-behavioral therapy (CBT and require multiple treatment trials or combination therapies. Comorbidity may also influence treatment response. The role of streptococcal infections in pediatric OCD has become an area of intense scrutiny and controversy. In this article, current treatment methods for OCD will be reviewed, with special attention to strategies for treating OCD in children and in patients with comorbid tic disorders. Alternative psychotherapy strategies for patients who are highly anxious about starting CBT, such as cognitive therapy or augmentation with D-cycloserine, will be reviewed. Newer issues regarding use of antibiotics, neuroleptics, and glutamate modulators in OCD treatment will also be explored.Keywords: OCD, exposure/response prevention therapy, PANDAS, tic disorder

  20. Incident and emergency medical services management from a regional perspective.

    Science.gov (United States)

    Sisiopiku, Virginia P; Cavusoglu, Ozge

    2012-07-01

    Traffic crashes and other emergencies have impacts on traffic operations in transportation networks, often resulting in non-recurring congestion. Congestion, in turn, may impede the ability of Emergency Medical Services (EMS) to provide timely response to those in need of medical attention. The work in this paper investigated the impact of incidents of varying severity and duration on transportation network performance in the Birmingham (AL, USA) area. The intensity and extent of the impact over space and time were assessed on the basis of average speeds. The analysis of incident scenarios was performed using the Visual Interactive System for Transport Algorithms (VISTA) platform. Moreover, first responders' travel times to the scene of the incident were collected to identify best units for responding, in an effort to improve current dispatching practices. Finally, a secondary incident on the EMS to the hospital was considered to further demonstrate the superiority of Dynamic Traffic Assignment (DTA) over traditional static assignment methods in capturing dynamically changing traffic conditions. The study findings are expected to benefit local transportation planners, traffic engineers, emergency responders, and policy makers by allowing them to assess various response strategies to major incidents and emergencies and select the ones that minimize their potential impacts. PMID:22851940

  1. Managing Information Technology in Academic Medical Centers: A "Multicultural" Experience.

    Science.gov (United States)

    Friedman, Charles P.; Corn, Milton; Krumrey, Arthur; Perry, David R.; Stevens, Ronald H.

    1998-01-01

    Examines how beliefs and concerns of academic medicine's diverse professional cultures affect management of information technology. Two scenarios, one dealing with standardization of desktop personal computers and the other with publication of syllabi on an institutional intranet, form the basis for an exercise in which four prototypical members…

  2. The Role of Human Resource Management in Iranian SMEs; in the Case of Medical Imaging Centers

    Directory of Open Access Journals (Sweden)

    Amirhossein Akhavan

    2010-05-01

    Full Text Available Human Resource Management (HRM faces difficulties in small businesses which derive from the small size and absence of adequate financial resources. Many authors have investigated the changed version of HRM in small enterprises which is some deal different with HRM in large enterprises. But in Iran researches are not interested in investigating human resource management in the field of small businesses and this encouraged me to perform this research. At first, this study has reviewed HRM policies and practices in small and medium enterprises (SMEs in the world. Then Iranian medical imaging centers have been selected as knowledge SMEs and some related managerial information has been collected from them by observation and interview. The obtained findings are about the role that HRM plays in today Iranian SMEs in the case of medical imaging centers. In this chapter the type of Human Resource Management which is accomplished in medical imaging enterprises in Iran is discovered and you can find the mistakes performed by their managers. These findings are analyzed based on literatures. In the conclusion part, some differences between western and Iranian models are proved and the study concludes that most of the owner managers in medical imaging centers in Iran could not execute HRM practices, even if they knew them or not. At last, some key points are presented as final recommendations to Iranian medical imaging SMEs in order to help them to improve their efficiency in the future.

  3. Marketing and the medical specialist in the managed care environment.

    Science.gov (United States)

    Treister, N W

    1997-01-01

    Marketing means more than just communicating or advertising to potential patients; marketing means identifying your customers and working to meet or exceed their expectations. There are five key areas of a marketing plan: (1) Establish the foundation, beginning with your mission statement; (2) Assess your marketing environment by internal and external research; (3) Target your efforts, looking at image and perception; (4) Develop your particular mix of product, price, place of distribution, and promotion; and (5) implement and evaluate your marketing process. This article discusses the importance of a marketing plan for the medical specialist and highlights the features unique to a practice working in a system of capitated reimbursement. Applying these principles will help to demonstrate added value, protect the fundamental role of the patient-physician relationship, ensure that our efforts are aligned with professional missions and goals, and ultimately increase profitability and professional success. PMID:10169343

  4. Challenges of space medical operations and life sciences management

    Science.gov (United States)

    Haddad, S. G.

    1992-01-01

    The Kennedy Space Center (KSC) has been the premier launch and landing site for America's space program since the early 1960s. Visitors are cognizant of space vehicles, processing facilities and launch pads which are treasured national resources. However, most are unaware of the unique organization which supports launch and landing activities and manages the center's occupational medicine, environmental health, ecological and environmental monitoring functions, as well as human and plant research programs. Management of this multifaceted organization can be complex because funding its different functions comes from a number of sources. Additionally the diverse disciplines of personnel present a special challenge in maintaining professional competencies while assuring efficiency in cyclical operations. This article explains the organization's structure and reviews some of its accomplishments.

  5. Managing the culturally diverse medical practice team: twenty-five strategies.

    Science.gov (United States)

    Hills, Laura

    2014-01-01

    A common misconception is that the phrase workplace diversity means meeting certain quotas in employee race or gender categories. In fact, diversity is much more than that. This article explores the unique benefits and challenges of managing a culturally diverse medical practice team and offers practice managers 25 practical strategies. It describes the two types of diversity training that are beneficial to practice managers and the kinds of policies, practices, and procedures that foster and promote diversity. This article also explores ethnocentrism, racism, ageism, sexism, stereotyping, and other potentially divisive issues among a diverse medical practice team. It provides an assessment instrument practice managers can use to evaluate their own diversity management skills. Finally, this article defines specifically what is meant by the term diversity and explores the top 10 diversity issues in workplaces today. PMID:24873132

  6. Norethindrone Acetate in the Medical Management of Adenomyosis

    OpenAIRE

    Siddhi Mankame; Nanna Osei-Tutu; Hans von Gizycki; Ozgul Muneyyirci-Delale; Ashadeep Chandrareddy

    2012-01-01

    The role of norethindrone acetate (NA) in the management of adenomyosis was evaluated with a retrospective chart review of 28 premenopausal women between 27–49 years of age presenting with moderate to severe pelvic pain and bleeding. Bleeding and dysmenorrhea scores were analyzed using paired T-tests. There was significant improvement of both dysmenorrhea and bleeding after treatment. Age showed no correlation with dysmenorrhea or bleeding. Low dose NA could be considered an effective, well-t...

  7. Hyposalivation and Xerostomia: Etiology, Complications, and Medical Management.

    Science.gov (United States)

    Turner, Michael D

    2016-04-01

    Saliva is one of the most versatile, multifunctional substances produced by the body and has a critical role in the preservation of the oropharyngeal health. It comprises a serous and mucinous component and is secreted by the major salivary glands. The mucins in the saliva serve to protect and lubricate the hard and soft tissues of the mouth, protecting them from chemical and mechanical damage. Hyposalivation can be managed by various salivary substitutes, peripheral sialagogues, and central sialagogues. PMID:27040294

  8. What Is Aggressive Violence?

    Science.gov (United States)

    Singer, Dorothy G.; Luca, Wendy

    1985-01-01

    Responses to a questionnaire dealing with what constitutes aggressive violence on television indicate that health care providers tend to rate items describing acts on television as more aggressive than television writers, producers, and executives do. (MBR)

  9. Commentary: presenting the value of medical quality to nonclinical senior management and boards of directors.

    Science.gov (United States)

    Fetterolf, Donald E

    2003-01-01

    Many physicians find hospital or health plan boards of directors to be intimidating arenas for medical quality presentations. This essay presents a number of "pearls" gleaned from successful senior clinician managers who have learned to relate to senior management and advance in their careers. This commentary was developed from research and a presentation of the same title delivered at the American College of Medical Quality Annual Meeting held in Las Vegas in October, 2001. It is important that medical directors who work with financial managers convert quality concepts into "business value" concepts. Talking in the language of business, rather than the language of doctors, makes it much easier to communicate with management (although some translation is often in order). As a clinician presenting to financial managers, you should become familiar with financial terms and how they are used. Indeed, the development of a financial model representing clinical activity results in the highest level of success. There are a number of methods for estimating impact that have been found within general business and health services research areas that are acceptable. Successful presenters of information approach their task effectively. Reports are in a more readable format and convey information for action by the corporation rather than as a scholarly treatise. Approaching senior management, one must consider the psychology of individuals in senior positions. Senior medical executives who are successful report similar approaches to their tasks, and offer helpful insight into career advancement. PMID:12583640

  10. Medical residents perceptions of the need for management education in the postgraduate curriculum: a preliminary study

    Directory of Open Access Journals (Sweden)

    Judith W. Brouns

    2010-11-01

    Full Text Available Objectives: The curriculum of the new post-graduate medical training program in the Netherlands is comprised of seven competencies that residents should possess upon graduation. In this new curriculum however, the competency as manager receives relatively little attention. In this preliminary study we investigated the residents' need for management training and tried to identify the preferred form of intervention to develop these management skills. Methods: A survey was designed to investigate the perceived needs of residents for management training and the preferred form of training intervention. A total of 506 residents in four Dutch teaching hospitals were invited to participate in a web-based survey. Results were using descriptive statistics, Chi-square tests and Fisher's exact tests. Results: A total of 177 residents responded to the survey. Of the respondents, 85(n=146 reported a need for management training. The preferred management topics included negotiation skills, practice partnerships, knowledge of the health care system and career planning. The preferred training method was a workshop given by medical specialists or extramural content experts. The best timing for training was determined to be during residency. Conclusions: Dutch medical residents reported a need for management training. While this study justifies an intervention for training management skills in residents, more research is required to design appropriate programs that consider the preferences of residents.

  11. Quality management of eLearning for medical education: current situation and outlook

    OpenAIRE

    Abrusch, Jasmin; Marienhagen, Jörg; Böckers, Anja; Gerhardt-Szép, Susanne

    2015-01-01

    Introduction: In 2008, the German Council of Science had advised universities to establish a quality management system (QMS) that conforms to international standards. The system was to be implemented within 5 years, i.e., until 2014 at the latest. The aim of the present study was to determine whether a QMS suitable for electronic learning (eLearning) domain of medical education to be used across Germany has meanwhile been identified. Methods: We approached all medical universities in Germany ...

  12. Review Article: Medical, surgical and radiological management of perianal Crohn's fistulas

    OpenAIRE

    Tozer, Phil; Burling, David; Gupta, Arun; Phillips, Robin K.; Hart, Ailsa

    2010-01-01

    Abstract Background Crohn?s anal fistulas are common and cause considerable morbidity. Their management is often difficult; medical and surgical treatments rarely lead to true healing with frequent recurrence and complications. Aim In this review, we examine medical treatments previously and currently used, surgical techniques and the important role of optimal imaging. Methods We conducted a literature search in the Pub Med database using Crohn?s, Anal Fistula, ...

  13. MANAGEMENT TECHNOLOGY OF PROFESSIONAL DEVELOPMENT OF STAFF IN MEDICAL ORGANIZA TIONS

    OpenAIRE

    I. A. Revskaia

    2016-01-01

    The article analyzes the mechanisms and technology management personnel professionalization of medical organizations. The question is now becoming even more relevant within the health care sector optimization, the main purpose of which is claimed to improve the quality of health care by improving the efficiency of health care organizations and their personnel, including the availability of physicians and medical staff, their skills and professionalism. The problems of improving the technology...

  14. Quality management of eLearning for medical education: current situation and outlook

    OpenAIRE

    Abrusch, J; Marienhagen, J; Böckers, A; Gerhardt-Szép, S

    2015-01-01

    Introduction: In 2008, the German Council of Science had advised universities to establish a quality management system (QMS) that conforms to international standards. The system was to be implemented within 5 years, i.e., until 2014 at the latest. The aim of the present study was to determine whether a QMS suitable for electronic learning (eLearning) domain of medical education to be used across Germany has meanwhile been identified. Methods: We approached all medical universities in German...

  15. Implementing a Pharmacist-Led Medication Management Pilot to Improve Care Transitions

    Directory of Open Access Journals (Sweden)

    Rachel Root, PharmD, MS

    2012-01-01

    Full Text Available Purpose: The purpose of this project was to design and pilot a pharmacist-led process to address medication management across the continuum of care within a large integrated health-system.Summary: A care transitions pilot took place within a health-system which included a 150-bed community hospital. The pilot process expanded the pharmacist’s medication management responsibilities to include providing discharge medication reconciliation, a patient-friendly discharge medication list, discharge medication education, and medication therapy management (MTM follow-up.Adult patients with a predicted diagnosis-related group (DRG of congestive heart failure or chronic obstructive pulmonary disease admitted to the medical-surgical and intensive care units who utilized a primary care provider within the health-system were included in the pilot. Forty patients met the inclusion criteria and thirty-four (85% received an intervention from an inpatient or MTM pharmacist. Within this group of patients, 88 drug therapy problems (2.6 per patient were identified and 75% of the drug therapy recommendations made by the pharmacist were accepted by the care provider. The 30-day all-cause readmission rates for the intervention and comparison groups were 30.5% and 35.9%, respectively. The number of patients receiving follow-up care varied with 10 (25% receiving MTM follow-up, 26 (65% completing a primary care visit after their first hospital discharge, and 23 (58% receiving a home care visit.Conclusion: Implementation of a pharmacist-led medication management pilot across the continuum of care resulted in an improvement in the quality of care transitions within the health-system through increased identification and resolution of drug therapy problems and MTM follow-up. The lessons learned from the implementation of this pilot will be used to further refine pharmacy care transitions programs across the health-system.

  16. The Outcome of Surgery versus Medical Management in the Treatment of Vesicoureteral Reflux

    OpenAIRE

    Nelson, Caleb P.

    2008-01-01

    Evaluation of the relative merits of medical versus surgical management of vesicoureteral reflux (VUR) has been limited by the few prospective studies comparing these strategies. Among those trials that have been reported, the only consistent positive finding has been that incidence of febrile UTI is lower among children undergoing surgical treatment in comparison with medical treatment. Studies have not found significant differences in overall incidence of UTI, or in rates of new renal scarr...

  17. Aggressive commercial practicies

    OpenAIRE

    Tomanová, Magdaléna

    2008-01-01

    Diploma thesis evaluates the effectiveness of legal instruments to prevent the use of aggressive commercial practices. Thesis is divided into two main chapters, the first is the protection against aggressive commercial practices in business to consumer market and the second part is dedicated to the protection against aggressive practices in the business to business market. Each section compares the European protection of aggressive commercial practices (and also through European legislation i...

  18. Aggression on Roadways

    OpenAIRE

    Novaco, Raymond W.

    1989-01-01

    Aggression and the automobile have had a long standing association, yet research on aggressive behavior has neglected the roadway context. This chapter reviews existing work which has included archival analysis, field interview studies, personality research, and field experiments. Among the recurrent themes have been the relationship between aggressivity in driving to accident liability and to violence in the larger social context. Validity issues in road aggression research are discussed, an...

  19. Explanation of medical examination and management principle for the overexposed individuals

    International Nuclear Information System (INIS)

    Medical Examination and Management Principle for the Overexposed Individuals has been approved and issued by the Ministry of Health. Based on the extensive research of literature, collection of the previous nuclear and radiation accidents excessive exposed personnel data and specific situations in China, this standard was enacted according to the current national laws, regulations, and the opinions of peer experts. The standard specifies the scope of application, necessary projects of medical examination and treatment principle of excessive exposure (<1.0 Gy) personnel It is mainly used in nuclear and radiation by accident as personnel medical examination, treatment principle and the late effects of the medical follow-up principle. To correctly implement this standard and guide medical examination and treatment of excessively exposed personnel, the contents of this standard were interpreted in this article. (authors)

  20. Secure and efficient health data management through multiple watermarking on medical images.

    Science.gov (United States)

    Giakoumaki, A; Pavlopoulos, S; Koutsouris, D

    2006-08-01

    The landscape of healthcare delivery and medical data management has significantly changed over the last years, as a result of the significant advancements in information and communication technologies. Complementary and/or alternative solutions are needed to meet the new challenges, especially regarding security of the widely distributed sensitive medical information. Digital watermarking is a recently established research area with many applications; nevertheless, the potential of this technology to contribute value-added services to medical information management systems has only recently started to be realized by the research community. The paper presents a review of research efforts in the area of medical-oriented watermarking and proposes a wavelet-based multiple watermarking scheme; this scheme aims to address critical health information management issues, including origin and data authentication, protection of sensitive data, and image archiving and retrieval. In accordance with the strict limitations applying to medical images, the scheme allows the definition of a region of interest (ROI) whose diagnostic value is protected, since the only additional information embedded therein aims at integrity control. The robustness of the method is enhanced through a form of hybrid coding, which includes repetitive embedding of BCH encoded watermarks. The experimental results on different medical imaging modalities demonstrate the efficiency and transparency of the watermarking scheme. PMID:16937204

  1. Rising incidence and aggressive nature of cutaneous malignancies after transplantation: An update on epidemiology, risk factors, management and surveillance.

    Science.gov (United States)

    Tufaro, Anthony P; Azoury, Saïd C; Crompton, Joseph G; Straughan, David M; Reddy, Sashank; Prasad, Nijaguna B; Shi, Gang; Fischer, Anne C

    2015-12-01

    Although immunosuppression has been a key component to the success of solid-organ transplantation, the morbidity associated with long-term immunosuppression remains a substantial burden, particularly as recipients of transplants live longer. Indeed, malignancy is one of the most common reasons for mortality following transplantation and the most common of these cancers are cutaneous in origin. Recently, the incidence of these malignancies has been on the rise, partly due to the fact that recipients of these transplants are living longer as a result of improvements in surgical technique, immunosuppression and perioperative management. Although there have been initiatives to increase awareness of cutaneous malignancies following transplantation, such programs are not standardized and there continues to be gaps in skin cancer education and post-operative surveillance. This review provides an update on the epidemiology, risk factors, clinical management, prevention and surveillance of cutaneous malignancies. PMID:26690824

  2. Gibbon Aggression During Introductions: An International Survey.

    Science.gov (United States)

    Harl, Heather; Stevens, Lisa; Margulis, Susan W; Petersen, Jay

    2016-01-01

    Little is known regarding the prevalence of aggression seen during introductions of captive gibbons (Hylobatidae). In this study, an online survey was developed to quantify and collect contextual details regarding the frequency and types of aggression seen during introductions of captive gibbons (Hylobatidae). Nineteen percent of institutions (17 institutions) reported observing aggression, and 6 of these institutions recorded multiple instances of aggression, though a vast majority of these cases resulted in mild injuries or none at all. The female was the primary aggressor in 23% of cases, the male was the primary aggressor in 58% of cases, and both were the primary aggressor in 1 case. Although these aggressive interactions were often not associated with a known cause, 27% of cases were associated with food displacement. In most cases, management changes, including trying new pairings, greatly reduced situational aggression, suggesting that individual personalities may play a factor in aggression. These data begin to explain the extent of aggression observed in captive gibbons; future studies will address possible correlations with aggression and introduction techniques. PMID:26963568

  3. ISO 13485 a complete guide to quality management in the medical device industry

    CERN Document Server

    Abuhav, Itay

    2011-01-01

    Although complex and lengthy, the process of certification for the ISO 13485 can be easily mastered using the simple method outlined in ISO 13485: A Complete Guide to Quality Management in the Medical Device Industry. Written by an experienced industry professional, this practical book provides a complete guide to the ISO 13485 Standard certification for medical device manufacturing. Filled with examples drawn from the author's experience and spanning different sectors and fields of the medical device industry, the book translates the extra ordinary requirements and objectives of the standard

  4. “Keeping the Boogie Man Away”: Medication Self-Management among Women Receiving Anastrozole Therapy

    Directory of Open Access Journals (Sweden)

    Karen Wickersham

    2012-01-01

    Full Text Available The oral hormonal agent anastrozole improves clinical outcomes for women with breast cancer, but women have difficulty taking it for the five-year course. The unique medication-taking experiences related to self-management of anastrozole therapy for women with early stage breast cancer are not known. Our purpose was to describe the medication-taking experiences for postmenopausal women with early stage breast cancer who were prescribed a course of anastrozole therapy. Twelve women aged 58 to 67 years, midway through therapy, participated in audio-recorded interviews. Women’s medication-taking experiences involved a belief in their importance and an imperative to take anastrozole. We found that women’s side effect experiences, particularly menopausal symptoms, were significant, but only one woman stopped anastrozole due to side effects. Medication-taking included routinization interconnected with remembering/forgetting and a storage strategy. Some women noted a mutual medication-taking experience with their spouse, but most felt taking anastrozole was something they had to do alone. Our results provide insight into the way some women with early stage breast cancer manage their hormonal therapy at approximately the midpoint of treatment. Next steps should include examinations of patient-provider communication, potential medication-taking differences between pre- and postmenopausal women, and the effects of medication-taking on clinical outcomes.

  5. Management of the quality in medical applications with sealed sources

    International Nuclear Information System (INIS)

    In this work a model of Quality management based on the ISO 9001:2000 that it includes the application of some established approaches by the IAEA 50-C/SG-Q standard is proposed, so that the different focuses from both standards are joined and achieved: the client satisfaction and certification of the quality system, and structure behavior, components and systems at secure form with a minimum of accidents. This model incorporates a program of radiological protection that emphasizes the installation of a safety culture, (Author)

  6. [Contemporary medical management of the benign prostatic syndrome].

    Science.gov (United States)

    Madersbacher, S; Michel, M C; Dreikorn, K

    2008-02-01

    Two groups of drugs, alpha blockers and 5-alpha-reductase inhibitors (5ARI), are currently widely used for the medical treatment of benign prostatic syndrome (BPS). Alpha blockers are characterized by a rapid onset of efficacy. If given at an adequate dose, all alpha blockers have a similar efficacy, yet quantitative differences regarding side effects exist. The onset of clinical efficacy of 5ARIs is delayed and dependent on prostate volume. Symptom improvement is generally less pronounced than with alpha blockers, yet this difference declines with time. 5ARI, in contrast to alpha blockers, reduce prostate volume and the risk of long-term BPS complications such as prostate surgery or acute urinary retention. The combination therapy of alpha blockers and 5ARI is superior to either monotherapy; however, this superiority becomes evident only after prolonged (>1 year) therapy. Because of additive side effects, this combination should be reserved for BPS patients with a high risk of progression. Regarding plant extracts, no definitive recommendation can be given because of a limited number of high-quality clinical trials. The use of antimuscarinics in men with BPS with a dominance of storage symptoms and without significant obstruction is promising, although further trials, particularly with a longer study duration, are required. PMID:18210072

  7. Autonomous, In-Flight Crew Health Risk Management for Exploration-Class Missions: Leveraging the Integrated Medical Model for the Exploration Medical System Demonstration Project

    Science.gov (United States)

    Butler, D. J.; Kerstman, E.; Saile, L.; Myers, J.; Walton, M.; Lopez, V.; McGrath, T.

    2011-01-01

    The Integrated Medical Model (IMM) captures organizational knowledge across the space medicine, training, operations, engineering, and research domains. IMM uses this knowledge in the context of a mission and crew profile to forecast risks to crew health and mission success. The IMM establishes a quantified, statistical relationship among medical conditions, risk factors, available medical resources, and crew health and mission outcomes. These relationships may provide an appropriate foundation for developing an in-flight medical decision support tool that helps optimize the use of medical resources and assists in overall crew health management by an autonomous crew with extremely limited interactions with ground support personnel and no chance of resupply.

  8. Radiological and Nuclear Emergencies: Medical Management of Radiation Injuries

    Directory of Open Access Journals (Sweden)

    L. Ravi Shankar

    2011-02-01

    Full Text Available Nuclear radiation which could be in the form of alpha, beta, gamma rays, etc, could cause radioactive contamination, radiation burns, acute radiation syndrome or a combination of any of these above-mentioned disasters. Effects of radiation and the subsequent treatment depend on the severity of exposure and the organs directly involved. Radiation levels up to 200 rads lead to nausea and vomiting whilst radiation levels between 200 rads and 400 rads lead to diarrhea, vomiting and pneumonitis. Whilst 450 rads is lethal in 50 per cent population, doses above this cause increased fatality and organ involvement with the Central Nervous System being affected with 2000 rads radiation. Nuclear disaster management lies most importantly in identifying that patient who would recover if treated immediately. Whereas decontamination of skin and wounds is done first, immediate first aid may take priority in a seriously injured patient. In the event of internal contamination, effective decorporation maybe required. This is followed by prevention and treatment of infections in sterile conditions. Radiation burn injuries will require effective long-term management. Finally, what would be most important is the necessity to have suitable hospital care where bone marrow, stem cell transfusion and restitution of the immune system would take place.Defence Science Journal, 2011, 61(2, pp.113-117, DOI:http://dx.doi.org/10.14429/dsj.61.830

  9. A management plan for hospitals and medical centers facing radiation incidents

    Directory of Open Access Journals (Sweden)

    Fereshteh Davari

    2015-01-01

    Full Text Available Background: Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. Materials and Methods: In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. Results: We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. Conclusion: With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.

  10. A medical crisis management simulation activity for pediatric dental residents and assistants.

    Science.gov (United States)

    Tan, Gee Mei

    2011-06-01

    Dentists are expected to deliver safe and pain-free dental procedures after they graduate from dental school. This includes using local anesthetics and sedative drugs that may be associated with side effects and complications that can lead to crisis situations. This study postulated that teaching medical crisis management to dental residents and assistants using human patient simulation (HPS) would improve their confidence in managing crisis situations in the real world. Four medical crisis scenarios were designed and programmed into a pediatric simulator. The scenarios included anaphylaxis, laryngospasm during procedural sedation, sedative medication overdose, and multiple drug interaction with cardiac arrhythmia. The simulation room was outfitted with an authentic dental operatory and emergency equipment to enhance the realism. One first-or second-year pediatric dentistry resident and a staff dental assistant were assigned as a team to participate in each ten-minute scenario followed by a debriefing session. At the end of the sessions, the participants completed an anonymous survey regarding the simulation experience. There were a total of twenty-four participants, 91.7 percent of whom felt that HPS was a good tool for learning medical crisis and that they will be more confident in managing a similar situation in the dental office after this experience. A majority of the participants felt that using HPS as a tool to teach crisis management is an acceptable and valuable technique to help improve their confidence in managing crisis situations that may occur in dental offices. PMID:21642524

  11. Research Paradigm of Displaced Aggression

    OpenAIRE

    Tanno, Syota

    2013-01-01

    A review of research paradigm of displaced aggression is presented. The author arranged the Japanese wording of displaced aggression, summarized the historical transition of research on displaced aggression, and reviewed research paradigm of displaced aggression.

  12. The Modern Criteria for Medical Management of Acromegaly.

    Science.gov (United States)

    Frara, Stefano; Maffezzoni, Filippo; Mazziotti, Gherardo; Giustina, Andrea

    2016-01-01

    Acromegaly is an insidious disorder characterized by excess secretion of growth hormone (GH) and elevated circulating levels of insulin-like growth factor-I (IGF-I), generally caused by a pituitary adenoma. It is a rare disease associated with an average 10-year reduction in life expectancy due to metabolic, cardiovascular, and cerebrovascular comorbidities and reduced quality of life caused by paresthesias, fatigue, osteoarthralgia, or bone fractures. In 2000, Cortina Consensus Conference established general criteria for diagnosis and biochemical control of acromegaly, which have been revised in recent years, adapting them to emerging clinical evidences as well as the evolving assay techniques. Authors have proposed a binary definition of cure for acromegaly, where both GH and IGF-I are important determinants: the former is more linked to the presence of residual adenomatous tissue, while the latter to the peripheral activity of the disease. Control of tumor growth and complications is also an essential goal of treatment. Surgical, medical, and radiotherapy approaches are all valid alternatives. The surgical option is, however, unsuccessful in about 50% of patients. Somatostatin analogs (SRLs), octreotide LAR, and lanreotide ATG can inhibit cell growth, besides their beneficial effects on GH hypersecretion and on most comorbidities. Pasireotide is a new multireceptor-targeted SRL with reported superior biochemical efficacy to octreotide, due to higher affinity for SSTR-5, but potentially causing detrimental effects on glucose homeostasis. Pegvisomant could be a valid choice in all patients resistant to SRLs. It is a competitive GH antagonist, which efficaciously blocks IGF-I production, inhibiting the dimerization of GH receptor. Normal IGF-I levels represent, therefore, its only relevant efficacy endpoint, while only few cases of tumor growth on pegvisomant have been reported, so far. PMID:26940387

  13. Information Risk Management: Qualitative or Quantitative? Cross industry lessons from medical and financial fields

    Directory of Open Access Journals (Sweden)

    Upasna Saluja

    2012-06-01

    Full Text Available Enterprises across the world are taking a hard look at their risk management practices. A number of qualitative and quantitative models and approaches are employed by risk practitioners to keep risk under check. As a norm most organizations end up choosing the more flexible, easier to deploy and customize qualitative models of risk assessment. In practice one sees that such models often call upon the practitioners to make qualitative judgments on a relative rating scale which brings in considerable room for errors, biases and subjectivity. On the other hand under the quantitative risk analysis approach, estimation of risk is connected with application of numerical measures of some kind. Medical risk management models lend themselves as ideal candidates for deriving lessons for Information Security Risk Management. We can use this considerably developed understanding of risk management from the medical field especially Survival Analysis towards handling risks that information infrastructures face. Similarly, financial risk management discipline prides itself on perhaps the most quantifiable of models in risk management. Market Risk and Credit Risk Information Security Risk Management can make risk measurement more objective and quantitative by referring to the approach of Credit Risk. During the recent financial crisis many investors and financial institutions lost money or went bankrupt respectively, because they did not apply the basic principles of risk management. Learning from the financial crisis provides some valuable lessons for information risk management.

  14. The treatment of severe child aggression (TOSCA study: Design challenges

    Directory of Open Access Journals (Sweden)

    Farmer Cristan A

    2011-11-01

    Full Text Available Abstract Background Polypharmacy (the concurrent use of more than one psychoactive drug and other combination interventions are increasingly common for treatment of severe psychiatric problems only partly responsive to monotherapy. This practice and research on it raise scientific, clinical, and ethical issues such as additive side effects, interactions, threshold for adding second drug, appropriate target measures, and (for studies timing of randomization. One challenging area for treatment is severe child aggression. Commonly-used medications, often in combination, include psychostimulants, antipsychotics, mood stabilizers, and alpha-2 agonists, which vary considerably in terms of perceived safety and efficacy. Results In designing our NIMH-funded trial of polypharmacy, we focused attention on the added benefit of a second drug (risperidone to the effect of the first (stimulant. We selected these two drugs because their associated adverse events might neutralize each other (e.g., sleep delay and appetite decrease from stimulant versus sedation and appetite increase from antipsychotic. Moreover, there was considerable evidence of efficacy for each drug individually for the management of ADHD and child aggression. The study sample comprised children (ages 6-12 years with both diagnosed ADHD and disruptive behavior disorder (oppositional-defiant or conduct disorder accompanied by severe physical aggression. In a staged sequence, the medication with the least problematic adverse effects (stimulant was openly titrated in 3 weeks to optimal effect. Participants whose behavioral symptoms were not normalized received additional double-blind medication, either risperidone or placebo, by random assignment. Thus children whose behavioral symptoms were normalized with stimulant medication were not exposed to an antipsychotic. All families participated in an empirically-supported parent training program for disruptive behavior, so that the actual

  15. Tradução e adaptação cultural da Management of Aggression And Violence Attitude Scale – MAVAS – em enfermeiros brasileiros

    Directory of Open Access Journals (Sweden)

    Marcos Hirata Soares

    2013-08-01

    Full Text Available Este estudo objetivou traduzir e adaptar culturalmente a Management of Aggression and Violence Attitude Scale – MAVAS – para uso no Brasil. As etapas metodológicas seguiram as diretrizes internacionais para adaptação cultural de escalas psicométricas: equivalência conceitual, equivalência semântica, equivalência de itens e equivalência operacional. A validade de conteúdo realizada por um grupo de juízes resultou numa escala composta por 23 itens divididos em quatro fatores com Coeficientes de Validade de Conteúdo (CVC satisfatórios nos parâmetros avaliados: (0,88 para clareza de linguagem, 0,91 pertinência prática e 0,92 para relevância teórica. Os dados foram coletados no ano de 2011, em Londrina, PR, Brasil. Concluiu-se que a MAVAS-BR está traduzida e adaptada culturalmente para uso no Brasil e que o instrumento traduzido e adaptado apresenta validade de conteúdo satisfatória. Estudos futuros relacionados à MAVAS-BR são sugeridos, dentre eles a avaliação de suas qualidades psicométricas, como a validade de construto e a confiabilidade do instrumento.

  16. The Impact of Medical Tourism on Thai Private Hospital Management: Informing Hospital Policy

    OpenAIRE

    2012-01-01

    Background: The purpose of this paper is to help consolidate and understand management perceptions and experiences of a targeted group (n=7) of Vice-Presidents of international Private Thai hospitals in Bangkok regarding medical tourism impacts. Methods: The method adopted uses a small-scale qualitative inquiry. Examines the on-going development and service management factors which contribute to the establishment and strengthening of relationships between international patients and hospital m...

  17. Strength and Weakness of Crisis Management in Hormozgan Medical University’s Hospitals

    OpenAIRE

    Zahra Mastane; Lotfollah Mouseli; Maryam Jahangiri; Maryam Doost; Ali Eshghi

    2012-01-01

    Background & Objective: Various communities continuously try to manage the unexpected events. In this regard, hospitals with providing timely health care services has transformed to the most pragmatic unit of health system. Planning and preparation of them should be strategic policy of health system. This paper aimed to investigate the strength and weakness of crisis management in training hospitals of Hormozgan University of Medical Sciences. Materials & Methods: This is descriptive-analytic...

  18. A pilot study of a practice management training module for medical residents

    OpenAIRE

    Berkenbosch, Lizanne; Arno M M Muijtjens; Zimmermann, Luc J. I.; Heyligers, Ide C; Scherpbier, Albert J. J. A.; Busari, Jamiu O.

    2014-01-01

    Background In 2005 a competency based curriculum was introduced in the Dutch postgraduate medical training programs. While the manager’s role is one of the seven key competencies, there is still no formal management course in most postgraduate curricula. Based on a needs assessment we conducted, several themes were identified as important for a possible management training program. We present the results of the pilot training we performed to investigate two of these themes. Methods The topics...

  19. A proposal for health care management and leadership education within the UK undergraduate medical curriculum

    OpenAIRE

    Mafe, Cecilia

    2016-01-01

    Cecilia Mafe, Effie Menyah, Munachi Nkere Imperial College School of Medicine, Imperial College London, London, UK Abstract: Health care management and leadership education is an important gap in the undergraduate medical curriculum. Lack of training promotes poor decision making and may lead to inadequate health services, adversely affecting patients. We propose an integrated approach to health care management and leadership education at undergraduate level, to enable doctors to be effectiv...

  20. Evaluating condom catheter balloon tamponade in non-traumatic postpartum haemorrhage resistant to medical management

    Directory of Open Access Journals (Sweden)

    Syed Nawaz Ahmad

    2016-06-01

    Conclusions: Placement of a condom catheter balloon can successfully treat non-traumatic PPH refractory to medical management. It is simple, inexpensive, easily, available and in those with successful placement no procedure related morbidity was observed. The potential for it to be used by inexperienced operators in areas with limited resources makes it a useful tool in management of PPH. [Int J Reprod Contracept Obstet Gynecol 2016; 5(6.000: 1874-1878

  1. Integrated safety management for medical short-lived radioactive wastes

    International Nuclear Information System (INIS)

    The integrated disposal system was developed to make sure the disposal of wastes concerning positron emission tomography to comply with the regulations. The system consisted of a management system concerned with the data of wastes and a measurement system concerned with the residual radioactivity of wastes. The information of wastes was stored into the tags. The tags were pasted on the top surface of the container holding wastes. The tag's data was read by the reader. The reader was placed on the base and side surfaces in order to evaluate the dependency of the kind and volume of wastes respectively. The rate at which the reader succeeded in reading was researched. The successful rates in reading depended on the position of the tags and readers. The detection limit of the system was evaluated with the source 99mTc to be 218 Bq. The specific period for decay from 218 Bq to one atom of 18F was estimated to be 39 hours. (author)

  2. Current management and surgical outcomes of medically intractable epilepsy.

    Science.gov (United States)

    Ramey, Wyatt L; Martirosyan, Nikolay L; Lieu, Corinne M; Hasham, Hasnain A; Lemole, G Michael; Weinand, Martin E

    2013-12-01

    Epilepsy is one of the most common neurologic disorders in the world. While anti-epileptic drugs (AEDs) are the mainstay of treatment in most cases, as many as one-third of patients will have a refractory form of disease indicating the need for a neurosurgical evaluation. Ever since the first half of the twentieth century, surgery has been a major treatment option for epilepsy, but the last 10-15 years in particular has seen several major advances. As shown in relatively recent studies, resection is more effective for medically intractable epilepsy (MIE) than AED treatment alone, which is why most clinicians now endorse a neurosurgical consultation after approximately two failed regimens of AEDs, ultimately leading to decreased healthcare costs and increased quality of life. Temporal lobe epilepsy (TLE) is the most common form of MIE and comprises about 80% of epilepsy surgeries with the majority of patients gaining complete seizure-freedom. As the number of procedures and different approaches continues to grow, temporal lobectomy remains consistently focused on resection of mesial structures such as the amygdala, hippocampus, and parahippocampal gyrus while preserving as much of the neocortex as possible resulting in optimum seizure control with minimal neurological deficits. MIE originating outside the temporal lobe is also effectively treated with resection. Though not as successful as TLE surgery because of their frequent proximity to eloquent brain structures and more diffuse pathology, epileptogenic foci located extratemporally also benefit from resection. Favorable seizure outcome in each of these procedures has heavily relied on pre-operative imaging, especially since the massive surge in MRI technology just over 20 years ago. However, in the absence of visible lesions on MRI, recent improvements in secondary imaging modalities such as fluorodeoxyglucose positron emission computed tomography (FDG-PET) and single-photon emission computed tomography (SPECT

  3. Medicines Management, Medication Errors and Adverse Medication Events in Older People Referred to a Community Nursing Service: A Retrospective Observational Study

    OpenAIRE

    Elliott, Rohan A; Lee, Cik Yin; Beanland, Christine; Vakil, Krishna; Goeman, Dianne

    2016-01-01

    Background Increasing numbers of older people are receiving support with medicines management from community nursing services (CNSs) to enable them to live in their own homes. Little is known about these people and the support they receive. Objectives To explore the characteristics of older people referred for medicines management support, type of support provided, medication errors and adverse medication events (AMEs). Methods A retrospective observational study of a random sample of 100 old...

  4. Leadership and management in the undergraduate medical curriculum: a qualitative study of students’ attitudes and opinions at one UK medical school

    OpenAIRE

    Quince, Thelma; Abbas, Mark; Murugesu, Sughashini; Crawley, Francesca; Hyde, Sarah; Wood, Diana; Benson, John

    2014-01-01

    Objective To explore undergraduate medical students’ attitudes towards and opinions about leadership and management education. Design Between 2009 and 2012 we conducted a qualitative study comprising five focus group discussions, each devoted to one of the five domains in the Medical Leadership Competency Framework, (Personal Qualities, Working with Others, Managing Services, Improving Services and Setting Direction). Each discussion examined what should be learnt, when should learning occur,...

  5. Emergency medical management of radiation accident. Lessons learned from the JCO criticality accident

    International Nuclear Information System (INIS)

    A criticality accident occurred at the JCO nuclear fuel processing plant in Tokai-mura, Japan at 10:35 am on September 30, 1999. Three workers while working nearby were exposed to high doses of radiation, especially rich in neutron. They suffered from the acute radiation syndrome and two of them were still under medical treatment. This criticality accident taught us significant lessons of radiation protection for the personnels, e.g. physicians, nurses and firemen who are expected to rescue radiation-exposed patients in radiation accidents. In this article, medical management of radiation accident, e.g. treatment of patient, with high-dosed radiation-exposure and with internal contamination of radioactive nuclides and estimation of individual radiation dose, were briefly explained. The Japanese Association for Medical Management of Radiation Accident was founded on August 29, 1997, in order to promote the mutual communication of physicians who have to be engaged in treatment of radiation-exposed patients. (author)

  6. Management of medical and psychosocial consequences of a radiological or nuclear terrorist event

    International Nuclear Information System (INIS)

    Medical, psychological, and social consequences of a terrorist event involving the release of ionizing radiation will differ significantly from attacks with 'classical' explosives. Victims of a detonation of a 'dirty bomb' or a nuclear device can actually or allegedly absorb various doses of radiation and should be viewed as radiologically contaminated patients. Hence, both first responders and medical personnel should behave and act accordingly. General rules, guidelines, and procedures are described that should be implemented at all levels of medical management from the on-site emergency care until admittance to and treatment of the victims at a specialist hospital ward. The causes, manifestations and management of psychosocial sequelae of radiological terrorist incidents are also discussed. (author)

  7. Managing Awkward, Sensitive, or Delicate Topics in (Chinese) Radio Medical Consultations

    Science.gov (United States)

    Yu, Guodong; Wu, Yaxin

    2015-01-01

    This study, using conversation analysis as the research methodology, probes into the use of "nage" (literally "that") as a practice of managing awkward, sensitive, or delicate issues in radio phone-in medical consultations about sex-related problems. Through sequential manipulation and turn manipulation, the caller uses…

  8. IMPLEMENTING AN ISO 9001 MANAGEMENT SYSTEM IN PROCESSES OF ADDITIVE MANUFACTURING FOR MEDICAL USE

    OpenAIRE

    Ketinlly Yasmyne Nascimento Martins; Kléber Cavalcanti Nóbrega; Nadja Mª da Silva Oliveira Brito; Rodolfo Ramos Castelo Branco; Jorge Vicente Lopes da Silva

    2015-01-01

    Based on a case study, this paper presents a methodology to adopt ISO 9001 standards for organizations which make use of additive manufacturing to build products for medical use. Starting with a conceptual model, guidelines were identified to guide planning and operation of the management system, as well as its maintenance and improvement.

  9. Application of Department of Defense Software Management Techniques to Medical Software Development Projects

    OpenAIRE

    Stanford, Jean Hanmer; Siegel, Jean Lafaye

    1981-01-01

    The Department of Defense (DoD) is probably the biggest buyer and developer of computer software in the world. Over the years the DoD has developed, implemented, and tested various software management techniques. In this paper the authors describe the major formalized techniques and indicate how they could be applied to software development projects in medical environments.

  10. T2QM (Teaching and Total Quality Management) for Medical Teachers.

    Science.gov (United States)

    Bing-You, R. G.

    1997-01-01

    Explores the potential relationship of teaching and total quality management (TQM) and the subsequent benefits for individual medical teachers. Addresses issues such as defining teaching processes and quality teaching, responding to customers' needs, assessing current teaching practices, and improving one's own teaching. Contains 18 references.…

  11. IMPLEMENTING AN ISO 9001 MANAGEMENT SYSTEM IN PROCESSES OF ADDITIVE MANUFACTURING FOR MEDICAL USE

    Directory of Open Access Journals (Sweden)

    Ketinlly Yasmyne Nascimento Martins

    2015-12-01

    Full Text Available Based on a case study, this paper presents a methodology to adopt ISO 9001 standards for organizations which make use of additive manufacturing to build products for medical use. Starting with a conceptual model, guidelines were identified to guide planning and operation of the management system, as well as its maintenance and improvement.

  12. Successful Medical Management of a Left Ventricular Thrombus and Aneurysm Following Failed Thrombolysis in Myocardial Infarction

    OpenAIRE

    Oyedeji, Adebayo T.; Christopher Lee; Owojori, Olukolade O.; Ajegbomogun, Olabanji J; Adeseye A Akintunde

    2013-01-01

    We report the case of a patient with an extensive anterior myocardial infarction complicated by left ventricular systolic dysfunction, left ventricular apical thrombus and an apical left ventricular aneurysm following failed thrombolysis. We obtained serial two-dimensional echocardiograms at short intervals in the acute phase and also during the months of recovery and follow up. The patient was successfully and exclusively medically managed.

  13. 78 FR 61363 - Correction-Scientific Information Request on Medication Therapy Management

    Science.gov (United States)

    2013-10-03

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Correction--Scientific Information Request on Medication Therapy Management The original date of publication for this Federal Register notice was September 17, 2013, 78 FR 57159. On this publication, the Web site that appears under ADDRESSES is incorrect...

  14. Relationship between Emotional Intelligence and the Success of Educational Managers at Golestan University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Einollah Mollaei

    2012-01-01

    Full Text Available Introduction: Emotional intelligence is a new evolution in the field of thought – excitement relationship, which has a major effect on the success of managers. Therefore, the aim of this study was to assess the relationship between emotional intelligence and the success of educational managers at Golestan University of medical sciences. Methods: This study was conducted with all (n=96 educational managers (45 females and 51 males at Golestan University of Medical Sciences who were selected through census method in 2009. Data collection tools included a demographic data questionnaire, Shring Emotional Intelligence Scale and a success questionnaire. Relationship between emotional intelligence of the educational managers and their success rate was analyzed by spearman correlation coefficient. Results: The findings showed that mean emotional intelligence of successful and unsuccessful managers were 98.74 and 76.74 respectively. The spearman correlation coefficient between emotional intelligence and success of managers was 0.71 which indicates a direct relationship between emotional intelligence and success (P<0.001. Conclusion: With regard to the direct relationship between emotional intelligence of managers and their success demonstrated in this study, organizing some workshops on emotional intelligence are suggested to improve the capabilities of organizational managers.

  15. Supporting self-management for patients with complex medical needs: recommendations of a working group.

    Science.gov (United States)

    Bayliss, E A; Bosworth, H B; Noel, P H; Wolff, J L; Damush, T M; Mciver, L

    2007-06-01

    Increasing numbers of persons live with complex chronic medical needs and are at risk for poor health outcomes. These patients require unique self-management support, as they must manage many, often interacting, tasks. As part of a conference on Managing Complexity in Chronic Care sponsored by the Department of Veterans Affairs, a working group was convened to consider self-management issues specific to complex chronic care. In this paper, we assess gaps in current knowledge on self-management support relevant to this population, report on the recommendations of our working group, and discuss directions for future study. We conclude that this population requires specialized, multidimensional self-management support to achieve a range of patient-centred goals. New technologies and models of care delivery may provide opportunities to develop this support. Validation and quantification of these processes will require the development of performance measures that reflect the needs of this population, and research to prove effectiveness. PMID:18083671

  16. Safety in home care: A research protocol for studying medication management

    Directory of Open Access Journals (Sweden)

    Easty Anthony

    2010-06-01

    Full Text Available Abstract Background Patient safety is an ongoing global priority, with medication safety considered a prevalent, high-risk area of concern. Yet, we have little understanding of the supports and barriers to safe medication management in the Canadian home care environment. There is a clear need to engage the providers and recipients of care in studying and improving medication safety with collaborative approaches to exploring the nature and safety of medication management in home care. Methods A socio-ecological perspective on health and health systems drives our iterative qualitative study on medication safety with elderly home care clients, family members and other informal caregivers, and home care providers. As we purposively sample across four Canadian provinces: Alberta (AB, Ontario (ON, Quebec (QC and Nova Scotia (NS, we will collect textual and visual data through home-based interviews, participant-led photo walkabouts of the home, and photo elicitation sessions at clients' kitchen tables. Using successive rounds of interpretive description and human factors engineering analyses, we will generate robust descriptions of managing medication at home within each provincial sample and across the four-province group. We will validate our initial interpretations through photo elicitation focus groups with home care providers in each province to develop a refined description of the phenomenon that can inform future decision-making, quality improvement efforts, and research. Discussion The application of interpretive and human factors lenses to the visual and textual data is expected to yield findings that advance our understanding of the issues, challenges, and risk-mitigating strategies related to medication safety in home care. The images are powerful knowledge translation tools for sharing what we learn with participants, decision makers, other healthcare audiences, and the public. In addition, participants engage in knowledge exchange

  17. [Medication errors: importance of notification in the management of patient safety].

    Science.gov (United States)

    Bohomol, Elena; Ramos, Laís Helena

    2007-01-01

    Notifying medication errors is an important instrument in managing assistance quality and safety for the patient. The objective of this study was to verify with the nursing team their understanding that a medication error had been committed, and to observe how they notified responsible physicians of the event. To achieve this, researchers used a descriptive/exploratory survey with 89 professionals. The results demonstrate a lack of uniformity in understanding that medication errors had been committed, when these errors must be communicated to a physician, and when an event report must be filled out. The research shows the necessity to develop educational programs that shed light on exactly what constitutes a medication error, clarifying causes of the problem and providing solutions to solve it. PMID:17477164

  18. [Design and Implementation of a Mobile Operating Room Information Management System Based on Electronic Medical Record].

    Science.gov (United States)

    Liu, Baozhen; Liu, Zhiguo; Wang, Xianwen

    2015-06-01

    A mobile operating room information management system with electronic medical record (EMR) is designed to improve work efficiency and to enhance the patient information sharing. In the operating room, this system acquires the information from various medical devices through the Client/Server (C/S) pattern, and automatically generates XML-based EMR. Outside the operating room, this system provides information access service by using the Browser/Server (B/S) pattern. Software test shows that this system can correctly collect medical information from equipment and clearly display the real-time waveform. By achieving surgery records with higher quality and sharing the information among mobile medical units, this system can effectively reduce doctors' workload and promote the information construction of the field hospital. PMID:26485982

  19. Pattern of medical waste management: existing scenario in Dhaka City, Bangladesh

    Directory of Open Access Journals (Sweden)

    Rahman K Anisur

    2008-01-01

    Full Text Available Abstract Background Medical waste is infectious and hazardous. It poses serious threats to environmental health and requires specific treatment and management prior to its final disposal. The problem is growing with an ever-increasing number of hospitals, clinics, and diagnostic laboratories in Dhaka City, Bangladesh. However, research on this critical issue has been very limited, and there is a serious dearth of information for planning. This paper seeks to document the handling practice of waste (e.g. collection, storage, transportation and disposal along with the types and amount of wastes generated by Health Care Establishments (HCE. A total of 60 out of the existing 68 HCE in the study areas provided us with relevant information. Methods The methodology for this paper includes empirical field observation and field-level data collection through inventory, questionnaire survey and formal and informal interviews. A structured questionnaire was designed to collect information addressing the generation of different medical wastes according to amount and sources from different HCE. A number of in-depth interviews were arranged to enhance our understanding of previous and existing management practice of medical wastes. A number of specific questions were asked of nurses, hospital managers, doctors, and cleaners to elicit their knowledge. The collected data with the questionnaire survey were analysed, mainly with simple descriptive statistics; while the qualitative mode of analysis is mainly in narrative form. Results The paper shows that the surveyed HCE generate a total of 5,562 kg/day of wastes, of which about 77.4 per cent are non-hazardous and about 22.6 per cent are hazardous. The average waste generation rate for the surveyed HCE is 1.9 kg/bed/day or 0.5 kg/patient/day. The study reveals that there is no proper, systematic management of medical waste except in a few private HCE that segregate their infectious wastes. Some cleaners were found

  20. Strategic management of medical tourism in Iran based on SWOT model

    Directory of Open Access Journals (Sweden)

    Majid Daeichini

    2014-03-01

    Full Text Available Medicine and related services worldwide, branches of tourism as medical tourism, have created. Every year, thousands of tourists have access to modern medical services, and of course reasonably priced way to Iran, the more they attract and develop medical tourism, a comprehensive review is necessary. This study, based on an analytical method - a description, and utilization of available resources in the field of tourism management, tourism, and its role in the development of medical tourism in the country, as well as a comprehensive analysis SWOT, and enjoying open questionnaire was used to determine the basic strategies for the management and development of medical tourism in the country. The results of the analysis of the potential and limitations, it suggests that the benefit of proper infrastructure and the fields of health and medicine, and medical and hospital environments, and human capital of the country, benefiting from a weighted score of 0.64, in the first place strengths inappropriate accommodation and welfare facilities, with a weighted score of 0.48 in the first position of weakness, the incentive to travel to Iran for treatment among tourists, with a weighted score of 0.56, the highest rating have weight, and at the first available opportunity, and the continued Weakness adequate facilities to attract medical tourists, with a weighted score of 0.52, in the first place is under threat. The most important strategies that can be employed in this field, namely, infrastructure services, recreational facilities, health care centers and tourist sites, optimum use of the potential therapeutic, medical and human resources of the country, and efforts to strengthen absorption for the treatment of Iran stated

  1. A fundamental, national, medical disaster management plan: an education-based model.

    Science.gov (United States)

    Djalali, Ahmadreza; Hosseinijenab, Vahid; Hasani, Azadeh; Shirmardi, Kianoush; Castrén, Maaret; Ohlén, Gunnar; Panahi, Farzad

    2009-01-01

    During disasters, especially following earthquakes, health systems are expected to play an essential role in reducing mortality and morbidity. The most significant naturally occurring disaster in Iran is earthquakes; they have killed >180,000 people in the last 90 years. According to the current plan in 2007, the disaster management system of Iran is composed of three main work groups: (1) Prevention and risk management, (2) Education, and (3) Operation. This organizational separation has resulted in lack of necessary training programs for experts of specialized organizations, e.g., the Ministry of Health and Medical Education (MOHME).The National Board of MOHME arranged a training program in the field of medical disaster management. A qualified training team was chosen to conduct this program in each collaborating center, based on a predefined schedule. All collaborating centers were asked to recall 5-7 experts from each member university. Working in medical disaster management field for greater than or equal to 2 years was an inclusion criterion. The training programs lasted three days, consisted of all relevant aspects of medical disaster management, and were conducted over a six-month period (November 2007-April 2008). Pre-test and post-tests were used to examine the participants' knowledge regarding disaster management; the mean score on the pretest was 67.1 +/-11.6 and 88.1 +/-6.2, respectively. All participants were asked to hold the same training course for their organizations in order to enhance knowledge of related managers, stakeholders, and workers, and build capacity at the local and provincial levels. The next step was supposed to be developing a comprehensive medical disaster management plan for the entire country. Establishing nine disaster management regional collaborating centers in the health system of Iran has provided an appropriate base for related programs to be rapidly and easily accomplished throughout the country. This tree-shaped model is

  2. Radiation health risk management of Fukushima nuclear disaster. Role of medical personnel

    International Nuclear Information System (INIS)

    It consists of eight chapters such as 1) introduction, 2) medical personnel concerned to radiation emergency medicine, 3) understanding of radiological protection standard, 4) experience of Chernobyl, and radiation health risk management, 5) comment of the president of Science Council of Japan, 6) Fukushima Health Management Survey, 7) report of International Expert Symposium in Fukushima, 2011 and 8) conclusion. The cancer causes, effects of radiation on human body, comparison of thyroid cancer of children born before and after the disaster, relation between inner exposure and soil contamination of Cs-137, relative risks of some cancer causes to radiation cause, radiological protection standard dose, and Fukushima health management etc. are illustrated. (S.Y.)

  3. Medical Assistant-based care management for high risk patients in small primary care practices

    DEFF Research Database (Denmark)

    Freund, Tobias; Peters-Klimm, Frank; Boyd, Cynthia M.;

    2016-01-01

    Background: Patients with multiple chronic conditions are at high risk of potentially avoidable hospital admissions, which may be reduced by care coordination and self-management support. Medical assistants are an increasingly available resource for patient care in primary care practices. Objective......: To determine whether protocol-based care management delivered by medical assistants improves patient care in patients at high risk of future hospitalization in primary care. Design: Two-year cluster randomized clinical trial. Setting: 115 primary care practices in Germany. Patients: 2,076 patients...... with type 2 diabetes, chronic obstructive pulmonary disease, or chronic heart failure and a likelihood of hospitalization in the upper quartile of the population, as predicted by insurance data analysis. Intervention: We compared protocol-based care management including structured assessment, action...

  4. Transmitting patient and device data via GSM--central management for decentral mobile medical devices.

    Science.gov (United States)

    Bachmor, T; Schöchlin, J; Bolz, A

    2002-01-01

    Equipping medical devices with long range telemetry opens completely new possibilities for emergency response, home care and remote diagnosis. Mobile communications nowadays seem to be a generally accepted part of our modern world, but bridging the gap between new (consumer-) technologies and medical devices still is a challenge today. Providing a telemetry link (GSM) is just the trivial part--ensuring security, reliability and service management are the more critical tasks that need to be addressed. Therefore, a complete system concept consists of an automatic fleet management (e.g. periodic device-initiated service calls) as well as customer relationship management (CRM), including technical service and a trouble-ticket system. PMID:12451860

  5. "That's not how we do it": managing the inherited medical practice team.

    Science.gov (United States)

    Hills, Laura

    2013-01-01

    Most medical practice managers who take a new job will inherit an existing team. Those first few days on the job are critical because they can determine whether or not the new manager will succeed. This article provides a game plan for new medical practice managers so they get off on the right foot with their inherited teams. It suggests strategies for learning about the team's culture and for demonstrating visibly that there is a new manager in the job. It offers guidelines about introducing the new manager to the inherited team, discussing past experiences, and establishing new expectations. This article further provides practical tips for serving as a role model, gaining allies, and dealing with troublemakers quickly and effectively. It suggests strategies for speaking about the previous practice manager and for creating excitement with the inherited team. Finally, this article offers a set of 15 questions a new manager can ask members of the inherited team to get to know them, an additional 25-point team assessment instrument, and a step-by-step strategy for raising the bar for mediocre, lackluster, or dysfunctional inherited teams. PMID:24044200

  6. Prevalence and psychosocial factors of aggression among youth

    Directory of Open Access Journals (Sweden)

    Manoj Kumar Sharma

    2014-01-01

    Full Text Available Background: Youth indulgence themselves in various aggressive behaviors leading to significant psychosocial dysfunctions. The present study assesses the prevalence of aggression among youth and to assess the risk factors of aggression among youth. Materials and Methods: Anger Data sheet, Resilience Scale and Buss-Perry Aggression Scale, were administered on 5476 participants using survey design. Data was collected from different communities (college, residential, apartments and workplace of Bangalore, Jammu, Indore, Kerala, Rajasthan, Sikkim and Delhi. 47% were female and 53% were male. The mean age of the sample was 20.2 years. Comparative analysis was carried out by Pearson correlation coefficient and Chi-square was also carried out. Results: About 17.7% of the youth has high mean aggression score on Buss-Perry Aggression Scale. Males have high mean score on aggression than females. Males experienced more verbal aggression, physical aggression and anger than females. Younger age group (16-19 years experienced more aggression than older age group (20-26 years. The risk factors of the youth aggressions were identified as physical abuse in childhood, substance abuse such as alcohol and tobacco, negative peer influence, family violence, academic disturbance, psychological problems attention deficit-hyperactivity disorder, suspicious, loneliness, mood disturbance, negative childhood experience and TV and media. Conclusion: The study document, the presence of correlates of risk factors of aggression among youth and implies usages of management strategies to help them to handle aggression.

  7. Relationship between neurocognitive functioning and medication management ability over the first 6 months following allogeneic stem cell transplantation.

    Science.gov (United States)

    Mayo, S; Messner, H A; Rourke, S B; Howell, D; Victor, J C; Kuruvilla, J; Lipton, J H; Gupta, V; Kim, D D; Piescic, C; Breen, D; Lambie, A; Loach, D; Michelis, F V; Alam, N; Uhm, J; McGillis, L; Metcalfe, K

    2016-06-01

    Although neurocognitive impairment has been established as a major issue among cancer survivors, the real-world consequences of this impairment are unclear. This study investigated the relationship between neurocognitive functioning and medication management ability over time among 58 patients treated with allogeneic hematopoietic stem cell transplantation (HCT). Participants completed a neuropsychological test battery and a simulated medication management task at three time points: pre-transplant (T0), Day 100 (T1) and 6 months post transplant (T2). Neurocognitively impaired participants performed worse on the medication management task than neurocognitively normal participants at each time point, and were more likely to score in the impaired range of medication management ability post transplant (72% vs 20%, Pperformance in executive functioning/working memory consistently predicted impaired medication management ability, even when controlling for sociodemographic and clinical confounders (odds ratio=0.89, 95% confidence interval (0.80, 0.98), P=0.023). Lower physical symptom distress also predicted impaired medication management ability, but this effect decreased over time. Self-reported cognitive problems were not correlated with medication management ability at any time point. Findings suggest that poor neurocognitive functioning, particularly in the domain of executive functioning/working memory, is associated with worse medication management ability within the first 6 months after allogeneic HCT. PMID:26926230

  8. Primary care physician versus urologist: how does their medical management of LUTS associated with BPH differ?

    Science.gov (United States)

    Miner, Martin M

    2009-07-01

    Medical and surgical therapies for benign prostatic hyperplasia (BPH) are based largely on the results from adherence to the 2003 American Urological Association Guidelines. However, with the emergenceof medical therapies as first-line treatment and the expansion of medical therapy for lower urinary tract symptoms (LUTS) into the primary care office, the evaluation and management of men presenting with urinary symptoms can vary depending on provider type. This review explains the basis for BPH medical management in primary care with the review of three key studies. In addition, this review utilizes the data provided by the first longitudinal, observational BPH registry to evaluate patient outcomes and practice patterns in both urologist and primary care offices. From these data, we can conclude that men seeing urologists were more likely to be on medical therapy than men seeing primary care physicians (PCPs), who more often utilized watchful waiting. Urologists also were more likely to prescribe 5-alpha-reductase inhibitors (5ARIs), combination therapy with an alpha-blocker and 5ARI, and anticholinergic therapy. In contrast, the use of nonselective alpha-blockerswas appreciably greater among men seeing PCPs than men seeing urologists. PMID:19570485

  9. Integrating Six Sigma into a Quality Management System in the Medical Device Industry

    Directory of Open Access Journals (Sweden)

    Nadica Hrgarek

    2009-06-01

    Full Text Available Normal 0 21 false false false MicrosoftInternetExplorer4 Six Sigma is a valuable management strategy to improve business processes, reduce development and production costs, increase profit margin and improve customer satisfaction. The purpose of this paper is to describe how applicable Six Sigma concepts may complement and support formal quality management systems (QMS in the medical device industry.A significant number of issues, which increase the development costs and times, is often found during different phases of a medical device life cycle. Some defects with high patient safety risk may result in dangerous and very costly product recalls.The basic idea of this paper is to explore the possibilities of integrating Six Sigma techniques with an existing QMS throughout the entire life cycle of a medical device. This paper addresses how Six Sigma techniques, when appropriately integrated into the QMS at medical device companies, can eliminate defects earlier in the medical device life cycle, identify major opportunities for cost savings, focus on customer needs and expectations, and improve the overall business processes.

  10. Early childhood aggression

    OpenAIRE

    Alink, Lenneke Rosalie Agnes

    2006-01-01

    In this thesis the development, stability, and correlates of early childhood aggression were investigated. The normative development was examined in a general population sample using questionnaires completed by the parents of 12-, 24-, and 36-month-old children and again one year later. Results showed an early childhood aggression curve, with increasing rates of aggression in the second year of life and decreasing rates in the fourth year. One-year stabilities were moderate for 12-month-olds ...

  11. Assessing a hospital's medical IT network risk management practice with 80001-1.

    Science.gov (United States)

    Hegarty, Francis J; MacMahon, Silvana Togneri; Byrne, Patricia; McCaffery, Fergal

    2014-01-01

    Medical device interoperability has been identified as a key way of decreasing healthcare costs while improving patient care. 1 This has led to a shift toward placing more medical devices onto information technology (IT) networks. However, placing medical devices onto an IT network may lead to additional risks to safety, effectiveness and security of the devices, the network, and the data. ANSI/AAMI/IEC 80001-1 addresses the roles, responsibilities, and activities that need to be carried out when managing these risks. In this article, we describe an exercise undertaken to assess the medical IT network risk management practice implemented within a hospital to control risk associated with a clinical information system (CIS). The level of compliance with the 80001-1 standard was determined using an assessment framework developed by the Regulated Software Research Centre. The purpose of this exercise was to test and inform the development of an assessment method that is part of the assessment framework for this standard. The exercise also sought to identify how the management of such an existing CIS project meets the requirements of 80001-1. PMID:24548041

  12. [The development of strategic management of high-tech surgical medical care].

    Science.gov (United States)

    Nechaev, V S; Krasnov, A V

    2013-01-01

    The high-tech surgical medical care is one of the most effective types of medical care in Russia. However high-tech surgical treatment very often is inaccessible for patients. The development of basics of strategic management of high-tech surgical care makes it possible to enhance availability of this type of care and to shorten the gap between volumes of rendered care and population needs. This approach can be resulted in decrease of disability and mortality of the most prevalent diseases of cardio-vascular diseases, malignant neoplasms, etc. The prerequisites can be developed to enhance life quality and increase longevity of population. PMID:24175384

  13. Management of Symptomatic Intracranial Stenosis.

    Science.gov (United States)

    Hoak, David A; Lutsep, Helmi L

    2016-09-01

    Intracranial atherosclerotic disease is a common cause of stroke worldwide, causing approximately 10 % of strokes in the USA and up to 50 % in Asian populations. Recurrent stroke risks are particularly high in those with a stenosis of 70 % or more and a recent transient ischemic attack or stroke. Warfarin has been associated with higher major hemorrhage rates and no reduction of recurrent stroke compared to aspirin in patients with symptomatic intracranial stenosis. After early trials showed the feasibility of stenting, two randomized trials compared stenting plus medical management to medical management alone in symptomatic intracranial stenosis. Stenting was linked with increased risk and showed no benefit in any subpopulation of patients. Aggressive medical management in the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial was associated with half the risk of stroke compared to that in similar patients in a previous symptomatic intracranial stenosis trial after adjustment of confounding characteristics. Aggressive medical management comprises risk factor control, including a target systolic blood pressure <140 mmHg, a low density lipoprotein <70 mg/dL, hemoglobin A1C <7.0 %, and lifestyle management that incorporates exercise, smoking cessation and weight management, and the use of antithrombotics. PMID:27443379

  14. The relationship between the social management of emotional intelligence and academic performance among medical students.

    Science.gov (United States)

    Chew, Boon-How; Md Zain, Azhar; Hassan, Faezah

    2015-01-01

    Positive social interaction with peers was said to facilitate cognitive and intellectual development leading to good academic performance. There was paucity of published data on the effect of social management (SM) emotional intelligence (EI) on academic performance. We conducted this study to examine their relationship in the undergraduate medical students in a public medical school in Malaysia. This was a cross-sectional study using the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) to measure the SM. The first and final year medical students were invited to participate. Students answered a paper-based demography questionnaire and completed the online MSCEIT in privacy. Independent predictors were identified using multivariate analyses. A total of 163 (84 first year and 79 final year) medical students completed the study (at a response rate of 66.0%). SM score (B = -.10 95% CI -.175 to -.015, p = .021) was significantly related to the continuous assessment (CA) marks (adjusted R(2) = .45, F13,137 = 10.26, p emotional social intelligence and academic success in undergraduate medical students. A different collection of social skills and SM EI could be constructive towards academic achievement in medical schools. PMID:24773524

  15. Benefits of photograph transmission for trauma management in isolated areas: cases from the French tele-medical assistance service.

    Science.gov (United States)

    Dehours, Emilie; Tourneret, Marie-Laure; Roux, Patrick; Tabarly, Julien

    2016-01-01

    French maritime tele-medical assistance is currently performed by a telephone consultation associated with complementary transmission of data (photographs, electrocardiograms, etc.) over the internet. Five case reports are presented to illustrate how photo transmission is useful to managing initial care and monitoring isolated patients. Case reports included: Case 1: management of a hand burn; Case 2: management of a finger wound; Case 3: management of an ocular foreign body; Case 4: management of a subungual haematoma; Case 5: management of phlegmon. In conclusions, photo transmission improves our practice of maritime tele-medical medicine. New high-definition technologies will help in the development of videoconferences on ships. PMID:27364173

  16. Utilization technique of 'radiation management manual in medical field (2012).' What should be learnt from the Fukushima nuclear accident

    International Nuclear Information System (INIS)

    From the abstract of contents of the 'Radiation management manual in medical field (2012),' the utilization technique of the manual is introduced. Introduced items are as follows: (1) Exposure management; exposure management for radiation medical workers, patients, and citizens in the medical field, and exposure management for radiation workers and citizens involved in the emergency work related to the Fukushima nuclear accident, (2) Health management; health management for radiation medical workers, (3) Radiation education: Education/training for radiation medical workers, and radiation education for health care workers, (4) Accident and emergency measures; emergency actions involved in the radiation accidents and radiation medicine at medical facilities

  17. The Management of a Patient with Elevated Intraocular Pressure Resistant to Medical Treatment: Anterior Chamber Irrigation

    Directory of Open Access Journals (Sweden)

    Abdullah Beyoğlu

    2014-10-01

    Full Text Available A 7-year-old male patient was medically treated in another center for hyphema which occurred after blunt trauma to his right eye. He was admitted to our clinic when his visual acuity decreased after being discharged. Biomicroscopic examination revealed total hyphema. Intraocular pressure (IOP was 48 mm Hg in the right eye with Goldmann applanation tonometry. Since IOP could not be managed by medical therapy and there was no regression in hyphema, anterior chamber was irrigated. As in our case, it should not be forgotten that re-hemorrhage may occur in the first week of hyphema during childhood. Moreover, surgical treatment should be considered when hemorrhage does not regress with medical treatment, increased IOP persists, and when there is a risk of corneal endothelial staining (corneal blood staining. (Turk J Ophthalmol 2014; 44: 400-2

  18. Girls' Aggressive Behavior

    Science.gov (United States)

    Owens, Larry; Shute, Rosalyn; Slee, Phillip

    2004-01-01

    In contrast to boys' bullying behavior which is often overt and easily visible, girls' aggression is usually indirect and covert. Less research has been conducted on the types of bullying that girls usually engage in. Using focus groups composed of teenaged girls, Dr. Owens and colleagues examine the nature of teenage girls' indirect aggression.

  19. The perception of aggression

    NARCIS (Netherlands)

    Jansen, G; Dassen, T; Moorer, P

    1997-01-01

    Several academic and clinical disciplines are involved in clarifying the concept of aggression by formulating operational and descriptive definitions. In the present paper the validity of the definitions of aggression, reported by nurses in an earlier qualitative study, is examined, using a survey a

  20. The Medical Examiner/Coroner's Guide for Contaminated Deceased Body Management.

    Science.gov (United States)

    Hanzlick, Randy; Nolte, Kurt; deJong, Joyce

    2009-12-01

    In the past few years, a number of publications and other resources have appeared concerning the management of mass fatality incidents. Some are geared toward the general management of incidents while others cover more specific topics such as decontamination procedures. Still others cover selected agents, including chemical, biologic, or radiologic ones. Few publications have been written specifically for medical examiners and coroners. The Medical Examiner and Coroner's Guide for Contaminated Deceased Body Management is written specifically for the medical examiner or coroner who will be in charge of investigations of fatalities that result from terrorism or other events that result in contaminated remains. In some such cases, agents may be used that will require mitigation of environmental hazards and decontamination of human bodies. To that end, this Guide provides information and suggestions that may be useful in understanding the principles involved in decontamination procedures, recognizing that it may not be the medical examiner or coroner staff who actually conducts decontamination procedures. The suggestions in this guide may differ slightly from those in other publications. However, those who have contributed to this guide believe that the recommendations are practical, workable, have a scientific basis, and do not differ much in substance when compared with other relevant publications. The contents of this Guide may be reproduced for practical use but the Guide may not be sold and it may not be cited for advertisement purposes. Reference to specific commercial products is for informational purposes only and does not constitute endorsement of the product or company which produces the product. The recommendations contained in this Guide are not mandated nor are they required by federal, state, or local law. Rather, the recommendations are intended to assist medical examiners and coroners for the purposes of planning and providing a set of reasonable

  1. The political economy of a public health case management program's transition into medical homes.

    Science.gov (United States)

    Wells, Rebecca; Cilenti, Dorothy; Issel, L Michele

    2015-11-01

    Throughout the United States, public health leaders are experimenting with how best to integrate services for individuals with complex needs. To that end, North Carolina implemented a policy incorporating both local public health departments and other providers into medical homes for low income pregnant women and young children at risk of developmental delays. To understand how this transition occurred within local communities, a pre-post comparative case study was conducted. A total of 42 people in four local health departments across the state were interviewed immediately before the 2011 policy change and six months later: 32 professionals (24 twice) and 10 pregnant women receiving case management at the time of the policy implementation. We used constant comparative analysis of interview and supplemental data to identify three key consequences of the policy implementation. One, having medical homes increased the centrality of other providers relative to local health departments. Two, a shift from focusing on personal relationships toward medical efficiency diverged in some respects from both case managers' and mothers' goals. Three, health department staff re-interpreted state policies to fit their public health values. Using a political economy perspective, these changes are interpreted as reflecting shifts in public health's broader ideological environment. To a large extent, the state successfully induced more connection between health department-based case managers and external providers. However, limited provider engagement may constrain the implementation of the envisioned medical homes. The increased focus on medical risk may also undermine health departments' role in supporting health over time by attenuating staff relationships with mothers. This study helps clarify how state public health policy innovations unfold at local levels, and why front line practice may in some respects diverge from policy intent. PMID:26460509

  2. Q-Pro: a quality control management system for medical equipment.

    Science.gov (United States)

    Kolitsi, Z; Bliznakov, J; Gueorguieva-Bliznakova, K; Theodorakos, Y; Pallikarakis, N

    2000-01-01

    Q-Pro is an application for quality control (QC) and inspection of medical equipment. The system has been designed on the basis of a broad requirements analysis, contributed by clinical engineers from several European countries and with a focus on current and forthcoming regulatory requirements concerning the quality control and risk management for medical equipment. Q-Pro comprises a generalized application, providing the necessary flexibility to accommodate the different degrees of difficulty and specialization in creating or customizing QC protocols, carrying out inspections and managing collected data. The system incorporates a tool library for QC protocol design, widely used multimedia as well as a local database for protocol and inventory data archiving. The paper presents a detailed account of the system context of use, design and functionality. PMID:11036578

  3. The impact of managed care on patients' trust in medical care and their physicians.

    Science.gov (United States)

    Mechanic, D; Schlesinger, M

    1996-06-01

    Social trust in health care organizations and interpersonal trust in physicians may be mutually supportive, but they also diverge in important ways. The success of medical care depends most importantly on patients' trust that their physicians are competent, take appropriate responsibility and control, and give their patients' welfare the highest priority. Utilization review and structural arrangements in managed care potentially challenge trust in physicians by restricting choice, contradicting medical decisions and control, and restricting open communication with patients. Gatekeeping and incentives to limit care also raise serious trust issues. We argue that managed care plans rather than physicians should be required to disclose financial arrangements, that limits be placed on incentives that put physicians at financial risk, and that professional norms and public policies should encourage clear separation of interests of physicians from health plan organization and finance. PMID:8637148

  4. Psychiatric and Medical Management of Marijuana Intoxication in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Bui, Quan M.

    2015-05-01

    Full Text Available We use a case report to describe the acute psychiatric and medical management of marijuana intoxication in the emergency setting. A 34-year-old woman presented with erratic, disruptive behavior and psychotic symptoms after recreational ingestion of edible cannabis. She was also found to have mild hypokalemia and QT interval prolongation. Psychiatric management of cannabis psychosis involves symptomatic treatment and maintenance of safety during detoxification. Acute medical complications of marijuana use are primarily cardiovascular and respiratory in nature; electrolyte and electrocardiogram monitoring is indicated. This patient’s psychosis, hypokalemia and prolonged QTc interval resolved over two days with supportive treatment and minimal intervention in the emergency department. Patients with cannabis psychosis are at risk for further psychotic sequelae. Emergency providers may reduce this risk through appropriate diagnosis, acute treatment, and referral for outpatient care. [West J Emerg Med. 2015;16(3:414–417.

  5. The Role of Evaluation Pharmacy Information System in Management of Medication Related Complications

    Science.gov (United States)

    Isfahani, Sakineh Saghaeiannejad; Raeisi, Ahmad Reza; Ehteshami, Asghar; Janesari, Hassan; Feizi, Avat; Mirzaeian, Razieh

    2013-01-01

    Introduction As a natural phenomenon in the patient’s medication therapy, medication clinical complications potentially or concretely interrupt medical care consequential productivity for the patients. Medication related clinical complications include drug errors, drug side effects, drug interactions and drug usage-related challenges. The present research intends to explore the role that the Pharmacy Information System (PIS) may play in the management of medication complications with reference to the pharmaceutical societies of America and Australia in selected teaching, private and social services hospitals of the city of Isfahan. Methodology As an applied, descriptive-analytical study, this study has been conducted in teaching, private and social services hospitals situated in the city of Isfahan in 2011. The research population consisted of the PISs used in the hospitals under study. Research sample was the same as the population. The data collection instrument used was a self-designed checklist developed based on the guidelines of the American Society of Health System Pharmacists and Pharmaceutical Society of Australia validity of which was assessed by expert professors’ views. The data, collected by observation and interview methods, were put into SPSS 18 software to be analyzed. Findings The findings of the study revealed that among the 19 hospitals in question, the highest and lowest ranks in observing the societies of the pharmacists’ established standards related to medication therapy, i.e. registration of drug use status and drug interactions belonged to social services hospitals (mean score of %10.1) and private hospitals (mean score of %6.24), respectively. Conclusion Based on the findings, it can be claimed that the hospitals in question did not pay due attention to standards established by the societies of pharmacists regarding the medication therapy including register of drug usage status, drug interactions and drug side effects in their PISs

  6. Inpatient verbal aggression: content, targets and patient characteristics.

    Science.gov (United States)

    Stewart, D; Bowers, L

    2013-04-01

    Verbally aggressive behaviour on psychiatric wards is more common than physical violence and can have distressing consequences for the staff and patients who are subjected to it. Previous research has tended to examine incidents of verbal aggression in little detail, instead combining different types of aggressive behaviour into a single measure. This study recruited 522 adult psychiatric inpatients from 84 acute wards. Data were collected from nursing and medical records for the first 2 weeks of admission. Incidents of verbal aggression were categorized and associations with patient characteristics examined. There were 1398 incidents of verbal aggression in total, reported for half the sample. Types of verbal aggression were, in order of prevalence: abusive language, shouting, threats, expressions of anger and racist comments. There were also a large number of entries in the notes which did not specify the form of verbal aggression. Staff members were the most frequent target of aggression. A history of violence and previous drug use were consistently associated with verbal aggression. However, there were also some notable differences in patient variables associated with specific types of verbal aggression. Future studies should consider using multidimensional measures of verbal aggression. PMID:22486899

  7. Parents’ Aggressive Influences and Children's Aggressive Problem Solutions with Peers

    OpenAIRE

    Duman, Sarah; Margolin, Gayla

    2007-01-01

    This study examined children's aggressive and assertive solutions to hypothetical peer scenarios in relation to parents’ responses to similar hypothetical social scenarios and parents’ actual marital aggression. The study included 118 9−10 year old children, and their mothers and fathers. Children's aggressive solutions correlated with same-sex parents’ actual marital aggression. For children with mothers who exhibit low actual marital aggression, mothers’ aggressive solutions to hypothetical...

  8. Managing medical research data with a Web-Interfacing Repository Manager.

    OpenAIRE

    Jakobovits, R. M.; Brinkley, J. F.

    1997-01-01

    This paper describes the Web-Interfacing Repository Manager (WIRM), a perl toolkit for managing and deploying multimedia data, which is built entirely from free, platform-independent components. The WIRM consists of an object-relational API layered over a relational database, with built-in support for file management and CGI programming. The basic underlying data structure for all WIRM data is the repository object, a perl associative array whose values are bound to a row of a table in the re...

  9. Evaluation of a Consumer-Generated Marketing Plan for Medication Therapy Management Services

    OpenAIRE

    Brian J. Isetts, Ph.D.; Jon C. Schommer, Ph.D.; Sarah M. Westberg, Pharm.D.; Julie K. Johnson, Pharm.D.; Nickie Froiland; Julie M. Hedlund, MBA

    2012-01-01

    The purpose of this project was to utilize a consumer-directed, care model redesign methodology to develop and evaluate a marketing plan for medication therapy management services (MTMS) provided in community pharmacies. This was accomplished through a six-step process: (1) application of “design thinking” for eliciting consumer input on redesigning MTMS and marketing approaches, (2) exploratory research, (3) focus group analysis, (4) marketing plan development, (5) marketing plan implementat...

  10. Investigation of Management Status on MedicalWastes in Public Hospitals of Arak City

    Directory of Open Access Journals (Sweden)

    R Nabizadeh

    2011-04-01

    Full Text Available "nBackground and Objectives: Not paying attention to management and control of medical wastes in different stages of production, keeping, gathering, transporting and finally eliminating them all have been creating various setbacks such that the environment and human's health are in danger with the relevant consequences. This descriptive cross-sectional study was performed in Vali-e Asr, Amir Kabir, Taleghani, Amir Al-Momenin and Imam Khomeini hospitals of Arak city in 2009. In this research the current condition of gathering, maintaining, transportation and final elimination of hospital wastes of Arak city was investigated .Eventually an appropriate model was introduced."nMaterial and Methods: Solid wastes were separated, weighed and registered in two sequential intervals. In order to get acquaintance with the management procedure of medical solid wastes in the hospitals studied, a questionnaire approved byW.H.O was used. The questions were then replied by the Managers and Hygiene Experts worked at hospitals and their responses were recorded."nResults: The investigations conducted in 5 hospitals reveal that the average per annual was2.9 Kg in 24 hours per active bed and 4.6 Kg for each patient. This volume consists of 60% for semi-home solid wastes, 39% for infectious solid wastes, 0.34% for sharp wastes, 0.28% for the pathologic and 0.38% for medicinal and chemical solid wastes."nConclusion: According to the results obtained in this study, in order to reduce pollution create in the hospitals, action should be taken to deal with pollutants at their source of generation. The staff members involved in waste collection and transportation should practice all the personal protection measures.finaly it also should be considered that,success in medical waste management wouldn't be achievable unless all groups of medical staff involved cooperate and participle.

  11. Contribution of Electronic Medical Records to the Management of Rare Diseases

    OpenAIRE

    Dominique Bremond-Gignac; Elisabeth Lewandowski; Henri Copin

    2015-01-01

    Purpose. Electronic health record systems provide great opportunity to study most diseases. Objective of this study was to determine whether electronic medical records (EMR) in ophthalmology contribute to management of rare eye diseases, isolated or in syndromes. Study was designed to identify and collect patients' data with ophthalmology-specific EMR. Methods. Ophthalmology-specific EMR software (Softalmo software Corilus) was used to acquire ophthalmological ocular consultation data from pa...

  12. Ranking of institutional barriers regarding management of medical equipment enterprises in municipal economic system

    OpenAIRE

    Iana Panukhnyk; Olena Panukhnyk

    2015-01-01

    This article describes characteristics of the institutional factor as one of the obstacles for management of medical equipment enterprises in municipal economic system. The author finds out that the institutional environment is determined by the legal and administrative infrastructure within which entrepreneurs, companies and government interact to create well-being of the nation. The dynamics of results indicator "Competitiveness Index" was investigated for the whole Ukraine, as well as for ...

  13. Management of Medical Morbidities and Risk Factors Before Surgery: Smoking, Diabetes, and Other Complicating Factors

    OpenAIRE

    Ellsworth, Warren A.; Colon, Gustavo A.

    2006-01-01

    Patients interested in elective cosmetic procedures often have comorbidities and suffer from medical problems that influence the operative plan and surgical outcome. In the history and physical examination, it is important for the surgeon to identify these areas and be familiar with the associated risks in relation to the planned cosmetic procedure. Common problems that influence plastic surgery and wound healing in general include cigarette smoking, diabetes mellitus, and management of commo...

  14. Evaluation of a sequential structured educational curriculum for emergency medical technicians in airway management

    OpenAIRE

    Parida, Satyen; Mishra, Sandeep Kumar; Badhe, Ashok Shankar

    2014-01-01

    Background and Aims: Emergency medical technician (EMT) training programs for certification vary greatly from course to course, but it is necessary that each course at least meets local and national requirements. It is reasonable to expect that EMTs’ performance should improve after a structured educational curriculum. We hypothesized that EMTs’ performance in airway management would improve after a sequential structured educational curriculum involving airway, followed by cardiopulmonary res...

  15. Orthanc - Lightweight, Scriptable DICOM Server for Medical Image Management in Radiotherapy

    OpenAIRE

    Jodogne, Sébastien; SOBCZAK, Sonia; DEVILLERS, Magali; LENAERTS, Eric; Martinive, Philippe; Coucke, Philippe

    2013-01-01

    High-quality radiotherapy (RT) treatment planning requires the combination of information arising from multiple medical imaging modalities. For this reason, RT implies the setup and the management of complex flows of images between the various modalities and software of the hospital. Even though biomedical images are most commonly stored and transferred using the DICOM standard, it remains hard to automatize and optimize these clinical flows that are very specific to each hospi...

  16. "Unwell while Aboriginal": iatrogenesis in Australian medical education and clinical case management

    OpenAIRE

    Ewen SC; Hollinsworth D

    2016-01-01

    Shaun C Ewen,1 David Hollinsworth2 1Melbourne Poche Centre for Indigenous Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, 2Indigenous Studies, Faculty of Arts, Business and Law, University of the Sunshine Coast, Sippy Downs, QLD, Australia Introduction: Attention to Aboriginal health has become mandatory in Australian medical education. In parallel, clinical management has increasingly used Aboriginality as an identifier in both de...

  17. "Unwell while Aboriginal": iatrogenesis in Australian medical education and clinical case management

    OpenAIRE

    Ewen, Shaun

    2016-01-01

    Shaun C Ewen,1 David Hollinsworth2 1Melbourne Poche Centre for Indigenous Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, 2Indigenous Studies, Faculty of Arts, Business and Law, University of the Sunshine Coast, Sippy Downs, QLD, Australia Introduction: Attention to Aboriginal health has become mandatory in Australian medical education. In parallel, clinical management has increasingly used Aboriginality as an identifier in bot...

  18. Chronic Daily Headache in Korea: Prevalence, Clinical Characteristics, Medical Consultation and Management

    OpenAIRE

    Park, Jeong-Wook; Moon, Heui-Soo; Kim, Jae-Moon; Lee, Kwang-Soo; Chu, Min Kyung

    2014-01-01

    Background and Purpose Chronic daily headache (CDH) is a commonly reported reason for visiting hospital neurology departments, but its prevalence, clinical characteristics, and management have not been well documented in Korea. The objective of this study was to characterize the 1-year prevalence, clinical characteristics, medical consultations, and treatment for CDH in Korea. Methods The Korean Headache Survey (KHS) is a nationwide descriptive survey of 1507 Korean adults aged between 19 and...

  19. Managing the quality of medical services from patients' perspectieve- theory and reality

    OpenAIRE

    Anna Murawska

    2013-01-01

    Purpose: The aim of the article was to asses and analyze the quality management of medical services from the patient perspective. The research focused particularly on service provided by reception staff, nurses and doctors. Factors which directly influence the quality of services were carefully studied. Methodology: While the study was based on the quota sampling method, researchers used the personal interview technique and the questionnaire. The research was conducted in three healthcare fac...

  20. Evaluating medical residents as managers of care: a critical appraisal of assessment methods

    Directory of Open Access Journals (Sweden)

    Busari JO

    2014-02-01

    Full Text Available Jamiu O Busari,1,2 Lorette A Stammen,2 Lokke M Gennissen,2 Rob M Moonen1 1Department of Pediatrics, Atrium Medical Center, Henri Dunantstraat 5, 6401 CX Heerlen, the Netherlands; 2Faculty of Health, Medicine and Life Sciences, University of Maastricht, the Netherlands Introduction: The increasing demands for effective and efficient health care delivery systems worldwide have resulted in an expansion of the desired competencies that physicians need to possess upon graduation. Presently, medical residents require additional professional competencies that can prepare them to practice adequately in a continuously changing health care environment. Recent studies show that despite the importance of competency-based training, the development and evaluation of management competencies in residents during residency training is inadequate. The aim of this literature review was to find out which assessment methods are currently being used to evaluate trainees' management competencies and which, if any, of these methods make use of valid and reliable instruments. Methods: In September 2012, a thorough search of the literature was performed using the PubMed, Cochrane, Embase®, MEDLINE®, and ERIC databases. Additional searches included scanning the references of relevant articles and sifting through the “related topics” displayed by the databases. Results: A total of 25 out of 178 articles were selected for final review. Four broad categories emerged after analysis that best reflected their content: 1 measurement tools used to evaluate the effect of implemented curricular interventions; 2 measurement tools based on recommendations from consensus surveys or conventions; 3 measurement tools for assessing general competencies, which included care-management; and 4 measurement tools focusing exclusively on care-management competencies. Conclusion: Little information was found about (validated assessment tools being used to measure care-management competence

  1. How does the healthcare system affect medication self-management among older adults with multimorbidity?

    Science.gov (United States)

    Meranius, Martina Summer; Hammar, Lena Marmstål

    2016-03-01

    Individuals with multimorbidity commonly have several concurrent prescriptions and experience healthcare obstacles related to managing different diagnoses and medications. This study aimed to provide a deeper understanding of how older adults with multimorbidity experience medication self-management and how this is affected by the healthcare system. The National Board of Research Ethics approved the study, and 20 older adults with multimorbidity participated in in-depth interviews that were analysed using a hermeneutic approach. Three levels of interpretation emerged. At the first level, lack of participation in healthcare communication hinders adherence and safety, and feeling abandoned to self-care leads to health risk-taking. At the second level, the healthcare organisation is seen as an obstacle to medication self-management. The overall interpretation was a system of repairing 'parts' but not enabling the experience of health. This study shows that the healthcare system is able to treat and relieve an individual's symptoms, but seems unable to help them achieve and promote good health, or to provide the support they need to function in everyday life. PMID:25919419

  2. A review of immediacy and implications for provider–patient relationships to support medication management

    Science.gov (United States)

    Bartlett Ellis, Rebecca J; Carmon, Anna F; Pike, Caitlin

    2016-01-01

    Objectives This review is intended to 1) describe the construct of immediacy by analyzing how immediacy is used in social relational research and 2) discuss how immediacy behaviors can be incorporated into patient–provider interventions aimed at supporting patients’ medication management. Methods A literature search was conducted using Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google Scholar, OVID, PubMed, and Education Resource Information Center (ERIC) EBSCO with the keyword “immediacy”. The literature was reviewed and used to describe historical conceptualizations, identify attributes, examine boundaries, and identify antecedents and consequences of immediacy. Results In total, 149 articles were reviewed, and six attributes of immediacy were identified. Immediacy is 1) reciprocal in nature and 2) reflected in the communicator’s attitude toward the receiver and the message, 3) conveys approachability, 4) respectfulness, 5) and connectedness between communicators, and 6) promotes receiver engagement. Immediacy is associated with affective learning, cognitive learning, greater recall, enhanced relationships, satisfaction, motivation, sharing, and perceptions of mutual value in social relationships. Conclusion Immediacy should be further investigated as an intervention component of patient–provider relationships and shared decision making in medication management. Practice implications In behavioral interventions involving relational interactions between interveners and participants, such as in medication management, the effects of communication behaviors and immediacy during intervention delivery should be investigated as an intervention component. PMID:26792985

  3. Managing perceived conflicts of interest while ensuring the continued innovation of medical technology.

    Science.gov (United States)

    Van Haute, Andrew

    2011-09-01

    If it were not for the ongoing collaboration between vascular surgeons and the medical technology industry, many of these advanced treatments used every day in vascular interventional surgery would not exist. The flip side of this coin is that these vital relationships create multiple roles for surgeons and must be appropriately managed. The dynamic process of innovation, along with factors such as product delivery technique refinement, education, testing and clinical trials, and product support, all make it necessary for ongoing and close collaboration between surgeons and the device industry. This unique relationship sometimes leads to the perception of conflicts of interest for physicians, in part because the competing pressures from the multiple, overlapping roles as clinician/caregiver/investigator/innovator/customer are significant. To address this issue, the Advanced Medical Technology Association (AdvaMed), the nation's largest medical technology association representing medical device and diagnostics companies, developed a Code of Ethics to guide medical technology companies in their interactions with health care professionals. First introduced in 1993, the AdvaMed Code strongly encourages both industry and physicians to commit to openness and high ethical standards in the conduct of their business interactions. The AdvaMed Code addresses many of the types of interactions that can occur between companies and health care professionals, including training, consulting agreements, the provision of demonstration and evaluation units, and charitable donations. By following the Code, companies send a strong message that treatment decisions must always be based on the best interest of the patient. PMID:21872113

  4. A Mass Merchandiser's Role in Enhancing Pharmacy Students’ Business Plan Development Skills for Medication Therapy Management Services

    OpenAIRE

    Morris Moultry, Aisha

    2011-01-01

    Objectives. To develop a relationship between a pharmacy management course and a mass merchandiser and to determine whether involving pharmacy managers from the mass merchandiser in the course would enhance student skills in developing a business plan for medication therapy management services.

  5. Superiority of thoracoscopic sympathectomy over medical management for the palmoplantar subset of severe hyperhidrosis.

    Science.gov (United States)

    Baumgartner, Fritz J; Bertin, Shana; Konecny, Jiri

    2009-01-01

    Severe hyperhidrosis is a disabling disorder whose management is controversial. Medical treatment consists of topical aluminum chloride, oral anticholinergics, ionotophoresis, and botulinum toxin A (Botox) injections. Despite the minimally invasive nature of thoracoscopic sympathectomy, there is a common perception that surgery is only a "last resort." The palmoplantar subtype of hyperhidrosis is particularly problematic for patients professionally and socially. The purpose of our study was to determine the safety, efficacy, and side effects of the various medical treatments vs. bilateral thoracoscopic sympathectomy (BTS) for palmoplantar hyperhidrosis. Consecutive patients (n = 192) were selected based on massive palmar sweating, similar level of plantar sweating, bimodal onset in early childhood or puberty, and exacerbation with ordinary hand lotion. A prospective cohort of 47 patients underwent medical treatment with their responses monitored on a prospective basis, and 145 patients underwent retrospective evaluation of their medical treatment based on their histories. Patients whose medical treatments failed or resulted in intolerable side effects were offered outpatient BTS surgery at the T2-T3 level. Of the 47 prospective patients, 46 received topical aluminum chloride, 40 anticholinergics, six iontophoresis, and 45 BTS surgery. Only one patient was successfully treated with aluminum chloride (2.2%) and one successfully treated with anticholinergics (2.5%), and these did not undergo surgery. Iontophoresis was not successful in any prospectively followed patient. BTS was effective in curing palmar hyperhidrosis in 100% of patients. The superiority of BTS vs. topical aluminum chloride, anticholinergics, and iontophoresis to successfully treat palmar hyperhidrosis was highly statistically significant (p aluminum chloride, 38 with oral anticholinergics, 31 with iontophoresis, eight with Botox, one with no medical treatment, and 144 with BTS surgery. All medical

  6. Aggressive properties of underground water; 1 : 1 000 000

    International Nuclear Information System (INIS)

    Aggressive properties of underground waters are characterised on the basis of analytically established indicators. The input data were taken from the database of the Geochemical Atlas of Slovakia, part Groundwater (Statny geologicky ustav D. Stura, Bratislava, 1996). The detected parameters of aggressiveness (pH value, aggressive CO2 and S042- ion content, in mg.dm-3, and the carbonate water hardness TK in nmol.dm-3) were compared to the STN 73 1215 Concrete Constructions Standard; Classification of Aggressive Environments. The excess of the threshold values of the individual indicators of aggressiveness is marked by the filling of the corresponding single quadrant in the circular target while the aggressiveness levels (slightly, moderately and highly aggressive environment) or their combinations are expressed by colour. The source material is used for assessment of problems than may occur in the sphere of water-management and constructions. (authors)

  7. Levels of Aggression among Turkish Adolescents and Factors Leading to Aggression.

    Science.gov (United States)

    Avci, Dilek; Kilic, Mahmut; Tari Selcuk, Kevser; Uzuncakmak, Tugba

    2016-07-01

    Aggression, an increasing problem among adolescents, is a potential threat to public health as it can lead to violence. Determining the factors causing aggression plays an important role in taking measures to reduce violence. This study aimed at determining the level of aggression among adolescents and at identifying the factors associated with high levels of aggression. This cross-sectional study was conducted with 2,409 Turkish adolescents. Data were collected with the Socio-demographic Questionnaire, Aggression Scale, Perceived Social Support Scale, and Communication Skills Attitude Scale. Data were analyzed using descriptive statistics, the chi-square test, t-test, and logistic regression. The participants' mean aggression score was 91.83 ± 24.05, and 24.0% of the adolescents' aggression levels rated high. According to the logistic regression model, aggression was 1.26 times higher among males, 1.92 times higher among those who perceived their mental health as poor, 1.58 times higher among those with suicidal ideation, 1.29 times higher among those who did not get prepared for university entrance exams, and 1.62 times higher among those who perceived their school performance as poor. Perceived family social support was a protective factor against high aggression. Approximately one out of every four adolescents in the two Turkish high schools where the study was conducted was determined to display high levels of aggression. Therefore, in order to reduce aggression among adolescents, programs such as coping management and coping with anger should be applied by nurses. Programs should include not only students but also families. PMID:27111434

  8. Useful measures and models for analytical quality management in medical laboratories.

    Science.gov (United States)

    Westgard, James O

    2016-02-01

    The 2014 Milan Conference "Defining analytical performance goals 15 years after the Stockholm Conference" initiated a new discussion of issues concerning goals for precision, trueness or bias, total analytical error (TAE), and measurement uncertainty (MU). Goal-setting models are critical for analytical quality management, along with error models, quality-assessment models, quality-planning models, as well as comprehensive models for quality management systems. There are also critical underlying issues, such as an emphasis on MU to the possible exclusion of TAE and a corresponding preference for separate precision and bias goals instead of a combined total error goal. This opinion recommends careful consideration of the differences in the concepts of accuracy and traceability and the appropriateness of different measures, particularly TAE as a measure of accuracy and MU as a measure of traceability. TAE is essential to manage quality within a medical laboratory and MU and trueness are essential to achieve comparability of results across laboratories. With this perspective, laboratory scientists can better understand the many measures and models needed for analytical quality management and assess their usefulness for practical applications in medical laboratories. PMID:26426893

  9. An exploratory study of female partner aggression: The role of relationship dynamics

    OpenAIRE

    Penn, Carrie E.

    2002-01-01

    The purpose of this exploratory study was to examine differences between female and male aggression; to examine the effect various aggression, dominance, and couple variables have on female physical aggression; to identify which combination of these variables bests explains female aggression in a sample of couples seeking therapy for domestic violence/anger management; and to identify the influence of male physical aggression on the predictor variables. Overall, based on women's reports, 74....

  10. E-book for Knowledge Management in Scientific Research Conducted in the Medical Sciences Graduate Program

    Directory of Open Access Journals (Sweden)

    Oramis Sosa Palacios

    2014-12-01

    Full Text Available The training of students enrolled in the Medical Sciences graduate program (residents includes research activities such as research projects, the final paper of the specialty, scientific events and scientific publications. Knowledge gaps in residents lead to problems seen in both the poor quality of the research project and the final paper of the specialty and in the lack of autonomy to make decisions, affecting their overall training. An electronic book aimed at residents was created for knowledge management in scientific research. The first version was designed using the Crheasoft 2.0 program. It consists of: presentation, start modules, list of topics and complementary information. It comprises condensed knowledge on: research management, research methodology, statistics, information management, computer science, linguistics and language. This e-book contributes to the execution of research activities and promotes learning independence.

  11. Management of radioactive material safety programs at medical facilities. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Camper, L.W.; Schlueter, J.; Woods, S. [and others

    1997-05-01

    A Task Force, comprising eight US Nuclear Regulatory Commission and two Agreement State program staff members, developed the guidance contained in this report. This report describes a systematic approach for effectively managing radiation safety programs at medical facilities. This is accomplished by defining and emphasizing the roles of an institution`s executive management, radiation safety committee, and radiation safety officer. Various aspects of program management are discussed and guidance is offered on selecting the radiation safety officer, determining adequate resources for the program, using such contractual services as consultants and service companies, conducting audits, and establishing the roles of authorized users and supervised individuals; NRC`s reporting and notification requirements are discussed, and a general description is given of how NRC`s licensing, inspection and enforcement programs work.

  12. Management of radioactive material safety programs at medical facilities. Final report

    International Nuclear Information System (INIS)

    A Task Force, comprising eight US Nuclear Regulatory Commission and two Agreement State program staff members, developed the guidance contained in this report. This report describes a systematic approach for effectively managing radiation safety programs at medical facilities. This is accomplished by defining and emphasizing the roles of an institution's executive management, radiation safety committee, and radiation safety officer. Various aspects of program management are discussed and guidance is offered on selecting the radiation safety officer, determining adequate resources for the program, using such contractual services as consultants and service companies, conducting audits, and establishing the roles of authorized users and supervised individuals; NRC's reporting and notification requirements are discussed, and a general description is given of how NRC's licensing, inspection and enforcement programs work

  13. In-hospital delirium risk assessment, diagnosis and management; medications to avoid

    Directory of Open Access Journals (Sweden)

    Andrew Clegg

    2013-03-01

    Full Text Available Background: Delirium is a common, but potentially preventable complication of acute illness that is associated with important adverse outcomes including increased length of hospital admission, risk of dementia and admission to long-term care. In-hospital risk assessment and diagnosis: Age over 65, severe illness, current hip fracture and presence of cognitive impairment or dementia are important risk factors for delirium. Assess people with any of these risk factors for recent changes or fluctuations in behaviour that might indicate delirium. If any indicators are present, complete a full cognitive assessment to confirm the diagnosis of delirium. In-hospital risk management: Multicomponent delirium prevention interventions can reduce the incidence of delirium in hospital by around one third and should be provided to people with any of the important risk factors that do not have delirium at admission. A medication review that considers both the number and type of prescribed medications is an important part of the multicomponent delirium prevention intervention. Which medications to avoid in people at risk of delirium: For people at risk of delirium, avoid new prescriptions of benzodiazepines or consider reducing or stopping these medications where possible. Opioids should be prescribed with caution in people at risk of delirium but this should be tempered by the observation that untreated severe pain can itself trigger delirium. Caution is also required when prescribing dihydropyridines and antihistamine H1 antagonists for people at risk of delirium and considered individual patient assessment is advocated. Conclusion: Delirium is common, distressing to patients, relatives and carers and is associated with important adverse outcomes. Multicomponent delirium prevention interventions can reduce the incidence of delirium by approximately one third and usually incorporate a medication review. Identification of which medications to avoid in people at

  14. ERp in medical disposable materials management%ERP在医用耗材管理中的应用

    Institute of Scientific and Technical Information of China (English)

    王志康; 娄海芳

    2012-01-01

    Combined with the development requirements of hospital medical disposable materials management and hospital information management,introduced a novel medical disposable materials management pattern which base on the enterprise resource planning chain supply systems.By optimizing purchasing procedure,inventory management,precision financial management,to realize the integrated management of the medical consumable materials affairs and financial affairs.%结合医院医用耗材管理和医院信息化发展的要求,探讨一种新颖的基于ERP供应链管理的医用耗材管理模式,通过优化采购流程和库存管理以及精益的财务管理,实现医院对医用耗材业务、财务一体化管理.

  15. Critical Limb Ischemia: Advanced Medical Therapy

    OpenAIRE

    Davies, Mark G.

    2012-01-01

    Systemic atherosclerosis and its risk factors are present in the majority of patients with critical limb ischemia. Aggressive medical therapy is an immediate and necessary part of the work-up and management of these patients and will involve a multidisciplinary approach. Risk stratification based on a patient’s current clinical cardiovascular condition is important in determining the most appropriate and safe intervention and will allow both the patient and physician to make an informed decis...

  16. Physicians’ use of computerized clinical decision supports to improve medication management in the elderly – the Seniors Medication Alert and Review Technology intervention

    Directory of Open Access Journals (Sweden)

    Alagiakrishnan K

    2016-01-01

    Full Text Available Kannayiram Alagiakrishnan,1 Patricia Wilson,2 Cheryl A Sadowski,3 Darryl Rolfson,1 Mark Ballermann,4,5 Allen Ausford,6,7 Karla Vermeer,7 Kunal Mohindra,8 Jacques Romney,9 Robert S Hayward10 1Department of Medicine, Division of Geriatric Medicine, 2Department of Medicine, 3Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, 4Chief Medical Information Office, Alberta Health Services, 5Division of Critical Care, Department of Medicine, University of Alberta, 6Department of Family Medicine, University of Alberta, 7Lynwood Family Physician, 8eClinician EMR, Alberta Health Services-Information Systems, 9Department of Medicine, Division of Endocrinology, 10Division of General Internal Medicine, University of Alberta, Edmonton, AB, Canada Background: Elderly people (aged 65 years or more are at increased risk of polypharmacy (five or more medications, inappropriate medication use, and associated increased health care costs. The use of clinical decision support (CDS within an electronic medical record (EMR could improve medication safety.Methods: Participatory action research methods were applied to preproduction design and development and postproduction optimization of an EMR-embedded CDS implementation of the Beers’ Criteria for medication management and the Cockcroft–Gault formula for estimating glomerular filtration rates (GFR. The “Seniors Medication Alert and Review Technologies” (SMART intervention was used in primary care and geriatrics specialty clinics. Passive (chart messages and active (order-entry alerts prompts exposed potentially inappropriate medications, decreased GFR, and the possible need for medication adjustments. Physician reactions were assessed using surveys, EMR simulations, focus groups, and semi-structured interviews. EMR audit data were used to identify eligible patient encounters, the frequency of CDS events, how alerts were managed, and when evidence links were followed.Results: Analysis of

  17. Management of Occupational exposure for pregnant workers in the medical field in Spain

    International Nuclear Information System (INIS)

    Spanish Government has recently approved new regulations on ionizing radiation, transposing most of the provisions of Directive 96/29 EURATOM. For pregnant workers the regulations require that, once the employer has been notified, it will be unlikely that the equivalent dose to the fetus exceed 1 mSv during the remainder of the pregnane. The radiation dose to the fetus cannot be directly measured. In order to avoid this ambiguity, ICRP'60 proposed a supplementary limit of 2 mSv to the dose to the surface of the abdomen of the pregnant woman during the remainder of the pregnancy. Unfortunately this proposal has not been considered either by the European Directive or by the Spanish regulations. In order to clarify the management of occupational exposure of pregnant workers in the medical field, a commission integrated by representatives of the Spanish Consejo de Seguridad Nuclear, the national authority in the radiation protection field, and the Spanish Societies of Radiation Protection and Medical Physics have prepared an additional guidance, including practical recommendations directed to pregnant workers, to the employers as well as to the employment medical advisers. Furthermore a classification of working places in the medical field where pregnant women can work has been establish. Finally a reference level of the dose to the surface of the abdomen has been introduced in order to ensure the observance of the dose limit to the fetus. (Author)

  18. [Medical economics in tuberculosis management: what will come after the TB ward?].

    Science.gov (United States)

    Yotsumoto, Hideki

    2009-11-01

    Current unprofitability of medical services in tuberculosis (TB) ward in Japan has been induced by low medical fee and long-term hospital stays, aggravated by unoccupied beds due to the decrease in the number of patients. For the solution of this issue, the increase of medical fee, shortening of the length of hospital stay and drastic reduction of oversupplied beds are essential. An increment of medical fee by the change in the system would be appreciated, but even under the current system, the balance between revenue and expenditure could be obtained by reducing the length of hospital stay toward 4 weeks, and the elimination of deficit in TB ward could be accomplished by these efforts; shortening of length of hospital stay and reduction of TB beds. Although the latter might result in the difficulty of sustaining TB wards, these patients could be treated in the infectious disease ward. The integration of TB Control Law to Infectious Disease Control Law suggests that TB is not a special disease in Japan. If a true "short course therapy" era would be realized by novel anti-tuberculosis drugs, a dramatic change in TB management would occur in the near future. PMID:19999596

  19. A Stress Management Program for Higher Risk Medical Students: Preliminary Findings.

    Science.gov (United States)

    Brennan, Julie; McGrady, Angele; Lynch, Denis J; Schaefer, Paul; Whearty, Kary

    2016-09-01

    Approximately 10 % of first year medical students have clinically relevant anxiety or depression which may affect academic success and quality of life. This study tested the effects of a stress management intervention on indicators of anxiety, depression and self-efficacy in self-selected first year medical students. Forty two medical students volunteered to participate and provided informed consent. An eight session intervention was offered and focused on building relaxation skills, adaptive coping, and basic nutrition. Anxiety, depression, and self-efficacy were assessed pre and post intervention. This group of students had significantly higher baseline values of depression and anxiety but lower self-efficacy compared to a previous study of medical students at the same institution (p anxiety (p anxiety and depression in this group suggested that these students were at risk for later clinical syndromes. Intervention directed to decreasing the effects of stress was associated with improvement in indicators of distress and may modify the longer term risk. PMID:26969177

  20. Aggressive Attitudes Predict Aggressive Behavior in Middle School Students.

    Science.gov (United States)

    McConville, David W.; Cornell, Dewey G.

    2003-01-01

    This prospective study found that self-reported attitudes toward peer aggression among 403 middle school students were both internally consistent and stable over time (7 months). Aggressive attitudes were correlated with four outcome criteria for aggressive behavior: student self-report of peer aggression; peer and teacher nominations of bullying;…

  1. Aggression in Pretend Play and Aggressive Behavior in the Classroom

    Science.gov (United States)

    Fehr, Karla K.; Russ, Sandra W.

    2013-01-01

    Research Findings: Pretend play is an essential part of child development and adjustment. However, parents, teachers, and researchers debate the function of aggression in pretend play. Different models of aggression predict that the expression of aggression in play could either increase or decrease actual aggressive behavior. The current study…

  2. Case Mix Management Systems: An Opportunity to Integrate Medical Records and Financial Management System Data Bases

    OpenAIRE

    Rusnak, James E.

    1987-01-01

    Due to previous systems selections, many hospitals (health care facilities) are faced with the problem of fragmented data bases containing clinical, demographic and financial information. Projects to select and implement a Case Mix Management System (CMMS) provide an opportunity to reduce the number of separate physical files and to migrate towards systems with an integrated data base. The number of CMMS candidate systems is often restricted due to data base and system interface issues. The h...

  3. Tax aggressiveness in private family firms: An agency perspective

    OpenAIRE

    STEIJVERS, Tensie; Niskanen, Mervi

    2014-01-01

    This article investigates, from an agency perspective, whether private family firms, compared to private nonfamily firms, are more tax aggressive. Moreover, for private family firms, the effect of the extent of separation between ownership and management on tax aggressiveness is studied. Additionally, we verify whether effective board monitoring moderates this relationship. Using Finnish survey data, results show that private family firms are less tax aggressive than nonfamily firms. For the ...

  4. Canine aggression toward people: a guide for practitioners.

    Science.gov (United States)

    Sueda, Karen Lynn C; Malamed, Rachel

    2014-05-01

    This article reviews the various causes of human-directed aggression in dogs and provides a step-by-step plan guiding the general practitioner through history taking, behavior observations, diagnosis, consultation, treatment, and follow-up care. Charts summarizing how to obtain behavioral information, the client's management options, treatment recommendations, diagnosis and treatment of human-directed aggression, and the clinician's role in preventing human-directed aggression are included. A graphic illustration of canine body language is also provided. PMID:24766702

  5. Aggressive angiomyxoma of the vulva presenting as a pedunculated swelling

    Directory of Open Access Journals (Sweden)

    Mandal Shramana

    2008-04-01

    Full Text Available Aggressive angiomyxoma is a rare, locally aggressive soft tissue tumor that has high propensity for local recurrence. It involves mainly the pelvis, vulva, perineum, vagina and urinary bladder in adult women in the reproductive age. Considering its locally aggressive nature, appropriate management and long-term follow-up is necessary. We describe a case of a 22-year-old young pregnant patient presenting with a large pedunculated swelling on the left labia majora.

  6. Interpractice audit of diagnosis and management of hypertension in primary care: educational intervention and review of medical records.

    OpenAIRE

    Mashru, M.; Lant, A.

    1997-01-01

    OBJECTIVE: To determine whether peer review medical audit in a primary care setting changes clinical behaviour in relation to the management of hypertension. DESIGN: Review of medical records in general practices to identify hypertensive patients followed up by assessment of the pre-educational and post-educational management of interventions. SETTING: Six general practices in north west London picked at random within defined criteria of geography and size. SUBJECTS: 740 hypertensive patients...

  7. Researchers' experience with project management in health and medical research: Results from a post-project review

    OpenAIRE

    Elliott Elizabeth J; Bartu Anne E; D'Antoine Heather A; Henley Nadine; France Kathryn E; Payne Janet M; Bower Carol

    2011-01-01

    Abstract Background Project management is widely used to deliver projects on time, within budget and of defined quality. However, there is little published information describing its use in managing health and medical research projects. We used project management in the Alcohol and Pregnancy Project (2006-2008) http://www.ichr.uwa.edu.au/alcoholandpregnancy and in this paper report researchers' opinions on project management and whether it made a difference to the project. Methods A national ...

  8. The medical management of high risk individuals. Experiences with persons exposed to chronic internal irradiation

    International Nuclear Information System (INIS)

    The medical management and counseling of persons at high risk due to exposure to chemicals or radiation or due to personal disposition, present an additional challenge for physicians and especially radiologists involved. This article is based on own experiences with patients who had been exposed to Thorotrast. They had been injected with the contrast medium Thorotrast, which was in use world-wide until around 1950. Thorotrast caused a chronic alpha irradiation mainly of the liver (up to 0.4 Gy/a), spleen (1.2 Gy/a) and bone marrow (0.1 Gy/a). For the Thorotrast patients and their physicians the most worrying problem was the risk of primary malignant liver tumors which occurred in more than 20% of the exposed persons, i.e. 100 times more frequently than in a non-exposed control group. The medical and especially radiological experiences with the management of these patients summarize a general aspect of the problem and can be referred to when managing other high risk groups. (orig.)

  9. "Unwell while Aboriginal": iatrogenesis in Australian medical education and clinical case management

    Directory of Open Access Journals (Sweden)

    Ewen SC

    2016-05-01

    Full Text Available Shaun C Ewen,1 David Hollinsworth2 1Melbourne Poche Centre for Indigenous Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, 2Indigenous Studies, Faculty of Arts, Business and Law, University of the Sunshine Coast, Sippy Downs, QLD, Australia Introduction: Attention to Aboriginal health has become mandatory in Australian medical education. In parallel, clinical management has increasingly used Aboriginality as an identifier in both decision making and reporting of morbidity and mortality. This focus is applauded in light of the gross inequalities in health outcomes between indigenous people and other Australians. Methods: A purposive survey of relevant Australian and international literature was conducted to map the current state of play and identify concerns with efforts to teach cultural competence with Aboriginal people in medical schools and to provide “culturally appropriate” clinical care. The authors critically analyzed this literature in light of their experiences in teaching Aboriginal studies over six decades in many universities to generate examples of iatrogenic effects and possible responses. Results and discussion: Understanding how to most effectively embed Aboriginal content and perspectives in curriculum and how to best teach and assess these remains contested. This review canvasses these debates, arguing that well-intentioned efforts in medical education and clinical management can have iatrogenic impacts. Given the long history of racialization of Aboriginal people in Australian medicine and the relatively low levels of routine contact with Aboriginal people among students and clinicians, the review urges caution in compounding these iatrogenic effects and proposes strategies to combat or reduce them. Conclusion: Long overdue efforts to recognize gaps and inadequacies in medical education about Aboriginal people and their health and to provide equitable health services

  10. The Education Review Board: A Mechanism for Managing Potential Conflicts of Interest in Medical Education.

    Science.gov (United States)

    Borus, Jonathan F; Alexander, Erik K; Bierer, Barbara E; Bringhurst, F Richard; Clark, Christopher; Klanica, Kaley E; Stewart, Erin C; Friedman, Lawrence S

    2015-12-01

    Concerns about the influence of industry support on medical education, research, and patient care have increased in both medical and political circles. Some academic medical centers, questioning whether industry support of medical education could be appropriate and not a conflict of interest, banned such support. In 2009, a Partners HealthCare System commission concluded that interactions with industry remained important to Partners' charitable academic mission and made recommendations to transparently manage such relationships. An Education Review Board (ERB) was created to oversee and manage all industry support of Partners educational activities.Using a case review method, the ERB developed guidelines to implement the commission's recommendations. A multi-funder rule was established that prohibits industry support from only one company for any Partners educational activity. Within that framework, the ERB established guidelines on industry support of educational conferences, clinical fellowships, and trainees' expenses for attending external educational programs; gifts of textbooks and other educational materials; promotional opportunities associated with Partners educational activities; Partners educational activities under contract with an industry entity; and industry-run programs using Partners resources.Although many changes have resulted from the implementation of the ERB guidelines, the number of industry grants for Partners educational activities has remained relatively stable, and funding for these activities declined only moderately during the first three full calendar years (2011-2013) of ERB oversight. The ERB continually educates both the Partners community and industry about the rationale for its guidelines and its openness to their refinement in response to changes in the external environment. PMID:26083402

  11. Medical management of erectile dysfunction in aging males: is it too late to treat?

    Directory of Open Access Journals (Sweden)

    Kai Zhang

    2014-02-01

    Full Text Available Erectile dysfunction (ED is a common disorder among aging males. However, most aging males refuse to seek medical help and believe that ED is an irreversible event in the aging process. The purpose of this study was to describe the current medical management of ED in aging males and to examine whether it is too late to treat this disorder in these elderly men. From 2007 to 2008, 4507 patients diagnosed with ED were gathered from 46 centers in China; 4241 completed the study, 3837 of whom were treated with sildenafil. The 3837 patients were divided into five groups based on age (group A: 20-30 years; group B: 31-40 years; group C: 41-50 years; group D: 51-60 years; and group E: >60 years. After comparing pre- and posttreatment International Index of Erectile Function-Erectile Function domain (IIEF-EF questionnaires, Erection Hardness Scale (EHS, and IIEF Q13 ("How satisfied have you been with your overall sex life?", we discovered that the aging males had worse erectile function, erection hardness, and sexual satisfaction than the younger males (P < 0.001. After treatment, the improvement rates in the IIEF-EF, EHS, and IIEF Q13 scores were 107.0%, 83.1%, and 116.5%, respectively. The magnitude of these changes demonstrated significant differences among groups (P < 0.001. Accordingly, aging males are likely to benefit more from medical treatment. We propose that aging males should be informed that age is not a limiting factor for medical ED management, and it is never too late to treat.

  12. Factors affecting response to medical management in patients of filarial chyluria: A prospective study

    Science.gov (United States)

    Goyal, Neeraj Kumar; Goel, Apul; Sankhwar, Satyanarayan; Singh, Vishwajeet; Ali, Wahid; Natu, S. M.; Singh, Bhupendra Pal; Sinha, Rahul Janak; Dalela, Divakar

    2014-01-01

    Introduction: Filarial chyluria is a common problem in filarial endemic countries. Its management begins with medical therapy but some patients progress to require surgery. The present study aimed to determine factors affecting response to medical management in patients of filarial chyluria. Materials and Methods: This prospective study conducted between August 2008 and November 2012, included conservatively managed patients of chyluria. Demographic profile, clinical presentation, treatment history and urinary triglycerides (TGs) and cholesterol levels at baseline were compared between the responders and non-responders. Apart from the clinical grade of chyluria, hematuria was evaluated as an independent risk factor. Results: Out of the 222 patients (mean age, 37.99 ± 13.29 years, 129 males), 31 patients failed to respond while 35 had a recurrence after initial response; the overall success rate being 70.3% at a mean follow-up of 25 months. No difference was observed in demographics, clinical presentation, presence of hematuria, disease duration and mean urinary TGs loss between responders and non-responders. On multivariate analysis, patients with treatment failure were found to have a higher-grade disease (14.3% Grade-I, 36.6% Grades-II and 60% Grade-III), higher number of pretreatment courses (1.59 ± 1.08 vs. 1.02 ± 0.79) and heavier cholesterol (26.54 ± 23.46 vs. 8.81 ± 8.55 mg/dl) loss at baseline compared with responders (P < 0.05). Conclusion: Conservative management has a success rate in excess of 70%, not affected by the disease chronicity, previous episodes and recurrent nature. However, higher-grade disease, extensive pre-treatment with drugs and higher urinary cholesterol loss at baseline are the predictors of poor response. Hematuria is not an independent poor risk factor for conservative management. PMID:24497677

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

    Science.gov (United States)

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

    2016-01-01

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

  14. Managing data quality in an existing medical data warehouse using business intelligence technologies.

    Science.gov (United States)

    Eaton, Scott; Ostrander, Michael; Santangelo, Jennifer; Kamal, Jyoti

    2008-01-01

    The Ohio State University Medical Center (OSUMC) Information Warehouse (IW) is a comprehensive data warehousing facility that provides providing data integration, management, mining, training, and development services to a diversity of customers across the clinical, education, and research sectors of the OSUMC. Providing accurate and complete data is a must for these purposes. In order to monitor the data quality of targeted data sets, an online scorecard has been developed to allow visualization of the critical measures of data quality in the Information Warehouse. PMID:18998950

  15. Regression of ventriculomegaly following medical management of a patient with Hurler syndrome.

    Science.gov (United States)

    Liang, Jennifer; Singhal, Ash

    2016-05-01

    Hurler syndrome is the most severe form of mucopolysaccharidosis (MPS) Type 1. Progressive neurocognitive decline in this condition can be accompanied by macrocephaly, ventriculomegaly, and/or periventricular signal changes on MRI, which often leads to a neurosurgical referral. In this case, the authors describe a 2-year-old boy with ventriculomegaly and periventricular T2 signal changes, both of which decreased following medical management of Hurler syndrome. The authors discuss the possible mechanisms for this finding and the implications for neurosurgical treatment of this condition. PMID:26745646

  16. The Design and Management of Medical Device Clinical Trials Strategies and Challenges

    CERN Document Server

    Abdel-aleem, Salah M

    2011-01-01

    Clinical trials tasks and activities are widely diverse and require certain skill sets to both plan and execute. This book provides professionals in the field of clinical research with valuable information on the challenging issues of the design, execution, and management of clinical trials, and how to resolve these issues effectively. It discusses key obstacles such as challenges to patient recruitment, investigator and study site selection, and dealing with compliance issues. Through practical examples, professionals working with medical device clinical trials will discover the appropriate s

  17. Update on Medical Management of Clinical Manifestations of Chronic Kidney Disease.

    Science.gov (United States)

    Quimby, Jessica M

    2016-11-01

    Dysregulation of normal kidney functions in chronic kidney disease (CKD) leads to several pathophysiologic abnormalities that have the potential to significantly clinically affect the CKD patient. This article discusses the clinical impact of hypertension, hypokalemia, anemia, dysrexia, nausea/vomiting, and constipation in the CKD patient and therapies for these conditions. These clinical manifestations of disease may not occur in every patient and may also develop later during the progression of disease. Therefore, monitoring for, identifying, and addressing these factors is considered an important part of the medical management of CKD. PMID:27593576

  18. Managing Psychological Stress in the MS Medical Visit: Patient Perspectives and Unmet Needs

    Science.gov (United States)

    Senders, Angela; Sando, Kelsi; Wahbeh, Helané; Peterson, Amie; Shinto, Lynne

    2015-01-01

    Psychological stress can negatively impact multiple sclerosis (MS). To further understand how stress is addressed in the MS medical visit, 34 people with MS participated in focus groups. Transcripts were analyzed by inductive thematic analysis. The majority of participants did not discuss stress with their provider, citing barriers to communication such as lack of time, poor coordination between specialties, physician reliance on pharmaceutical prescription, and patient lack of self-advocacy. Participants recommended several ways to better manage psychological wellbeing in the clinical setting. These findings provide a foundation for future studies aimed at minimizing the detrimental effect of stress in MS. PMID:25527612

  19. Performance of online drug information databases as clinical decision support tools in infectious disease medication management.

    Science.gov (United States)

    Polen, Hyla H; Zapantis, Antonia; Clauson, Kevin A; Clauson, Kevin Alan; Jebrock, Jennifer; Paris, Mark

    2008-01-01

    Infectious disease (ID) medication management is complex and clinical decision support tools (CDSTs) can provide valuable assistance. This study evaluated scope and completeness of ID drug information found in online databases by evaluating their ability to answer 147 question/answer pairs. Scope scores produced highest rankings (%) for: Micromedex (82.3), Lexi-Comp/American Hospital Formulary Service (81.0), and Medscape Drug Reference (81.0); lowest includes: Epocrates Online Premium (47.0), Johns Hopkins ABX Guide (45.6), and PEPID PDC (40.8). PMID:18999059

  20. Proposal for the conclusion of a partnership agreement, without competitive tendering, for the management of medical emergencies on the CERN site and the training of CERN's medical staff and firefighters in emergency situations

    CERN Document Server

    2014-01-01

    Proposal for the conclusion of a partnership agreement, without competitive tendering, for the management of medical emergencies on the CERN site and the training of CERN's medical staff and firefighters in emergency situations

  1. Annual research review: harms experienced by child users of online and mobile technologies: the nature, prevalence and management of sexual and aggressive risks in the digital age

    OpenAIRE

    Livingstone, Sonia; Peter K. Smith

    2014-01-01

    Aims and scope: The usage of mobile phones and the internet by young people has increased rapidly in the past decade, approaching saturation by middle childhood in developed countries. Besides many benefits, online content, contact or conduct can be associated with risk of harm; most research has examined whether aggressive or sexual harms result from this. We examine the nature and prevalence of such risks, and evaluate the evidence regarding the factors that increase or protect against harm...

  2. Annual Research Review: Harms experienced by child users of online and mobile technologies: the nature, prevalence and management of sexual and aggressive risks in the digital age

    OpenAIRE

    Livingstone, Sonia; Peter K. Smith

    2014-01-01

    Aims and scope The usage of mobile phones and the internet by young people has increased rapidly in the past decade, approaching saturation by middle childhood in developed countries. Besides many benefits, online content, contact or conduct can be associated with risk of harm; most research has examined whether aggressive or sexual harms result from this. We examine the nature and prevalence of such risks, and evaluate the evidence regarding the factors that increase or protect against h...

  3. A prediction model for the radiation safety management behavior of medical cyclotrons

    International Nuclear Information System (INIS)

    This study attempted to provide reference materials for improving the behavior level in radiation safety managements by drawing a prediction model that affects the radiation safety management behavior because the radiation safety management of medical Cyclotrons, which can be used to produce radioisotopes, is an important factor that protects radiation caused diseases not only for radiological operators but average users. In addition, this study obtained follows results through the investigation applied from January 2 to January 30, 2008 for the radiation safety managers employed in 24 authorized organizations, which have already installed Cyclotrons, through applying a specific form of questionnaire in which the validity was guaranteed by reference study, site investigation, and focus discussion by related experts. The radiation safety management were configured as seven steps: step 1 is a production preparation step, step 2 is an RI production step, step 3 is a synthesis step, step 4 is a distribution step, step 5 is a quality control step, step 6 is a carriage container packing step, and step 7 is a transportation step. It was recognized that the distribution step was the most exposed as 15 subjects (62.5%), the items of 'the sanction and permission related works' and 'the guarantee of installation facilities and production equipment' were the most difficult as 9 subjects (37.5%), and in the trouble steps in such exposure, the item of 'the synthesis and distribution' steps were 4 times, respectively (30.8%). In the score of the behavior level in radiation safety managements, the minimum and maximum scores were 2.42 and 4.00, respectively, and the average score was 3.46 ± 0.47 out of 4. Prosperity and well-being programs in the behavior and job in radiation safety managements (r=0.529) represented a significant correlation statistically. In the drawing of a prediction model based on the factors that affected the behavior in radiation safety managements, general

  4. Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn's disease

    DEFF Research Database (Denmark)

    Ruemmele, F M; Veres, G; Kolho, K L;

    2014-01-01

    Children and adolescents with Crohn's disease (CD) present often with a more complicated disease course compared to adult patients. In addition, the potential impact of CD on growth, pubertal and emotional development of patients underlines the need for a specific management strategy of pediatric...... aim was to base on a thorough review of existing evidence a state of the art guidance on the medical treatment and long term management of children and adolescents with CD, with individualized treatment algorithms based on a benefit-risk analysis according to different clinical scenarios. In children...... and adolescents who did not have finished their growth, exclusive enteral nutrition (EEN) is the induction therapy of first choice due to its excellent safety profile, preferable over corticosteroids, which are equipotential to induce remission. The majority of patients with pediatric-onset CD require...

  5. An intelligent healthcare management system: a new approach in work-order prioritization for medical equipment maintenance requests.

    Science.gov (United States)

    Hamdi, Naser; Oweis, Rami; Abu Zraiq, Hamzeh; Abu Sammour, Denis

    2012-04-01

    The effective maintenance management of medical technology influences the quality of care delivered and the profitability of healthcare facilities. Medical equipment maintenance in Jordan lacks an objective prioritization system; consequently, the system is not sensitive to the impact of equipment downtime on patient morbidity and mortality. The current work presents a novel software system (EQUIMEDCOMP) that is designed to achieve valuable improvements in the maintenance management of medical technology. This work-order prioritization model sorts medical maintenance requests by calculating a priority index for each request. Model performance was assessed by utilizing maintenance requests from several Jordanian hospitals. The system proved highly efficient in minimizing equipment downtime based on healthcare delivery capacity, and, consequently, patient outcome. Additionally, a preventive maintenance optimization module and an equipment quality control system are incorporated. The system is, therefore, expected to improve the reliability of medical equipment and significantly improve safety and cost-efficiency. PMID:20703695

  6. Aggressive behaviors in the psychiatric emergency service

    Directory of Open Access Journals (Sweden)

    Yves Chaput

    2011-03-01

    Full Text Available Yves Chaput1, Lucie Beaulieu2, Michel Paradis3, Edith Labonté41Department of Psychiatry, McGill University, Montreal (presently in private practice; 2Department of Psychiatry, Haut Richelieu Hospital, Saint-Jean-sur-Richelieu, Quebec; 3Department of Psychiatry, University of Montreal, Montreal; 4Department of Psychiatry, Laval University, Quebec, CanadaIntroduction: Studies of aggressive behaviors in a nonforensic mental health setting have focused primarily on the inpatient ward and, on event prediction, using behavior-based clinical rating scales. Few studies have specifically targeted aggressive behaviors in the psychiatric emergency service or determined whether assessing the demographic and clinical characteristics of such patients might prove useful for their more rapid identification.Methods: We used a prospectively acquired database of over 20,900 visits to four services in the province of Quebec, Canada, over a two-year period from September 2002 onwards. A maximum of 72 variables could be acquired per visit. Visits with aggression (any verbally or physically intimidating behavior, both present and past, were tagged. Binary logistic regressions and cross-tabulations were used to determine whether the profile of a variable differed in visits with aggression from those without aggression.Results: About 7% of visits were marked by current aggression (verbal 49%, physical 12%, verbal and physical 39%. Including visits with a “past only” history of aggression increased this number to 20%. Variables associated with aggression were gender (male, marital status (single/separated, education (high school or less, employment (none, judicial history (any type, substance abuse (prior or active, medication compliance (poor, type of arrival to psychiatric emergency services (involuntary, police, judiciary, landlord, reason for referral (behavioral dyscontrol, diagnosis (less frequent in anxiety disorders, and outcome (more frequently placed under

  7. Factors which affect the occurrence of nursing errors in medication administration and the errors' management

    Directory of Open Access Journals (Sweden)

    Theodore Kapadohos

    2012-04-01

    Full Text Available Nursing, as a humanitarian science, offers its services, on the comprehensive care of patients. Each nurse handling, involves the possibility of error. Meurier appointed nursing error as "any act, any decision or omission by a nurse, assessed as incorrect, by more experienced colleagues, and have adverse consequences for patients". Medication errors are the most common category of nursing errors. They affect health, patient safety and also have a high economic impact to health systems of each country. Aim: The present study investigated the causative factors of nursing errors, the frequency of medication errors and the ways of reporting, recording and managing these errors in the hospitals of Greece. Method: For the purpose of this study, a descriptive cross-sectional design was used. The sample consisted of 176 registered nurses, from eight public and three private hospitals, working in the ICU and their duties included the administration of drugs. Data collection was performed using an anonymous structured questionnaire that included demographic characteristics of the sample and closed questions about the factors implicated in the occurrence of errors and their management. To investigate the existence of correlation between demographics and various questions referred to the management of errors by nurses, the criterion of heterogeneity X2 of Pearson was used and to check for correlation between questions that reflect the participants' views on working conditions and management of errors, the non-parametric correlation coefficient of Spearman (Spearman rho was applied. The statistical analysis was performed using SPSS 17 software. Results: After statistical analysis of data, the most important causative factors for the occurrence of errors are the nursing workload (78.9%, the distraction of nurses (75.8% and the burnout (56.8%. More than 9 out of 10 nurses have made errors in drug administration (91.5%, especially with the wrong dose (34.7% and

  8. Registration of aggressive incidents in an adolescent forensic psychiatric unit and implications for further practice.

    Science.gov (United States)

    Tremmery, S; Danckaerts, M; Bruckers, L; Molenberghs, G; De Hert, M; Wampers, M; De Varé, J; de Decker, A

    2014-09-01

    Although aggression is part of daily life in psychiatric units for adolescents, empirical data on its prevalence are sparse. Only few studies have described prevalence of aggressive incidents in adolescent psychiatric wards, and data in forensic psychiatric care are even more limited. Available studies reported high prevalence rates of aggression, ranging from 0.4 to 2.4 incidents of aggression per day across (forensic) child and adolescent psychiatric units. Between 27 and 78 % of all admitted youth committed an aggressive act. In this study, we collected systematically registered data of all aggressive incidents from the first 2 years (2010-2012) on a newly established forensic adolescent psychiatric unit, which used a formal aggression management program embedded in the social competence model, which is based on early intervention in the 'chain of behavior' to prevent any further escalation. The inclusion of also minor aggressive incidents is unique in the literature and the clinical relevance is highlighted. A mean of one incident a day took place, with each adolescent involved in at least one incident. Notably, 1.7 aggressive incidents per month made seclusion of restraint use necessary. Based on the social competence theory, the aggression management model suggests intervening early in the cascade of aggression, in order to prevent further escalation and reduce the need for intrusive interventions. Evidence supported that aggression is a contextual event, as external factors clearly influence the incidence of aggression. Aggression management should be built on both relational and structural security. PMID:24682593

  9. 41 CFR 105-55.009 - Aggressive agency collection activity.

    Science.gov (United States)

    2010-07-01

    ... to collect the debt or terminate collection action. See 31 CFR 285.12 (Transfer of Debts to Treasury... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Aggressive agency... Administration 55-COLLECTION OF CLAIMS OWED THE UNITED STATES § 105-55.009 Aggressive agency collection...

  10. 7 CFR 3.10 - Aggressive agency collection activity.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Aggressive agency collection activity. 3.10 Section 3.10 Agriculture Office of the Secretary of Agriculture DEBT MANAGEMENT Standards for the Administrative Collection and Compromise of Claims § 3.10 Aggressive agency collection activity. An agency...

  11. Patient aggression in clinical psychiatry: perceptions of mental health nurses.

    NARCIS (Netherlands)

    Jonker, E.J.; Goossens, P.J.J.; Steenhuis, I.H.; Oud, N.E.

    2008-01-01

    Mental health nurses are faced with an increasing number of aggressive incidents during their daily practice. The coercive intervention of seclusion is often used to manage patient aggression in the Netherlands. However, GGZ Nederland, the Dutch association of service providers for mental health and

  12. Contribution of Electronic Medical Records to the Management of Rare Diseases

    Directory of Open Access Journals (Sweden)

    Dominique Bremond-Gignac

    2015-01-01

    Full Text Available Purpose. Electronic health record systems provide great opportunity to study most diseases. Objective of this study was to determine whether electronic medical records (EMR in ophthalmology contribute to management of rare eye diseases, isolated or in syndromes. Study was designed to identify and collect patients’ data with ophthalmology-specific EMR. Methods. Ophthalmology-specific EMR software (Softalmo software Corilus was used to acquire ophthalmological ocular consultation data from patients with five rare eye diseases. The rare eye diseases and data were selected and collected regarding expertise of eye center. Results. A total of 135,206 outpatient consultations were performed between 2011 and 2014 in our medical center specialized in rare eye diseases. The search software identified 29 congenital aniridia, 6 Axenfeld/Rieger syndrome, 11 BEPS, 3 Nanophthalmos, and 3 Rubinstein-Taybi syndrome. Discussion. EMR provides advantages for medical care. The use of ophthalmology-specific EMR is reliable and can contribute to a comprehensive ocular visual phenotype useful for clinical research. Conclusion. Routinely EMR acquired with specific software dedicated to ophthalmology provides sufficient detail for rare diseases. These software-collected data appear useful for creating patient cohorts and recording ocular examination, avoiding the time-consuming analysis of paper records and investigation, in a University Hospital linked to a National Reference Rare Center Disease.

  13. Ozone (O3: an excellent adjunctive tool in medical and surgical management of patient

    Directory of Open Access Journals (Sweden)

    Vipin Thakkar

    2014-08-01

    Full Text Available In the condition like increasing susceptibility to allergic reaction and weaken response to antibiotics, along with constantly growing prices for medical treatment, new non-medicinal methods are to be appreciated. The history of medical ozone starts in the XX century. The pioneers to apply ozone in clinical practice were E. Payer, A. Fish and H. Wolf. Ozone as an antiseptic means had been known and used from the beginning of the XX century, however, extensive and systemic research in the field of ozone therapy started in Germany in mid 70s, when ozone-resistant polymer materials and convenient ozone generating equipment came into every day clinical practice. Ozone (O3 therapy due to its disinfection effect and its capacity to transport and release oxygen into tissues is gaining a justified recognizing in many countries of the world. O3 therapy can produce its immune modulators, anti-inflammatory, bactericidal, virucidal, fungicidal, analgesics and other effects. Considering this the purpose of this literature is to highlight the significance of Ozone as an excellent adjunctive tool in the management of various medical and surgical conditions. [Int J Res Med Sci 2014; 2(4.000: 1257-1261

  14. Emergency preparedness: medical management of nuclear accidents involving large groups of victims

    International Nuclear Information System (INIS)

    The treatment of overexposed individuals implies hospitalisation in a specialized unit applying hematological intense care. If the accident results in a small number of casualties, the medical management does not raise major problems in most of the countries, where specialized units exist, as roughly 7% of the beds are available at any time. But an accident which would involved tens or hundreds of people raises much more problems for hospitalization. Such problems are also completely different and will involve steps in the medical handling, mainly triage, (combined injuries), determination of whole body dose levels, transient hospitalization. In this case, preplanning is necessary, adapted to the system of medical care in case of a catastrophic event in the given Country, with the main basic principles : emergency concerns essentially the classical injuries (burns and trauma) - and contamination problems in some cases - treatment of radiation syndrome is not an emergency during the first days but some essential actions have to be taken such as early blood sampling for biological dosimetry and for HLa typing

  15. Impact of video-ambulatory electroencephalography on the medical management of epilepsy.

    Science.gov (United States)

    Manfredonia, Francesco; Lawley, Andrew; Cavanna, Andrea E

    2016-06-15

    Video-ambulatory electroencephalography (video-AEEG) is increasingly being used in secondary care centres for the diagnostic work-up of new cases with suspected epilepsy and for the review of known cases with active seizures despite medical treatment. We reviewed how the outcome of video-AEEG influenced the medical management of patients who underwent this investigation at a neurophysiology department within a secondary care centre. Out of a total of 171 consecutive video-AEEG studies performed over a period of two years, 111 could be included in our retrospective analysis, based on availability and completeness of relevant clinical information pre- and post-investigation. In our sample, 55.9% of patients had typical clinical events captured on video-AEEG and diagnostic yield was higher in patients with a previously established diagnosis of epilepsy (n=62; diagnostic yield 62.9%). A total of 27 patients (24.3%) had changes in medical treatment following video-AEEG, most frequently antiepileptic drug introduction/increase when epileptic seizures were captured. This proportion was similar between patients with or without a previously established diagnosis of epilepsy. Our findings in a real-life setting confirm the usefulness of video-AEEG in influencing the clinical attitude towards complex patients with suspected or longstanding history of epilepsy. PMID:27206892

  16. Management of death, dying and euthanasia: attitudes and practices of medical practitioners in South Australia.

    Science.gov (United States)

    Stevens, C A; Hassan, R

    1994-03-01

    This article presents the first results of a study of the decisions made by health professionals in South Australia concerning the management of death, dying, and euthanasia, and focuses on the findings concerning the attitudes and practices of medical practitioners. Mail-back, self-administered questionnaires were posted in August 1991 to a ten per cent sample of 494 medical practitioners in South Australia randomly selected from the list published by the Medical Board of South Australia. A total response rate of 68 per cent was obtained, 60 per cent of which (298) were usable returns. It was found that forty-seven per cent had received requests from patients to hasten their deaths. Nineteen per cent had taken active steps which had brought about the death of a patient. Sixty-eight per cent thought that guidelines for withholding and withdrawal of treatment should be established. Forty-five per cent were in favour of legalisation of active euthanasia under certain circumstances. PMID:8035439

  17. Training of medical teams on-site for individual and coordinated response in emergency management

    DEFF Research Database (Denmark)

    Andersen, Verner

    2003-01-01

    A system for training of coordination and cooperation of decision makers in emergency management has been under construction for some time. A first prototype of the system was developed in the MUSTER system. The system is being developed modularly with one module for each of the suborganisations ...... system for specific training set-ups for specific groups of trainees. The first module completed as a commercial system, "Training of medical teams on site", will be presented.......A system for training of coordination and cooperation of decision makers in emergency management has been under construction for some time. A first prototype of the system was developed in the MUSTER system. The system is being developed modularly with one module for each of the suborganisations...... involved in the complete preparedness: fire brigade, police, medical team, civil defence, etc. All these modules will in the end be integrated on a common integration platform, either to a fully-fledged system covering all aspects of training for the complete preparedness, or for creating a dedicated...

  18. Satisfaction With Medication Therapy Management Services at a University Ambulatory Care Clinic.

    Science.gov (United States)

    Kim, Shiyun; Martin, Michelle T; Pierce, Andrea L; Zueger, Patrick

    2016-06-01

    A survey was issued to patients enrolled in the Medication Therapy Management Clinic (MTMC) at University of Illinois Hospital and Health Sciences (June 2011-January 2012) in order to assess satisfaction with pharmacy services provided by pharmacists. A 23-item survey was offered to 65 patients in the MTMC program before or after clinic visits. Since there is a paucity of data indicating the level of satisfaction with MTM services provided by pharmacists, this survey may contribute to the process of building a greater collaboration between the pharmacist and patient. Sixty-two of 65 patients completed the survey; satisfaction with MTMC pharmacists was demonstrated to be significantly positively correlated with overall satisfaction with the MTMC. Patient satisfaction is not significantly different according to age, gender, ethnicity, or number of disease states. Satisfaction with the pillbox service is not significantly different between younger and older patients. It was also noted that patients taking a greater number of medications had higher levels of satisfaction. Most patients indicated that they were satisfied with the MTMC pharmacists and services; further study linking patient satisfaction with MTM services to improved patient outcomes may allow our MTMC to serve as a model for other pharmacist-managed MTMCs serving similar patient populations. PMID:25312261

  19. MANAGEMENT OF NURSING ASSISTANCE: CASE STUDY IN A MEDICAL CLINIC IN A UNIVERSITY HOSPITAL

    Directory of Open Access Journals (Sweden)

    Bianca Gonçalves Rodrigues

    2014-02-01

    Full Text Available It was aimed to show a case study about the management of nursing assistance. This paper is descriptive, a case study. As its source of study, the medical clinic in a school-hospital in Montes Claros, Minas Gerais was chosen. For the management, tools as Matrix SWOT, 5W2H and Protocol Forms of Risk Prevention were used in the management of caring in nursing. The tools and the results reached through the tools were contextualized in the light of literature, in which highlights the relevance of these tools. Through its use, it is possible to promote improvements in the given assistance to clients, once it shows opportunities, threats, strengths, weaknesses and the risk analysis in which the people involved in the care are exposed. In this way, it is needed that the tools are more and more utilized in the daily routine of the nursing work, and that this joins forces with the leadership and the management of care.

  20. 浅探医疗设备的有效管理%Effective Management of Medical Equipment

    Institute of Scientific and Technical Information of China (English)

    蔡新良; 杨策源; 李雷

    2011-01-01

    简述医疗设备的配置和应用在医院现代化建设上的作用,明确了医疗设备有效管理的概念和意义.从加强设备购置的有效管理和监督、提高设备的使用率、加强设备的维修维护等方面提出实现医疗设备有效管理的几个方法.%The role that the configuration and application of medical equipment play in the modernization construction of hospital is described in this paper, and the concept and significance of effective management of medical equipment are defined clearly. Methods for the realization of effective management of medical equipment are proposed from strengthening the effective management and supervision of equipment procurement, improving equipment utilization, and strengthening equipment maintenance and records management. The authors finally point out that the enforceability of the effective management of medical equipment can only be ensured in the root by improving the management system executable.[Chinese Medical Equipment Journal, 2011 ,32(4) :124-125

  1. Individual strategies of aggressive and non-aggressive male mice in encounters with trained aggressive residents

    OpenAIRE

    Benus, Rensina F.; Koolhaas, Jaap M.; Oortmerssen, Geert A. van

    1992-01-01

    To determine whether individual differences in offensive behaviour are related to differences in defensive behaviour, the responses of male wild house mice, Mus domesticus, of an aggressive and a non-aggressive line to defeat by physically stronger residents were analysed. Individuals of the aggressive line engaged in more flight behaviour, whereas the males of the non-aggressive line predominantly showed immobility. The higher flight tendency of the aggressive intruders provoked more attacks...

  2. 医用高值耗材的信息化管理%High Cost Medical Consumables Management

    Institute of Scientific and Technical Information of China (English)

    谭丹华

    2013-01-01

      随着医疗新技术新项目的开展和人们生活质量的不断提高,高值医用耗材使用量大幅度增加,涉及的医疗费用和承担的医疗风险也同步增长,如何做好高值医用耗材的现代化管理工作成为现代医疗水平的标志。%With the new medical technology and new projects development and people life quality rise ceaselessly, High value medical supplies used to increase substantial y, Related to medical costs and bear the medical risk is synchronous growth. How to do a good job of high value medical supplies modern management work becomes the modern medical level symbol.

  3. Radiation event medical management (REMM): website guidance for health care providers.

    Science.gov (United States)

    Bader, Judith L; Nemhauser, Jeffrey; Chang, Florence; Mashayekhi, Bijan; Sczcur, Marti; Knebel, Ann; Hrdina, Chad; Coleman, Norman

    2008-01-01

    Planning for and exercising the medical response to potential chemical, biological, radiological, nuclear, and explosive (CBRNE) terrorist events are new responsibilities for most health care providers. Among potential CBRNE events, radiological and/or nuclear (rad/nuc) events are thought to have received the least attention from health care providers and planners. To assist clinicians, the U.S. Department of Health and Human Services (HHS) has created a new, innovative tool kit, the Radiation Event Medical Management (REMM) web portal (http://remm.nlm.gov). Goals of REMM include providing (1) algorithm-style, evidence-based, guidance about clinical diagnosis and treatment during mass casualty rad/nuc events; (2) just-in-time, peer-reviewed, usable information supported by sufficient background material and context to make complex diagnosis and management issues understandable to those without formal radiation medicine expertise; (3) a zip-file of complete web portal files downloadable in advance so the site would be available offline without an Internet connection; (4) a concise collection of the printable, key documents that can be taken into the field during an event; (5) a framework for medical teams and individuals to initiate rad/nuc planning and training; and (6) an extensive bibliography of key, peer-reviewed, and official guidance documents relevant to rad/nuc responses. Since its launch, REMM has been well received by individual responders and teams across the country and internationally. It has been accessed extensively, particularly during training exercises. Regular content updates and addition of new features are ongoing. The article reviews the development of REMM and some of its key content areas, features, and plans for future development. PMID:18189170

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

    OpenAIRE

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

    2016-01-01

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

  5. Medical management of radio-contaminated wounded by the French military health service

    International Nuclear Information System (INIS)

    The French armed forces health service has set up in France specialized installation only designed and used to take care of radio contaminated patients. These installations can be used for the military and for the civilians, e.g. in case of an accident in a civilian nuclear installation or in case of terrorist attack with a few injured. The main principles of the medical management of a radio contaminated wounded are: - Trauma care is the first priority, - External decontamination has to be treated as fast and reasonably as possible, - Medical treatment for internal contamination is more efficiency that is given earlier (stable iodine, DTPA). Three type of installations have been developed to take charge of contaminated patient or with a suspicion of contamination: - The hasty decontamination post, to take into account the involved victims physically fit, - The advance post for radio-contaminated wounded (P.A.B.R.C.), for the relative emergency whom evacuation can be delayed after medical examination, - The center for the treatment of radio-contaminated wounded(C.T.B.R.C.), in an hospital area, for the absolute emergencies (needing some resuscitation and emergency surgery for saving life, like stopping an hemorrhage). Each military hospital in France has is own C.T.B.R.C. These structures are dedicated to the decontamination, that means that all type of decontamination would be conducted here: skin decontamination, internal decontamination by specific de-contaminant if needed, and decontamination of a contaminated wound by surgical means. This type of surgery might be associated with a precise detection. At his arrival, in a first time, the victim is examined by an emergency physician who is in charge of the structure. Secondly, he makes a triage concerning the medical emergency to identify the type of emergency, life threatening emergency or not. - If the patient is a critical case then the medical treatment takes precedence over contamination - If the patient is

  6. How to Enhance Quality Management on Medical Records%如何加强病案质量管理

    Institute of Scientific and Technical Information of China (English)

    王冠英; 郑新瑞; 王宏斌; 张珊红

    2012-01-01

    The quality of the medical records management is an important constituent of overall hospital quality management. This article introduces methods and experience of the medical records quality management from how to construct medical records quality management system, perfect regulations and implement it, strengthen training, promote the process quality control, constantly update and perfect the system of rewards and penalties.%病案质量管理是医院质量管理的重要组成部分.从建立健全三级病案质控体系、完善规章制度、强化培训、加强环节控制、优化反馈流程、落实奖惩等6方面,介绍了病案质量管理的主要做法.

  7. Analysis of the awareness of medical radioactive waste management plans (with focus on Busan and Gyeongsangnam-do)

    International Nuclear Information System (INIS)

    This study was conducted to propose medical radioactive waste management methods by background factors of radioactive workers, their awareness of safety management and reduce the difficulty of self-disposal. A population of 102 radiotechnologist who work at hospital in Busan was the subject of this study and a survey was conducted to them. the analysis for the collected data used SPSS/PC+Win13 version and one-way, ANOVA was carried out of verify differences between the groups. The result showed that most of workers had correct awareness of radioactive waste management. Also, about the difficulty of self-disposal, legal procedures were mentioned most often, and as efficient improvement of management methods is concerned, changing the awareness of safety management and disposal was proposed. According to this study, the right way of managing medical radioactive waste is to change the awareness of radioactive workers by reinforcing regular training

  8. Analysis of the awareness of medical radioactive waste management plans (with focus on Busan and Gyeongsangnam-do)

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Se Sik; Choi, Seok Yoon; Kim, Jung Hoon [Dept. of Radiological Science, College of Health Science, Catholic University of Pusan, Busan (Korea, Republic of)

    2014-03-15

    This study was conducted to propose medical radioactive waste management methods by background factors of radioactive workers, their awareness of safety management and reduce the difficulty of self-disposal. A population of 102 radiotechnologist who work at hospital in Busan was the subject of this study and a survey was conducted to them. the analysis for the collected data used SPSS/PC+Win13 version and one-way, ANOVA was carried out of verify differences between the groups. The result showed that most of workers had correct awareness of radioactive waste management. Also, about the difficulty of self-disposal, legal procedures were mentioned most often, and as efficient improvement of management methods is concerned, changing the awareness of safety management and disposal was proposed. According to this study, the right way of managing medical radioactive waste is to change the awareness of radioactive workers by reinforcing regular training.

  9. Voluntary medical male circumcision: logistics, commodities, and waste management requirements for scale-up of services.

    Directory of Open Access Journals (Sweden)

    Dianna Edgil

    2011-11-01

    Full Text Available BACKGROUND: The global HIV prevention community is implementing voluntary medical male circumcision (VMMC programs across eastern and southern Africa, with a goal of reaching 80% coverage in adult males by 2015. Successful implementation will depend on the accessibility of commodities essential for VMMC programming and the appropriate allocation of resources to support the VMMC supply chain. For this, the United States President's Emergency Plan for AIDS Relief, in collaboration with the World Health Organization and the Joint United Nations Programme on HIV/AIDS, has developed a standard list of commodities for VMMC programs. METHODS AND FINDINGS: This list of commodities was used to inform program planning for a 1-y program to circumcise 152,000 adult men in Swaziland. During this process, additional key commodities were identified, expanding the standard list to include commodities for waste management, HIV counseling and testing, and the treatment of sexually transmitted infections. The approximate costs for the procurement of commodities, management of a supply chain, and waste disposal, were determined for the VMMC program in Swaziland using current market prices of goods and services. Previous costing studies of VMMC programs did not capture supply chain costs, nor the full range of commodities needed for VMMC program implementation or waste management. Our calculations indicate that depending upon the volume of services provided, supply chain and waste management, including commodities and associated labor, contribute between US$58.92 and US$73.57 to the cost of performing one adult male circumcision in Swaziland. CONCLUSIONS: Experience with the VMMC program in Swaziland indicates that supply chain and waste management add approximately US$60 per circumcision, nearly doubling the total per procedure cost estimated previously; these additional costs are used to inform the estimate of per procedure costs modeled by Njeuhmeli et al. in

  10. A stewardship intervention program for safe medication management and use of antidiabetic drugs

    Directory of Open Access Journals (Sweden)

    Zhao RY

    2015-07-01

    Full Text Available Rui-yi Zhao,1 Xiao-wen He,1 Yan-min Shan,1 Ling-ling Zhu,2 Quan Zhou3 1Clinical Nurse Specialist Section, Division of Nursing, 2Geriatric VIP Care Ward, Division of Nursing, 3Department of Pharmacy, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of China Background: Diabetes patients are complex due to considerations of polypharmacy, multimorbidities, medication adherence, dietary habits, health literacy, socioeconomic status, and cultural factors. Meanwhile, insulin and oral hypoglycemic agents are high-alert medications. Therefore it is necessary to require a multidisciplinary team’s integrated endeavors to enhance safe medication management and use of antidiabetic drugs.Methods: A 5-year stewardship intervention program, including organizational measures and quality improvement activities in storage, prescription, dispensing, administration, and monitoring, was performed in the Second Affiliated Hospital of Zhejiang University, People’s Republic of China, a 3,200-bed hospital with 3.5 million outpatient visits annually.Results: The Second Affiliated Hospital of Zhejiang University has obtained a 100% implementation rate of standard storage of antidiabetic drugs in the Pharmacy and wards since August 2012. A zero occurrence of dispensing errors related to highly “look-alike” and “sound-alike” NovoMix 30® (biphasic insulin aspart and NovoRapid® (insulin aspart has been achieved since October 2011. Insulin injection accuracy among ward nurses significantly increased from 82% (first quarter 2011 to 96% (fourth quarter 2011 (P<0.05. The number of medication administration errors related to insulin continuously decreased from 20 (2011 to six (2014. The occurrence rate of hypoglycemia in non–endocrinology ward diabetes inpatients during 2011–2013 was significantly less than that in 2010 (5.03%–5.53% versus 8.27% (P<0.01. Percentage of correct management of

  11. Aggressive retinal astrocytoma associated with tuberous sclerosis

    OpenAIRE

    Mitamura, Yoshinori

    2012-01-01

    Machiko Tomida,1 Yoshinori Mitamura,1 Takashi Katome,1 Hiroshi Eguchi,1 Takeshi Naito,1 Takayuki Harada21Department of Ophthalmology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, 2Visual Research Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, JapanAbstract: We report the case of a patient with an aggressive retinal astrocytoma accompanied with macular edema and neovascular vessels, who was initially treated with intravitreal bevaci...

  12. Researchers' experience with project management in health and medical research: Results from a post-project review

    Directory of Open Access Journals (Sweden)

    Elliott Elizabeth J

    2011-06-01

    Full Text Available Abstract Background Project management is widely used to deliver projects on time, within budget and of defined quality. However, there is little published information describing its use in managing health and medical research projects. We used project management in the Alcohol and Pregnancy Project (2006-2008 http://www.ichr.uwa.edu.au/alcoholandpregnancy and in this paper report researchers' opinions on project management and whether it made a difference to the project. Methods A national interdisciplinary group of 20 researchers, one of whom was the project manager, formed the Steering Committee for the project. We used project management to ensure project outputs and outcomes were achieved and all aspects of the project were planned, implemented, monitored and controlled. Sixteen of the researchers were asked to complete a self administered questionnaire for a post-project review. Results The project was delivered according to the project protocol within the allocated budget and time frame. Fifteen researchers (93.8% completed a questionnaire. They reported that project management increased the effectiveness of the project, communication, teamwork, and application of the interdisciplinary group of researchers' expertise. They would recommend this type of project management for future projects. Conclusions Our post-project review showed that researchers comprehensively endorsed project management in the Alcohol and Pregnancy Project and agreed that project management had contributed substantially to the research. In future, we will project manage new projects and conduct post-project reviews. The results will be used to encourage continuous learning and continuous improvement of project management, and provide greater transparency and accountability of health and medical research. The use of project management can benefit both management and scientific outcomes of health and medical research projects.

  13. Primary Care Providers’ experiences with Pharmaceutical Care-based Medication Therapy Management Services

    Directory of Open Access Journals (Sweden)

    Heather L. Maracle, Pharm.D.

    2012-01-01

    Full Text Available This study explored primary care providers’ (PCPs experiences with the practice of pharmaceutical care-based medication therapy management (MTM. Qualitative, semi-structured interviews were conducted with six PCPs who have experiences working with MTM pharmacists for at least three years. The first author conducted the interviews that were audio-taped, transcribed, and coded independently. The codes were then harmonized via discussion and consensus with the other authors. Data were analyzed for themes using the hermeneutic-phenomenological method as proposed by Max van Manen. Three men and three women were interviewed. On average, the interviewees have worked with MTM pharmacists for seven years. The six (6 themes uncovered from the interviews included: (1 “MTM is just part of our team approach to the practice of medicine”: MTM as an integral part of PCPs’ practices; (2 “Frankly it’s education for the patient but it’s also education for me”: MTM services as a source of education; (3 “It’s not exactly just the pharmacist that passes out the medicines at the pharmacy”: The MTM practitioner is different from the dispensing pharmacist; (4 “So, less reactive, cleaning up the mess, and more proactive and catching things before they become so involved”: MTM services as preventative health care efforts; (5“I think that time is the big thing”: MTM pharmacists spend more time with patients; (6 “There’s an access piece, there’s an availability piece, there’s a finance piece”: MTM services are underutilized at the clinics. In conclusion, PCPs value having MTM pharmacists as part of their team in ambulatory clinics. MTM pharmacists are considered an important source of education to patients as well as to providers as they are seen as having a unique body of knowledge –medication expertise. All PCPs highly treasure the time and education provided by the MTM pharmacists, their ability to manage and adjust patients

  14. Neuroimaging and Aggression.

    Science.gov (United States)

    Mills, Shari; Raine, Adrian

    1994-01-01

    Brain imaging research allows direct assessment of structural and functional brain abnormalities, and thereby provides an improved methodology for studying neurobiological factors predisposing to violent and aggressive behavior. This paper reviews 20 brain imaging studies using four different types of neuroimaging techniques that were conducted in…

  15. Early childhood aggression

    NARCIS (Netherlands)

    Alink, Lenneke Rosalie Agnes

    2006-01-01

    In this thesis the development, stability, and correlates of early childhood aggression were investigated. The normative development was examined in a general population sample using questionnaires completed by the parents of 12-, 24-, and 36-month-old children and again one year later. Results show

  16. Anonymity, Deindividuation and Aggression.

    Science.gov (United States)

    Baron, Robert S.

    Several writers suggest that reducing one's sense of individuality reduces social restraints. The author suggests that the effect of uniformity of appearance on aggression is unclear when anonymity is held constant. This poses a problem of interpretation given that a distinction must be made between lack of individuality and anonymity. One must…

  17. Relational Aggression among Students

    Science.gov (United States)

    Young, Ellie L.; Nelson, David A.; Hottle, America B.; Warburton, Brittney; Young, Bryan K.

    2011-01-01

    "Relational aggression" refers to harm within relationships caused by covert bullying or manipulative behavior. Examples include isolating a youth from his or her group of friends (social exclusion), threatening to stop talking to a friend (the silent treatment), or spreading gossip and rumors by email. This type of bullying tends to be…

  18. Witz, Lust und Aggression

    DEFF Research Database (Denmark)

    Rösing, Lilian Munk

    2014-01-01

    Artiklen beskæftiger sig med forholdet mellem vits, lyst og aggression med udgangspunkt i lysten ved aggressiv litterær humor, eksemplificeret ved tekststeder fra Shakespeares Hamlet. Der argumenteres for, at aggressionen eller angrebet er et fælles centralt aspekt ved Sigmund Freuds og Friedrich...

  19. Nutrition, neurotoxicants & aggressive behaviour

    NARCIS (Netherlands)

    Zaalberg, A.

    2015-01-01

    Nutrition, neurotoxicants and aggressive behaviour Antisocial behaviour, such as violence, is explained not only by the social environment, as was long believed. Also nutrients and neurotoxicants might play a role. Whether this is the case was studied in this thesis. In two empirical studies possibl

  20. Implementation and evaluation of a medical image management system with content-based retrieval support

    International Nuclear Information System (INIS)

    Objective: the present paper describes the implementation and evaluation of a medical images management system with content-based retrieval support (PACS-CBIR) integrating modules focused on images acquisition, storage and distribution, and text retrieval by keyword and images retrieval by similarity. Materials and methods: internet-compatible technologies were utilized for the system implementation with free ware, and C++, PHP and Java languages on a Linux platform. There is a DICOM-compatible image management module and two query modules, one of them based on text and the other on similarity of image texture attributes. Results: results demonstrate an appropriate images management and storage, and that the images retrieval time, always < 15 sec, was found to be good by users. The evaluation of retrieval by similarity has demonstrated that the selected images extractor allowed the sorting of images according to anatomical areas. Conclusion: based on these results, one can conclude that the PACS-CBIR implementation is feasible. The system has demonstrated to be DICOM-compatible, and that it can be integrated with the local information system. The similar images retrieval functionality can be enhanced by the introduction of further descriptors. (author)

  1. Ionizing radiations management in university, medical and industrial media; La gestion des sources ionisantes en milieux universitaire, medical et industriel

    Energy Technology Data Exchange (ETDEWEB)

    Klein, D. [Universite Technologique de Belfort Montbeliard - LERMPS, 90 - Belfort (France)]|[Universite de Franche Comte, CREST-IRMA, 25 - Montbeliard (France)

    2001-07-01

    The radioactive sources are useful in several areas: medicine, research, measurement laboratories. Severe accidents in the past (Forbach in France 1991, Arequipa, Peru 1999, Goiania, Brazil 1987) remind us of the dangerous character of ionizing radiations. That is why the the management of radioactive sources are so regulated. Radiation protection and legal aspects of sealed and unsealed sources management are evoked, as well as the different official organisms that take a part in their management. (N.C.)

  2. Analysis of associations between behavioral traits and four types of aggression in Shiba Inu.

    Science.gov (United States)

    Kaneko, Fumihiro; Arata, Sayaka; Takeuchi, Yukari; Mori, Yuji

    2013-10-01

    Canine aggression is one of the behavioral problems for which veterinary behaviorists are most frequently consulted. Despite this, the classification of canine aggression is controversial, and there are several classification methodologies. While the etiology of canine aggression differs among the types of aggression, the behavioral background underlying aggression is not well understood. Behavior trait-based evaluation of canine aggression would improve the effectiveness and efficiency of managing canine aggression problems. We developed a questionnaire addressing 14 behavioral items and items related to four types of canine aggression (owner-, child-, stranger- and dog-directed aggression) in order to examine the associations between behavioral traits and aggression in Shiba Inu. A total of 400 Shiba Inu owners recruited through dog events (n=134) and veterinary hospitals (n=266) completed the questionnaire. Factor analysis sorted the behavioral items from both the event and clinic samples into four factors: "sociability with humans," "reactivity to stimuli," "chase proneness" and "fear of sounds." While "reactivity to stimuli" correlated significantly positively with all of the four types of aggression (P=0.007 to aggression (Pcanine aggression differ among the types of aggression and that specific behavioral traits are frequently simultaneously involved in several types of aggression. PMID:23719752

  3. Assurance of medical device quality with quality management system: an analysis of good manufacturing practice implementation in Taiwan.

    Science.gov (United States)

    Li, Tzu-Wei; Tu, Pei-Weng; Liu, Li-Ling; Wu, Shiow-Ing

    2015-01-01

    The implementation of an effective quality management system has always been considered a principal method for a manufacturer to maintain and improve its product and service quality. Globally many regulatory authorities incorporate quality management system as one of the mandatory requirements for the regulatory control of high-risk medical devices. The present study aims to analyze the GMP enforcement experience in Taiwan between 1998 and 2013. It describes the regulatory implementation of medical device GMP requirement and initiatives taken to assist small and medium-sized enterprises in compliance with the regulatory requirement. Based on statistical data collected by the competent authority and industry research institutes, the present paper reports the growth of Taiwan local medical device industry after the enforcement of GMP regulation. Transition in the production, technologies, and number of employees of Taiwan medical device industry between 1998 and 2013 provides the competent authorities around the world with an empirical foundation for further policy development. PMID:26075255

  4. Assurance of Medical Device Quality with Quality Management System: An Analysis of Good Manufacturing Practice Implementation in Taiwan

    Directory of Open Access Journals (Sweden)

    Tzu-Wei Li

    2015-01-01

    Full Text Available The implementation of an effective quality management system has always been considered a principal method for a manufacturer to maintain and improve its product and service quality. Globally many regulatory authorities incorporate quality management system as one of the mandatory requirements for the regulatory control of high-risk medical devices. The present study aims to analyze the GMP enforcement experience in Taiwan between 1998 and 2013. It describes the regulatory implementation of medical device GMP requirement and initiatives taken to assist small and medium-sized enterprises in compliance with the regulatory requirement. Based on statistical data collected by the competent authority and industry research institutes, the present paper reports the growth of Taiwan local medical device industry after the enforcement of GMP regulation. Transition in the production, technologies, and number of employees of Taiwan medical device industry between 1998 and 2013 provides the competent authorities around the world with an empirical foundation for further policy development.

  5. Parents' Aggressive Influences and Children's Aggressive Problem Solutions with Peers

    Science.gov (United States)

    Duman, Sarah; Margolin, Gayla

    2007-01-01

    This study examined children's aggressive and assertive solutions to hypothetical peer scenarios in relation to parents' responses to similar hypothetical social scenarios and parents' actual marital aggression. The study included 118 children ages 9 to 10 years old and their mothers and fathers. Children's aggressive solutions correlated with…

  6. Relational Aggression and Physical Aggression among Adolescent Cook Islands Students

    Science.gov (United States)

    Page, Angela; Smith, Lisa F.

    2016-01-01

    Both physical and relational aggression are characterised by the intent to harm another. Physical aggression includes direct behaviours such as hitting or kicking; relational aggression involves behaviours designed to damage relationships, such as excluding others, spreading rumours, and delivering threats and verbal abuse. This study extended…

  7. [Medical doctors driving technological innovation: questions about and innovation management approaches to incentive structures for lead users].

    Science.gov (United States)

    Bohnet-Joschko, Sabine; Kientzler, Fionn

    2010-01-01

    Management science defines user-generated innovations as open innovation and lead user innovation. The medical technology industry finds user-generated innovations profitable and even indispensable. Innovative medical doctors as lead users need medical technology innovations in order to improve patient care. Their motivation to innovate is mostly intrinsic. But innovations may also involve extrinsic motivators such as gain in reputation or monetary incentives. Medical doctors' innovative activities often take place in hospitals and are thus embedded into the hospital's organisational setting. Hospitals find it difficult to gain short-term profits from in-house generated innovations and sometimes hesitate to support them. Strategic investment in medical doctors' innovative activities may be profitable for hospitals in the long run if innovations provide first-mover competitive advantages. Industry co-operations with innovative medical doctors offer chances but also bear potential risks. Innovative ideas generated by expert users may result in even higher complexity of medical devices; this could cause mistakes when applied by less specialised users and thus affect patient safety. Innovations that yield benefits for patients, medical doctors, hospitals and the medical technology industry can be advanced by offering adequate support for knowledge transfer and co-operation models. PMID:21147434

  8. Medical Group Visits: A Feasibility Study to Manage Patients With Chronic Pain in an Underserved Urban Clinic

    OpenAIRE

    Gardiner, Paula; Dresner, Danielle; Barnett, Katherine Gergen; Sadikova, Ekaterina; Saper, Robert

    2014-01-01

    Background: Chronic pain affects millions of racially diverse Americans. Evidence suggests that group medical visits are effective for treating chronic pain; similarly, a number of studies demonstrate the effectiveness of certain evidence-based complementary therapies in managing pain. Objectives: The primary goal of this study is to evaluate the feasibility of the integrative medical group visit (IMGV) care model in an inner-city racially diverse outpatient clinic. IMGV combines patient-cent...

  9. Social Support and Lifestyle vs. Medical Diabetes Self-Management in the Diabetes Study of Northern California (DISTANCE)

    OpenAIRE

    Rosland, AM; Piette, JD; Lyles, CR; Parker, MM; Moffet, HH; Adler, NE; Schillinger, D.; Karter, AJ

    2014-01-01

    © 2014, The Society of Behavioral Medicine (outside the USA). Purpose: Examine social support’s association with seven individual chronic illness self-management behaviors: two healthy “lifestyle” behaviors (physical activity, diet) and five more highly skilled and diabetes-specific (medical) behaviors (checking feet, oral medication adherence, insulin adherence, self-monitored blood glucose, primary care appointment attendance). Background: In chronic illness self-care, social support may in...

  10. Social Support and Lifestyle vs. Medical Diabetes Self-Management in the Diabetes Study of Northern California (DISTANCE)

    OpenAIRE

    Rosland, AM; Piette, JD; Lyles, CR; Parker, MM; Moffet, HH; Adler, NE; Schillinger, D.; Karter, AJ

    2014-01-01

    Background In chronic illness self-care, social support may influence some health behaviors more than others. Purpose Examine social support's association with seven individual chronic illness self-management behaviors: two healthy "lifestyle" behaviors (physical activity, diet) and five more highly skilled and diabetes-specific (medical) behaviors (checking feet, oral medication adherence, insulin adherence, self-monitored blood glucose, primary care appointment attendance). Methods Using cr...

  11. A computerized representation of a medical school curriculum: integration of relational and text management software in database design.

    OpenAIRE

    Mattern, W. D.; Wagner, J A; Brown, J.S.; Fisher-Neenan, L.

    1991-01-01

    We describe the development of a computer-based representation of the medical school curriculum at the University of North Carolina at Chapel Hill (UNC-CH). Over the past seven years the Medical School's Office of Academic Affairs has employed both relational database and text management software to design an integrated curriculum database system. Depending on the function selected--exploring the curriculum, searching through course outlines, retrieving elective descriptions, identifying teac...

  12. Rational Management: Medical Authority and Ideological Conflict in Ruth Lawrence's "Breastfeeding: A Guide for the Medical Profession."

    Science.gov (United States)

    Hausman, Bernice L.

    2000-01-01

    Presents a close reading of one chapter of the only guidebook for physicians about breast feeding. Notes that the medical discussion of the psychological aspects of breast feeding articulates conflicting ideological views of women and their place in society. Suggests medicine reflects and contributes to a cultural context ambivalent about women's…

  13. Coping with Agitation and Aggression

    Science.gov (United States)

    Alzheimer ’s Caregiving Tips Coping with Agitation and Aggression People with Alzheimer’s disease may become agitated or aggressive as the disease gets worse. Agitation means that a person is restless or worried. ...

  14. Employer-based coverage and medical travel options: lessons for healthcare managers.

    Science.gov (United States)

    Karuppan, Corinne Marie

    2014-01-01

    Outbound medical travel (MT) involves U.S. patients going abroad to seek medical care. Over the past decade, there has been much discussion about MT's broadening appeal to several segments of U.S. healthcare consumers, but little is known about its penetration in the employer-based coverage (EBC) marketplace. The objectives of this article are to fill this gap and identify (1) the current status of MT options in EBC, (2) the differences between adopters and nonadopters of MT options, and (3) the factors that impede adoption. The results were obtained from a nationwide survey of human resources (HR) professionals making decisions regarding medical benefits. In this sample (n = 608), 16.8% of the respondents offered outbound MT options to their employees, often bypassing their insurance providers. Besides benefiting from a strong HR function, these organizations tended to be more involved in global business transactions, more open to change, more sensitive to cost savings, and more flexible in implementing administrative innovations than nonadopters were. An organizational climate conducive to innovation may explain their propensity to downplay the importance of well-known obstacles to implementation, such as the effort required to make changes, an emphasis on short-term goals, and the fear of liability. The lessons to be learned by U.S. healthcare managers are clear. To attract a value-conscious market, they must offer an attractive package of outstanding quality (clinical outcomes and patient experience) at competitive costs. Operational excellence may thus be the key to slowing the inevitable diffusion of MT options in EBC and maintaining or even expanding the U.S. market share of elective surgeries. PMID:24988676

  15. Medical management of severe local radiation injury after acute X-ray exposure

    International Nuclear Information System (INIS)

    Medical management during acute period in a case of severe local radiation injury after acute X-ray exposure includes 3 stages. During the fist stage patient got conservative treatment according to the common pathogenetic mechanisms of LRI (dis aggregating therapy, stimulation of regeneration, dis intoxication therapy, antibiotic therapy, pain relief therapy, Local anti-burn therapy-specific non-adhesive bandage with antiseptic and anti-burn medicaments); estimation of severity, deepness and area of injury by clinical picture and dates of instrumental methods of examining; defining necessity and volume of surgical treatment; preparing arrangements for surgical treatment. This stage ends with forming of demarcation line of a very hard severity of a Local Radiation Injure. The second stage includes necrectomy of the area of a very hard severity with microsurgical plastic by re vascularized flap and auto dermoplastic. The third stage - adaptation of re vascularized flap and total epithelization of injured area. (author)

  16. Part 2, Conflict management. How to shape positive relationships in medical practices and hospitals.

    Science.gov (United States)

    Sotile, W M; Sotile, M O

    1999-01-01

    Managing workplace conflict is one of the most important, stressful, and time-consuming tasks faced by today's physician leaders. In Part 1 of this article series, the authors describe how to assess an organization's interpersonal dynamics. True change comes from interventions that help an organization to become a positive interpersonal culture, one that fosters cooperation and collaboration. Part 2 offers seven steps to solving the disruptive physician problem: (1) provide protection to complainants; (2) listen, empathize, and avoid communication triangles; (3) confront offenders with data, authority, and compassion; (4) if needed, get outside help; (5) offer workplace training and experiences that foster positive relationships; (6) follow-up; and (7) practice what you preach. The self-assessment and intervention guidelines discussed in this series of articles can help physician executive move beyond struggling with episodes of conflict to shaping stress-resilient medical organizations. PMID:10558284

  17. Aggression, impulsivity, and suicide risk in benign chronic pain patients – a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Margari F

    2014-09-01

    Full Text Available Francesco Margari,1 Marina Lorusso,2 Emilia Matera,3 Adriana Pastore,1 Giuseppina Zagaria,3 Francesco Bruno,4 Filomena Puntillo,4 Lucia Margari31Psychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University Hospital of Bari, Bari, Italy; 2Department of Mental Health ASL BAT, Barletta, Italy; 3Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University Hospital of Bari, Bari Italy; 4Anesthesia and Intensive Care Unit, Department of Emergency and Organ Transplants, University Hospital of Bari, Bari, ItalyObjectives: The objective of this study was to investigate the role that psychopathological dimensions as overt aggression and impulsivity play in determining suicide risk in benign chronic pain patients (CPPs. Furthermore we investigated the possible protective/risk factors which promote these negative feelings, analyzing the relationship between CPPs and their caregivers.Methods: We enrolled a total of 208 patients, divided into CPPs and controls affected by internistic diseases. Assessment included collection of sociodemographic and healthcare data, pain characteristics, administration of visual analog scale (VAS, Modified Overt Aggression Scale (MOAS, Barratt Impulsiveness Scale Version 11 (BIS, Hamilton Depression Rating Scale (HDRS, and a caregiver self-administered questionnaire. All variables were statistically analyzed.Results: A significant difference of VAS, MOAS-total/verbal/auto-aggression, HDRS-total/suicide mean scores between the groups were found. BIS mean score was higher in CPPs misusing analgesics. In CPPs a correlation between MOAS-total/verbal/auto-aggression with BIS mean score, MOAS with HDRS-suicide mean score and BIS with HDRS-suicide mean scores were found. The MOAS and BIS mean scores were significantly higher when caregivers were not supportive.Conclusion: In CPPs, aggression and impulsivity could increase the risk of suicide. Moreover

  18. Managing complex processing of medical image sequences by program supervision techniques

    Science.gov (United States)

    Crubezy, Monica; Aubry, Florent; Moisan, Sabine; Chameroy, Virginie; Thonnat, Monique; Di Paola, Robert

    1997-05-01

    Our objective is to offer clinicians wider access to evolving medical image processing (MIP) techniques, crucial to improve assessment and quantification of physiological processes, but difficult to handle for non-specialists in MIP. Based on artificial intelligence techniques, our approach consists in the development of a knowledge-based program supervision system, automating the management of MIP libraries. It comprises a library of programs, a knowledge base capturing the expertise about programs and data and a supervision engine. It selects, organizes and executes the appropriate MIP programs given a goal to achieve and a data set, with dynamic feedback based on the results obtained. It also advises users in the development of new procedures chaining MIP programs.. We have experimented the approach for an application of factor analysis of medical image sequences as a means of predicting the response of osteosarcoma to chemotherapy, with both MRI and NM dynamic image sequences. As a result our program supervision system frees clinical end-users from performing tasks outside their competence, permitting them to concentrate on clinical issues. Therefore our approach enables a better exploitation of possibilities offered by MIP and higher quality results, both in terms of robustness and reliability.

  19. Medication and supplement use for managing joint symptoms among patients with knee and hip osteoarthritis: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Driban Jeffrey B

    2012-03-01

    Full Text Available Abstract Background The purpose was to determine the professionally-guided and self-guided medication and supplement use for joint symptom management among patients with knee and/or hip osteoarthritis (OA in an urban hospital-based outpatient orthopedic practice. Methods The study design was cross-sectional. Patients diagnosed by radiographs and clinical symptoms with knee and/or hip OA were recruited from an inner-city hospital-based outpatient orthopaedic office. A total of 184 patients were queried for their participation. Four investigator-generated, interview-based questionnaires were used. Sampling error was ± 7.84%. Logistic regression models and Fisher Exact Tests were performed to determine factors that may be associated with negative behaviors related to medication or supplement use (e.g., reporting medication as ineffective, using multiple medications in the same day to manage symptoms. Odds ratios (OR and 95% confidence intervals (CI were calculated for significant findings. Results Among the 162 participants, a majority reported professionally-guided recommendations and over 40% reported at least one self-guided intervention. 37 participants reported dual-use during the same day, and among those,15 reported dual-use at the same time. Among participants taking multiple interventions in the same day, 40.5% reported using prescription and over-the-counter medications. Use of multiple medications or supplements in one day was more common among participants who reported OA at multiple joints (OR [95% CI] = 2.48 [1.03 to 5.96] but less common among participants who did not complete high school (OR [95% CI] = 0.26 [0.08 to 0.83]. Of the 15 participants who reported dual-use at the same time, 11 were professionally-guided, 5 were professional and self-guided, and 1 was solely self-guided. Overall, 28% of participants reported their intervention as ineffective, sought an alternative method to achieve symptomatic relief, or were prescribed a

  20. 浅谈医用耗材信息化管理%Discussion on The Informatization Management of Medical Consumables

    Institute of Scientific and Technical Information of China (English)

    陈晓俐; 徐桂华

    2013-01-01

    The paper briefly explains the traditional management mode of medical consumables and its disadvantages, and introduces in detail the informatization management mode of the low value medical consumables and the high value medical consumables. The informatization management of medical consumables implements elaborate management of medical consumables, improves work efficiency, and accelerates the modernization of hospital by using the system, network, procedure and transparency of information technology.%本文简要说明了医用耗材的传统管理模式及其弊端,详细介绍了低值医用耗材与高值医用耗材的信息化管理模式。医用耗材的信息化管理利用信息化技术的系统性、网络性、程序性和透明性,实现了医用耗材精细化管理,提高了工作效率,加速了医院现代化建设。

  1. Meta-Analysis of Three Different Types of Fatigue Management Interventions for People with Multiple Sclerosis: Exercise, Education, and Medication

    Directory of Open Access Journals (Sweden)

    Miho Asano

    2014-01-01

    Full Text Available Fatigue is a common symptom of multiple sclerosis (MS with negative impacts extending from general functioning to quality of life. Both the cause and consequences of MS fatigue are considered multidimensional and necessitate multidisciplinary treatment for successful symptom management. Clinical practice guidelines suggest medication and rehabilitation for managing fatigue. This review summarized available research literature about three types of fatigue management interventions (exercise, education, and medication to provide comprehensive perspective on treatment options and facilitate a comparison of their effectiveness. We researched PubMed, Embase, and CINAHL (August 2013. Search terms included multiple sclerosis, fatigue, energy conservation, Amantadine, Modafinil, and randomized controlled trial. The search identified 230 citations. After the full-text review, 18 rehabilitation and 7 pharmacological trials targeting fatigue were selected. Rehabilitation interventions appeared to have stronger and more significant effects on reducing the impact or severity of patient-reported fatigue compared to medication. Pharmacological agents, including fatigue medication, are important but often do not enable people with MS to cope with their existing disabilities. MS fatigue affects various components of one’s health and wellbeing. People with MS experiencing fatigue and their healthcare providers should consider a full spectrum of effective fatigue management interventions, from exercise to educational strategies in conjunction with medication.

  2. A virtual reality apartment as a measure of medication management skills in patients with schizophrenia: a pilot study.

    Science.gov (United States)

    Kurtz, Matthew M; Baker, Elizabeth; Pearlson, Godfrey D; Astur, Robert S

    2007-09-01

    Performance on a novel, virtual reality (VR) assessment of medication management skills, the Virtual Reality Apartment Medication Management Assessment (VRAMMA), was investigated in 25 patients with schizophrenia and 18 matched healthy controls. The VRAMMA is a virtual 4-room apartment consisting of a living room with an interactive clock and TV, a bedroom, a kitchen, and a bathroom with an interactive medicine cabinet. After an exploratory phase, participants were given a mock prescription regimen to be taken 15 minutes later from pill bottles located in the medicine cabinet in the bathroom of the virtual environment. The VRAMMA was administered with a validated measure of medication management skills, several neurocognitive tests, and a symptom scale. Results revealed that (1) schizophrenic patients made significantly more quantitative errors in the number of pills taken, were less accurate at taking the prescribed medications at the designated time, and checked the interactive clock less frequently than healthy controls; (2) in patients with schizophrenia, there was significant agreement in classification of adherence vs nonadherence between a validated measure of medication management skills and the VRAMMA; and (3) in patients with schizophrenia, years of education and a measure of verbal learning and memory were linked to quantitative errors on the VRAMMA, while positive symptoms, specifically delusional symptoms, were inversely linked to distance traveled within the VRAMMA. This is the first study, to our knowledge, to provide evidence for the utility of VR technology in the assessment of instrumental role functioning in patients with schizophrenia. PMID:16956984

  3. Children's normative beliefs about aggression and aggressive behavior.

    Science.gov (United States)

    Huesmann, L R; Guerra, N G

    1997-02-01

    Normative beliefs have been defined as self-regulating beliefs about the appropriateness of social behaviors. In 2 studies the authors revised their scale for assessing normative beliefs about aggression, found that it is reliable and valid for use with elementary school children, and investigated the longitudinal relation between normative beliefs about aggression and aggressive behavior in a large sample of elementary school children living in poor urban neighborhoods. Using data obtained in 2 waves of observations 1 year apart, the authors found that children tended to approve more of aggression as they grew older and that this increase appeared to be correlated with increases in aggressive behavior. More important, although individual differences in aggressive behavior predicted subsequent differences in normative beliefs in younger children, individual differences in aggressive behavior were predicted by preceding differences in normative beliefs in older children. PMID:9107008

  4. Importancia de la exploración médico forense en las agresiones sexuales a menores Importance of forensic medical exploration in the sexual aggression of minors

    Directory of Open Access Journals (Sweden)

    M.L. Suárez Solá

    2003-01-01

    Full Text Available De un total de 58 denuncias por presuntas agresiones y abusos sexuales entre los años 1993 a 2001, las dividimos en tres grupos de edad (menores de 6 años, entre 6 y 12 años y de 12 a 18 años. Fueron estudiadas estadísticamente y examinados los hallazgos de las exploración física genital, extragenital y estado psíquico. En los resultados pudimos observar que denunciaron más las niñas mayores (13-18 años. Los hallazgos más sobresalientes fueron la integridad himeneal en el 76 % de los casos, la exploración extragenital normal en el 83% y psicológica en el 74%. Destacamos una dificultad para llegar al diagnóstico motivado por la ausencia de lesiones en la mayoría de los casos, lo que hace necesario que el examen físico y la toma de muestras se deba realizar lo antes posible. Hacemos hincapié en el valor terapéutico de una exploración física en las condiciones adecuadas ya que ayuda psicológicamente tanto a la presunta víctima como a los familiares próximos, refuerza el diagnóstico y puede reducir las secuelas futuras.We have registered a total of 58 incidents of alleged sexual aggression and abuse between 1993 and 2001. They were categorized in three groups according to age (i.e., less than 6 years old, between 6 and 12 and between 13 and 18. We have carried out statistical studies on the samples and examined the results of genital and extra genital physical exploration as well as the mental state of the victim. The study shows that underage girls between 13 and 18 made the largest number of complaints to the police. The most significant finding was of hymeneal integrity in 76% of the cases, and normal extra genital and psychological exploration in 83% and 74% of the cases respectively. This shows the difficulty in proving the allegations in most of the cases due to the lack of physical evidence. It is, therefore, of paramount importance to perform a physical exploration and take medical samples as soon as possible. We

  5. Using the Deming quality improvement method to manage medical record department product lines.

    Science.gov (United States)

    Postal, S N

    1990-06-01

    The above application of the quality improvement cycle provides insight into the use of the Deming method to address one of several identified customer needs and expectations obtained during the managing phase of product-line administration. Implementation of the quality improvement method requires a major commitment from all team members. Process improvement requires a willingness to be detail oriented. Gathering of statistics--such as analysis turn-around time--and evaluation are critical. This objective view of processes requires accountability and a commitment to change. Improvements focus on long-term problem resolution, not the quick fixes that result from addressing symptoms of problems. True problem resolution occurs by solving the root causes of variations. Medical record departments must move from being outcome oriented to being process focused. It is no longer feasible to be constantly putting out fires in an environment that demands well-planned and well-designed products that meet customers' expectations. The long-term management of product lines requires a systematic method of planning, doing, checking, and acting. The Deming quality improvement method provides a framework for positive change that focuses on quality processes resulting in a quality product that meets consumers' needs. PMID:10106656

  6. Advanced medical countermeasures for radiological accidents and nuclear disasters: prevention, prophylaxis, treatment and pre- and post-exposure management.

    Science.gov (United States)

    Popov, Dmitri; Maliev, Slava; Jones, Jeffrey

    Countermeasures against nuclear terrorism to prevent or limit the number of irradiated human population or radiation intoxications include early identification of the nuclear terrorism event and all persons which exposed by radiation, decontamination program and procedures, radiation control, and medical countermeasures which include medical diagnosis,differential diagnosis of Acute Radiation Syndromes by Immune Enzyme Assay , pre-exposure vaccination with Human Antiradiation Vaccine, post-exposure specific treatment - de-intoxication with Radiation Antidote IgG (blocking Antiradiation Antibodies). Our Advanced Medical Technology elaborated as a part of effective countermeasure include Plan of Action.Countermeasures against nuclear terrorism to prevent or limit the number of high level of lethality and severe forms of radiation illness or intoxications include A.early identification of the nuclear terrorism event and persons exposed,b. appropriate decontamination, c. radiation control, and d.medical countermeasures and medical management of ARS. Medical countermeasures, which include medical interventions such as active immuneprophylaxis with Human Antiradiation Vaccine , passive immune-prophylaxis with Antiradiation Antitoxins immune-globulins IgG , and chemoprophylaxis - post-exposure antioxidants prophylaxis and antibioticprophylaxis. Medical countermeasures with Antiradiation Vaccine should be initiated before an exposure (if individuals are identified as being at high risk for exposure)but after a confirmed exposure event Antiradiation Vaccine not effective and Antiradiation Antidot IgG must be applyed for treatment of Acute Radiation Syndromes.

  7. Nutrition, neurotoxicants & aggressive behaviour

    OpenAIRE

    Zaalberg, A.

    2015-01-01

    Nutrition, neurotoxicants and aggressive behaviour Antisocial behaviour, such as violence, is explained not only by the social environment, as was long believed. Also nutrients and neurotoxicants might play a role. Whether this is the case was studied in this thesis. In two empirical studies possible relations between nutrients and behaviour were investigated. In the first study, levels of nutrients in blood samples of forensic psychiatric patients were measured. Low levels of omega-3 fatty a...

  8. Individual strategies of aggressive and non-aggressive male mice in encounters with trained aggressive residents

    NARCIS (Netherlands)

    Benus, Rensina F.; Koolhaas, Jaap M.; Oortmerssen, Geert A. van

    1992-01-01

    To determine whether individual differences in offensive behaviour are related to differences in defensive behaviour, the responses of male wild house mice, Mus domesticus, of an aggressive and a non-aggressive line to defeat by physically stronger residents were analysed. Individuals of the aggress

  9. The influence of dysfunctional impulsivity and alexithymia on aggressive behavior of psychiatric patients.

    Science.gov (United States)

    de Schutter, Marja A M; Kramer, Hein J M Th; Franken, Ernest J F; Lodewijkx, Hein F M; Kleinepier, Tom

    2016-09-30

    Current approaches in Dutch mental health care institutions towards inpatients' aggression have focused predominantly on environmental factors, such as training the staff in aggression management. However, personality traits might be an important factor in patients' aggression - as shown by incidents in the wards. This study explores the influence of dysfunctional impulsivity and alexithymia on psychiatric patients' aggressive behavior, through self-reports and through involvement in aggressive incidents. Personality traits influencing patients' aggression emphasize the importance of a more direct approach to their aggression. Clinical patients at Dutch mental health care institution Emergis (n=84) filled out questionnaires about their aggressiveness (using Buss and Perry's Aggression Questionnaire Short Form), dysfunctional impulsivity and alexithymia. Multiple regression analyses indicated that dysfunctional impulsivity positively related to self-reported aggressive behavior. The relationship, however, could not be confirmed for inpatients' aggression as reported by the staff on the wards. Unexpectedly affective alexithymia negatively related to hostility. Gender differences in self-reported aggression were found. Female patients showed higher levels of hostility. Regression analyses indicated that the male gender positively related to physical aggression. Findings emphasize the importance of a new approach in Dutch mental health care, in which patients may engage in aggression-regulation training programs. PMID:27387554

  10. Obesity management and continuing medical education in primary care: results of a Swiss survey

    Directory of Open Access Journals (Sweden)

    Huber Carola A

    2011-12-01

    Full Text Available Abstract Background The worldwide increase in obesity is becoming a major health concern. General practitioners (GPs play a central role in managing obesity. We aimed to examine Swiss GPs self-reported practice in diagnosis and treatment of obesity with a special focus on the performance of waist measurement. Methods A structured self-reported questionnaire was mailed to 323 GPs recruited from four urban physician networks in Switzerland. Measures included professional experience, type of practice, obesity-related continuing medical education (CME and practice in dealing with obesity such as waist measurement. We assessed the association between the performance of waist measurement and obesity-related CME by multivariate ordered logistic regression controlling for GP characteristics as potential confounders. Results A total of 187 GPs responded to the questionnaire. More than half of the GPs felt confident in managing obesity. The majority of the GPs (73% spent less than 4 days in the last 5 years on obesity-related CME. More than half of GPs gave advice to reduce energy intakes (64%, intakes of high caloric and alcoholic drinks (56% and to increase the physical activity (78%. Half of the GPs seldom performed waist measurement and documentation. The frequency of obesity-related CME was independently associated with the performance of waist measurement when controlled for GPs' characteristics by multivariate ordered logistic regression. Conclusions The majority of GPs followed guideline recommendations promoting physical activity and dietary counselling. We observed a gap between the increasing evidence for waist circumference assessment as an important measure in obesity management and actual clinical practice. Our data indicated that specific obesity-related CME might help to reduce this gap.

  11. Parental and medical knowledge and management of fever in Italian pre-school children

    Directory of Open Access Journals (Sweden)

    Chiappini Elena

    2012-07-01

    Full Text Available Abstract Background Guidelines for the management of fever in children have been recently published, however “fever phobia” is still spreading. To provide information which may sustain educational interventions tailored to our population we investigated the parental and medical knowledge and management of fever in preschool children. Methods A questionnaire was administered to a convenient sample of Italian parents and paediatricians. The questionnaire elicited information about definition and cause of fever, concerns about fever, method of temperature measurement, and treatment modalities. Results Overall, 388 parents and 480 paediatricians were interviewed. All the parents believed that fever could cause at least one harmful effect and 89.9% (n = 349 believed that, if left untreated, it can cause brain damage or seizures. Parents used multiple resources to obtain information about fever but 67.8% (n = 264 considered paediatricians as their primary resource. Several wrong behaviours were found in the same proportions among parents and paediatricians: 78.5% of paediatricians (n = 377 and 77.8% of parents (n = 302 used physical method to reduce fever (P = 0.867; 27.0% of paediatricians (n = 103 and 21.4% (n = 83 of parents declared to alternate ibuprofen and acetaminophen (P = 0.953. Differently, 73.1% (n = 351 of paediatricians preferred oral to rectal administration of antipyretics compared to 48.7% (n = 190 of parents (P  Conclusions Paediatricians’ attitudes greatly influence the parental behaviours and beliefs. Implementation of educational programs regarding the management of the febrile child are needed in our setting.

  12. Evaluation of the implementation of the knowledge management processes in Shiraz University of Medical Sciences teaching hospitals, 2014

    OpenAIRE

    Roxana Sharifian; Nasrin Shokrpour; Fahimeh Salehpour

    2015-01-01

    Introduction: Recognition and implementation of knowledge management have an important effect on improving the quality of hospital activities. According to the direct relationship with the society’s health, health and treatment departments need knowledgeable and skillful staff. Thus, this research investigated different dimensions of the knowledge management processes in teaching hospitals of Shiraz University of Medical Sciences in 2014. Method: This cross-sectional analytical st...

  13. Best practice project management: an analysis of the front end of the innovation process in the medical technology industry

    OpenAIRE

    Tracey Giles; Kathryn Cormican

    2014-01-01

    There are strong motivating factors for more effective project management practices at the front end of the innovation (FEI) process. Shrewd management of these pre-development activities has proven to be one of the greatest differentials for success. This study presents findings from an empirical case study analysis of a large organization operating in the medical technology industry in Ireland. We synthesized the literature to identify five critical success factors (CSFs) known to be effect...

  14. Accreditation status of hospital pharmacies and their challenges of medication management: A case of south Iranian largest university

    Directory of Open Access Journals (Sweden)

    Omid Barati

    2016-01-01

    Full Text Available Considering the importance of accreditation for hospital pharmacies, this study was to determine the challenges of medication management in hospital pharmacies affiliated with Shiraz University of Medical Sciences, Iran. The study was a mix-method research conducted in two qualitative and quantitative phases during the years 2014–2015 in Shiraz, Iran. National Accreditation Standard checklist for hospitals was used for data collection in the first phase, and Delphi method was applied in three rounds to achieve the most challenges of medication management and the related solutions. Results indicated a medium status of accreditation for all three dimensions in the above hospital pharmacies (3.53, 42.15 and 7, respectively. Lack of clinical pharmacists, nonparticipation of the pharmacy director in annual budgeting, lack of access to patient information, discontinuity of pharmaceutical care for patients discharged, defects in pharmacy staff training, lack of legislation in support of pharmacists and lack of adequate access to physicians' prescriptions, shortages in reporting medication errors, and lack of evidence related to microbial contamination are the most challenges extracted from the second phase. It seems that the studied hospital pharmacies encounter numerous problems regarding accreditation, pharmaceutical care as well as appropriate medication management and supply chain. Attempts to solve these problems can play an important role in improving the efficiency and effectiveness of pharmacies in Iran.

  15. Accreditation status of hospital pharmacies and their challenges of medication management: A case of south Iranian largest university.

    Science.gov (United States)

    Barati, Omid; Dorosti, Hesam; Talebzadeh, Alireza; Bastani, Peivand

    2016-01-01

    Considering the importance of accreditation for hospital pharmacies, this study was to determine the challenges of medication management in hospital pharmacies affiliated with Shiraz University of Medical Sciences, Iran. The study was a mix-method research conducted in two qualitative and quantitative phases during the years 2014-2015 in Shiraz, Iran. National Accreditation Standard checklist for hospitals was used for data collection in the first phase, and Delphi method was applied in three rounds to achieve the most challenges of medication management and the related solutions. Results indicated a medium status of accreditation for all three dimensions in the above hospital pharmacies (3.53, 42.15 and 7, respectively). Lack of clinical pharmacists, nonparticipation of the pharmacy director in annual budgeting, lack of access to patient information, discontinuity of pharmaceutical care for patients discharged, defects in pharmacy staff training, lack of legislation in support of pharmacists and lack of adequate access to physicians' prescriptions, shortages in reporting medication errors, and lack of evidence related to microbial contamination are the most challenges extracted from the second phase. It seems that the studied hospital pharmacies encounter numerous problems regarding accreditation, pharmaceutical care as well as appropriate medication management and supply chain. Attempts to solve these problems can play an important role in improving the efficiency and effectiveness of pharmacies in Iran. PMID:27429924

  16. Motives in Sexual Aggression: The Chinese Context.

    Science.gov (United States)

    Tang, Catherine So-Kum; And Others

    1993-01-01

    Compared sexual and aggressive motives for sexual aggression in Chinese college students. Male undergraduates (N=146) completed self-report measures. Results suggest that sex guilt and aggressive guilt acted as inhibitors for their respective drives and sexual aggression resulted from aggressive, rather than sexual, motives. Sexual aggression may…

  17. Organization, Management and Function of International Space Station (ISS) Multilateral Medical Operations

    Science.gov (United States)

    Duncan, James M.; Bogomolov, V. V.; Castrucci, F.; Koike, Y.; Comtois, J. M.; Sargsyan, A. E.

    2007-01-01

    Long duration crews have inhabited the ISS since November of 2000. The favorable medical outcomes of its missions can be largely attributed to sustained collective efforts of all ISS Partners medical organizations. In-flight medical monitoring and support, although crucial, is just a component of the ISS system of Joint Medical Operations. The goal of this work is to review the principles, design, and function of the multilateral medical support of the ISS Program. The governing documents, which describe the relationships among all ISS partner medical organizations, were evaluated, followed by analysis of the roles, responsibilities, and decision-making processes of the ISS medical boards, panels, and working groups. The degree of integration of the medical support system was evaluated by reviewing the multiple levels of the status reviews and mission assurance activities carried out throughout the last six years. The Integrated Medical Group, consisting of physicians and other essential personnel in the mission control centers represents the front-line medical support of the ISS. Data from their day-to-day activities are presented weekly at the Space Medicine Operations Team (SMOT), where known or potential concerns are addressed by an international group of physicians. A broader status review is conducted monthly to project the state of crew health and medical support for the following month, and to determine measures to return to nominal state. Finally, a comprehensive readiness review is conducted during preparations for each ISS mission. The Multilateral Medical Policy Board (MMPB) issues medical policy decisions and oversees all health and medical matters. The Multilateral Space Medicine Board (MSMB) certifies crewmembers and visitors for training and space flight to the Station, and physicians to practice space medicine for the ISS. The Multilateral Medical Operations Panel (MMOP) develops medical requirements, defines and supervises implementation of

  18. Medical management of levodopa-associated motor complications in patients with Parkinson's disease.

    Science.gov (United States)

    Jankovic, Joseph; Stacy, Mark

    2007-01-01

    Parkinson's disease is a neurodegenerative disorder that affects approximately 1% of people over the age of 60 years. Levodopa is standard, and often initial, therapy for patients with this condition; however, with continued treatment and as the disease progresses, up to 80% of patients experience 'wearing-off' symptoms, dyskinesias and other motor complications. These levodopa-associated problems may become disabling and profoundly affect quality of life. Medications commonly used to manage these symptoms include monoamine oxidase type B (MAO-B) inhibitors, catechol-O-methyltransferase (COMT) inhibitors, the NMDA receptor antagonist amantadine and dopamine receptor agonists. Agents that block MAO-B, such as rasagiline and selegiline, are used as both initial and adjunctive therapy in patients with Parkinson's disease. These medications increase concentrations of dopamine in the brain by blocking its reuptake from the synaptic cleft, a mechanism that can slow motor decline, increase 'on' time and improve symptoms of Parkinson's disease. Adverse events with these agents can include confusion, hallucination and orthostatic hypotension. MAO-B inhibition may elicit drug-drug interactions if administered with TCAs, SSRIs or SNRIs. Conventional oral selegiline is associated with potentially harmful plasma concentrations of three major amphetamine metabolites, although metabolite concentrations are significantly lower with a new orally disintegrating tablet (ODT) selegiline formulation. Selegiline ODT is also absorbed more efficiently and shows less pharmacokinetic variability than conventional oral selegiline.COMT mediates peripheral catabolism of levodopa. Therefore, agents that block COMT, such as tolcapone and entacapone, increase the elimination half-life of levodopa. Given adjunctively with levodopa, COMT inhibitors can decrease 'off' time and increase 'on' time, as well as lower the daily levodopa dose. Although more potent than entacapone, tolcapone requires

  19. Performance Management of High Performance Computing for Medical Image Processing in Amazon Web Services

    Science.gov (United States)

    Bao, Shunxing; Damon, Stephen M.; Landman, Bennett A.; Gokhale, Aniruddha

    2016-01-01

    Adopting high performance cloud computing for medical image processing is a popular trend given the pressing needs of large studies. Amazon Web Services (AWS) provide reliable, on-demand, and inexpensive cloud computing services. Our research objective is to implement an affordable, scalable and easy-to-use AWS framework for the Java Image Science Toolkit (JIST). JIST is a plugin for Medical-Image Processing, Analysis, and Visualization (MIPAV) that provides a graphical pipeline implementation allowing users to quickly test and develop pipelines. JIST is DRMAA-compliant allowing it to run on portable batch system grids. However, as new processing methods are implemented and developed, memory may often be a bottleneck for not only lab computers, but also possibly some local grids. Integrating JIST with the AWS cloud alleviates these possible restrictions and does not require users to have deep knowledge of programming in Java. Workflow definition/management and cloud configurations are two key challenges in this research. Using a simple unified control panel, users have the ability to set the numbers of nodes and select from a variety of pre-configured AWS EC2 nodes with different numbers of processors and memory storage. Intuitively, we configured Amazon S3 storage to be mounted by pay-for-use Amazon EC2 instances. Hence, S3 storage is recognized as a shared cloud resource. The Amazon EC2 instances provide pre-installs of all necessary packages to run JIST. This work presents an implementation that facilitates the integration of JIST with AWS. We describe the theoretical cost/benefit formulae to decide between local serial execution versus cloud computing and apply this analysis to an empirical diffusion tensor imaging pipeline. PMID:27127335

  20. 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

  1. Human-centered risk management for medical devices - new methods and tools.

    Science.gov (United States)

    Janß, Armin; Plogmann, Simon; Radermacher, Klaus

    2016-04-01

    Studies regarding adverse events with technical devices in the medical context showed, that in most of the cases non-usable interfaces are the cause for use deficiencies and therefore a potential harm for the patient and third parties. This is partially due to the lack of suitable methods for interlinking usability engineering and human-centered risk management. Especially regarding the early identification of human-induced errors and the systematic control of these failures, medical device manufacturers and in particular the developers have to be supported in order to guarantee reliable design and error-tolerant human-machine interfaces (HMI). In this context, we developed the HiFEM methodology and a corresponding software tool (mAIXuse) for model-based human risk analysis. Based on a two-fold approach, HiFEM provides a task-type-sensitive modeling structure with integrated temporal relations in order to represent and analyze the use process in a detailed way. The approach can be used from early developmental stages up to the validation process. Results of a comparative study with the HiFEM method and a classical process-failure mode and effect analysis (FMEA) depict, that the new modeling and analysis technique clearly outperforms the FMEA. Besides, we implemented a new method for systematic human risk control (mAIXcontrol). Accessing information from the method's knowledge base enables the operator to detect the most suitable countermeasures for a respective risk. Forty-one approved generic countermeasure principles have been indexed as a resulting combination of root causes and failures in a matrix. The methodology has been tested in comparison to a conventional approach as well. Evaluation of the matrix and the reassessment of the risk priority numbers by a blind expert demonstrate a substantial benefit of the new mAIXcontrol method. PMID:26985681

  2. Performance management of high performance computing for medical image processing in Amazon Web Services

    Science.gov (United States)

    Bao, Shunxing; Damon, Stephen M.; Landman, Bennett A.; Gokhale, Aniruddha

    2016-03-01

    Adopting high performance cloud computing for medical image processing is a popular trend given the pressing needs of large studies. Amazon Web Services (AWS) provide reliable, on-demand, and inexpensive cloud computing services. Our research objective is to implement an affordable, scalable and easy-to-use AWS framework for the Java Image Science Toolkit (JIST). JIST is a plugin for Medical- Image Processing, Analysis, and Visualization (MIPAV) that provides a graphical pipeline implementation allowing users to quickly test and develop pipelines. JIST is DRMAA-compliant allowing it to run on portable batch system grids. However, as new processing methods are implemented and developed, memory may often be a bottleneck for not only lab computers, but also possibly some local grids. Integrating JIST with the AWS cloud alleviates these possible restrictions and does not require users to have deep knowledge of programming in Java. Workflow definition/management and cloud configurations are two key challenges in this research. Using a simple unified control panel, users have the ability to set the numbers of nodes and select from a variety of pre-configured AWS EC2 nodes with different numbers of processors and memory storage. Intuitively, we configured Amazon S3 storage to be mounted by pay-for- use Amazon EC2 instances. Hence, S3 storage is recognized as a shared cloud resource. The Amazon EC2 instances provide pre-installs of all necessary packages to run JIST. This work presents an implementation that facilitates the integration of JIST with AWS. We describe the theoretical cost/benefit formulae to decide between local serial execution versus cloud computing and apply this analysis to an empirical diffusion tensor imaging pipeline.

  3. Availability of Education and Training for Medical Specialists about the Impact of Dementia on Comorbid Disease Management

    Science.gov (United States)

    Ibrahim, Joseph Elias; Davis, Marie-Claire

    2013-01-01

    Individuals with dementia carry an additional health burden of multiple comorbid conditions. Effectively assessing and treating these comorbid conditions requires the medical specialist to be aware of, understand, and manage the effects of dementia on their clinical subspecialty practice. This ecological study describes the dementia-related…

  4. Geospatial Modeling and Disease Insect Vector Management at the USDA-ARS Center for Medical, Agricultural, and Veterinary Entomology

    Science.gov (United States)

    Geospatial modeling at the Center for Medical, Agricultural and Veterinary Entomology (CMAVE) is used assist in the surveillance of insect vectors and in the management of insect transmitted diseases. The most recent Geospatial Modeling/Technology Transfer success involves the prediction of Rift Val...

  5. The Interface between Substance Abuse and Chronic Pain Management in Primary Care: A Curriculum for Medical Residents

    Science.gov (United States)

    Gunderson, Erik W.; Coffin, Phillip O.; Chang, Nancy; Polydorou, Soteri; Levin, Frances R.

    2009-01-01

    Objectives: To develop and assess a housestaff curriculum on opioid and other substance abuse among patients with chronic noncancer pain (CNCP). Methods: The two-hour, case-based curriculum delivered to small groups of medical housestaff sought to improve assessment and management of opioid-treated CNCP patients, including those with a substance…

  6. The Effectiveness of Antidepressant Medication in the Management of Behaviour Problems in Adults with Intellectual Disabilities: A Systematic Review

    Science.gov (United States)

    Sohanpal, S. K.; Deb, S.; Thomas, C.; Soni, R.; Lenotre, L.; Unwin, G.

    2007-01-01

    Background: A comprehensive systematic review was performed to establish the current evidence base regarding the effectiveness of antidepressant medication for the management of behaviour problems in adults with intellectual disabilities. Method: An electronic search of PsycInfo, Embase, Medline and Cinahl databases was conducted spanning the time…

  7. 75 FR 21662 - Access to Employee Exposure and Medical Records; Extension of the Office of Management and Budget...

    Science.gov (United States)

    2010-04-26

    ... Secretary of Labor's Order No. 5-2007 (72 FR 31160). Signed at Washington, DC, on April 20, 2010. David... Occupational Safety and Health Administration Access to Employee Exposure and Medical Records; Extension of the Office of Management and Budget's (OMB) Approval of Information Collection (Paperwork)...

  8. Hypokalaemia: Improving the investigation, management and therapeutic monitoring of hypokalaemic medical inpatients at a district general hospital.

    Science.gov (United States)

    Jordan, Mark; Caesar, Jenny

    2015-01-01

    Hypokalaemia is prevalent in 20% of hospitalised patients. Furthermore, inadequate management of hypokalemia was identified in 24% of these patients. Associated with significant patient morbidity and mortality, the identification, investigation, and treatment of hypokalaemia was identified as an area for improvement in the management of medical inpatients. The project aims to measure the assessment, management, and therapeutic monitoring of medical inpatients with hypokalaemia in a district general hospital. All medical inpatients over a one week period who met the criteria for hypokalaemia (serum potassium ECG requests, repeat U&Es, serum magnesium analysis, treatment prescribed, and medication review dates was collated. A re-audit was completed after the introduction of a set of interventions which included a hypokalaemia treatment algorithm. Pre-intervention analysis of all medical inpatients, who met our inclusion criteria for hypokalaemia, identified 32 patients. 25 of these patients met the criteria for mild hypokalaemia (3.1-3.4 mmol/L) and 7 met the criteria for moderate hypokalaemia (2.5-3.0 mmol/L). Only 7/32 (22 %) patients were receiving adequate treatment based on trust guidelines. Post intervention results showed marked improvement in the management of patients with hypokalaemia. A total of 30 patients were identified in this post-intervention group. There were 16/30 patients who qualified as mild hypokalaemia (3.1-3.4 mmol/L) and 14/30 with moderate hypokalaemia (2.5-3.0 mmol/L). 19/30 (63%) patients in the post-intervention group were correctly prescribed appropriate medication doses consistent with the treatment algorithm. Following the initial success of the project, analysis at 3 months showed a positive trend for sustained improvement when compared to the pre-intervention results. PMID:26734439

  9. Advances in the medical management of the severe cutaneous radiation syndrome

    International Nuclear Information System (INIS)

    The cutaneous radiation syndrome is a dose dependant complex pathological syndrome which follows a brief localized exposure and characterized by erythema, swelling, moist desquamation, ulceration and necrosis (25-30 Gy). Highly penetrating gamma radiation induces severe dose dependent lesions involving skin, subcutaneous tissue, muscle, vessels, nerves and occasionally, bony structures. The classical treatment of this syndrome includes the debridement of devitalized tissues, the application of bacteriostatic agents coated in non-adherent dressings, opiate-based drugs and in some cases the use of non-steroidal anti-inflammatory drugs. For ulceration and necrosis treatment, the classical surgery is ulcerectomy, necrectomy and amputation for the distal extremity injuries. For the profound et large necrosis, the lesion should be excised and the wound bed covered with a good quality, full-thickness skin graft. Unfortunately the delayed of appearance of this syndrome results often in non specialized medical treatment. Furthermore, because of the chronic evolution (months or years) the management of the cutaneous radiation syndrome has not been considered as a priority for the medical management. Recent accident like the Georgian accident demonstrated that new techniques such as artificial skin graft could change significantly patient prognosis. This technique is routinely used for thermal burn in specialized burn units. We realized the first application of this methodology in the field of radiopathology. An important factor of this technique is that in the case of recurrence of radionecrosis. Often observed, using this technique further grafting may be employed. However the success of this procedure depends on an effective control of the infection. These has sadly been illustrated in the last accident case in Peru where it was impossible to perform the artificial skin graft due to the persistence of a non-eradicated local infection. Whether this particular approach has a

  10. Implementation of a web-based tool for patient medication self-management: the Medication Self-titration Evaluation Programme (Med-STEP for blood pressure control

    Directory of Open Access Journals (Sweden)

    Richard W Grant

    2013-12-01

    Full Text Available Background Informatics tools may help support hypertension management.Objective To design, implement and evaluate a web-based system for patient anti-hypertensive medication self-titration.Methods Study stages included: six focus groups (50 patients to identify barriers/facilitators to patient medication self-titration, software design informed by qualitative analysis of focus group responses and a six-month single-arm pilot study (20 patients to assess implementation feasibility.Results Focus groups emphasised patient need to feel confident that their own primary care providers were directly involved and approved of the titration protocol. Physicians required 3.3 ± 2.8 minutes/patient to create individualised six-step medication pathways for once-monthly blood pressure evaluations. Pilot participants (mean age of 51.5 ± 11 years, 45% women, mean baseline blood pressure 139/84 ± 12.2/7.5 mmHg had five medication increases, two non-adherence self-reports, 52months not requiring medication changes, 24 skipped months and 17 months with no evaluations due to technical issues. Four pilot patients dropped out before study completion. From baseline to study completion, blood pressure decreased among the 16 patients remaining in the study (8.0/4.7 mmHg, p = 0.03 for both systolic and diastolic pressures.Conclusions Lessons learned included the benefit of qualitative patient analysis prior to system development and the feasibility of physicians designing individual treatment pathways. Any potential clinical benefits were offset by technical problems, the tendency for patients to skip their monthly self-evaluations and drop outs. To be more widely adopted such systems must effectively generalise to a wider range of patients and be integrated into clinical workflow.

  11. A Comment on "T2QM (Teaching and Total Quality Management) for Medical Teachers" by R.G. Bing-You.

    Science.gov (United States)

    Leinster, S. J.

    1997-01-01

    Responds to R.G. Bing-You's argument for the application of total quality management (TQM) techniques to medical teaching. Argues that attempts to apply TQM to medical education are fundamentally flawed because medical education is not an intrinsically commercial transition. (DDR)

  12. 核心自我评价对医学生无聊倾向性与攻击行为的中介作用%The mediating effect of self-evaluation on boredom proneness and aggression in medical students

    Institute of Scientific and Technical Information of China (English)

    许娟; 邓学红; 刘苗苗; 李秋丽; 戴秀英

    2014-01-01

    Objective To explore the relationship among boredom proneness,core self-evaluation and aggression in medical students and to provide clues and evidence for preventing aggression and their relevant interventions.Methods The Boredom Proneness Scale for College Students(C-BPQ),Chinese Version of Buss & Perry Aggression Questionnaire (AQ-CV)and Core Self-evaluations Scale were employed to investigate 1667 medical students in one medical university in Ningxia.Results There were significant differences between high and low boredom proneness groups in core self-evaluations,total aggression score and each factors (core self-evaluations:(29.67±5.10) vs (41.67±4.64),AQ-CV scores:(36.43±17.18) vs (17.58±12.45),physical aggression:(31.62 ±20.46) vs (17.02 ±15.28),verbal aggression:(37.44±19.03) vs (24.68±17.14),anger:(40.93±22.32) vs (18.85±16.86),hostility:(37.34± 19.41) vs (14.86± 13.57),self-aggression:(35.47 ±21.66) vs (13.57± 14.28),all P<0.001).There were positive correlation among total score of boredom proneness,internal and external stimuli dimensions,total score of AQ-CV and each factors (P<0.001) and negative correlation between total score of boredom proneness and core self-evaluation(P<0.001).There were negative correlation among core self-evaluation score,AQ-CV scores and each factor(P<0.001).Regression analysis showed that boredom proneness and core self-evaluation could predict the aggression to a certain extent (P<0.01).Core self-evaluation played a mediating role between boredom proneness and aggression taking 48.25% proportion of the total effect of the mediation.Conclusion Boredom proneness is closely related to aggressive behavior.Core self-evaluation plays a mediating role between boredom proneness and aggression.%目的 探讨医学生无聊倾向性、核心自我评价与攻击行为的关系,为攻击行为的预防和干预提供线索与依据.方法 采用大学生无聊倾向性问卷(C-BPQ)、核心自我评价量表

  13. Aggressive HIV-1?

    OpenAIRE

    van der Hoek Lia; de Ronde Anthony; Berkhout Ben

    2005-01-01

    Abstract New York City health officials announced on February 11, 2005 that a patient rapidly developed full-blown AIDS shortly after being diagnosed with a rare, drug-resistant strain of HIV-1. The New York City Department of Health issued an alert to all hospitals and doctors and a press conference was held to announce the emergence of an aggressive HIV-1 strain that may be difficult to treat and that appears to trigger rapid progression to AIDS. Is the panic justified?

  14. Efficacy of Atypical Antipsychotic Medication in the Management of Behaviour Problems in Children with Intellectual Disabilities and Borderline Intelligence: A Systematic Review

    Science.gov (United States)

    Unwin, Gemma L.; Deb, Shoumitro

    2011-01-01

    The use of medications to manage problem behaviours is widespread. However, robust evidence to support their use seems to be lacking. The aim was to review research evidence into the efficacy of atypical antipsychotic medication in managing problem behaviour in children with intellectual disabilities and borderline intelligence. A systematic…

  15. Management of activated parts generated during the dismantling of linear accelerators for medical uses

    International Nuclear Information System (INIS)

    During years 2006-2008 have been carried out to the dismantling of several linear accelerators of medical use in Spain. The two first were in the Hospital of 'La Princesa' in Madrid and in the Hospital 'Santa Creu y Sant Pau' in Barcelona. The disassembling of such was made by technicians of the providing company and of the own hospital, with the advising of experts of the Radiological Protection and Radiophysics Service of such. Technicians of the Radiological Protection Technical Unit (RPU) of ENRESA collaborated in these dismantlings with the objective to determine that pieces could be evacuated conventionally as metallic scraps and which had to be managed as radioactive waste. In the following dismantling the classification of the pieces were carried out by the technicians of the providing company. After that the technicians of the RPU of ENRESA verified this classification and characterized, in detail, the pieces classified as radioactive wasted before their removal. In this paper the activities carried out to classify the pieces and the legal bases in which it leans on, as well as the measures made for the characterization of the materials considered as radioactive waste are described. (author)

  16. Comparisons in the Medical Management of Three Cases of Plutonium-Contaminated Wounds

    International Nuclear Information System (INIS)

    Three cases are described having small wounds on the fingers contaminated by plutonium. In each patient routine decontamination procedures were carried out which were sufficiently rigorous to ensure that all contamination was removed from the intact skin leaving only that remaining in the depths of the wound. The medical management of these patients followed much the same sort of pattern in each case, i.e. excision of the wound was undertaken and this was either preceded or followed by the intravenous administration of DTPA. However, the times at which these various procedures were carried out varied in relation to each other and to the time of injury, and, therefore, one of the purposes of this paper is to discuss the effect of this time variation on the ultimate wound and total body content of plutonium. In one of the patients an attempt has been made to define the relative effectiveness of small and large quantities of DTPA on urinary plutonium excretion, this being achieved by the alternative administration of the DTPA in doses of 1 g and 0.1 g. (author)

  17. Pharmaceutical speakers' bureaus, academic freedom, and the management of promotional speaking at academic medical centers.

    Science.gov (United States)

    Boumil, Marcia M; Cutrell, Emily S; Lowney, Kathleen E; Berman, Harris A

    2012-01-01

    Pharmaceutical companies routinely engage physicians, particularly those with prestigious academic credentials, to deliver "educational" talks to groups of physicians in the community to help market the company's brand-name drugs. Although presented as educational, and even though they provide educational content, these events are intended to influence decisions about drug selection in ways that are not based on the suitability and effectiveness of the product, but on the prestige and persuasiveness of the speaker. A number of state legislatures and most academic medical centers have attempted to restrict physician participation in pharmaceutical marketing activities, though most restrictions are not absolute and have proven difficult to enforce. This article reviews the literature on why Speakers' Bureaus have become a lightning rod for academic/industry conflicts of interest and examines the arguments of those who defend physician participation. It considers whether the restrictions on Speakers' Bureaus are consistent with principles of academic freedom and concludes with the legal and institutional efforts to manage industry speaking. PMID:22789048

  18. TRIGEMINAL NEURALGIA: AN OVERVIEW OF LITERATURE WITH EMPHASIS ON MEDICAL MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Shamimul Hasan

    2012-11-01

    Full Text Available Pain is a complex human psycho-physiological experience. Neuralgic pain is produced by a change in neurological structure or function rather than by the excitation of pain receptors that causes nociceptive pain. Neuralgic pain follows the path of a nerve that may give rise to the sensation of tooth pain which often is a diagnostic dilemma for dentist. Trigeminal neuralgia is a disorder of the trigeminal nerve that causes episodes of unilateral intense, stabbing, electric shock like pain in the areas of the face supplied by trigeminal nerve-lips, eyes, nose, scalp, forehead, upper and lower jaw. TN is not fatal, but is universally considered to be one of the most painful afflictions known. An early and accurate diagnosis is mandatory, as therapeutic interventions can reduce or eliminate pain attacks. Treatment of this debilitating condition may be varied, ranging from medical management to surgical interventions. This article deals about the etio-pathogenesis, clinical characterstics, diagnosis and treatment strategies for trigeminal neuralgia.

  19. Medical store management: an integrated economic analysis of a tertiary care hospital in central India.

    Science.gov (United States)

    Mahatme, Ms; Dakhale, Gn; Hiware, Sk; Shinde, At; Salve, Am

    2012-04-01

    Economic analysis plays a pivotal role in the management of medical store. The main objectives of this study were to consider always better control-vital, essential and desirable (ABC-VED) analysis with economic order quantity (EOQ), comparison of indexed cost and the actual cost, and to assess the expenditure for the forthcoming years. Based on cost and criticality, a matrix of nine groups by combining ABC and VED analysis was formulated. Drug categories were narrowed down for prioritization to direct supervisory monitoring. The subgroups AE and AV of the categories category I and II should be ordered based on EOQ. The difference between the actual annual drug expenditure (ADE) and the derived indexed cost using the cost inflation index (CII) was calculated. Linear regression was used to assess the expenditure for the forth coming years. The total ADE for the financial year of 2010-2011 was Rs. 1,91,44,253 which was only 7.68% of annual hospital expenditure. Using the inflation index, the indexed cost of acquisition of ADE for year 2010-2011 was Rs. 1,95,10,387. The difference between the two was estimated to be 2.11%. Thus, the CII justifies the demand of increased budget for next year and prompts us for cautious use of drugs. By taking into consideration the ADE of last 10 years, we have forecasted the budget for forthcoming years which will help significantly for making policies according to the available budget. PMID:22754264

  20. Medical Management of Cyclosporine-Induced Gingival Overgrowth Using Oral Azithromycin in Six Dogs

    Directory of Open Access Journals (Sweden)

    Alison Diesel

    2015-02-01

    Full Text Available Gingival overgrowth is an uncommon adverse effect of cyclosporine administration in veterinary species. In people, gingival overgrowth is a common complication of cyclosporine administration for immunosuppression, generally following transplant procedures. Azithromycin has been used successfully for managing gingival overgrowth in human transplant patients when cyclosporine administration cannot be reduced or discontinued. This case series describes six dogs being administered cyclosporine for various dermatologic diseases that developed gingival overgrowth. The dogs were prescribed systemic azithromycin, with or without concurrent dose reduction of cyclosporine. Oral administration of 6.6–10.8 mg/kg of azithromycin once daily for 4–14 weeks was effective for complete clinical resolution of gingival overgrowth. In most cases, gingival overgrowth did not recur even with continued cyclosporine administration long-term. Adverse events of long-term azithromycin administration did not occur in any of the dogs. This series highlights a potentially beneficial medical treatment option for gingival overgrowth even when cyclosporine dose reduction is not possible or elected, without the need for surgical resection of proliferative gingival tissue.