Sample records for army medical department

  1. Army Medical Department Leaders in Military Operations Other Than War

    National Research Council Canada - National Science Library

    Sadlon, Gary


    .... Likewise, the Army Medical Department (AMEDD) must insure its leaders, specifically those selected to deploy world-wide, have a more diverse skill set that enables them to fully operate within the full spectrum of scenarios...

  2. Physician Retention in the Army Medical Department (United States)


    Fifteen years ago, these jobs were filled by General Medical Officers ( GMO ) -- graduates of internships who spent some time “muddying their boots” in the...field while waiting a year or two for the residency position of their choice. Today, the GMO is an endangered species. In an effort to provide the best

  3. The Mobile Modular Surgical Hospital: the Army Medical Department’s Future Unit of Action (United States)


    requirements. Paula C. Lodi in her monogram “The Army Medical Department and Full Spectrum Operations” written for the School of Advanced Military...Center, 2004), 2.1-2.10. 14Paula C. Lodi, The Army Medical Department and Full Spectrum Operations, ( Monogram , School of Advanced Military Studies...paper in the past ten years on the level III hospital. Paula C. Lodi in her monogram “The Army Medical Department and Full Spectrum Operations” written

  4. Equal Opportunity Program Management for the Army Medical Department (United States)


    applies to someone who has the physical, cultural, or linguistic characteristics of a national group. Personal Racism , Sexism , or Bigotry: The ...Management and Army Demographics and Statistics Departments. LTC Horrell arranged my VIP trip to the Defense Equal Opportunity Management Institute (DEOMI...harassment in the organization. Organizational productivity is maximized when illegal discrimination is eradicated. One theory of why discrimination

  5. Department of the Army Supply Bulletin, Army Medical Department Supply Information, SB8-75-S7

    National Research Council Canada - National Science Library


    .... Army Medical Materiel Agency (USAMMA), Fort Detrick, Maryland This edition focuses on the mission and functions of the SCMD and its capability to support the "Warfighter" during a full range of contingency operations While all of...

  6. The United States Army Medical Department Journal, April - June 2008 (United States)


    Amazon community at Iquitos, Stancil42 (Naval Medical Research Center Detachment, Peru ) received a grant to optimize strategies for preventing the breeding...Detachment, Lima, Peru ; Naval Medical Research Unit-2, Jakarta, Indonesia; and the Naval Medical Research Unit 3, Cairo, Egypt. These resources...the soil beneath tents and camps. In an effort to prevent sand flies breeding in rodent burrows, the Genesis Company (Wellington, Colorado) won an

  7. The United States Army Medical Department Journal. January-March 2013 (United States)


    HEATSTROKE IN A MILITARY WORKING DOG January – March 2013 37 THE ARMY MEDICAL DEPARTMENT JOURNAL Respiratory alkalosis can develop as a result of...dropped to 99.1ºF within 35 minutes after presentation, and the pulse and respiratory rate normalized. The mu- cous membranes were pink, but tacky. The MWD...throughout the body, including blood cells, myocardium, skeletal muscle, soft tissues, and cells of the respiratory and nervous systems.5 Venom

  8. Implementation of the Asthma Practice Guideline in the Army Medical Department: Evaluation of Process and Effects

    National Research Council Canada - National Science Library

    Farley, Donna O; Cretin, Shan; Vernez, Georges; Pieklik, Suzanne; Quiter, Elaine; Ashwood, J. S; Tu, Wenli


    .... The Quality Management Directorate of the Army Medical Command (MEDCOM) contracted with RAND to work as a partner in the development and testing of guideline implementation methods for ultimate application to an Army-wide guideline program...

  9. U.S. Army Medical Department Journal (July-September 1998)

    National Research Council Canada - National Science Library

    Peake, James B; Goodman, Robert L; Hillhouse, Roger H; Newsome, Steve; Reed, Lester H; Hume, Jr., Carroll R. Dotson ;Roderick F; Gussenhoven, Elisabeth; Garland, Frederick N; Still, Ron; Campbell, Kyle D; Austerman, Wayne R


    .... The "MAMC Improvement Award Program" describes the Madigan Army Medical Center's incentive program to reward organizational groups within a military hospital for improving efficiency, quality of care...

  10. U.S. Army Medical Department Journal (January-March 2000)

    National Research Council Canada - National Science Library

    Peake, James B; Goodman, Petra; De Lorenzo, Robert A; LaRavia, Dennis; Thomas, Timothy L; O'Hara, Charles P; Goodman, Robert L


    This issue of the AMEDD Journal contains several articles of interest. "Proceedings of the 1999 Madigan Research Day" identifies the award-winning research abstracts of this annual Madigan Army Medical Center event...

  11. U.S. Army Medical Department Journal (April-June 2006) (United States)


    basic laboratory equipment and techniques acquired at the AMS, demonstrated that Puerto Rican anemia was due to the hookworm, Necator americanus.* In...Sciences, Bangkok, Thailand; US Army Medical Research Unit-Kenya, Nairobi; Naval Medical Research Center Detachment, Lima, Peru ; Naval Medical Research...2006 131 Colombia, Ecuador, El Salvador, Netherland Antilles, Antigua, Belize, Bolivia, Costa Rica, Guatemala, Nicaragua, Panama, Peru (air, water

  12. Army medical imaging system: ARMIS

    International Nuclear Information System (INIS)

    Siedband, M.P.; Kramp, D.C.


    Recent advances of stimulable phosphor screens, data cards using optical storage means, and new personal computers with image processing capability have made possible the design of economical filmless medical imaging systems. The addition of communication links means that remote interpretation of images is also possible. The Army Medical Imaging System uses stimulable phosphor screens, digital readout, a small computer, an optical digital data card device, and a DIN/PACS link. Up to 200 images can be stored in the computer hard disk for rapid recall and reading by the radiologist. The computer permits image processing, annotation, insertion of text, and control of the system. Each device contains an image storage RAM and communicates with the computer via the small computer systems interface. Data compression is used to reduce the required storage capacity and transmission times of the 1-mB images. The credit card-size optical data cards replace film and can store 12 or more images. The data cards can be read on an independent viewer. The research is supported by the U.S. Army Biomedical Research and Development Laboratory

  13. Evaluation of the Low Back Pain Practice Guideline Implementation in the Army Medical Department

    National Research Council Canada - National Science Library

    Farley, Donna


    ... clinical care practices across the Army health system. This report presents the final results of the evaluation that RAND conducted as part of the demonstration for the low back practice guideline, which was conducted in 1999 and 2000...

  14. U.S. Army Medical Department Journal (January-March 2004) (United States)


    the Center’s workforce emphasizes flexibility, adaptability, and a multi- disciplined approach in providing technical products to its Army...grant award to Slab DSP to develop new integrated circuit. Press release. Auckland , New Zealand: PHITEK Systems; June 4, 2002. 11. Sharp B

  15. U.S. Army Medical Department Journal, January-March 2007 (United States)


    events thundered onward. The term “Reconstruction Aides” was changed in 1926 to “ physiotherapy ” and “occupational therapy.”6 Only a few years later...The training of occupational therapists witnessed a similar buildup with the start of a student occupational therapy program in 1962.7 The decade...Soldiers was paramount.15 POST-VIETNAM In the year after the fall of Saigon, the Army Student Occupational Therapy program also ended due to the need

  16. U.S. Army Medical Department Journal, April-June 2008 (United States)


    IGR), against dengue vector mosquitoes. In the Peruvian Amazon community at Iquitos, Stancil42 (Naval Medical Research Center Detachment, Peru ...Research Unit- Kenya, Nairobi; Naval Medical Research Center Detachment, Lima, Peru ; Naval Medical Research Unit-2, Jakarta, Indonesia; and the Naval...These projects have revealed that sand flies often emerge from the soil beneath tents and camps. In an effort to prevent sand flies breeding in rodent

  17. U.S. Army Medical Department Journal (January-March 2003)

    National Research Council Canada - National Science Library

    Porr, Darrel R; Melanson, Mark A; Winstead, , Alison D; Zolman, Ryan P; Moore, Christopher J; Gbur, Jr., Lester W. Grau ;Charles J; Yarvis, Clint Schreckhise ;Jeffrey; Bordnick, Patrick; Jones, Timothy K; Austerman, Wayne R


    .... "Ground Evacuation in the Republic of Korea," by CPT Christopher J. Moore, MS, USA, outlines the medical evacuation system in South Korea and the difficulties that terrain, weather, and overcrowded highways may pose in the event of hostilities...

  18. Medical Department, United States Army. Surgery in World War II. Neurosurgery. Volume 1 (United States)


    116 Photomicrograph showing petechial hemorrhages in cortex ------------------- 378 117 Photomicrograph showing nerve cell changes in caudate nucleus...headache unrelieved by ordinary medication or when there were signs of increasing intracranial hypertension; and (4) diagnosis of persistent fever ...hemorrhage at various points along the track of the bullet, was almost. invariably present for some days, or even for weeks, after injury. Fever was also

  19. Utilizing Integrative Medicine in the U.S. Army Medical Department (United States)


    Restoring healing to medicine is like restoring justice to the law.‖ --Dean Ornish, MD1 Introduction The 2009 National Defense Authorization...for all providers as an introduction to IM concepts, areas of practice, and an overview of each modality, with links to further references. This... Shakespeare , Hamlet, I.v.166-67. 67 ―When Congress authorized the USPSTF, it required the Department of Health and Human Services (HHS) to support

  20. Madigan Army Medical Center Department of Clinical Investigation Annual Progress Report Fiscal Year 1999 (United States)


    ferrets with diseased adrenal glands are usually unremarkable, occasionally a complete blood count may reveal regenerative or nonregenerative anemia and...renal failure and hypertension in non-pregnant individuals, and in pregnant women with preeclampsia . To date there exist no studies demonstrating the...Investigator: CDR Sylvia Y . N. Young, MC, USN Department: Preventive Medicine Facility: MAMC Associate Investigator(s): LTC Jeffrey D. Gunzenhauser, MC

  1. Department of the Army - The Fiscal Year 2008 Military Personnel, Army Appropriation and the Antideficiency Act (United States)


    of the Army, U.S. Army Audit Agency, Budgeting for the Military Personnel, Army Appropriation, Report No. A-2010-0028- FFM (Jan. 6, 2010); Department...of the Army, U.S. Army Audit Agency, Military Personnel, Army FY 05 Subsistence Charges, Report No. A-2008-0037- FFM (Feb. 12, 2008); Department of

  2. Battlefield Tourniquets: Lessons Learned in Moving Current Care Toward Best Care in an Army Medical Department at War. (United States)

    Kragh, John F; Dubick, Michael A


    Bleeding prevention and control by tourniquet use by out-of-hospital caregivers is a major breakthrough in military medicine of current wars. The present review documents developments in tourniquet practices since 2001 among the US military services for aid in improving doctrine, policy, and especially care in wars to come. Tourniquets are an adjunct for resuscitation in self-care and buddy aid and today are issued to all military servicepersons who deploy into a combat zone. In the US Army, virtually every Soldier is trained in first aid tourniquet use; since 2009 they are instructed early and often to use them early and often. Despite substantial knowledge gains among the services in tourniquet use and resulting improvements in casualty survival, current evidence shows persistent difficulties in achieving best care with tourniquet use for individual trauma patients. Nevertheless, contemporary tourniquet use incorporates key lessons learned over the last 14 years of war that include: (1) tourniquet use reliably stops bleeding from limb wounds and prevents mortality in prehospital settings; and (2) brief tourniquet use appears to be safe. These 2 lessons have become so evident that civilian emergency medical systems have begun using them, albeit unevenly. Collection and interpretation of data of casualties with tourniquet use have showed that such intervention has lifesaving benefit through 2 mechanisms: control of both ongoing hemorrhage and shock severity. The next generation of interventions in bleeding control involves developing the skill sets, education, and standards of tourniquet users which may improve hemorrhage control in wars to come.

  3. Annual Progress Report FY 93 (Walter Reed Army Medical Center, Department of Clinical Investigation). Clinical Investigation Program. Volume 2 (United States)


    129 REPORT DATE: 03/04/93 WORK UNIT a 1332-91 DETAIL SUMMARY SHEET TITLE: Thermogenic Agent Promotion of Weight Loss in Obese Soldiers KEYWORDS...thermogenic, promotion, obese PRINCIPAL INVESTIGATOR: Solomon, Barbara DNSc DEPARTMENT: Department of Medicine STATUS: Completed SERVICE: Endocrine...are: possible variance between adult and chilhood forms of HD, patterns of previous infectious disease exposure, socioeconomic patterns, familial

  4. Patient Reasons for Non-Urgent Utilization of the Dwight David Eisenhower Army Medical Center Emergency Department

    National Research Council Canada - National Science Library

    Sizemore, Charles J


    .... A review of the present body of literature revealed common themes why non-urgent patients typically present at emergency departments, the impacts to hospitals, and possible initiatives that could be...

  5. 76 FR 56406 - Science and Technology Reinvention Laboratory Demonstration Project; Department of the Army; Army... (United States)


    ... DEPARTMENT OF DEFENSE Office of the Secretary Science and Technology Reinvention Laboratory Demonstration Project; Department of the Army; Army Research, Development and Engineering Command; Tank... personnel management demonstration project for eligible TARDEC employees. Within that notice the table...

  6. The United States Army Medical Department Journal, April - June 2011. Prehospital combat casualty care; The starting point of battlefield survival (United States)


    from a porcine model of acute respiratory diseases secondary to pulmonary contusion. TRANSCUTANEOUS CO2 Are more accurate methods of estimating...combat medic diagnoses a tension pneumothorax from observing the patient and, if feasible, by auscultation with a stethoscope . Dyspnea, distended...Jugular veins, hypotension, and decreased unilateral breath sounds are the major findings for the diagnosis. The stethoscope was invented in 1816 by

  7. Annual Research Progress Report Fiscal Year 1990. Volume 1. Department of Clinical Investigation (Brooke Army Medical Center) (United States)


    granulomE , Arch. Dermatol., (in press). Low, G. J. Ionizing radiation-induced pemphigus. Arch. Dermatol., (in press). McCollough, M. L. Dominant...the severity of their headache on a linear pain scale as well as a verbal scale. Patients were questioned as to whether they had received medications...occurred either by phone or in the Neurologist’s office, using the same verbal and linear scales. Progress: In all, six patients were entered into the

  8. Historical Review: The U.S. Army Medical Belt for Front Line First Aid: A Well-Considered Design That Failed the Medical Department During the First World War. (United States)

    Wever, Peter C; Korst, Mike B J M; Otte, Maarten


    In December 1913, a board of medical officers was appointed to adapt new U.S. Army equipment to the needs of the Hospital Corps. One of the improvements concerned substitution of the satchel-like Hospital Corps pouch used to carry first aid equipment. A waist belt with 10 pockets, known as the medical belt, was devised, and supplied with a tourniquet, adhesive plaster, safety pins, iodine swabs, sublimated gauze, individual dressing packets, gauze bandages, aromatic spirit of ammonia, and common pins. In addition, an ax carrier accommodating a hand ax, a canteen hanger, and a pouch to carry diagnosis tags and instruments were attached to the medical belt. In 1916, the medical belt was incorporated in the field supply tables in the Manual for the Medical Department. The next year, on April 6, 1917, the U.S. Congress declared war on Germany in reaction to sinking of American ships by German submarines. Although the medical belt had given satisfaction in preliminary trials, it did not withstand the test of war. In practice, the medical belt proved a source of dissatisfaction both as to the methods of packing and its contents, which were considered useless in modern warfare. Subsequently, discontinuance of the medical belt was recommended. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  9. [Andrologic disease detected during army medical visit]. (United States)

    Campodonico, Fabio; Michelazzi, Alberto; Capurro, Anna; Carmignani, Giorgio


    Aim of this study is to investigate the prevalence of andrologic diseases in young men (age 18 years) recruited for conscription in a north-western Italian region. A random sample of 1993 young men was evaluated at the Army Medical Visit Center of the Military District of Genoa. The visits were performed by the same doctor. An examination of external genitalia and secondary sex characters was made and the medical history of each conscript was recorded. Investigation procedures were standardized according to the guidelines of the WHO for the diagnosis and management of the infertile male. Andrologic disorders were found in 547 subjects (27.5%) and first diagnosed in 412 (20.7%). Specific acquired or congenital disorders are discussed. Some patients with most significant diseases were referred to the Urologic Department for second level diagnostic exams. This study underlines the role of the army medical visit as a tool for andrologic screening in young males. The military health service may be a relevant institution for postpuberal control and it could be useful to prevent future sexual and fertility problems in adult males.

  10. Department of the Army, FY 1999 Amended Budget Estimates, Army Working Capital Fund

    National Research Council Canada - National Science Library


    The Department of the Army has historically operated a significant number of its organic commercial and industrial facilities under revolving fund concepts to encourage these activities to function...

  11. Army Medical Support for Peace Operations and Humanitarian Assistance, (United States)


    or contractors. Some coalition troops may uti - lize the theater medical system in ways it was not intended. Coalition partners’ own medical assets...agencies, and the State Depart- ment often urge the Army to expand medical services and to uti - lize any excess capacity for purposes other than the...Psychologists (new 67D). Similar concerns involved comptrollers and preventive medicine officers, field medical pharmacists , and personnel managers

  12. Department of the Army Installation Restoration Program

    International Nuclear Information System (INIS)

    Anderson, A.W.


    The Army's Installation Restoration Program (IRP) was established in 1975 in response to regulatory action at several installations where past disposal practices had caused contamination of streams and groundwater. The need to decontaminate excess Army-owned real estate also was considered in early IRP activities. A variety of site types have been discovered on Army installations. The major site types evaluated to date include: contaminated soil areas, landfills, lagoons, buildings, burning grounds, sumps, pits, storage tanks, sewage treatment plants, storage pads, industrial wastewater treatment plants, and salvage yards. Twenty Army installations have been proposed for or listed on the National Priorities List (NPL). The need for taking action at hazardous waste sites, however, is based on threats they pose to human health, welfare or the environment. Sites do not have to be on the SPL in order to be cleaned up through IRP activities. All of the sites that caused Army installations to be proposed for the NPL are being evaluated and cleaned up. In addition, all Army properties have been or will be assessed and where needed they will be addressed by the IRP

  13. US Army Medical Research and Development Report. (United States)


    RI) US ARMY MEDICAL RESEARCH AND DEVELOPMENT REPORT. Colonel/John Jr DTIC JUL 1 5 1980; A USL &MY MEDICAL BIOENGINEERING RESEARCH AND DEVELOPMENT...pollutants in water or soil . Pollutant by-products and breakdown products in water, air or soil will be isolated, characterized, and quantified. Where...determination of selected low-level pollutants io soil and water. Degradation products and secondary pollutants arising from munitions manufacture or pest

  14. An Analysis of Primary Care Provider Productivity in the Department of Family and Community Medicine at Carl R. Darnall Army Medical Center (United States)


    are the Weekend Acute Care Clinic ( WACC ), After Hours Clinic (AHC), Troop Medical Clinic 10 (TMC 10), Troop Medical Clinic 12 (TMC 12), and Troop...and expense data. WACC Weekend Acute Care Clinic is staffed on a rotational basis by DFCM core assets; 0800-1700 on Saturdays & Sundays, by walk-in and

  15. The Deployed Warfighter Protection Research Program: Finding New Methods to Vanquish Old Foes (The United States Army Medical Department Journal, April-June 2008) (United States)


    pyriproxyfen, the most powerful insect growth regulator (IGR), against dengue vector mosquitoes. In the Peruvian Amazon community at Iquitos, Stancil42 (Naval...Medical Research Center Detachment, Peru ) received a grant to optimize strategies for preventing the breeding of Aedes aegypti mosquitoes in...effort to prevent sand flies breeding in rodent burrows, the Genesis Company (Wellington, Colorado) won an award for producing insecticidal baits that

  16. Army Healthcare Enterprise Management System

    National Research Council Canada - National Science Library


    ... to buy the Enterprise Management System. The Information Technology Business Center provides information technology services to Fort Sam Houston tenants which include the Army Medical Command and the Army Medical Department Center and School...

  17. Measuring US Army medical evacuation: Metrics for performance improvement. (United States)

    Galvagno, Samuel M; Mabry, Robert L; Maddry, Joseph; Kharod, Chetan U; Walrath, Benjamin D; Powell, Elizabeth; Shackelford, Stacy


    The US Army medical evacuation (MEDEVAC) community has maintained a reputation for high levels of success in transporting casualties from the point of injury to definitive care. This work served as a demonstration project to advance a model of quality assurance surveillance and medical direction for prehospital MEDEVAC providers within the Joint Trauma System. A retrospective interrupted time series analysis using prospectively collected data was performed as a process improvement project. Records were reviewed during two distinct periods: 2009 and 2014 to 2015. MEDEVAC records were matched to outcomes data available in the Department of Defense Trauma Registry. Abstracted deidentified data were reviewed for specific outcomes, procedures, and processes of care. Descriptive statistics were applied as appropriate. A total of 1,008 patients were included in this study. Nine quality assurance metrics were assessed. These metrics were: airway management, management of hypoxemia, compliance with a blood transfusion protocol, interventions for hypotensive patients, quality of battlefield analgesia, temperature measurement and interventions, proportion of traumatic brain injury (TBI) patients with hypoxemia and/or hypotension, proportion of traumatic brain injury patients with an appropriate assessment, and proportion of missing data. Overall survival in the subset of patients with outcomes data available in the Department of Defense Trauma Registry was 97.5%. The data analyzed for this study suggest overall high compliance with established tactical combat casualty care guidelines. In the present study, nearly 7% of patients had at least one documented oxygen saturation of less than 90%, and 13% of these patients had no documentation of any intervention for hypoxemia, indicating a need for training focus on airway management for hypoxemia. Advances in battlefield analgesia continued to evolve over the period when data for this study was collected. Given the inherent high

  18. [On the role of army physicians in the creation of Ukrainian medical terminology]. (United States)

    Radysh, Ia F; Holyk, L A


    Tha article is devoted to the analysis of the role army surgeons had in creation of Ukrainean medical terminology. In the article, medical dictionaries are briefly analyzed, of which Ukrainean army surgeons are authors or co-authors.

  19. The 1991 Department of the Army Service Response Force exercise: Procedural Guide SRFX-91

    Energy Technology Data Exchange (ETDEWEB)

    Madore, M.A.; Thomson, R.S.; Haffenden, R.A.; Baldwin, T.E.; Meleski, S.A.


    This procedural guide was written to assist the US Army in planning for a chemical emergency exercise at Tooele Army Depot in Utah. The roles of various members of the emergency response community are described for various accident scenarios, and the relationships between the various responders are identified. For the June 1991 exercise at Tooele, the emergency response community includes the command structure at Tooele Army Depot; the US Army Service Response Force and other Department of Defense agencies; emergency response personnel from Tooele, Salt Lake, and Utah counties and municipal governments; the Utah Comprehensive Emergency Management Agency and other state agencies; and various federal agencies.

  20. United States Army Medical Department Journal. Leadership in the Army Medical Department, October - December 2009 (United States)


    growth following the gap is the grandchildren of the baby boomers known as generation Y , or millennial . The rise in the birth rate is noticeable in...M. Healthy design. Lancet. 2004;364:405-406. 13. Urich RS, Zimring CM, Zhu X, Dubose J, Seo H, Choi Y , et al. A review of the literature on...origin or background, from Latin ethnicus (nation, people). Religion \\ri-’li-J3n\\ a personal set or institutionalized system of attitudes, beliefs, and

  1. A Pilot Project Demonstrating that Combat Medics Can Safely Administer Parenteral Medications in the Emergency Department. (United States)

    Schauer, Steven G; Cunningham, Cord W; Fisher, Andrew D; DeLorenzo, Robert A


    Introduction Select units in the military have improved combat medic training by integrating their functions into routine clinical care activities with measurable improvements in battlefield care. This level of integration is currently limited to special operations units. It is unknown if regular Army units and combat medics can emulate these successes. The goal of this project was to determine whether US Army combat medics can be integrated into routine emergency department (ED) clinical care, specifically medication administration. Project Design This was a quality assurance project that monitored training of combat medics to administer parenteral medications and to ensure patient safety. Combat medics were provided training that included direct supervision during medication administration. Once proficiency was demonstrated, combat medics would prepare the medications under direct supervision, followed by indirect supervision during administration. As part of the quality assurance and safety processes, combat medics were required to document all medication administrations, supervising provider, and unexpected adverse events. Additional quality assurance follow-up occurred via complete chart review by the project lead. Data During the project period, the combat medics administered the following medications: ketamine (n=13), morphine (n=8), ketorolac (n=7), fentanyl (n=5), ondansetron (n=4), and other (n=6). No adverse events or patient safety events were reported by the combat medics or discovered during the quality assurance process. In this limited case series, combat medics safely administered parenteral medications under indirect provider supervision. Future research is needed to further develop this training model for both the military and civilian setting. Schauer SG , Cunningham C W, Fisher AD , DeLorenzo RA . A pilot project demonstrating that combat medics can safely administer parenteral medications in the emergency department. Prehosp Disaster Med. 2017;32(6):679-681.

  2. Asthma Medication Ratio Predicts Emergency Depart... (United States)

    U.S. Department of Health & Human Services — According to findings reported in Asthma Medication Ratio Predicts Emergency Department Visits and Hospitalizations in Children with Asthma, published in Volume 3,...

  3. The evolution of dependent medical care in the U.S. Army. (United States)

    Herold, Thomas J S


    There is great focus within the military medical community regarding the ever growing cost of medical care overall and dependent care specifically. A great deal of discussion relates to the delivery of care through a growing military-civilian partnership, where an increased amount of health care will be referred to an ever growing network of civilian providers. The U.S. military establishment now stands at an important crossroad leading into the future of dependent care. However, the special concerns, which arise from the responsibility of caring for military dependents, are not a solely recent phenomenon. Ever since the establishment of a permanent standing U.S. Army in the late 1700s, there have been families in need of medical treatment. Although changes occurred continuously, the development and evolution of policies regulating the delivery of medical care to dependants can be divided into three periods. The first is the longest and ranges from the establishment of the Army until the year 1900. The second period spans from 1900 to the post-Korean War year of 1956. The third and final period is from 1956 to 1975. Special changes and advances in each of these periods have served to shape the face of dependent care in today's Army Medical Department.


    CERN Multimedia

    Service Médical


    Following an idea from SUVA (The Swiss National Fund for Accidents), from the first September 2000 the CERN Medical Service is organising a campaign of displays and information on the handling of loads. Please come and visit us at one of these points of information that will be situated at various points around the two CERN sites (buildings 57, 100, 119, 194, 867, 904).

  5. Clinical Investigation Program (Tripler Army Medical Center) (United States)


    8217 I have learned an immense amount during this last year. Clinicians have no idea of the real world of medical research, finance, and politics. We (I...91. 10 Pfanner TP, Person DA, Berenberg JL, Lockett LJ: Eosinophilia Myalgia Syndrome: A Case Report and One Year Follow-Up. American College of ...protocol as yet. This is a non therapeutic study designed to gather epidemiologic and late effects data on long term (>Syrs) survivors of Wilms’ tumor

  6. 77 FR 59021 - License Amendment Request for the U.S. Department of the Army, National Ground Intelligence... (United States)


    ... the U.S. Department of the Army, National Ground Intelligence Center, Charlottesville, VA AGENCY... held by the U.S. Department of the Army, National Ground Intelligence Center (the licensee), for..., Maryland 20852. FOR FURTHER INFORMATION CONTACT: Dennis Lawyer, Health Physicist, Commercial and R&D Branch...

  7. The Central Simulation Committee (CSC): a model for centralization and standardization of simulation-based medical education in the U.S. Army healthcare system. (United States)

    Deering, Shad; Sawyer, Taylor; Mikita, Jeffrey; Maurer, Douglas; Roth, Bernard J


    In this report, we describe the organizational framework, operations and current status of the Central Simulation Committee (CSC). The CSC was established in 2007 with the goals of standardizing simulation-based training in Army graduate medical education programs, assisting in redeployment training of physicians returning from war, and improving patient safety within the Army Medical Department. Presently, the CSC oversees 10 Simulation Centers, controls over 21,000 sq ft of simulation center space, and provides specialty-specific training in 14 medical specialties. In the past 2 years, CSC Simulation Centers have trained over 50,000 Army medical students, residents, physician assistants, nurses, Soldiers and DoD civilian medical personnel. We hope this report provides simulation educators within the military, and our civilian simulation colleagues, with insight into the workings of our organization and provides an example of centralized support and oversight of simulation-based medical education.

  8. Proceedings of the AMEDD (Army Medical Department) Clinical Psychology Short Course: Military Applications of Neuropsychology and Health Psychology Held in Presidio of San Francisco, California on 9-13 March 1987. Volume 1 (United States)


    syndrome. Medical Clinics of North America, 70, 708-719. Barnes, Deborah (1986) Grim projections for AIDS epidemic. Science, 232, 1589- 1590 . Bennett, J. A...65_ 96-97. Redfield, R. R., Wright, D. C. & Tramount, E. C. (1986) The Walter Reed staging classification for IfrLV-IIt/LAV Infection. The New England ... women with blood and cardiovascular findings. Circulation, 24, 1173-1184. Sackett, D., Taylor, D., Haynes, R., Johnson, A., Gibson, E., & Roberts, R

  9. 1986 AMEDD (Army Medical Department) Clinical Psychology Short Course: Tripler Army Medical Center, Honolulu, Hawaii. (United States)


    system in which it operates. Beginning with Ferdinand de Saussure (1857-1914) and his published lectures entitled, Course in General Linguistics ( important contribution was made to the study of language and human communication. Saussure introduced the idea that the study of one language (alone...and by itself) without reference to other language or languages was, indeed, a worthy occupation for a language scientist. Saussure built upon the

  10. Unwarranted Variation in the Medical Management of Injured Civilian Workers in the U.S. Army Medical Command

    National Research Council Canada - National Science Library

    Rice, William A


    ... submitted from each Army medical treatment facility (MTF). Using hierarchical multiple linear regression, these variables were tested as potential predictors of the average total cost per case of an injured civilian employee in each MTF...

  11. Cost-Benefit Analysis of Radiation Therapy Services at Tripler Army Medical Center

    National Research Council Canada - National Science Library

    Diehl, Diane S


    The purpose of this analysis was to examine the costs and benefits associated with continuance of "in-house" radiation therapy services to eligible beneficiaries at Tripler Army Medical Center (TAMC...

  12. Modelling Cooperative Work at a Medical Department

    DEFF Research Database (Denmark)

    Christensen, Lars Rune; Hildebrandt, Thomas


    Based on ethnographic fieldwork, and the modelling of work processes at a medical department, this paper considers some of the opportunities and challenges involved in working with models in a complex work setting. The paper introduces a flexible modelling tool to CSCW, called the DCR Portal......, and considers how it may be used to model complex work settings collaboratively. Further, the paper discusses how models created with the DCR portal may potentially play a key role in making a cooperative work ensemble appreciate, discuss and coordinate key interdependencies inherent to their cooperative work...

  13. Army Combat Medic Resilience: The Process of Forging Loyalty. (United States)

    Abraham, Preetha A; Russell, Dale W; Huffman, Sarah; Deuster, Patricia; Gibbons, Susanne W


    This study presents a grounded theory analysis of in-depth interviews of United States Army Combat Medics (CMs) who had served in Iraq and/or Afghanistan. The study explores how 17 CMs nominated by their peers as resilient cope with military stressors in order to identify the factors that enable them to thrive amidst harsh conditions. Four distinct categories of characteristics unique to this group emerged: (1) social bonding, (2) readiness, (3) dual loyalty as performance, and (4) leader by example. Forging loyalty underpins these characteristics and represents the main process used by resilient CMs and comprised three behavior patterns: (1) commitment to the family, (2) commitment to the military mission, and (3) commitment to their guiding religious and spiritual beliefs. Prominent behavioral tendencies of forging loyalty likely developed during childhood and re-enforced by families, friends, and other role models. Based on the findings, new training and education efforts should focus on developing positive emotional, environmental, and social resources to enhance the health and well-being of service members and their families.

  14. Radiology in World War II (Medical Department, United States Army) (United States)


    efornied each wvorkinog dav. bv a roil utie dlevelopied lo1 expiediite till(- elir . t8 ii~ap .11id ~iieiui’iie~hiiloi’ij~i were. facil itated by thle...ETOUSA. The officer sent to the European theater as Chief of Redeployment, a pharmacist by training, made arbitrary decisions on matters in which he was...lgt44 f.4t. wL*r ithi1l14’iI that lo4,keli tiks, pilorlen e-xuldite bill thant wals found14 ote il411’ uti r After f1’,lebidelo’ilt. I cavit v 1II4

  15. United States Army Medical Department Journal, January-March 2010 (United States)


    uti - lization of government-owned inventions by licensing inventions to the private sector. Licensing of federally owned inventions and other...physical therapists, podiatrists, optometrists, clinical dieticians, social workers, clinical pharmacists , clinical psychologists, occupational

  16. The United States Army Medical Department Journal. October - December 2010 (United States)


    sciences and biomedical information. As such, the Journal’s articles are readily accessible to researchers and scholars throughout the global ...and training.” However, realizing this vision in today’s highly interactive, information- saturated, and global environment is tougher than ever...assignment reminders, and learning aids. According to the eLearning Guild, over 30 percent of organizations surveyed currently deliver some amount of

  17. A Study to Develop an Army Medical Department Wellness Program (United States)


    attitude--a feeling of "let it happen.ൖ Other tech- niques for managing stress through relaxation exercises include prayer, meditation , yoga, autogenic ...exercise. B. Biofeedback. C. Relaxation techniques. D. Autogenic training. E. Transcendental meditation . III. Third Hour of Instruction - Physiological

  18. The United States Army Medical Department Journal, January - March 2009 (United States)


    discovered while an assessor is in the food establishment, so the assessor should remain flexible, observant, and receptive . While assessing a Kuwait had an acceptable facility which included a designated veterinary trailer with a storage area, as well as a treatment room/laboratory...Veterinary Corps officer.7ŕ𔃽" Although historically inaccurate, the 1963 movie entitled "Miracle of the White Stallions" was loosely based on

  19. Quality of Care Indicators in the AMEDD (Army Medical Department) (United States)


    answered 4. Total consultations requested 5. Total complications 6. Total nosocomial infections 7. Total cases treated with transfusion Number of...Medicaid and Maternal and Child 2 . Health Programs" (Denlo, 1983). Although primarily intended as a cost contain- ment program, through their review...Houston, Texas. 54. Infection Report, Information Reporting System SERVI-SHARE, Des Moines, IA, 1981. ,o. 4’. I *1o 4., -, i1 55. Institute for the Study

  20. The United States Army Medical Department Journal. October - December 2012 (United States)


    designer drugs.4 Spice is used as an alternative to marijuana because of the similarity of their “high” effects. Depending on the synthetic compound in...Poison Control Centers (bath salts data, synthetic marijuana data);, accessed June 11...A review of herbal marijuana 1. alternatives (K2, spice), synthetic cathinones (bath salts), kratom, Salvia divinorum, methoxetamine, and pipera

  1. The United States Army Medical Department Journal. July - September 2011 (United States)


    wide.3 Ships of the US Maritime Prepositioning Force regularly anchor at Saipan,4 and there are US military training sites on the island. It is a... ankle sprains) and overuse (eg, anterior knee pain, medial tibial stress syndrome, and plantar fasciitis), accounted for over 4.8 million of the...patients with PFPS. Gastrocnemius and soleus muscle flexibility are important to ankle joint range of motion. Using ankle dorsiflexion as a measure for

  2. US Army Medical Department Journal, October-December 2008 (United States)


    teeth, large caries burdens, and unrelenting periodontal disease are endemic. The overwhelming need for comprehensive dental care makes the... disease -nonbattle injury rate in the history of land warfare. This is largely a result of the preventive medicine and veterinary medicine teams...contingency operating bases. The Corps Commander established a force protection dog program that allows units to acquire a dog for the express purpose of

  3. US Army Medical Department Journal, April - June 2007 (United States)


    decline of the population A, of avian influenza . to smaller, more One of the numerous damaged buildings at Forward manageable populations. Operating...mostly nonbattle injuries, place the largest Acinetobacter infections, leishmaniasis, and zoonotic burden on our military healthcare system, in garrison...Nile virus fever or Lyme disease, which operates in sewers, swamps, and backyards under the involve animal reservoirs. It is probably accurate to

  4. Crucible of fire: the Boer War and the birth of the Canadian Army Medical Corps. (United States)

    McCulloch, I


    Although Canada's military physicians didn't come to prominence until WW I and WW II, the Canadian Army Medical Corps (CAMC), the forerunner of the Royal Canadian Army Medical Corps and the current Canadian Forces Medical Service, actually had its origins in the Boer War. During that turn-of-the-century conflict, field hospitals accompanied Canadian troops to South Africa. Ian McCulloch discusses that early type of medical service and the steps that led to the creation of the CAMC. Images p1495-a p1496-a PMID:7585380

  5. Priorities for a 21st-century defense: aligning u.s. Army environmental science and engineering officer resources with the department of defense strategic guidance. (United States)

    Licina, Derek; Rufolo, Dennis; Story, Mike


    The recently published Department of Defense (DoD) strategic guidance highlights the need to ?shape a joint force for the future.? Supporting requirements to shape the joint force while the overall DoD force structure is reduced will be challenging. Fortunately, based on its unique training and experience, the Army Environmental Science and Engineering Officer (ESEO) profession is positioned today to fill anticipated joint public health requirements. Obtaining the U.S. Army Medical Department (AMEDD) approval to meet these requirements will have near-term consequences for the ESEO profession as some existing (albeit antiquated) authorizations may go unfilled. However, long-term dividends for the Medical Service Corps (MSC), AMEDD, Army, and DoD will be achieved by realigning critical resources to future joint and interagency requirements. Assigning ESEOs now to organizations such as the Theater Special Operations Commands (TSOCs), U.S. Agency for International Development (USAID), and the North Atlantic Treaty Organization (NATO) with perceived and real joint force health protection/public health requirements through unique means will ensure our profession remains relevant today and supports the joint force of tomorrow. 2013.

  6. [Formation and development of military-medical service of Terek Cossak Army in XIX--beginning XX c]. (United States)

    Akhmadov, T Z


    The article is dedicated to one nor enough investigated question of medical supplement of irregular Cossak army in North Caucasus in XIX--beginning XX c. The role of the government and cossaks in formation and development of medical service in Terek Cossak Army is showed. Characteristic pecularities of health care of mountain population after administrative development of the district by Tsar Russia. The author underlined that despite the disadvantages, medical service of Terek Cossak Army and Terek district in described period was right developing system of medical care for irregular army and population.

  7. African-American Medical Personnel in the US Army in the First World War. (United States)

    Marble, Sanders


    In WWI, the United States was segregated by custom and law, and the Army obeyed the laws, reducing opportunities for Black medical professionals to serve their country in uniform. This article surveys African-American medical personnel serving in the US Army in World War I. It includes physicians, dentists, veterinarians, and other commissioned officers, as well as medical enlisted men. Overall, despite segregation and associated professional limitations, determined individuals still served with distinction in a variety of roles, opening doors for future advances. Published by Elsevier Inc.

  8. Charges Assessed the Army by the Defense Logistics Agency for Deployable Medical Systems

    National Research Council Canada - National Science Library


    .... Deployable medical systems are standardized modular field hospitals that can be prepositioned in the event of a contingency, national emergency, or war operations. In FY 1994, the Defense Personnel Support Center billed the Army $25 million for acquiring and assembling deployable medical systems.

  9. Medical records department and balanced scorecard approach. (United States)

    Ajami, Sima; Ebadsichani, Afsaneh; Tofighi, Shahram; Tavakoli, Nahid


    The Medical Records Department (MRD) is an important source for evaluating and planning of healthcare services; therefore, hospital managers should improve their performance not only in the short-term but also in the long-term plans. The Balanced Scorecard (BSC) is a tool in the management system that enables organizations to correct operational functions and provides feedback around both the internal processes and the external outcomes, in order to improve strategic performance and outcomes continuously. The main goal of this study was to assess the MRD performance with BSC approach in a hospital. This research was an analytical cross-sectional study in which data was collected by questionnaires, forms and observation. The population was the staff of the MRD in a hospital in Najafabad, Isfahan, Iran. To analyze data, first, objectives of the MRD, according to the mission and perspectives of the hospital, were redefined and, second, indicators were measured. Subsequently, findings from the performance were compared with the expected score. In order to achieve the final target, the programs, activities, and plans were reformed. The MRD was successful in absorbing customer satisfaction. From a customer perspective, score in customer satisfaction of admission and statistics sections were 82% and 83%, respectively. The comprehensive nature of the strategy map makes the MRD especially useful as a consensus building and communication tool in the hospital.

  10. Nuclear Medical Science Officers: Army Health Physicists Serving and Defending Their Country Around the Globe (United States)

    Melanson, Mark; Bosley, William; Santiago, Jodi; Hamilton, Daniel


    Tracing their distinguished history back to the Manhattan Project that developed the world's first atomic bomb, the Nuclear Medical Science Officers are the Army's experts on radiation and its health effects. Serving around the globe, these commissioned Army officers serve as military health physicists that ensure the protection of Soldiers and those they defend against all sources of radiation, military and civilian. This poster will highlight the various roles and responsibilities that Nuclear Medical Science Officers fill in defense of the Nation. Areas where these officers serve include medical health physics, deployment health physics, homeland defense, emergency response, radiation dosimetry, radiation research and training, along with support to the Army's corporate radiation safety program and international collaborations. The poster will also share some of the unique military sources of radiation such as depleted uranium, which is used as an anti-armor munition and in armor plating because of its unique metallurgic properties. )

  11. Administration: Army Congressional Fellowship Program

    National Research Council Canada - National Science Library


    This printing publishes a new Army Regulation. This regulation presents the policies and procedures under which the Army manages the Army Congressional Fellowship Program and supplements applicable Department...

  12. Medical students' unique experience of army leadership training: a qualitative study. (United States)

    Earis, John; Garner, J; Haddock, D; Jenkins, J; Jha, V


    To assess the interactive experience of first year medical students attending the leadership and management course hosted by a British Army Reserve Field Hospital developed in partnership with Liverpool University. 244 students submitted a 1000-word structured reflective learning assignment about their reaction to, learning from and any behaviour and attitude changes as a result of, the training. The assignments were thematically analysed to identify how aspects of the training had impacted upon the students' understanding of leadership and teamwork. Their comments relating to the army were analysed to gain insight into their views and experience of the training. Students were surprised at how enjoyable and useful they found the course. Initially they expressed scepticism about what they could learn in an army-based environment. However, the training, particularly command and planning tasks, helped them appreciate and understand the different skills individuals can bring to a team environment, and the importance of everyone contributing. While some students were challenged by aspects of the course, with support and encouragement from team-mates and the army personnel, they learned they could achieve more together. Teaching leadership and management skills to medical students is a challenge which can be effectively addressed by adapting and developing army training resources. Students overcame initial scepticism about participating, and learned a lot about themselves and each other. In addition, the army developed a better understanding of the doctors of the future. The expertise of the army in delivering this training was crucial to its success as the medical school could not have provided this experience unsupported. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  13. Review of U.S. Army Aviation Accident Reports: Prevalence of Environmental Stressors and Medical Conditions (United States)


    terminology related to an aforementioned stressor or medical condition. Table 1 presents the identified operational stressor with the keywords extracted...USAARL Report No. 2018-02 Review of U.S. Army Aviation Accident Reports: Prevalence of Environmental Stressors and Medical Conditions By Kathryn...Environmental Stressors and Medical Conditions N/A N/A N/A N/A N/A N/A Feltman, Kathryn A. Kelley, Amanda M. Curry, Ian P. Boudreaux, David A. Milam

  14. Psychology departments in medical schools: there's one in Canada, eh? (United States)

    McIlwraith, Robert D


    Comments on the original article by Robiner et al. (see record 2014-07939-001) regarding psychologists in medical schools and academic medical center settings. Robiner et al. reported that their extensive review "revealed no independent departments of psychology in U.S. medical schools." The current authors note north of the border in Canada there is one department of psychology in a medical school. The Department of Clinical Health Psychology has been a department within the Faculty of Medicine of the University of Manitoba since 1995. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  15. Business Case Analysis of the Walter Reed Army Medical Center Medical/Surgical Prime Vendor Generation III Service Level Electron Program

    National Research Council Canada - National Science Library

    Markot, Peter B


    ...) staffing and medical/surgical services offered under the Prime Vendor (PV) Generation III contract would provide the best supply chain management solution for Walter Reed Army Medical Center (WRAMC...

  16. Analysis of the experience in participation of army medical service in medical arrangement in case of radiation accident

    International Nuclear Information System (INIS)

    Zhilyaev, E.G.; Goncharov, S.F.; Vorontsov, I.V.; Legeza, V.I.; Berzin, I.A.


    The paper presented calculations of manpower and money funds for rendering aid to the injured persons in case of radiation accident. The authors offered a scheme of using medical anti-radial aids on various stages of radiation accident; immediately after the accident in case of non-predicted and controlled radiation exposure. Army Medical Service is capable of solving promptly the tasks of medical aid with the help of highly mobile specialized medical units, the use of which is stipulated in the system of the Russian Service of disaster medicine. 10 refs.; 1 tab

  17. Quantitative Analysis of Contributing Factors Affecting Patient Satisfaction in Family Medicine Service Clinics at Brooke Army Medical Center (United States)


    Predictors of patient satisfaction for Brooke Army Medical Center Family Medicine Service primary care clinics was performed. Data was obtained from...Factors Affecting Patient Satisfaction in Family Medicine Service Clinics at Brooke Army Medical Center Presented to MAJ Eric Schmacker, Ph.D. All patients ’ medical information was protected at all times and under no circumstances will be discussed or released to any outside agency

  18. The Culture of General Palliative Nursing Care in Medical Departments

    DEFF Research Database (Denmark)

    Bergenholtz, Heidi; Jarlbæk, Lene; Hølge-Hazelton, Bibi


    in medical departments. Methods: An ethnographic study, using Spradley's 12-step method, with observational field studies and interviews with nurses from three medical departments in a Danish regional hospital. Findings: Three cultural themes emerged from the analysis, focusing on the setting, the practice...... and the nurses' reflections on GPNC: (1) GPNC provided in a treatment setting, (2) transition to loving care and the licence to perform palliative care (PC) and (3) potential for team improvement. Conclusions: GPNC as a culture in medical departments seemed to be embedded in a setting not suited for dying...

  19. U.S. Army Medical Research Institute of Infectious Diseases (United States)

    ... members from biological threats. Our specialized capabilities include Biosafety Level 3 and Level 4 laboratories, world-class ... for the Department of Defense, we set the standard for identification of biological agents. Our customers in ...

  20. A Study of Civilian Registered Nurse Recruitment at Madigan Army Medical Center, Tacoma, Washington. (United States)


    34 May, 1981, "Nurse, Where Are You?" Judy Armstrong . 5 1nitial Report and Preliminary Recommendations, National Commission on Nursing (September 1981...Interview with Ms. R. Marsh, Staffing Specialist, Force Develop- ment Division, Madigan Army Medical Center, Tacoma, WA (Dec 81) 20Philip Kotler ...Marketing Management. Boston: Allyn and Bacon, Inc., 1980. Kotler , Philip. Marketing for Nonprofit Institutions. Englewood Cliffs, N.D.: Prentice-Hall


    Directory of Open Access Journals (Sweden)

    V. Ya Gelman


    Full Text Available The aim of the study is the analysis of the problems faced by heads and staff of IT departments in medical universities. Methodology and research methods. The methods involve expert estimation, analysis and generalization of practical work experience of IT departments. Results and scientific novelty. The main aspects and specifics of professional activity of IT departments of modern medical schools are designated. The approaches to the definition of the hierarchy of goals in the professional activities of the department, as well as quantitative and qualitative indicators that assess the effectiveness of their achievements are analyzed. The contradictions arising between long-term and short-term goals of the IT department are highlighted. The main challenges which heads of IT departments can deal with in the course of day-to-day management work planning are described. The problems arising in educational, educational-methodical and scientific work of department, in its economic activity, solution of personnel affairs, and aspects of material support are considered. The possible solutions to these problems are proposed. Practical significance. The results of the analysis, proposed approaches and practical recommendations will enable to better organize the work of the IT department in a medical school. The advantage of the proposed approaches consists in their versatility: with some adjustment, they can be used by other departments, regardless of the specifics and the type of educational institution.

  2. Walter Reed Army Medical Center's Internet-based electronic health portal. (United States)

    Abbott, Kevin C; Boocks, Carl E; Sun, Zhengyi; Boal, Thomas R; Poropatich, Ronald K


    Use of the World Wide Web (WWW) and electronic media to facilitate medical care has been the subject of many reports in the popular press. However, few reports have documented the results of implementing electronic health portals for essential medical tasks, such as prescription refills and appointments. At Walter Reed Army Medical Center, "Search & Learn" medical information, Internet-based prescription refills and patient appointments were established in January 2001. A multiphase retrospective analysis was conducted to determine the use of the "Search & Learn" medical information and the relative number of prescription refills and appointments conducted via the WWW compared with conventional methods. From January 2001 to May 2002, there were 34,741 refills and 819 appointments made over the Internet compared with 2,275,112 refills and approximately 500,000 appointments made conventionally. WWW activity accounted for 1.52% of refills and 0.16% of appointments. There was a steady increase in this percentage over the time of the analysis. In April of 2002, the monthly average of online refills had risen to 4.57% and online appointments were at 0.27%. Online refills were projected to account for 10% of all prescriptions in 2 years. The "Search & Learn" medical information portion of our web site received 147,429 unique visits during this same time frame, which was an average of 326 visitors per day. WWW-based methods of conducting essential medical tasks accounted for a small but rapidly increasing percentage of total activity at Walter Reed Army Medical Center. Subsequent phases of analysis will assess demographic and geographic factors and aid in the design of future systems to increase use of the Internet-based systems.

  3. Defining the management role of the department medical director. (United States)

    Brady, T F; Carpenter, C R


    Through analysis of medical and administrative director positions it is possible to identify an organizational structure for medical departments that enhances departmental operations. Possible roles and tasks that describe managerial responsibilities are considered, and a review of the literature identifies options for how these roles or tasks can be shared between medical and nonmedical managers at the departmental level. These options are refined based on interviews with department-level managers at a case study hospital. Three models are then explored: unity of command, shared accountability, and split accountability. The unity of command model is recommended. In this model, the medical director assumes total authority and accountability for departmental operations through some sort of "enfranchisement." A more formal planning process and a review of job descriptions are also recommended.

  4. Medical identity theft in the emergency department: awareness is crucial. (United States)

    Mancini, Michelino


    Medical identity theft in the emergency department (ED) can harm numerous individuals, and many frontline healthcare providers are unaware of this growing concern. The two cases described began as typical ED encounters until red flags were discovered upon validating the patient's identity. Educating all healthcare personnel within and outside the ED regarding the subtle signs of medical identity theft and implementing institutional policies to identify these criminals will discourage further fraudulent behavior.

  5. Medical Identity Theft in the Emergency Department: Awareness is Crucial (United States)

    Mancini, Michelino


    Medical Identity theft in the emergency department (ED) can harm numerous individuals, and many frontline healthcare providers are unaware of this growing concern. The two cases described began as typical ED encounters until red flags were discovered upon validating the patient’s identity. Educating all healthcare personnel within and outside the ED regarding the subtle signs of medical identity theft and implementing institutional policies to identify these criminals will discourage further fraudulent behavior. PMID:25493150

  6. The health of the American slave examined by means of Union Army medical statistics. (United States)

    Freemon, F R


    The health status of the American slave in the 19th century remains unclear despite extensive historical research. Better knowledge of slave health would provide a clearer picture of the life of the slave, a better understanding of the 19th-century medicine, and possibly even clues to the health problems of modern blacks. This article hopes to contribute to the literature by examining another source of data. Slaves entering the Union Army joined an organization with standardized medical care that generated extensive statistical information. Review of these statistics answers questions about the health of young male blacks at the time American slavery ended.

  7. US Army Medical Bioengineering Research and Development Laboratory Annual Progress Report for FY 84. Volume 1 (United States)


    guanidIne nitrate, is biodegraded slowly in surface waters alone and relatively rapidly if present with metabolizable carbon, in which case the compound...Operation." AORN Journal 40 (1984):330. Goethals, Gerald B. "So, You Want to be in Movies ?" Today’s OR Nurse 6 (1984):36-37. Goyal, Sagar M., S.A. Schaub...Development Laboratory MR 8-84 (May 1984). Mitchell, Wayne R. Preliminarx Results of Biodegradation Studies for Guanidine Nitrate. US Army Medical

  8. PACS and its hospital-wide implementation: A case study at the Madigan Army Medical Center

    International Nuclear Information System (INIS)

    Choi, Hyung Sik; Kim, Yong Min; Smith, Donald V.; Bender, Gregory N.


    PACS represents the future of radiology in modern hospitals. Workstations and databases can be developed to substantially increase clinician's productivity, improve diagnostic accuracy, and make a large amount of knowledge and patient information available on-line to the physician. Currently, there are several hospitals in the process of implementing a total PACS system. They include Madigan Army Medical Center (Tacoma, Washington), VA Hospital in Baltimore, and Hammersmith Hospital in London (1). In order to provide the radiologist, the clinicians, and other health personnel in Korea with the general concept of PACS and its up-to-date status report, we describe the MDIS system being implemented in MAMC (Madigan Army Medical Center) which is the first hospital-wide large-scale PACS in the world. The major PACS components in MAMC have been installed since March 1992 and the full system implementation will be completed by summer 1993. The goal of the MDIS system in MAMC is to increase to more than 90% filmless by the end of 1993. In this paper, we discuss the introduction and background of PACS and its potential benefits, the current status of PACS installation in MAMC and the future plan, and the flow of image data and text information in MAMC

  9. Medical Statistics in World War II (Medical Department, United States Army) (United States)


    Glaucoma -.----------------------- .............------------- 1,198 140 438 800 R99 09 Ophthalmoplegls -------------------------.----------------- It0...03111 1.’,a .g. 0." ’.u11 O.121 11.10 (1.21 0.131 5 A.M3i 5.41 6.71 7.46 7.117 Ahm 4,111 11.54 C .31 l .... (i0.111 1.311 -0 1O.O 917 0.04 0.03 11.111...27 lalahmanlumi hkalmmmar) ............................ . . . .24 IIIM ~ ahM *Mnlt.IM &SR OuV. l L

  10. Medical Identity Theft in the Emergency Department: Awareness is Crucial

    Directory of Open Access Journals (Sweden)

    Michelino Mancini


    Full Text Available Medical Identity theft in the emergency department (ED can harm numerous individuals, and many frontline healthcare providers are unaware of this growing concern. The two cases described began as typical ED encounters until red flags were discovered upon validating the patient’s identity. Educating all healthcare personnel within and outside the ED regarding the subtle signs of medical identity theft and implementing institutional policies to identify these criminals will discourage further fraudulent behavior. [West J Emerg Med. 2014;15(7:–0.

  11. A Study to Evaluate the Organization and the Operating Procedures of the Patient Assistance Function at Brooke Army Medical Center, Fort Sam Houston, Texas (United States)


    15 March 1979. 59Interview with Wendy L. Farace , Head Nurse, Obstetrics/Gynecology Clinic, Brooke Army Medical Center, Fort Sam Houston, Texas, 8...6 February 1979. Farace , Wendy L. Head Nurse, Obstetrica/Gynecology Clinic, Brooke Army Medical Center, Fort Sam Houston, Texas. Interview, 8 January

  12. Motivational Profiles of Medical Students of Nepalese Army Institute of Health Sciences. (United States)

    Shrestha, Lochana; Pant, Shambhu Nath


    Students enter the medical study with different types of motives. Given the importance of academic motivation for good academic achievement of the students, the present study was designed to reveal the possible relationship between academic motivation and achievement in medical students. In this cross-sectional study medical students (N=364) of Nepalese Army institute of Health Sciences were participated and classified to different subgroups using intrinsic and controlled motivation scores. Cluster membership was used as an independent variable to assess differences in study strategies and academic performance. Four clusters were obtained: High Intrinsic High Controlled, Low Intrinsic High Controlled, High Intrinsic Low Controlled, and Low Intrinsic Low Controlled. High Intrinsic High Controlled and High Intrinsic Low Controlled profile students constituted 36.1%, 22.6% of the population, respectively. No significant differences were observed as regards to deep strategy and surface strategy between high interest status motivated and high interest-motivated students. However, both of the clusters had significantly deeper, surface strategy and better academic performance than status-motivated and low-motivation clusters (p motivated and interest-motivated medical students were associated with good deep and surface study strategy and good academic performance. Low-motivation and status-motivated students were associated with the least academic performance with less interest learning behaviors. This reflected that motivation is important required component for good learning outcomes for medical students Keywords: Academic performance; controlled motivation; clusters; intrinsic motivation; motivation.

  13. The medical physicist in a nuclear medicine department

    International Nuclear Information System (INIS)

    Trujillo Z, F.E.; Gomez A, E.


    The diagnostic studies and therapeutic treatments carried out in a Nuclear Medicine department make use of radioactive material. For such a reason it becomes necessary to take a strict control in the reception, use and waste that are generated of the typical works inside the department. Also, work related with the quality control of the equipment dedicated to produce images and of those not image formers, need to carry out to guarantee its maximum performance; as well as quality of the diagnostic and of the therapy imparted in patients. Additionally its are needed to make originated works of the individual procedures to patient and of the acquisition of radioactive materials and removal of the waste or radioactive contaminations. Presently work the recommendations of the American College of Radiology (ACR), the European Federation of Organizations for Medical Physics (EFOMP) and of the Mexican Official Standards relating to the functions that should be observed in a Nuclear Medicine Department are exposed. The ACR and the EFOMP, conclude in their recommendations that the medical physicist fulfills with the suitable profile and likewise they describe in detail the actions and functions that he should supervise, to carry out, to document and to inform. (Author)

  14. Critical Drivers for Safety Culture: Examining Department of Energy and U.S. Army Operational Experiences - 12382

    Energy Technology Data Exchange (ETDEWEB)

    Lowes, Elizabeth A. [The S.M. Stoller Corporation, Broomfield, Colorado (United States)


    Evaluating operational incidents can provide a window into the drivers most critical to establishing and maintaining a strong safety culture, thereby minimizing the potential project risk associated with safety incidents. By examining U.S. Department of Energy (DOE) versus U.S. Army drivers in terms of regulatory and contract requirements, programs implemented to address the requirements, and example case studies of operational events, a view of the elements most critical to making a positive influence on safety culture is presented. Four case studies are used in this evaluation; two from DOE and two from U.S. Army experiences. Although the standards guiding operations at these facilities are different, there are many similarities in the level of hazards, as well as the causes and the potential consequences of the events presented. Two of the incidents examined, one from a DOE operation and the other from a U.S. Army facility, resulted in workers receiving chemical burns. The remaining two incidents are similar in that significant conduct of operations failures occurred resulting in high-level radioactive waste (in the case of the DOE facility) or chemical agent (in the case of the Army facility) being transferred outside of engineering controls. A review of the investigation reports for all four events indicates the primary causes to be failures in work planning leading to ineffective hazard evaluation and control, lack of procedure adherence, and most importantly, lack of management oversight to effectively reinforce expectations for safe work planning and execution. DOE and Army safety programs are similar, and although there are some differences in contractual requirements, the expectations for safe performance are essentially the same. This analysis concludes that instilling a positive safety culture comes down to management leadership and engagement to (1) cultivate an environment that values a questioning attitude and (2) continually reinforce expectations

  15. [Medical manuscripts in the library of the Deontology Department of the Ankara University Medical School]. (United States)

    Arda, B


    At every academical platform on medical history and its instruction, lack of Turkish medical historiography is mainly emphasized. There are two main factors determining the situation: 1-There isn't any comprehensive Turkish medical history textbook. 2-There are difficulties in reaching the primary sources in this field. Everybody agrees with the importance of reaching medical manuscripts easily and reading and evaluating them in medical history. For this reason, it is important to know where we can find them. In this article, medical manuscripts which are available in the library of the Deontology Department of Ankara University Medical School are introduced. The manuscripts have been listed in alphabetical order of the authors' name. The bibliographic items, such as the size, writing style, and type of paper used, are mentioned.

  16. Changes in Temporary Disability Reporting Following the Implementation of the Army Medical Readiness Transformation. (United States)

    Sapp, Jason E; Cody, Matthew J; Douglas, Kevin M


    In November 2014, the U.S. Army held a readiness summit to address concerns about the accuracy of medical reporting systems. At the time, soldiers on temporary disability were tracked as a medical readiness classification (MRC) 3A or 3B. MRC 3A soldiers had a medical condition with recovery expected within 30 d and MRC 3B soldiers were expected to take longer than 30 d to recover. Both groups were considered "non-available" and presumably non-deployable. Starting June 1, 2016, with the implementation of the Army Medical Readiness Transformation, soldiers on temporary disability longer than 14 d began to be reported as MRC 3s and are considered "non-deployable." The purpose of this study is to compare the number of soldiers on temporary disability previously reported as MRC 3A and 3B to the number listed as MRC 3 under the new reporting system for a light infantry brigade and to quantify the types and relative percentage of medical conditions leading to temporary disability under the new system. This cross-sectional analysis was conducted between January 1 and December 31, 2016 at Fort Carson, Colorado and included all soldiers assigned to Second Brigade, Fourth Infantry Division. We calculated the average number and proportion of soldiers on temporary disability at any one time for the period prior to implementation of the new reporting system (January 1 through May 31, 2016) and compared this to the period after implementation on June 1, 2016. The difference between the two independent proportions was calculated along with the lower and upper limits of the 95% confidence interval for the difference. Between January 1 and May 31, 2016, the average number of soldiers on temporary disability at any one time was 186, accounting for 4.3% of the authorized unit strength. After June 1, 2016, the average number increased to 244 or 5.7%. The difference in the proportion of temporary profiles was 1.4% (95% confidence interval 0.43-2.3%). From June 1 through December 31

  17. Behavioral Sciences in a Changing Army: Proceedings of Army Medical Department (AMEDD) Behavioral Sciences Seminar, 19-23 March 1979 held at Fitzsimons Army Medical Center, Aurora, Colorado, (United States)


    t’. rip , t.4 I . ’ ,’ i .. , I.\\t tj b I 4:.’J~ 41 4. fl it. 14 j. J~tlj I’ I I i LO he 44.44(1 t. I 4148 t A I I t. 1 I . .. .. f. ’ X84 tltit d4,V...Ianers clhoulcl maiic II, r tra ru nq and a+ tetlouiiee at UClHtipi~ :lponlI.J; Sdk vi 1. l ! Cii~kr-iiUS oenef ci -or,-y m;ould u,- rout lins] v curl ...parents with less than 3 years’ service. This will be expanded to include all enlisted sole parents. 137 p( 2. Reenlistment Control: AR 601-280 permits a

  18. 77 FR 57112 - Notice of Inventory Completion: U.S. Department of Defense, Army, Fort Sill Museum, Lawton, OK (United States)


    ... Landmark and Museum, U.S. Army Fires Center of Excellence, Fort Sill, OK 73503, telephone (580) 442-6570... trapping, 3 metal rings, 2 metal rivets, 17 metal nails, 53 metal bracelets, 1 metal pail, 1,500 glass... A. Neel, Director, Fort Sill National Historic Landmark and Museum, U.S. Army Fires Center of...

  19. A 12-month descriptive analysis of emergency intubations at Brooke Army Medical Center: a National Emergency Airway Registry study. (United States)

    April, Michael D; Schauer, Steven G; Brown Rd, Calvin A; Ng, Patrick C; Fernandez, Jessie; Fantegrossi, Andrea E; Maddry, Joseph K; Summers, Shane; Sessions, Daniel J; Barnwell, Robert M; Antonacci, Mark


    Emergency airway management is a critical skill for military healthcare providers. Our goal was to describe the Emergency Department (ED) intubations at Brooke Army Medical Center (BAMC) over a 12-month period. Physicians performing endotracheal intubations in the BAMC ED complete data collection forms for each intubation event as part of the National Emergency Airway Registry, including patient demographics, intubation techniques, success and failure rates, adverse events, and patient disposition. We cross-referenced these forms against the numbers of intubation events reported in the ED nursing daily reports to ensure capture of all intubations. Providers completed forms for every intubation within 6 weeks of the procedure. We analyzed data from March 28, 2016, to March 27, 2017. During the study period, providers performed 259 intubations in the BAMC ED. Reasons for intubation were related to trauma for 184 patients (71.0%) and medical conditions for 75 patients (29.0%). Overall, first-attempt success was 83.0%. Emergency medicine residents performed a majority of first attempts (95.0%). Most common devices chosen on first attempt were a video laryngoscope for 143 patients (55.2%) and a direct laryngoscope for 115 patients (44.4%). One patient underwent cricothyrotomy. The 2 most common induction agents were ketamine (59.8%; 95% CI, 55.2%-67.4%) and etomidate (19.3%; 95% CI, 14.7%-24.7%). The most common neuromuscular blocking agents were rocuronium (62.9%; 95% CI, 56.7%-68.8%) and succinylcholine (18.9%; 95% CI, 14.3%-24.2%). In the BAMC ED, emergency intubation most commonly occurred for trauma indications using video laryngoscopy with a high first-pass success.

  20. Graphical User Interface for a Remote Medical Monitoring System: U.S. Army Medic Recommendations (United States)


    screens. The majority of medics (70%) also wanted a name lis! screen that, when tapped , would go to an individual patient screen. In the name list...button has been pushed. Tapping on thaI button would prompt the user to enter the password. Tapping on the light button would illuminate the screen...a summary of current local weather conditions would be dis- played in the lower ! eft of the screen. In the lower right of this map screen is

  1. Improving the medical records department processes by lean management. (United States)

    Ajami, Sima; Ketabi, Saeedeh; Sadeghian, Akram; Saghaeinnejad-Isfahani, Sakine


    Lean management is a process improvement technique to identify waste actions and processes to eliminate them. The benefits of Lean for healthcare organizations are that first, the quality of the outcomes in terms of mistakes and errors improves. The second is that the amount of time taken through the whole process significantly improves. The purpose of this paper is to improve the Medical Records Department (MRD) processes at Ayatolah-Kashani Hospital in Isfahan, Iran by utilizing Lean management. This research was applied and an interventional study. The data have been collected by brainstorming, observation, interview, and workflow review. The study population included MRD staff and other expert staff within the hospital who were stakeholders and users of the MRD. The MRD were initially taught the concepts of Lean management and then formed into the MRD Lean team. The team then identified and reviewed the current processes subsequently; they identified wastes and values, and proposed solutions. The findings showed that the MRD units (Archive, Coding, Statistics, and Admission) had 17 current processes, 28 wastes, and 11 values were identified. In addition, they offered 27 comments for eliminating the wastes. The MRD is the critical department for the hospital information system and, therefore, the continuous improvement of its services and processes, through scientific methods such as Lean management, are essential. The study represents one of the few attempts trying to eliminate wastes in the MRD.

  2. Medical audit on asthma in an emergency department. (United States)

    Linares, T; Campos, A; Torres, M; Reyes, J


    To determine the management of acute bronchial asthma in an adult emergency department. A retrospective medical audit of 46 consecutive adult patients with acute asthma exacerbations was performed. We collected information from 48 episodes of acute asthma over a 5-month period. Using classical audit methodology, four indicators were examined: severity evaluation, diagnostic tests, specific treatment, and discharge treatment plans. The least recorded severity indicators were respiratory rate (27 %), heart rate (50 %) and peak expiratory flow (20 %). Heart and respiratory auscultation were recorded in all patients and oxygen saturation was recorded in 93 %. Laboratory blood test and chest radiograph were performed in all patients. Arterial blood gas was tested in 57 %, electrocardiography in 17 %, and coagulation in 39 %. No treatment was provided in 12 % of patients. Bronchodilator medications were administered in all treated patients and oxygen was prescribed in 60 %. Systemic corticosteroids (methylprednisolone or hydrocortisone) were administered in 80 % of treated patients. Seventeen percent of patients were discharged from hospital with no change to their usual treatment. The following weak points were identified: 1) Severity assessment is inadequate, 2) use of diagnostic tests is excessive, 3) patients discharged to home with no treatment plan. Opportunities for improvement consisted of: 1) greater availability of peak expiratory flow meters, 2) individualized use of diagnostic tests, and 3) management protocols.

  3. A Statistical Analysis of the Relationship of Distance and Mode of Transportation on Length of Stay at Brooke Army Medical Center

    National Research Council Canada - National Science Library

    Hagen, John


    .... Transportation Command's (TRANSCOM) aeromedical evacuation system, to determine their influence on length of hospital stay at Brooke Army Medical Center in FY 1996 in order to better understand the irnpact these patients have on utilization management...

  4. 75 FR 65028 - Notice of Intent To Repatriate Cultural Items: U.S. Department of Defense, Army Corps of... (United States)


    ... unassociated funerary objects are 32 projectile points, 25 projectile point fragments, 30 blades, 52 blade... the Cascade Range and the lower reaches of the Yakima River drainage. Officials of the U.S. Army Corps...

  5. Baseline Assessment of the Department of the Army Cost Estimating and Analysis (CE/A) and Cost Management (CM) Capabilities

    National Research Council Canada - National Science Library

    Doyle, Michael C


    .../A) and cost management (CM) capabilities. In particular, it supports the Deputy Assistant Secretary of the Army- Cost AND Economics' mission to provide DA with cost, performance and economic analysis in the form of expertise, models, data...

  6. The United States Army Medical Department Journal. The United States Army Dental Corps: A Century of Commitment, Service, and Care (United States)


    previously treated 888 18.27 Necrotic pulp 618 12.72 Periaradicular abscess 578 11.89 Anatomic space infection 558 11.48 Other 505 10.39...Bleeding 931 42.92 Other 747 34.44 Necrotizing Ulcerative Gingivitis 420 19.36 Ailing/Failing Implant 36 1.66 Periodontal Abscess 25 1.15 Anatomic...increased risk of coronary heart disease, stroke, pulmonary embolism, and breast cancer.15 Postmenopausal women with history of hysterectomy taking

  7. Emergency department overcrowding: Quality improvement in a Taiwan Medical Center. (United States)

    Hsu, Chen-Mei; Liang, Li-Lin; Chang, Yun-Te; Juang, Wang-Chuan


    Overcrowding of hospital emergency departments (ED) is a worldwide health problem. The Taiwan Joint Commission on Hospital Accreditation has stressed the importance of finding solutions to overcrowding, including, reducing the number of patients with >48 h stay in the ED. Moreover, the Ministry of Health and Welfare aims at transferring non-critical patients to district or regional hospitals. We report the results of our Quality Improvement Project (QIP) on ED overcrowding, especially focusing on reducing length of stay (LOS) in ED. For QIP, the following 3 action plans were initiated: 1) Changing the choice architecture of patients' willingness to transfer from opt-in to opt-out; 2) increasing the turnover rate of beds and daily monitoring of the number of free beds for boarding ED patients; 3) reevaluation of patients with a LOS of >32 h after the morning shift. Transfer rates increased minimally after implementation of this project, but the sample size was too small to achieve statistical significance. No significant increase was observed in the number of free medical beds, but discharge rates after 12 pm decreased significantly (p 32 h were reevaluated first. After QIP, the proportion of LOSs of >48 h dropped significantly. Changing the choice architecture may require further systemic effort and a longer observation duration. Higher-level administrators will need to formulate a more comprehensive bed management plan to speed up the turnover rate of free inpatient beds. Copyright © 2018. Published by Elsevier B.V.

  8. Medication Review and Patient Outcomes in an Orthopedic Department

    DEFF Research Database (Denmark)

    Lisby, Marianne; Bonnerup, Dorthe Krogsgaard; Brock, Birgitte


    OBJECTIVE: We investigated the health-related effect of systematic medication review performed by a clinical pharmacist and a clinical pharmacologist on nonelective elderly orthopedic patients. METHODS: This is a nonblinded randomized controlled study of 108 patients 65 years or older treated...... with at least 4 drugs. For the intervention, the clinical pharmacist reviewed the participants' medication after completion of the usual medication routine. Information was collected from medical charts, interviews with participants, and database registrations of drug purchase. Results were conferred...

  9. Median and ulnar neuropathies in U.S. Army Medical Command Band members. (United States)

    Shaffer, Scott W; Koreerat, Nicholas R; Gordon, Lindsay B; Santillo, Douglas R; Moore, Josef H; Greathouse, David G


    Musicians have been reported as having a high prevalence of upper-extremity musculoskeletal disorders, including carpal tunnel syndrome. The purpose of this study was to determine the presence of median and ulnar neuropathies in U.S. Army Medical Command (MEDCOM) Band members at Fort Sam Houston, Texas. Thirty-five MEDCOM Band members (30 males, 5 females) volunteered to participate. There were 33 right-handed musicians, and the mean length of time in the MEDCOM Band was 12.2 yrs (range, 1-30 yrs). Subjects completed a history form, were interviewed, and underwent a physical examination of the cervical spine and bilateral upper extremities. Nerve conduction studies of the bilateral median and ulnar nerves were performed. Electrophysiological variables served as the reference standard for median and ulnar neuropathy and included distal sensory latencies, distal motor latencies, amplitudes, conduction velocities, and comparison study latencies. Ten of the 35 subjects (29%) presented with abnormal electrophysiologic values suggestive of an upper extremity mononeuropathy. Nine of the subjects had abnormal median nerve electrophysiologic values at or distal to the wrist; 2 had bilateral abnormal values. One had an abnormal ulnar nerve electrophysiologic assessment at the elbow. Nine of these 10 subjects had clinical examination findings consistent with the electrophysiological findings. The prevalence of mononeuropathies in this sample of band members is similar to that found in previous research involving civilian musicians (20-36%) and far exceeds that reported in the general population. Prospective research investigating screening, examination items, and injury prevention measures in musicians appears to be warranted.

  10. [Medical service of Russian Army in the First World War 1914-1918 (to the 95th anniversary of the beginning of war)]. (United States)

    Korniushko, I G; Gladkikh, P F; Loktev, A E


    During the First World War 1914-1918 Russian Army hadn't a united medical service, military-medical affair was diluted in multiple governances. Evacuation of wounded and ill persons was an affair of Evacuation Governance of Main Governance the General Staff. Process of treatment in field and stationary medical formations was administered by sanitarium chiefs of armies and theaters of operation, bureaucrats of Russian Red Cross Society, Russian Union of Cities and Territorial Union. Supply by medical property, accounting and arrangement of medical staff was administered by Main Military-Sanitarium Governance, supply by sanitarium-household property--by Main Indent Governance, health resort affair--by Governance of Supreme chief of sanitarium and evacuation part in Empire of prince Ol'denburgskiy P.A. On the base of different sources were characterized casualty of Russian Army during the war.

  11. Evaluation and comparison of medical records department of Iran university of medical sciences teaching hospitals and medical records department of Kermanshah university of medical sciences teaching hospitals according to the international standards ISO 9001-2000 in 2008

    Directory of Open Access Journals (Sweden)

    maryam ahmadi


    Conclusion: The rate of final conformity of medical records system by the criteria of the ISO 9001-2000 standards in hospitals related to Iran university of medical sciences was greater than in hospitals related to Kermanshah university of medical sciences. And total conformity rate of medical records system in Kermanshah hospitals was low. So the regulation of medical records department with ISO quality management standards can help to elevate its quality.

  12. Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) (United States)

    Department of Veterans Affairs — Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) is a health care benefit program designed for the dependents of certain Veterans....

  13. Department of Neurosurgery, Madurai Medical College and the development of neurosurgery in South Tamil Nadu. (United States)

    Thiruppathy, Subbiah; Manimaran, Ramiah; Niban, Gopalakrishnan M; Muthukumar, Natarajan


    The development of neurosurgery in South Tamil Nadu can be traced to the Department of Neurosurgery, Madurai Medical College and Government Rajaji Hospital, Madurai, Tamil Nadu, India. The hospital was established in the year 1940 and Madurai Medical College was started in 1954. Prof. M. Natarajan founded this department in September, 1963. This department has a Neurosurgery Residency Program that is 50 years old. The establishment of this department and its growth to its present stature is documented here.

  14. The United States Army Medical Department Journal. October-December 2007 (United States)


    understanding of the concepts of emotional intelligence researched and championed by Daniel Goleman and his associates for the past several decades hold...Agincourt EMOTIONAL INTELLIGENCE – INTRODUCTION READING: Goleman D. What makes a leader? Harv Bus Rev. 2004;82(1):82-91. VIDEO: Gettysburg, Scenes: 8...10; Prisoner delivery/Used by idiots/What we’re fighting for (New Line Cinema, 1993). EMOTIONAL INTELLIGENCE – STYLES OF LEADERSHIP I READING: Goleman

  15. Department of Clinical Investigation, Annual Research Progress Report, Fiscal Year 2007 (Madigan Army Medical Center) (United States)


    the Elderly Perry JT #206038 T L Venous Distensibility Index as a Predictor of Radiocephalic Arteriovenous Fistula Maturation Perry JT...specific aims: (1) to increase our understanding of the frequency and severity of pain problems in youth with spina bifida (SB), muscular dystrophy...Subgroups of youth with spina bifida (30), cerebral palsy (57), and muscular disorders (20) in the study from other sites have been identified and

  16. Hand Surgery In World War II. Medical Department, United States Army, (United States)


    Few of these patients presented deep cicatrices , latent infection was minimal, and as a rule the position of function was maintained. DEBARKATION...HOSPITAL 217 Many patients were received with large dorsal cicatrices which, although healed, were unstable. Joints and tendons not directly injured by...burns were frequently damaged by constriction and immobility because of superimposed cicatrices . Joint stiffness was likely to be even more pronounced

  17. Blood Program in World War II. Medical Department, United States Army (United States)


    phase of which was the supply of p asma for the Armed Forces. At the suggestion of Col. (later Brig. Gen.) Charles C. Hillman, MC, Chief, Professional...American Red Cross and the National Foundation for Infantile Paralysis at the cost of processing. THE KOREAN WAR 785 RED BLOOD CELLS During the Korean...after, 725 262-263 National Formulary, 377 Multiple injections of- National Foundation for Infantile Paralysis, blood substitutes, 373 784 bovine

  18. The United States Army Medical Department Journal, July-September 2009 (United States)


    including Escherichia coli O157:H7, Salmonella enteritidis, Yersinia pseudotuberculosis, Helicobactor pylori, Vibrio cholerae , and rotavirus,3-11 as shown...of houseflies (Musca domestica) in the transmission of Vibrio cholerae in India. Acta Tropica. 2001;78:31-34. 11. Tan SW, Yap KL, Lee HL. Mechanical...northeastern Mexico . J Am Mosq Control Assoc. 2001;17(2):93-97. 22. Cohnstaedt LW, Gillen JI, Munstermann LE. Light- emitting diode technology improves

  19. U.S. Army Medical Department Journal, July-September 2007 (United States)


    Korea. In addition, classes have included Air Force Public Health Officers and a civilian involved in quality assurance at a meat processing facility...does not account for a variety of inhibitory ingredients (eg, fat, sodium chloride, sodium nitrite , liquid smoke) or inhibitory processing conditions...would have to be developed using meats containing representative amounts of salt, nitrite , and/or other inhibitory compounds. Other researchers have

  20. MEDBASE: Strategic Planning and Implementation of an Army Medical Department Software Application (United States)


    downtime procedures) Software/ hardware performance testing Contingency plans Celebration / people management Risk Zone 4 Planning for upgrades...goal to “Crush Adidas !” and Honda’s goal in 1970 to “destroy Yamaha!”. MEDBASE: Strategy and Implementation 57 (3) Role Model BHAGs suit up-and...Crush Adidas ! (Nike, 1960s) Yamaha so tsubusu! We will destroy Yamaha! (Honda, 1970s) Role-Model BHAGs suit up-and-coming organizations Become the

  1. Department of Clinical Investigation, Annual Research Progress Report, Fiscal Year 2006 (Madigan Army Medical Center) (United States)


    O’Boyle AL, Valley MT, Bland DR, Kahn MA, Schaffer JI. Prevalence of Severe Pelvic Organ Prolapse in Relation to Job Description and Socioeconomic...ProLab Glutamine® to a sports beverage or utilizing a sports beverage such as Growling Dog Replacement Drink®, both widely available for purchase...form. Technical Approach: A standard postpartum hemorrhage simulation has been designed using the NOELLE mannequin and the new uterine hemorrhage

  2. U.S. Army Medical Department Journal, July-September 2007

    National Research Council Canada - National Science Library

    Aldridge, Don; Aquino, Janet


    ...: Surgical Treatment for the Military Working Dog, A Clinical Trial of Ivermectin Against Eyeworms in German Shepherd Military Working Dogs, Using Predictive Microbiology to Evaluate Risk and Reduce...

  3. Medical Department, United States Army. Wound Ballistics for World War II. (United States)


    Similarly, there were elliptic entry wounds, a result of the " keyholing " effect of bullets hitting with their sides. Table 2 gives a description of small...interlocked welded steel, and their turrets were constructed in one piece in order to give sufficient rigidity. The King Tiger was virtually invulnerable...Reed N. Fitch, T4g. Charles J. Berzenyi, and TIg . Charles R. Restife. The team was organized to participate in the contemplated New Ireland operation

  4. Medical Department, United States Army. Surgery in World War 2. Neurosurgery. Volume 2 (United States)


    extension, without respect for such anatonlic barriers as fascia , peri- osteuni, or the serosal mnenmbranes or the capsules of viscera. T[ie appearance...NEUROSURGERY a bilateral atypical plantar response was obtained in complete lesions, in the form of a delayed, weak, slow, vermicular type of plantar ...wound after closure of the dura, and closure was effected in layers. Because this was a re- opened wound, a slip drain was left beneath the fascia for

  5. U.S. Army Medical Department Journal, July-September 2006 (United States)


    climate, which necessary to transform vision into reality and to emphasizes that racism , sexism , and prejudice are achieve the desired end result. lie...every 5 NBI Soldiers were being seen for eitherankle or knee injury. This rapid increase was the Based on statistical evidence,’ the physicians on the ...based on the work of Carl Jung and his theory of Murray and Johnson, using the Myers-Briggs, studied psychological types.10 female Naval Academy

  6. The United States Army Medical Department Journal. July-September 2010 (United States)


    wide range of dedicated healthcare professionals who collaborate time and again to advance the state-of-the- art of care for our Warriors who...2010. 5. Bsisu MS. The Arab Table. New York, NY: HarperCollins; 2005. 6. Zubaida S, Tapper R, eds. A Taste of Thyme: Culinary Cultures of the

  7. The United States Army Medical Department Journal. October-December 2011 (United States)


    left side of the shield are the 13 stripes of the American Flag. The green staff is the staff of Asclepius (according to Greek mythology , the first...endures but change. When the Greek philosopher Heraclitus penned that contemplation some 2,500 years ago, he undoubtedly had no concept of its

  8. Improving the Emergency Department's Processes of Coding and Billing at Brooke Army Medical Center

    National Research Council Canada - National Science Library

    Lehning, Peter


    .... Beginning in October 2002, outpatient itemized billing was mandated for use in the AMEDD. This system shifted the process of billing for outpatient services from an allinclusive rate to one based on the actual care provided...

  9. The United States Army Medical Department Journal. April-June 2010 (United States)


    against civilians residing in the United States). On the other hand, it is evident that terrorists are willing to both kill their countrymen and to...would have killed most men. By 1836 he was clearly in decline, but his reputation and force of personality were still such that most of the Alamo’s...War. New York, NY: Putnam; 1971:131-170. 26. James M. The Raven. Atlanta, GA: Mockingbird Books, Inc;1977:31. 27. Prucha FP. The Sword of the

  10. The United States Army Medical Department Journal. July-September 2012 (United States)


    efforts have been conducted in endemic countries (Mexico, Guatemala, Brazil, and Peru ) in Central and South America. Surveillance techniques in...Parsippany, NJ Simple Green Concentrate, Sunshine Makers Inc,  Huntington Beach , CA Pine Sol Concentrate (active ingredient 8.7% pine  oil), The...High levels of ambient particulate matter and burn pit smoke can irritate the eyes and respiratory passages at the time of exposure. Air pollution

  11. U.S. Army Medical Department Journal (October-December 2006) (United States)


    Force 115 Med in Iraq. The RTS-Med staff provided a building adjacent to the hospital for the Task Force Tactical Operations Center ( TOC ). Personnel from...the McCoy Directorate of Information Management laid more phone lines and computer network cable into the building. Through this effort the TOC improve their understanding of health issues. For example, an epidemiological study of sexually transmitted diseases (STD) at Fort Bragg, North

  12. U.S. Army Medical Department Journal, July-September 2007

    National Research Council Canada - National Science Library

    Aldridge, Don; Aquino, Janet


    ...: Past, Present, and Future, The Impact of Leishmaniasis on Military Working Dogs with Mediterranean Basin Exposure, The Hidden Work of a Laboratory Animal Veterinarian, Challenges in Biodefense...

  13. The United States Army Medical Department Journal. Force Health Protection April - June 2009 (United States)


    that may significantly increase long-term health risks (eg cancer ) through appropriate command channels.I<p6) Likewise, Joint Chiefs of Staff...Control with Glyphosate . Dover, DE: Delaware Division of Fish and Wildlife; 1984. AUTHORS CPT Rufolo is a project officer, Environmental Health

  14. U.S. Army Medical Department Journal, January-March 2006 (United States)


    Caries Detection z MAJ Jerry Carbone, DC, USA, et al Prosthodontic Rehabilitation of a Patient with Amelogenesis Imperfecta: 41 A Clinical Report LTC...Rehabilitation of a having) posterior restorations you’ll enjoy LTC Patient with Amelogenesis Inpecta: A Clinical Nicholas Coppola’s "A Policy...Prosthodontic Rehabilitation of a Patient with Amelogenesis Imperfecta: A Clinical Report LTC Minaxi I. Patel, DC, USA LTC David A. Mott, DC, USA COL

  15. Measuring the efficiency of dental departments in medical centers: a nonparametric analysis approach. (United States)

    Wang, Su-Chen; Tsai, Chi-Cheng; Huang, Shun-Te; Hong, Yu-Jue


    Data envelopment analysis (DEA), a cross-sectional study design based on secondary data analysis, was used to evaluate the relative operational efficiency of 16 dental departments in medical centers in Taiwan in 1999. The results indicated that 68.7% of all dental departments in medical centers had poor performance in terms of overall efficiency and scale efficiency. All relatively efficient dental departments were in private medical centers. Half of these dental departments were unable to fully utilize available medical resources. 75.0% of public medical centers did not take full advantage of medical resources at their disposal. In the returns to scale, 56.3% of dental departments in medical centers exhibited increasing returns to scale, due to the insufficient scale influencing overall hospital operational efficiency. Public medical centers accounted for 77.8% of the institutions affected. The scale of dental departments in private medical centers was more appropriate than those in public medical centers. In the sensitivity analysis, the numbers of residents, interns, and published papers were used to assess teaching and research. Greater emphasis on teaching and research in medical centers has a large effect on the relative inefficiency of hospital operation. Dental departments in private medical centers had a higher mean overall efficiency score than those in public medical centers, and the overall efficiency of dental departments in non-university hospitals was greater than those in university hospitals. There was no information to evaluate the long-term efficiency of each dental department in all hospitals. A different combination of input and output variables, using common multipliers for efficiency value measurements in DEA, may help establish different pioneering dental departments in hospitals.

  16. Unified Medical Command and Control in the Department of Defense (United States)


    This is the Joint Task Force – Capital Medical (JTF CAPMED ) model, in which organizations, resources, and personnel are aligned under a single...This was demonstrated in the formation of the JTF- CAPMED , designed as a 3-star level command controlling military medical activities in the National...used ground vehicles, helicopters and fixed wing aircraft for strategic casualty evacuation (CASEVAC). Enroute care is standard and critical in

  17. Sleep practices among medical students in Pediatrics Department of ...

    African Journals Online (AJOL)

    Background: Medical students are a population who are at great risk of having bad sleep practice and hygiene due to demanding clinical and academic activities. Poor sleep practices are a disturbing and destabilizing phenomenon. It affects many people and can affect the quality of work, performance and education of ...

  18. Development of an electronic medical report delivery system to 3G GSM mobile (cellular) phones for a medical imaging department. (United States)

    Lim, Eugene Y; Lee, Chiang; Cai, Weidong; Feng, Dagan; Fulham, Michael


    Medical practice is characterized by a high degree of heterogeneity in collaborative and cooperative patient care. Fast and effective communication between medical practitioners can improve patient care. In medical imaging, the fast delivery of medical reports to referring medical practitioners is a major component of cooperative patient care. Recently, mobile phones have been actively deployed in telemedicine applications. The mobile phone is an ideal medium to achieve faster delivery of reports to the referring medical practitioners. In this study, we developed an electronic medical report delivery system from a medical imaging department to the mobile phones of the referring doctors. The system extracts a text summary of medical report and a screen capture of diagnostic medical image in JPEG format, which are transmitted to 3G GSM mobile phones.

  19. Medical prescription adherence among patient visiting gynecology department

    International Nuclear Information System (INIS)

    Rafique, M.; Arshad, H.; Tabassum, H.; Khan, N. U. S.; Qamar, K.


    Objective: The aim of this study was to explore the level of Medical prescription adherence among gynecological patients of Pakistan. Study Design: Cross-sectional study. Place and Duration of Study: The study was conducted in Punjab province and data were collected from June 2015 to April 2016. Material and Methods: This cross-sectional study was carried out in main cities of Punjab province of Pakistan; Lahore, Gujranwala, Faisalabad and Sheikhupura. The survey data was collected from different location of cities. Patients visiting the gynecological and going to chemists for getting the prescribed medicine were selected through probability based random sampling for this study. The questionnaire consisted on the extent to which they adhere to time, dose, frequency and procedure prescribed from their doctors. The questions were asked in native language (Urdu). The data analysis was performed by using SPSS software (Ver.21). Results: Results of this study, based on sample from four big cities of Punjab province of Pakistan, showed that the level of medical prescription was associated with the age, qualification and background of the patients. Adherence level of patients reporting with rural background was observed higher than the adherence level of patients from urban areas. Conclusion: Over all the patient require counseling regarding adherence to medical prescription irrespective of the nature of the disease. (author)

  20. U.S. Army Medical Command Injury Summary, Active Duty Personnel, 2014 (United States)


    Michelle Canham-Chervak 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Army...Public Health Center (Provisional), Aberdeen Proving Ground, Maryland 21010-5403 8. PERFORMING ORGANIZATION REPORT NUMBER S.0023116-16 9. SPONSORING... softball bases (Pollack et al., 2005) • Mouthguards for football, basketball (Knapik et al., 2007) • Protective eyewear (Cass, 2012; Goldstein and Wee

  1. Chernobyl: response of medical physics departments in the United Kingdom

    Energy Technology Data Exchange (ETDEWEB)

    Haywood, J K


    This conference drew attention to gaps in United Kingdom arrangements for dealing with the effects (both supposed and real) of accidents at civil nuclear installations on the populations which surround them; it showed how, in the case of the Chernobyl accident, Medical Physicists in the National Health Service responded to plug these gaps in spite of the organisational difficulties which the crisis presented; and it suggested a method of incorporating this hitherto underestimated resource into national planning for civil nuclear accidents. Reports are included from Newcastle, Charing Cross Hospital, The London Hospital, Cambridge, Westminster Hospital, Leeds, Liverpool, Cardiff, Canterbury, Swansea (environmental measurements) and Mount Vernon.

  2. 77 FR 50089 - Army Education Advisory Committee Meeting (United States)


    ... DEPARTMENT OF DEFENSE Department of the Army Army Education Advisory Committee Meeting AGENCY... the Army announces the following committee meeting: Name of Committee: Army Education Advisory... learning environment. The agenda will include topics relating to Army Learning Model 2015 and support to...

  3. 77 FR 11084 - Army Education Advisory Committee Meeting (United States)


    ... DEPARTMENT OF DEFENSE Department of the Army Army Education Advisory Committee Meeting AGENCY... the Army announces the following committee meeting: Name of Committee: Army Education Advisory... Army 2020 learning environment. The agenda will include topics relating Arm Learning Model 2015 and to...

  4. 78 FR 33074 - Army Science Board Summer Study Session (United States)


    ...--This study evaluates what science and technology competencies the Army must maintain and/or develop as... DEPARTMENT OF DEFENSE Department of the Army Army Science Board Summer Study Session AGENCY... the Army announces the following committee meeting: 1. Name of Committee: Army Science Board (ASB). 2...

  5. Pathology and Laboratory Medicine Support for the American Expeditionary Forces by the US Army Medical Corps During World War I. (United States)

    Wright, James R; Baskin, Leland B


    Historical research on pathology and laboratory medicine services in World War I has been limited. In the Spanish American War, these efforts were primarily focused on tropical diseases. World War I problems that could be addressed by pathology and laboratory medicine were strikingly different because of the new field of clinical pathology. Geographic differences, changing war tactics, and trench warfare created new issues. To describe the scope of pathology and laboratory medicine services in World War I and the value these services brought to the war effort. Available primary and secondary sources related to American Expeditionary Forces' laboratory services were analyzed and contrasted with the British and German approaches. The United States entered the war in April 1917. Colonel Joseph Siler, MD, a career medical officer, was the director, and Colonel Louis B. Wilson, MD, head of pathology at the Mayo Clinic, was appointed assistant director of the US Army Medical Corps Division of Laboratories and Infectious Disease, based in Dijon, France. During the next year, they organized 300 efficient laboratories to support the American Expeditionary Forces. Autopsies were performed to better understand treatment of battlefield injuries, effects of chemical warfare agents, and the influenza pandemic; autopsies also generated teaching specimens for the US Army Medical Museum. Bacteriology services focused on communicable diseases. Laboratory testing for social diseases was very aggressive. Significant advances in blood transfusion techniques, which allowed brief blood storage, occurred during the war but were not primarily overseen by laboratory services. Both Siler and Wilson received Distinguished Service Medals. Wilson's vision for military pathology services helped transform American civilian laboratory services in the 1920s.

  6. Study of the calibration of the medical physics department - radon dosimeter in a radon facility

    International Nuclear Information System (INIS)

    Nikololpoulos, D.; Louizi, A.; Papadimitriou, D.; Proukakis, C.


    Several techniques have been developed to measure radon indoors.The use of a Solid State Nuclear Track Detector closed in a cup, has turned out to be the most appropriate for long term measurements. The Medical Physics Department of the Athens University is carrying out radon measurements in dwellings, apartments, outdoor air and mines since 1996. For this purpose a simple device, the so called Medical Physics Department radon dosimeter, has been constructed, which measures the radon concentration averaged over a long period of time. In the present paper the calibration technique introduced and the results of the calibration of the Medical Physics Department. (authors)

  7. [Department of Otorhinolaryngology of the I.P. Pavlov Saint-Peterburg First State Medical University]. (United States)

    Karpishchenko, S A

    This article is designed to report the results of the analysis ofacademic, scientific, and clinical activities of the Department of Otorhinolaryngology of the I.P. Pavlov Saint-Peterburg First State Medical University.

  8. Evaluating the Coding and Workload Accounting Improvement Initiative of Madigan Army Medical Center

    National Research Council Canada - National Science Library

    Bewley, Lee W; Bender, Brian J


    ... documentation, provider coding accuracy and education, and clinic electronic medical record (AHLTA) usage. The desired end state of the CWAI is improved medical documentation and coding accuracy at MAMC...

  9. Analysis of publications in Medical Journal of Chinese People’s Liberation Army during 2006 to 2010

    Directory of Open Access Journals (Sweden)

    Dong-ping ZHU


    Full Text Available Objective To analyze the characteristics of articles published in the Medical Journal of Chinese People’s Liberation Army(MJCPLA from year 2006 to 2010,so as to provide some beneficial references for further advance of the journal.Methods Each bibliometrics index of MJCPLA during 2006 to 2010 was analyzed with literature metrology.Results A total of 2442 articles were published in 60 issues over 5 years characterizing reasonable column setting,a high proportion,accounting for 43.5%,of fund-supported researches,with coauthor paper accounting for 95.6% and coauthor degree at 5.20.The articles were provided by authors widely distributed from 31 provinces,autonomous regions,mulicipality,and Macao Special Administrative Region,America,Ukraine,German and other overseas areas,implying the author ranks are of tremendous strength,and the readers group is of steady.Conclusion For the high quality of materials being published,the MJCPLA has a claim to one of the most important military medical information sources and an important core journal in medical field.

  10. Challenges and Opportunities: Building a Relationship Between a Department of Biomedical Engineering and a Medical School. (United States)

    George, Steven C; Meyerand, M Elizabeth


    A department of biomedical engineering can significantly enhance the impact of their research and training programs if a productive relationship with a medical school can be established. In order to develop such a relationship, significant hurdles must be overcome. This editorial summarizes some of the major challenges and opportunities for a department of biomedical engineering as they seek to build or enhance a relationship with a medical school. The ideas were formulated by engaging the collective wisdom from the Council of Chairs of the biomedical engineering departments.

  11. Implementing Protocols to Improve Patient Safety in the Medical Imaging Department. (United States)

    Carrizales, Gwen; Clark, Kevin R


    Patient safety is a focal point in healthcare because of recent changes issued by CMS. Hospital reimbursement rates have fallen, and these reimbursement rates are governed by CMS mandates regarding patient safety procedures. Reimbursement changes are reflected in the National Patient Safety Goals (NPSGs) administered annually by The Joint Commission. Medical imaging departments have multiple areas of patient safety concerns including effective handoff communication, proper patient identification, and safe medication/contrast administration. This literature review examines those areas of patient safety within the medical imaging department and reveals the need for continued protocol and policy changes to keep patients safe.

  12. Department

    African Journals Online (AJOL)



    Sep 20, 2016 ... Department of Biological and Environmental Sciences, Kibabii University. Abstract. This study ... Key Words: Climate Change, Regional Circulation Model, PRECIS, Bungoma County ... by different computer models is much.

  13. Characterization of the medical department of pharmaceutical companies operating in Portugal

    Directory of Open Access Journals (Sweden)

    Acílio Gala


    Full Text Available In a context of strong regulatory demands and high economic pressures and constraints, medical departments within pharmaceutical companies, have demonstrated its strategic relevance even though the functions to embrace are not globally consensual. In this context, a study that intended to analyse the management of medical activities, in pharmaceutical companies operating in Portugal, including allocated human resources and investment trends, was implemented. Quantitative information was collected through an electronic survey, in pharmaceutical companies with activity in Portugal. The analysis of the results supported the conclusion that the majority of the companies are affiliates of international companies and that 79% of them have formalized medical departments. The human resources of the medical departments of the participant companies include several professional classes, with predominance of pharmacists. Globally, the number of employees of the medical area has registered a systematic growth in the last years. It was also possible to conclude that the majority of the companies are increasing the investment in medical affairs activities. This study enables the understanding of these activities in pharmaceutical companies operating in Portugal, within the international panorama of pharmaceutical industry. It contributes to improve the knowledge about the relevance of medical departments while enabling the definition of novel pathways to increase the competiveness and sustainability of the companies.

  14. Patients' acceptance of medical photography in a French adult and paediatric dermatology department: a questionnaire survey. (United States)

    Hacard, F; Maruani, A; Delaplace, M; Caille, A; Machet, L; Lorette, G; Samimi, M


    Despite the increasing use of medical photography by dermatologists, no study on patients' perceptions of photography in dermatology has been performed to date. Firstly, to evaluate patients' perceptions of medical photography. Secondly, to assess whether perceptions differed between patients in our adult department and parents accompanying a child in our paediatric department. An opinion survey was conducted at the Hospital of Tours (France) among adult patients (adult department) and accompanying parents (paediatric department) by completion of a questionnaire after any medical photography had been performed. We collected 272 questionnaires regarding 158 adults and 114 children. A camera used only in the department, and storage of the images in the department's records were the most accepted modalities (> 90%), especially in the paediatric survey. Respondents agreed with the sharing of the images with other practitioners and in medical meetings (> 85%) rather than distribution via publications (58·3%), e-mails (45·5%), health magazines (44·3%) and websites (32·0%). Most (78·8%) considered that the consent form should list all the possible uses of the images. Need for renewed consent for each use of the images was significantly more often expressed in the paediatric than the adult survey (44·5% vs. 24·5%, P = 0·001). More than 95% of respondents considered medical photography to be useful for improving diagnosis, monitoring of skin disease and aiding teaching. These findings could be used to improve practice, to increase the acceptability of medical photography and for devising a standardized consent form for medical practitioners performing medical photography. © 2013 The Authors BJD © 2013 British Association of Dermatologists.

  15. Integrating Medical Supply as Part of the Army's Single Integrated Materiel Manager Concept--Why or why Not?

    National Research Council Canada - National Science Library

    Baxter, Shelia


    .... To achieve the goal of seamless logistics integration capabilities, one concept is to establish a Single Integrated Materiel Manager for the Army which envisions integrating all such functions...

  16. Eliciting comprehensive medication histories in the emergency department: the role of the pharmacist.

    Directory of Open Access Journals (Sweden)

    Crook M


    Full Text Available The Australian Pharmaceutical Advisory Committee guidelines call for a detailed medication history to be taken at the first point of admission to hospital. Accurate medication histories are vital in optimising health outcomes and have been shown to reduce mortality rates. This study aimed to examine the accuracy of medication histories taken in the Emergency Department of the Royal Adelaide Hospital. Medication histories recorded by medical staff were compared to those elicited by a pharmacy researcher. The study, conducted over a six-week period, included 100 patients over the age of 70, who took five or more regular medications, had three or more clinical co-morbidities and/or had been discharged from hospital in three months prior to the study. Following patient interviews, the researcher contacted the patient’s pharmacist and GP for confirmation and completion of the medication history. Out of the 1152 medications recorded as being used by the 100 patients, discrepancies were found for 966 medications (83.9%. There were 563 (48.9% complete omissions of medications. The most common discrepancies were incomplete or omitted dosage and frequency information. Discrepancies were mostly medications that treated dermatological and ear, nose and throat disorders but approximately 29% were used to treat cardiovascular disorders. This study provides support for the presence of an Emergency Department pharmacist who can compile a comprehensive and accurate medication history to enhance medication management along the continuum of care. It is recommended that the patient’s community pharmacy and GP be contacted for clarification and confirmation of the medication history.

  17. Energy Survey of Eisenhower Army Medical Center, Fort Gordon, Augusta, Georgia. Volume 2. Appendices

    National Research Council Canada - National Science Library


    ...) including low cost/no cost ECO's and perform complete evaluations of each. Energy equipment replacement projects already underway, approved, or planned by the Medical Center staff will be factored into the evaluations...

  18. Medical Diplomacy in the United States Army: A Concept Whose Time Has Come

    National Research Council Canada - National Science Library

    Krueger, Mary V


    ... to the terrorists who wish to defeat US troops, as well as the Western way of life. Medical diplomacy is a nonlethal tool used in combination with economic and diplomatic efforts to achieve this end...

  19. "An army of reformed drunkards and clergymen": the medicalization of habitual drunkenness, 1857-1910. (United States)

    Chavigny, Katherine A


    Historians have recognized that men with drinking problems were not simply the passive subjects of medical reform and urban social control in Gilded Age and Progressive Era America but also actively shaped the partial medicalization of habitual drunkenness. The role played by evangelical religion in constituting their agency and in the historical process of medicalization has not been adequately explored, however. A post-Civil War evangelical reform culture supported institutions that treated inebriates along voluntary, religious lines and lionized former drunkards who publicly promoted a spiritual cure for habitual drunkenness. This article documents the historical development and characteristic practices of this reform culture, the voluntarist treatment institutions associated with it, and the hostile reaction that developed among medical reformers who sought to treat intemperance as a disease called inebriety. Those physicians' attempts to promote therapeutic coercion for inebriates as medical orthodoxy and to deprive voluntarist institutions of public recognition failed, as did their efforts to characterize reformed drunkards who endorsed voluntary cures as suffering from delusions arising from their disease. Instead, evangelical traditions continued to empower reformed drunkards to publicize their own views on their malady which laid the groundwork for continued public interest in alcoholics' personal narratives in the twentieth century. Meanwhile, institutions that accommodated inebriates' voluntarist preferences proliferated after 1890, marginalizing the medical inebriety movement and its coercive therapeutics. © The Author 2013. Published by Oxford University Press. All rights reserved. For permissions, please e-mail:

  20. 32 CFR 631.14 - Army policy. (United States)


    ... 32 National Defense 4 2010-07-01 2010-07-01 true Army policy. 631.14 Section 631.14 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL...-Installation Operations (Military Patrols and Investigative Activities) and Policy § 631.14 Army policy. (a...

  1. United States Department of Health and Human Services Biodosimetry and radiological/nuclear medical countermeasure programs

    International Nuclear Information System (INIS)

    Homer, Mary J.; Raulli, Robert; Esker, John; Moyer, Brian; Wathen, Lynne; DiCarlo-Cohen, Andrea L.; Maidment, Bert W.; Rios, Carmen; Macchiarini, Francesca; Hrdina, Chad; Prasanna, Pataje G.


    The United States Department of Health and Human Services (HHS) is fully committed to the development of medical countermeasures to address national security threats from chemical, biological, radiological, and nuclear agents. Through the Public Health Emergency Medical Countermeasures Enterprise, HHS has launched and managed a multi-agency, comprehensive effort to develop and operationalize medical countermeasures. Within HHS, development of medical countermeasures includes the National Institutes of Health (NIH), (led by the National Institute of Allergy and Infectious Diseases), the Office of the Assistant Secretary of Preparedness and Response/Biomedical Advanced Research and Development Authority (BARDA); with the Division of Medical Countermeasure Strategy and Requirements, the Centers for Disease Control and Prevention, and the Food and Drug Administration as primary partners in this endeavor. This paper describes various programs and coordinating efforts of BARDA and NIH for the development of medical countermeasures for radiological and nuclear threats. (authors)

  2. A continuous quality improvement project to reduce medication error in the emergency department. (United States)

    Lee, Sara Bc; Lee, Larry Ly; Yeung, Richard Sd; Chan, Jimmy Ts


    Medication errors are a common source of adverse healthcare incidents particularly in the emergency department (ED) that has a number of factors that make it prone to medication errors. This project aims to reduce medication errors and improve the health and economic outcomes of clinical care in Hong Kong ED. In 2009, a task group was formed to identify problems that potentially endanger medication safety and developed strategies to eliminate these problems. Responsible officers were assigned to look after seven error-prone areas. Strategies were proposed, discussed, endorsed and promulgated to eliminate the problems identified. A reduction of medication incidents (MI) from 16 to 6 was achieved before and after the improvement work. This project successfully established a concrete organizational structure to safeguard error-prone areas of medication safety in a sustainable manner.

  3. Medical admissions through the emergency department: Who, how and how long?

    DEFF Research Database (Denmark)

    Arvidsen, Pernille; Pressel, Eckart

    Objectives: The study aims to describe the clinical characteristics of elderly patients admitted to medical wards through the emergency department (ED).Methods: In a first part, we described demographic changes in the uptake area and ED visits of older patients in a 900 bed university hospital...... in Central Copenhagen from 2004-2014.In a second descriptive-retrospective part we studied clinical characteristics of patients >65 years admitted to the medical wards through the ED in January 2014 (n=132). We collected data on medication, comorbidities and admission rates to stationary wards .Results......: The number of ED visits of persons >65 years increased by 28.3% during the study period whereas the number of persons aged ≥65 years in the uptake area remained stable. 21.1 % of the patients admitted to the medical wardswere transferred to the geriatric department. Conclusion: •The growing number of older...

  4. Cough Variant Asthma in Medical Outpatient Department of a Tertiary Care Hospital in Bangladesh


    Rukhsana Parvin; Shekhar Bhattacharjee; Swapna Bhattacharjee


    Background: Cough variant asthma (CVA) is a subset of asthma where the only symptom is chronic persistent cough. Many cases go unrecognized due to lack of proper evaluation. Response to asthma medication with features supportive of airway hypersensitivity helps in management of this disease. Objective: To find out the proportion of cough variant asthma among the patients attending medicine outpatient department of Enam Medical College, Savar, Dhaka. Materials and Methods: This cross sectional...

  5. A Policy Analysis of U.S. Army Professional Filler System (PROFIS) Sourcing Management at the Regional Medical Command Level in Support of an Expeditionary Army at War (United States)


    many personnel had little knowledge or understanding of their wartime units and jobs and met for the very first time when they arrived at the...this handbook useful in teaching an undergraduate introduction to public policy and for executive education groups" (Bardach, 1996, Foreword,). The...FY04 Budget ($M) (includes $76.8 GWOT) D...cM F F A 47% Percent Residency wf, 9.. Ft . TX Ci 0 Programs of Army Total El P-.TX GPk * ft C.- Cb, X PROFIS

  6. A prospective, multicenter study of pharmacist activities resulting in medication error interception in the emergency department. (United States)

    Patanwala, Asad E; Sanders, Arthur B; Thomas, Michael C; Acquisto, Nicole M; Weant, Kyle A; Baker, Stephanie N; Merritt, Erica M; Erstad, Brian L


    The primary objective of this study is to determine the activities of pharmacists that lead to medication error interception in the emergency department (ED). This was a prospective, multicenter cohort study conducted in 4 geographically diverse academic and community EDs in the United States. Each site had clinical pharmacy services. Pharmacists at each site recorded their medication error interceptions for 250 hours of cumulative time when present in the ED (1,000 hours total for all 4 sites). Items recorded included the activities of the pharmacist that led to medication error interception, type of orders, phase of medication use process, and type of error. Independent evaluators reviewed all medication errors. Descriptive analyses were performed for all variables. A total of 16,446 patients presented to the EDs during the study, resulting in 364 confirmed medication error interceptions by pharmacists. The pharmacists' activities that led to medication error interception were as follows: involvement in consultative activities (n=187; 51.4%), review of medication orders (n=127; 34.9%), and other (n=50; 13.7%). The types of orders resulting in medication error interceptions were written or computerized orders (n=198; 54.4%), verbal orders (n=119; 32.7%), and other (n=47; 12.9%). Most medication error interceptions occurred during the prescribing phase of the medication use process (n=300; 82.4%) and the most common type of error was wrong dose (n=161; 44.2%). Pharmacists' review of written or computerized medication orders accounts for only a third of medication error interceptions. Most medication error interceptions occur during consultative activities. Copyright © 2011. Published by Mosby, Inc.

  7. Establishment of the Department of Anaesthesia at Harvard Medical School-1969. (United States)

    Mizrahi, Ilan; Desai, Sukumar P


    The first academic departments of anesthesia were established in the United States at the University of Wisconsin-Madison in 1927, with Ralph M. Waters named as chairman, and in the UK at Oxford University in 1937, with Robert Macintosh as chairman. Compared to these early departments, more than 3 decades would pass before Harvard Medical School decided it was time to establish a department of anaesthesia, in 1969. We examine the forces on both sides of the issue, for and against, and how they played out in the late 1960s. Published articles, books, interviews, and biographical and autobiographical notes as well as primary source documents such as reports of department and medical school committee meetings were examined to obtain information relevant to our investigation. The late 1960s were an ideal time for the chiefs of anesthesia at the various Harvard teaching hospitals to make a strong argument in favor of establishment of an independent department of anaesthesia. Although strongly opposed by Francis Daniels Moore, Chief of Surgery at Peter Bent Brigham Hospital, an independent department at Harvard was established in 1969. The recognition of anesthesia as a distinctive specialty at universities across the country as well as the specific concerns over administration, hiring, and the future of the clinical service in the 1960s provided overwhelming support for the establishment of a separate, free-standing department of anaesthesia at one of the most tradition-bound universities in the United States-Harvard. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Product-line administration: a framework for redefining medical record department services. (United States)

    Postal, S N


    Product-line administration is a viable approach for managing medical records services in an environment that demands high quantity and quality service levels. Product-line administration directs medical record department team members to look outside of the department and seek input from the customers it is intended to serve. The feedback received may be alarming at first, as the current state of products usually reveals a true lack of customer input. As the planning, defining, managing, and marketing phases are implemented, the road will not be easy and rewards will be slow to come. Product-line administration does not provide quick fixes, but it does provide long-term problem resolution as products are refined and new products developed to meet customer needs and expectations. In addition to better meeting the needs of the department's external customers, the department's internal customers' needs and expectations will be addressed. The participative management approach will help nurture each team member's creativity. The team members will have the opportunity to reach their full potential while reaping the rewards and benefits of providing products and services that meet the needs and expectations of all department customers. The future of the health care industry promises more changes as the country moves toward some form of prospective payment in the ambulatory setting. Reactive management and the constant struggle to catch up can no longer be accepted as a management approach. It is imperative that the medical record department be viewed as a business with product lines composed of quality products. The planning, defining, managing, and marketing components of product-line administration afford responsiveness to the current situation and the development of quality products that will ensure that medical record departments are prepared for the future.

  9. [End-of-life in specialized medical pediatrics department: A French national survey]. (United States)

    Ravanello, Alice; Desguerre, Isabelle; Frache, Sandra; Hubert, Philippe; Orbach, Daniel; Aubry, Régis


    In France, most of children die in the hospital. This national survey aimed to achieve better understanding of end-of life care in specialized medical pediatrics departments for children facing the end-of-life, identify the available resources, put forward the difficulties encountered by professionals and describe end-of-life paths of children who died in these departments. This study is based on a nationwide survey conducted among all existing specialized medical pediatrics departments (onco-haematology, neurology, reanimation) in France in 2015. Among 94 specialized medical pediatrics departments in France, 53 participated in our survey (response rate=56%). At the time of the survey, 13% of inpatients were facing the end-of-life. Regarding training, 13% of departments did not have personnel trained in palliative care and 21% did not set up any professional support. However, when taking care of a child's end of life in 2014, 77% of these departments solicited a regional resource team of pediatric palliative care. This survey helps describe 225 end-of-life paths of children decease of a terminal illness in the specialized pediatrics departments. Seventy-two percent suffered from refractory symptoms before their death, 64% were concerned by a terminal sedation and 75% by a limitation of life-sustaining treatment decision. End-of-life care is a reality for specialized pediatrics departments. The frequency of major and refractory symptoms often requires the completion of sedation. The resources of service are acceptable but some deficiencies have been noted especially concerning training and support for caregivers, adaptation of premises or family support. Copyright © 2017. Published by Elsevier SAS.

  10. New methodology to implement quality control programs in medical imaging departments

    International Nuclear Information System (INIS)

    Furquim, Tania A.C.; Yanikian, Denise; Costa, Paulo R.


    The implementation of quality control programmes is studied in order to assure a better performance in medical imaging departments. The necessity of a continuous training of all technicians involved is highlighted. The contribution of these professionals is emphasized as fundamental to the success of the project

  11. Pharmacist advice is accepted more for medical than for surgical patients in an emergency department

    DEFF Research Database (Denmark)

    Backer Mogensen, Christian; Olsen, Inger; Thisted, Anette Rehn


    Pharmacists' advice may reduce medication errors in the emergency department (ED). However, pharmacists' recommendations are of little value if not acknowledged by physicians. The aim of the present study was to analyze how often and which categories of pharmacist recommendations were taken...

  12. A Study of Patient Satisfaction in the Pediatrics Clinic at Water Reed Army Medical Center (United States)


    Coordinated Care Program set forth by the Assistant Secretary of Defense for Health Affairs, Dr. Mendez , (January, 1992): "The Coordinated Care Program...William Walker, MC, Chief, Pediatric Clinic; CPT Kurt Allebach, MS, Administrator, Department of Pediatrics; Ms Carol Tross, Nursing Supervisor...of Defense moves to Coordinated Care with mandatory enrollment ( Mendez , 1992). The impact on this research may be an overestimation of the true level

  13. Annual Progress Report (FY-79) Clinical Investigation Service. Walter Reed Army Medical Center (United States)


    Binaural .Ap’ii2cation for HearLng Impaired 367 Listeners. (T:7-73 SP C) xiv DEPARTMENT OF SURGERY conined Otolaryngology Service conaUmed PAGE 2523 The...GYNECOLOGY 4116 The Evaluation of Fetal Systolic Time Intervals and Beat to Beat 434 Interval Variations in Fetal Heart Rate as Early Indicators of Fetal...Disorders. Schwartz DM, et al. Binaural Hearing Aids: A Paradox. In Bess FH, Amplification in Education On press). Schwartz DM, et al. The Relationship

  14. 78 FR 69077 - Army Education Advisory Subcommittee Meeting Notice (United States)


    ... DEPARTMENT OF DEFENSE Department of the Army Army Education Advisory Subcommittee Meeting Notice... leading to provisional findings will be referred to the Army Education Advisory Committee for deliberation...: ATFL-APO, Monterey, CA 93944, [email protected] , (831) 242-5828. SUPPLEMENTARY INFORMATION...

  15. 77 FR 27209 - Army Education Advisory Subcommittee Meeting Notice (United States)


    ... DEPARTMENT OF DEFENSE Department of the Army Army Education Advisory Subcommittee Meeting Notice...: Board of Visitors, U.S. Army War College Subcommittee. Date of Meeting: May 31, 2012. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command Conference Room, Root Hall, Carlisle...

  16. 77 FR 4026 - Army Education Advisory Subcommittee Meeting Notice (United States)


    ... DEPARTMENT OF DEFENSE Department of the Army Army Education Advisory Subcommittee Meeting Notice... Visitors, U.S. Army War College Subcommittee. Date of Meeting: February 23, 2012. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command Conference Room, Root Hall, Carlisle...

  17. 78 FR 23759 - Army Education Advisory Subcommittee Meeting Notice (United States)


    ... DEPARTMENT OF DEFENSE Department of the Army Army Education Advisory Subcommittee Meeting Notice... Visitors, U.S. Army War College Subcommittee. Dates of Meeting: May 16, 2013. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command Conference Room, Root Hall, Carlisle Barracks...

  18. Commentary: Interim leadership of academic departments at U.S. medical schools. (United States)

    Grigsby, R Kevin; Aber, Robert C; Quillen, David A


    Medical schools and teaching hospitals are experiencing more frequent turnover of department chairs. Loss of a department chair creates instability in the department and may have a negative effect on the organization at large. Interim leadership of academic departments is common, and interim chairs are expected to immediately demonstrate skills and leadership abilities. However, little is known about how persons are prepared to assume the interim chair role. Newer competencies for effective leadership include an understanding of the business of medicine, interpersonal and communication skills, the ability to deal with conflict and solve adaptive challenges, and the ability to build and work on teams. Medical schools and teaching hospitals need assistance to meet the unique training and support needs of persons serving as interim leaders. For example, the Association of American Medical Colleges and individual chair societies can develop programs to allow current chairs to reflect on their present positions and plan for the future. Formal leadership training, mentorship opportunities, and conscientious succession planning are good first steps in preparing to meet the needs of academic departments during transitions in leadership. Also, interim leadership experience may be useful as a means for "opening the door" to underrepresented persons, including women, and increasing the diversity of the leadership team.

  19. Clinical pharmacist evaluation of medication inappropriateness in the emergency department of a teaching hospital in Malta

    Directory of Open Access Journals (Sweden)

    West LM


    Full Text Available Appropriate prescribing remains an important priority in all medical areas of practice. Objective: The objective of this study was to apply a Medication Appropriateness Index (MAI to identify issues of inappropriate prescribing amongst patients admitted from the Emergency Department (ED.Method: This study was carried out at Malta’s general hospital on 125 patients following a two-week pilot period on 10 patients. Patients aged 18 years and over and on medication therapy were included. Medication treatment for inappropriateness was assessed by using the MAI. Under-prescribing was also screened for. Results: Treatment charts of 125 patients, including 697 medications, were assessed using a MAI. Overall, 115 (92% patients had one or more medications with one or more MAI criteria rated as inappropriate, giving a total of 384 (55.1% medications prescribed inappropriately. The mean SD MAI score per drug was 1.78 (SD=2.19. The most common medication classes with appropriateness problems were supplements (20.1%, antibiotics (20.0% and steroids (19.8%. The most common problems involved incorrect directions (26% and incorrect dosages (18.5%. There were 36 omitted medications with untreated indications. Conclusion: There is considerable inappropriate prescribing which could have significant negative effects regarding patient care.

  20. U.S. Army Corps of Engineers and U.S. Department of Energy partnering for cleanup of the 1100 Area, Hanford Site, Washington

    International Nuclear Information System (INIS)

    Johansen, M.; Liias, R.; Chong, R.


    The US Department of Energy's Hanford Site was listed on the National Priorities List (NPL) in July 1989 and was divided and listed as four Sites: the 1100 Area, the 100 Area, the 200 Area, and the 300 Area. Each Area was further divided into sub-units called Operable Units. This paper describes Remedial Investigation and Feasibility Study activities for the 1100 Area leading to the first Record of Decision at the Hanford Site. Key issues included: (1) Definition of future land use; risk assessments and resulting remedial actions depended heavily upon future land use definition because no significant exposure pathways currently exist for the Site, (2) Potential impacts of groundwater contamination to a nearby groundwater well field supplying potable water to Richland, (3) Coordination with an offsite potentially responsible party (PRP) from whose property the groundwater contamination emanated, and (4) The development and determination of precedent setting cleanup requirements and approaches for the entire Hanford Site. The US Army Corps of Engineers, Walla Walla District, performed work leading to the signing of the Record of Decision in September, 1993. The Corps continues to perform investigative, design, and remedial action work at areas of the Site including activities supporting the cleanup and ultimate release of two large portions of the Hanford Site known as the Arid Lands Ecology Reserve (ALE) and the North Slope. These two areas comprise more than half of the total area of the entire Hanford reservation

  1. US Army Medical Materiel development activity, 1987 annual report. Progress report, 1 January-31 December 1987

    Energy Technology Data Exchange (ETDEWEB)

    Pedersen, C.E.


    Information relating to accomplishments in military medicine in three areas is presented. The Project Management Support Division (PMSD) provides centralized administrative, financial management, contracting, and logistical support to the Project Managers and staff. The Biological Systems Project Management Division manages the development and acquisition of biological products to prevent casualties or loss of soldier effectiveness due to disease. These diseases may be naturally acquired (close contact, unsanitary conditions, contaminated environment, biting insects), or delivered deliberately (aerosols). Product Officers exploit domestic and foreign medical technology to remedy deficiencies identified by the Combat Developer and monitor research projects for their application to disease protective measures. The Pharmaceutical Systems Project Management Division centrally manages the development and the initial production of pharmaceutical products (antidotes and drugs), related drug delivery systems (autoinjectors and transdermal patches), and decontamination products. These products are fielded as preventive, protective, and therapeutic modalities for use against chemical and biological warfare threats, certain endemic diseases, and the treatment of combat casualties. The Applied Medical Systems Project Management Division is a multidisciplinary team with broad mission responsibilities to centrally manage the development and initial production of applied medical products, related diagnostic equipment, optical corrective devices for protective masks, and pesticide delivery systems.

  2. Practice on medical support in dealing with abandoned chemical weapons by Japanese army in China

    Directory of Open Access Journals (Sweden)

    Liu LIU


    Full Text Available Japanese abandoned chemical weapons (JACWs are a momentous and eventful historical issue for both China and Japan. Large quantities of chemical weapons abandoned by the Japanese invaders still remain on Chinese soil after 1945 when Japanese invaders were defeated and surrendered. Up to date, JACWs have been found in 19 provinces (cities or districts of mainland China. The types of JACWs include chemical bombs, chemical aerial bombs, gas cylinders and loose packed barrels. The types of toxic agents include mustard gas, irritant agents, choking agents, systemic poisoning agents and etc. In order to eliminate JACWs to reduce injuries produced by toxic agents, Chinese government, in cooperation with Japanese government, organized a special troop to search, excavate, retrieve, and destroy JACWs. Up to date, about 50,000 pieces of poisonous chemical had retrieved and destroyed. The first operation was officially begun in Nanjing in October 2010. The main points of medical support on the operation of destroying JACWs include proper treatment of the newly discovered patients caused by JACWs, preparedness for handling the emergency medical rescue, and to actively provide routine medical support for JACWs operation field.

  3. [Anniversary of the medical department of the Federal Office for Safe Storage and Destruction of Chemical Weapons]. (United States)

    Kuz'menko, I E


    The article is devoted to the process of formation and development of CW destruction management system and medical support of professional activities of personnel. Founders of Medical department of the Federal Directorate for Safe Storage and Destruction of Chemical Weapons are presented. Main principles and ways of working of medical department in specific conditions are covered.

  4. A comparison of medical litigation filed against obstetrics and gynecology, internal medicine, and surgery departments. (United States)

    Hamasaki, Tomoko; Hagihara, Akihito


    The aim of this study was to review the typical factors related to physician's liability in obstetrics and gynecology departments, as compared to those in internal medicine and surgery, regarding a breach of the duty to explain. This study involved analyzing 366 medical litigation case reports from 1990 through 2008 where the duty to explain was disputed. We examined relationships between patients, physicians, variables related to physician's explanations, and physician's breach of the duty to explain by comparing mean values and percentages in obstetrics and gynecology, internal medicine, and surgical departments with the t-test and χ(2) test. When we compared the reasons for decisions in cases where the patient won, we found that the percentage of cases in which the patient's claim was recognized was the highest for both physician negligence, including errors of judgment and procedural mistakes, and breach of the duty to explain, in obstetrics and gynecology departments; breach of the duty to explain alone in internal medicine departments; and mistakes in medical procedures alone in surgical departments (p = 0.008). When comparing patients, the rate of death was significantly higher than that of other outcomes in precedents where a breach of the duty to explain was acknowledged (p = 0.046). The proportion of cases involving obstetrics and gynecology departments, in which care was claimed to be substandard at the time of treatment, and that were not argued as breach of a duty to explain, was significantly higher than those of other evaluated departments (p duty to explain had been breached when seeking patient approval (or not) was significantly higher than in other departments (p = 0.002). It is important for physicians working in obstetrics and gynecology departments to carefully explain the risk of death associated with any planned procedure, and to obtain genuinely informed patient consent.

  5. Adoption of medication alert systems in hospital outpatient departments in Taiwan. (United States)

    Kuo, Yu-Chun; Cheng, Shou-Hsia


    The adoption of medication alert systems in the health care sector varies among regions. In Taiwan, the health authority introduced policies in 2005 to encourage the adoption of medication alert systems in hospitals. This study aimed to understand the adoption of medication alert systems in the outpatient departments of hospitals in Taiwan using a nationwide survey. A questionnaire was developed and mailed to 380 accredited general hospitals in Taiwan in 2013. The information collected from the questionnaire concerning the outpatient department included (1) the time of adoption of a medication alert system; (2) the operation of individual alert functions: availability, management, and stability; and (3) hospital characteristics: accreditation level, teaching status, ownership, and number of beds. A total of 216 hospitals completed and returned the questionnaire, corresponding to a response rate of 56.8%. The adoption rate of medication alert systems in hospital outpatient departments increased from less than 10% in 1997-95.83% in 2012. Approximately two-thirds of the hospitals developed and maintained the alert systems independently or collaboratively with vendors. Teaching and large hospitals tended to develop more advanced alert functions such as drug-drug interaction functions. Improving the safety and quality of pharmaceutical services and meeting the policy requirements are reasons for hospitals to establish medication alert systems. The adoption rate of medication alert systems reached 95% in accredited general hospitals in Taiwan. Government policy and available health information professionals and vendors may somewhat contribute to the high adoption rate. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Inpatient Obstetric Care at Irwin Army Community Hospital: A Study to Determine the Most Efficient Organization (United States)


    Reese’s new birthing suites may curb maternity malpractice suits. Modern Healthcare, 16 (11), 48. Clark, L., & Stewart, R. (1982). Nurse-midwifery...Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law , no person shall be...US Army Medical Department Center and School Bldg 2841 MCCS-HRA (US Army-Baylor Program in HCA) 3151 Scott Road, Suite 1412 Fort Sam Houston, TX 78234

  7. The Effects of a Customer Service Initiative at Moncrief Army Community Hospital (United States)



  8. Army Technology (United States)


    that allows them to perform applied research under the Institute for Biotechnology research team 1 2 3 20 | ARMY TECHNOLOGY MAGAZINE ...DASA(R&T) Deputy Assistant Secretary of the Army for Research and Technology Download the magazine , view online or read each individual story with...Army photo by Conrad Johnson) Front and back cover designs by Joe Stephens EXECUTIVE DEPUTY TO THE COMMANDING GENERAL Army Technology Magazine is an

  9. U.S. Army Medical Bioengineering Research and Development Laboratory Annual Progress Report FY 1985. Volume 1 (United States)


    Dental Corps, Malaysian Armed Forces; MAJ Johan van Geyzel, Malaysian Embassy, Washington, DC 7 March - BG Dato Chen Kwee Fong, Chief of Engineers... Malaysian Armed Forces; MAJ Johan van Geyzel, Malaysian Embassy, MAJ Tairobi bin Abdul Razak, Malaysian Army 2 July - BG William 0. Rodgers, Australian Army...and Diets for Culturing and Testing with Daphnia magna." Paper presented at the Ninth Symposium of Aquatic Toxicology and Environmental Fate sponsored

  10. The design of a corporate identity for a department of medical illustration: a case study. (United States)

    Thompson, G


    This paper outlines the author's attempt to design and introduce a corporate identity into the Department of Medical Illustration at the South Buckinghamshire NHS Trust. It is intended to furnish the reader with an insight into the process of designing a corporate identity and to relate one department's experience. This may be useful for those who wish to develop a corporate identity of their own or contribute, as a department, towards an identity for their own Trust or other institution. A major change in government policy about the identity of NHS Trusts has meant that use of the department's new logo has had to be abandoned in favour of the new NHS corporate identity.

  11. When the visit to the emergency department is medically nonurgent: provider ideologies and patient advice. (United States)

    Guttman, N; Nelson, M S; Zimmerman, D R


    It is estimated that more than half of pediatric hospital emergency department (ED) visits are medically nonurgent. Anecdotal impressions suggest that ED providers castigate medically nonurgent visits, yet studies on such visits are scarce. This study explored the perspectives of 26 providers working in the EDs of two urban hospitals regarding medically nonurgent pediatric ED visits and advising parents or guardians on appropriate ED use. Three provider ideologies regarding the appropriateness of medically nonurgent ED use were identified and found to be linked to particular communication strategies that providers employed with ED users: restrictive, pragmatic, and all-inclusive. The analysis resulted in the development of a typology of provider ideological orientations toward ED use, distinguished according to different orientations toward professional dominance.

  12. [The low consumption of outpatient medical care in the department of Ardennes (France) (author's transl)]. (United States)

    Lebrun, T; Sailly, J C


    The purpose of the research explained in this article was to build up a methodology which allows to set up a map of low consumption of outpatient medical care and to find out to which extent the low recorded demand is attributable tho the medical aids supply. French National Health Service files were the basic data for this research which was led into the department of Ardennes. First and foremost the investigation was to identify on a district level with low consumer families after having eliminated demands' factors. Thus one could set up maps of low consumption in comparison with maps of low prescription. The investigation showed that low consumer families live generally in the cantons of low medical care consumption concerned mainly with low medical aids suppliers.

  13. [Medical short stay unit for geriatric patients in the emergency department: clinical and healthcare benefits]. (United States)

    Pareja, Teresa; Hornillos, Mercedes; Rodríguez, Miriam; Martínez, Javier; Madrigal, María; Mauleón, Coro; Alvarez, Bárbara


    To evaluate the impact of comprehensive geriatric assessment and management of high-risk elders in a medical short stay unit located in the emergency department of a general hospital. We performed a descriptive, prospective study of patients admitted to the medical short stay unit for geriatric patients of the emergency department in 2006. A total of 749 patients were evaluated, with a mean (standard deviation) stay in the unit of 37 (16) h. The mean age was 86 (7) years; 57% were women, and 50% had moderate-severe physical impairment and dementia. Thirty-five percent lived in a nursing home. The most frequent reason for admission was exacerbation of chronic cardiopulmonary disease. Multiple geriatric syndromes were identified. The most frequent were immobility, pressure sores and behavioral disorders related to dementia. Seventy percent of the patients were discharged to home after being stabilized and were followed-up by the geriatric clinic and day hospital (39%), the home care medical team (11%), or the nursing home or primary care physician (20%). During the month after discharge, 17% were readmitted and 7.7% died, especially patients with more advanced age or functional impairment. After the unit was opened, admissions to the acute geriatric unit fell by 18.2%. Medical short stay units for geriatric patients in emergency departments may be useful for geriatric assessment and treatment of exacerbations of chronic diseases. These units can help to reduce the number of admissions and optimize the care provided in other ambulatory and domiciliary geriatric settings.

  14. Autonomic nervous system activity as risk predictor in the medical emergency department: a prospective cohort study. (United States)

    Eick, Christian; Rizas, Konstantinos D; Meyer-Zürn, Christine S; Groga-Bada, Patrick; Hamm, Wolfgang; Kreth, Florian; Overkamp, Dietrich; Weyrich, Peter; Gawaz, Meinrad; Bauer, Axel


    To evaluate heart rate deceleration capacity, an electrocardiogram-based marker of autonomic nervous system activity, as risk predictor in a medical emergency department and to test its incremental predictive value to the modified early warning score. Prospective cohort study. Medical emergency department of a large university hospital. Five thousand seven hundred thirty consecutive patients of either sex in sinus rhythm, who were admitted to the medical emergency department of the University of Tübingen, Germany, between November 2010 and March 2012. None. Deceleration capacity of heart rate was calculated within the first minutes after emergency department admission. The modified early warning score was assessed from respiratory rate, heart rate, systolic blood pressure, body temperature, and level of consciousness as previously described. Primary endpoint was intrahospital mortality; secondary endpoints included transfer to the ICU as well as 30-day and 180-day mortality. One hundred forty-two patients (2.5%) reached the primary endpoint. Deceleration capacity was highly significantly lower in nonsurvivors than survivors (2.9 ± 2.1 ms vs 5.6 ± 2.9 ms; p model yielded an area under the receiver-operator characteristic curve of 0.706 (0.667-0.750). Implementing deceleration capacity into the modified early warning score model led to a highly significant increase of the area under the receiver-operator characteristic curve to 0.804 (0.770-0.835; p capacity was also a highly significant predictor of 30-day and 180-day mortality as well as transfer to the ICU. Deceleration capacity is a strong and independent predictor of short-term mortality among patients admitted to a medical emergency department.

  15. Frequency of medication errors in an emergency department of a large teaching hospital in southern Iran

    Directory of Open Access Journals (Sweden)

    Vazin A


    Full Text Available Afsaneh Vazin,1 Zahra Zamani,1 Nahid Hatam2 1Department of Clinical Pharmacy, Faculty of Pharmacy, 2School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Abstract: This study was conducted with the purpose of determining the frequency of medication errors (MEs occurring in tertiary care emergency department (ED of a large academic hospital in Iran. The incidence of MEs was determined through the disguised direct observation method conducted by a trained observer. A total of 1,031 medication doses administered to 202 patients admitted to the tertiary care ED were observed over a course of 54 6-hour shifts. Following collection of the data and analysis of the errors with the assistance of a clinical pharmacist, frequency of errors in the different stages was reported and analyzed in SPSS-21 software. For the 202 patients and the 1,031 medication doses evaluated in the present study, 707 (68.5% MEs were recorded in total. In other words, 3.5 errors per patient and almost 0.69 errors per medication are reported to have occurred, with the highest frequency of errors pertaining to cardiovascular (27.2% and antimicrobial (23.6% medications. The highest rate of errors occurred during the administration phase of the medication use process with a share of 37.6%, followed by errors of prescription and transcription with a share of 21.1% and 10% of errors, respectively. Omission (7.6% and wrong time error (4.4% were the most frequent administration errors. The less-experienced nurses (P=0.04, higher patient-to-nurse ratio (P=0.017, and the morning shifts (P=0.035 were positively related to administration errors. Administration errors marked the highest share of MEs occurring in the different medication use processes. Increasing the number of nurses and employing the more experienced of them in EDs can help reduce nursing errors. Addressing the shortcomings with further research should result in reduction

  16. Our Destiny - Better Financial Management and Stewardship: Organization of the Guide to the Department of the Army FY 1996 Annual Financial Report

    National Research Council Canada - National Science Library


    .... This guide focuses on financial and program management information from the FY 1996 Annual Financial Report for general funds, which was prepared by the Army and the Defense Finance and Accounting...

  17. Criteria of medical care evaluation in daily in-patient department in pediatrics

    Directory of Open Access Journals (Sweden)

    Grozdova T.U.


    Full Text Available The research goal is to work out criteria for the evaluation of medical care quality. Materials included 386 medical cards of daily in-patients, 216 medical cards of in-patients; 602 cards of analysis of case histories; 4 computer data bases. Methods of mathematical statistics were successfully used in the study. The comparative method of data analysis was applied to the research work. Intensity of medical care in values from 0,1 to 0,5 conditional units corresponded to requirements of criterion of estimation of medical care quality. Parameters of medicinal treatment were close to the standards of treatment in interval from 44,4 to 100%, as criterion of quality of medical care. Specific weight of apparatus and instrumental researches constituted an interval from 7, 4% to 22, 6%, forming corresponding criterion. Interval of effectiveness according to standards of consultations is from 0, 26 to 1, 04 conditional units. In conclusion the article stated that the characteristics for criteria to evaluate medical care in daily in-patient departments were worked out on the basis of indices obtained during the research work

  18. [Impact of an automated dispensing system for medical devices in cardiac surgery department]. (United States)

    Clou, E; Dompnier, M; Kably, B; Leplay, C; Poupon, E; Archer, V; Paul, M


    To secure medical devices' management, the implementation of automated dispensing system in surgical service has been realized. The objective of this study was to evaluate security, organizational and economic impact of installing automated dispensing system for medical devices (ASDM). The implementation took place in a cardiac surgery department. Security impact was assessed by comparing traceability rate of implantable medical devices one year before and one year after installation. Questionnaire on nurses' perception and satisfaction completed this survey. Resupplying costs, stocks' evolution and investments for the implementation of ASDM were the subject of cost-benefit study. After one year, traceability rate is excellent (100%). Nursing staffs were satisfied with 87.5% by this new system. The introduction of ASDM allowed a qualitative and quantitative decrease in stocks, with a reduction of 30% for purchased medical devices and 15% for implantable medical devices in deposit-consignment. Cost-benefit analysis shows a rapid return on investment. Real stock decrease (purchased medical devices) is equivalent to 46.6% of investment. Implementation of ASDM allows to secure storage and dispensing of medical devices. This system has also an important economic impact and appreciated by users. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

  19. Pediatric care as part of the US Army medical mission in the global war on terrorism in Afghanistan and Iraq, December 2001 to December 2004. (United States)

    Burnett, Mark W; Spinella, Philip C; Azarow, Kenneth S; Callahan, Charles W


    Our objective in this report was to describe the epidemiologic features of and workload associated with pediatric admissions to 12 US Army military hospitals deployed to Iraq and Afghanistan. The Patient Administration Systems and Biostatistics Activity database was queried for all local national patients Afghanistan and Iraq between December 2001 and December 2004. Pediatric admissions during the study period were 1012 (4.2%) of 24,227 admissions, occupying 10% of all bed-days. The median length of stay was 4 days (interquartile range: 1-8 days). The largest proportion of children were 11 to 17 years of age (332 of 757 children; 44%), although 45 (6%) of 757 children hospitalized were Afghanistan and Iraq. Military medical planners must continue to improve pediatric medical support, including personnel, equipment, and medications that are necessary to treat children injured during combat operations, as well as those for whom the existing host nation medical infrastructure is unable to provide care.

  20. Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments


    Langabeer, James R.; Gonzalez, Michael; Alqusairi, Diaa; Champagne-Langabeer, Tiffany; Jackson, Adria; Mikhail, Jennifer; Persse, David


    Introduction Emergency medical services (EMS) agencies transport a significant majority of patients with low acuity and non-emergent conditions to local emergency departments (ED), affecting the entire emergency care system’s capacity and performance. Opportunities exist for alternative models that integrate technology, telehealth, and more appropriately aligned patient navigation. While a limited number of programs have evolved recently, no empirical evidence exists for their efficacy. T...

  1. Violence toward health workers in Bahrain Defense Force Royal Medical Services’ emergency department

    Directory of Open Access Journals (Sweden)

    Rafeea F


    Full Text Available Faisal Rafeea,1 Ahmed Al Ansari,2–4 Ehab M Abbas,1 Khalifa Elmusharaf,5 Mohamed S Abu Zeid1 1Emergency Department, Bahrain Defense Force Hospital, Riffa, Bahrain; 2Training and Education Department, Bahrain Defense Force Hospital, Riffa, Bahrain; 3Department of General Surgery, College of Medicine and Medical Science, Arabian Gulf University, Manama, Bahrain; 4Medical Education Department, Royal College of Surgeons in Ireland - Medical University of Bahrain, Busaiteen, Bahrain; 5Graduate Entry Medical School, University of Limerick, Ireland Background: Employees working in emergency departments (EDs in hospital settings are disproportionately affected by workplace violence as compared to those working in other departments. Such violence results in minor or major injury to these workers. In other cases, it leads to physical disability, reduced job performance, and eventually a nonconducive working environment for these workers. Materials and methods: A cross-sectional exploratory questionnaire was used to collect data used for the examination of the incidents of violence in the workplace. This study was carried out at the ED of the Bahrain Defense Force (BDF Hospital. Participants for the study were drawn from nurses, support staff, and emergency physicians. Both male and female workers were surveyed.Results: The study included responses from 100 staff in the ED of the BDF Hospital in Bahrain (doctors, nurses, and support personnel. The most experienced type of violence in the workers in the past 12 months in this study was verbal abuse, which was experienced by 78% of the participants, which was followed by physical abuse (11% and then sexual abuse (3%. Many cases of violence against ED workers occurred during night shifts (53%, while physical abuse was reported to occur during all the shifts; 40% of the staff in the ED of the hospital were not aware of the policies against workplace violence, and 26% of the staff considered leaving their jobs

  2. Brigadier General James Stevens Simmons (1890-1954), Medical Corps, United States Army: a career in preventive medicine. (United States)

    Marble, Sanders


    James Simmons began his career in the US Army as a laboratory officer and his assignments progressed into tropical medicine research. His interests and work evolved into preventive medicine (PM, as the Army termed public health), and he took both a PhD and a Doctorate in Public Health. As the Army's leading PM officer he was appointed head of PM in 1940 and guided the Army's PM effort through World War II. His responsibility ran from gas masks through healthy nutrition and occupational health to an enormous variety of diseases; by the war's end, the breadth and importance of PM was reflected in the Preventive Medicine Division, having fully one-sixth of all military personnel at the Surgeon General's Office. Simmons used his strong professional credentials to tap into civilian medicine for expertise the Army lacked and he established organizations that survive to this day. After retirement, he sought to expand the field of public health and raise another generation of public health physicians.

  3. Increasing Therapist Productivity: Using Lean Principles in the Rehabilitation Department of an Academic Medical Center. (United States)

    Johnson, Diana; Snedeker, Kristie; Swoboda, Michael; Zalieckas, Cheryl; Dorsey, Rachel; Nohe, Cassandra; Smith, Paige; Roche, Renuka

    The Department of Rehabilitation Services, within the University of Maryland Medical Center's 650-bed academic medical center, was experiencing difficulty in meeting productivity standards. Therapists in the outpatient division believed they were not spending enough time performing billable patient care activities. Therapists in the inpatient division had difficulty keeping pace with the volume of incoming referrals. Collectively, these issues caused dissatisfaction among referral sources and frustration among the staff within the rehabilitation department. The department undertook a phased approach to address these issues that included examining the evidence, using Lean process improvement principles, and employing transformational leadership strategies to drive improvements in productivity and efficiency. The lessons learned support the importance of having meaningful metrics appropriate for the patient population served, the use of Lean as an effective tool for improving productivity in rehabilitation departments, the impact of engaging staff at the grassroots level, and the importance of having commitment from leaders. The study findings have implications for not only rehabilitation and hospital leadership, but CEOs and managers of any business who need to eliminate waste or increase staff productivity.

  4. Delegation of medical tasks in French radiation oncology departments: current situation and impact on residents' training. (United States)

    Thureau, S; Challand, T; Bibault, J-E; Biau, J; Cervellera, M; Diaz, O; Faivre, J-C; Fumagalli, I; Leroy, T; Lescut, N; Martin, V; Pichon, B; Riou, O; Dubray, B; Giraud, P; Hennequin, C


    A national survey was conducted among the radiation oncology residents about their clinical activities and responsibilities. The aim was to evaluate the clinical workload and to assess how medical tasks are delegated and supervised. A first questionnaire was administered to radiation oncology residents during a national course. A second questionnaire was mailed to 59 heads of departments. The response rate was 62% for radiation oncology residents (99 questionnaires) and 51% for heads of department (30). Eighteen heads of department (64%) declared having written specifications describing the residents' clinical tasks and roles, while only 31 radiation oncology residents (34%) knew about such a document (P=0.009). A majority of residents were satisfied with the amount of medical tasks that were delegated to them. Older residents complained about insufficient exposure to new patient's consultation, treatment planning and portal images validation. The variations observed between departments may induce heterogeneous trainings and should be addressed specifically. National specifications are necessary to reduce heterogeneities in training, and to insure that the residents' training covers all the professional skills required to practice radiation oncology. A frame endorsed by academic and professional societies would also clarify the responsibilities of both residents and seniors. Copyright © 2013 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  5. Prognosis and risk factors for deterioration in patients admitted to a medical emergency department

    DEFF Research Database (Denmark)

    Henriksen, Daniel Pilsgaard; Brabrand, Mikkel; Lassen, Annmarie Touborg


    vital signs at arrival to a medical emergency department (MED). DESIGN AND SETTING: Single-centre, retrospective cohort study of all patients admitted to the MED from September 2010-August 2011. SUBJECTS: Patients were included when their vital signs (systolic blood pressure, pulse rate, respiratory.......2-3.0%) among the non-deteriorating, hazard ratio 4.11 (95% CI: 2.38-7.10). CONCLUSIONS: Among acutely admitted medical patients who arrive with normal vital signs, 31.0% showed signs of deterioration within 24 hours. Risk factors included old age, Do-not-attempt-to-resuscitate order, admission from the open...... general ED. Thirty-day mortality among patients with deterioration was four times higher than among non-deteriorating patients. Further research is needed to determine whether intensified monitoring of vital signs can help to prevent deterioration or mortality among medical emergency patients....

  6. Exploring Barriers to Medication Safety in an Ethiopian Hospital Emergency Department: A Human Factors Engineering Approach

    Directory of Open Access Journals (Sweden)

    Ephrem Abebe


    Full Text Available Objective: To describe challenges associated with the medication use process and potential medication safety hazards in an Ethiopian hospital emergency department using a human factors approach. Methods: We conducted a qualitative study employing observations and semi-structured interviews guided by the Systems Engineering Initiative for Patient Safety model of work system as an analytical framework. The study was conducted in the emergency department of a teaching hospital in Ethiopia. Study participants included resident doctors, nurses, and pharmacists. We performed content analysis of the qualitative data using accepted procedures. Results: Organizational barriers included communication failures, limited supervision and support for junior staff contributing to role ambiguity and conflict. Compliance with documentation policy was minimal. Task related barriers included frequent interruptions and work-related stress resulting from job requirements to continuously prioritize the needs of large numbers of patients and family members. Person related barriers included limited training and work experience. Work-related fatigue due to long working hours interfered with staff’s ability to document and review medication orders. Equipment breakdowns were common as were non-calibrated or poorly maintained medical devices contributing to erroneous readings. Key environment related barriers included overcrowding and frequent interruption of staff’s work. Cluttering of the work space compounded the problem by impeding efforts to locate medications, medical supplies or medical charts. Conclusions: Applying a systems based approach allows a context specific understanding of medication safety hazards in EDs from low-income countries. When developing interventions to improve medication and overall patient safety, health leaders should consider the interactions of the different factors. Conflict of Interest We declare no conflicts of interest or

  7. The Evolution of Army Leader Development (United States)


    Human Resources Command, OPMD- MFE -I. 4 U.S. Army General Officer Management Office, Army General Officer Roster (Washington, DC, U.S. Department of the...Human Resources Command, Command Management Branch post board data analysis. 15 Data from the United States Army Human Resources Command, OPMD- MFE -A...May 1, 2008), D-1. 25 19 Data from the United States Army Human Resources Command, OPMD- MFE -A, 01 February, 2013. 20 U.S. Joint Chiefs of

  8. Internal evaluation of public health department of Semnan university of medical sciences

    Directory of Open Access Journals (Sweden)

    Behrad Pour- Mohammadi


    Full Text Available Introduction: Internal evaluation is a fundamental determinant to quality development in teachingdepartments and faculties. The purpose of this study was an internal departmental evaluation in the publichealth department of Semnan university of medical sciences (SUMS.Materials and Methods: This work was performed (during 2008-2009 in department of public health ofSUMS utilizing an accreditation model. The assessment covered 9 areas, namely: educational missions andobjectives, management and organization, educational programs, scientific board, students, educationalresources, research activities, assessment and evaluation, and graduates. Questionnaires were developed bythe scientific members of the department. After collecting the data, results were categorized according toGourman scoring scale, from unsatisfied class to very strong class, with the range of 1-5 scores.Results: The mean scores in the 9 evaluation areas were obtained and the rankings were as below:Educational programs area was in strong ranking; educational missions and objectives, scientific board,and assessment and evaluation areas were in good ranking; management and organization area was in morethan satisfied ranking; students area was in satisfied ranking; educational resources and research activitiesareas were in borderline ranking; and finally, the department was ranked as unsatisfied in the graduatesarea.Conclusions: Results showed that by achieved mean of 3.19 in whole of the evaluation areas, the publichealth department has placed in "more than satisfied" class. Although the overall status is acceptable, thereis a need to modify the weak points in the suboptimal areas to improve the educational quality in thisdepartment.

  9. Medical emergencies in the imaging department of a university hospital: event and imaging characteristics. (United States)

    van Tonder, F C; Sutherland, T; Smith, R J; Chock, J M E; Santamaria, J D


    We aimed to describe the characteristics of medical emergencies that occurred in the medical imaging department (MID) of a university hospital in Melbourne, Australia. A database of 'Respond Medical Emergency Team (MET)' and 'Respond Blue' calls was retrospectively examined for the period June 2003 to November 2010 in relation to events that occurred in the MID. The hospital medical imaging database was also examined in relation to these events and, where necessary, patients' notes were reviewed. Ethics approval was granted by the hospital ethics review board. There were 124 medical emergency calls in the MID during the study period, 28% Respond Blue and 72% Respond MET. Of these 124 calls, 26% occurred outside of usual work hours and 12% involved cardiac arrest. The most common reasons for the emergency calls were seizures (14%) and altered conscious state (13%). Contrast anaphylaxis precipitated the emergency in 4% of cases. In 83% of cases the emergency calls were for patients attending the MID for diagnostic imaging, the remainder being for a procedure. Of the scheduled imaging techniques, 45% were for computed tomography. The scheduled imaging was abandoned due to the emergency in 12% of cases. When performed, imaging informed patient management in 34% of cases in diagnostic imaging and in all cases in the context of image-guided procedures. Medical emergency calls in the MID often occurred outside usual work hours and were attributed to a range of medical problems. The emergencies occurred in relation to all imaging techniques and imaging informed patient management in many cases. Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.

  10. Leaving against medical advice of addicted to drugs in a Department of Infectious Diseases: Economical analysis

    Directory of Open Access Journals (Sweden)

    Julia González


    Full Text Available Giving up health recommendations and care against medical advice is a setback that may happen in daily health work. In a pilot study made at the Department of Infectious Diseases in Hospital Gregorio Marañón (Madrid, Spain, during the first five months in 1998, the incidence of leaving against medical advice was 12,3 times higher than the mean in that hospital (7,03% vs 0,57%. Patients involved in this kind of event were drug abusers with acute infectious problems in a HIV primary infection or a multiple drug dependency. 42% of this patients returned to the hospital in the next 15 days. The research group thought out to study this problem under this hypothesis: Leaving against medical advice, besides having harmful consequences for the patient and the public health, produces an increase in the cost and the stay of the patient in hospital.The main objective of the research was to set up the economic the deviation in the cost/stay of a group of patients that had left against medical advice or in a regular process. It is a prospective and observational study. We studied 284 drug abusers staying in the Department of Infectious Diseases between Oct, 1st, 1999 and Sept, 30th, 2000. The research variables were: 1. Sociodemographic: Initials, , age, sex, and history number. 2. Clinical: Leaving medical diagnosis, returning medical diagnosis. 3. Administrative: Group of Related Diagnosis (GRD, admission date, leaving date, returning date and estimated cost of the episode. All episodes were grouped by kind of leaving and GRD. The cost/stay was calculated adjusted to GRD, and the deviations inside GRD were analyzed in the regular leaving group and the leaving against medical advice group.Results: Around 90% admission episodes were grouped in 6 GRD: 714 (47.92%, 541 (8.85%, 709 (8.85%, 710 (7,81%, 101 (7,29% y 715 (7,29%. The Pneumonia in HIV (GRD 714 caused the majority of the admissions. Global deviation adjusted to cost/stay was 29,44% (more expensive

  11. National Institutes of Health Funding to Departments of Orthopaedic Surgery at U.S. Medical Schools. (United States)

    Silvestre, Jason; Ahn, Jaimo; Levin, L Scott


    The National Institutes of Health (NIH) is the largest supporter of biomedical research in the U.S., yet its contribution to orthopaedic research is poorly understood. In this study, we analyzed the portfolio of NIH funding to departments of orthopaedic surgery at U.S. medical schools. The NIH RePORT (Research Portfolio Online Reporting Tools) database was queried for NIH grants awarded to departments of orthopaedic surgery in 2014. Funding totals were determined for award mechanisms and NIH institutes. Trends in NIH funding were determined for 2005 to 2014 and compared with total NIH extramural research funding. Funding awarded to orthopaedic surgery departments was compared with that awarded to departments of other surgical specialties in 2014. Characteristics of NIH-funded principal investigators were obtained from department web sites. In 2014, 183 grants were awarded to 132 investigators at 44 departments of orthopaedic surgery. From 2005 to 2014, NIH funding increased 24.3%, to $54,608,264 (p = 0.030), but the rates of increase seen did not differ significantly from those of NIH extramural research funding as a whole (p = 0.141). Most (72.6%) of the NIH funding was awarded through the R01 mechanism, with a median annual award of $343,980 (interquartile range [IQR], $38,372). The majority (51.1%) of the total funds supported basic science research, followed by translational (33.0%), clinical (10.0%), and educational (5.9%) research. NIH-funded orthopaedic principal investigators were predominately scientists whose degree was a PhD (71.1%) and who were male (79.5%). Eleven NIH institutes were represented, with the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) providing the preponderance (74.2%) of the funding. In 2014, orthopaedic surgery ranked below the surgical departments of general surgery, ophthalmology, obstetrics and gynecology, otolaryngology, and urology in terms of NIH funding received. The percentage increase of NIH

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

    Directory of Open Access Journals (Sweden)

    Bui, Quan M.


    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.

  13. Pain Management for Sickle Cell Disease in the Pediatric Emergency Department: Medications and Hospitalization Trends. (United States)

    Cacciotti, Chantel; Vaiselbuh, Sarah; Romanos-Sirakis, Eleny


    The majority of emergency department (ED) visits and hospitalizations for patients with sickle cell disease (SCD) are pain related. Adequate and timely pain management may improve quality of life and prevent worsening morbidities. We conducted a retrospective chart review of pediatric patients with SCD seen in the ED, selected by sickle cell-related ICD-9 codes. A total of 176 encounters were reviewed from 47 patients to record ED pain management and hospitalization trends. Mean time to pain medication administration was 63 minutes. Patients received combination (nonsteroidal anti-inflammatory drug [NSAID] + narcotic) pain medications for initial treatment at a minority of ED encounters (19%). A higher percentage of patients who received narcotics alone as initial treatment were hospitalized as compared with those who received combination treatment initially ( P= 0.0085). Improved patient education regarding home pain management as well as standardized ED guidelines for assessment and treatment of sickle cell pain may result in superior and more consistent patient care.

  14. Application of medical psychology in the reception of nuclear medicine department

    International Nuclear Information System (INIS)

    Zhan Hao; Xiong Jie; Huang Daijuan; Yuan Bin; Xu Wendai; Zhang Yongxue


    Reception of nuclear medicine department is often ignored. In fact, it is an important part of clinical work. If the patient's psychological status is understood, and the psychological knowledge is handles and applied in practice, the quality of work can be improved. The personnel in nuclear medicine should recognize the significance of humanity in medical practice and acquire the communication skill between doctors and patients. They should also understand the four aspects of psychological need of patients: The need of being understood and respected; the need of being greeted, accepted and a sense of belonging; the need of being informed; the need of feeling safe and rehabilitated

  15. Scientific conference at the Department of Biomedical Sciences, Russian Academy of Medical Sciences

    International Nuclear Information System (INIS)

    Rybakova, M.N.


    Review of reports at the scientific conference of the department of biomedical sciences of the Russian Academy of Medical Sciences, held in April, 1997, on the topic of Novel techniques in biomedical studied. Attention was paid to the creation and uses of rapid diagnosis instruments in micro devices, to the development of electron-photon, immuno enzyme and radionuclide techniques and their realization in automatic special equipment. Delay of native industry in creation of scientific-capacious highly efficient products, especially in the field of radiodiagnosis and instruments for laboratory studies was marked

  16. The Prevalence of Pemphigus (Razi Hospital and Department of Oral Pathology, Tehran University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Eshghyar N


    Full Text Available The aim of this retrospective statistical study was to determine the prevalcence and frequency of"nage and sex distributions of pemphigus disease. Pemphigus disease classified as autoimmune bullous"ndermatoses which is a chronic mucocutaneous disease."nThis study was performed in Razi Hospital and department of oral pathology of dental school, Tehran"nUniversity of Medical Sciences. The most frequently effected area was buccal moucosa of oral cavity. The"nmost rate of recurrence was found in oral cavity which being more common in middle age females (25-44"nyears.

  17. Assessment of medical radiation exposure to patients and ambient doses in several diagnostic radiology departments (United States)

    Sulieman, A.; Elhadi, T.; Babikir, E.; Alkhorayef, M.; Alnaaimi, M.; Alduaij, M.; Bradley, D. A.


    In many countries diagnostic medical exposures typically account for a very large fraction of the collective effective dose that can be assigned to anthropological sources and activities. This in part flags up the question of whether sufficient steps are being taken in regard to potential dose saving from such medical services. As a first step, one needs to survey doses to compare against those of best practice. The present study has sought evaluation of the radiation protection status and patient doses for certain key radiological procedures in four film-based radiology departments within Sudan. The radiation exposure survey, carried out using a survey meter and quality control test tools, involved a total of 299 patients their examinations being carried out at one or other of these four departments. The entrance surface air kerma (ESAK) was determined from exposure settings using DosCal software and an Unfors -Xi-meter. The mean ESAK for x-ray examination of the chest was 0.30±0.1 mGy, for the skull it was 0.96±0.7 mGy, for the abdomen 0.85±0.01 mGy, for spinal procedures 1.30±0.6 mGy and for procedures involving the limbs it was 0.43±0.3 mGy. Ambient dose-rates in the reception area, at the closed door of the x-ray room, recorded instantaneous values of up to 100 μSv/h. In regard to protection, the associated levels were found to be acceptable in three of the four departments, corrective action being required for one department, regular quality control also being recommended.

  18. Education in medical billing benefits both neurology trainees and academic departments. (United States)

    Waugh, Jeff L


    The objective of residency training is to produce physicians who can function independently within their chosen subspecialty and practice environment. Skills in the business of medicine, such as clinical billing, are widely applicable in academic and private practices but are not commonly addressed during formal medical education. Residency and fellowship training include limited exposure to medical billing, but our academic department's performance of these skills was inadequate: in 56% of trainee-generated outpatient notes, documentation was insufficient to sustain the chosen billing level. We developed a curriculum to improve the accuracy of documentation and coding and introduced practice changes to address our largest sources of error. In parallel, we developed tools that increased the speed and efficiency of documentation. Over 15 months, we progressively eliminated note devaluation, increased the mean level billed by trainees to nearly match that of attending physicians, and increased outpatient revenue by $34,313/trainee/year. Our experience suggests that inclusion of billing education topics into the formal medical curriculum benefits both academic medical centers and trainees. © 2014 American Academy of Neurology.

  19. The Army Lawyer (United States)


    authors in the articles do not necessarily reflect the view of The Judge Advocate General or the Department of the Army. Masculine or feminine...for the hegemonic power (read ‘United States’) and its followers to determine international public enemy on a case-by-case basis. A legal

  20. Operations of and Challenges to the Army Medical Department during the US-Mexican War, 1846-1848 (United States)


    recounts the attempt to find and move the wounded off the battlefield before dark . Unfortunately many wounded soldiers remained on the field, exposed...convenience, or the gratification of either one of those gallant souls who so valiantly fought and so signally triumphed on the battle fields of Palo Alto

  1. Behavioral and Mental Healthcare: Total Warrior Care Commitment. U.S. Army Medical Department Journal, July-September 2008 (United States)


    International Critical Inci- dent Stress Foundation, Inc; 2003. 23. Bolton EE, Glenn DM , Orsillo S, Roemer L, Litz BT. The relationship between self...Seligman MEP, eds. Positive Psychology in Practice. New York: John Wiley & Sons; 2004:20. Aristotle. Nicomachean Ethics. Crisp R, trans. New York

  2. Proceedings: Army Medical Department Service Psychology Symposium Held at El Paso, Texas on 13-17 November 1978 (United States)


    neuroses, psychopathy, hysteria and hypochondriasis . (See Feldman and Maleski, 1948; Fodor, 1947; Montgomery and Stephens, 1972; Russell, et al., 1971...and McCreary, 1978). In general this literature reports all low back pain patient groups have increased elevation on those MMPI scales, Hypochondriasis ...and Hysteria, felt to reflect tendencies toward preoccupation with one’s body and toward expression of psychological conflict somatically . Patients

  3. Annual Research Progress Report for Department of Clinical Investigation (Madigan Army Medical Center), October 1990 - September 1991 (United States)


    Protocol for a Multicenter Study for thýe Treatment 47 190,091 of Central Precocious Puberty with D-Trp(6)-Des-Gly(10)-N- ethylamide-LHRH, A Long-Acting...Analog of Luteinizing Herr-,"ne Releasing.... Moore DC 0 Characterization of LiI Isoform.i in Treatl and Untreated 48 n91� Precocioas Puberty Moore DC...Epidermoid Carcinoma of the Penis , Phase II 33 Index To Protocols (cont’d) PI and No. &AM Davidson H C SWOG 8573: Treatment of Limited Small Cell Lung

  4. Annual Research Progress Report Fiscal Year 1992. Volume 2. Department of Clinical Investigation (Brooke Army Medical Center) (United States)


    Vesico-Colonic Anastomosis. (T) A-4-90 Botulinum Toxin Detection by Mouse Bioassay. (0) 294 A-5-90 Production of Mouse Positive and Negative Control...Protocol for Acute 518 Lymphocytic Leukemia. (0) POG 9005 ALinC 15: Dose Intensification of Methotrexate and 519 6- Mercaptopurine for ALL in Childhood...cultures, food products , serum and fecal specimens. Technical Approach: Pairs of mice are selected and anesthetized with 2 ml of halothane in an

  5. Annual Research Progress Report Fiscal Year 1990. Volume 2. Department of Clinical Investigation (Brooke Army Medical Center) (United States)


    effective laboratory to teach residents the proper, safe methjod of passing an esophagoscope and bronchoscope and the use of CO2 laser in the larynx. The...bronchus and CO2 laser complication. 398 Detail Summary Sheet Date: 2 Oct 90 Proj No: T-6-87 Status: Ongoing Title: Utilization of Goats for the...gastrointestinal toxicity alopecia , cardiotoxicity and allergic reaction. There has been less cardiotoxicity observed on this study than has been observed with

  6. Department of Clinical Investigation, Madigan Army Medical Center, Tacoma, Washington. Annual Research Progress Report, Fiscal Year 1993 (United States)


    107 Cambier PA 0 Transcatheter Closure of the Patent Ductus Arteriosus Using a 108 #93/074 Retrievabler Coil Occlusion System in the Newborn Lamb Model...92 Protocol No.: 93/074 Status: On-going Title: Transcatheter Closure of the Patent Ductus Arteriosus Using a Retrievabler Coil Occlusion System in the...Surfactant 194 #92/086 Webb SB C Incidence of Patent Ductus Arteriosus in Premature Infants 195 #93/094 Receiving Exogenous Surfactant Therapy Young

  7. Job characteristic perception and intrinsic motivation in medical record department staff. (United States)

    Isfahani, Sakineh Saghaeiannejad; Bahrami, Soosan; Torki, Sedighe


    Human resources are key factors in service organizations like hospitals. Therefore, motivating human recourses to achieve the objectives of an organization is important. Job enrichment is a strategy used to increase job motivation in staffs. The goal of the current study is to determine the relationship between job characteristics and intrinsic motivation in medical record staff in hospitals related to Medical Science University in Isfahan in 2011-2012 academic year. The type of the study is descriptive and corelational of multi variables. The population of the study includes all the medical record staffs of medical record department working in Medical Science hospitals of Isfahan. One hundred twentyseven subjects were selected by conducting a census. In the present study, data collected by using two questionnaires of job characteristics devised by Hackman and Oldeham, and of intrinsic motivation. Content validity was confirmed by experts and its reliability was calculated through coefficient of Cronbach's alpha (r1 = 0.84- r2 = 0.94). The questionnaires completed were entered into SPSS(18) software; furthermore, statistical analysis done descriptively (frequency percent, mean, standard deviation, Pierson correlation coefficient,...) and inferentially (multiple regression, MANOVA, LSD). A significant relationship between job characteristics as well as its elements (skill variety, task identity, task significance, autonomy and feedback) and intrinsic motivation was noticed. (p intrinsic motivation was significant and job feedback had the most impact upon the intrinsic motivation. No significant difference was noticed among the mean amounts of job characteristic perception according to age, gender, level of education, and the kind of educational degree in hospitals. However, there was a significant difference among the mean amounts of job characteristic perception according to the unit of service and the years of servicein hospitals. The findings show that all job

  8. The effect of patient death on medical students in the emergency department. (United States)

    Batley, Nicholas J; Bakhti, Rinad; Chami, Ali; Jabbour, Elsy; Bachir, Rana; El Khuri, Christopher; Mufarrij, Afif J


    The emotional consequences of patient deaths on physicians have been studied in a variety of medical settings. Reactions to patient death include distress, guilt, and grief. Comparatively, there are few studies on the effects of patient death on physicians and residents in the Emergency Department (ED). The ED setting is considered unique for having more sudden deaths that likely include the young and previously healthy and expectations for the clinician to return to a dynamic work environment. To date, no studies have looked at the effects of patient deaths on the more vulnerable population of medical students in the ED. This study examined aspects of patient deaths in the ED that most strongly influence students' reactions while comparing it to those of an inpatient setting. Semi-structured qualitative interviews were carried out with a total of 16 medical students from the American University of Beirut, Medical Center in Lebanon who had recently encountered a patient death in the ED. Questions included their reaction to the death, interaction with patients and their family members, the response of the medical team, and coping mechanisms adopted. The analysis revealed the following as determinant factors of student reaction to patient death: context of death; including age of patient, expectation of death, first death experience, relating patient death to personal deaths, and extent of interaction with patient and family members. Importantly, deaths in an inpatient setting were judged as more impactful than ED deaths. ED deaths, however, were especially powerful when a trauma case was deemed physically disturbing and cases in which family reactions were emotionally moving. The study demonstrates that students' emotional reactions differ as a function of the setting (surprise and shock in the ED versus sadness and grief in an inpatient setting). Debriefing and counseling sessions on ED deaths may benefit from this distinction.

  9. Professional Ethics and Organizational Commitment Among the Education Department Staff of Tabriz University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Ali Imani


    Full Text Available Background: Concepts such as organizational commitment and employees’ and managers’ ethics provide decision-makers and policy makers with potentially useful information which can result in increasing organizational efficiency and effectiveness. This study aimed to explore the relationship between professional ethics and organizational commitment among the staff working in the education departments of Tabriz University of Medical Sciences. Methods: This cross-sectional study was conducted in 2015. The study population consisted of all staff working as educational experts in the education departments of Tabriz University of Medical Sciences (N = 65. Data collection instruments used in this study were two standard questionnaires on professional ethics and organizational commitment. SPSS software version 21 was used to analyze the data. Results: According to the results, mean scores obtained for professional ethics and organizational commitment were (91.57± 9.13 (95% CI, 89.23-93.91 and (64.89 ± 10.37 (95% CI, 62.2367.54, respectively. A significant relationship was observed between professional ethics and organizational commitment among the educational experts working in Tabriz University of Medical Sciences (correlation coefficient = 0.405 (P = 0.001 (at 95% confidence level. Furthermore, there was a significant relationship between professional ethics and work experience (P = 0.043. The highest level of professional ethics observed was associated with those participants having a work experience of ranging from 6 to 10 years. Individuals with fulltime employment scored the highest in organizational commitment. Conclusion: Educational experts possessed a high level of professional ethics. The finding provides the grounds for promoting organizational commitment, which will lead to higher levels of organizational effectiveness.

  10. Assessment of prehospital medical care for the patients transported to emergency department by ambulance

    Directory of Open Access Journals (Sweden)

    Sehnaz Akın Paker


    Full Text Available Objectives: In our study we aimed to investigate the quality and quantity of medical management inside ambulances for 14 and over 14 years old patients transported to a level three emergency department (ED. Material and methods: Our study was conducted prospectively at a level three ED. 14 and over 14 years old patients who were transported to the ED by ambulance were included in the study consecutively. “Lack of vital rate” was described as missing of one or more of five vital rates during ambulance transportation. Both of two attending emergency physicians evaluated the medical procedures and management of patients at the ambulance simultaneously and this was recorded on the study forms. Results: Four hundred and fifty six patients were included in the study. Missing vital signs were identified for 90.1% (n = 322 of the patients that were transported by physicians and 92.4% (n = 73 of the patients that were transported by paramedics. For five patients with cardiac arrest two (33.3% had cardiopulmonary resuscitation (CPR, one (20% was intubated, one (20% received adrenaline. Out of 120 patients, needed spinal immobilization, 69 (57.5% had spinal board. Cervical collar usage was 65.1% (n = 69 We have revealed that 316 (69.3% patients did not receive at least one of the necessary medical intervention or treatment. Conclusion: During ambulance transportation, life-saving procedures like cardiopulmonary resuscitation, vital sign measurement, crucial treatment administration, endotracheal intubation, defibrillation, fracture immobilization were not performed adequately. Increasing the training on the deficient interventions and performing administrative inspections may improve quality of patient care. Keywords: Emergency department, Ambulance, Prehospital emergency care

  11. Risk of cataract among medical staff in neurosurgical department occupationally exposed to radiation

    International Nuclear Information System (INIS)

    Stankova-Mileva, I.; Vassileva, J.; Djounova, J.


    In this study we present the risk of cataract among medical staff in neurosurgical department occupationally exposed to radiation compared to those of non-radiation workers. Cataract is the most common degenerative opacity of the crystalline lens developing with aging. Other risk factors for cataract are: infrared and ultraviolet radiation, systemic diseases (diabetes, hypertonic disease), eye diseases (glaucoma, high myopia), drugs (steroids), etc. High risk of developing cataract we find among staff occupationally exposed to radiation during operations - interventional cardiologists and neurosurgeons. This study includes 30 people between 33 and 60 years of age working in neurosurgical department and control group (the same amount and age of people not exposed to radiation in their work). After visual acuity measurement, the lens was examined by retroillumination method (red reflex) and using a bio microscope. The patients were asked for presence of ocular and systemic diseases, eye trauma, drug, alcohol and tobacco abuse and for how many years they work in this department. There was one case with cataract among neurosurgeons. The doctor doesn't have eye or systemic diseases, doesn't take any drugs and is not alcohol or tobacco abuser. In the control group there were two persons with subcapsular cataract but they have diabetes. Radiation is one of the risk factors for cataract. Continuing of this epidemiological survey will provide further knowledge on the potential risk of occupational radiation-induced cataract among neurosurgical staff and will contribute for optimization of radiation protection. (authors)

  12. Army Reserve Military Intelligence: Time for Change (United States)


    Miramax Books, 2002. Goleman , Daniel . Emotional Intelligence . New York: Bantam Books, 1997. Goleman , Daniel , Richard Boyatzis, and Annie McKee...or position of the Department of the Army, Department of Defense, or the U.S. Government. ARMY RESERVE MILITARY INTELLIGENCE : TIME FOR CHANGE...Research Project 3. DATES COVERED 00-00-2009 to 00-00-2010 4. TITLE AND SUBTITLE Army Reserve Military Intelligence : Time for Change 5a

  13. Emergency Department Crowding and Loss of Medical Licensure: A New Risk of Patient Care in Hallways

    Directory of Open Access Journals (Sweden)

    Robert W. Derlet


    Full Text Available We report the case of a 32-year-old male recently diagnosed with type 2 diabetes treated at an urban university emergency department (ED crowded to 250% over capacity. His initial symptoms of shortness of breath and feeling ill for several days were evaluated with chest radiograph, electrocardiogram (EKG, and laboratory studies, which suggested mild diabetic ketoacidosis. His medical care in the ED was conducted in a crowded hallway. After correction of his metabolic abnormalities he felt improved and was discharged with arrangements made for outpatient follow-up. Two days later he returned in cardiac arrest, and resuscitation efforts failed. The autopsy was significant for multiple acute and chronic pulmonary emboli but no coronary artery disease. The hospital settled the case for $1 million and allocated major responsibility to the treating emergency physician (EP. As a result the state medical board named the EP in a disciplinary action, claiming negligence because the EKG had not been personally interpreted by that physician. A formal hearing was conducted with the EP’s medical license placed in jeopardy. This case illustrates the risk to EPs who treat patients in crowded hallways, where it is difficult to provide the highest level of care. This case also demonstrates the failure of hospital administration to accept responsibility and provide resources to the ED to ensure patient safety. [West J Emerg Med. 2014;15(2:137–141.

  14. Medication Administration Errors in an Adult Emergency Department of a Tertiary Health Care Facility in Ghana. (United States)

    Acheampong, Franklin; Tetteh, Ashalley Raymond; Anto, Berko Panyin


    This study determined the incidence, types, clinical significance, and potential causes of medication administration errors (MAEs) at the emergency department (ED) of a tertiary health care facility in Ghana. This study used a cross-sectional nonparticipant observational technique. Study participants (nurses) were observed preparing and administering medication at the ED of a 2000-bed tertiary care hospital in Accra, Ghana. The observations were then compared with patients' medication charts, and identified errors were clarified with staff for possible causes. Of the 1332 observations made, involving 338 patients and 49 nurses, 362 had errors, representing 27.2%. However, the error rate excluding "lack of drug availability" fell to 12.8%. Without wrong time error, the error rate was 22.8%. The 2 most frequent error types were omission (n = 281, 77.6%) and wrong time (n = 58, 16%) errors. Omission error was mainly due to unavailability of medicine, 48.9% (n = 177). Although only one of the errors was potentially fatal, 26.7% were definitely clinically severe. The common themes that dominated the probable causes of MAEs were unavailability, staff factors, patient factors, prescription, and communication problems. This study gives credence to similar studies in different settings that MAEs occur frequently in the ED of hospitals. Most of the errors identified were not potentially fatal; however, preventive strategies need to be used to make life-saving processes such as drug administration in such specialized units error-free.

  15. Referral letters to the emergency department: is the medication list accurate?

    LENUS (Irish Health Repository)

    McCullagh, M


    Medication errors are common when patients transfer across healthcare boundaries. This study was designed to investigate the quality of information on medicines provided by general practitioners (GPs) on emergency department (ED) referral letters. A convenience sample of referral letters to the ED of a teaching hospital was reviewed. The medication list and\\/or patient\\'s drug allergy status were noted. Medicines reconciliation including patient (or carer) interview was conducted to determine the patient\\'s actual home medication list. This was compared with the GP list and any discrepancies were identified and addressed. A total of 92 referral letters were included in the analysis of which 60 were computer-generated and 32 were hand-written. GPs provided dose and frequency of administration information in 47 (51%) of the letters sampled i.e. 44 (71%) computer-generated versus 3 (10%) hand-written; p < 0.001. In addition, the patient was taking their medicines exactly as per the GP list in 20 (22%) of cases. The patient\\'s drug allergy status was documented in 13 (14%) of the letters.

  16. 2007 Army Modernization Plan (United States)


    Additional confi gurations include two NATO li ers with patients and one medical a endant. The aircra has a hoist for use in emergency...including airframes, wiring bundles and hydraulic systems on the remanufactured CH-47Fs are new. Program Status. The Army received its fi rst fully...Expansible Van and the 10T Dump Truck. Another new variant, the FMTV-Load Handling System, is expected to be fi elded in late-2007, initially to medical



    The Center for Army Profession and Ethic (CAPE) has fielded education and training materials (including doctrine, pamphlets , videos, brochures , and...Army Pamphlet (DA PAM) 600-3, Commissioned Officer Development and Career Management, states that a goal of warrant officer training and education... Pamphlet 600-25, U.S. Army noncommissioned officer professional development and career management. Washington, D.C.: Headquarters, Department of the Army

  18. The 5Cs of Consultation: Training Medical Students to Communicate Effectively in the Emergency Department. (United States)

    Kessler, Chad S; Tadisina, Kashyap Komarraju; Saks, Mark; Franzen, Doug; Woods, Rob; Banh, Kenny V; Bounds, Richard; Smith, Michael; Deiorio, Nicole; Schwartz, Alan


    Effective communication is critical for health care professionals, particularly in the Emergency Department (ED). However, currently, there is no standardized consultation model that is consistently practiced by physicians or used for training medical graduates. Recently, the 5Cs of Consultation model (Contact, Communicate, Core Question, Collaborate, and Close the Loop) has been studied in Emergency Medicine residents using simulated consultation scenarios. Using an experimental design, we aimed to evaluate the efficacy of the 5Cs consultation model in a novel learner population (medical students) and in a "real time and real world" clinical setting. A prospective, randomized, controlled study was conducted at eight large, academic, urban, tertiary-care medical centers (U.S. and Canada). Intervention involved two experimental groups (asynchronous and live training) compared to a baseline control group. All participants placed up to four consult phone calls. A senior physician observed and assessed each call using a preapproved 5Cs checklist and a Global Rating Scale (GRS). Participants who received training (asynchronous or live) scored significantly higher on the 5Cs checklist total and GRS than the control group. Both training methods (asynchronous and live) were equally effective. Importantly, learning gains were sustained as students' 5Cs checklist total and GRS scores remained consistently higher at their second, third, and fourth consult (relative to their first consult). At posttest, all participants reported feeling more confident and competent in relaying patient information. Medical students can be trained to use the 5Cs model in a timely, inexpensive, and convenient manner and increase effectiveness of physician consultations originating from the ED. Published by Elsevier Inc.

  19. Army Hearing Program Status Report Quarter 2 Fiscal Year 2017 (United States)


    U.S. Army Publ ic Heal th Center Army Hearing Program Status Report Q2 FY17 Clinical Public Health and Epidemiology Directorate Army... Hearing Division General Medical: 500A July 2017 Approved for public release; distribution unlimited Army Hearing Program Status Report, Q2FY17...56               INTRODUCTION The Army Hearing Program Status Report (AHPSR) is a component of the Public Health

  20. Using Medical Student Quality Improvement Projects to Promote Evidence-Based Care in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Michael W. Manning


    Full Text Available Introduction The Association of American Medical Colleges’ (AAMC initiative for Core Entrustable Professional Activities for Entering Residency includes as an element of Entrustable Professional Activity 13 to “identify system failures and contribute to a culture of safety and improvement.” We set out to determine the feasibility of using medical students’ action learning projects (ALPs to expedite implementation of evidence-based pathways for three common patient diagnoses in the emergency department (ED setting (Atrial fibrillation, congestive heart failure, and pulmonary embolism. Methods These prospective quality improvement (QI initiatives were performed over six months in three Northeastern PA hospitals. Emergency physician mentors were recruited to facilitate a QI experience for third-year medical students for each project. Six students were assigned to each mentor and given class time and network infrastructure support (information technology, consultant experts in lean management to work on their projects. Students had access to background network data that revealed potential for improvement in disposition (home for patients. Results Under the leadership of their mentors, students accomplished standard QI processes such as performing the background literature search and assessing key stakeholders’ positions that were involved in the respective patient’s care. Students effectively developed flow diagrams, computer aids for clinicians and educational programs, and participated in recruiting champions for the new practice standard. They met with other departmental clinicians to determine barriers to implementation and used this feedback to help set specific parameters to make clinicians more comfortable with the changes in practice that were recommended. All three clinical practice guidelines were initiated at consummation of the students’ projects. After implementation, 86% (38/44 of queried ED providers felt comfortable

  1. Using Medical Student Quality Improvement Projects to Promote Evidence-Based Care in the Emergency Department. (United States)

    Manning, Michael W; Bean, Eric W; Miller, Andrew C; Templer, Suzanne J; Mackenzie, Richard S; Richardson, David M; Bresnan, Kristin A; Greenberg, Marna R


    The Association of American Medical Colleges' (AAMC) initiative for Core Entrustable Professional Activities for Entering Residency includes as an element of Entrustable Professional Activity 13 to "identify system failures and contribute to a culture of safety and improvement." We set out to determine the feasibility of using medical students' action learning projects (ALPs) to expedite implementation of evidence-based pathways for three common patient diagnoses in the emergency department (ED) setting (Atrial fibrillation, congestive heart failure, and pulmonary embolism). These prospective quality improvement (QI) initiatives were performed over six months in three Northeastern PA hospitals. Emergency physician mentors were recruited to facilitate a QI experience for third-year medical students for each project. Six students were assigned to each mentor and given class time and network infrastructure support (information technology, consultant experts in lean management) to work on their projects. Students had access to background network data that revealed potential for improvement in disposition (home) for patients. Under the leadership of their mentors, students accomplished standard QI processes such as performing the background literature search and assessing key stakeholders' positions that were involved in the respective patient's care. Students effectively developed flow diagrams, computer aids for clinicians and educational programs, and participated in recruiting champions for the new practice standard. They met with other departmental clinicians to determine barriers to implementation and used this feedback to help set specific parameters to make clinicians more comfortable with the changes in practice that were recommended. All three clinical practice guidelines were initiated at consummation of the students' projects. After implementation, 86% (38/44) of queried ED providers felt comfortable with medical students being a part of future ED QI

  2. Sir William Burnett (1779-1861), professional head of the Royal Naval Medical Department and entrepreneur. (United States)

    Penn, Christopher


    Sir William Burnett (1779-1861) had an active career as a Royal Navy surgeon in the French Revolutionary and Napoleonic Wars, including service at the battles of St Vincent, the Nile and Trafalgar. From 1822 to 1855 he was professional head of the Royal Naval Medical Department, when he provided effective leadership in a time of great change. Although his official work earned him the reputation of a "hard-working, unimaginative, somewhat harsh man", his correspondence shows a very humane centre under the official carapace. His official performance and reputation were both eroded towards the end of his career by his determined promotion of zinc chloride, for which he held lucrative patents.

  3. The suitability of ISO 9001 as a quality system for a medical illustration department. (United States)

    Fleming, C M; Armes, F M


    The Medical illustration Department within Bradford Hospitals NHS Trust is typical of many such units in the UK that are facing increasing competition from the commercial sector and Private Finance Initiatives, and at the same time, being driven by NHS initiatives towards having a demonstrable quality system. It was considered that having a recognized quality management system would ensure that the service provided was more efficient and effective, improve quality, guard against competition, be an asset if the organization was benchmarked against others, and provide evidence of quality assurance to our customers. This paper summarizes the history of quality management, discusses a number of quality systems in the NHS in general, and in Bradford Hospitals NHS Trust in particular, and puts forward the reasons for choosing ISO9001. Finally, the process leading to accreditation is described.

  4. Evaluating the Effectiveness of Community and Hospital Medical Record Integration on Management of Behavioral Health in the Emergency Department. (United States)

    Ngo, Stephanie; Shahsahebi, Mohammad; Schreiber, Sean; Johnson, Fred; Silberberg, Mina


    This study evaluated the correlation of an emergency department embedded care coordinator with access to community and medical records in decreasing hospital and emergency department use in patients with behavioral health issues. This retrospective cohort study presents a 6-month pre-post analysis on patients seen by the care coordinator (n=524). Looking at all-cause healthcare utilization, care coordination was associated with a significant median decrease of one emergency department visit per patient (p management of behavioral health patients.

  5. Equivalent doses of ionizing radiation received by medical staff at a nuclear medicine department

    International Nuclear Information System (INIS)

    Dziuk, E.; Kowalczyk, A.; Siekierzynski, M.; Jazwinski, J.; Chas, J.; Janiak, M.K.; Palijczuk, D.


    Aim: Total annual activity of I-131 used for the treatment of thyroid disorders at the Dept.of Nuclear Medicine, Central Clinical Hospital, Military University School of Medicine, in Warsaw, Poland, equal to 190 GBq; at the same time, total activity of Tc-99m utilized at the same Department for diagnostic purposes reached 1 TBq. As estimated from the radiometer readings, in extreme cases the equivalent at a couple of measurement points at this Department may exceed 200 mSv per year. Thus, in the present study we aimed to assess the potential risk of the exposure of medical personnel of the Department to ionizing radiation. Material and Methods: Polymethacrylate cases each housing four thermoluminescent dosimeters were continuously worn for one year by the nurses and doctors with the dosimeters being replaced by the new ones every three months. In addition, cases containing thermoluminescent dosimeters (three dosimeters per case) were placed in 20 different measurement points across the Department and the monitoring of the doses was carried out continuously for more than six years (from May 1995 to March 2002). Based on the quarterly readings of the dosimeters, equivalent doses were calculated for both the members of the personnel and the measurement space points. Results: The doses registered in the patient rooms ranged 5 to 90 mSv x y -1 , in the application room 10 to 15 mSv x y -1 , in the laboratory rooms 1.5 to 30 mSv x y -1 , and in the waiting room 2 to 6 mSv x y -1 ; no increment above the background level was detected in the nurses' station. Accordingly, the annual doses calculated from the dosimeters worn by the staff ranged 0.2 to 1.1 mSv x y -1 ; these latter findings were confirmed by direct readings from individual film dosimeters additionally worn by the staff members. Conclusion: The obtained results indicate that it is unlikely for the personnel of the monitored Nuclear Medicine Department to receive doses of radiation exceeding 40% of the annual

  6. Army dreamers. (United States)


    The birth of the Army Nursing Service took place in 1854, when Florence Nightingale, at the request of the Secretary of State for War, recruited and took to Scutari Hospital 38 women to tend the wounded of the Crimean war.

  7. Unusual clustering of coefficients of variation in published articles from a medical biochemistry department in India. (United States)

    Hudes, Mark L; McCann, Joyce C; Ames, Bruce N


    A simple statistical method is described to test whether data are consistent with minimum statistical variability expected in a biological experiment. The method is applied to data presented in data tables in a subset of 84 articles among more than 200 published by 3 investigators in a small medical biochemistry department at a major university in India and to 29 "control" articles selected by key word PubMed searches. Major conclusions include: 1) unusual clustering of coefficients of variation (CVs) was observed for data from the majority of articles analyzed that were published by the 3 investigators from 2000-2007; unusual clustering was not observed for data from any of their articles examined that were published between 1992 and 1999; and 2) among a group of 29 control articles retrieved by PubMed key word, title, or title/abstract searches, unusually clustered CVs were observed in 3 articles. Two of these articles were coauthored by 1 of the 3 investigators, and 1 was from the same university but a different department. We are unable to offer a statistical or biological explanation for the unusual clustering observed.

  8. Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments. (United States)

    Langabeer, James R; Gonzalez, Michael; Alqusairi, Diaa; Champagne-Langabeer, Tiffany; Jackson, Adria; Mikhail, Jennifer; Persse, David


    Emergency medical services (EMS) agencies transport a significant majority of patients with low acuity and non-emergent conditions to local emergency departments (ED), affecting the entire emergency care system's capacity and performance. Opportunities exist for alternative models that integrate technology, telehealth, and more appropriately aligned patient navigation. While a limited number of programs have evolved recently, no empirical evidence exists for their efficacy. This research describes the development and comparative effectiveness of one large urban program. The Houston Fire Department initiated the Emergency Telehealth and Navigation (ETHAN) program in 2014. ETHAN combines telehealth, social services, and alternative transportation to navigate primary care-related patients away from the ED where possible. Using a case-control study design, we describe the program and compare differences in effectiveness measures relative to the control group. During the first 12 months, 5,570 patients participated in the telehealth-enabled program, which were compared against the same size control group. We found a 56% absolute reduction in ambulance transports to the ED with the intervention compared to the control group (18% vs. 74%, P models are effective at reducing unnecessary ED ambulance transports and increasing EMS unit productivity. This provides support for broader EMS mobile integrated health programs in other regions.

  9. Analysis of Factors and Medical Errors Involved in Patient Complaints in a European Emergency Department

    Directory of Open Access Journals (Sweden)

    Pauline Haroutunian


    Full Text Available Introduction: Patients’ complaints from Emergency Departments (ED are frequent and can be used as a quality assurance indicator. Objective: Factors contributing to patients’ complaints (PCs in the emergency department were analyzed.  Methods: It was a retrospective cohort study, the qualitative variables of patients’ complaints visiting ED of a university hospital were compared with Chi-Square and t test tests. Results: Eighty-five PC were analyzed. The factors contributing to PC were: communication (n=26, length of stay (LOS (n=24, diagnostic errors (n=21, comfort and privacy issues (n=7, pain management (n=6, inappropriate treatment (n=6, delay of care and billing issues (n=3. PCs were more frequent when patients were managed by residents, during night shifts, weekends, Saturdays, Mondays, January and June. Moreover, the factors contributing to diagnostic errors were due to poor communication, non-adherence to guidelines and lack of systematic proofreading of X-rays. In 98% of cases, disputes were resolved by apology and explanation and three cases resulted in financial compensation. Conclusion: Poor communication, LOS and medical errors are factors contributing to PCs. Improving communication, resolving issues leading to slow health care provision, adequate staffing and supervision of trainees may reduce PCs.

  10. Nuclear risk: information of medical practitioners in Isere Department. Impact of the booklet: 'doctors and nuclear risk'

    International Nuclear Information System (INIS)

    Jonquet, M.E.


    In this thesis, the author first presents 'Isere, pilot department' operation, then the importance of nuclear risks in Isere, considers the role and place of medical practitioners in the management of this risk and in information request of medical personnel. The author also presents the booklet 'Doctors and nuclear risk' and analyzes the results of study on its impact close to medical population. 9 tabs., 25 figs

  11. Acute Stress and Anxiety in Medical Residents on the Emergency Department Duty

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    Joaquín M. González-Cabrera


    Full Text Available The objectives of this longitudinal study were to compare salivary cortisol release patterns in medical residents and their self-perceived anxiety levels between a regular working day and a day when on call in the emergency department (ED-duty day and to determine any differences in cortisol release pattern as a function of years of residency or sex. The study included 35 residents (physicians-in-training of the Granada University Hospital, Granada, Spain. Acute stress was measured on a regular working day and an ED-duty day, evaluating anxiety-state with the Spanish version of the State-Trait Anxiety Inventory. Physiological stress assessment was based on salivary cortisol levels. Cortisol release concentrations were higher on an ED-duty day than on a regular working day, with a significantly increased area under the curve (AUC (p < 0.006. This difference slightly attenuated with longer residency experience. No gender difference in anxiety levels was observed (p < 0.001. According to these findings, the hypothalamic-pituitary-adrenal axis activity and anxiety levels of medical residents are higher on an ED-duty day than on a regular working day.

  12. [Prognostic factors in community acquired pneumonia. Prospective multicenter study in internal medical departments]. (United States)

    Apolinario Hidalgo, R; Suárez Cabrera, M; Geijo Martínez, M P; Bernabéu-Wittel, M; Falguera Sacrest, M; Limiñana Cañal, J M


    the aims of the present study were to evaluate the clinical and microbiological characteristics of patients suffering from community-acquired pneumonia attended in the Internal Medical Departments of several Spanish institutions and to analyze those prognostic factors predicting thirty-day mortality in such patients. Past medical history, symptoms and signs, radiological pattern and blood parameters including albumin and C Reactive Protein, were recorded for each patient. Time from admission to starting antibiotics (in hours) and follow-up (in days) were also recorded. Patients were stratified by the Pneumonia Severity Index in five risk classes. 389 patients were included in the study, most of them in Fine categories III to V. Mortality rate for all patients was 12.1% (48 patients), increasing up to 40% in Fine Class V. Neither age, sex nor time from admission to the start of antibiotic treatment predicted survival rates. Plasmatic levels of PCR or microbiologic diagnosis were not related to clinical outcome. In the Cox regression analysis, oriented patients (OR 0.138, IC95% 0.055-0.324), and those with normal albuminemia (OR 0.207, IC95% 0.103-0.417) showed better survival rates. On the contrary, those with active carcinoma (OR 3.2, IC95% 1.181-8.947) significantly showed a reduced life expectancy. Besides the fully accepted Fine scale criteria, albumin measurements should be included in routine evaluation in order to improve patient s prognostic classification.

  13. Financial incentives and accountability for integrated medical care in Department of Veterans Affairs mental health programs. (United States)

    Kilbourne, Amy M; Greenwald, Devra E; Hermann, Richard C; Charns, Martin P; McCarthy, John F; Yano, Elizabeth M


    This study assessed the extent to which mental health leaders perceive their programs as being primarily accountable for monitoring general medical conditions among patients with serious mental illness, and it assessed associations with modifiable health system factors. As part of the Department of Veterans Affairs (VA) 2007 national Mental Health Program Survey, 108 mental health program directors were queried regarding program characteristics. Perceived accountability was defined as whether their providers, as opposed to external general medical providers, were primarily responsible for specific clinical tasks related to serious mental illness treatment or high-risk behaviors. Multivariable logistic regression was used to determine whether financial incentives or other system factors were associated with accountability. Thirty-six percent of programs reported primary accountability for monitoring diabetes and cardiovascular risk after prescription of second-generation antipsychotics, 10% for hepatitis C screening, and 17% for obesity screening and weight management. In addition, 18% and 27% of program leaders, respectively, received financial bonuses for high performance for screening for risk of diabetes and cardiovascular disease and for alcohol misuse. Financial bonuses for diabetes and cardiovascular screening were associated with primary accountability for such screening (odds ratio=5.01, pFinancial incentives to improve quality performance may promote accountability in monitoring diabetes and cardiovascular risk assessment within mental health programs. Integrated care strategies (co-location) might be needed to promote management of high-risk behaviors among patients with serious mental illness.

  14. Assessment of diabetic teleretinal imaging program at the Portland Department of Veterans Affairs Medical Center. (United States)

    Tsan, Grace L; Hoban, Keely L; Jun, Weon; Riedel, Kevin J; Pedersen, Amy L; Hayes, John


    We conducted a retrospective chart review of 200 diabetic patients who had teleretinal imaging performed between January 1, 2010, and January 1, 2011, at Portland Department of Veterans Affairs (VA) Medical Center outpatient clinics to assess the effectiveness of the diabetic teleretinal imaging program. Twenty patients (10%) had diabetic retinopathy. Ninety percent of the available teleretinal imaging studies were of adequate quality for interpretation. In accordance with local VA policy at that time, all teleretinal imaging patients should have been referred for a dilated retinal examination the following year. Image readers referred 97.5% of the patients to eye clinics for subsequent eye examinations, but the imagers scheduled appointments for only 80% of these patients. The redundancy rate, i.e., patients who had an eye examination within the past 6 mo, was 11%; the duplicate recall rate, i.e., patients who had a second teleretinal imaging performed within 1 yr of the eye examination, was 37%. Rates of timely diabetic eye examinations at clinics with teleretinal imaging programs, particularly when teleretinal imaging and eye clinics were colocated at the same community-based outpatient clinic, were higher than those without a teleretinal imaging program. We concluded that the Portland VA Medical Center's teleretinal imaging program was successful in increasing the screening rate for diabetic retinopathy.

  15. Spreading a medical home redesign: effects on emergency department use and hospital admissions. (United States)

    Reid, Robert J; Johnson, Eric A; Hsu, Clarissa; Ehrlich, Kelly; Coleman, Katie; Trescott, Claire; Erikson, Michael; Ross, Tyler R; Liss, David T; Cromp, DeAnn; Fishman, Paul A


    The patient-centered medical home (PCMH) is being rapidly deployed in many settings to strengthen US primary care, improve quality, and control costs; however, evidence supporting this transformation is still lacking. We describe the Group Health experience in attempting to replicate the effects on health care use seen in a PCMH prototype clinic via a systemwide spread using Lean as the change strategy. We used an interrupted time series analysis with a patient-month unit of analysis over a 4-year period that included baseline, implementation, and stabilization periods for 412,943 patients. To account for secular trends across these periods, we compared changes in use of face-to-face primary care visits, emergency department visits, and inpatient admissions with those of a nonequivalent comparison group of patients served by community network practices. After accounting for secular trends among network patients, patients empaneled to the PCMH clinics had 5.1% and 6.7% declines in primary care office visits in early and later stabilization years, respectively, after the implementation year. This trend was accompanied by a 123% increase in the use of secure electronic message threads and a 20% increase in telephone encounters. Declines were also seen in emergency department visits at 1 and 2 years (13.7% and 18.5%) compared with what would be expected based on secular trends in network practices. No statistically significant changes were found for hospital admissions. The Group Health experience shows it is possible to reduce emergency department use with PCMH transformation across a diverse set of clinics using a clear change strategy (Lean) and sufficient resources and supports.

  16. Encouraging Work Family Balance: Why The Department of Defense Needs A Family Medical Leave Act (United States)


    the author does not propose a policy, she recognizes there needs to be one implemented which would include counseling of single service members and...Sergeant (E-5) ranks with a total of 19,987 Soldiers. These two rank groups accounted for 72% of the overall population Soldiers discharged. The Army...psychological injuries, seek counseling , participate in safety planning, relocation, or other steps to ensure physical safety of service member

  17. [Accuracy in the medication history and reconciliation errors in the emergency department]. (United States)

    de Andrés-Lázaro, Ana M; Sevilla-Sánchez, Daniel; Ortega-Romero, M del Mar; Codina-Jané, Carles; Calderón-Hernanz, Beatriz; Sánchez-Sánchez, Miquel


    To assess the accuracy of pharmaceutical anamnesis obtained at the Emergency Department (ED) of a tertiary referral hospital and to determine the prevalence of medication reconciliation errors (RE). This was a single-center, prospective, interventional study. The home medication list obtained by a pharmacist was compared with the one recorded by a doctor to identify inaccuracies. Subsequently, the home medication list was compared with the active prescription at the ED. All unexplained discrepancies were checked with the doctor in charge to evaluate if a RE has occurred. An univariate analysis was performed to identify factors associated with RE. The pharmacist identified a higher number of drugs than doctors (6.89 versus 5.70; P<0.05). Only 39% of the drugs obtained by doctors were properly written down in the patient's record. The main cause of discrepancy was omission of information regarding the name of the drug (39%) or its dosage (33%). One hundred and fifty-seven RE were identified and they affected 85 patients (43%), mainly related to information omission (62%). Age and polymedication were identified as main risk factors of RE. The presence of a caregiver or relative in the ED was judged to be a protective factor. No relationship was found between inaccuracies in the registries and RE. The process of obtaining a proper pharmaceutical anamnesis still needs improvement. The pharmacist may play a role in the process of obtaining a good quality anamnesis and increase patient safety by detecting RE. Better information systems are needed to avoid this type of incidents. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  18. Cough Variant Asthma in Medical Outpatient Department of a Tertiary Care Hospital in Bangladesh

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    Rukhsana Parvin


    Full Text Available Background: Cough variant asthma (CVA is a subset of asthma where the only symptom is chronic persistent cough. Many cases go unrecognized due to lack of proper evaluation. Response to asthma medication with features supportive of airway hypersensitivity helps in management of this disease. Objective: To find out the proportion of cough variant asthma among the patients attending medicine outpatient department of Enam Medical College, Savar, Dhaka. Materials and Methods: This cross sectional study was conducted in Enam Medical College Hospital, Savar, Dhaka over a period of two years from July 2009 to July 2011. Cough variant asthma was diagnosed mainly on clinical ground as chronic cough without wheezing, fever, weight loss, shortness of breath or sputum or any other apparent cause that persisted for more than eight weeks with absolutely normal physical examination of chest, normal chest radiography and blood count except raised eosinophil count and IgE level. Patients who met these criteria were given 2 weeks course of inhaler beclomethasone propionate and were assessed for improvement. Those who improved after steroid inhalation were categorised as having cough variant asthma. Results: Out of purposively selected 148 patients complaining only of chronic dry cough for more than eight weeks, 92 patients met the primary selection criteria for cough variant asthma. These 92 patients were given 2 weeks trial of 250 ìgm beclomethasone inhalation twice daily. Seventy nine patients reported almost complete recovery from chronic cough after 2 weeks and were categorized as having CVA. Thirteen patients did not improve and were not categorized as CVA. Conclusion: These findings suggest that cough variant asthma is the most common among the patients with chronic cough not due to any apparent cause. The efficacy of inhaled corticosteroid suggests that early intervention is effective in the treatment of this disease.

  19. The effect of medical trainees on pediatric emergency department flow: a discrete event simulation modeling study. (United States)

    Genuis, Emerson D; Doan, Quynh


    Providing patient care and medical education are both important missions of teaching hospital emergency departments (EDs). With medical school enrollment rising, and ED crowding becoming an increasing prevalent issue, it is important for both pediatric EDs (PEDs) and general EDs to find a balance between these two potentially competing goals. The objective was to determine how the number of trainees in a PED affects patient wait time, total ED length of stay (LOS), and rates of patients leaving without being seen (LWBS) for PED patients overall and stratified by acuity level as defined by the Pediatric Canadian Triage and Acuity Scale (CTAS) using discrete event simulation (DES) modeling. A DES model of an urban tertiary care PED, which receives approximately 40,000 visits annually, was created and validated. Thirteen different trainee schedules, which ranged from averaging zero to six trainees per shift, were input into the DES model and the outcome measures were determined using the combined output of five model iterations. An increase in LOS of approximately 7 minutes was noted to be associated with each additional trainee per attending emergency physician working in the PED. The relationship between the number of trainees and wait time varied with patients' level of acuity and with the degree of PED utilization. Patient wait time decreased as the number of trainees increased for low-acuity visits and when the PED was not operating at full capacity. With rising numbers of trainees, the PED LWBS rate decreased in the whole department and in the CTAS 4 and 5 patient groups, but it rose in patients triaged CTAS 3 or higher. A rising numbers of trainees was not associated with any change to flow outcomes for CTAS 1 patients. The results of this study demonstrate that trainees in PEDs have an impact mainly on patient LOS and that the effect on wait time differs between patients presenting with varying degrees of acuity. These findings will assist PEDs in finding a

  20. Nanotechnology Laboratory Collaborates with Army to Develop Botulism Vaccine | FNLCR (United States)

    The Nanotechnology Characterization Laboratory (NCL) is collaborating with the Army to develop a candidate vaccine against botulism. Under a collaboration agreement between the National Cancer Institute and the U.S. Army Medical Research Institute of

  1. 32 CFR Appendix G to Part 623 - Continental US Army Boundaries (United States)


    ... 32 National Defense 3 2010-07-01 2010-07-01 true Continental US Army Boundaries G Appendix G to Part 623 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY SUPPLIES AND EQUIPMENT LOAN OF ARMY MATERIEL Pt. 623, App. G Appendix G to Part 623—Continental US Army Boundaries...

  2. Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments

    Directory of Open Access Journals (Sweden)

    James Robert Langabeer


    Full Text Available Introduction Emergency medical services (EMS agencies transport a significant majority of patients with low acuity and non-emergent conditions to local emergency departments (ED, affecting the entire emergency care system’s capacity and performance. Opportunities exist for alternative models that integrate technology, telehealth, and more appropriately aligned patient navigation. While a limited number of programs have evolved recently, no empirical evidence exists for their efficacy. This research describes the development and comparative effectiveness of one large urban program. Methods The Houston Fire Department initiated the Emergency Telehealth and Navigation (ETHAN program in 2014. ETHAN combines telehealth, social services, and alternative transportation to navigate primary care-related patients away from the ED where possible. Using a case-control study design, we describe the program and compare differences in effectiveness measures relative to the control group. Results During the first 12 months, 5,570 patients participated in the telehealth-enabled program, which were compared against the same size control group. We found a 56% absolute reduction in ambulance transports to the ED with the intervention compared to the control group (18% vs. 74%, P<.001. EMS productivity (median time from EMS notification to unit back in service was 44 minutes faster for the ETHAN group (39 vs. 83 minutes, median. There were no statistically significant differences in mortality or patient satisfaction. Conclusion We found that mobile technology-driven delivery models are effective at reducing unnecessary ED ambulance transports and increasing EMS unit productivity. This provides support for broader EMS mobile integrated health programs in other regions.

  3. Evaluation of quality control in the college of medical radiological sciences, conventional x-ray department

    International Nuclear Information System (INIS)

    Babiker, Esameldeen Mohamed Tom


    Quality control in diagnostic radiography aims to ensure continuous production of diagnostic images with optimum quality, using minimum necessary dose to the patients and staff. Therefore an ineffective quality control program can lead to poor quality images that can impair diagnosis, increase operating costs and contribute to unnecessary radiation exposure to both patients and staff. Apply basic quality control program is responsibility of each x-ray facility, and to achieve maximum benefits, all levels of management and technical staff must support and participate in operating the programme. The main parameters to be monitored during the quality control programme include: dose consistency, k Vp accuracy, k Vp variations, exposure timer accuracy, besides checking image receptors, recording system and processing conditions. The aims of this project is to evaluate the quality control in the x-ray department of the college of medical radiologic sciences. The evaluation was an experimental study done by checking the operational status of the radiographic equipment, beside data collection using questionnaires regarding quality control. In the applied experiments the results show that there is a noted variation in the accuracy of k Vp, exposure timer and also in the dose consistency. The obtained results from image receptors and processing system showed noted variations too. The results of the questionnaire and direct interviewing showed other causes of quality degradation such as absence of test tools, the status of the equipment, absence of regular quality control testing, in addition to absence of an organized team to deal with quality. (Author)

  4. Optimization of working conditions of medical staff of isotopic diagnostic departments. Optimizatsiya uslovij truda meditsinskogo personala radiodiagnosticheskikh otdelenij

    Energy Technology Data Exchange (ETDEWEB)

    Ovsyannikov, A S [Akademiya Meditsinskikh Nauk SSSR, Moscow (USSR). Inst. Gigieny Truda i Professional' nykh Zabolevanij


    The study was undertaken to analyze the characteristics of the work of medical staff of isotopic diagnostic departments during use of {sup 99m}Tc isotope generators. The data on the functional load of physicians and paramedical staff were given along with the description of radiation doses and dose rates at various stages of work. The measures on optimization of labour conditions by means of the appropriate department's design, improvement of the regime of nurses' work and adequate allocation and utilization of medical equipment were developed.

  5. Investments for medical equipment in a mother and child health hospital: correlation with level of services/departments. (United States)

    Trevisanuto, Daniele; Raggi, Roberto; Bavuusuren, Bayasgalantai; Tudevdorj, Erkhembaatar; Doglioni, Nicoletta; Zanardo, Vincenzo


    To assess whether investments for medical equipments assigned by a team of experts to a mother and child health hospital located in Mongolia were correlated with structural, organizational, and educational level of its services/departments. A score was used for evaluating the level of each service/department. It was based on a 'structural area' and an 'organizational and educational area'. Destination of funds was determined by a team of experts in collaboration with the head of the service/department. Thirty-three of 36 services/departments (91.6%) were evaluated. A total sum of 4,432,140 Euros to invest in medical equipment was estimated. Assigned investments were inversely correlated with the total (structural plus organizational and educational area) score (n = 33; r =  -0.59; p = 0.0002), and the specific scores for structural area (n = 33; r = -0.46; p = 0.005) and organizational and educational area (n = 33; r =  -0.56; p = 0.0006). A large part of the funds for medical equipment was destined to services/departments with low organizational and educational conditions, limiting the potential effect of the aid meanwhile supporting the most in need departments. Educational efforts and monitoring of specific long-term indicators are mandatory.

  6. Estimates of electronic medical records in U.S. Emergency departments.

    Directory of Open Access Journals (Sweden)

    Benjamin P Geisler

    Full Text Available BACKGROUND: Policymakers advocate universal electronic medical records (EMRs and propose incentives for "meaningful use" of EMRs. Though emergency departments (EDs are particularly sensitive to the benefits and unintended consequences of EMR adoption, surveillance has been limited. We analyze data from a nationally representative sample of US EDs to ascertain the adoption of various EMR functionalities. METHODOLOGY/PRINCIPAL FINDINGS: We analyzed data from the National Hospital Ambulatory Medical Care Survey, after pooling data from 2005 and 2006, reporting proportions with 95% confidence intervals (95% CI. In addition to reporting adoption of various EMR functionalities, we used logistic regression to ascertain patient and hospital characteristics predicting "meaningful use," defined as a "basic" system (managing demographic information, computerized provider order entry, and lab and imaging results. We found that 46% (95% CI 39-53% of US EDs reported having adopted EMRs. Computerized provider order entry was present in 21% (95% CI 16-27%, and only 15% (95% CI 10-20% had warnings for drug interactions or contraindications. The "basic" definition of "meaningful use" was met by 17% (95% CI 13-21% of EDs. Rural EDs were substantially less likely to have a "basic" EMR system than urban EDs (odds ratio 0.19, 95% CI 0.06-0.57, p = 0.003, and Midwestern (odds ratio 0.37, 95% CI 0.16-0.84, p = 0.018 and Southern (odds ratio 0.47, 95% CI 0.26-0.84, p = 0.011 EDs were substantially less likely than Northeastern EDs to have a "basic" system. CONCLUSIONS/SIGNIFICANCE: EMRs are becoming more prevalent in US EDs, though only a minority use EMRs in a "meaningful" way, no matter how "meaningful" is defined. Rural EDs are less likely to have an EMR than metropolitan EDs, and Midwestern and Southern EDs are less likely to have an EMR than Northeastern EDs. We discuss the nuances of how to define "meaningful use," and the importance of considering not only

  7. Medication problems are frequent and often serious in a Danish emergency department and may be discovered by clinical pharmacists

    DEFF Research Database (Denmark)

    Backer Mogensen, Christian; Thisted, Anette Rehn; Olsen, Inger


    Transferring a patient from one health-care sector to another implies a risk of medication errors. It is of interest to evaluate whether a specialist in clinical pharmacy is beneficial for the patients in the emergency departments (ED). The aim of the present study was to report the incidence, ca......, categories and seriousness of medication problems discovered by clinical pharmacists in an ED and to evaluate if it is possible for pharmacists to identify those groups of patients who are most at risk of medication problems....

  8. Standardizing Medication Error Event Reporting in the U.S. Department of Defense

    National Research Council Canada - National Science Library

    Nosek, Ronald A., Jr; McMeekin, Judy; Rake, Geoffrey W


    ...) began an aggressive examination of medical errors and the strategies for minimizing them. A primary goal was the creation of a standardized medication event reporting system, including a central registry for the compilation of reported data...

  9. Performance evaluation of medical records departments by analytical hierarchy process (AHP) approach in the selected hospitals in Isfahan : medical records dep. & AHP. (United States)

    Ajami, Sima; Ketabi, Saeedeh


    Medical Records Department (MRD) is an important unit for evaluating and planning of care services. The goal of this study is evaluating the performance of the Medical Records Departments (MRDs) of the selected hospitals in Isfahan, Iran by using Analytical Hierarchy Process (AHP). This was an analytic of cross-sectional study that was done in spring 2008 in Isfahan, Iran. The statistical population consisted of MRDs of Alzahra, Kashani and Khorshid Hospitals in Isfahan. Data were collected by forms and through brainstorm technique. To analyze and perform AHP, Expert Choice software was used by researchers. Results were showed archiving unit has received the largest importance weight with respect to information management. However, on customer aspect admission unit has received the largest weight. Ordering weights of Medical Records Departments' Alzahra, Kashani and Khorshid Hospitals in Isfahan were with 0.394, 0.342 and 0.264 respectively. It is useful for managers to allocate and prioritize resources according to AHP technique for ranking at the Medical Records Departments.

  10. [Medication errors in a hospital emergency department: study of the current situation and critical points for improving patient safety]. (United States)

    Pérez-Díez, Cristina; Real-Campaña, José Manuel; Noya-Castro, María Carmen; Andrés-Paricio, Felicidad; Reyes Abad-Sazatornil, María; Bienvenido Povar-Marco, Javier


    To determine the frequency of medication errors and incident types in a tertiary-care hospital emergency department. To quantify and classify medication errors and identify critical points where measures should be implemented to improve patient safety. Prospective direct-observation study to detect errors made in June and July 2016. The overall error rate was 23.7%. The most common errors were made while medications were administered (10.9%). We detected 1532 incidents: 53.6% on workdays (P=.001), 43.1% during the afternoon/evening shift (P=.004), and 43.1% in observation areas (P=.004). The medication error rate was significant. Most errors and incidents occurred during the afternoon/evening shift and in the observation area. Most errors were related to administration of medications.

  11. Educational climate seems unrelated to leadership skills of clinical consultants responsible of postgraduate medical education in clinical departments

    DEFF Research Database (Denmark)

    Malling, Bente Vigh; Mortensen, Lene S.; Scherpbier, Albert J J


    The educational climate is crucial in postgraduate medical education. Although leaders are in the position to influence the educational climate, the relationship between leadership skills and educational climate is unknown. This study investigates the relationship between the educational climate...... in clinical departments and the leadership skills of clinical consultants responsible for education....

  12. Boundaries - US Army Corps of Engineers - Habitat Restoration and Enhancement Projects (HREPs) (United States)

    Army Corps of Engineers, Department of the Army, Department of Defense — Congress authorized the Environmental Management Program (EMP) in the 1986 Water Resources Development Act to help address ecological needs on the Upper Mississippi...

  13. Walter Reed Army Medical Center (WRAMC) and Office of Management and Budget (OMB) Circular A-76: Implications for the Future

    National Research Council Canada - National Science Library

    Grasso, Valerie B


    This report examines the issues surrounding the recent Walter Reed public-private competition conducted under OMB Circular A-76 and its potential impact on future Department of Defense competitions...

  14. Dedication increases productivity: an analysis of the implementation of a dedicated medical team in the emergency department. (United States)

    Ramos, Pedro; Paiva, José Artur


    In several European countries, emergency departments (EDs) now employ a dedicated team of full-time emergency medicine (EM) physicians, with a distinct leadership and bed-side emergency training, in all similar to other hospital departments. In Portugal, however, there are still two very different models for staffing EDs: a classic model, where EDs are mostly staffed with young inexperienced physicians from different medical departments who take turns in the ED in 12-h shifts and a dedicated model, recently implemented in some hospitals, where the ED is staffed by a team of doctors with specific medical competencies in emergency medicine that work full-time in the ED. Our study assesses the effect of an intervention in a large academic hospital ED in Portugal in 2002, and it is the first to test the hypothesis that implementing a dedicated team of doctors with EM expertise increases the productivity and reduces costs in the ED, maintaining the quality of care provided to patients. A pre-post design was used for comparing the change on the organisational model of delivering care in our medical ED. All emergency medical admissions were tracked in 2002 (classic model with 12-h shift in the ED) and 2005/2006 (dedicated team with full-time EM physicians), and productivity, costs with medical human resources and quality of care measures were compared. We found that medical productivity (number of patients treated per hour of medical work) increased dramatically after the creation of the dedicated team (X 2 KW = 31.135; N = 36; p work reduced both in regular hours and overtime. Moreover, hospitalisation rates decreased and the length of stay in the ED increased significantly after the creation of the dedicated team. Implementing a dedicated team of doctors increased the medical productivity and reduced costs in our ED. Our findings have straightforward implication for Portuguese policymakers aiming at reducing hospital costs while coping with increased ED demand.

  15. Graphical User Interface (GUI) for the Warfighter Physiological Status Monitoring (WPSM) System - U.S. Army Medic Recommendations

    National Research Council Canada - National Science Library

    Tharion, William J; Kaushik, Sangeeta


    .... This information is sent wirelessly to a personal digital assistant (PDA) held by the medic. The primary purpose of this study was to determine what features should be included in the graphical user interface (GUI...

  16. Impact of a computerized provider radiography order entry system without clinical decision support on emergency department medical imaging requests. (United States)

    Claret, Pierre-Géraud; Bobbia, Xavier; Macri, Francesco; Stowell, Andrew; Motté, Antony; Landais, Paul; Beregi, Jean-Paul; de La Coussaye, Jean-Emmanuel


    The adoption of computerized physician order entry is an important cornerstone of using health information technology (HIT) in health care. The transition from paper to computer forms presents a change in physicians' practices. The main objective of this study was to investigate the impact of implementing a computer-based order entry (CPOE) system without clinical decision support on the number of radiographs ordered for patients admitted in the emergency department. This single-center pre-/post-intervention study was conducted in January, 2013 (before CPOE period) and January, 2014 (after CPOE period) at the emergency department at Nîmes University Hospital. All patients admitted in the emergency department who had undergone medical imaging were included in the study. Emergency department admissions have increased since the implementation of CPOE (5388 in the period before CPOE implementation vs. 5808 patients after CPOE implementation, p=.008). In the period before CPOE implementation, 2345 patients (44%) had undergone medical imaging; in the period after CPOE implementation, 2306 patients (40%) had undergone medical imaging (p=.008). In the period before CPOE, 2916 medical imaging procedures were ordered; in the period after CPOE, 2876 medical imaging procedures were ordered (p=.006). In the period before CPOE, 1885 radiographs were ordered; in the period after CPOE, 1776 radiographs were ordered (pmedical imaging did not vary between the two periods. Our results show a decrease in the number of radiograph requests after a CPOE system without clinical decision support was implemented in our emergency department. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Evaluation of a Constrained Facet Analysis Efficiency Model for Identifying the Efficiency of Medical Treatment Facilities in the Army Medical Department (United States)


    examples on their use is available with the PASS User Documentation Manual. 2 The data structure of PASS requires a three- lvel organizational...files, and missing control variables. A specific problem noted involved the absence of 8087 mathematical co-processor on the target IBM-XT 21 machine...System, required an operational understanding of the advanced mathematical technique used in the model. Problems with the original release of the PASS

  18. Does Spanish instruction for emergency medicine resident physicians improve patient satisfaction in the emergency department and adherence to medical recommendations?

    Directory of Open Access Journals (Sweden)

    Stoneking LR


    Full Text Available LR Stoneking,1 AL Waterbrook,1 J Garst Orozco,2 D Johnston,1 A Bellafiore,1 C Davies,3 T Nuño,1 J Fatás-Cabeza,4 O Beita,5 V Ng,1 KH Grall,6 W Adamas-Rappaport7 1Department of Emergency Medicine, University of Arizona, Tucson, AZ, 2Department of Emergency Medicine, Sinai Health System, Chicago, IL, 3Department of Emergency Medicine, Maricopa Medical Center, Phoenix, AZ, 4Department of Spanish and Portuguese, University of Arizona, Tucson, AZ, 5Department of Family and Community Medicine, University of Arizona, Tucson, AZ, 6Department of Emergency Medicine, Regions Hospital, St Paul, MN, 7Department of Surgery, University of Arizona, Tucson, AZ, USA Background: After emergency department (ED discharge, Spanish-speaking patients with limited English proficiency are less likely than English-proficient patients to be adherent to medical recommendations and are more likely to be dissatisfied with their visit.Objectives: To determine if integrating a longitudinal medical Spanish and cultural competency curriculum into emergency medicine residency didactics improves patient satisfaction and adherence to medical recommendations in Spanish-speaking patients with limited English proficiency.Methods: Our ED has two Emergency Medicine Residency Programs, University Campus (UC and South Campus (SC. SC program incorporates a medical Spanish and cultural competency curriculum into their didactics. Real-time Spanish surveys were collected at SC ED on patients who self-identified as primarily Spanish-speaking during registration and who were treated by resident physicians from both residency programs. Surveys assessed whether the treating resident physician communicated in the patient’s native Spanish language. Follow-up phone calls assessed patient satisfaction and adherence to discharge instructions.Results: Sixty-three patients self-identified as primarily Spanish-speaking from August 2014 to July 2015 and were initially included in this pilot study

  19. Emergency department boarding and adverse hospitalization outcomes among patients admitted to a general medical service. (United States)

    Lord, Kito; Parwani, Vivek; Ulrich, Andrew; Finn, Emily B; Rothenberg, Craig; Emerson, Beth; Rosenberg, Alana; Venkatesh, Arjun K


    Overcrowding in the emergency department (ED) has been associated with patient harm, yet little is known about the association between ED boarding and adverse hospitalization outcomes. We sought to examine the association between ED boarding and three common adverse hospitalization outcomes: rapid response team activation (RRT), escalation in care, and mortality. We conducted an observational analysis of consecutive patient encounters admitted from the ED to the general medical service between February 2013 and June 2015. This study was conducted in an urban, academic hospital with an annual adult ED census over 90,000. We defined boarding as patients with greater than 4h from ED bed order to ED departure to hospital ward. The primary outcome was a composite of adverse outcomes in the first 24h of admission, including RRT activation, care escalation to intensive care, or in-hospital mortality. A total of 31,426 patient encounters were included of which 3978 (12.7%) boarded in the ED for 4h or more. Adverse outcomes occurred in 1.92% of all encounters. Comparing boarded vs. non-boarded patients, 41 (1.03%) vs. 244 (0.90%) patients experienced a RRT activation, 53 (1.33%) vs. 387 (1.42%) experienced a care escalation, and 1 (0.03%) vs.12 (0.04%) experienced unanticipated in-hospital death, within 24h of ED admission. In unadjusted analysis, there was no difference in the composite outcome between boarding and non-boarding patients (1.91% vs. 1.91%, p=0.994). Regression analysis adjusted for patient demographics, acuity, and comorbidities also showed no association between boarding and the primary outcome. A sensitivity analysis showed an association between ED boarding and the composite outcome inclusive of the entire inpatient hospital stay (5.8% vs. 4.7%, p=0.003). Within the first 24h of hospital admission to a general medicine service, adverse hospitalization outcomes are rare and not associated with ED boarding. Copyright © 2018 Elsevier Inc. All rights

  20. Drug abuse-related accidents leading to emergency department visits at two medical centers. (United States)

    Chen, Isaac Chun-Jen; Hung, Dong-Zong; Hsu, Chi-Ho; Wu, Ming-Ling; Deng, Jou-Fang; Chang, Chin-Yu; Shih, Hsin-Chin; Liu, Chen-Chi; Wang, Chien-Ying; Wen, Yi-Szu; Wu, Jackson Jer-Kan; Huang, Mu-Shun; Yang, Chen-Chang


    Drug abuse is becoming more prevalent in Taiwan, as evidenced by increasing reports of drug trafficking and drug abuse-related criminal activity, and the wide use of more contemporary illicit drugs. Consequently, drug abuse-related accidents are also expected to occur with greater frequency. However, no study has yet specifically evaluated the prevalence, pattern, and outcomes of drug abuse-related accidents among patients visiting emergency departments (EDs) in Taiwan. We conducted an ambidirectional study with patients who visited the EDs of Taipei Veterans General Hospital (TVGH) and China Medical University Hospital (CMUH) due to drug abuse-related accidents from January 2007 through September 2009. Information on the patients' baseline characteristics and clinical outcomes was collected and analyzed. During the study period, a total of 166 patients visited the EDs of one of the two study hospitals due to drug abuse-related accidents. This yielded a prevalence of drug abuse of 0.1% among all patients visiting the ED due to accident and/or trauma. Fifty-six out of the 166 patients visited the ED at TVGH, most patients being between 21 and 40 years old. Opioids (41.1%) were the drugs most commonly abused by the patients, followed by benzodiazepines (32.1%). More than two-thirds of the patients (n=38, 67.9%) required hospitalization, and three patients died (5.4%). In contrast, 110 patients with drug abuse-related accidents visited the ED at CMUH during the study period. Most of these subjects had abused benzodiazepines (69.1%), were between 21 and 40 years old, and were female. Fewer than one-fifth of the patients (n=19, 17.3%) required hospitalization, with no deaths reported. There were significant between-hospital differences in terms of patient gender, drugs of choice, injury mechanisms, method and time of the ED visit, triage levels, and need for hospitalization. Although the prevalence of drug abuse-related accidents was low, and only three patient deaths

  1. Army TLS (United States)


    Fast Deflation Device Tether marking Pennants Balloon / Tether marking LED Flashing light Loading Ramps Customized Trailer for transportation and Field...amount of xtra lift that permits the ballon to rise (if Res_Lift = 0, balloon is at equilibrium) RL = NL – Payload – Tether Payload: the weight of...Army TLS The TLS uses tethered aerodynamic blimps and precision-powered winches to loft one or more specialty-designed meteorological payloads that

  2. Occupational and Environmental Health Programs in a Medical School: Should They Be a Department? (United States)

    Rom, William N.


    Occupational and environmental health programs are beginning to be developed in many medical schools. The attitudes of medical school deans on their past experiences, current plans, and thoughts for the future for occupational and environmental health were surveyed and are described. (MLW)

  3. Impact of Severe Acute Respiratory Syndrome (SARS Outbreaks on the Use of Emergency Department Medical Resources

    Directory of Open Access Journals (Sweden)

    Chien-Cheng Huang


    Conclusion: The SARS outbreak did not eliminate the need of critically ill patients for advanced medical support. However, besides an overall decrease in patient numbers, the SARS epidemic markedly altered demographic information, clinical characteristics, and the use of medical services by adult patients in the ED of a SARS-dedicated hospital.

  4. Why do general medical patients have a lengthy wait in the emergency department before admission?

    Directory of Open Access Journals (Sweden)

    Nin-Chieh Hsu


    Conclusion: Complex comorbidities and terminal conditions with DNR consent were associated with the prolonged ED stay for general medical patients. The hospital manager should pay attention to general medical patients with multiple comorbidities as well as those who require palliative care.

  5. The Impact of a Health IT Changeover on Medical Imaging Department Work Processes and Turnaround Times: A mixed method study. (United States)

    Georgiou, A; Prgomet, M; Lymer, S; Hordern, A; Ridley, L; Westbrook, J


    To assess the impact of introducing a new Picture Archiving and Communication System (PACS) and Radiology Information System (RIS) on: (i) Medical Imaging work processes; and (ii) turnaround times (TATs) for x-ray and CT scan orders initiated in the Emergency Department (ED). We employed a mixed method study design comprising: (i) semi-structured interviews with Medical Imaging Department staff; and (ii) retrospectively extracted ED data before (March/April 2010) and after (March/April 2011 and 2012) the introduction of a new PACS/RIS. TATs were calculated as: processing TAT (median time from image ordering to examination) and reporting TAT (median time from examination to final report). Reporting TAT for x-rays decreased significantly after introduction of the new PACS/RIS; from a median of 76 hours to 38 hours per order (pMedical Imaging staff reported that the changeover to the new PACS/RIS led to gains in efficiency, particularly regarding the accessibility of images and patient-related information. Nevertheless, assimilation of the new PACS/RIS with existing Departmental work processes was considered inadequate and in some instances unsafe. Issues highlighted related to the synchronization of work tasks (e.g., porter arrangements) and the material set up of the work place (e.g., the number and location of computers). The introduction of new health IT can be a "double-edged sword" providing improved efficiency but at the same time introducing potential hazards affecting the effectiveness of the Medical Imaging Department.

  6. Evaluating acute medical admissions through emergency departments in Hong Kong: can one adjust for case-mix variation? (United States)

    Rainer, T H; Sollich, P; Piotrowski, T; Coolen, A C C; Cheng, B; Graham, C A


    Healthcare systems are under pressure to efficiently and safely reduce acute care admissions to hospital. There is a need to develop a standardised system for assessing emergency department performance which takes into account case-mix variation. The objective of this study was to derive and validate a standardised tool for assessing variations in medical admissions through emergency departments in Hong Kong. Retrospective study of patients attending emergency departments of 14 acute hospitals in Hong Kong. Data were retrieved from a centralised administrative database. Of 2,531,225 patients who attended emergency departments between 1 January 2001 and 31 December 2003, 780,444 (30.8%) were admitted to medical wards. A model derived from 2001 data shows well-calibrated admission probabilities, with an area under the receiver operating characteristic curve for probability of admission of 90.3 (95% CI ±0.11). The areas under the receiver operating characteristic curves for 2002 and 2003 validation sets were 89.9 (95% CI ±0.11) and 89.0 (95% CI ±0.12), respectively. With an averaged benchmark, reductions in medical admissions of up to 19% could be achieved, while under the most optimistic assumption, reductions of up 36% could be achieved. A tool for benchmarking hospital medical admissions and minimising case-mix variation has been derived and validated in Hong Kong, but it requires further validation in other healthcare systems given the wide variations in admission thresholds internationally. This may be used as one potential method to evaluate the performance of emergency departments against a common standard.

  7. U.S. Department of Energy Office of Occupational Medicine and Medical Surveillance 1995--1997 triannual report

    Energy Technology Data Exchange (ETDEWEB)



    From 1995 through 1997 the Office of Occupational Medicine and Medical Surveillance (EH-61) has made numerous achievements that have enhanced the performance of the office and more importantly, the Department of Energy (DOE). This report provides specific information about program activities and accomplishments, as well as individual contacts for each program. The mission of EH-61 is the prevention of worker illness by fostering outstanding occupational medicine and medical surveillance programs within the DOE complex. This mission is being realized as a result of efforts in four main business lines: (1) Surveillance; (2) Research, (3) Policy/Technical Support; and (4) Information/Communication.

  8. A CBO Study: Growth in Medical Spending by the Department of Defense

    National Research Council Canada - National Science Library

    Percy, Allison


    The Department of Defense (DoD) faces a growing burden in providing peacetime health care for military personnel, retirees, and their dependents and survivors-who all together number over 8 million...

  9. Medical and administrative management of a nuclear medicine department with a microcomputer

    International Nuclear Information System (INIS)

    Legras, B.; Kohler, F.


    The use of a microcomputer for data management in a department of Nuclear Medicine has allowed to reduce considerably office work, and supplies the physicians with very useful statistics on the investigations carried out [fr

  10. Systemwide Deployment of Medical Team Training: Lessons Learned in the Department of Defense

    National Research Council Canada - National Science Library

    King, Heidi B; Kohsin, Beth; Salisbury, Mary


    .... Lessons learned within the U.S. Department of Defense indicate that for teamwork initiatives to be effective, they must possess a clear blueprint defining the solid steps for building the desired culture...

  11. AMEDD Clinical Psychology Short Course Held in Letterman Army Medical Center, San Francisco, California on 5-9 February 1990 (United States)


    hypochondriasis about AIDS (62-67). The medical consequenLes of irrational fears and erroneous beliefs about HIV transmission include (a) shortages emotional or somatic symptoms through cognitive or somatic complaints. The BASIC-BIS approach recommends that psychosomatic states be assessed...via somatic parameters (physical complaints/symptoms, galvanic skin response, skin temperature, heart rate, and electromyogram, etc.) and cognitive

  12. Educational climate seems unrelated to leadership skills of clinical consultants responsible of postgraduate medical education in clinical departments. (United States)

    Malling, Bente; Mortensen, Lene S; Scherpbier, Albert J J; Ringsted, Charlotte


    The educational climate is crucial in postgraduate medical education. Although leaders are in the position to influence the educational climate, the relationship between leadership skills and educational climate is unknown. This study investigates the relationship between the educational climate in clinical departments and the leadership skills of clinical consultants responsible for education. The study was a trans-sectional correlation study. The educational climate was investigated by a survey among all doctors (specialists and trainees) in the departments. Leadership skills of the consultants responsible for education were measured by multi-source feedback scores from heads of departments, peer consultants, and trainees. Doctors from 42 clinical departments representing 21 specialties participated. The response rate of the educational climate investigation was moderate 52% (420/811), Response rate was high in the multisource-feedback process 84.3% (420/498). The educational climate was scored quite high mean 3.9 (SD 0.3) on a five-point Likert scale. Likewise the leadership skills of the clinical consultants responsible for education were considered good, mean 5.4 (SD 0.6) on a seven-point Likert scale. There was no significant correlation between the scores concerning the educational climate and the scores on leadership skills, r = 0.17 (p = 0.29). This study found no relation between the educational climate and the leadership skills of the clinical consultants responsible for postgraduate medical education in clinical departments with the instruments used. Our results indicate that consultants responsible for education are in a weak position to influence the educational climate in the clinical department. Further studies are needed to explore, how heads of departments and other factors related to the clinical organisation could influence the educational climate.

  13. Analysis of medical institutions with various organizational forms of rehabilitation treatment and outpatient departments

    Directory of Open Access Journals (Sweden)

    Shapovalenko T.V.


    Full Text Available The study aimed organization of the analysis of activity of two medical institutions rendering services in rehabilitation and recovery treatment to adult population, having various organizational forms. Material and Methods. For five years there had been studied practical experience of rendering medical care on recovery treatment and rehabilitation to adult population on the basis of medico-statistical processing of reporting documentation of the Medicine Recovery Center and the rehabilitation, Ministry of Health of Russia functioning on the basis of the "Medical and Rehabilitation Center" — large versatile medical center and the interdistrict center of recovery treatment on the basis of city policlinic of St. Petersburg. Results. As a result it had been established an advisability of rendering this type of specialized medical care by medical institutions with different organizational forms. Conclusion. The interdistrict centers of rehabilitation functioning as a part of city policlinics, are undoubtedly necessary, as the closest medical setting for patients' homes, however such functions as diagnostics of a functional condition of an organism and an objective assessment of a state of health of patients with use of screening techniques; inspection of the organized collectives and groups of the population for the purpose of identification of groups of risk, establishment of extent of influence of environmental factors on a state of health, active supervision over persons with factors of the increased risk of diseases and correction of the revealed functional violations, etc. can be performed only in the centers organized on the basis of modern versatile treatment-and-prophylactic establishments, equipped with the modern diagnostic devices, allowing to supplement traditional methods of drug therapy with new effective techniques of treatment.

  14. Pediatric Care as Part of the US Army Medical Mission in the Global War on Terrorism in Afghanistan and Iraq, December 2001 to December 2004

    National Research Council Canada - National Science Library

    Burnett, Mark W; Spinella, Philip C; Azarow, Kenneth S; Callahan, Charles W


    OBJECTIVE. Our objective in this report was to describe the epidemiologic features of and workload associated with pediatric admissions to 12 US Army military hospitals deployed to Iraq and Afghanistan. METHODS...

  15. Reflections from a chair: Leadership of a clinical department at an academic medical center. (United States)

    Willett, Christopher G


    The leadership position of an academic departmental chair can be a positive and rewarding opportunity. These rewards principally stem from the success of the faculty, residents, other trainees, nurses, and everyone supporting the department. With health care reform and the constraints of the federal budget, increasing attention and time has become directed toward administrative management. There are multiple and often competing constituencies and agendas requiring thoughtful strategies to achieve departmental goals. The objectives of a chair are advancing patient care, education, and research. True excellence of a department is achieved by the innovation of its faculty. © 2015 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

  16. Inspector General, DoD, Oversight of the Army Audit Agency Audit of the FY 2000 Army Working Capital Fund Financial Statements

    National Research Council Canada - National Science Library


    Our objectives were to oversee the Army Audit Agency audit of the FY 2000 Department of the Army Working Capital Fund financial statements to verify whether we can rely on their work and to determine...

  17. The impact of evidence-based sepsis guidelines on emergency department clinical practice: a pre-post medical record audit. (United States)

    Romero, Bernadine; Fry, Margaret; Roche, Michael


    To explore the number of patients presenting with sepsis before and after guideline implementation; the impact of sepsis guidelines on triage assessment, emergency department management and time to antibiotics. Sepsis remains one of the leading causes of mortality and morbidity within hospitals. Globally, strategies have been implemented to reduce morbidity and mortality rates, which rely on the early recognition and management of sepsis. To improve patient outcomes, the New South Wales government in Australia introduced sepsis guidelines into emergency departments. However, the impact of the guidelines on clinical practice remains unclear. A 12-month pre-post retrospective randomised medical record audit of adult patients with a sepsis diagnosis. Data were extracted from the emergency department database and paper medical record. Data included patient demographic (age, gender), clinical information (time of arrival, triage code, seen by time, disposition, time to antibiotic, pathology, time to intravenous fluids) and patient assessment data (heart rate, respiratory rate, blood pressure, temperature, oxygen saturations, medication). This study demonstrated a statistically significant 230-minute reduction in time to antibiotics post implementation of the guidelines. The post group (n = 165) received more urgent triage categories (n = 81; 49·1%), a 758-minute reduction in mean time to second litre of intravenous fluids and an improvement in collection of lactate (n = 112, 67·9%), also statistically significant. The findings highlight the impact the guidelines can have on clinician decision-making and behaviour that support best practice and positive patient outcomes. The sepsis guidelines improved the early assessment, recognition and management of patients presenting with sepsis in one tertiary referral emergency department. The use of evidenced-based guidelines can impact clinical decision-making and behaviour, resulting in the translation and support of

  18. Lessons from Google and Apple: creating an open workplace in an academic medical department to foster innovation and collaboration. (United States)

    Ricciotti, Hope A; Armstrong, Walter; Yaari, Gabriel; Campion, Suzanne; Pollard, Mary; Golen, Toni H


    An expanding obstetrics-gynecology department at an academic medical center was faced with too little physical space to accommodate its staff, including trainees, attending physicians, researchers, scientists, administrative leadership, nurses, physician assistants, and scheduling/phone staff. Staff also felt that the current use of space was not ideal for collaboration and innovation. In 2011, the department collected data on space use, using a neutral surveyor and a standardized data collection tool. Using these data, architects and facilities managers met with the department to develop a floor plan proposal for a new use of the space. Site visits, departmental meetings, literature reviews, and space mock-ups complemented the decision process. The final architectural plan was developed using an iterative process that included all disciplines within the department. The redesigned workspace accommodates more staff in a modernized, open, egalitarian setup. The authors' informal observations suggest that the physical proximity created by the new workspace has facilitated timely and civil cross-discipline communication and improvements in team-oriented behavior, both of which are important contributors to safe patient care. This innovation is generalizable and may lead other academic departments to make similar changes. In the future, the authors plan to measure the use of the space and to relate that to outcomes, including clinical (coordination of care/patient satisfaction), administrative (absenteeism/attrition), research (grant volume), and efficiency and cost measures.

  19. Examining Regionalization Efforts to Develop Lessons Learned and Consideration for Department of Defense Medical Facilities (United States)


    outsourcing effects of military maintenance depots. They found maintenance depots were not working at full capacity and in some cases privatizing the...need to look at the impact of the consolidated departments and if a common goal can be achieved. Funding differences can also affect regionalization...therefore be out of service until fixed. Mitchell & Pasch [5] added that there could be a customer service impact consolidating local facilities into

  20. Students' attitudes towards impact of the health department website on their health literacy in Semnan University of Medical Sciences. (United States)

    Mahdizadeh, Jamileh; Valinejadi, Ali; Pooyesh, Behnoosh; Jafari, Fatemeh; Kahouei, Mehdi


    Health literacy has been of interest to policymakers because of its impact on health decision-making as one of the important issues for promoting community health and improving the quality of health care delivery. Therefore, it seems necessary to examine the status of the website of the health sector of the University of Medical Sciences in promoting health literacy from the viewpoint of the students. This cross-sectional study was performed on 529 medical and allied students in schools affiliated to Semnan University of Medical Sciences, Semnan, Iran between 2016 and 2017. In this study, a valid and reliable adult health literacy questionnaire designed by Montazeri et al. was used. The questionnaire was distributed among students in medical and allied health schools and they were asked to complete the questionnaire. Independent-samples t-test, one-way ANOVA, and Pearson product-moment correlation were used to analyze data by SPSS 19. Mean scores of the participants' attitudes towards reading of health information was 3.14 and towards decision and usage of health information was 2.53. Relationship between the study subjects' demographic characteristics and their attitudes was significant (pwebsite. Hence, the results of this study showed that the website of the health department needs to be redesigned, and this design would allow a better link between the University of Medical Sciences and its audience to promote health literacy.

  1. Students’ attitudes towards impact of the health department website on their health literacy in Semnan University of Medical Sciences (United States)

    Mahdizadeh, Jamileh; Valinejadi, Ali; Pooyesh, Behnoosh; Jafari, Fatemeh


    Background and aim Health literacy has been of interest to policymakers because of its impact on health decision-making as one of the important issues for promoting community health and improving the quality of health care delivery. Therefore, it seems necessary to examine the status of the website of the health sector of the University of Medical Sciences in promoting health literacy from the viewpoint of the students. Methods This cross-sectional study was performed on 529 medical and allied students in schools affiliated to Semnan University of Medical Sciences, Semnan, Iran between 2016 and 2017. In this study, a valid and reliable adult health literacy questionnaire designed by Montazeri et al. was used. The questionnaire was distributed among students in medical and allied health schools and they were asked to complete the questionnaire. Independent-samples t-test, one-way ANOVA, and Pearson product-moment correlation were used to analyze data by SPSS 19. Results Mean scores of the participants’ attitudes towards reading of health information was 3.14 and towards decision and usage of health information was 2.53. Relationship between the study subjects’ demographic characteristics and their attitudes was significant (pwebsite. Hence, the results of this study showed that the website of the health department needs to be redesigned, and this design would allow a better link between the University of Medical Sciences and its audience to promote health literacy. PMID:29588815

  2. Role of the medical physicist in quality control in diagnostic x-ray departments

    International Nuclear Information System (INIS)

    Cameron, J.R.


    Medical physicists can play a role in education of future radiologists and technologists by teaching quality control needs and techniques. He or she can also provide service to the diagnostic section by establishing a quality control program. Finally, the medical physicist can play an important role in the development of simple and inexpensive techniques for quality control by radiological technologists. The ongoing work at the University of Wisconsin in this area is to provide quality control in measurement of the effective kVcp, the measurement of the effective focal spot size, the performance of the processing equipment, the output in mR/mAs, and the measurement of the half-value-layer and the total filtration. (U.S.)

  3. Medical student case presentation performance and perception when using mobile learning technology in the emergency department. (United States)

    Tews, Matthew; Brennan, Kimberly; Begaz, Tomer; Treat, Robert


    Hand-held mobile learning technology provides opportunities for clinically relevant self-instructional modules to augment traditional bedside teaching. Using this technology as a teaching tool has not been well studied. We sought to evaluate medical students' case presentation performance and perception when viewing short, just-in-time mobile learning videos using the iPod touch prior to patient encounters. Twenty-two fourth-year medical students were randomized to receive or not to receive instruction by video, using the iPod Touch, prior to patient encounters. After seeing a patient, they presented the case to their faculty, who completed a standard data collection sheet. Students were surveyed on their perceived confidence and effectiveness after using these videos. Twenty-two students completed a total of 67 patient encounters. There was a statistically significant improvement in presentations when the videos were viewed for the first time (p=0.032). There was no difference when the presentations were summed for the entire rotation (p=0.671). The reliable (alpha=0.97) survey indicated that the videos were a useful teaching tool and gave students more confidence in their presentations. Medical student patient presentations were improved with the use of mobile instructional videos following first time use, suggesting mobile learning videos may be useful in medical student education. Clinical educators should consider whether, in an instance where live bedside or direct interactive teaching is unavailable, using just-in-time educational videos on a handheld device might be useful as a supplemental instructional strategy.


    Energy Technology Data Exchange (ETDEWEB)

    Joe M. Aldrich


    The Former Radiation Worker Medical Surveillance Program at Rocky Flats was conducted in Arvada, CO, by Oak Ridge Associated Universities through the Oak Ridge Institute for Science and Education under DOE Contract DE-AC05-00OR22750. Objectives of the program were to obtain information on the value of medical surveillance among at-risk former radiation workers and to provide long-term internal radiation dosimetry information to the scientific community. This program provided the former radiation workers of the Rocky Flats Environmental Technology Site (formerly Rocky Flats Plant) an opportunity to receive follow-up medical monitoring and a re-evaluation of their internal radiation dose. The former Rocky Flats radiation worker population is distinctive because it was a reasonably stable work force that received occupational exposures, at times substantial, over several decades. This report reflects the summation of health outcomes, statistical analyses, and dose assessment information on former Rocky Flats radiation workers to the date of study termination as of March 2004.


    International Nuclear Information System (INIS)

    Aldrich, Joe M.


    The Former Radiation Worker Medical Surveillance Program at Rocky Flats was conducted in Arvada, CO, by Oak Ridge Associated Universities through the Oak Ridge Institute for Science and Education under DOE Contract DE-AC--05-00OR22750. Objectives of the program were to obtain information on the value of medical surveillance among at-risk former radiation workers and to provide long-term internal radiation dosimetry information to the scientific community. This program provided the former radiation workers of the Rocky Flats Environmental Technology Site (formerly Rocky Flats Plant) an opportunity to receive follow-up medical monitoring and a re-evaluation of their internal radiation dose. The former Rocky Flats radiation worker population is distinctive because it was a reasonably stable work force that received occupational exposures, at times substantial, over several decades. This report reflects the summation of health outcomes, statistical analyses, and dose assessment information on former Rocky Flats radiation workers to the date of study termination as of March 2004

  6. Input of Psychosocial Information During Multidisciplinary Team Meetings at Medical Oncology Departments: Protocol for an Observational Study. (United States)

    Horlait, Melissa; Van Belle, Simon; Leys, Mark


    Multidisciplinary team meetings (MDTMs) have become standard practice in oncology and gained the status of the key decision-making forum for cancer patient management. The current literature provides evidence that MDTMs are achieving their intended objectives but there are also indications to question the positive impact of MDTMs in oncology settings. For cancer management to be patient-centered, it is crucial that medical information as well as psychosocial aspects-such as the patients' living situation, possible family problems, patients' mental state, and patients' perceptions and values or preferences towards treatment or care-are considered and discussed during MDTMs. Previous studies demonstrate that failure to account for patients' psychosocial information has a negative impact on the implementation of the treatment recommendations formulated during MDTMs. Few empirical studies have demonstrated the predominant role of physicians during MDTMs, leading to the phenomenon that medical information is shared almost exclusively at the expense of psychosocial information. However, more in-depth insight on the underlying reasons why MDTMs fail to take into account psychosocial information of cancer patients is needed. This paper presents a research protocol for a cross-sectional observational study that will focus on exploring the barriers to considering psychosocial information during MDTMs at medical oncology departments. This protocol encompasses a cross-sectional comparative case study of MDTMs at medical oncology departments in Flanders, Belgium. MDTMs from various oncology subspecialties at inpatient medical oncology departments in multiple hospitals (academic as well as general hospitals) are compared. The observations focus on the "multidisciplinary oncology consultation" (MOC), a formally regulated and financed type of MDTM in Belgian oncology since 2003. Data are collected through nonparticipant observations of MOC-meetings. Observational data are

  7. Enhanced risk prediction model for emergency department use and hospitalizations in patients in a primary care medical home. (United States)

    Takahashi, Paul Y; Heien, Herbert C; Sangaralingham, Lindsey R; Shah, Nilay D; Naessens, James M


    With the advent of healthcare payment reform, identifying high-risk populations has become more important to providers. Existing risk-prediction models often focus on chronic conditions. This study sought to better understand other factors to improve identification of the highest risk population. A retrospective cohort study of a paneled primary care population utilizing 2010 data to calibrate a risk prediction model of hospital and emergency department (ED) use in 2011. Data were randomly split into development and validation data sets. We compared the enhanced model containing the additional risk predictors with the Minnesota medical tiering model. The study was conducted in the primary care practice of an integrated delivery system at an academic medical center in Rochester, Minnesota. The study focus was primary care medical home patients in 2010 and 2011 (n = 84,752), with the primary outcome of subsequent hospitalization or ED visit. A total of 42,384 individuals derived the enhanced risk-prediction model and 42,368 individuals validated the model. Predictors included Adjusted Clinical Groups-based Minnesota medical tiering, patient demographics, insurance status, and prior year healthcare utilization. Additional variables included specific mental and medical conditions, use of high-risk medications, and body mass index. The area under the curve in the enhanced model was 0.705 (95% CI, 0.698-0.712) compared with 0.662 (95% CI, 0.656-0.669) in the Minnesota medical tiering-only model. New high-risk patients in the enhanced model were more likely to have lack of health insurance, presence of Medicaid, diagnosed depression, and prior ED utilization. An enhanced model including additional healthcare-related factors improved the prediction of risk of hospitalization or ED visit.

  8. Trends of the effective dose distribution of occupational exposures in medical and research departments for KIRAMS in Republic of Korea

    International Nuclear Information System (INIS)

    Park, M.; Kim, G. S.; Ji, Y. H.; Jung, M. S.; Kim, K. B.; Jung, H.


    This work proposes the basic reference data of occupational dose management and statistical dose distribution with the classification of radiation work groups though analysis of occupational dose distribution. Data on occupational radiation exposure from medical and scientific usage of radiation in Korea Institute of Radiological and Medical Sciences for the years 2002-11 are presented and evaluated with the characteristic tendency of radiation working groups. The results of occupational radiation exposure were measured by personal dosemeters. The monitored occupational exposure dose data were evaluated according to the average effective dose and collective dose. The most annual average effective dose for all occupational radiation workers was under 1 mSv. Considering the dose distribution of each department, most overexposure workers worked in radiopharmaceutical product facilities, nuclear medicine department and radiation oncology department. In addition, no monitored workers were found to have received an occupational exposure over 50 mSv in single year or 100 mSv in this period. Although the trend of occupational exposure was controlled <1 mSv after 2007 and the radiation protection status was sufficient, it was consistently necessary to optimise and reduce the occupational radiation exposure. (authors)

  9. The medical physicist in a nuclear medicine department; El fisico medico en un departamento de medicina nuclear

    Energy Technology Data Exchange (ETDEWEB)

    Trujillo Z, F.E.; Gomez A, E. [Instituto nacional de Cancerologia, 14000 Mexico D.F. (Mexico)


    The diagnostic studies and therapeutic treatments carried out in a Nuclear Medicine department make use of radioactive material. For such a reason it becomes necessary to take a strict control in the reception, use and waste that are generated of the typical works inside the department. Also, work related with the quality control of the equipment dedicated to produce images and of those not image formers, need to carry out to guarantee its maximum performance; as well as quality of the diagnostic and of the therapy imparted in patients. Additionally its are needed to make originated works of the individual procedures to patient and of the acquisition of radioactive materials and removal of the waste or radioactive contaminations. Presently work the recommendations of the American College of Radiology (ACR), the European Federation of Organizations for Medical Physics (EFOMP) and of the Mexican Official Standards relating to the functions that should be observed in a Nuclear Medicine Department are exposed. The ACR and the EFOMP, conclude in their recommendations that the medical physicist fulfills with the suitable profile and likewise they describe in detail the actions and functions that he should supervise, to carry out, to document and to inform. (Author)

  10. Conception of a computer for the nuclear medical department of the Augsburg hospital center

    International Nuclear Information System (INIS)

    Graf, G.; Heidenreich, P.


    A computer system based on the Siemens R30 process computer has been employed at the Institute of Nuclear Medicine of the Augsburg Hospital Center since early 1981. This system, including the development and testing of organ-specific evaluation programs, was used as a basis for the conception of the new computer system for the department of nuclear medicine of the Augsburg Hospital Center. The computer system was extended and installed according to this conception when the new 1400-bed hospital was opened in the 3rd phase of construction in autumn 1982. (orig.) [de

  11. Boundaries - US Army Corps of Engineers - St. Paul District (MVP) Civil Works (United States)

    Army Corps of Engineers, Department of the Army, Department of Defense — The US Army Corps of Engineers - St. Paul District Civil Works boundary. Boundary is based on 1:24k watershed data and coordination with MVR to determine shared...

  12. Disability management: corporate medical department management of employee health and productivity. (United States)

    Burton, W N; Conti, D J


    This study describes a proactive in-house program for managing short-term disability (STD) in the workforce of a very large banking system. The goals of this program were to (1) minimize the personal and economic impacts of STD by early intervention, (2) validate the extent and duration of STD, and (3) coordinate medical services and provide guidance to managers that would facilitate an early return to work. This program was made possible by the installation of a comprehensive database, called Occupational Medicine and Nursing Information System. This database mainly includes employees' claims for inpatient and outpatient health services, disability and workers' compensation benefits, wellness program participation, medical examinations and laboratory tests, use of prescription drugs, and results of Health Risk Appraisals. As a result of these efforts, STD event duration declined after this STD management program was implemented in locations heretofore outside the system, and by providing full pay for part-time work after STD, within the system as well. Of note, the average number of STD days per employee showed substantial variation by health plan, including the fact that it was higher (3.9 STD days/employee) for health maintenance organization participants than for indemnity plan members (2.7 STD days/employee).

  13. Evaluation of tumor registry validity in Samsung medical center radiation oncology department

    International Nuclear Information System (INIS)

    Park, Won; Huh, Seung Jae; Kim, Dae Yong; Shin, Seong Soo; Ahn, Yong Chan; Lim, Do Hoon; Kim, Seon Woo


    A tumor registry system for the patients treated by radiotherapy at Samsung Medical Center since the opening of a hospital at 1994 was employed. In this study, the tumor registry system was introduced and the validity of the tumor registration was analyzed. The tumor registry system was composed of three parts: patient demographic, diagnostic, and treatment information. All data were input in a screen using a mouse only. Among the 10,000 registered cases in the tumor registry system until Aug, 2002, 199 were randomly selected and their registration data were compared with the patients' medical records. Total input errors were detected in 15 cases (7.5%). There were 8 error items in the part relating to diagnostic information: tumor site 3, pathology 2, AJCC staging 2 and performance status 1. In the part relating to treatment information there were 9 mistaken items: combination treatment 4, the date of initial treatment 3 and radiation completeness 2. According to the assignment doctor, the error ratio was consequently variable. The doctors who did no double-checks showed higher errors than those that did (15.6%: 3.7%). Our tumor registry had errors within 2% for each item. Although the overall data quality was high, further improvement might be achieved through promoting sincerity, continuing training periodic validity tests and keeping double-checks. Also, some items associated with the hospital information system will be input automatically in the next step

  14. [Contribution to the establishment of quality assurance in five medical microbiology departments in Togo]. (United States)

    Katawa, G; Kpotsra, A; Karou, D S; Eklou, M; Tayi, K E; de Souza, C


    In Togo, as in many other developing countries, there is a lack of data on quality control and assurance of laboratories. The present study aimed to access for the quality management system in five medical bacteriology laboratories in Togo. The study was conducted from May to August 2006. Data were recorded by an audit on the reliability of results and the technical organization of laboratories. The standard ISO 15189:2003, the Togolese guide of good laboratory practices (GBEA-Togo) and the WHO medical bacteriology standards were used as references. The results of the audit showed a lack of culture media in laboratories, inappropriate choice of culture media, partial identification of some microorganisms, variability of identification procedures, a lack of diagnostic reagents and an inability to identify some potentially pathogenic bacteria. Concerning the technical organization of laboratories, compliance average ranging from 25.8 to 54.8 % was recorded. This indicates a limited organization of such laboratories. The issue of this study showed that laboratories must be equipped, their technical organization should be improved and they must establish a program of equipment maintenance.

  15. Medication Errors in a Swiss Cardiovascular Surgery Department: A Cross-Sectional Study Based on a Novel Medication Error Report Method

    Directory of Open Access Journals (Sweden)

    Kaspar Küng


    Full Text Available The purpose of this study was (1 to determine frequency and type of medication errors (MEs, (2 to assess the number of MEs prevented by registered nurses, (3 to assess the consequences of ME for patients, and (4 to compare the number of MEs reported by a newly developed medication error self-reporting tool to the number reported by the traditional incident reporting system. We conducted a cross-sectional study on ME in the Cardiovascular Surgery Department of Bern University Hospital in Switzerland. Eligible registered nurses ( involving in the medication process were included. Data on ME were collected using an investigator-developed medication error self reporting tool (MESRT that asked about the occurrence and characteristics of ME. Registered nurses were instructed to complete a MESRT at the end of each shift even if there was no ME. All MESRTs were completed anonymously. During the one-month study period, a total of 987 MESRTs were returned. Of the 987 completed MESRTs, 288 (29% indicated that there had been an ME. Registered nurses reported preventing 49 (5% MEs. Overall, eight (2.8% MEs had patient consequences. The high response rate suggests that this new method may be a very effective approach to detect, report, and describe ME in hospitals.

  16. The impact of a pre-hospital medical response unit on patient care and emergency department attendances.

    LENUS (Irish Health Repository)

    Deasy, C


    A rapid response team was instigated in Cork to improve prehospital care and reduce unnecessary Emergency Department (ED) visits. This consisted of a Specialist Registrar (SpR) in Emergency Medicine and a Paramedic who attended all "999" calls in a designated rapid response vehicle on the allotted study days. Two hundred and sixty-three patients were seen on designated days between Jan 2004 and March 2006. Presentations seen included; road traffic accident (23%) collapse (12%), fall (10%) and seizure (8%). The majority of calls were to houses (36%). The most common medical intervention was intravenous cannulation (25%). Intravenous medications were administered in 21% of these patients--morphine sulphate was the most common drug given. It was possible to safely discharge 31% of patients on scene. In our experience skilled Emergency Medicine doctors attending at scene could provide advanced care and reduce ambulance transportation and patient attendance.

  17. Evaluation of the Medical Care of Patients with Hypertension in an Emergency Department and in Ambulatory Hypertension Unit

    Directory of Open Access Journals (Sweden)

    Fernando Nobre


    Full Text Available OBJECTIVE: To evaluate the characteristics of the patients receiving medical care in the Ambulatory of Hypertension of the Emergency Department, Division of Cardiology, and in the Emergency Unit of the Clinical Hospital of the Ribeirão Preto Medical School. METHODS: Using a protocol, we compared the care of the same hypertensive patients in on different occasions in the 2 different places. The characteristics of 62 patients, 29 men with a mean age of 57 years, were analyzed between January 1996 and December 1997. RESULTS: The care of these patients resulted in different medical treatment regardless of their clinical features and blood pressure levels. Thus, in the Emergency Unit, 97% presented with symptoms, and 64.5% received medication to rapidly reduce blood pressure. In 50% of the cases, nifedipine SL was the elected medication. Patients who applied to the Ambulatory of Hypertension presenting with similar features, or, in some cases, presenting with similar clinically higher levels of blood pressure, were not prescribed medication for a rapid reduction of blood pressure at any of the appointments. CONCLUSION: The therapeutic approach to patients with high blood pressure levels, symptomatic or asymptomatic, was dependent on the place of treatment. In the Emergency Unit, the conduct was, in the majority of cases, to decrease blood pressure immediately, whereas in the Ambulatory of Hypertension, the same levels of blood pressure, in the same individuals, resulted in therapeutic adjustment with nonpharmacological management. These results show the need to reconsider the concept of hypertensive crises and their therapeutical implications.

  18. A study to assess burnout among nurses of maternity department in Gauhati Medical College Hospital, Assam

    Directory of Open Access Journals (Sweden)

    Marami Baishya


    Full Text Available Background: Burnout in healthcare workers, especially among nurses, can have an impact on overall healthcare delivery system. For health in general and maternal health in particular, wellbeing of healthcare workers, including nurses, is of paramount importance. Material and methods: This study aimed to assess burnout among nurses working in the maternity department. One hundred nurses of a tertiary care centre, selected by non-purposive convenient sampling, were examined by a standardised questionnaire. Data were analysed by descriptive statistics. Results: Burnout in depersonalisation was moderate while that in emotional exhaustion and personal achievement were of low-levels. Conclusion: Understanding the nature of the problem of burnout can guide in better management.

  19. Violence toward health workers in Bahrain Defense Force Royal Medical Services’ emergency department (United States)

    Rafeea, Faisal; Al Ansari, Ahmed; Abbas, Ehab M; Elmusharaf, Khalifa; Abu Zeid, Mohamed S


    Background Employees working in emergency departments (EDs) in hospital settings are disproportionately affected by workplace violence as compared to those working in other departments. Such violence results in minor or major injury to these workers. In other cases, it leads to physical disability, reduced job performance, and eventually a nonconducive working environment for these workers. Materials and methods A cross-sectional exploratory questionnaire was used to collect data used for the examination of the incidents of violence in the workplace. This study was carried out at the ED of the Bahrain Defense Force (BDF) Hospital. Participants for the study were drawn from nurses, support staff, and emergency physicians. Both male and female workers were surveyed. Results The study included responses from 100 staff in the ED of the BDF Hospital in Bahrain (doctors, nurses, and support personnel). The most experienced type of violence in the workers in the past 12 months in this study was verbal abuse, which was experienced by 78% of the participants, which was followed by physical abuse (11%) and then sexual abuse (3%). Many cases of violence against ED workers occurred during night shifts (53%), while physical abuse was reported to occur during all the shifts; 40% of the staff in the ED of the hospital were not aware of the policies against workplace violence, and 26% of the staff considered leaving their jobs at the hospital. Conclusion This study reported multiple findings on the number of workplace violence incidents, as well as the characteristics and factors associated with violence exposure in ED staff in Bahrain. The results clearly demonstrate the importance of addressing the issue of workplace violence in EDs in Bahrain and can be used to demonstrate the strong need for interventions. PMID:29184452

  20. 75 FR 22757 - Federal Advisory Committee; Army Education Advisory Committee; Charter Renewal (United States)


    ..., school curriculums, educational philosophy and objectives, program effectiveness, facilities, staff and... DEPARTMENT OF DEFENSE Office of the Secretary Federal Advisory Committee; Army Education Advisory... Defense gives notice that it is renewing the charter for the Army Education Advisory Committee (hereafter...

  1. U.S. Army War College Key Strategic Issues List

    National Research Council Canada - National Science Library


    The Key Strategic Issues List (KSIL) offers military and civilian researchers a ready reference of topics that are of particular interest to the Department of the Army and the Department of Defense...

  2. Medical Surveillance Monthly Report (MSMR). Volume 4, Number 3, April 1998 (United States)


    expressed are not necessarily those of the Department of the Army. Surveillance Trends Frequencies, rates and trends of hospitalizations and associated...Army Medical Center lets 33,000), and leukocytosis (WBCs 15.6). Her urinalysis revealed trace protein and hematuria. Serologic tests for IgM and IgG...addition, several cases received intravenous penicillin when they were admitted to TAMC. All cultures were negative for leptospira ; thus, it is

  3. Determinants of Contraceptive Availability at Medical Facilities in the Department of Veterans Affairs (United States)

    Cope, Jacqueline R; Yano, Elizabeth M; Lee, Martin L; Washington, Donna L


    OBJECTIVE To describe the variation in provision of hormonal and intrauterine contraception among Veterans Affairs (VA) facilities. DESIGN Key informant, cross-sectional survey of 166 VA medical facilities. Data from public use data sets and VA administrative databases were linked to facility data to further characterize their contextual environments. PARTICIPANTS All VA hospital-based and affiliated community-based outpatient clinics delivering services to at least 400 unique women during fiscal year 2000. MEASUREMENTS Onsite availability of hormonal contraceptive prescription and intrauterine device (IUD) placement. RESULTS Ninety-seven percent of facilities offered onsite prescription and management of hormonal contraception whereas 63% offered placement of IUDs. After adjusting for facility caseload of reproductive-aged women, 3 organizational factors were independently associated with onsite IUD placement: (1) onsite gynecologist (adjusted odds ratio [OR], 20.35; 95% confidence interval [CI], 7.02 to 58.74; Pwomen's health training to other clinicians (adjusted OR, 3.40; 95% CI 1.19 to 9.76; P=.02). CONCLUSIONS VA's provision of hormonal and intrauterine contraception is in accordance with community standards, although onsite availability is not universal. Although contraception is a crucial component of a woman's health maintenance, her ability to obtain certain contraceptives from the facility where she obtains her primary care is largely influenced by the availability of a gynecologist. Further research is needed to determine how fragmentation of women's care into reproductive and nonreproductive services impacts access to contraception and the incidence of unintended pregnancy. PMID:16637943

  4. Patient’s Satisfaction of Emergency Department Affiliated Hospital of Babol University of Medical Sciences in 2013 -14

    Directory of Open Access Journals (Sweden)

    H Datobar


    Full Text Available BACKGROUND AND OBJECTIVE: Patient satisfaction in emergency departments is an indicator of healthcare quality, evaluation of which can promote awareness of the relevant authorities regarding its status. This study aimed to evaluate patient satisfaction in emergency departments in hospitals affiliated to Babol University of Medical Sciences. METHODS: This cross-sectional study was performed in patients admitted to emergency departments in hospitals affiliated to Babol University of Medical Sciences, Babol, Iran, during a period of eight months (2013-2014. The participants were chosen through convenience sampling. Information regarding hospital environment, facilities, and nursing team was collected using a standard questionnaire. Standard questionnaire responses were classified to” don’t happen, dissatisfied, low, medium and high satisfaction”. Then medium and high responses classified to favorable satisfaction (above average and low or dissatisfied responses were classified to unfavorable satisfaction. In case the patients were unable to fill-out the questionnaire, their companion completed it for them. FINDINGS: Overall, 444 (87.9% patients expressed optimum satisfaction. The highest rate of dissatisfaction (14.8%, n=74 was related to environment and services, while the highest rate of satisfaction (49.3%, n=246 was pertinent to nursing staff. The results indicated that the rate of satisfaction in residents of rural areas was 0.55 times higher than in urban residents (OR: 1.55, 95% CI: 1.12-2.70, p=0.02, 50% lower in patients compared to companions (OR: 0.55, 95% CI: 0.36-0.83, p=0.05,and  in the evening shift was 0.65 times higher than in those admitted in the morning (OR: 1.65, 95% CI: 1.06-2.58, p=0.03. Moreover, this rate in patients admitted at night shift was 0.74 times higher than in those admitted in the morning (OR: 1.74, 95% CI: 1.12-2.70, p=0.01. CONCLUSION: This study demonstrated optimum patient satisfaction in emergency

  5. Text mining approach to predict hospital admissions using early medical records from the emergency department. (United States)

    Lucini, Filipe R; S Fogliatto, Flavio; C da Silveira, Giovani J; L Neyeloff, Jeruza; Anzanello, Michel J; de S Kuchenbecker, Ricardo; D Schaan, Beatriz


    Emergency department (ED) overcrowding is a serious issue for hospitals. Early information on short-term inward bed demand from patients receiving care at the ED may reduce the overcrowding problem, and optimize the use of hospital resources. In this study, we use text mining methods to process data from early ED patient records using the SOAP framework, and predict future hospitalizations and discharges. We try different approaches for pre-processing of text records and to predict hospitalization. Sets-of-words are obtained via binary representation, term frequency, and term frequency-inverse document frequency. Unigrams, bigrams and trigrams are tested for feature formation. Feature selection is based on χ 2 and F-score metrics. In the prediction module, eight text mining methods are tested: Decision Tree, Random Forest, Extremely Randomized Tree, AdaBoost, Logistic Regression, Multinomial Naïve Bayes, Support Vector Machine (Kernel linear) and Nu-Support Vector Machine (Kernel linear). Prediction performance is evaluated by F1-scores. Precision and Recall values are also informed for all text mining methods tested. Nu-Support Vector Machine was the text mining method with the best overall performance. Its average F1-score in predicting hospitalization was 77.70%, with a standard deviation (SD) of 0.66%. The method could be used to manage daily routines in EDs such as capacity planning and resource allocation. Text mining could provide valuable information and facilitate decision-making by inward bed management teams. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  6. Legal, Social, Ethical, and Medical Perspectives on the Care of the Statutory Rape Adolescent in the Emergency Department. (United States)

    Tsai, Shiu-Lin; Acosta, Elvira; Cardenas, Toni; Sigall, Jeremy K; Van Geem, Kevin


    Rapes involving adolescents who present to the emergency department (ED) are fraught with ethical and legal complexities and are often emotionally turbulent for patients, their families, and medical providers. Management requires a thoughtful approach from multiple standpoints, including legal, psychosocial, ethical, and medical ones. However, there is no standardized sexual assault education for emergency medicine residents, and management practices vary widely. 1,2 We present a hypothetical statutory rape case based on real cases that occurred in New York City and bring together the perspectives of an attorney on the legal parameters, two social workers on the psychosocial issues, an ethicist on the moral considerations, and a pediatric emergency physician-who is also a sexual assault forensic examiner-on the medical treatments. We aim to provide a framework for physicians to navigate issues of patient-physician privilege involving minors, privacy rules, and mandatory reporting laws. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  7. Evaluation of natural language processing from emergency department computerized medical records for intra-hospital syndromic surveillance

    Directory of Open Access Journals (Sweden)

    Pagliaroli Véronique


    Full Text Available Abstract Background The identification of patients who pose an epidemic hazard when they are admitted to a health facility plays a role in preventing the risk of hospital acquired infection. An automated clinical decision support system to detect suspected cases, based on the principle of syndromic surveillance, is being developed at the University of Lyon's Hôpital de la Croix-Rousse. This tool will analyse structured data and narrative reports from computerized emergency department (ED medical records. The first step consists of developing an application (UrgIndex which automatically extracts and encodes information found in narrative reports. The purpose of the present article is to describe and evaluate this natural language processing system. Methods Narrative reports have to be pre-processed before utilizing the French-language medical multi-terminology indexer (ECMT for standardized encoding. UrgIndex identifies and excludes syntagmas containing a negation and replaces non-standard terms (abbreviations, acronyms, spelling errors.... Then, the phrases are sent to the ECMT through an Internet connection. The indexer's reply, based on Extensible Markup Language, returns codes and literals corresponding to the concepts found in phrases. UrgIndex filters codes corresponding to suspected infections. Recall is defined as the number of relevant processed medical concepts divided by the number of concepts evaluated (coded manually by the medical epidemiologist. Precision is defined as the number of relevant processed concepts divided by the number of concepts proposed by UrgIndex. Recall and precision were assessed for respiratory and cutaneous syndromes. Results Evaluation of 1,674 processed medical concepts contained in 100 ED medical records (50 for respiratory syndromes and 50 for cutaneous syndromes showed an overall recall of 85.8% (95% CI: 84.1-87.3. Recall varied from 84.5% for respiratory syndromes to 87.0% for cutaneous syndromes. The

  8. Aging, patient-bed management and overcrowding in the medical departments

    Directory of Open Access Journals (Sweden)

    Aldina Gardellini


    Full Text Available BACKGROUND Hospital overcrowding (HO profoundly affects the whole hospital system, reducing productivity and efficiency. The aging population and the increased prevalence of chronic-degenerative diseases, susceptible to acute exacerbations, make the elderly as frequent users of the emergency room (ER. There is a general agreement that the current disease-oriented and episodic model of care does not adequately cope with the complex needs of older patients. Hospital admission and discharge do not sufficiently link with primary care and other community resources, such as long-term care facilities and outpatient clinics. AIM OF THE STUDY To evaluate, using a simple dedicated software, the activity data of nine hospitals of Local Health Authority of Bologna (Italy (ER accesses, hospital admissions, average length of stay – LOS and the impact of a patient and bed management net in which managers, doctors and nurses share their operational skills to improve patient flow in medical and geriatric wards. RESULTS Data show that 24% ER accesses concern people > 75 years old; 51% admissions concern people > 75 years old; half of these admissions are from ER frequent users (FU = ≥ 3 ER accesses/ year. Only 15% admissions of younger people are from ER frequent users. Each of > 75 years old frequent users produces an average of 2 admissions/year. At the end of the first year of this experience, ER accesses and admissions rose more than 8%. In our model of bed-management (patient and bed management net-software matching hospital capacity with admission, escalation measures LOS was shortened by an average 0.5-1 day to a range from 0,5 to 1 day. DISCUSSION HO is due to mismanagement of chronic diseases (CD. Further actions are needed in primary health care to avoid unscheduled hospital due to CD. Applications for admission to hospital should be administered in the real context of the needs, developing both measures to face the contingent situation (setting

  9. Personnel of human anatomy department of Saratov State Medical University n.a. V. I. Razumovsky as the participants of the Great Patriotic War

    Directory of Open Access Journals (Sweden)

    Aleshkina O.Yu.


    Full Text Available The article provides evidence on participation of assistants who worked at the Department of Human Anatomy of Saratov State Medical University n.a. V. I. Razumovsky and took part in the Great Patriotic War.

  10. External audit on the clinical practice and medical decision-making at the departments of radiotherapy in Budapest and Vienna. (United States)

    Esik, O; Seitz, W; Lövey, J; Knocke, T H; Gaudi, I; Németh, G; Pötter, R


    To present an example of how to study and analyze the clinical practice and the quality of medical decision-making under daily routine working conditions in a radiotherapy department, with the aims of detecting deficiencies and improving the quality of patient care. Two departments, each with a divisional organization structure and an established internal audit system, the University Clinic of Radiotherapy and Radiobiology in Vienna (Austria), and the Department of Radiotherapy at the National Institute of Oncology in Budapest (Hungary), conducted common external audits. The descriptive parameters of the external audit provided information on the auditing (auditor and serial number of the audit), the cohorts (diagnosis, referring institution, serial number and intention of radiotherapy) and the staff responsible for the treatment (division and physician). During the ongoing external audits, the qualifying parameters were (1) the sound foundation of the indication of radiotherapy, (2) conformity to the institution protocol (3), the adequacy of the choice of radiation equipment, (4) the appropriateness of the treatment plan, and the correspondence of the latter with (5) the simulation and (6) verification films. Various degrees of deviation from the treatment principles were defined and scored on the basis of the concept of Horiot et al. (Horiot JC, Schueren van der E. Johansson KA, Bernier J, Bartelink H. The program of quality assurance of the EORTC radiotherapy group. A historical overview. Radiother. Oncol. 1993,29:81-84), with some modifications. The action was regarded as adequate (score 1) in the event of no deviation or only a small deviation with presumably no alteration of the desired end-result of the treatment. A deviation adversely influencing the result of the therapy was considered a major deviation (score 3). Cases involving a minor deviation (score 2) were those only slightly affecting the therapeutic end-results, with effects between those of cases

  11. External audit on the clinical practice and medical decision-making at the departments of radiotherapy in Budapest and Vienna

    International Nuclear Information System (INIS)

    Esik, O.; Seitz, W.; Loevey, J.; Knocke, T.H.; Gaudi, I.; Nemeth, G.; Poetter, R.


    Purpose: To present an example of how to study and analyze the clinical practice and the quality of medical decision-making under daily routine working conditions in a radiotherapy department, with the aims of detecting deficiencies and improving the quality of patient care.Methods: Two departments, each with a divisional organization structure and an established internal audit system, the University Clinic of Radiotherapy and Radiobiology in Vienna (Austria), and the Department of Radiotherapy at the National Institute of Oncology in Budapest (Hungary), conducted common external audits. The descriptive parameters of the external audit provided information on the auditing (auditor and serial number of the audit), the cohorts (diagnosis, referring institution, serial number and intention of radiotherapy) and the staff responsible for the treatment (division and physician). During the ongoing external audits, the qualifying parameters were (1) the sound foundation of the indication of radiotherapy, (2) conformity to the institution protocol (3), the adequacy of the choice of radiation equipment, (4) the appropriateness of the treatment plan, and the correspondence of the latter with (5) the simulation and (6) verification films. Various degrees of deviation from the treatment principles were defined and scored on the basis of the concept of Horiot et al. (Horiot JC, Schueren van der E, Johansson KA, Bernier J, Bartelink H. The program of quality assurance of the EORTC radiotherapy group. A historical overview. Radiother. Oncol. 1993;29:81-84), with some modifications. The action was regarded as adequate (score 1) in the event of no deviation or only a small deviation with presumably no alteration of the desired end-result of the treatment. A deviation adversely influencing the result of the therapy was considered a major deviation (score 3). Cases involving a minor deviation (score 2) were those only slightly affecting the therapeutic end-results, with effects

  12. Supervision and feedback for junior medical staff in Australian emergency departments: findings from the emergency medicine capacity assessment study

    Directory of Open Access Journals (Sweden)

    Weiland Tracey J


    Full Text Available Abstract Background Clinical supervision and feedback are important for the development of competency in junior doctors. This study aimed to determine the adequacy of supervision of junior medical staff in Australian emergency departments (EDs and perceived feedback provided. Methods Semi-structured telephone surveys sought quantitative and qualitative data from ED Directors, Directors of Emergency Medicine Training, registrars and interns in 37 representative Australian hospitals; quantitative data were analysed with SPSS 15.0 and qualitative data subjected to content analysis identifying themes. Results Thirty six of 37 hospitals took part. Of 233 potential interviewees, 95 (40.1% granted interviews including 100% (36/36 of ED Directors, and 96.2% (25/26 of eligible DEMTs, 24% (19/81 of advanced trainee/registrars, and 17% (15/90 of interns. Most participants (61% felt the ED was adequately supervised in general and (64.2% that medical staff were adequately supervised. Consultants and registrars were felt to provide most intern supervision, but this varied depending on shift times, with registrars more likely to provide supervision on night shift and at weekends. Senior ED medical staff (64% and junior staff (79% agreed that interns received adequate clinical supervision. Qualitative analysis revealed that good processes were in place to ensure adequate supervision, but that service demands, particularly related to access block and overcrowding, had detrimental effects on both supervision and feedback. Conclusions Consultants appear to provide the majority of supervision of junior medical staff in Australian EDs. Supervision and feedback are generally felt to be adequate, but are threatened by service demands, particularly related to access block and ED overcrowding.

  13. 2009 Center for Army Leadership Annual Survey of Army Leadership (CASAL): Army Education (United States)


    right time, handling pre- education attitudes, and tracking performance gains and career advantages related to academics.  Developing current, relevant...Army Leadership Technical Report 2010-2 2009 CENTER FOR ARMY LEADERSHIP ANNUAL SURVEY OF ARMY LEADERSHIP (CASAL): ARMY EDUCATION ...Joshua Hatfield ICF International John P. Steele Center for Army Leadership June 2010 The Center for Army Leadership An

  14. Prevalence of unrecognized depression and associated factors among patients attending medical outpatient department in Adare Hospital, Hawassa, Ethiopia

    Directory of Open Access Journals (Sweden)

    Tilahune AB


    Full Text Available Asres Bedaso Tilahune,1 Gezahegn Bekele,1 Nibretie Mekonnen,2 Eyerusalem Tamiru2 1School of Nursing and Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia; 2Department of Medical Case Team, Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia Abstract: Depression is an illness that involves the body, mood, and thoughts and that affects the way a person eats, sleeps, feels about him or herself and thinks about things. Depression is one of the most common mental disorders affecting 121 million people in the world, and it frequently goes unrecognized among patients. It is estimated that 5%–10% of the population at any given time is suffering from identifiable depression needing psychiatric or psychosocial intervention. An institution-based cross-sectional study design was implemented to determine the magnitude and associated factors of unrecognized depression among patients attending the adult medical outpatient department in Adare Hospital, Hawassa, Southern Nations, Nationalities, and Peoples’ Region, Ethiopia, among 326 patients selected using systematic random sampling technique. Data were collected using the interviewer-administered technique. A structured questionnaire was used to collect data on sociodemographic characteristics and other independent variables. Depression was assessed using the Patient Health Questionnaire 9. Data were entered and analyzed using SPSS 20. The level of significance was determined at P<0.05. About 326 patients were interviewed, of whom 186 (57.1% were males. The mean age of participant was 34 with standard deviation of ±13.1 years. Current substance users accounted for 106 (32.5% of the total participants. Of 326 respondents, 80 (24.5% had significant depressive symptoms, while the detection rate of depression by the clinician was 0%. Depression was associated with female sex (adjusted odds ratio [AOR] =1.63 [1.14–2.34], age >60 years (AOR =4

  15. Army Sustainment. Volume 44, Issue 5. September-October 2012 (United States)


    Department of Defense or any of its agencies, and do not change or supersede official Army publications. The masculine pro - noun may refer to either gender...the Army Test and Evaluation Command (ATEC), AMC, and the Army staff, who con - stitute the candidate selection panel. CASCOM provides the TRADOC...improper use of these items that causes the fires. The Occupational Safety and Health Administration ( OSHA ) states that equipment needs to be used

  16. Department of the Army Cost Analysis Manual

    National Research Council Canada - National Science Library


    .... The specific goal of this manual is to help the cost analyst serve the customer. This is done by providing reference material on cost analysis processes, methods, techniques, structures, and definitions...

  17. Department of the Army Cost Analysis Manual (United States)


    SECTION I - AUTOMATED COST ESTIMATING INTEGRATED TOOLS ( ACEIT ) ................................................................179 SECTION II - AUTOMATED...Management & Comptroller) endorsed the Automated Cost Estimating Integrated Tools ( ACEIT ) model and since it is widely used to prepare POEs, CCAs and...CRB IPT (in ACEIT ) will be the basis for information contained in the CAB. Any remaining unresolved issues from the IPT process will be raised at the

  18. 15th Anniversary of the Molecular Techniques Unit at the Department of Forensic Medicine at Wroclaw Medical University. (United States)

    Pluta, Dominika; Tokarski, Miron; Karpiewska, Anna; Dobosz, Tadeusz


    Molecular Techniques Unit at the Department of Forensic Medicine, Wroclaw Medical University has been operating since December 2003. Soon it will be 15 years since its establishment. This anniversary become an inspiration to write down the story of this institution whose origins illustrate the immense changes that have taken place in forensic genetics. The aim of our work was also to consolidate the professional achievements of Professor Tadeusz Dobosz, chief of the Unit, one of the pioneers of introducing DNA testing technology into Polish forensic medicine. The most important achievements of the Unit include participation in two EU research projects, the development of a non-destructive method of extraction of genetic material, research in field of gene therapy and certification of the Laboratory of the Molecular Techniques Unit by the Polish Accreditation Center (PCA) confirming compliance with the requirements of the PN-EN ISO/IEC 17025:2005 standard.

  19. Challenges to effective crisis management: using information and communication technologies to coordinate emergency medical services and emergency department teams. (United States)

    Reddy, Madhu C; Paul, Sharoda A; Abraham, Joanna; McNeese, Michael; DeFlitch, Christopher; Yen, John


    The purpose of this study is to identify the major challenges to coordination between emergency department (ED) teams and emergency medical services (EMS) teams. We conducted a series of focus groups involving both ED and EMS team members using a crisis scenario as the basis of the focus group discussion. We also collected organizational workflow data. We identified three major challenges to coordination between ED and EMS teams including ineffectiveness of current information and communication technologies, lack of common ground, and breakdowns in information flow. The three challenges highlight the importance of designing systems from socio-technical perspective. In particular, these inter-team coordination systems must support socio-technical issues such as awareness, context, and workflow between the two teams.

  20. Using Technology, Clinical Workflow Redesign, and Team Solutions to Achieve the Patient Centered Medical Home (United States)


    Redesign, and Team Solutions to Achieve the Patient Centered Medical Home LTC Nicole Kerkenbush, MHA, MN Army Medical Department, Office of the...TITLE AND SUBTITLE Using Technology, Clinical Workflow Redesign, and Team Solutions to Achieve the Patient Centered Medical Home 5a. CONTRACT...Describe how these tools are being used to implement the Patient Centered Medical Home care model 2 2011 MHS Conference MEDCOM AHLTA Provider Satisfaction

  1. COGME 1995 Physician Workforce Funding Recommendations for Department of Health and Human Services' Programs. Council on Graduate Medical Education, 7th Report. (United States)

    Council on Graduate Medical Education.

    This report presents specific recommendations to the Department of Health and Human Services and Congress from the Council on Graduate Medical Education that address Medicare's direct and indirect graduate medical education (GME) payments and the monies allocated by the Public Health Service that is targeted toward physician education and primary…

  2. Pattern of Dermatological Cases Attending Skin-VD Outpatient Department in a Medical College Hospital of Bangladesh

    Directory of Open Access Journals (Sweden)

    Abu Baker


    Full Text Available Background: The pattern of skin diseases varies from one country to another and even from region to region of the same country. We are geographically placed in the tropical region with natural outcome of communicable diseases. We conducted this cross sectional study in a tertiary hospital of Bangladesh keeping the proposition in mind that infectious diseases occupy maximum percentage among skin and venereal diseases in outpatients in Bangladesh. Objectives: To classify the diseases attending the Skin & VD outpatient department of Enam Medical College Hospital (EMCH and to draw comments and recommendations on the basis of findings. Materials and Methods: All patients irrespective of age and sex attending the OPD of Skin-VD Department of Enam Medical College Hospital during a 2-year time-period (from January 2009 to December 2010 were included in the study. Structured questionnaire, check-list and face-to-face interview (whenever necessary were used as tools of data collection. Statistical analyses were done by SPSS version Windows 11.1. Results: Total number of patients was 12100. Most of the patients were aged (>18 years; 64.28%, dominated by male (61.63%, married (56.1%, literate (71.11%, coming from far (>5 km; 63.5% and of middle class origin (59.73%. Out of the total cases, maximum (23.42% were diagnosed as eczema, followed by infectious diseases (17%, acne (8.69% and psoriasis (6.36%. Conclusion: In this study we found infectious diseases to occupy the second position next to eczema and our findings nullify the proposition that infectious diseases occupy maximum percentage among skin and venereal diseases in outpatients in Bangladesh.


    Directory of Open Access Journals (Sweden)

    I. V. Rakhmanova


    Full Text Available Background: The authors set a goal to analyze the problem of management of simultaneous medical and educational follow-up of premature children during the 1st year of life under the conditions of out-patient department of a large hospital (by the example of consulting and diagnostic centre of Morozov Children Municipal Clinical Hospital. Patients and methods: Audiologic examination was performed in 293 premature children. Ninety three children with the consequences of perinatal central nervous system damage were included into the program of correctional diagnostic medical and educational rehabilitation (they were examined by otolaryngologist-audiologist, neurologist and logopedist. Results: Premature children even with normal hearing function at the age of 3 months have very high level of prespeech development retardation (from 75 to 96%, depending on their gestation age. Conclusion: Logopedics examination of premature children at the age of 3 months allows to reveal signs of their mental retardation (motor activity, aural perception, communicative, cognitive and emotional spheres, prespeech activity in the overwhelming majority of cases.

  4. Use of emergency department electronic medical records for automated epidemiological surveillance of suicide attempts: a French pilot study. (United States)

    Metzger, Marie-Hélène; Tvardik, Nastassia; Gicquel, Quentin; Bouvry, Côme; Poulet, Emmanuel; Potinet-Pagliaroli, Véronique


    The aim of this study was to determine whether an expert system based on automated processing of electronic health records (EHRs) could provide a more accurate estimate of the annual rate of emergency department (ED) visits for suicide attempts in France, as compared to the current national surveillance system based on manual coding by emergency practitioners. A feasibility study was conducted at Lyon University Hospital, using data for all ED patient visits in 2012. After automatic data extraction and pre-processing, including automatic coding of medical free-text through use of the Unified Medical Language System, seven different machine-learning methods were used to classify the reasons for ED visits into "suicide attempts" versus "other reasons". The performance of these different methods was compared by using the F-measure. In a test sample of 444 patients admitted to the ED in 2012 (98 suicide attempts, 48 cases of suicidal ideation, and 292 controls with no recorded non-fatal suicidal behaviour), the F-measure for automatic detection of suicide attempts ranged from 70.4% to 95.3%. The random forest and naïve Bayes methods performed best. This study demonstrates that machine-learning methods can improve the quality of epidemiological indicators as compared to current national surveillance of suicide attempts. Copyright © 2016 John Wiley & Sons, Ltd.

  5. California emergency department visit rates for medical conditions increased while visit rates for injuries fell, 2005-11. (United States)

    Hsia, Renee Y; Nath, Julia B; Baker, Laurence C


    The emergency department (ED) is the source of most hospital admissions; provides care for patients with no other point of access to the health care system; receives advanced care referrals from primary care physicians; and provides surveillance data on injuries, infectious diseases, violence, and adverse drug events. Understanding the changes in the profile of disease in the ED can inform emergency services administration and planning and can provide insight into the public's health. We analyzed the trends in the diagnoses seen in California EDs from 2005 to 2011, finding that while the ED visit rate for injuries decreased by 0.7 percent, the rate of ED visits for noninjury diagnoses rose 13.4 percent. We also found a rise in symptom-related diagnoses, such as abdominal pain, along with nervous system disorders, gastrointestinal disease, and mental illness. These trends point out the increasing importance of EDs in providing care for complex medical cases, as well as the changing nature of illness in the population needing immediate medical attention. Project HOPE—The People-to-People Health Foundation, Inc.

  6. Graduate Medical Education Funding and Curriculum in Physical Medicine and Rehabilitation: A Survey of Physical Medicine and Rehabilitation Department Chairs. (United States)

    Perret, Danielle; Knowlton, Tiffany; Worsowicz, Gregory


    This national survey highlights graduate medical education funding sources for physical medicine and rehabilitation (PM&R) residency programs as well as perceived funding stability, alignment of the current funding and educational model, the need of further education in postacute care settings, and the practice of contemporary PM&R graduates as perceived by PM&R department/division chairs. Approximately half of the reported PM&R residency positions seem to be funded by Centers of Medicare and Medicaid Services; more than 40% of PM&R chairs believe that their residency program is undersized and nearly a quarter feel at risk for losing positions. A total of 30% of respondents report PM&R resident experiences in home health, 15% in long-term acute care, and 52.5% in a skilled nursing facility/subacute rehabilitation facility. In programs that do not offer these experiences, most chairs feel that this training should be included. In addition, study results suggest that most PM&R graduates work in an outpatient setting. Based on the results that chairs strongly feel the need for resident education in postacute care settings and that most graduates go on to practice in outpatient settings, there is a potential discordance for our current Centers of Medicare and Medicaid Services graduate medical education funding model being linked to the acute care setting.

  7. The Quality of Medication Treatment for Mental Disorders in the Department of Veterans Affairs and in Private-Sector Plans. (United States)

    Watkins, Katherine E; Smith, Brad; Akincigil, Ayse; Sorbero, Melony E; Paddock, Susan; Woodroffe, Abigail; Huang, Cecilia; Crystal, Stephen; Pincus, Harold Alan


    The quality of mental health care provided by the U.S. Department of Veterans Affairs (VA) was compared with care provided to a comparable population treated in the private sector. Two cohorts of individuals with mental disorders (schizophrenia, bipolar disorder, posttraumatic stress disorder, major depression, and substance use disorders) were created with VA administrative data (N=836,519) and MarketScan data (N=545,484). The authors computed VA and MarketScan national means for seven process-based quality measures related to medication evaluation and management and estimated national-level performance by age and gender. In every case, VA performance was superior to that of the private sector by more than 30%. Compared with individuals in private plans, veterans with schizophrenia or major depression were more than twice as likely to receive appropriate initial medication treatment, and veterans with depression were more than twice as likely to receive appropriate long-term treatment. Findings demonstrate the significant advantages that accrue from an organized, nationwide system of care. The much higher performance of the VA has important clinical and policy implications.

  8. Family presence during trauma activations and medical resuscitations in a pediatric emergency department: an evidence-based practice project. (United States)

    Kingsnorth, Jennifer; O'Connell, Karen; Guzzetta, Cathie E; Edens, Jacki Curreri; Atabaki, Shireen; Mecherikunnel, Anne; Brown, Kathleen


    The existing family presence literature indicates that implementation of a family presence policy can result in positive outcomes. The purpose of our evidence-based practice project was to evaluate a family presence intervention using the 6 A's of the evidence cycle (ask, acquire, appraise, apply, analyze, and adopt/adapt). For step 1 (ask), we propose the following question: Is it feasible to implement a family presence intervention during trauma team activations and medical resuscitations in a pediatric emergency department using national guidelines to ensure appropriate family member behavior and uninterrupted patient care? Regarding steps 2 through 4 (acquire, appraise, and apply), our demonstration project was conducted in a pediatric emergency department during the implementation of a new family presence policy. Our family presence intervention incorporated current appraisal of literature and national guidelines including family screening, family preparation, and use of family presence facilitators. We evaluated whether it was feasible to implement the steps of our intervention and whether the intervention was safe in ensuring uninterrupted patient care. With regard to step 5 (analyze), family presence was evaluated in 106 events, in which 96 families were deemed appropriate and chose to be present. Nearly all families (96%) were screened before entering the room, and all were deemed appropriate candidates. Facilitators guided the family during all events. One family presence event was terminated. In all cases patient care was not interrupted. Regarding step 6 (adopt/adapt), our findings document the feasibility of implementing a family presence intervention in a pediatric emergency department while ensuring uninterrupted patient care. We have adopted family presence as a standard practice. This project can serve as the prototype for others. Copyright (c) 2010 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

  9. Does providing prescription information or services improve medication adherence among patients discharged from the emergency department? A randomized controlled trial. (United States)

    McCarthy, Melissa L; Ding, Ru; Roderer, Nancy K; Steinwachs, Donald M; Ortmann, Melinda J; Pham, Julius Cong; Bessman, Edward S; Kelen, Gabor D; Atha, Walter; Retezar, Rodica; Bessman, Sara C; Zeger, Scott L


    We determine whether prescription information or services improve the medication adherence of emergency department (ED) patients. Adult patients treated at one of 3 EDs between November 2010 and September 2011 and prescribed an antibiotic, central nervous system, gastrointestinal, cardiac, or respiratory drug at discharge were eligible. Subjects were randomly assigned to usual care or one of 3 prescription information or services intervention groups: (1) practical services to reduce barriers to prescription filling (practical prescription information or services); (2) consumer drug information from MedlinePlus (MedlinePlus prescription information or services); or (3) both services and information (combination prescription information or services). Self-reported medication adherence, measured by primary adherence (prescription filling) and persistence (receiving medicine as prescribed) rates, was determined during a telephone interview 1 week postdischarge. Of the 3,940 subjects enrolled and randomly allocated to treatment, 86% (N=3,386) completed the follow-up interview. Overall, primary adherence was 88% and persistence was 48%. Across the sites, primary adherence and persistence did not differ significantly between usual care and the prescription information or services groups. However, at site C, subjects who received the practical prescription information or services (odds ratio [OR]=2.4; 95% confidence interval [CI] 1.4 to 4.3) or combination prescription information or services (OR=1.8; 95% CI 1.1 to 3.1) were more likely to fill their prescription compared with usual care. Among subjects prescribed a drug that treats an underlying condition, subjects who received the practical prescription information or services were more likely to fill their prescription (OR=1.8; 95% CI 1.0 to 3.1) compared with subjects who received usual care. Prescription filling and receiving medications as prescribed was not meaningfully improved by offering patients patient

  10. Impact of automated dispensing cabinets on medication selection and preparation error rates in an emergency department: a prospective and direct observational before-and-after study. (United States)

    Fanning, Laura; Jones, Nick; Manias, Elizabeth


    The implementation of automated dispensing cabinets (ADCs) in healthcare facilities appears to be increasing, in particular within Australian hospital emergency departments (EDs). While the investment in ADCs is on the increase, no studies have specifically investigated the impacts of ADCs on medication selection and preparation error rates in EDs. Our aim was to assess the impact of ADCs on medication selection and preparation error rates in an ED of a tertiary teaching hospital. Pre intervention and post intervention study involving direct observations of nurses completing medication selection and preparation activities before and after the implementation of ADCs in the original and new emergency departments within a 377-bed tertiary teaching hospital in Australia. Medication selection and preparation error rates were calculated and compared between these two periods. Secondary end points included the impact on medication error type and severity. A total of 2087 medication selection and preparations were observed among 808 patients pre and post intervention. Implementation of ADCs in the new ED resulted in a 64.7% (1.96% versus 0.69%, respectively, P = 0.017) reduction in medication selection and preparation errors. All medication error types were reduced in the post intervention study period. There was an insignificant impact on medication error severity as all errors detected were categorised as minor. The implementation of ADCs could reduce medication selection and preparation errors and improve medication safety in an ED setting. © 2015 John Wiley & Sons, Ltd.

  11. Russian First Department of Roentgenology (on the occasion of 80th anniversary of Department of Roentgenology with a Course of Pediatric Roentgenology, Saint Petersburg Medical Academy for Postgraduate Training

    International Nuclear Information System (INIS)

    Trofimova, T.N.; Parizhskij, Z.M.


    Historical retrospective analysis is given for Oldest Russian (1898) - Department of Roentgenology of S.-Petersburg Medical Academy for Postgraduate Training permitting t assess the development of mentioned discipline in scientific, clinical, training, technical and organizational directions. For the period of existence of the Department the way was passed from biomedical radiography room to powerful Department based in many treatment-and-prophylactic establishments of the city carrying out large research work being a leading centre for postgraduate training on radiodiagnosis in the Northern-Western part of Russia [ru

  12. Legacy in the Sand: The United States Army Armament, Munitions and Chemical Command in Operations Desert Shield and Desert Storm (United States)


    States Army Medical Department, over 1.5 million British-designed Small Box Respirator ( SBR ) masks, utilizing activated coconut charcoal as a filter, had...conflicts this nation will tfce-short in rjuration but of high intensity. In such a war, relance must bpp oaced upon the established stockpile and the...Supply System SAW squad automatic weapon SBA Small Business Administration SBR small box respirator SCR senior command representati’e SCRAM self-contained

  13. Analysis of Inappropriate Admissions of Residents of Medicalized Nursing Homes to Emergency Departments: A Prospective Multicenter Study in Burgundy. (United States)

    Manckoundia, Patrick; Menu, Didier; Turcu, Alin; Honnart, Didier; Rossignol, Sylvie; Alixant, Jean-Christophe; Sylvestre, Franck-Henry; Bailly, Vanessa; Dion, Michèle; Putot, Alain


    To determine the rate of inappropriate admissions to emergency departments (EDs) and to identify determinants of these admissions. Prospective multicenter study. Burgundy (France), EDs and medical nursing homes (MNHs). 1000 Burgundy MNH residents admitted to EDs, from April 17 to June 20, 2013. For each subject, a questionnaire was completed. Data included age, gender, type of health professional who referred the resident to the ED (THP), whether or not a medical dispatcher organized the transfer to the ED, transport mode, reason for admission to the ED, level of independence according to the Groupes Iso-Ressource score (GIRS), and diagnosis made in the ED. The French version of the Appropriateness Evaluation Protocol grid was applied to each admission to the ED, and in some situations, the expert committee ruled on the appropriateness of the admission to the ED. MNH characteristics were also recorded. Two groups were constituted according to the appropriateness or not of admission to the ED. Mean age of the 1000 residents was 87. There were 706 women. Two-thirds were referred to the EDs by a physician, mainly a general practitioner. In 91.7%, the transfer to the ED was organized by a medical dispatcher, and 8.8% were transported by medicalized transport. More than 95% had a GIRS ≤4. Among the admissions to EDs, 18.1% were inappropriate. Female gender (P = .017), nonmedicalized transport (P = .002), public MNH (P = .044), and nonaccess to a geriatric opinion in an emergency (P = .043) were determinants of inappropriate admission to EDs. In this first study on admissions to EDs of MNH residents using French data, we found a lower rate of admissions to the ED than that reported in the literature. Female gender, nonmedicalized transport, public MNH, and nonaccess to a geriatric opinion in an emergency were associated with inappropriate admission to EDs. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier

  14. Transition and Transfer of Remediated Formerly Utilized Sites Remedial Action Program (FUSRAP) Sites from U.S. Army Corps of Engineers (USACE) to U.S. Department of Energy (DOE)

    Energy Technology Data Exchange (ETDEWEB)

    Carpenter, Cliff [U.S. Department of Energy, Office of Legacy Management; Castillo, Darina [U.S. Department of Energy, Office of Legacy Management; Fatherly, Nicki [U.S. Army Corps of Engineers; Miller, Michele [Navarro Research and Engineering


    The US Department of Energy (DOE) expects to receive the transfer of 10 FUSRAP Sites from the US Army Corps of Engineers (USACE) over the next 10 years; however, the timing of the transfers is highly dependent upon federal funding of the ongoing remedial actions. When remediation for each site is complete and the 2-year operations and maintenance period has concluded, each site will transfer from USACE to DOE for long-term surveillance and maintenance (LTS&M). US DOE’s Office of Legacy Management (LM) will accept program responsibility for these sites and conduct LTS&M activities required to maintain protectiveness, preserve site-specific knowledge, and retain the cleanup and stewardship records while keeping stakeholders informed. Since the last FUSRAP site transfer occurred in 2007, LM in coordination with USACE intends to establish a transition process to promote the seamless transfer of sites from the time when the first record of decision is signed to the completion of FUSRAP activities. The approach to transfer active FUSRAP sites to completed sites status has been historically outlined in foundational documents such as the 1999 Memorandum of Understanding and supporting letters of agreement between the two agencies. As more complex FUSRAP sites are completed, this transition process will provide a model between the two agencies to communicate future long-term care liabilities. Ultimately, the FUSRAP transition process is structured to acquire and preserve site knowledge and information necessary for protecting the environment and public health. As of 2015, LM has transitioned and accepted programmatic responsibility for over 90 sites. From LM’s perspective, successful transition of any site includes understanding the long-term environmental liabilities. LM uses site transition framework requirements from past transitions to develop site-specific transition plans. Site-specific transition plans are developed by LM in coordination with USACE and executed


    Directory of Open Access Journals (Sweden)

    V. M. Alifirova


    Full Text Available The history of the development of the Tomsk Scientific School Neurologists and the past and current events in the Department of Neurology and Neurosurgery of Siberian State Medical University are described. The Department of Neurology was established in 1881–1882. At a different times the department was headed by many great Russian physicians such as Michail G. Kurlov, Leonid I. Omorokov, Nikolay V. Schubin, Nikolay I. Komandenko. In addition to the academic work the department leads research in many fields of neurology, including movement disorders, cerebrovascular diseases, demyelinating and paroxysmal diseases. 

  16. A history of US Army PAs. (United States)

    Chalupa, Robyn L; Marble, W Sanders


    The US military has a long tradition of using physician assistants (PAs). The Army began using PAs in 1971 in an effort to supplement the physicians and surgeons in the medical corps. As their numbers grew, PAs gradually replaced general medical officers assigned to battalions. Later, specialty positions developed in aviation medicine, orthopedics, and emergency medicine. The need for a PA serving as an adviser in the major commands slowly developed at all levels of leadership. In 2015, the Army removed limitations on female PAs assigned to combat units. PAs lead in tactical and clinical settings, filling command roles, senior clinical positions, and administrative leadership roles.

  17. Prescribing pattern of antipsychotic drugs in the outpatient department of psychiatry in Silchar Medical College and Hospital, Assam

    Directory of Open Access Journals (Sweden)

    Pinaki Chakravarty


    Full Text Available Objective: To study the prescribing pattern of antipsychotic drugs in the outpatient department of psychiatry in Silchar Medical College and Hospital (SMCH of Assam. Methods: It is a prospective cross-sectional study which was carried out for three months from August to November 2015 in the outpatient department of psychiatry. All patients irrespective of their ages and sexes were included in this study. Inpatients, referred patients, patients not willing to give consent, patients of epilepsy as well as those cases where diagnoses were not certain were excluded from the study. The prescription patterns of antipsychotic drugs and the occurrences of various psychiatric diseases on both the sexes were studied after taking permission from the Institutional Ethical Committee (SMCH. Results: A total of 112 prescriptions were analysed. The most common disease was found to be schizophrenia. Total drugs prescribed were 265 and average number of drugs per prescription was 2.36. It was seen that out of the 112 prescriptions, monotherapy was practiced in 19.64% (22 compared to polytherapy in 80.35% (90. Out of 265 prescribed drugs atypical antipsychotics were 112 (42.26%, typical antipsychotics 12 (4.52%, antiepileptics 57 (21.50%, antidepressants 29 (10.94%, antiparkinsonian 29 (10.94%, and others 26 (9.81%. Antipsychotics given orally were 122 of which olanzapine was 54 (44.26%, risperidone 40 (32.78%, chlorpromazine ten (8.19%, quetiapine eight (6.55%, aripiprazole five (4.09%, amisulpiride five (4.09% were seen. Injectable antipsychotics were two, of which only haloperidol two (100%. Antipsychotics in combination prescription with same groups were 14 (12.5%, with antidepressants, antipileptics, antiparkinsonian were 88 (78.57% and other agents were ten (8.92%, which included pantoprazole, multivitamins, and benfotiamine. Conclusion: This study shows that atypical antipsychotics are the most common drugs prescribed in patients with psychotic illness and

  18. Proceedings of the Current Trends in Army Medical Department Psychology Held at San Antonio, Texas on 8-12 November 1976. (United States)


    program and/or begin training in family evaluations. A third option is Play Therapy . a. The Dreikur’s parent training program requires the trainee to...option at Level II, Play Therapy , requires the trainee to learn and implement the principles of play therapy necessary to help the child (1) identify, (2...label, and (3) appropriately express his feelings, The trainee must demonstrate mastery of these skills with at least two children. Mastery of play

  19. The Defense Department’s Enduring Contributions to Global Health. The Future of the U.S. Army and Navy Overseas Medical Laboratories (United States)


    Drug Resistance Laboratories 1520-1600 Kombewa Clinical Research Center (CRC) - Tour and Clinical Trials Program Brief LTC Louis Macareo and Agnes “ Mama ...can lead to AIDS, in which the body’s compromised immune system makes it more susceptible to the development of infections and cancers . For this reason

  20. A Study to Establish a Measure of Clinical Productivity among Physicians in the Department of Family Practice Outpatient Clinics, Madigan Army Medical Center (United States)


    789.0 7890 pelvic ) (64) 61 Psoriasis and Pityriasis (70) 696.0 to 696.9 6961,6963 62 Irritable Colon (72) 564.1 558- 564.5 63 Chronic Cystic Disease of...075.9 573.3 80 Chronic Ulcer of Skin 707.0 to 707.9 707- (-) 81 Strabismus (84) 378.0 to 378.9 No equivalent separate code 82 Diverticular Disease of...of ensuring product ( disease treatment) output... (Arbitman, 1986, p. 31). Along with new developments in productivity measurement in the inpatient

  1. Analysis of causes of intraocular lens explantations in the material of Department of Ophthalmology, Medical University of Lodz. (United States)

    Wilczyński, Michał; Wilczyńska, Olena; Omulecki, Wojciech


    Implantation of intraocular lenses (IOLS) has become a standard practice in cataract surgery, however, similar to any other type of surgery, using IOLs is not complication-free and sometimes explantation of intraocular lenses may be necessary. This study was to gather data and analyze causes of intraocular lens explantations, performed in the Department of Ophthalmology, Medical University of Łódź. The data were gathered from medical documentation of all patients who underwent intraocular lens removal from January 2003 to July 2006. The examined group consisted of 16 patients (16 eyes): 9 women (fraction 0.56), and 7 men (fraction 0.44), at the age from 21 to 82 years (mean age 62.4 years, SD +/- 15.5). In all patients IOL explantation was performed under local, peribulbar anaesthesia. Two groups of patients were distinguished: patients who had an anterior chamber lens explanted (3 patients, fraction 0.19) and patients who underwent posterior chamber lens explantation (13 patients, fraction 0.81). Causes of AC IOL explantations were: vaulting of the IOL (1 eye, fraction 0.06), luxation of the IOL to the vitreous cavity (1 eye, fraction 0.06), and painful eyeball after anterior chamber lens implantation (1 eye, fraction 0.06). Causes of PC IOL explantations were: subluxation of the IOL (6 eyes, fraction 0.38), luxation of the lens to the vitreous cavity (3 eyes, fraction 0.19), luxation of the lens to the anterior chamber (1 eye, fraction 0.06), endophthalmitis (2 eyes, fraction 0.13) and incorrect lens power (1 eye, fraction 0.06). In the majority of eyes (n = 13, fraction 0.81) the removed implant was replaced by another intraocular lens, but 3 eyes (fraction 0.19) were left aphakic. We did not observe serious intra- or early postoperative complications which might influence the final result of the operation.

  2. Keys to Achieving Target First Medical Contact to Balloon Times and Bypassing Emergency Department More Important Than Distance

    Directory of Open Access Journals (Sweden)

    Saad Ezad


    Full Text Available Background. Australian guidelines advocate primary percutaneous coronary intervention (PPCI as the reperfusion strategy of choice for ST elevation myocardial infarction (STEMI in patients in whom it can be performed within 90 minutes of first medical contact; otherwise, fibrinolytic therapy is preferred. In a large health district, the reperfusion strategy is often chosen in the prehospital setting. We sought to identify a distance from a PCI centre, which made it unlikely first medical contact to balloon time (FMCTB of less than 90 minutes could be achieved in the Hunter New England health district and to identify causes of delay in patients who were triaged to a PPCI strategy. Methods and Results. We studied 116 patients presenting via the ambulance service with STEMI from January 2016 to December 2016. In patients who were taken directly to the cardiac catheterisation lab, a maximum distance of 50 km from hospital resulted in 75% of patients receiving PCI within 90 minutes and approximately 95% of patients receiving PCI within 120 minutes. Patients who bypassed the emergency department (ED were significantly more likely to have FMCTB of less than 90 minutes (p<0.001 despite having a longer travel distance (28.5 km versus 17.4 km, p<0.001. Patients transiting via the ED were significantly more likely to present out of hours (60 versus 24.2% p<0.001. Conclusions. Patients who do not bypass the ED have a longer FMCTB across all spectrum of distances from the PCI centre; therefore, bypassing the ED is key to achieving target FMCTB times. Using a cutoff distance of 50 km may reduce human error in estimating travel time to our PCI centre and thereby identifying patients who should receive prehospital thrombolysis.

  3. The effectiveness of holistic diabetic management between Siriraj Continuity of Care clinic and medical out-patient department. (United States)

    Chalermsri, Chalobol; Paisansudhi, Supalerg; Kantachuvesiri, Pitchaporn; Pramyothin, Pornpoj; Washirasaksiri, Chaiwat; Srivanichakorn, Weerachai; Nopmaneejumruslers, Cherdchai; Chouriyagune, Charoen; Pandejpong, Denla; Phisalprapa, Pochamana


    Diabetes mellitus is one of the most common diseases in the Thai population, and it is well known that diabetic complications could be prevented with appropriate management. Despite published guidelines, most Thai patients with diabetes do not achieve treatment goals. Siriraj Continuity of Care clinic (CC clinic) was recently established in order to provide training for medical students and internal medicine residents. It is possible that the training component in the CC clinic may contribute to better overall outcomes in type 2 diabetes mellitus (type 2 DM) patients when compared with usual care at the medical out-patient department (OPD). To compare the effectiveness of diabetic management in type 2 diabetes mellitus patients who attended the CC clinic and the medical OPD. Retrospective chart review was performed in type 2 diabetes mellitus patients who were treated at either clinic at Siriraj Hospital in 2007-2011. Baseline demographics, treatment strategies and outcomes, and participation in an appropriate health maintenance program were assessed in both groups. Seven hundred and fifty seven medical records were reviewed, including 383 patients in the CC clinic group and 374 in the OPD group. Mean HbA1c was significantly lower in the CC clinic group compared with the OPD group (7.3 +/- 0.9% and 7.8 +/- 1.3%, respectively, < 0.001). The number of patients who achieved goal HbA1c of less than 7% in CC clinic group was 123 (32.1%) compared with 91 (24.3%) in the OPD group (p = 0.039). More patients were screened for diabetic complications in the CC clinic group compared with the OPD group, including screening for diabetic neuropathy (57.4% vs. 2.1%, p < 0.001), diabetic retinopathy (56.7% vs. 36.6%, p < 0.001), and diabetic nephropathy (80.9% vs. 36.9%, p < 0.001). Patients in the CC clinic group had a higher rate of age-appropriate cancer screening than those in the OPD group (54.2% vs. 13.3%, p < 0.001 for breast cancer; 24.0% vs. 0.9%, p < 0.001 for cervical

  4. How can hospitals better protect the privacy of electronic medical records? Perspectives from staff members of health information management departments. (United States)

    Sher, Ming-Ling; Talley, Paul C; Cheng, Tain-Junn; Kuo, Kuang-Ming


    The adoption of electronic medical records (EMR) is expected to better improve overall healthcare quality and to offset the financial pressure of excessive administrative burden. However, safeguarding EMR against potentially hostile security breaches from both inside and outside healthcare facilities has created increased patients' privacy concerns from all sides. The aim of our study was to examine the influencing factors of privacy protection for EMR by healthcare professionals. We used survey methodology to collect questionnaire responses from staff members in health information management departments among nine Taiwanese hospitals active in EMR utilisation. A total of 209 valid responses were collected in 2014. We used partial least squares for analysing the collected data. Perceived benefits, perceived barriers, self-efficacy and cues to action were found to have a significant association with intention to protect EMR privacy, while perceived susceptibility and perceived severity were not. Based on the findings obtained, we suggest that hospitals should provide continuous ethics awareness training to relevant staff and design more effective strategies for improving the protection of EMR privacy in their charge. Further practical and research implications are also discussed.

  5. Discovering the Army's Core Competencies

    National Research Council Canada - National Science Library

    Rudesheim, Frederick


    This paper seeks to answer the question, "Has the Army correctly identified its core competencies to ensure the Army can adequately respond to the national military strategy?" FM 1, The Army (Prototype Draft...

  6. Medical Logistics Lessons Observed During Operations Enduring Freedom and Iraqi Freedom. (United States)

    Dole, Mark J; Kissane, Jonathan M


    Medical Logistics (MEDLOG) is a function of the Army's integrated System for Health that provides the medical products and specialized logistics services required to deliver health protection and care under all operational conditions. In unified land operations, MEDLOG is an inherent function of Health Service Support (HSS), which also includes casualty care and medical evacuation. This paper focuses on a few key lessons observed during Operations Enduring Freedom and Iraqi Freedom with direct implications for the support of HSS in future operations as envisioned in the Army Operating Concept and the Joint Concept for Health Services. It also examines a few key enablers that helped mitigate these challenges that are not yet fully acknowledged in Army Medical Department doctrine, policy, and planning.

  7. Women in the Army (United States)


    Army womenpower re- quirements with no apparent end in sight. No country, not even Russia or Israel, has ever made a conscious decision to include...provide a basis for decision making. iiI CHAPTER ONE AN HISTORICAL OVERVIEW Few books have been written which outline the history of military women...with a bill introducing the Women’s Army Auxillary Corps (WAAC). In order 7 that the Army could maintain control over this sensitive issue, General

  8. Grace Under Fire: The Army Nurses of Pearl Harbor, 1941. (United States)

    Milbrath, Gwyneth R


    Much has been written about the military events of December 7, 1941; however, little has been documented about the nurses' work and experience at Pearl Harbor, Hawaii. The aerial assault on Pearl Harbor was the first time in US history that Army nurses had been on the front line of battle. Nurses quickly triaged and stabilized those who could be saved, and provided compassion and comfort to those who were dying, in an environment where the nurses were unsure of their own survival. Traditional historical methods and a social history framework were used in this investigation. Primary sources included oral histories from the US Army Medical Department Center of History and Heritage and the State of Hawaii's website, Hawaii Aviation. Secondary sources included published books, newspaper articles, military websites, and history texts. Due to the limited bed capacity, Hickam Field Hospital converted to an evacuation hospital. Nurses, physicians, and medical corpsman triaged, stabilized, and transported those likely to survive, while staging the dead behind the building. The emergency room at Tripler Hospital was quickly flooded with patients from the battlefield, but the staff was able to sort patients appropriately to the wards, to the operating room, or provide comfort care as they died. At Schofield Hospital, collaboration between tireless doctors, nurses, and corpsmen was key to providing life-saving surgery and care.

  9. Army Maintenance System Transformation

    National Research Council Canada - National Science Library

    Gilbertson, Frank V


    .... Used in conjunction with pertinent historical data and developed with Army transformation goals in mind, General Systems thinking can provide the framework for guiding maintenance transformation...

  10. Distribution and Supply Chain Management: Educating the Army Officer

    National Research Council Canada - National Science Library

    Solseth, Mark E


    ... and distribution management environment. It analyzes how officers should attain these skills using the three pillars of leader development in Department of the Army Pamphlet 600-3, "Commissioned Officer Development and Career Management...

  11. U.S. Army War College Guide to Strategy

    National Research Council Canada - National Science Library

    Cerami, Joseph


    For more than 3 decades, the Army War College Department of National Security and Strategy has faced the challenge of educating future strategic leaders on the subject of national security, or grand strategy...

  12. Army Transformation The Unhinging of Title 10 Logistics Support

    National Research Council Canada - National Science Library

    Lundgren, Kenneth S


    .... Successful expeditionary operations will require a much better understanding of the Department of Defense and US Army transformation strategies and how those proposed changes will impact the joint community.

  13. An Overdue Post-Cold War Army Structure

    National Research Council Canada - National Science Library

    Dixon, Michael


    ...). The Army has rapidly aligned itself with the Department of Defense (DoD) Transformation plan and is aggressively identifying and building required capabilities now in support of the Global War on Terrrorism (GWOT...

  14. Synopsis of Diet in Dermatology: A one day CME conducted by the Department of Dermatology, Kasturba Medical College, Manipal, March 3, 2013

    Directory of Open Access Journals (Sweden)

    Smitha S Prabhu


    Full Text Available Food is intricately related to mind and body and is one of the elements sustaining life, in disease as well as in health. There are many myths and misgivings regarding partake of food and its medicinal properties. The Department of Dermatology, Kasturba Medical College (KMC, Manipal organized a continuing medical education (CME on Diet in Dermatology on 3rd March 2013 focusing on pertinent issues regarding diet and medicinal use of food.


    Directory of Open Access Journals (Sweden)

    Suleyman Erhan DEVECI


    Full Text Available This study was carried out with the aim of identifying risk factors coronary artery disease (CAD in the employees of Elazig Security Department. Questionnaires were applied to members and/or spouses (313 individuals of Elazig Security Department admitting to the Health Office for any reason in November-December 2003. Measurements for fasting blood sugar, serum cholesterol levels and blood pressure values were carried out. Of the individuals participating in this study, 1.9% reported having diabetes, 2.9% heart disease and 5.4% hypertension. Mean blood pressure measurements were; systolic 114.1±15.9 and diastolic 74.6±10.3 mmHg, mean fasting blood glucose values were reported as 90.9±16.6 mg/dl. 8.9% had high systolic and 7.7% had high diastolic blood pressure measurements, 16.0% had elevated total cholesterol and 3.5% had elevated fasting blood sugar levels. 36.7% reported to be current smokers, 20.8% reported having regular physical activity. 65.5% reported skipping meals and 47.3% reported eating snacks between the meals. In the group that was analyzed, the rates of smoking, sedentary life style and irregular eating habits that are considered as risk factors for CAD were high. [TAF Prev Med Bull 2006; 5(4.000: 235-243

  16. American Recovery and Reinvestment Act (ARRA) FEMP Technical Assistance U.S. Army – Project 276 Renewable Resource Development on Department of Defense Bases in Alaska: Challenges and Opportunities

    Energy Technology Data Exchange (ETDEWEB)

    Warwick, William M.


    The potential to increase utilization of renewable energy sources among military facilities in Alaska through coordinated development and operation is the premise of this task. The US Army Pacific Command requested assistance from PNNL to help develop a more complete understanding of the context for wheeling power within Alaska, including legal and regulatory barriers that may prohibit the DOD facilities from wheeling power among various locations to optimize the development and use of renewable resources.

  17. Application of time series analysis in modelling and forecasting emergency department visits in a medical centre in Southern Taiwan. (United States)

    Juang, Wang-Chuan; Huang, Sin-Jhih; Huang, Fong-Dee; Cheng, Pei-Wen; Wann, Shue-Ren


    Emergency department (ED) overcrowding is acknowledged as an increasingly important issue worldwide. Hospital managers are increasingly paying attention to ED crowding in order to provide higher quality medical services to patients. One of the crucial elements for a good management strategy is demand forecasting. Our study sought to construct an adequate model and to forecast monthly ED visits. We retrospectively gathered monthly ED visits from January 2009 to December 2016 to carry out a time series autoregressive integrated moving average (ARIMA) analysis. Initial development of the model was based on past ED visits from 2009 to 2016. A best-fit model was further employed to forecast the monthly data of ED visits for the next year (2016). Finally, we evaluated the predicted accuracy of the identified model with the mean absolute percentage error (MAPE). The software packages SAS/ETS V.9.4 and Office Excel 2016 were used for all statistical analyses. A series of statistical tests showed that six models, including ARIMA (0, 0, 1), ARIMA (1, 0, 0), ARIMA (1, 0, 1), ARIMA (2, 0, 1), ARIMA (3, 0, 1) and ARIMA (5, 0, 1), were candidate models. The model that gave the minimum Akaike information criterion and Schwartz Bayesian criterion and followed the assumptions of residual independence was selected as the adequate model. Finally, a suitable ARIMA (0, 0, 1) structure, yielding a MAPE of 8.91%, was identified and obtained as Visit t =7111.161+(a t +0.37462 a t -1). The ARIMA (0, 0, 1) model can be considered adequate for predicting future ED visits, and its forecast results can be used to aid decision-making processes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. Three years audit of the emergency patients in the department of ENT of a rural medical college. (United States)

    Barman, Debasis; Maridal, Satadal; Goswami, Saileswar; Hembram, Rabi


    Surgical audit is a systematic, critical analysis of the quality of surgical care provided, with the aims of improving quality of care, continuing education for surgeons, and guiding appropriate use of health resources. Emergency service is an integral part of any discipline of clinical medicine and it is considered as an indicator of quality of healthcare system. A three years record based, retrospective, cross-sectional study was carried out in the department of ear, nose and throat (ENT) of Midnapore Medical College, Paschim Medinipur,West Bengal to identify the total attendance of various emergency patients, diagnosis made thereafter, the mode of interference and outcome and the potential problems in the quality of care provided to the community. A total of 9051 patients had been admitted/attended in the ENT emergency from January 2008 to December 2010 who were included in this audit. Detailed statistical analysis of the data showed male: female (2.38:1) with the peak in the first decade of life. Majority of the patients were from Medinipur sadar (58.43%). The total otological cases were maximum (42.41%) in comparison to nose (28.98%) and throat (28.60%). The most common ear emergencies were earache due to impacted wax, acute suppurative otitis media, foreign body ear and the trauma/injury. Chronic suppurative otitis media with complications were the least. Amongst the sinonasal emergency, the most common aetiology was the epistaxis and foreign body nose in children. The different types of foreign body impaction in the throat and the inflammatory condition of throat or the inspiratory stridor due to upper airway obstruction were the main emergency situation recorded. Some cases were fatal. The overall mortality was 0.44%.



    content/?q=historic-cyber-unit-begins- daily-action . 14 John M. McHugh , Secretary of the Army, HQDA General Order 2014-02, Affirmation of Secretary McHugh , John M., Secretary of the Army, HQDA General Order 2014-02, Affirmation of Secretary of

  20. The transmission and interpretation of emergency department radiographs. (United States)

    James, J J; Grabowski, W; Mangelsdorff, A D


    Twenty-five radiographic studies representative of the spectrum of trauma cases that might present to an emergency department were selected from actual cases presenting at Brooke Army Medical Center (BAMC) in San Antonio, Texas. The studies were then transmitted from a local television studio via satellite back to BAMC and three other Army hospitals. A panel of 29 physicians (11 radiologists, 7 emergency physicians, and 11 others from various specialty areas) viewed the images on commercial grade television sets and attempted to make a diagnosis. The diagnostic accuracy of the radiologists (86%) was significantly better than that of the other two groups (77% each). However, given the overall expense of a teleradiology network, this difference in accuracy - especially when translated into clinically significant errors - might not justify the establishment of such a network in terms of cost-effectiveness.

  1. Traumatic injuries of the permanent maxillory incisors at dental department, pakistan institute of medical sciences islamabad: A retrospective study

    International Nuclear Information System (INIS)

    Khan, N.A.; Maxood, A.; Khan, M.A.


    The study aims to ascertain the prevalence of traumatic dental injures of the maxillary permanent incisors at Dental Department, Pakistan Institute of Medical Science Islamabad during the years 2003-2005. Information concerning age, sex, cause, type of tooth number of injured teeth and patterns of tooth injury were recorded retrospectively from 33 patients aged between 8-40 years, comprising 498 traumatized teeth. The dental record of all the patients presenting with dental trauma were examined for collection of data relating to age, sex, cause, number of injured teeth, type of tooth and type of tooth trauma. Type of tooth trauma was recorded according to the Andreason classification. The data was subsequently processed and analyzed using the SPSS statistical software programme. The statistical significance level was set at 5%. Of the 336 patients, 227 were males (67.6%) and 109 were female (32.4%). The gender difference was statistically significant (p<0.0001). The patients had a total of 498 traumatized teeth. A large number of dental trauma occurred in patients aged between 9-11 years. Most injuries involved one tooth in 227 patients (67.6%). However two teeth in 90 patients (26.7%), three teeth in 11 patients (3.2%) and only in 8 patients (2.3%) four teeth were involved. Fractures in enamel only occurred in 74 teeth (14.6%). Uncomplicated crown fractures in 208 teeth (41.9%) were the most commonly encountered dental trauma. 137 teeth (27.6%) suffered complicated crown fractures, 44 teeth (8.9%) uncomplicated crown-root fractures, 19 teeth (3.8%) complicated crown-root fractures and avulsion in 16 teeth (3.2%) only. The main causes were falls in 225 patients (66.9%), collision with objects in 40 patients (11.9%), road traffic accident in 31 patients (9.2%) violence in 31 patients (6.2%), and sports in 19 patients (5.6%). The maxillary central incisor was traumatized in 384 teeth showing a high percentage of 77%. Raising public dental awareness regarding the

  2. Emergency Department Chief Complaint and Diagnosis Data to Detect Influenza-Like Illness with an Electronic Medical Record (United States)

    May, Larissa S.; Griffin, Beth Ann; Bauers, Nicole Maier; Jain, Arvind; Mitchum, Marsha; Sikka, Neal; Carim, Marianne; Stoto, Michael A.


    Background: The purpose of syndromic surveillance is early detection of a disease outbreak. Such systems rely on the earliest data, usually chief complaint. The growing use of electronic medical records (EMR) raises the possibility that other data, such as emergency department (ED) diagnosis, may provide more specific information without significant delay, and might be more effective in detecting outbreaks if mechanisms are in place to monitor and report these data. Objective: The purpose of this study is to characterize the added value of the primary ICD-9 diagnosis assigned at the time of ED disposition compared to the chief complaint for patients with influenza-like illness (ILI). Methods: The study was a retrospective analysis of the EMR of a single urban, academic ED with an annual census of over 60, 000 patients per year from June 2005 through May 2006. We evaluate the objective in two ways. First, we characterize the proportion of patients whose ED diagnosis is inconsistent with their chief complaint and the variation by complaint. Second, by comparing time series and applying syndromic detection algorithms, we determine which complaints and diagnoses are the best indicators for the start of the influenza season when compared to the Centers for Disease Control regional data for Influenza-Like Illness for the 2005 to 2006 influenza season using three syndromic surveillance algorithms: univariate cumulative sum (CUSUM), exponentially weighted CUSUM, and multivariate CUSUM. Results: In the first analysis, 29% of patients had a different diagnosis at the time of disposition than suggested by their chief complaint. In the second analysis, complaints and diagnoses consistent with pneumonia, viral illness and upper respiratory infection were together found to be good indicators of the start of the influenza season based on temporal comparison with regional data. In all examples, the diagnosis data outperformed the chief-complaint data. Conclusion: Both analyses

  3. Y2K medical disaster preparedness in New York City: confidence of emergency department directors in their ability to respond. (United States)

    Silber, S H; Oster, N; Simmons, B; Garrett, C


    To study the preparedness New York City for large scale medical disasters using the Year 2000 (Y2K) New Years Eve weekend as a model. Surveys were sent to the directors of 51 of the 9-1-1-receiving hospitals in New York City before and after the Y2K weekend. Inquiries were made regarding hospital activities, contingencies, protocols, and confidence levels in the ability to manage critical incidents, including weapons of mass destruction (WMD) events. Additional information was collected from New York City governmental agencies regarding their coordination and preparedness. The pre-Y2K survey identified that 97.8% had contingencies for loss of essential services, 87.0% instituted their disaster plan in advance, 90.0% utilized an Incident Command System, and 73.9% had a live, mock Y2K drill. Potential terrorism influenced Y2K preparedness in 84.8%. The post-Y2K survey indicated that the threat of terrorism influenced future preparedness in 73.3%; 73.3% had specific protocols for chemical; 62.2% for biological events; 51.1% were not or only slightly confident in their ability to manage any potential WMD incidents; and 62.2% felt very or moderately confident in their ability to manage victims of a chemical event, but only 35.6% felt similarly about victims of a biological incident. Moreover, 80% felt there should be government standards for hospital preparedness for events involving WMD, and 84% felt there should be government standards for personal protective and DECON equipment. In addition, 82.2% would require a moderate to significant amount of funding to effect the standards. Citywide disaster management was coordinated through the Mayor's Office of Emergency Management. Although hospitals were on a heightened state of alert, emergency department directors were not confident in their ability to evaluate and manage victims of WMD incidents, especially biological exposures. The New York City experience is an example for the rest of the nation to underscore the need

  4. Validation of the Brief Confusion Assessment Method for Screening Delirium in Elderly Medical Patients in a German Emergency Department. (United States)

    Baten, Verena; Busch, Hans-Jörg; Busche, Caroline; Schmid, Bonaventura; Heupel-Reuter, Miriam; Perlov, Evgeniy; Brich, Jochen; Klöppel, Stefan


    Delirium is frequent in elderly patients presenting in the emergency department (ED). Despite the severe prognosis, the majority of delirium cases remain undetected by emergency physicians (EPs). At the time of our study there was no valid delirium screening tool available for EDs in German-speaking regions. We aimed to evaluate the brief Confusion Assessment Method (bCAM) for a German ED during the daily work routine. We implemented the bCAM into practice in a German interdisciplinary high-volume ED and evaluated the bCAM's validity in a convenience sample of medical patients aged ≥ 70 years. The bCAM, which assesses four core features of delirium, was performed by EPs during their daily work routine and compared to a criterion standard based on the criteria for delirium as described in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Compared to the criterion standard, delirium was found to be present in 46 (16.0%) of the 288 nonsurgical patients enrolled. The bCAM showed 93.8% specificity (95% confidence interval [CI] = 90.0%-96.5%) and 65.2% sensitivity (95% CI = 49.8%-78.7%). Positive and negative likelihood ratios were 10.5 and 0.37, respectively, while the odds ratio was 28.4. Delirium was missed in 10 of 16 cases, since the bCAM did not indicate altered levels of consciousness and disorganized thinking. The level of agreement with the criterion standard increased for patients with low cognitive performance. This was the first study evaluating the bCAM for a German ED and when performed by EPs during routine work. The bCAM showed good specificity, but only moderate sensitivity. Nevertheless, application of the bCAM most likely improves the delirium detection rate in German EDs. However, it should only be applied by trained physicians to maximize diagnostic accuracy and hence improve the bCAM's sensitivity. Future studies should refine the bCAM. © 2018 by the Society for Academic Emergency Medicine.

  5. Frequency of Burnout, Sleepiness and Depression in Emergency Medicine Residents with Medical Errors in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Alireza Aala


    Full Text Available Aims: Medical error is a great concern of the patients and physicians. It usually occurs due to physicians’ exhaustion, distress and fatigue. In this study, we aimed to evaluate frequency of distress and fatigue among emergency medicine residents reporting a medical error. Materials and Methods: The study population consisted of emergency medicine residents who completed an emailed questionnaire including self-assessment of medical errors, the Epworth Sleepiness Scale (ESS score, the Maslach Burnout Inventory, and PRIME-MD validated depression screening tool.   Results: In this survey, 100 medical errors were reported including diagnostic errors in 53, therapeutic errors in 24 and following errors in 23 subjects. Most errors were reported by males and third year residents. Residents had no signs of depression, but all had some degrees of sleepiness and burnout. There were significant differences between errors subtypes and age, residency year, depression, sleepiness and burnout scores (p<0.0001.   Conclusion: In conclusion, residents committing a medical error usually experience burnout and have some grades of sleepiness that makes them less motivated increasing the probability of medical errors. However, as none of the residents had depression, it could be concluded that depression has no significant role in medical error occurrence and perhaps it is a possible consequence of medical error.    Keywords: Residents; Medical error; Burnout; Sleepiness; Depression

  6. Patients Who Attend the Emergency Department Following Medication Overdose: Self-Reported Mental Health History and Intended Outcomes of Overdose (United States)

    Buykx, Penny; Ritter, Alison; Loxley, Wendy; Dietze, Paul


    Medication overdose is a common method of non-fatal self-harm. Previous studies have established which mental health disorders are commonly associated with the behaviour (affective, substance use, anxiety and personality disorders) and which medications are most frequently implicated (benzodiazepines, antidepressants, antipsychotics and non-opioid…

  7. Accession Medical Standards Analysis and Research Activity (AMSARA) 2014, Annual Report, and four Supplemental Applicants and Accessions Tables for: Army, Air Force, Marine, and Navy (United States)


    active component accessions, between 2008 and 2013, 13% were accessed with a history of medical disqualification that was either remediated prior to...between 2008 and 2013, 15% accessed with a history of previous medical disqualification and 1% were hospitalized in the first year of service. About...include achievement, adjustment, attention-seeking, cooperation, dominance, even- temperedness, generosity, intellectual efficiency, non- delinquency

  8. U.S. Army Concept of Operations and Standard Operating Procedure for Acquisition Program Managers Using Item Unique Identification (United States)


    a pop up screen will ask to file save as Figure 88. the form on my documents or desktop . Source: Department of the Army (n.d.-e...77 Open the form from desktop or mydocuments in Adobe Acrobat...policy was published as Army Directive 2016–21 in May 2016. Army items requiring serial number management will require IUID. This includes items

  9. 32 CFR 552.25 - Entry regulations for certain Army training areas in Hawaii. (United States)


    ... in Hawaii. 552.25 Section 552.25 National Defense Department of Defense (Continued) DEPARTMENT OF THE... Regulations for Certain Army Training Areas in Hawaii § 552.25 Entry regulations for certain Army training areas in Hawaii. (a) Purpose. (1) This regulation establishes procedures governing the entry onto...

  10. Twenty years of operation of the Radioisotope Department of the 3rd Medical Clinic, Faculty of General Medicine, Charles University in Prague

    International Nuclear Information System (INIS)

    Kapitola, J.


    Twenty years ago a radioisotope department was established in the old building of the 3rd Medical Clinic in Prague 2. The department is suitably placed and meets present requirements. It was set up as part of the 3rd Medical Clinic and of the Laboratory for endocrinology and Metabolism which gave it its main orientation and scope. Its present scope is much broader. In the twenty years since it was established 115,800 examinations were carried out, some 40 examination methods were introduced, 103 publications published, members of the department were co-authors of another 113 publications, they completed 11 research projects. The production of the department represents a substantial part of laboratory material especially in the diagnosis of endocrinopathy and metabolic disorders at the Clinic and is a significant part of the material of a number of research projects. The department has significantly contributed to the development of nuclear medicine in the Czechoslovak Socialist Republic in thyroid diagnosis, by the first introduction of radioimmunoassay methods, by the introduction of certain other special examination and laboratory methods and is currently taking part in the fulfilment of tasks given by the zoning of nuclear medicine in health care in Czechoslovakia in general and in Prague in particular. (author)

  11. [Physical medicine in hospital. Minimum standards in a physical medical department in acute inpatient areas in rheumatology]. (United States)

    Reißhauer, A; Liebl, M E


    Standards for what should be available in terms of equipment and services in a department of physical medicine caring for acute inpatients do not exist in Germany. The profile of a department determines the therapeutic services it focuses on and hence the technical facilities required. The German catalogue of operations and procedures defines minimum thresholds for treatment. In the opinion of the authors a department caring for inpatients with acute rheumatic diseases must, as a minimum, have the facilities and equipment necessary for offering thermotherapeutic treatment. Staff trained in physical therapeutic procedures and occupational therapy is also crucial. Moreover, it is desirable that the staff should be trained in manual therapy.

  12. What the Army Needs to Know to Align Its Operational and Institutional Activities (United States)


    responsibilities of the Army leadership. In their roles as stakeholders in short-term acquisition, the Army leaders named here bring to bear the...required immunizations, be medically healthy, and have dental readiness classification of 1 or 2. Personal medical equipment (e.g., earplugs, eyeglasses

  13. Department of Neurosurgery, Seth Gordhandas Sunderdas Medical College and King Edward VII Memorial (K.E.M.) Hospital, Mumbai. (United States)

    Pandya, Sunil; Goel, Atul


    Seth Gordhandas Sunderdas Medical College and King Edward VII Memorial (K.E.M.) Hospital, Mumbai were inaugurated in 1925. This article traces its illustrious history and of the eminent neurosurgeons who shaped its destiny.

  14. Organization of educational process at the department of human anatomy of Saratov State Medical University n.a. V. I. Razumovsky

    Directory of Open Access Journals (Sweden)

    Bugaeva I0


    Full Text Available Human anatomy is one of the basic disciplines in the system of medical education. Knowledge in this area is necessary for the development of related theoretical subjects and constitutes a basis for studying clinical disciplines. Therefore the priority task of department of human anatomy is qualitative training of students at the modern level using classical and innovative pedagogical and computer technologies, being based on competence-based approach to training. In the article the features of organization of educational process at department of Human Anatomy of Saratov State Medical University n.a. V. I. Razumovsky, within the Federal state educational standard of the 3rd generation which key differences are considered: acquisition by students of cultural and professional competences.

  15. Army's drinking water surveillance program

    International Nuclear Information System (INIS)

    Sneeringer, P.V.; Belkin, F.; Straffon, N.; Costick, S.A.


    In 1976 a total of 827 water sources from Army installations throughout the world were sampled and analyzed for 53 chemical constituents and physical parameters. Medically significant contaminants included radiation measurements, heavy metals, fluoride, nitrate, and pesticides. Radiological activity appeared to vary with geographic location; a majority being from water sources in the western part of the U.S. No results for tritium were found to exceed the health-reference limit. Confirmatory analyses for radium-226 identified 3 groundwater sources as exceeding the limit; one was attributed to natural activity and the other sources are currently being investigated. Of the metals considered to be medically significant, mercury, chromium, lead, cadmium, silver, barium and arsenic were found in amounts within health level limits. Nitrate levels exceeding the health limit were confirmed for 2 drinking water sources

  16. The Army Ethic (United States)


    The Constitution and Declaration of Independence simultaneously hold two different views of human nature, an individualist and a collectivist view...Profession, defines the Army Ethic as “the evolving set of laws, values, and beliefs, deeply embedded within the core of the Army culture and...incorporate other viewpoints or respond to shifts in morality, religion, economics, and other socio- cultural factors. This thesis will use the term

  17. The Total Army (United States)

    2016-01-01 (accessed April 25, 2016); Nicolas Giacometti, “China’s Nuclear Modernization between the operational and tactical levels of war.48 47. Michelle Tan , “US Army Generals Criticize Outdated Deployment Model: ‘We’ve Gotten...unveils-its-big-8-initiatives/81882852/ (accessed March 16, 2016). 58. Michelle Tan , “US Army Generals Criticize Outdated Deployment Model: ‘We’ve

  18. Army Leader Transitions Handbook (United States)


    The courseware allows users to tailor training materials to specific needs. Users access this at the CAL AKO website or Army eLearning skillportfe/login/usarmylogin.cfm. New users must register with eLearning . Then login, select “Army Custom Curricula” and scroll to...challenges of your transition. Patience, flexibility and a good understanding of influence techniques on your part will help make any needed realignment a

  19. 33 CFR 334.1060 - Oakland Outer Harbor adjacent to the Oakland Army Base; restricted area. (United States)


    ... CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE DANGER ZONE AND RESTRICTED AREA.... Redesignated at 50 FR 42696, Oct. 22, 1985; 51 FR 25198, July 11, 1986, as amended at 62 FR 17557, Apr. 10...

  20. Army Communicator. Volume 27, Number 3, Fall 2002 (United States)


    play in the Army’s transformation to the Objec- tive Force.” Gizmo’s debut in the Beatle Bailey comic strip came July 4. And according to a source close...Approved for public release; distribution is unlimited. Headquarters, Department of the Army ARMY COMMUNICATOR Voice of the Signal Regiment ! PB 11...02-3 Fall 2002 Vol. 27 No. 3 ! Special focus: radio’s resurgence -- its “new” uses in the current and near- future Army, Pgs. 2-18 ! Signal-planning

  1. 75 FR 34714 - Updated Record of Decision (ROD) for Revised Army Growth and Force; Structure Realignment Decisions (United States)


    ... Proving Ground, MD 21010-5401. FOR FURTHER INFORMATION CONTACT: LTC David Patterson, Media Relations... strategic requirements. The Department of the Army prepared a Programmatic Environmental Impact Statement...

  2. Assessing the Burden of Diabetes Mellitus in Emergency Departments in the United States: The National Hospital Ambulatory Medical Care Survey (NHAMCS) (United States)

    Asao, Keiko; Kaminski, James; McEwen, Laura N.; Wu, Xiejian; Lee, Joyce M.; Herman, William H.


    Objective To evaluate the performance of three alternative methods to identify diabetes in patients visiting Emergency Departments (EDs), and to describe the characteristics of patients with diabetes who are not identified when the alternative methods are used. Research Design and Methods We used data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) 2009 and 2010. We assessed the sensitivity and specificity of using providers’ diagnoses and diabetes medications (both excluding and including biguanides) to identify diabetes compared to using the checkbox for diabetes as the gold standard. We examined the characteristics of patients whose diabetes was missed using multivariate Poisson regression models. Results The checkbox identified 5,567 ED visits by adult patients with diabetes. Compared to the checkbox, the sensitivity was 12.5% for providers’ diagnoses alone, 20.5% for providers’ diagnoses and diabetes medications excluding biguanides, and 21.5% for providers’ diagnoses and diabetes medications including biguanides. The specificity of all three of the alternative methods was >99%. Older patients were more likely to have diabetes not identified. Patients with self-payment, those who had glucose measured or received IV fluids in the ED, and those with more diagnosis codes and medications, were more likely to have diabetes identified. Conclusions NHAMCS's providers’ diagnosis codes and medication lists do not identify the majority of patients with diabetes visiting EDs. The newly introduced checkbox is helpful in measuring ED resource utilization by patients with diabetes. PMID:24680472

  3. Army Logistician. Volume 41, Issue 1, January-February 2009 (United States)


    metrics and academic discipline. ARMy LOGISTICIAN PROFESSIONAL BULLETIN OF UNITED STATES ARMY LOGISTICS 47 According to Miles and Huberman , “when...transformation efforts from an NCW 8 Matthew B. Miles and A. Michael Huberman , Qualitative Data Analysis, Sage, Thousand Oaks, California, 1994. 9 Department of...their first 5 months in Iraq, the 426th BSB “Taskmasters” drove more than 89,000 miles on perilous roads to deliver their essential cargo—a feat

  4. The United States Army Comprehensive Soldier Fitness: A Critical Look (United States)


    Psychoanalysis Professor Stephen Soldz, stated “ the problems identified with CSF are legion. It is time for the Army to step back from uncritically...Frederick J. Gellert Department of Command, Leadership and Management Project Adviser This manuscript is submitted in partial fulfillment of the ...organization and at every level within the Army, MRTs serve as the principal advisor to the leadership regarding CSF and as a resource for Soldiers

  5. Back Pain in the U.S. Army Aviation Community (United States)


    69 0 Active Duty 268 250 18 Reserve/National Guard 136 130 6 Dept. of the Army Civilian 16 16 0 Contractor 2 2 0 *Missing 45 45 0...respondents based on reported military affiliation could be qualified to receive such benefits (Department of the Army Civilians and contractors that are...activity actual help manage my pain 23 20-Seat material is non-supportive- I used an organ aero seat helped. Seat ht when reclined was to low

  6. Army Energy and Water Reporting System Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Deprez, Peggy C.; Giardinelli, Michael J.; Burke, John S.; Connell, Linda M.


    There are many areas of desired improvement for the Army Energy and Water Reporting System. The purpose of system is to serve as a data repository for collecting information from energy managers, which is then compiled into an annual energy report. This document summarizes reported shortcomings of the system and provides several alternative approaches for improving application usability and adding functionality. The U.S. Army has been using Army Energy and Water Reporting System (AEWRS) for many years to collect and compile energy data from installations for facilitating compliance with Federal and Department of Defense energy management program reporting requirements. In this analysis, staff from Pacific Northwest National Laboratory found that substantial opportunities exist to expand AEWRS functions to better assist the Army to effectively manage energy programs. Army leadership must decide if it wants to invest in expanding AEWRS capabilities as a web-based, enterprise-wide tool for improving the Army Energy and Water Management Program or simply maintaining a bottom-up reporting tool. This report looks at both improving system functionality from an operational perspective and increasing user-friendliness, but also as a tool for potential improvements to increase program effectiveness. The authors of this report recommend focusing on making the system easier for energy managers to input accurate data as the top priority for improving AEWRS. The next major focus of improvement would be improved reporting. The AEWRS user interface is dated and not user friendly, and a new system is recommended. While there are relatively minor improvements that could be made to the existing system to make it easier to use, significant improvements will be achieved with a user-friendly interface, new architecture, and a design that permits scalability and reliability. An expanded data set would naturally have need of additional requirements gathering and a focus on integrating

  7. Screening for Suicidal Ideation and Attempts among Emergency Department Medical Patients: Instrument and Results from the Psychiatric Emergency Research Collaboration (United States)

    Allen, Michael H.; Abar, Beau W.; McCormick, Mark; Barnes, Donna H.; Haukoos, Jason; Garmel, Gus M.; Boudreaux, Edwin D.


    Joint Commission National Patient Safety Goal 15 calls for organizations "to identify patients at risk for suicide." Overt suicidal behavior accounts for 0.6% of emergency department (ED) visits, but incidental suicidal ideation is found in 3%-11.6%. This is the first multicenter study of suicide screening in EDs. Of 2,243 patients in…

  8. 75 FR 24754 - Cost of Hospital and Medical Care Treatment Furnished by the Department of Defense Military... (United States)


    ... OFFICE OF MANAGEMENT AND BUDGET Cost of Hospital and Medical Care Treatment Furnished by the... Third Persons AGENCY: Office of Management and Budget, Executive Office of the President. ACTION: Notice.... 593; 42 U.S.C. 2652), and delegated to the Director of the Office of Management and Budget by the...

  9. 78 FR 21631 - Fiscal Year 2013 Cost of Hospital and Medical Care Treatment Furnished by the Department of... (United States)


    ... OFFICE OF MANAGEMENT AND BUDGET Fiscal Year 2013 Cost of Hospital and Medical Care Treatment... Tortiously Liable Third Persons AGENCY: Office of Management and Budget, Executive Office of the President...-603 (76 Stat. 593; 42 U.S.C. 2652), and delegated to the Director of the Office of Management and...

  10. 76 FR 15349 - Fiscal Year 2011 Cost of Hospital and Medical Care Treatment Furnished by the Department of... (United States)


    ... OFFICE OF MANAGEMENT AND BUDGET Fiscal Year 2011 Cost of Hospital and Medical Care Treatment... Tortiously Liable Third Persons AGENCY: Executive Office of the President, Office of Management and Budget... 87-693 (76 Stat. 593; 42 U.S.C. 2652), and delegated to the Director of the Office of Management and...

  11. 76 FR 53921 - Privacy Act of 1974; Department of Homeland Security ALL-034 Emergency Care Medical Records... (United States)


    ... AGENCY: Privacy Office, DHS. ACTION: Notice of Privacy Act system of records. SUMMARY: In accordance with... Security Office of Health Affairs to collect and maintain records on individuals who receive emergency care... consistent, quality medical care. To support MQM, OHA operates the electronic Patient Care Record (ePCR), an...

  12. Department of Defense perspective

    International Nuclear Information System (INIS)

    Devine, R.


    This paper examines radiation instrumentation from the Department of Defense perspective. Radiation survey instruments and calibration, or RADIAC, as it is called in the services, while administratively falling under the Assistant Secretary of Defense for Atomic Energy, has generally been managed at a lower level. The Naval Electronics Systems Command and Army Signal Corp are the two principles in the Department of Defense for RADIAC. The actions of the services are coordinated through the tri-service RADIAC working group, which meets about every year and a half. Several points from this organization are highlighted

  13. Optimizing Dam Operations for Power and for Fish: an Overview of the US Department of Energy and US Army Corps of Engineers ADvanced Turbine Development R&D. A Pre-Conference Workshop at HydroVision 2006, Oregon Convention Center, Portland, Oregon July 31, 2006

    Energy Technology Data Exchange (ETDEWEB)

    Dauble, Dennis D.


    This booklet contains abstracts of presentations made at a preconference workshop on the US Department of Energy and US Army Corps of Engineers hydroturbine programs. The workshop was held in conjunction with Hydrovision 2006 July 31, 2006 at the Oregon Convention Center in Portland Oregon. The workshop was organized by the Corps of Engineers, PNNL, and the DOE Wind and Hydropower Program. Presenters gave overviews of the Corps' Turbine Survival Program and the history of the DOE Advanced Turbine Development Program. They also spoke on physical hydraulic models, biocriteria for safe fish passage, pressure investigations using the Sensor Fish Device, blade strike models, optimization of power plant operations, bioindex testing of turbine performance, approaches to measuring fish survival, a systems view of turbine performance, and the Turbine Survival Program design approach.

  14. Hazardous Waste Surveys of Two Army Installations and an Army Hospital. (United States)


    232 Nickel-63 Uranium-238 Plutonium-239 Polonium - 210 6 Army Medical Treatment Facilities: General Administration Army Regulation (AR) 40-2, 42A peren...Adhesive BN R 0x AU DOI545AO GI. 312 F 44 0,3 27)d17 N6341( 2 14,5 0 6 Adhesive 81 A XY AO D041419A0 PI 210 82140 O0 5824596 RO.34 140376139 Adhesi E ON...conform to clean air pollutant standards. 46 4 Noninfectious Solid Waste. Most wastes in this category are: (1) food waste from the military mess and

  15. Army Business Transformation - Next Steps

    National Research Council Canada - National Science Library


    As a follow-on to the Army Science Board 2005 Summer Study on Best Practices, the Army Science Board was tasked to identify areas where alternative approaches and application of transforming practices...

  16. ISD Designed Medical Specialist Training. (United States)

    Rock, Samuel K., Jr.; Chagalis, George P.

    The Basic Medical Specialist course has one of the largest enrollments of the U.S. Army's Academy of Health Sciences; 11,000 soldiers were trained in this course in 1977 and 1978. Training encompasses both emergency first aid (for field medics) and basic nursing skills. A task force working to improve Army training developed this course, in…

  17. Need of Department of General Practice / Family Medicine at AIIMS (All India Institute of Medical Sciences): Why the apex medical institute in India should also contribute towards training and education of general practitioners and family physicians. (United States)

    Pal, Ranabir; Kumar, Raman


    Family medicine or general practice is the practicing discipline of the majority doctors in India, however formal academic departments of general practice (or family medicine) do not exist in India, as it is not a mandatory requirement as prescribed by the Medical Council of India; the principal regulator of medical education. Currently India has capacity to produce more than 60,000 medical graduates per year, majority of whom are expected to become general practitoners or primary care doctors without under going any vocational training in general practice or family medicine. The 92 nd parliamentary standing committee report (on health and family welfare) of the Indian Parliament recommended that Government of India in coordination with State Governments should establish robust postgraduate programs in Family Medicine and facilitate introducing Family Medicine discipline in all medical colleges. This will not only minimize the need for frequent referrals to specialist and decrease the load on tertiary care but also provide continuous health care for the individuals and families. The authors concur with the parliament of India and strongly feel that "Family Medicine" (community-based comprehensive clinical practice) deserves dedicated and distinct department at all medical colleges in India in order to availability of qualified medical doctors in the community-based health system. AIIMS, New Delhi, along with other newly established AIIMS, should rise to their foundation mandate of supporting excellence in all disciplines of medical science and to this historic responsibility; and not just remain an ivory tower of tertiary care based fragmented (into sub specialties) hospital culture.

  18. Army Contract Writing System (ACWS) (United States)


    2016 Major Automated Information System Annual Report Army Contract Writing System (ACWS) Defense Acquisition Management Information Retrieval...Information 4 Responsible Office 4 References 4 Program Description 5 Business Case 5 Program Status 6 Schedule 7 Performance...Program Information Program Name Army Contract Writing System (ACWS) DoD Component Army Responsible Office Program Manager References MAIS

  19. Coding Accuracy of the Ambulatory Data System: A Study of Coding Accuracy Within the General Internal Medicine Clinic, Walter Reed Army Medical Center (United States)


    concerns center around its ultimate goal to maximize appropriate care and minimize or eliminate inappropriate care (DoD UM Policy , 1996). While the...uasp cncd . GCK Tobacco taw disorder tr’O: Anemia ID: Acute bronchial ID: A«Jtt]ihiir<rtiK*i» 10: Acute refft iafection ID: Acute xinucm ID...181-187. Department of Defense (DoD) Ultilization Management Policy for the Direct Care System (Draft) (1996). Duncan, D.G. & Servais, C.S., (1996

  20. Evaluation of a Computerized Problem-Oriented Medical Record in a Hospital Department: Does it Support Daily Clinical Practice?

    DEFF Research Database (Denmark)

    Bossen, Claus


    led to more time spent documenting clinical work, fragmentation of patient situation into separate problems, and lack of overview.Conclusion: The problem-oriented method for structuring a computerized medical record may provide a description of how physicians think or ought to think, but does...... not adequately support complex clinical work. While the CPOMR can be used for patients with few, simple problems who are admitted for only a short time, the CPOMR is not useful for patients with a complex set of problems or for patients admitted for longer periods of time. This is in accordance with criticism...

  1. Medications (United States)

    ... Red Dress ® , and Red Dress ® are registered trademarks of U.S. Department of Health and Human Services. National Wear Red Day ® is a registered trademark of the U.S. Department of Health and Human ...

  2. The impact of an integrated hospital-community medical information system on quality and service utilization in hospital departments. (United States)

    Nirel, Nurit; Rosen, Bruce; Sharon, Assaf; Blondheim, Orna; Sherf, Michael; Samuel, Hadar; Cohen, Arnon D


    In 2005, an innovative system of hospital-community on-line medical records (OFEK) was implemented at Clalit Health Services (CHS). The goals of the study were to examine the extent of OFEK's use and its impact on quality indicators and medical-service utilization in Internal Medicine and General Surgery wards of CHS hospitals. Examining the frequency of OFEK's use with its own track-log data; comparing, "before" and "after", quality indicators and service utilization data in experimental (CHS patients) versus control groups (other patients). OFEK's use increased by tens of percentages each year, Internal Medicine wards showed a significant decrease in the number of laboratory tests and 3 CT tests performed compared with the control group. Wards using OFEK extensively showed a greater decrease in CT tests, in one imaging test, and in the average number of ambulatory hospitalizations. No similar changes were found in General Surgery wards. The study helps evaluate the extent to which OFEK's targets were achieved and contributes to the development of measures to examine the impact of such systems, which can be used to assess a broad range of Health Information Technology (HIT) systems. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  3. Recognition difference and improvement direction of the radiological technologists and patient against medical service in department radiology - Inchon area in the object

    International Nuclear Information System (INIS)

    An, Sung Min; Kim, Sung Chul


    Satisfaction of the patient against the medical service in department of radiology and it evaluated the different recognition of radiological technologist and patient, and investigates it's improvement direction. It sent the reply the above the which is a usual result in question result of the most that, the receipt process it was complicated in the portion which is insufficient. 'The receipt process is complication', 'waiting time is long' and ' don't radiation protection for patient and guardian'. Also these a facts was recognizing patients and radiological technologist all. And the effort of the radiological technologist is necessary with the method which reduces a recognition difference. The periodical medical service satisfaction investigates and must endeavor in reform measure preparation

  4. Prediction of Mobility Limitations after Hospitalization in Older Medical Patients by Simple Measures of Physical Performance Obtained at Admission to the Emergency Department

    DEFF Research Database (Denmark)

    Bodilsen, Ann Christine; Hedegaard Klausen, Henrik; Petersen, Janne


    Objective: Mobility limitations relate to dependency in older adults. Identification of older patients with mobility limitations after hospital discharge may help stratify treatment and could potentially counteract dependency seen in older adults after hospitalization. We investigated the ability...... of four physical performance measures administered at hospital admission to identify older medical patients who manifest mobility limitations 30 days after discharge. Design: Prospective cohort study of patients (≥65 years) admitted to the emergency department for acute medical illness. During the first...... included. Of those, 128 (40%) patients had mobility limitations at follow-up. Univariate analyzes showed that each of the physical performance measures was strongly associated with mobility limitations at follow-up (handgrip strength(women), OR 0.86 (0.81–0.91), handgrip strength(men), OR 0.90 (0...

  5. Energy and nutritional value of diets used in patients alimentation and their assessment by patients of selected clinical department in the Military Medical Institute in Warsaw. (United States)

    Kłos, Krzysztof; Bertrandt, Jerzy; Jałocha, Lukasz; Matuszewski, Tomasz; Abramowicz, Michał


    The aim of the work was laboratory assessment of energy and nutritional value of general and light diets used in patients of selected clinical department in the Military Medical Institute in Warsaw alimentation. Using questionnaire method the assessment of diets was done by patients too. Meals given to patients in hospital not always fulfilled nutritional requirements. Additional consumption of supplementary products did not always meet the requirements of proper nutrition. Half of examined patients appraised nutrition variety as good but at the same time claimed the there was not enough fruits and vegetables.

  6. AVTA Federal Fleet PEV Readiness Data Logging and Characterization Study for Department of Veterans Affairs. James J. Peters VA Medical Center, Bronx, NY

    Energy Technology Data Exchange (ETDEWEB)

    Schey, Stephen [Intertek Testing Services, North America, Phoenix, AZ (United States); Francfort, Jim [Idaho National Lab. (INL), Idaho Falls, ID (United States)


    This report focuses on the Department of Veterans Affairs, James J. Peters VA Medical Center (VA - Bronx) fleet to identify daily operational characteristics of select vehicles and report findings on vehicle and mission characterizations to support the successful introduction of PEVs into the agencies’ fleets. Individual observations of these selected vehicles provide the basis for recommendations related to electric vehicle adoption and whether a battery electric vehicle or plug-in hybrid electric vehicle (collectively referred to as PEVs) can fulfill the mission requirements.

  7. Electronic medication complete communication strategy for opioid prescriptions in the emergency department: Rationale and design for a three-arm provider randomized trial. (United States)

    McCarthy, Danielle M; Courtney, D Mark; Lank, Patrick M; Cameron, Kenzie A; Russell, Andrea M; Curtis, Laura M; Kim, Kwang-Youn A; Walton, Surrey M; Montague, Enid; Lyden, Abbie L; Gravenor, Stephanie J; Wolf, Michael S


    Thousands of people die annually from prescription opioid overdoses; however there are few strategies to ensure patients receive medication risk information at the time of prescribing. To compare the effectiveness of the Emergency Department (ED) Electronic Medication Complete Communication (EMC 2 ) Opioid Strategy (with and without text messaging) to promote safe medication use and improved patient knowledge as compared to usual care. The ED EMC 2 Opioid Strategy consists of 5 automated components to promote safe medication use: 1) physician reminder to counsel, 2) inbox message sent on to the patient's primary care physician, 3) pharmacist message on the prescription to counsel, 4) MedSheet supporting prescription information, and 5) patient-centered Take-Wait-Stop wording of prescription instructions. This strategy will be assessed both with and without the addition of text messages via a three-arm randomized trial. The study will take place at an urban academic ED (annual volume>85,000) in Chicago, IL. Patients being discharged with a new prescription for hydrocodone-acetaminophen will be enrolled and randomized (based on their prescribing physician). The primary outcome of the study is medication safe use as measured by a demonstrated dosing task. Additionally actual safe use, patient knowledge and provider counseling will be measured. Implementation fidelity as well as costs will be reported. The ED EMC 2 Opioid Strategy embeds a risk communication strategy into the electronic health record and promotes medication counseling with minimal workflow disruption. This trial will evaluate the strategy's effectiveness and implementation fidelity as compared to usual care. This trial is registered on with identifier NCT02431793. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Incidence and prevalence of hospital-acquired infections in a cohort of patients admitted to medical departments

    DEFF Research Database (Denmark)

    Petersen, Martin Haubro; Holm, Morten Olskjær; Pedersen, Svend Stenvang


    INTRODUCTION: Hospital-acquired infections (HAI) are a significant cause of morbidity and mortality. Only point prevalence analyses of HAI have been recorded in Denmark. The aim of this study was to investigate the incidence and prevalence of HAI in patients admitted to departments of internal.......7-10.6). Exposure to bladder catheter was associated with an increased risk of urinary tract infection, incidence rate ratio 4.9; (95% CI 1.8-11.5). For the initial 14 days of hospitalization, the incidence of HAI was independent, while the prevalence increased linearly with duration of admittance. CONCLUSION......: The incidence of HAI was relatively constant during the initial 14-day-period of hospitalization, suggesting that shortening the period will have no major impact on the incidence of HAI. The prevalence was 9.7%, which is in line with results from prior studies....

  9. Capillary refill time is a predictor of short-term mortality for adult patients admitted to a medical department

    DEFF Research Database (Denmark)

    Mrgan, Monija; Rytter, Dorte; Brabrand, Mikkel


    the relationship between CRT (using two existing definitions and as a continuous variable) and short-term mortality. METHODS: We included all acutely admitted adult patients to a medical admission unit. We measured CRT, blood pressure, pulse, temperature and peripheral oxygen saturation. We presented the data...... mortality with all definitions of CRT. Performing multivariable analysis, controlling for age, sex, mean blood pressure, pulse, temperature and peripheral oxygen saturation, we found increasing CRT as a continuous variable and according to the Schriger and Baraff definition to be associated with increased...... mortality. Both the Trauma score and Schriger and Baraff definitions had high negative predictive values. The calculations on the Schriger and Baraff defition were based on limited power. CONCLUSIONS: We found a significant association between CRT measured as a continuous variable and short-term mortality...

  10. Prevailing Status and Treatment Seeking Awareness Among Patients Attending in The Orthodontics Department of Bangabandhu Sheikh Mujib Medical University

    Directory of Open Access Journals (Sweden)

    Tanzila Rafique


    Full Text Available Background: Malocclusion is problem since antiquity. But people’s perception about the problem varies with their geographical location and cultural background. The problem seems to be more acute in developing countries like Bangladesh. Objectives: The present study was undertaken to assess the awareness about aesthetic problem of malocclusion and treatment seeking behavior among the patients attending in orthodontic department of BSMMU. Methods: The present cross-sectional study was carried out in the Department of Orthodontic, Faculty of Dentistry, BSMMU, over a period 24 months from January 2008 to December 2009. A total of 110 participants who were suffering from malocclusion and came for dental treatment were the study population. Results: The mean age of the patients was 21 years and the youngest and the oldest patients were 8 and 32 years old respectively with female to male ratio being roughly 3:2. Graduate or postgraduate level educated patients were predominant (53.6%. Over 70% of the respondents viewed malocclusion as an aesthetic problem, 50% as functional problem, 55.5% social problem and 69.1% oral problem. Two-third (67% told that malocclusion was a treatable condition. Approximately 43% of the patients identified trauma as a cause of malocclusion, 40% gingivitis or periodontitis and 35.5% dental caries. About one-third (32.7% of the respondents was of the opinion that certain habits should be avoided to prevent malocclusion, 15.5% told timely treatment of malocclusion, 30% told prevention of early loss of teeth due to caries, 12.7% were in favour of the use of a space maintainer in places of premature loss of a deciduous tooth. Over 90% of the respondents held the view that symptoms of malocclusion, its prevention and different treatment options should get the priority in educating the society about malocclusion. However, 80% of the respondents told that causative factors should discussed. Regarding ways of behaviour change

  11. Army Sustainability Report 2010 (United States)


    the Fairfax Village Neighborhood Center’s native plant and butterfly garden. The center is the first LEED platinum military project (photo: US Army... Bush in 2007. 11 Statement of Deputy Under Secretary of Defense for Strategy, Plans, and Forces, Kathleen Hicks before the Senate Environment and

  12. Paternity analysis based on NGM SElect system in the Medical and Forensic Genetics Laboratory, Department of Forensic Medicine, Medical University of Lodz

    Directory of Open Access Journals (Sweden)

    Beata Markiewicz-Knyziak


    Full Text Available The aim of the study was to evaluate the usefulness of the NGM SElect multiplex kit for paternity testing in the population of central Poland, and compare it with the IDENTIFILER system. The study material consisted of buccal swabs taken from individuals who reported to the Medical and Forensic Genetics Laboratory in Lodz. Samples from 450 trio cases of disputed paternity carried out in 2010–2014 were investigated. Genomic DNA was extracted from buccal swabs collected from 1,350 individuals using the Swab kit (A&A Biotechnology according to the manufacturer’s protocol. DNA amplification was performed using the AmpFℓSTR ® NGM Select TM PCR Amplification Kit (Life Technologies. PCR products were separated by capillary electrophoresis using HID 3500 Genetic Analyzer. In the analyzed cases with paternity confirmation in the NGM SElect system, the maximum value of PI was 3.9 × 10 12 , which corresponds to the probability of paternity W = 99.9999999999%. It was thus significantly higher than analogical parameters obtained in the IDENTIFILER system (PI = 6.0 × 10 10 , W = 99.99999999%. The NGM SElect kit was unable to resolve just one case out of 450, which represents only 0.2% of all analyzed disputed paternity cases. The study showed the SE33 (ACTBP2 locus to have the highest evidence value in paternity analysis out of all investigated autosomal STRs.

  13. 32 CFR 516.14 - Service of process on DA or Secretary of Army. (United States)


    ... 32 National Defense 3 2010-07-01 2010-07-01 true Service of process on DA or Secretary of Army... CIVIL AUTHORITIES AND PUBLIC RELATIONS LITIGATION Service of Process § 516.14 Service of process on DA or Secretary of Army. The Chief, Litigation Division, shall accept service of process for Department...

  14. Army Strategic Leader Competency Development: Small Changes for a Large Impact (United States)


    an Infantry Officer is similar to other Maneuver, Fire, and Effects ( MFE ) Officers, and the majority of General Officers come for the MFE ranks.24...Army, CASAL 2010, 12. 65 Discussion with COL Reese Turner, Former MFE Branch Chief, 13 Nov 12, on how branches assign officers to OES assignments. 66 U.S. Department of the Army, CASAL 2010, 18.

  15. Medical science in the light of the Holocaust: Departing from a post-war paper by Ludwik Fleck. (United States)

    Hedfors, Eva


    In scholarly debates, Ludwik Fleck's post-war paper 'Problemy naukoznawstwa [Problems of the Science of Science]', published in 1946, has been taken unanimously to illustrate the epistemology expounded in his monograph Genesis and Development of a Scientific Fact. The paper has also been seen to support parts of the received view of Fleck, notably that he manufactured an anti-typhus vaccine while imprisoned in Buchenwald. However, a different narrative emerges when comparing Fleck's paper with other accounts, also published in 1946 and written by other prisoners alluded to by Fleck in his paper. The situation is further complicated by four papers, published in prestigious scientific journals between 1942 and 1945, by the German medical leader of the typhus studies accounted for by Fleck. In addition, a thus-far neglected paper by Fleck, published in 1946 and summarizing his observations on typhus, discloses his role in the Buchenwald studies. Despite the obvious difficulties with tracing the history behind these works, notably the one on Nazi science, the contention is that what was attempted in Buchenwald in the name of science amounted to pseudoscience. This conclusion is amply supported not only by the accounts given by Fleck's fellow prisoners, but also by his own post-war paper on typhus. Based on the above findings, it is suggested that the mythology about Fleck, established in the 1980s, has been accomplished by a selective reading of his papers and also that the role played by Fleck was more complex than has so far been contemplated.

  16. Doses to medical workers operating in a PET/CT department after the use of new dynamic techniques

    International Nuclear Information System (INIS)

    Dalianis, K; Kollias, G; Malamitsi, J; Euthimiadou, R; Andreou, J; Georgiou, E; Prassopoulos, V


    Since new radiopharmaceuticals are used like [18F]-fluoro-3'-deoxy-3'-L- fluorothymidine and 18F fluoromethylcholine, also new dynamic techniques of imaging are used, measurements concerning the doses to medical staff are needed. The aim of this study was to measure the effective whole body dose of the personnel and compare them with the oldest. Estimation of equivalent dose for all members of the staff was monitored with the use of TLDs badges and electronic dosimeters. The duration of the study was year 2011 (983 patients).Concerning the nurses, we measured 10% increase in the wholebody doses and that is due to the longer time they spent near the patient (dynamic protocol). For technologist we measure 15-21% increase for they come near the patient immediately after administration. We can observe that there is an increase of the doses for technologists and nurses the numbers are significantly lower than the recommended annual dose limit by Euratrom 97/43. (paper)

  17. Doses to medical workers operating in a PET/CT department after the use of new dynamic techniques. (United States)

    Dalianis, K.; Kollias, G.; Malamitsi, J.; Euthimiadou, R.; Andreou, J.; Georgiou, E.; Prassopoulos, V.


    Since new radiopharmaceuticals are used like [18F]-fluoro-3'-deoxy-3'-L- fluorothymidine and 18F fluoromethylcholine, also new dynamic techniques of imaging are used, measurements concerning the doses to medical staff are needed. The aim of this study was to measure the effective whole body dose of the personnel and compare them with the oldest. Estimation of equivalent dose for all members of the staff was monitored with the use of TLDs badges and electronic dosimeters. The duration of the study was year 2011 (983 patients).Concerning the nurses, we measured 10% increase in the wholebody doses and that is due to the longer time they spent near the patient (dynamic protocol). For technologist we measure 15-21% increase for they come near the patient immediately after administration. We can observe that there is an increase of the doses for technologists and nurses the numbers are significantly lower than the recommended annual dose limit by Euratrom 97/43.

  18. The relationship between emotional intelligence and transformational-transactional leadership style among the heads of nursing education departments in Iranian medical universities, 2012

    Directory of Open Access Journals (Sweden)


    Full Text Available Background and objectives: Emotional intelligence contributes to the success in leadership, especially among nursing managers. This study sought to determine the relationship between the components of emotional intelligence and transformational-transactional leadership style among the heads of nursing education departments of Iranian medical universities.Methods: This cross-sectional study used convenience sampling to select the managers of 68 nursing education departments from the country’s universities of medical sciences. Data were collected using the Bar-On Emotional Quotient Inventory and Bass’s Multifactor Leadership Questionnaire. Data analysis was performed with Pearson’s correlation coefficient, analysis of variance, and Student’s test in SPSS version 16.0.Results: There was a direct, positive correlation between emotional intelligence and leadership style (P < 0.05 r = 0.36. The components of problem solving, happiness, independence, self-actualization, emotional self-awareness, interpersonal relationship, optimism, and accountability showed significant correlations with all leadership styles. However, impulse control was not significantly correlation with any of the leadership styles.Conclusion: Considering the significant positive correlation between the components of emotional intelligence and leadership styles, training about emotional intelligence and its components and reinforcing the components of emotional intelligence can be beneficial to presenting leadership styles and thus more successful management.

  19. In memory of professor Czesław Niżankowski, Head of the Department of Anatomy, Wroclaw Medical University. (United States)

    Kacała, Ryszard R; Wronecki, Krzysztof; Kacała, Arkadiusz; Domagała, Zygmunt; Porwolik, Michał


    Professor Czesław Niżankowski was an academic teacher and researcher at several universities; head of the Department of Anatomy at Wroclaw Medical University (1966-1982); and head of the Department of Biological Sciences at the Wrocław School of Physical Education (since 1972 University School of Physical Education in Wrocław), as well as the chancellor there. He contributed greatly to the development of morphological sciences, supervising many doctoral and post-doctoral works. He dedicated considerable time to the preparation of anatomical specimens of lungs, hearts and organs of the gastrointestinal tract. At the Museum of Anatomy, there are over 100 specimens of lungs prepared using the forced air technique improved by Professor Niżankowski, along with specimens of the bronchial tree and vascular system prepared using a corrosive technique. Professor Niżankowski was an active member of scientific societies in Wrocław and in other cities in Poland. For his accomplishments, he received a number of ministerial and state awards, including the Knight's Cross of the Order of Polonia Restituta, and was granted an honorary doctorate by Wroclaw Medical University.

  20. [Laboratory medicine in the obligatory postgraduate clinical training system--common clinical training program in the department of laboratory medicine in our prefectural medical university hospital]. (United States)

    Okamoto, Yasuyuki


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

  1. An Analytical Comparison of the Opinions of Physicians Working in Emergency and Trauma Surgery Departments at Tabriz and Vienna Medical Universities Regarding Family Presence during Resuscitation. (United States)

    Soleimanpour, Hassan; Behringer, Wilhelm; Tabrizi, Jafar Sadegh; Sarahrudi, Kambiz; Golzari, Samad E J; Hajdu, Stefan; Rasouli, Maryam; Nikakhtar, Mehdi; Mehdizadeh Esfanjani, Robab


    The present study evaluated the opinions of physicians working in the emergency and trauma surgery departments of Vienna Medical University, in Austria, and Tabriz Medical University, in Iran, regarding the presence of patients' relatives during resuscitation. In a descriptive-analytical study, the data obtained from questionnaires that had been distributed randomly to 40 specialists and residents at each of the participating universities were analyzed. The questionnaire consisted of two sections aimed at capturing the participants' demographic data, the participants' opinions regarding their support for the family's presence during resuscitation, and the multiple potential factors affecting the participants' attitudes, including health beliefs, triggers that could facilitate the procedure, self-efficacy, intellectual norms, and perceived behavioral control. The questionnaire also included a direct question (Question 16) on whether the participants approved of family presence. Each question could be answered using a Likert-type scale. The results showed that the mean scores for Question 16 were 4.31 ± 0.64 and 3.57 ± 1.31 for participants at Vienna and Tabriz universities, respectively. Moreover, physicians at Vienna University disapproved of the presence of patients' families during resuscitation to a higher extent than did those at Tabriz University (P = 0.018). Of the studied prognostic factors affecting the perspectives of Vienna Medical University's physicians, health beliefs (P = 0.000; B = 1.146), triggers (P = 0.000; B = 1.050), and norms (P = 0.000; B = 0.714) were found to be significant. Moreover, of the studied prognostic factors affecting the perspectives of Tabriz Medical University's physicians, health beliefs (P = 0.000; B = 0.875), triggers (P = 0.000; B = 1.11), self-efficacy (P = 0.001; B = 0.5), and perceived behavioral control (P = 0.03; B = 0.713) were significant. Most physicians at Vienna and Tabriz Medical universities were not open

  2. Why do patients seek primary medical care in emergency departments? An ethnographic exploration of access to general practice. (United States)

    MacKichan, Fiona; Brangan, Emer; Wye, Lesley; Checkland, Kath; Lasserson, Daniel; Huntley, Alyson; Morris, Richard; Tammes, Peter; Salisbury, Chris; Purdy, Sarah


    To describe how processes of primary care access influence decisions to seek help at the emergency department (ED). Ethnographic case study combining non-participant observation, informal and formal interviewing. Six general practitioner (GP) practices located in three commissioning organisations in England. Reception areas at each practice were observed over the course of a working week (73 hours in total). Practice documents were collected and clinical and non-clinical staff were interviewed (n=19). Patients with recent ED use, or a carer if aged 16 and under, were interviewed (n=29). Past experience of accessing GP care recursively informed patient decisions about where to seek urgent care, and difficulties with access were implicit in patient accounts of ED use. GP practices had complicated, changeable systems for appointments. This made navigating appointment booking difficult for patients and reception staff, and engendered a mistrust of the system. Increasingly, the telephone was the instrument of demand management, but there were unintended consequences for access. Some patient groups, such as those with English as an additional language, were particularly disadvantaged, and the varying patient and staff semantic of words like 'urgent' and 'emergency' was exacerbated during telephone interactions. Poor integration between in-hours and out-of-hours care and patient perceptions of the quality of care accessible at their GP practice also informed ED use. This study provides important insight into the implicit role of primary care access on the use of ED. Discourses around 'inappropriate' patient demand neglect to recognise that decisions about where to seek urgent care are based on experiential knowledge. Simply speeding up access to primary care or increasing its volume is unlikely to alleviate rising ED use. Systems for accessing care need to be transparent, perceptibly fair and appropriate to the needs of diverse patient groups. © Article author(s) (or

  3. Student-selected component in the medical curriculum: investigations and psychiatric referral for paracetamol overdose in an accident and emergency department

    Directory of Open Access Journals (Sweden)

    Cowman JG


    Full Text Available James G Cowman, Manuel Bakheet Royal College of Surgeons in Ireland – Medical University of Bahrain, Manama, Bahrain Background: A student-selected component (SSC of the medical curriculum requires the student to be self-directed in locating and undertaking a placement in a clinical specialty of their choosing and completing a project. The clinical area for experience was an accident and emergency department, and our topic was a focused audit on the investigations and referral for paracetamol overdose. The purpose of this paper is twofold: to reflect on the education value to medical students of an SSC in a medical curriculum, and to highlight learning and understanding through completion of an audit.Materials and methods: An audit approach was applied. The aim of the project study was to investigate the level of compliance with best-practice guidelines for investigations and psychiatric referral in paracetamol overdose.Results: A total of 40 cases meeting the inclusion criteria were randomly selected. The sample had a mean age of 27 years, of whom 70.5% were female, and the ingested dose of paracetamol ranged from 0.864 to 80 g. Paracetamol abuse may present as intentional and unintentional overdose. In our study, 85% of cases were identified as intentional overdose and 76% had a history of psychiatric illness. Generally, medical management was compliant with guidelines, with some minor irregularities. The international normalized ratio was the most underperformed test.Conclusion: Our choice of topic, paracetamol overdose, contributed to our understanding of the breadth of factors to be considered in the emergency medical management of a patient. In this regard, we had the benefit of understanding how the diagnostic and therapeutic factors, when applied in accordance with best-practice guidelines, work very effectively. The SSC impacted positively on our cognitive, personal, and professional development. In facilitating the student with

  4. The simple query "Do you want more pain medication?" is not a reliable way to assess acute pain relief in patients in the emergency department. (United States)

    Chauny, Jean-Marc; Marquis, Martin; Paquet, Jean; Lavigne, Gilles; Cournoyer, Alexis; Manzini, Christiane; Daoust, Raoul


    The management of acute pain constitutes an essential skill of emergency department (ED) physicians. However, the accurate assessment of pain intensity and relief represents a clinically challenging undertaking. Some studies have proposed to define effective pain relief as the patient's refusal for additional analgesic administration. The aim of this study was to verify whether such a refusal is effectively indicative of pain relief. This prospective cohort study included ED patients who received single or multiple doses of pain medication for an acute pain problem. Patients were evaluated for pain relief using one Likert scale and two dichotomous questions: Is your pain relieved? and Do you want more analgesics? Non-relieved patients were further analysed using a checklist as to the reasons behind their refusal for supplemental pain medication. We have recruited 378 adult patients with a mean age of 50.3 years (±19.1); 60% were women and had an initial mean pain level of 7.3 (±2.0) out of 10. We observed that 68 out of 244 patients who were adequately relieved from pain asked for more analgesics (28%), whereas 51 out of 134 patients who were not relieved from pain refused supplemental drugs (38%). Reasons for refusal included wanting to avoid side effects, feeling sufficiently relieved, and disliking the medication's effects. Over a third of ED patients in acute pain were not relieved but refused supplemental pain medication. Patients have reported legitimate reasons to decline further analgesics, and this refusal cannot be used as an indication of pain relief.

  5. Army Programs: Army Finance and Accounting Quality Assurance Program

    National Research Council Canada - National Science Library


    This regulation discusses the primary responsibilities of commanders and staff officers at installation and higher levels for execution of the Army Finance and Accounting Quality Assurance (QA) Program...

  6. History of the Army Ground Forces. Study Number 17. History of the Third Army (United States)


    impotence; Facist Italy rattled swords, and Germany was giving itself to Nazism. On 9 August 1932, without fanfare and almost without public awareness, the...picking up pecans under ofte tree. 5. All units should continue to remove the physically unfit as rapidly as possible. While this conference was going...with War Department orders, he visited the Fifth Army front in Italy , as an observer, in November, 1943. In his report to General McNair,322 General

  7. Union Directions - Army Response. (United States)


    reflects the long-held belief in the Army that employee participation in decisions that affect their worklife is healthy and desirable. Although some...pluralistic society, checks and balances are as important for the economy as for the government. Business executives who salivate at the thought of vanishing...Unions. Reading, MA: Addison-Wesley, 1976. 37. National Federation of Federal Employees. NFFE’s Guide to Quality of Worklife Programs. No. G-21

  8. Operationalizing Army Cyber (United States)


    killed just under 3,000 people and cost the U.S. economy somewhere between three and five trillion dollars. The Japanese attacked with a state... economy , and military readiness. The challenge is to design an Army Cyber force that can support the United States Cyber Command (USCYBERCOM) national...still keeps the intelligence and signal functions separate in most units today from battalion to echelon above Corps ( EAC ). There are many past reasons

  9. 1998 Army Modernization Plan (United States)


    Biological (CB) Protective Duty Uniform (STO) • Biometrics (SRO) • Nanoscience (SRO) • Millimeter Wave Material and Dissemination Technology... Biometrics and Nanoscience SROs will enable the development of advanced NBC detection and characterization systems, including the exploitation of biologically...Requirements Trailers • Procure HEMAT Trailers Figure K-23 K-19 //;<?. U.S. Army 1997Modernization Plan This final fleet assessment, made against the

  10. Nostalgia in the Army (17th-19th Centuries). (United States)

    Battesti, Michèle


    People died from nostalgia in the army in the 17th-19th centuries. The term 'nostalgia', created by the doctor Johannes Hofer (1669-1752), from Mulhouse, came from the Germanic Heimweh, or 'homesickness'. It affected the young people enrolled in the army, such as Swiss mercenaries. Longing for their native land, they were consumed by an ongoing desire to return home. If it was impossible to do so, they sank into 'a sadness accompanied with insomnia, anorexia and other unpleasant symptoms' that could lead to death. Nostalgia became classified as a disease during the last quarter of the 18th century and ravaged the French army during the Revolution and the Napoleonic wars. However, as soon as the wars ended, it ceased to exist in the army (except the colonial army). It was removed from the nosology in the first half of the 19th century. Rapidly explained as an example of a misdiagnosis or a confusion between 'connection and cause', nostalgia needs to be assessed in regard to the medical debate between 'alienists' and 'organicists'. Creating much concern, nostalgia needs to be considered in the historical context of a society destabilized by modernity, with some individuals uprooted by the sudden transition from civil society to military life. It raises questions about the role that the army played in the creation of the French national union. Nostalgia may have also covered psychic traumatisms later designated as combat fatigue, war neurosis, or post-traumatic stress disorder. © 2016 S. Karger AG, Basel.

  11. [Value of angiography and embolisation in treatment of head and neck vascular malformations at Otolaryngology Department, Poznań University of Medical Sciences, Poland]. (United States)

    Wróbel, Maciej; Kopeć, Tomasz; Juszkat, Robert; Szyfterl, Witold; Borucki, Łukasz


    Angiography is an invasive, radiological investigation of vascular system. It plays an important role within variety of diagnostic tools in head and neck pathologies. In selected cases with well defined tumor supply vessels, angiography may be combined with intravascular obliteration. This possibility widen indications, which comprise diagnostic arteriographies - visualization of blood supply and extension of vascularization; therapeutic and diagnostic arteriographies - palliative or radical in character, dependent on pathology; and therapeutic angiographies as adjuvant therapy prior to surgical treatment. Authors present their experience with endovascular techniques application in head and neck pathologies. Material comprised 59 angiographies performed in patients treated at Otolaryngology Department at Poznań University of Medical Sciences between 2000-2007. In conclusion authors emphasize advantages and disadvantages, as well as, the role of the endovascular treatment in head and neck surgery.


    Directory of Open Access Journals (Sweden)

    O. B. Ershova


    Full Text Available Osteoporosis (OP is one of the most common diseases and is characterized by serious clinical manifestations such as low-energy bone fractures that cause severe social consequences. In this connection, OP is now receiving much attention worldwide. In Yaroslavl, the Department of Therapy (Head, Professor N.I. Korshunov, MD, Institute of Postgraduate Education, Yaroslavl State Medical University (Chancellor, Prof. A.V. Pavlov, MD, has been intensively conducting researches into different aspects of OP for more than 20 years. The main areas of the investigations performed are the issues of the epidemiology and outcomes of osteoporotic fractures, the relationship of OP to different diseases (rheumatoid arthritis, cardiovascular diseases, as well as the specific features of the development of OP in fertile men and women and the problem of calcium and vitamin D deficiency in pregnant women. 

  13. [Professional dysphonia and its risk factors in the material of the outpatient clinic of the Department of Otolaryngology, Medical Academy of Białystok]. (United States)

    Kosztyła-Hojna, Bozena; Rogowski, Marek; Ruczaj, Jan; Pepiński, Witold


    Occurrence of professional dysphonia was analysed in a group of 309 patients treated in the Phoniatric Outpatient Clinic, Department of Otolaryngology, Medical Academy in Białystok through the period of 1999-2001. In a group of professional voice users female teachers of primary schools and lower secondary schools predominated. Obtained results were compared with those from a group of 65 persons of other occupations. In the both groups other harmful factors affecting the voice organ were excluded. The clinical assessment included subjective and objective laryngological examination using videolaryngostroboscopy. The clinical material was evaluated in a view of functional and organic disorders of the voice organ. Early occurrence and aggravation of functional changes in the larynx was recorded in non professional voice users in the course of their seniority. In professional patients organic changes were more common and occurred earlier than functional disorders. Severity of dysphonia was related to the larynx pathology, especially of a functional character.

  14. Army Healthcare Enterprise Management System

    National Research Council Canada - National Science Library


    .... The complaint alleged that the Army Healthcare Enterprise Management System was not properly competed, potential conflicts of interest existed, and possible contract performance problems existed...

  15. Defense Logistics Army Should Assess Cost and Benefits of the Workload Performance System Expansion

    National Research Council Canada - National Science Library


    .... In the Department of Defense's (DOD) fiscal years 1997 and 1998 Annual Statements of Assurance, DOD noted difficulties in relating personnel requirements to workload and budget as a material weakness in the Army's manpower requirements...

  16. 2005 United States Army Corps of Engineers (USACE) Post-Hurricane Katrina Levee Surveys (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — These topographic data were collected for the U.S. Army Corps of Engineers by a helicopter-mounted LiDAR sensor over the New Orleans Hurricane Protection Levee...

  17. 2010 US Army Corps of Engineers (USACE) Portland District Columbia River Lidar (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Columbia River Light Detection and Ranging (LiDAR) survey project was a collaborative effort to develop detailed high density LiDAR terrain data for the US Army...

  18. Comparison of cephalometric norms of pleasing faces with patients reported in the out patients department of orthodontic at liaquat university of medical and health sciences hyderabad/ jamshoro

    International Nuclear Information System (INIS)

    Nisa, Q.U.


    Objective: This was a cross sectional study aimed to analyze Cephalometric norms of patients reporting to outpatients department of Orthodontic Department Liaquat University of Medical and health sciences, Hyderabad / Jamshoro in comparison with the Caucasian norms. Methods: The study was carried out on true lateral cephalometric radiographs of 150 subjects (75 male, 75 female) between 18-28 years, with esthetically pleasing and harmonious faces, competent lips, class 1 molar relationship, with all permanent teeth present, no facial trauma and no history of previous orthodontic treatment. The mean, standard deviation and ranges of all measurements were compared with the norms established by Steiner. For all statistical evaluation was performed by SPSS 16.0 version software, the student t-test were performed to compare the sample with Steiner means. Results: several significant findings were notable in the result of the present study. The result of the present study sample showed retrusive mandible (p < 0.000), horizontal growth pattern, procline upper incisors (p < 0.000), decrease inter-incisal angle (p < 0.001) when compared with the Caucasian norms taken by Steiner. No significant findings were found between male and female in present study sample.Conclusion: There were no significant differences between the male and female Population cephalometric norms Even though, a careful analysis of cephalom norms of patients along with other diagnostic considerations before initiating orthodontic treatment for better stability. (author)

  19. Improvement of medical education using web-based lecture repetition and extension: e-learning experiences of the Department of Obstetrics and Gynecology, University of Tuebingen

    Directory of Open Access Journals (Sweden)

    Wallwiener, Markus


    Full Text Available In order to improve the education of its medical students, the Department of Obstetrics and Gynecology of the University of Tuebingen established e-learning in terms of web-based lecture repetition and extension. Subsequent to lectures, questions are provided online. The participation is voluntary, but requires registration. The results of the analysed period (winter term 2004/2005, summer term 2005 and winter term 2005/2006 including more than 380 e-learning users are encouraging. An average of 45% of the target group used the offered online questions. The students who completed at least 75% of all prepared question units achieved significantly better results than their traditional learning fellow students (p=0.002. Users got more frequent the marks "good" and "very good". Twice as much conventional learning students as e-learning users failed the examination. E-Learning and the technical implementation are repeatedly appreciated by the students. In the future, more medical courses will be supplemented with e-learning, according to the students request.

  20. Odontogenic keratocyst: a 31- year retrospective study in the oral and maxillofacial pathology department, Faculty of Dentistry, Tehran University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Eshghyar N.


    Full Text Available Statement of Problem: Odontogenic keratocyst is a developmental odontogenic cyst which arises from dental lamina. One of the important features of odontogenic keratocyst is strong tendency to recurrence. Purpose: The purpose of this study was the statistical evaluation of age and gender of patient as well as area of involvement in odontogenic keratocysts in the oral and maxillofacial pathology department of dental faculty of Tehran University of Medical Sciences from 1971-2002. Materials and Methods: This study was a cross sectional, descriptive one. Medical records were reviewed and variables such as age, gender and site of involvement were recorded. The data were analyzed with SPSS software. Results: The relative frequency of odontogenic keratocyst was 36%. 66% of cysts were in men and 34% in women. 68% of lesions affected the lower jaw and 32% the upper jaw. Regarding the site of involvement, 48% of lesions involved the molar region of mandible and 42%, the anterior part of maxilla. The occurrence of keratocysts was higher in this sites. Most of the cases were diagnosed in the third decade. Conclusion: Based on the findings of this study, odontogenic keratocyst was more prevalent in men, mandible and the third decade. The posterior part of mandible and anterior region of maxilla were involved most frequently.

  1. [Adequacy of antibiotic therapy for urinary tract infection in a Medical Department from the university hospital of Lille: A retrospective cohort study]. (United States)

    Deconinck, L; Maillard, H; Lemaitre, M; Barbottin, E; Bakhache, E; Galperine, T; Puisieux, F; Hatron, P-Y; Lambert, M


    The main objective of the study was to assess the adequacy of antibiotic therapy for urinary tract infections (UTI) in a French hospital medical department. The secondary objective was to identify factors associated with inadequacy of the antibiotic therapy. A retrospective single centre cohort study was performed in the Post-Emergency Medicine Department (PEMD) of the university hospital of Lille. All patients presenting with an UTI from May 2012 to April 2014 were included. Adequacy of antibiotic therapy was assessed with reference to local guidelines. Factors associated with inadequacy of antibiotic prescription were determined using a multivariate logistic regression model. Two hundred and twenty-eight patients were included. The antibiotic prescription was fully adequate in 173 patients (76%) with appropriate use of a single or a combination antibiotic therapy in 96%, appropriate drug in 80%, appropriate dosage in 89% and appropriate route of administration in 95%. The risk for antibiotic inadequacy was significantly higher in patients with cystitis than in those with pyelonephritis (OR 12.01; 95% CI 4.17-34.65), when antibiotics were prescribed in the Emergency Department (OR 6.84; 95% CI 2.29-20.47) or before hospital admission (OR 382.46; 95% CI 19.61≥999.99) compared to when antibiotics were first administered in the PEMD, and in patients with severe UTI (OR 19.55; 95% CI 2.79-137.01). Adequacy of antibiotic therapy for UTI is relatively high in our study, reflecting the effective dissemination of antibiotic guidelines. However, antibiotic therapy is still inappropriate in cystitis, severe UTI and in case of prescription before the admission in the PEMD. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  2. Bilastine in allergic rhinoconjunctivitis and urticaria: a practical approach to treatment decisions based on queries received by the medical information department

    Directory of Open Access Journals (Sweden)

    Amalia Leceta


    Full Text Available Background: Bilastine is a safe and effective commonly prescribed non-sedating H1-antihistamine approved for symptomatic treatment in patients with allergic disorders such as rhinoconjunctivitis and urticaria. It was evaluated in many patients throughout the clinical development required for its approval, but clinical trials generally exclude many patients who will benefit in everyday clinical practice (especially those with coexisting diseases and/or being treated with concomitant drugs. Following its introduction into clinical practice, the Medical Information Specialists at Faes Farma have received many practical queries regarding the optimal use of bilastine in different circumstances. Data sources and methods: Queries received by the Medical Information Department and the responses provided to senders of these queries. Results: The most frequent questions received by the Medical Information Department included the potential for drug-drug interactions with bilastine and commonly used agents such as anticoagulants (including the novel oral anticoagulants, antiretrovirals, antituberculosis regimens, corticosteroids, digoxin, oral contraceptives, and proton pump inhibitors. Most of these medicines are not usually allowed in clinical trials, and so advice needs to be based upon the pharmacological profiles of the drugs involved and expert opinion. The pharmacokinetic profile of bilastine appears favourable since it undergoes negligible metabolism and is almost exclusively eliminated via renal excretion, and it neither induces nor inhibits the activity of several isoenzymes from the CYP 450 system. Consequently, bilastine does not interact with cytochrome metabolic pathways. Other queries involved specific patient groups such as subjects with renal impairment, women who are breastfeeding or who are trying to become pregnant, and patients with other concomitant diseases. Interestingly, several questions related to topics that are well covered in

  3. Army General Fund Adjustments Not Adequately Documented or Supported (United States)


    For financial statements to be accepted into CARS, the amounts must match. In theory , the amount submitted by the various accounting systems and...DEFENSE (COMPTROLLER)/ CHIEF FINANCIAL OFFICER DIRECTOR, DEFENSE FINANCE AND ACCOUNTING SERVICE AUDITOR GENERAL, DEPARTMENT OF THE ARMY SUBJECT... financial management system requirements, applicable Federal accounting standards, and the U.S. Government Standard General Ledger at the

  4. 78 FR 64205 - Army Science Board Fall Plenary Meeting (United States)


    ... by 41 CFR 102-3.150(a). Therefore, the Advisory Committee Management Officer for the Department of..., (703) 545-8652,"> or Carolyn German, (703) 545-8654, carolyn.t.german[email protected] . SUPPLEMENTARY INFORMATION: None. Brenda S. Bowen, Army...

  5. Pattern of prescription drug use in Nigerian army hospitals

    African Journals Online (AJOL)

    Army Dental Centre, Military Hospital, Awolowo Road, Ikoyi, 1Department of ... Correspondence to: Dr. E. Taiwo Adebayo, General Post Office Box 3338, Kaduna – 800 001, Nigeria. .... meet their individual requirements for an adequate ..... reference materials such as essential drugs list, ... and sterilization equipment.

  6. United States Army Medical Materiel Development Activity (United States)


    and BPL were provided by the contractor to USAMMDA personnel as required. 3 ,I SAutomatic Data Processing Support: During 1988, USAMI.DA procured...PABO, and WRAIR cooperated to immunize 40,000 volunteers in a double blind study of 0. neningitidis Vaccine. Controls received a licensed Group C

  7. Modified Diet Recipes for Army Medical Facilities (United States)


    meatballs , Eggs , whole slightly 1 egg 45 weighing 33 grams each. beaten 3. Place on sheet pan and bake Water 1/3 cup 1/3 cup 10 minutes, or until... egg , water, and rolled oats. Shape into 30 meatballs , weighing 45 grams each. Place on sheet pan and bake 20 minutes or until done* Drain well... egg , water, and rolled oats. Shape into 30 meatballs , weighing 45 grams each. Place on sheet pan and bake 20 minutes or until done. Drain well

  8. Flexitime in an Army Medical Center. (United States)


    and Costigan (1973) conducted a longitudinal study of employee responses to the four day week in a medium-sized pharmaceutical company. The patterns...New York, New York, 1979. Nord, W.R. and Costigan, R. Worker adjustment to the four - day week : a longitudinal study. Journal of Applied Psychology, 58

  9. Army Blast Claims Evaluation Procedures (United States)


    ATIN: AFZX-JA Building 4551 Fort Polk, LA 71459-5000 Commander U.S. Army Engineer Center and Fort Leonard Wood ATIN: AlZT-JA Building 1706 East...U.S. Armed Forces Claims Service, Korea APO AP 96205-0084 No. of Copies Organization 1 Commander U.S. Army South ATI’N: SOJA Building 154 APO

  10. Comparison of hospitalizations, emergency department visits, and costs in a historical cohort of Texas Medicaid patients with chronic obstructive pulmonary disease, by initial medication regimen. (United States)

    Rascati, Karen L; Akazawa, Manabu; Johnsrud, Michael; Stanford, Richard H; Blanchette, Christopher M


    Limited information is available on the relative outcomes and treatment costs of various pharmacotherapies for chronic obstructive pulmonary disease (COPD) in a Medicaid population. This study compared the effects of initial medication regimens for COPD on COPD-related and all-cause events (hospitalizations and/or emergency department [ED] visits) and COPD-related and all-cause costs. The study population was a historical cohort of Texas Medicaid beneficiaries aged 40 to 64 years with COPD-related medical costs (International Classification of Diseases, Ninth Revision, Clinical Modification codes 491.xx, 492.xx, 496.xx), 24 months of continuous Medicaid enrollment (12 months before and after the index prescription), and at least 1 prescription claim (index) for a combination product containing fluticasone propionate + salmeterol, an inhaled corticosteroid, salmeterol, or ipratropium between April 1, 2001, and March 31, 2003. The analyses of events employed Cox proportional hazards regression, controlling for baseline factors and preindex events. The analyses of costs used a 2-part model with logistic regression and generalized linear model to adjust for baseline characteristics and preindex utilization and costs. The study population included 6793 patients (1211 combination therapy, 968 inhaled corticosteroid, 401 salmeterol, and 4213 ipratropium). Only combination therapy was associated with a significantly lower risk for any COPD-related event (hazard ratio [HR] = 0.733; 95% CI, 0.650-0.826) and any all-cause event (HR = 0.906; 95% CI, 0.844-0.972) compared with ipratropium. COPD-related prescription costs were higher in all cohorts compared with the ipratropium cohort, but COPD-related medical costs were lower, offsetting the increase in prescription costs. For all-cause costs, prescription costs were higher in the combination-therapy cohort (+$415; P costs in the combination-therapy cohort (-$1735; P costs. In this historical population of Texas Medicaid

  11. The Army Study Program. (United States)



  12. Survey determinant factors of telemedicine strategic planning from the managers and experts perspective in the health department, isfahan university of medical sciences. (United States)

    Keshvari, Hamid; Haddadpoor, Asefeh; Taheri, Behjat; Nasri, Mehran; Aghdak, Pezhman


    Awareness of Outlook, objectives, benefits and impact of telemedicine technology that can promote services quality, reduce costs, increase access to Specialized and subspecialty services, and immediately guide the health system subconsciously to the introduction greater use of technology. Therefore, the aim of this study was to determine the strengths, weaknesses, opportunities and threats in the telemedicine strategic planning from the managers and experts perspective in the health department, Isfahan University of Medical Sciences, in order to take a step towards facilitating strategic planning and approaching the equity aim in health in the province. This is a descriptive-analytical study, that data collection was done cross-sectional. The study population was composed of all managers and certified experts at the health department in Isfahan university of Medical Sciences. The sample size was 60 patients according to inclusion criteria. Information was collected by interview method. Researcher attempted to use the structured and specific questionnaire Then were investigated the viewpoints of experts and managers about determinative factors (strengths, weaknesses, opportunities and threats) in the strategic planning telemedicine. Data were analyzed using descriptive statistics (frequency, mean) and software SPSS 19. Data analysis showed that change management (100%) and continuity of supply of credit (79/3%) were weakness point within the organization and strengths of the program were, identity and health telemedicine programs (100%), goals and aspirations of the current directors of the organization and its compliance with the goals of telemedicine (100%), human resources interested using computers in daily activities in peripheral levels (93/1%). Also organization in the field of IT professionals, had opportunities, and repayment specialist's rights by insurance organizations is a threat for it. According to the strengths, weaknesses, opportunities and threats

  13. Prescription of opioid and nonopioid analgesics for dental care in emergency departments: Findings from the National Hospital Ambulatory Medical Care Survey. (United States)

    Okunseri, Christopher; Okunseri, Elaye; Xiang, Qun; Thorpe, Joshua M; Szabo, Aniko


    The aim of this study was to examine trends and associated factors in the prescription of opioid analgesics, nonopioid analgesics, opioid and nonopioid analgesic combinations, and no analgesics by emergency physicians for nontraumatic dental condition (NTDC)-related visits. Our secondary aim was to investigate whether race/ethnicity is a possible predictor of receiving a prescription for either type of medication for NTDC visits in emergency departments (EDs) after adjustment for potential covariates. We analyzed data from the National Hospital Ambulatory Medical Care Survey for 1997-2000 and 2003-2007, and used multinomial multivariate logistic regression to estimate the probability of receiving a prescription for opioid analgesics, nonopioid analgesics, or a combination of both, compared with receiving no analgesics for NTDC-related visits. During 1997-2000 and 2003-2007, prescription of opioid analgesics and combinations of opioid and nonopioid analgesics increased, and that of no analgesics decreased over time. The prescription rates for opioid analgesics, nonopioid analgesics, opioid and nonopioid analgesic combinations, and no analgesics for NTDC-related visits in EDs were 43 percent, 20 percent, 12 percent, and 25 percent, respectively. Majority of patients categorized as having severe pain received prescriptions for opioids for NTDC-related visits in EDs. After adjusting for covariates, patients with self-reported dental reasons for visit and severe pain had a significantly higher probability of receiving prescriptions for opioid analgesics and opioid and nonopioid analgesic combinations. Prescription of opioid analgesics increased over time. ED physicians were more likely to prescribe opioid analgesics and opioid and nonopioid analgesic combinations for NTDC-related visits with reported severe pain. © 2014 American Association of Public Health Dentistry.

  14. Factors influencing readiness to deploy in disaster response: findings from a cross-sectional survey of the Department of Veterans Affairs Disaster Emergency Medical Personnel System. (United States)

    Zagelbaum, Nicole K; Heslin, Kevin C; Stein, Judith A; Ruzek, Josef; Smith, Robert E; Nyugen, Tam; Dobalian, Aram


    The Disaster Emergency Medical Personnel System (DEMPS) program provides a system of volunteers whereby active or retired Department of Veterans Affairs (VA) personnel can register to be deployed to support other VA facilities or the nation during national emergencies or disasters. Both early and ongoing volunteer training is required to participate. This study aims to identify factors that impact willingness to deploy in the event of an emergency. This analysis was based on responses from 2,385 survey respondents (response rate, 29%). Latent variable path models were developed and tested using the EQS structural equations modeling program. Background demographic variables of education, age, minority ethnicity, and female gender were used as predictors of intervening latent variables of DEMPS Volunteer Experience, Positive Attitude about Training, and Stress. The model had acceptable fit statistics, and all three intermediate latent variables significantly predicted the outcome latent variable Readiness to Deploy. DEMPS Volunteer Experience and a Positive Attitude about Training were associated with Readiness to Deploy. Stress was associated with decreased Readiness to Deploy. Female gender was negatively correlated with Readiness to Deploy; however, there was an indirect relationship between female gender and Readiness to Deploy through Positive Attitude about Training. These findings suggest that volunteer emergency management response programs such as DEMPS should consider how best to address the factors that may make women less ready to deploy than men in order to ensure adequate gender representation among emergency responders. The findings underscore the importance of training opportunities to ensure that gender-sensitive support is a strong component of emergency response, and may apply to other emergency response programs such as the Medical Reserve Corps and the American Red Cross.

  15. 76 FR 66282 - Army Educational Advisory Committee (United States)


    ... Committee: U.S. Army War College Subcommittee of the Army Education Advisory Committee. Dates of Meeting: November 15, 2011. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command... issues and matters related to the continued growth and development of the United States Army War College...

  16. 76 FR 72914 - Army Educational Advisory Committee (United States)


    ...: U.S. Army War College Subcommittee of the Army Education Advisory Committee. Dates of Meeting: December 14, 2011. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command... issues and matters related to the continued growth and development of the United States Army War College...

  17. Decoupling of the minority PhD talent pool and assistant professor hiring in medical school basic science departments in the US (United States)

    Gibbs, Kenneth D; Basson, Jacob; Xierali, Imam M; Broniatowski, David A


    Faculty diversity is a longstanding challenge in the US. However, we lack a quantitative and systemic understanding of how the career transitions into assistant professor positions of PhD scientists from underrepresented minority (URM) and well-represented (WR) racial/ethnic backgrounds compare. Between 1980 and 2013, the number of PhD graduates from URM backgrounds increased by a factor of 9.3, compared with a 2.6-fold increase in the number of PhD graduates from WR groups. However, the number of scientists from URM backgrounds hired as assistant professors in medical school basic science departments was not related to the number of potential candidates (R2=0.12, p>0.07), whereas there was a strong correlation between these two numbers for scientists from WR backgrounds (R2=0.48, pprofessors and posited no hiring discrimination. Simulations show that, given current transition rates of scientists from URM backgrounds to faculty positions, faculty diversity would not increase significantly through the year 2080 even in the context of an exponential growth in the population of PhD graduates from URM backgrounds, or significant increases in the number of faculty positions. Instead, the simulations showed that diversity increased as more postdoctoral candidates from URM backgrounds transitioned onto the market and were hired. DOI: PMID:27852433

  18. [The teaching of orthodontics in the opinion of students from Department of Dentistry of Pomeranian Medical University in the academic year of 2005/2006]. (United States)

    Syryńska, Maria; Post, Marcin; Tsynkel, Pavel; Durka, Magdalena


    The aim of the paper was to get to know, collect and present information provided by students about classes from orthodontic and their opinion regarding the conduction of clinical and theoretical exercises. The study group was comprised of 69 fifth year students from the Department of Orthodontics of the Pomeranian Medical University. The material was collected by the use of an anonymous questionnaire distributed after the final exam from orthodontics. The questionnaire was created for the study and contained 6 questions. Most of the students have admitted that knowledge gained during the 4th year was useful on the 5th year and that the information presented on orthodontic seminars during the 5th year was beneficial in regard to clinical exercises. Graduates have admitted that they felt well prepared in the field of orthodontic profilaxis and removable appliances but not enough prepared in the field of fixed appliances, retention and the repair of damaged appliances. The number of patients on clinical exercises in most answers was rated as "enough". Most of the students have answered that the way of the exercises have been conducted in their groups was acceptable and the time on exercises has been properly used. Laboratory exercises and seminars on the 4th and 5th year of studies have supplemented the knowledge of students and prepared them for clinical work in orthodontics. Students have proved to be good observers when indicating the weak points of didactics.

  19. Investing In The Army Organic Industrial Base To Operate And Win In A Complex And Austere Environment (United States)


    as required remains essential to equipping the Army, the Joint Force and, in many cases, our allies and coalition forces. ―Honorable McHugh and...manufacture cannons and mortars cannot be found anywhere else in the Defense Department. ―Secretary of the Army, John McHugh , Watervliet Arsenal Visit

  20. Department of Defense support to spill response operations

    International Nuclear Information System (INIS)

    Ducey, D.L. Jr.; Walker, A.H.


    The Department of Defense (DOD), operating through the Directorate of Military Support in the Department of the Army, supports state, local and other federal agency response operations in a wide range of natural and man-caused emergencies. Examples within the past six years include the Ashland Oil tank collapse in Floreffe, Pennsylvania, Exxon Valdez cleanup, Loma Prieta earthquake, hurricanes Hugo and Andrew, Mexico City earthquake, Armero (Columbia) volcanic eruption, and Puerto Rico floods and mud slides. From March 24 to September 27, 1989, the period of the Exxon Valdez initial cleanup operations, DOD provided military and civilian personnel, US Navy ships for housing response workers, cargo and medical evacuation aircraft (fixed wing and helicopters), skimmers, modified dredges, landing craft, Dracones, Zodiak boats, radios, computers, and other miscellaneous equipment. This was in addition to assets of the Alaska Army and Air National Guard, which were committed by the governor. Support was provided to the US Coast Guard on scene coordinator and supervised by the Alaska Oil Spill Joint Task Force. The General Accounting Office, in its January 1990 report, Federal Costs Resulting from the Exxon Valdez Oil Spill, estimated that DOD spent $62.8 million through September 30, 1989, the largest expenditure by any federal agency. Use of military resources is a realistic scenario in certain situations. Primary responders at the federal and state level should understand how to request and employ these assets. This paper provides a background on DOD support to disaster relief operations, and discusses the types of support available to agencies responding to natural or man-caused emergencies, request and approval mechanisms, the Department of Defence organization to provide support, and reimbursement of the department

  1. Portraying the Army Reserve Components in Army War Games and Exercises

    National Research Council Canada - National Science Library

    Dillon, Dick


    .... Ensuring that accuracy and realism was the primary purpose of the Role of the Army National Guard and Army Reserve in Army Exercises workshop conducted at the Collins Center for Strategic Leadership from 23-26 September 2002.

  2. Investigative report, science committee of Aggregate corporation Radiological technologist society of the Oita prefecture. Questionnaires research on security control of department of radiological technology of medical facilities in the Oita prefecture. The second report. Research on high risk incident measures

    International Nuclear Information System (INIS)

    Eto, Yoshihiro; Mano, Isao; Takagi, Ikuya; Murakami, Yasunori; Sueyoshi, Seiji; Yoshimoto, Asahi


    Oita association of radiological technologists carried out the questionnaires about the measures against high lisk incidental in department of radiological technology at the medical facilities in Oita. We distributed the questionnaire to 102 facilities, which are worked by the technologists (member), and got response from 91 facilities (89%). Research contents are Patient verification method'' ''Input and verification of patient attribute'' ''Infection in hospital'' ''Stumbles and falls of patient'' Contrast enhancement CT'' ''Something related to pacemaker'' ''MRI inspection and the magnetic substance'' ''Remedy mistake'' and ''Risk management''. The Result, Low level recognition contents of medical accident measures are ''Contrast enhancement CT'' ''Stumbles and falls of patient'' Risk management of department of radiological technology''. (author)

  3. Fire Department Emergency Response

    International Nuclear Information System (INIS)

    Blanchard, A.; Bell, K.; Kelly, J.; Hudson, J.


    In 1995 the SRS Fire Department published the initial Operations Basis Document (OBD). This document was one of the first of its kind in the DOE complex and was widely distributed and reviewed. This plan described a multi-mission Fire Department which provided fire, emergency medical, hazardous material spill, and technical rescue services

  4. Implementation of the patient-centered medical home in the Veterans Health Administration: associations with patient satisfaction, quality of care, staff burnout, and hospital and emergency department use. (United States)

    Nelson, Karin M; Helfrich, Christian; Sun, Haili; Hebert, Paul L; Liu, Chuan-Fen; Dolan, Emily; Taylor, Leslie; Wong, Edwin; Maynard, Charles; Hernandez, Susan E; Sanders, William; Randall, Ian; Curtis, Idamay; Schectman, Gordon; Stark, Richard; Fihn, Stephan D


    In 2010, the Veterans Health Administration (VHA) began implementing the patient-centered medical home (PCMH) model. The Patient Aligned Care Team (PACT) initiative aims to improve health outcomes through team-based care, improved access, and care management. To track progress and evaluate outcomes at all VHA primary care clinics, we developed and validated a method to assess PCMH implementation. To create an index that measures the extent of PCMH implementation, describe variation in implementation, and examine the association between the implementation index and key outcomes. We conducted an observational study using data on more than 5.6 million veterans who received care at 913 VHA hospital-based and community-based primary care clinics and 5404 primary care staff from (1) VHA clinical and administrative databases, (2) a national patient survey administered to a weighted random sample of veterans who received outpatient care from June 1 to December 31, 2012, and (3) a survey of all VHA primary care staff in June 2012. Composite scores were constructed for 8 core domains of PACT: access, continuity, care coordination, comprehensiveness, self-management support, patient-centered care and communication, shared decision making, and team-based care. Patient satisfaction, rates of hospitalization and emergency department use, quality of care, and staff burnout. Fifty-three items were included in the PACT Implementation Progress Index (Pi2). Compared with the 87 clinics in the lowest decile of the Pi2, the 77 sites in the top decile exhibited significantly higher patient satisfaction (9.33 vs 7.53; P hospitalization rates for ambulatory care-sensitive conditions (4.42 vs 3.68 quarterly admissions for veterans 65 years or older per 1000 patients; P < .001), and lower emergency department use (188 vs 245 visits per 1000 patients; P < .001). The extent of PCMH implementation, as measured by the Pi2, was highly associated with important outcomes for both

  5. Increasing Army Retention Through Incentives

    National Research Council Canada - National Science Library

    Beerman, Kevin


    .... If the Army fails to address the enlisted retention issue in the near future departures of experienced NCOs will have a detrimental impact our military's ability to provide for our nation's security...

  6. Christian Contributions to Army Values

    National Research Council Canada - National Science Library

    D'Emma, Gregory


    .... The Army builds the soldier's heart, spirit, and soul by the values we instill. Over the years these values of loyalty, duty, respect, selfless service, honor, integrity, and personal courage have been trained and reinforced...

  7. Racial Extremism in the Army

    National Research Council Canada - National Science Library

    Hudson, Walter M


    ... modem phenomenon of "skinheads." I then discuss the history of white supremacist extremism in the Army, culminating in the December, 1995 murders of two black civilians by soldiers assigned to the 82d Airborne Division at Fort Bragg, North Carolina...

  8. Cranioplasty as the return-to-work factor - 112 patients with cranial defects treated in the Department of Neurosurgery at the Medical University of Lodz. (United States)

    Kasprzak, Piotr; Ormezowska, Elżbieta; Jaskólski, Dariusz


    The number of craniectomies and the consequent reconstructive procedures has grown during the past decades. Cranial defects and methods of their repair could have some influence on work capability of the patients and their employability. The authors analyzed a group of 112 patients with cranial defects treated in the Department of Neurosurgery at the Medical University of Lodz, Poland, in the course of the katamnestic period longer than 6 months after reconstructive operation, and observed them between February 2008 and February 2015. Their work capability and employment were compared, all the patients were interviewed concerning the reasons for not working according to the Social Insurance Institution predication procedure. Before the cranioplasty, all the patients were capable of working without limitations according to biological criteria and 89 of them were employed. Twenty-three not working people consisted of 6 pupils, 7 retired and 10 not working for other reasons. During the period between the craniectomy and the cranioplasty, 88 patients were capable of working and only 2 were employed. After the reconstruction, 93 were capable of working without limitations and 16 - with limitations. Forty-seven were employed during the period of the follow-up, the rest of patients consisted of 2 pupils, 13 retired and 50 not working for various reasons. Cranioplasty is a very important factor contributing to return to work. This outcome may be seen as having a great social value and be added to the functions of cranial repair as protective, esthetic and normalizing the intracranial pressure previously described in the literature. Int J Occup Med Environ Health 2017;30(5):803-809. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.



    visual testing, acoustic emission, NR, and other specialized methods such as infrared or thermography. These inspection processes are used to...include: polyethylene, steel, rubber , brass, aluminum, and ceramic (from left to right). Figures 5a and 5b show visual images of both sides of the...Boroflex is a proprietary product of specialized flexible rubber sheets containing high amounts of boron-10. Most of this exterior material was put in

  10. Past performance usage within the Department of Army


    Tappel, Joseph B.


    Approved for public release; distribution is unlimited In the ongoing attempt to deliver quality goods and services in less time and cost to the Government, the concept of "Best Value " contracting has been explored. One element of best value contracting is to consider factors along with price in the source selection process to achieve a perceived best value to the Government. Past performance measurement and its use in best value procurements has been developed since the early 1990s. This...

  11. Robotics In Manufacturing: Army View (United States)

    Michel, F. J.


    (Figure 1) This is an outline of my presentation today. The U. S. Army has a dual interest in the use of robots, namely: 1. As a substitute for or an extension of the soldier in the battlefield, and 2. in the factories that make Army materiel, or - as we call it -the the production base. The Production Base can again be divided into three separate segments, i.e., the Army owned and operated facilities or GOG6s, such as Rock Island and Watervliet arsenals, and not to be overlooked, the depot operations. There the Army manufactures gun tubes and other related parts for artillery weapons and repairs and overhauls them. A second category is the Army owned and contractor operated facilities or GOCOs,such as the ammunition plants, the tank plants at Lima, Ohio and Warren, Michigan and the Stratford Engine Plant in Connecticut where gas turbines for helicopter and the Abrams tank are manufactured. The last category covers the industrial base, that is those factories which are not only operated but also owned by the contractor himself also referred to as COCOs. You can see from this description that the Army is supported by a base which produces a diversified line of products. Therefore, the task of technology development and technology insertion is considerably more complex than what one encounters in the average U. S. Manufacturing organization.

  12. Challenging the Sacred Assumption: A Call for a Systemic Review of Army Aviation Maintenance (United States)


    much to me. You three are my heroes, and I can never repay you for your selfless sacrifice for me, our Army and our Nation. 1 Introduction...Command (AMCOM) lamented the increasing costs of sustaining aging fleets of aircraft. Major General Collyar stated, “Sustainment costs are eating away at...indicates the Army aviation is not alone . Across the Department of Defense, given the rising O&M spending, the services cannot “clearly identify the

  13. Engineer: The Professional Bulletin of Army Engineers, Jan-Apr 2010 (United States)


    Dornstadter 51 Transformation in Korea By Major Rafael Pazos and Captain Miguel Uc Headquarters, Department of the ArmyVolume 40 PB 5-10-1...States with an By Major Rafael Pazos and Captain Miguel Uc January-April 201052 Engineer initial grant of 205 acres at USAG–Humphreys, allowing the...the quality of life of our Service members. Major Pazos is the deputy commander of the United States Army Corps of Engineers (USACE), Gulf Region

  14. Army transformation leadership a study of core competencies for civilian leadership


    Taylor, Vickie.


    The U. S. Army is undergoing a substantial departure from its historical underpinnings to adapt and succeed in the emerging arena of asymmetric warfare-i.e., migrating from a traditional 'heavy' approach to an agile and responsive capability. Changes are not limited to equipment and doctrine, but are pervasive throughout all aspects of infrastructure and processes, including leadership. Army Transformation is outlined by the Department of Defense (DoD) April 2003 Transformation Planning Guid...

  15. Application of the Taxonomy of Injuries: Analysis of Army Recruit Injuries, CY 2016 (United States)


    Assessing Fitness for Military Enlistment: Physical , Medical, and Mental Health Standards. Washington, DC: The National Academies Press. 13. U.S. Army...Public Health Information Paper Application of the Taxonomy of Injuries: Analysis of Army Recruit Injuries, CY 2016 PHIP No. 12-01-0118...Recruit Injuries, CY2016; Public Health Information Paper 12-01-0118 5a. CONTRACT NUMBER n/a 5b. GRANT NUMBER

  16. Diversity Issues in the Army as Perceived by Army Students at the United States Army War College

    National Research Council Canada - National Science Library

    Webster, Cecil


    ..., welfare, and other related programs. In recognizing this diversity, this paper identifies some diversity issues within the Army, analyzes the perception of those diversity issues by the resident Army students in the USAWC Class of 1997...

  17. Comparative analysis of field ration for military personnel of the ukrainian army and armies of other countries worldwide


    M. Mardar; M. Hkrupalo; M. Stateva


    For the purpose of improvement of the Ukrainian nutritional standards this Article provides comparative analysis of field rations of different countries worldwide to make a proposal on improvement of food-stuff assortment in food ration for military personnel in the Armed Forces of Ukraine, Army of USA, the British Army, Army of Germany, Army of Italy, Army of Canada, Army of France, Army of Belarus, Army of Armenia. In accordance with the comparative analysis it was established that ration c...

  18. Results of the implementation of a new screening protocol for child maltreatment at the Emergency Department of the Academic Medical Center in Amsterdam. (United States)

    Teeuw, Arianne H; Sieswerda-Hoogendoorn, Tessa; Sangers, Esmée J; Heymans, Hugo S A; van Rijn, Rick R


    This study examines the results of the implementation of a new screening protocol for child maltreatment (CM) at the Emergency Department (ED) of the Academic Medical Center in Amsterdam, The Netherlands. This protocol consists of adding a so called 'top-toe' inspection (TTI), an inspection of the fully undressed child, to the screening checklist for child maltreatment, the SPUTOVAMO. We collected data from all patients 0-18 years old directly after introduction (February 2010) and 9 months later. Outcome measures were: completion of the screening and reasons for non-adherence. Data were collected on age, gender, reason for visiting the ED (defined by International Classification of Disease, ICD), presence of a chronic illness, type of professional performing the TTI and admission during week or weekend days. In February 560 and in November 529 paediatric patients were admitted. In February the complete screening protocol was performed in 42% of all children, in November in 17%. A correlation between completion of the SPUTOVAMO and having a TTI performed was found. Older age and presence of a chronic illness influenced the chance of having both SPUTOVAMO and TTI performed negatively. The completion rate of SPUTOVAMO was influenced by ICD code. Completion of TTI was influenced by type of investigator. The best performing professional was the ED physician followed by the paediatrician followed by the ED nurse. The reasons for not performing a TTI were not documented. Refusal of the TTI by a patient or parent was reported three times. Implementation of this new screening protocol for CM was only mildly successful and declined in time. A negative correlation between older child age and having a chronic illness and completion of the screening was found. A practical recommendation resulting from this study could be that, if CM screening protocols prove to be effective in detecting CM, regular training sessions have to be held. Filling out the checklist is something that

  19. A Study to Develop the Optimal Military Inter-Institutional Patient Referral Systems Model for DoD (Department of Defense) Military Medical Region III (United States)


    I rerr syttemn an do wlon t P ontimal military inter-instittiuonal patient referral systems model for DOD Military Medical Region III. A convenience...Dactin- on the Armed Services Medical Regulating Office and Patient Airlift "lc rcsusl.s of :his study indicated that the single largest breakdown...and the requirement to regulate to the closest medical facility with capability to care for the patient . L! / I Ii I i A STUDY TO DEVELOP THE OPTIMAL

  20. Strategic Analysis and Associated Management Products Supporting the Reengineering of Bayne-Jones Army Community Hospital: Consultative Products and Findings

    National Research Council Canada - National Science Library

    Fulton, Larry


    .... ̂Product 2 - "Bayne-Jones Army Community Hospital Web Site," a strategic Internet web site for marketing health and wellness, the TRICARE medical network, the Joint Readiness Training Center Surgeon's...