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Sample records for british medical association

  1. Auditing the British Medical Journal.

    OpenAIRE

    Channer, K S

    1994-01-01

    The purpose of this study was to audit the outcome in terms of change in practice of the published research from one volume of the British Medical Journal. All original papers and short reports from one Volume 296 of the British Medical Journal (BMJ) 1988 were read and classified into theoretical only, practical and theoretical and practical. Those papers with any practical message were reviewed by one of a panel of specialists in the subject of the paper to assess if the recommendation made ...

  2. Is the British Army medical grading functional assessment tool effective?

    Science.gov (United States)

    Mackie, Isobel

    2015-12-01

    Decision Support Aids (DSAs) have been widely used throughout industry and one (known as Table 7) is available to support British Army Medical Officers (MOs) grade soldiers against the Joint Medical Employment Standards. It is unknown how useful this DSA is in practice. An electronic questionnaire was distributed to British Army MOs working within Defence Primary Care facilities enquiring about MOs views on the usefulness of the DSA. Although the response rate was low, informative data were obtained. Between a half and a third of respondents felt that their judgement was affected in the application of the grading system when there were career implications to the grading MOs felt that the DSA allowed subjectivity in the grading. The results of this research suggest that although minor changes to Table 7 may improve service provision, an improvement in training in the application of Table 7 would be of greater benefit to the quality of occupational health service provision in the British Army.

  3. British Coal Corporation Medical Service annual report 1988-89

    Energy Technology Data Exchange (ETDEWEB)

    1992-01-01

    This annual report reviews the work of British Coal's Medical Service over the period 1988-89. Recruitment was at a lower level resulting in a reduction in the number of pre-employment medical examinations. Statistics are given for these, and for consultations during the year. The work of the rescue service is described. Results of surveys on the prevalence of pneumoconiosis in coal miners from 1961 to 1988 are presented in detail. The fall in prevalence continued. Continued attention has been paid to compliance with COSHH regulations, to encouraging the use of physiotherapy and to educating workers in lifting and handling methods. Following an incidence of Legionnaires Disease an investigation was carried out to identify the source of infection in an underground refrigeration plant. Studies on the mortality of coke workers have progressed. Reports are given on first aid and nursing services and on the administration of pethridine to injured miners.

  4. Chlamydial partner notification in the British Association for Sexual Health and HIV (BASHH) 2011 UK national audit against the BASHH Medical Foundation for AIDS and Sexual Health Sexually Transmitted Infections Management Standards.

    Science.gov (United States)

    McClean, H; Carne, C A; Sullivan, A K; Radcliffe, K W; Ahmed-Jushuf, I

    2012-10-01

    This paper reports on chlamydial partner notification (PN) performance in the 2011 BASHH national audit against the British Association for Sexual Health and HIV (BASHH) Medical Foundation for AIDS Sexual Health (MedFASH) Sexually Transmitted Infection Management Standards (STIMS). There was wide regional variation in level 3 clinic PN performance against the current standard of index case-reported chlamydial PN, with 43% (regional range 0-80%) of clinics outside London meeting the ≥0.6 contacts seen per index standard, and 85% of clinics (regional range 82-88%) in London meeting the ≥0.4 standard. For level 2 clinics, 39% (regional range 0-100%) of clinics outside London met the ≥0.6 standard, and 43% (regional range 40-50%) of clinics in London met the ≥0.4 standard. Performance for health-care worker (HCW)-verified contact attendance is also reported. New standards for each of these performance measures are proposed for all level 3 clinics: ≥0.6 contacts seen per index case based on index case report, and ≥0.4 contacts seen per index case based on HCW verification, both within four weeks of the first partner notification interview. The results are discussed with regard to the importance of adoption of standards by commissioners of services, relevance to national quality agendas, and the need for development of a national system of PN quality assurance measurement and reporting. PMID:23104751

  5. UK national audit against the key performance indicators in the British Association for Sexual Health and HIV Medical Foundation for AIDS and Sexual Health Sexually Transmitted Infections Management Standards.

    Science.gov (United States)

    McClean, H; Sullivan, A K; Carne, C A; Warwick, Z; Menon-Johansson, A; Clutterbuck, D

    2012-10-01

    A national audit of practice performance against the key performance indicators in the British Association for Sexual Health and HIV (BASHH) and HIV Medical Foundation for AIDS Sexual Health Standards for the Management of Sexually Transmitted Infections (STIs) was conducted in 2011. Approximately 60% and 8% of level 3 and level 2 services, respectively, participated. Excluding partner notification performance, the five lowest areas of performance for level 3 clinics were the STI/HIV risk assessment, care pathways linking care in level 2 clinics to local level 3 services, HIV test offer to patients with concern about STIs, information governance and receipt of chlamydial test results by clinicians within seven working days (the worst area of performance). The five lowest areas of performance for level 2 clinics were participating in audit, having an audit plan for the management of STIs for 2009-2010, the STI/HIV risk assessment, HIV test offer to patients with concern about STIs and information governance. The results are discussed with regard to the importance of adoption of the standards by commissioners of services because of their relevance to other national quality assurance drivers, and the need for development of a national system of STI management quality assurance measurement and reporting. PMID:23104750

  6. Hysteria and neurasthenia in pre-1914 British medical discourse and in histories of shell-shock

    OpenAIRE

    Loughran, Tracey

    2008-01-01

    Abstract Histories of shell-shock have argued that the diagnosis was subdivided into the categories hysteria and neurasthenia, and that the differential distribution and treatment of these diagnoses was shaped by class and gender expectations. These arguments depend on the presentation of hysteria and neurasthenia as opposed constructs in British medical discourse before 1914. An analysis of the framing of these diagnoses in British medical discourse c.1910?1914 demon...

  7. Private medical insurance and saving: evidence from the British Household Panel Survey.

    Science.gov (United States)

    Guariglia, Alessandra; Rossi, Mariacristina

    2004-07-01

    This paper uses the British Household Panel Survey for the years 1996-2000 to investigate the relationship between saving and private medical insurance in the UK. Because the National Health Service (NHS) gives comprehensive health coverage and is generally free at source, one would not expect private medical insurance to crowd-out saving. However, the NHS being characterised by long waiting lists and generally poor quality, many people prefer to use private health services. In such circumstances, those individuals who are not covered by private medical insurance, and who are therefore more exposed to facing unexpected out-of-pocket private health care expenditures or income losses while waiting for public treatment might save more for precautionary reasons than those who are covered. According to our findings, which are based on a wide range of econometric specifications, there is a positive association between insurance coverage and saving, suggesting that private medical insurance does not generally crowd-out private saving. However, we found some evidence of crowding-out in those areas where the quality of medical facilities is perceived as poor, and in rural areas, characterised by fewer NHS providers.

  8. Evidence-based guidelines for the pharmacological treatment of anxiety disorders : recommendations from the British Association for Psychopharmacology

    NARCIS (Netherlands)

    Baldwin, DS; Anderson, IM; Nutt, DJ; Bandelow, B; Bond, A; Davidson, JRT; den Boer, JA; Fineberg, NA; Knapp, M; Scott, J; Wittchen, HU

    2005-01-01

    These British Association for Psychopharmacology guidelines cover the range and aims of treatment for anxiety disorders. They are based explicitly on the available evidence and are presented as recommendations to aid clinical decision making in primary and secondary medical care. They may also serve

  9. Management of primary hypothyroidism: statement by the British Thyroid Association Executive Committee.

    Science.gov (United States)

    Okosieme, Onyebuchi; Gilbert, Jackie; Abraham, Prakash; Boelaert, Kristien; Dayan, Colin; Gurnell, Mark; Leese, Graham; McCabe, Christopher; Perros, Petros; Smith, Vicki; Williams, Graham; Vanderpump, Mark

    2016-06-01

    The management of primary hypothyroidism with levothyroxine (L-T4) is simple, effective and safe, and most patients report improved well-being on initiation of treatment. However, a proportion of individuals continue to suffer with symptoms despite achieving adequate biochemical correction. The management of such individuals has been the subject of controversy and of considerable public interest. The American Thyroid Association (ATA) and the European Thyroid Association (ETA) have recently published guidelines on the diagnosis and management of hypothyroidism. These guidelines have been based on extensive reviews of the medical literature and include sections on the role of combination therapy with L-T4 and liothyronine (L-T3) in individuals who are persistently dissatisfied with L-T4 therapy. This position statement by the British Thyroid Association (BTA) summarises the key points in these guidelines and makes recommendations on the management of primary hypothyroidism based on the current literature, review of the published positions of the ETA and ATA, and in line with best principles of good medical practice. The statement is endorsed by the Association of Clinical Biochemistry, (ACB), British Thyroid Foundation, (BTF), Royal College of Physicians (RCP) and Society for Endocrinology (SFE). PMID:26010808

  10. Dispensers, obeah and quackery: medical rivalries in post-slavery British Guiana.

    Science.gov (United States)

    De Barros, Juanita

    2007-08-01

    This paper examines the ambiguous place of medical assistants-dispensers-in a post-slavery British Caribbean colony, British Guiana, from the end of slavery in the 1830s to the early twentieth century. Although the latter were crucial to the functioning of the colonial medical system, local physicians resented them, complaining about the economic threat they posed and at times condemning them as quacks. These attacks were part of a wider discussion about the composition of the medical profession and the role of medical auxiliaries in colonial society, and to an extent, they echoed debates conducted in other jurisdictions in this period. But in the British Caribbean, this discussion was significantly different. There, long-standing views about obeah-an Afro-Creole medico-religious practice-as a particularly dangerous and uncivilised type of quackery was part of the discursive context. That those participating in this debate included African-descended physicians whose arrival in the medical profession was recent and contested demonstrates the vexed and complex nature of professionalisation in a post-slavery society.

  11. [Margot Jefferys: the British voice of medical sociology].

    Science.gov (United States)

    Nunes, Everardo Duarte

    2011-03-01

    Margot Jefferys (1916-1999) was not only the person who introduced medical sociology into Great Britain, but also the researcher and professor who, during thirty years, exerted the most deep influence on the teaching of health social sciences either in undergraduate or especially graduate studies, since the beginning of her career, in 1953, at the London School of Hygiene and Tropical Medicine. In addition to create a global panorama concerning the Jefferys' works, this study highlights two texts, which are situated into the field we are researching: the history of health sociology. The first one, published in 1991, discusses the relationships between epidemiology and sociology; and the second, published in 1996, discusses the field of medical sociology. Both texts are a series of considerations regarding the Jefferys' thought and the more recent questions of the field in Great Britain.

  12. Union-Active School Librarians and School Library Advocacy: A Modified Case Study of the British Columbia Teacher-Librarians' Association and the British Columbia Teachers' Federation

    Science.gov (United States)

    Ewbank, Ann Dutton

    2015-01-01

    This modified case study examines how the members of the British Columbia Teacher-Librarians' Association (BCTLA), a Provincial Specialist Association (PSA) of the British Columbia Teachers' Federation (BCTF), work together to advocate for strong school library programs headed by a credentialed school librarian. Since 2002, despite nullification…

  13. British Association of Clinical Anatomists: Abstracts of papers presented at the Annual General Meeting, 1983

    OpenAIRE

    1983-01-01

    The Annual General Meeting of the British Association of Clinical Anatomists for 1983 was held at the Royal College of Surgeons of England on 14th January 1983. The following are abstracts of the papers presented.

  14. American Medical Association

    Science.gov (United States)

    ... Medicare & Medicaid Private Payer Reform Claims Processing & Practice Revenue HIPAA Compliance Medical Liability Reform Delivering Care Delivering ... factors to consider before adopting a peer-comparison model designed to guide physicians toward improving the value ...

  15. Exploring Brand Associations and the Impact it has on Generation Y British-Indians and Non-British Indians: A Study of Luxury Fashion Brands

    OpenAIRE

    Sashidharan, Nisha

    2011-01-01

    Aim of the Project The main aim of the project is to explore the role of brand associations and conduct a comparative study to see the impact it has on the generation Y British Indian and Non-British Indian consumers purchasing luxury fashion brands. The three type of brand associations that would be tested are: product attributes, brand personality and country of origin. Methodology The methodology consisted of qualitative research, by which data was collected using semi-structur...

  16. [Experiments on living subjects: the vivisection debate in German and British medical weekly journals 1919-1939].

    Science.gov (United States)

    Lisner, Wiebke

    2009-01-01

    By the end of the 1920s, animal experiments were considered a standardized procedure for testing medical substances and therapies. In the context of the so-called "crisis of medicine", however, some physicians and the wider lay public in Germany and Great Britain criticized animal based research. While British antivivisectionists had little relevance in the 1930s, their German counterparts allied with the National Socialist Party and gained social and political force. The debates within the German and British medical profession about doctors' interventions in that debate, as well as the public perception of doctors will be analysed on the basis of the most important medical weekly journals of the time, that were involved in these debates. PMID:19746883

  17. Prevalence of masturbation and associated factors in a British national probability survey

    OpenAIRE

    Gerressu, Makeda; Mercer, Catherine H; Graham, Cynthia A.; Wellings, Kaye; Johnson, Anne M

    2008-01-01

    A stratified probability sample survey of the British general population, aged 16 to 44 years, was conducted from 1999 to 2001 (N = 11,161) using face-to-face interviewing and computer-assisted self-interviewing. We used these data to estimate the population prevalence of masturbation, and to identify sociodemographic, sexual behavioral, and attitudinal factors associated with reporting this behavior. Seventy-three percent of men and 36.8% of women reported masturbating in the 4 weeks prior t...

  18. Clinical practice with anti-dementia drugs: a consensus statement from British Association for Psychopharmacology.

    Science.gov (United States)

    Burns, Alistair; O'Brien, John; Auriacombe, Sophie; Ballard, Clive; Broich, Karl; Bullock, Roger; Feldman, Howard; Ford, Gary; Knapp, Martin; McCaddon, Andrew; Iliffe, Steve; Jacova, Claudia; Jones, Roy; Lennon, Sean; McKeith, Ian; Orgogozo, Jean-Marc; Purandare, Nitin; Richardson, Mervyn; Ritchie, Craig; Thomas, Alan; Warner, James; Wilcock, Gordon; Wilkinson, David

    2006-11-01

    The British Association for Psychopharmacology (BAP) coordinated a meeting of experts to review the evidence on the drug treatment for dementia. The level of evidence (types) was rated using a standard system: Types 1a and 1b (evidence from meta-analysis of randomised controlled trials or at least one controlled trial respectively); types 2a and 2b (one well-designed study or one other type of quasi experimental study respectively); type 3 (non-experimental descriptive studies); and type 4 (expert opinion). There is type 1a evidence for cholinesterase inhibitors (donepezil, rivastigmine and galantamine) for mild to moderate Alzheimer's disease; memantine for moderate to severe Alzheimer's disease; and for the use of bright light therapy and aromatherapy. There is type 1a evidence of no effect of anti inflammatory drugs or statins. There is conflicting evidence regarding oestrogens, with type 2a evidence of a protective effect of oestrogens but 1b evidence of a harmful effect. Type 1a evidence for any effect of B12 and folate will be forthcoming when current trials report. There is type 1b evidence for gingko biloba in producing a modest benefit of cognitive function; cholinesterase inhibitors for the treatment of people with Lewy body disease (particularly neuropsychiatric symptoms); cholinesterase inhibitors and memantine in treatment cognitive impairment associated with vascular dementia; and the effect of metal collating agents (although these should not be prescribed until more data on safety and efficacy are available). There is type 1b evidence to show that neither cholinesterase inhibitors nor vitamin E reduce the risk of developing Alzheimer's disease in people with mild cognitive impairment; and there is no evidence that there is any intervention that can prevent the onset of dementia. There is type 1b evidence for the beneficial effects of adding memantine to cholinesterase inhibitors, and type 2b evidence of positive switching outcomes from one

  19. Measuring Maturity of Use for Electronic Medical Records (EMRs) in British Columbia: The Physician Information Technology Office (PITO).

    Science.gov (United States)

    Rimmer, Carol; Hagens, Simon; Baldwin, Anne; Anderson, Carol J

    2014-01-01

    This article examines British Columbia (BC)'s Physician Information Technology Office's efforts to measure and improve the use of electronic medical records (EMRs) by select practices in BC with an assessment of their progress using a maturity model, and targeted support. The follow-up assessments showed substantial increases in the physicians' scores resulting from action plans that comprised a series of tailored support activities. Specifically, there was an increase from 21% to 83% of physicians who could demonstrate that they used their EMRs as the principal method of record-keeping.

  20. Protestants, Catholics, and Masonic Conspiracies: The British Association in Montreal (1884).

    Science.gov (United States)

    Toal, Ciaran

    2016-03-01

    The British Association for the Advancement of Science (BAAS), like many nineteenth-century institutions, sought to avoid controversy by excluding the discussion of political and religious topics from its proceedings. Nonpartisanship was a veneer it could hide behind. Yet during the Montreal meeting of 1884-the first time the association ventured beyond the comfortable confines of the British Isles-this "middle way" was tested. While local and visiting Anglophones, many of them BAAS members, viewed the proceedings and character of the association as "decidedly friendly" to religion and as promoting the broad interests of Protestants, Montreal's episcopacy and French-speaking press rallied against the anti-Catholic BAAS, accusing it of harboring a dangerous Masonic clique. In different material and social spaces, the relationship between science, religion, and the association was conceived in distinct ways. In examining this case, this essay seeks to augment the growing body of scholarship within science studies that recognizes the importance of writing both the history and the geography of encounters between science and religion. PMID:27197410

  1. Problem Gambling Treatment within the British National Health Service

    Science.gov (United States)

    Rigbye, Jane; Griffiths, Mark D.

    2011-01-01

    According to the latest British Gambling Prevalence Survey, there are approximately 300,000 adult problem gamblers in Great Britain. In January 2007, the "British Medical Association" published a report recommending that those experiencing gambling problems should receive treatment via the National Health Service (NHS). This study examines the…

  2. [The centenary of the Israel Medical Association].

    Science.gov (United States)

    Levy, Nissim

    2012-01-01

    On January 12th 1912, six Jewish physicians and one pharmacist assembled in Tel-Aviv to proclaim the founding of the Jaffa Hebrew Medical Society. One year later the Jewish doctors of Jerusalem established the "Society of Hebrew Speaking Physicians". On 28th December, 1918 a few weeks after the end of World War 1, both organizations merged into the Hebrew Medical Association which later became the Israel Medical Association (I.M.A.). The Association played a leading role in the advancement of medicine in the Holy Land and was instrumental in imposing the Hebrew medical terminology in the newly founded State of Israel.

  3. From medical astrology to medical astronomy: sol-lunar and planetary theories of disease in British medicine, c. 1700-1850.

    Science.gov (United States)

    Harrison, M

    2000-03-01

    After 1700, astrology lost the respect it once commanded in medical circles. But the belief that the heavens influenced bodily health persisted - even in learned medicine - until well into the nineteenth century. The continuing vitality of these ideas owed much to the new empirical and mechanical outlook of their proponents. Taking their cue from the work of Robert Boyle and Richard Mead, a number of British practitioners amassed statistical evidence which purported to prove the influence of the Moon upon fevers and other diseases. Such ideas flourished in the colonies and in the medical services of the armed forces, but their exponents were not marginal men. Some, like James Lind, were widely respected and drew support for their views from such influential figures as Erasmus Darwin.

  4. Gay and Lesbian Medical Association

    Science.gov (United States)

    ... Click here to learn more. GLMA and Other Associations Speak Out On Religious Freedom Laws As the Governors of and legislators in Arkansas and Indiana work to address the concerns about how religious freedom ... professional associations to join a letter sharing their perspectives as ...

  5. (Re-)reading medical trade catalogs: the uses of professional advertising in British medical practice, 1870-1914.

    Science.gov (United States)

    Jones, Claire L

    2012-01-01

    This article explores how medical practitioners read, used, and experienced medical trade catalogs in late-nineteenth- and early-twentieth-century Britain. Reader responses to the catalog, a book-like publication promoting medical tools, appliances, and pharmaceuticals, have been chronically understudied, as have professional reading practices within medicine more generally. Yet, evidence suggests that clinicians frequently used the catalog and did so in three main ways: to order medical products, to acquire new information about these products, and to display their own product endorsements and product designs. The seemingly widespread nature of these practices demonstrates an individual and collective professional desire to improve medical practice and highlights the importance of studying professional reading practices in the cultural history of medicine. PMID:23241910

  6. Teratogenic Mechanisms Associated with Prenatal Medication Exposure

    NARCIS (Netherlands)

    van Gelder, Marleen M. H. J.; van Rooijl, Iris A. L. M.; de Jong-van den Berg, Lolkje T. W.; Roeleveld, Nel

    2014-01-01

    Birth defects may originate through multiple mechanisms and may be caused by a variety of possible exposures, including medications in early pregnancy. In this review, we describe six principal teratogenic mechanisms suspected to be associated with medication use: folate antagonism, neural crest cel

  7. 2005 Distinguished Academician Lecture: Evolution of postgraduate medical education in Singapore--role of professional associations.

    Science.gov (United States)

    Shanmugaratnam, K

    2005-12-01

    From 1910 to 1945, doctors in Singapore received postgraduate training through apprenticeship. During the early post-war period, some doctors in the public service were given scholarships to study in Britain and to obtain higher professional qualifications from the British Royal Colleges. The events that most influenced subsequent development of postgraduate education in Singapore occurred between 1956 and 1969: the formation of the Academy of Medicine and the Singapore Medical Association (SMA); organisation of courses for candidates preparing for examinations of the Royal Australasian and British Colleges; competition between the Academy and the University over responsibility for postgraduate medical education; the inauguration of the School of Postgraduate Medical Studies (SPMS); and the introduction of Master of Medicine (M Med) degrees in various medical specialties. From 1970 to 1999, there was expansion in several aspects of postgraduate medical education: SPMS awarded more than 2000 M Med degrees; the Singapore Medical Council (SMC) established a Register of Specialists and formed a Specialist Accreditation Board; the Academy formed Chapters in 10 specialties and developed Advanced Specialty Training programmes leading to Fellowship of the Academy of Medicine Singapore (FAMS); the SMA formed Societies in some 20 specialties; and a College of Family Physicians was inaugurated. There have been more developments from 2000 to 2005: the University restructured SPMS as a Division of Graduate Medical Studies within the Faculty of Medicine; the SMC implemented compulsory Continuing Medical Education; and the Academy converted 6 of its 10 Chapters into Colleges. PMID:16453040

  8. Geochemistry of coal and associated sedimentary rocks from Elk Valley Coalfield, British Columbia, Canada

    Energy Technology Data Exchange (ETDEWEB)

    Goodarzi, F.; Cameron, A.R.; Labonte, M.; Grieve, D.A.; Beaton, A.P. (Geological Survey of Canada, Calgary, AB (Canada). Institute of Sedimentary and Petroleum Geology)

    1992-01-01

    This report is on analysis of coal seams in the Elk Valley Coalfield of British Columbia for their maceral composition, using reflected light and geochemistry. Detailed elemental analysis were carried out.

  9. Making Kew Observatory: the Royal Society, the British Association and the politics of early Victorian science.

    Science.gov (United States)

    Macdonald, Lee T

    2015-09-01

    Built in 1769 as a private observatory for King George III, Kew Observatory was taken over in 1842 by the British Association for the Advancement of Science (BAAS). It was then quickly transformed into what some claimed to be a 'physical observatory' of the sort proposed by John Herschel - an observatory that gathered data in a wide range of physical sciences, including geomagnetism and meteorology, rather than just astronomy. Yet this article argues that the institution which emerged in the 1840s was different in many ways from that envisaged by Herschel. It uses a chronological framework to show how, at every stage, the geophysicist and Royal Artillery officer Edward Sabine manipulated the project towards his own agenda: an independent observatory through which he could control the geomagnetic and meteorological research, including the ongoing 'Magnetic Crusade'. The political machinations surrounding Kew Observatory, within the Royal Society and the BAAS, may help to illuminate the complex politics of science in early Victorian Britain, particularly the role of 'scientific servicemen' such as Sabine. Both the diversity of activities at Kew and the complexity of the observatory's origins make its study important in the context of the growing field of the 'observatory sciences'. PMID:26256312

  10. Chasing the dragon - characterizing cases of leukoencephalopathy associated with heroin inhalation in British Columbia

    Directory of Open Access Journals (Sweden)

    Angus Natalie

    2011-01-01

    Full Text Available Abstract An association between leukoencephalopathy, a disease of the white matter of the brain, and smoking heroin is well recognized. This paper describes 27 cases of leukoencephalopathy identified in two cities in British Columbia, Canada 2001-2006; the largest number of geographically and temporally defined reported cases in North America. Twenty cases of leukoencephalopathy were identified in and around Vancouver with onset dates December 2001 to July 2003; seven further cases were identified in Victoria September 2005-August 2006. Twenty (74% of all cases were male, two couples were reported and eleven cases (55% had Asian ethnicity. One case reported smoking heroin on a single occasion and developed mild symptoms; all other cases were hospitalized. Thirteen (48% cases died; all had smoked heroin for a minimum of 3 years. Testing of one available heroin sample identified no substance other than common cutting agents. Although a specific etiology was not identified our study supports the theory of an intermittent exposure to a toxic agent added to the heroin or a combustion by-product. It also suggests a dose response effect rather than genetic predisposition. Collaboration with public health, health professionals, law enforcement and persons who use illegal drugs, will facilitate the early identification of cases to enable timely and complete follow-up including obtaining samples. Testing of implicated heroin samples may allow identification of the contaminant and therefore prevent further cases. It is therefore important to ensure key stakeholders are aware of our findings.

  11. Therapeutic drug monitoring (TDM) of antifungal agents: guidelines from the British Society for Medical Mycology

    OpenAIRE

    Ashbee, H. Ruth; Barnes, Rosemary A.; Johnson, Elizabeth M.; Richardson, Malcolm D.; Gorton, Rebecca; Hope, William W.

    2013-01-01

    The burden of human disease related to medically important fungal pathogens is substantial. An improved understanding of antifungal pharmacology and antifungal pharmacokinetics–pharmacodynamics has resulted in therapeutic drug monitoring (TDM) becoming a valuable adjunct to the routine administration of some antifungal agents. TDM may increase the probability of a successful outcome, prevent drug-related toxicity and potentially prevent the emergence of antifungal drug resistance. Much of the...

  12. Functional Movement Is Negatively Associated with Weight Status and Positively Associated with Physical Activity in British Primary School Children

    Directory of Open Access Journals (Sweden)

    Michael J. Duncan

    2012-01-01

    Full Text Available Although prior studies have suggested that overweight and obesity in childhood are associated with poorer functional movement performance, no study appears to have examined this issue in a pediatric population. The relations between BMI, ambulatory physical activity and functional movement screen (FMS performance were compared in 58, 10-11-year-old children. Total FMS score was significantly, negatively correlated with BMI (=.0001 and positively related to PA (=.029. Normal weight children scored significantly better for total FMS score compared to children classified as overweight/obese (=.0001. Mean ± S.D. of FMS scores were 15.5±2.2 and 10.6±2.1 in normal weight and overweight/obese children, respectively. BMI and PA were also significant predictors of functional movement (=.0001, Adjusted 2=.602 with BMI and PA predicting 52.9% and 7.3% of the variance in total FMS score, respectively. The results of this study highlight that ambulatory physical activity and weight status are significant predictors of functional movement in British children. Scientists and practitioners therefore need to consider interventions which develop functional movement skills alongside physical activity and weight management strategies in children in order to reduce the risks of orthopaedic abnormality arising from suboptimal movement patterns in later life.

  13. 2016 Laboratory guidelines for postvasectomy semen analysis: Association of Biomedical Andrologists, the British Andrology Society and the British Association of Urological Surgeons.

    Science.gov (United States)

    Hancock, P; Woodward, B J; Muneer, A; Kirkman-Brown, J C

    2016-07-01

    Post-vasectomy semen analysis (PVSA) is the procedure used to establish whether sperm are present in the semen following a vasectomy. PVSA is presently carried out by a wide variety of individuals, ranging from doctors and nurses in general practitioner (GP) surgeries to specialist scientists in andrology laboratories, with highly variable results.Key recommendations are that: (1) PVSA should take place a minimum of 12 weeks after surgery and after a minimum of 20 ejaculations. (2) Laboratories should routinely examine samples within 4 h of production if assessing for the presence of sperm. If non-motile sperm are observed, further samples must be examined within 1 h of production. (3) Assessment of a single sample is acceptable to confirm vasectomy success if all recommendations and laboratory methodology are met and no sperm are observed. Clearance can then be given. (4) The level for special clearance should be methods contained within these guidelines. Surgeons are responsible both preoperatively and postoperatively for the counselling of patients and their partners regarding complications and the possibility of late recanalisation after clearance. These 2016 guidelines replace the 2002 British Andrology Society (BAS) laboratory guidelines and should be regarded as definitive for the UK in the provision of a quality PVSA service, accredited to ISO 15189:2012, as overseen by the United Kingdom Accreditation Service (UKAS). PMID:27083211

  14. Teratogenic mechanisms associated with prenatal medication exposure.

    Science.gov (United States)

    van Gelder, Marleen M H J; van Rooij, Iris A L M; de Jong-van den Berg, Lolkje T W; Roeleveld, Nel

    2014-01-01

    Birth defects may originate through multiple mechanisms and may be caused by a variety of possible exposures, including medications in early pregnancy. In this review, we describe six principal teratogenic mechanisms suspected to be associated with medication use: folate antagonism, neural crest cell disruption, endocrine disruption, oxidative stress, vascular disruption, and specific receptor- or enzyme-mediated teratogenesis. Knowledge about these mechanisms, for some of which evidence is mainly derived from animal models, may not only be relevant for etiologic and post-marketing research, but may also have implications for prescribing behavior for women of reproductive age. Since combinations of seemingly unrelated medications may have effects through similar teratogenic mechanisms, the risk of birth defects may be strongly increased in multi-therapy. PMID:24698184

  15. [Croatian Medical Association--Branch Zagreb].

    Science.gov (United States)

    Kaić, Zvonimir; Sain, Snjezana; Gulić, Mirjana; Mahovlić, Vjekoslav; Krznarić, Zeljko

    2014-01-01

    The available literature shows us that "Druztvo ljeciteljah u Zagrebus (the Society of Healers in Zagreb) was founded as far back as the year 1845 by a total of thirteen members. This data allows us to follow the role of doctors and health workers in Zagreb through their everyday profession, research, organizational and social work as well as management through a period of over one hundred to seventy years. The Branch Zagreb was active before the official establishment of subsidiaries of CMA which is evident from the minutes of the regular annual assembly of the Croatian Medical Association on 21 March 1948. Until the end of 1956, there was no clear division of labor, functions and competencies between the Branch and the Main Board. Their actions were instead consolidated and the Branch operated within and under the name of Croatian Medical Association. In that year the Branch became independent. The Branch Zagreb is the largest and one of the most active branches of the Croatian Medical Association. At the moment, the Branch brings together 3621 members, regular members--doctors of medicine (2497), doctors of dental medicine (384), retired physicians (710), and associate members (30 specialists with higher education who are not doctors). The Branch is especially accomplished in its activities in the area of professional development of its members and therefore organizes a series of scientific conferences in the framework of continuous education of physicians, allowing its members to acquire necessary points for the extension of their operating license. The choir "Zagrebacki lijecnici pjevaci" (Zagreb Physicians' Choir) of the Croatian Medical Music Society of the CMA and its activities are inseparable from the Branch Zagreb. The Branch is firmly linked to the parent body, the CMA, and thus has a visible impact on the strategy and the activities of the Association as a whole. Most professional societies of the CMA have their headquarters in Zagreb and this is

  16. The emerging Medical and Geological Association.

    Science.gov (United States)

    Finkelman, R.B.; Centeno, J.A.; Selinus, O.

    2005-01-01

    The impact on human health by natural materials such as water, rocks, and minerals has been known for thousands of years but there have been few systematic, multidisciplinary studies on the relationship between geologic materials and processes and human health (the field of study commonly referred to as medical geology). In the past few years, however, there has been a resurgence of interest in medical geology. Geoscientists working with medical researchers and public health scientists have made important contributions to understanding novel exposure pathways and causes of a wide range of environmental health problems such as: exposure to toxic levels of trace essential and non-essential elements such as arsenic and mercury; trace element deficiencies; exposure to natural dusts and to radioactivity; naturally occurring organic compounds in drinking water; volcanic emissions, etc. By linking with biomedical/public health researchers geoscientists are finally taking advantage of this age-old opportunity to help mitigate environmental health problems. The International Medical Geology Association has recently been formed to support this effort.

  17. Beverage consumption habits “24/7” among British adults: association with total water intake and energy intake

    OpenAIRE

    Gibson Sigrid; Shirreffs Susan M

    2013-01-01

    Abstract Background Various recommendations exist for total water intake (TWI), yet it is seldom reported in dietary surveys. Few studies have examined how real-life consumption patterns, including beverage type, variety and timing relate to TWI and energy intake (EI). Methods We analysed weighed dietary records from the National Diet and Nutrition Survey of 1724 British adults aged 19–64 years (2000/2001) to investigate beverage consumption patterns over 24 hrs and 7 days and associations wi...

  18. Association of PrP genotype with lamb production traits in four commercial breeds of British upland sheep

    OpenAIRE

    Boulton, Kay; Moore, R C; Bishop, S. C.

    2010-01-01

    Selection of sheep on PrP genotype to reduce risks of classical scrapie outbreaks is now widespread in the British sheep industry. However a recurring concern from breeders is that PrP genotype may be unfavourably associated with lamb performance. In this study we report the results from our investigations into this claim using performance data from 12,673 PrP genotyped lambs in four breeds of upland and crossing sheep: Beulah (4014), Blue Faced Leicester (725), Lleyn (5208) and North Country...

  19. Supporting medical education research quality: the Association of American Medical Colleges' Medical Education Research Certificate program.

    Science.gov (United States)

    Gruppen, Larry D; Yoder, Ernie; Frye, Ann; Perkowski, Linda C; Mavis, Brian

    2011-01-01

    The quality of the medical education research (MER) reported in the literature has been frequently criticized. Numerous reasons have been provided for these shortcomings, including the level of research training and experience of many medical school faculty. The faculty development required to improve MER can take various forms. This article describes the Medical Education Research Certificate (MERC) program, a national faculty development program that focuses exclusively on MER. Sponsored by the Association of American Medical Colleges and led by a committee of established medical education researchers from across the United States, the MERC program is built on a set of 11 interactive workshops offered at various times and places across the United States. MERC participants can customize the program by selecting six workshops from this set to fulfill requirements for certification. This article describes the history, operations, current organization, and evaluation of the program. Key elements of the program's success include alignment of program content and focus with needs identified by prospective users, flexibility in program organization and logistics to fit participant schedules, an emphasis on practical application of MER principles in the context of the participants' activities and interests, consistency in program content and format to ensure standards of quality, and a sustainable financial model. The relationship between the national MERC program and local faculty development initiatives is also described. The success of the MERC program suggests that it may be a possible model for nationally disseminated faculty development programs in other domains.

  20. Evidence-based guidelines for the pharmacological treatment of schizophrenia: recommendations from the British Association for Psychopharmacology.

    Science.gov (United States)

    Barnes, Thomas R E

    2011-05-01

    These guidelines from the British Association for Psychopharmacology address the scope and targets of pharmacological treatment for schizophrenia. A consensus meeting, involving experts in schizophrenia and its treatment, reviewed key areas and considered the strength of evidence and clinical implications. The guidelines were drawn up after extensive feedback from the participants and interested parties, and cover the pharmacological management and treatment of schizophrenia across the various stages of the illness, including first-episode, relapse prevention, and illness that has proved refractory to standard treatment. The practice recommendations presented are based on the available evidence to date, and seek to clarify which interventions are of proven benefit. It is hoped that the recommendations will help to inform clinical decision making for practitioners, and perhaps also serve as a source of information for patients and carers. They are accompanied by a more detailed qualitative review of the available evidence. The strength of supporting evidence for each recommendation is rated.

  1. Trends in asthma-related direct medical costs from 2002 to 2007 in British Columbia, Canada: a population based-cohort study.

    Directory of Open Access Journals (Sweden)

    Pierrick Bedouch

    Full Text Available BACKGROUND: Asthma-related health resource use and costs may be influenced by increasing asthma prevalence, changes to asthma management guidelines, and new medications over the last decade. The objective of this work was to analyze direct asthma-related medical costs, and trends in total and per-patient costs of hospitalizations, physician visits, and medications. METHODS: A cohort of asthma patients from British Columbia (BC, Canada, was created. Asthma patients were identified using a validated case definition. Costs for hospitalizations, physician visits, and medications were calculated from billing records (in 2008 Canadian dollars. Trends in total and per-patient costs over the study period were analyzed using Generalized Linear Models. RESULTS: 398,235 patients satisfied the asthma case definition (mid-point prevalence 8.0%. Patients consumed $315.9 million (M in direct asthma-related health resources between 2002 and 2007. Hospitalizations, physician visits, and medication costs accounted for 16.0%, 15.7% and 68.2% of total costs, respectively. Cost of asthma increased from $49.4 M in 2002 to $54.7 M in 2007. Total annual costs attributable to hospitalizations and physician visits decreased (-39.8% and -25.5%, respectively; p<0.001, while medication costs increased (+38.7%; p<0.001. INTERPRETATION: This population-based analysis shows that the total direct cost of asthma in BC has increased since 2002, mainly due to a rise in asthma prevalence and cost of medication. Combination therapy with inhaled corticosteroids/long-acting beta-agonists has become a significant component of the cost of asthma. Although billing records capture only a fraction of the true burden of asthma, the simultaneous increase in medication costs and reductions in hospitalization and physician visit costs provides valuable insight for policy makers into the shifts in asthma-related resource use.

  2. Regional scale selenium loading associated with surface coal mining, Elk Valley, British Columbia, Canada.

    Science.gov (United States)

    Wellen, Christopher C; Shatilla, Nadine J; Carey, Sean K

    2015-11-01

    Selenium (Se) concentrations in surface water downstream of surface mining operations have been reported at levels in excess of water quality guidelines for the protection of wildlife. Previous research in surface mining environments has focused on downstream water quality impacts, yet little is known about the fundamental controls on Se loading. This study investigated the relationship between mining practices, stream flows and Se concentrations using a SPAtially Referenced Regression On Watershed attributes (SPARROW) model. This work is part of a R&D program examining the influence of surface coal mining on hydrological and water quality responses in the Elk Valley, British Columbia, Canada, aimed at informing effective management responses. Results indicate that waste rock volume, a product of mining activity, accounted for roughly 80% of the Se load from the Elk Valley, while background sources accounted for roughly 13%. Wet years were characterized by more than twice the Se load of dry years. A number of variables regarding placement of waste rock within the catchments, length of buried streams, and the construction of rock drains did not significantly influence the Se load. The age of the waste rock, the proportion of waste rock surface reclaimed, and the ratio of waste rock pile side area to top area all varied inversely with the Se load from watersheds containing waste rock. These results suggest operational practices that are likely to reduce the release of Se to surface waters.

  3. Regional scale selenium loading associated with surface coal mining, Elk Valley, British Columbia, Canada.

    Science.gov (United States)

    Wellen, Christopher C; Shatilla, Nadine J; Carey, Sean K

    2015-11-01

    Selenium (Se) concentrations in surface water downstream of surface mining operations have been reported at levels in excess of water quality guidelines for the protection of wildlife. Previous research in surface mining environments has focused on downstream water quality impacts, yet little is known about the fundamental controls on Se loading. This study investigated the relationship between mining practices, stream flows and Se concentrations using a SPAtially Referenced Regression On Watershed attributes (SPARROW) model. This work is part of a R&D program examining the influence of surface coal mining on hydrological and water quality responses in the Elk Valley, British Columbia, Canada, aimed at informing effective management responses. Results indicate that waste rock volume, a product of mining activity, accounted for roughly 80% of the Se load from the Elk Valley, while background sources accounted for roughly 13%. Wet years were characterized by more than twice the Se load of dry years. A number of variables regarding placement of waste rock within the catchments, length of buried streams, and the construction of rock drains did not significantly influence the Se load. The age of the waste rock, the proportion of waste rock surface reclaimed, and the ratio of waste rock pile side area to top area all varied inversely with the Se load from watersheds containing waste rock. These results suggest operational practices that are likely to reduce the release of Se to surface waters. PMID:26136156

  4. British medical students suffer an inordinate amount of stress compared to other university students: fact or fiction?

    OpenAIRE

    Shah S

    2015-01-01

    Savan Shah Faculty of Medicine, Imperial College London, London, UKHigh levels of stress in medical students are a commonly accepted phenomenon within the medical education community and as a result medical schools are often arraigned for not doing enough.1 Several studies in the UK have reported that medical students suffer significantly higher levels of stress than the age-matched general population.1 However, it can be argued that comparisons with the general population are misleading. All...

  5. Impairments, activity limitations and participation restrictions: Prevalence and associations among persons living with HIV/AIDS in British Columbia

    Directory of Open Access Journals (Sweden)

    Braitstein Paula

    2004-09-01

    Full Text Available Abstract Background To measure the prevalence of and associations among impairments, activity limitations and participation restrictions in persons living with HIV in British Columbia to inform support and care programs, policy and research. Methods A cross-sectional population-based sample of persons living with HIV in British Columbia was obtained through an anonymous survey sent to members of the British Columbia Persons With AIDS Society. The survey addressed the experience of physical and mental impairments, and the experience and level of activity limitations and participation restrictions. Associations were measured in three ways: 1 impact of types of impairment on social restriction; 2 impact of specific limitations on social restriction; and 3 independent association of overall impairments and limitations on restriction levels. Logistic regression was used to measure associations with social restriction, while ordinal logistic regression was used to measure associations with a three-category measure of restriction level. Results The survey was returned by 762 (50.5% of the BCPWA participants. Over ninety percent of the population experienced one or more impairments, with one-third reporting over ten. Prevalence of activity limitations and participation restrictions was 80.4% and 93.2%, respectively. The presence of social restrictions was most closely associated with mental function impairments (OR: 7.0 for impairment vs. no impairment; 95% CI: 4.7 – 10.4. All limitations were associated with social restriction. Among those with ≤ 200 CD4 cells/mm3, odds of being at a higher restriction level were lower among those on antiretrovirals (OR: 0.3 for antiretrovirals vs. no antiretrovirals; 95% CI: 0.1–0.9, while odds of higher restriction were increased with higher limitation (OR: 3.6 for limitation score of 1–5 vs. no limitation, 95%CI: 0.9–14.2; OR: 24.7 for limitation score > 5 vs. no limitation, 95%CI: 4.9–125.0. Among those

  6. Climatic associations of British species distributions show good transferability in time but low predictive accuracy for range change.

    Directory of Open Access Journals (Sweden)

    Giovanni Rapacciuolo

    Full Text Available Conservation planners often wish to predict how species distributions will change in response to environmental changes. Species distribution models (SDMs are the primary tool for making such predictions. Many methods are widely used; however, they all make simplifying assumptions, and predictions can therefore be subject to high uncertainty. With global change well underway, field records of observed range shifts are increasingly being used for testing SDM transferability. We used an unprecedented distribution dataset documenting recent range changes of British vascular plants, birds, and butterflies to test whether correlative SDMs based on climate change provide useful approximations of potential distribution shifts. We modelled past species distributions from climate using nine single techniques and a consensus approach, and projected the geographical extent of these models to a more recent time period based on climate change; we then compared model predictions with recent observed distributions in order to estimate the temporal transferability and prediction accuracy of our models. We also evaluated the relative effect of methodological and taxonomic variation on the performance of SDMs. Models showed good transferability in time when assessed using widespread metrics of accuracy. However, models had low accuracy to predict where occupancy status changed between time periods, especially for declining species. Model performance varied greatly among species within major taxa, but there was also considerable variation among modelling frameworks. Past climatic associations of British species distributions retain a high explanatory power when transferred to recent time--due to their accuracy to predict large areas retained by species--but fail to capture relevant predictors of change. We strongly emphasize the need for caution when using SDMs to predict shifts in species distributions: high explanatory power on temporally-independent records

  7. International Medical Geology Association (IMGA) formed

    Institute of Scientific and Technical Information of China (English)

    Olle Selinus; Jose Centeno; Robert Finkelman

    2006-01-01

    @@ "Medical Geology" is defined as the science dealing with the relationship between natural geological factors and health problems in man and animals and understanding the influence of ordinary environmental factors on the geographical distribution of such health problems. Medical Geology is therefore a broad and complicated subject and if the problems to be addressed are to be understood, mitigated, or resolved, it will require interdisciplinary contributions from different scientific fields (involving geo-scientists,medical scientists, health professionals, veterinarians, and biologists, etc.). Medical Geology involves the whole geo-sphere and can be considered as dealing with ecosystem health.

  8. Analysis of risk factors associated with hepatitis B and C infection in correctional institutions in British Columbia.

    Science.gov (United States)

    Préfontaine, R; Chaudhary, R; Mathias, R

    1994-07-01

    The factors associated with infection with hepatitis B (hbv) and C viruses (hcv) were studied in residents of correctional institutions in British Columbia. Four hundred and fifteen residents volunteered to participate in this study. Among 415 residents tested, 28% were positive for hvb or hcv markers. Sixty-five per cent of the residents positive for hbv markers were also infected with hcv. However, in hbv-negative residents, only 14% were positive for antibody to hcv (anti-hcv). The highest rates for hbv and hcv were in 25- to 44-year-old residents. The analysis of risk factors and infection predictors in 354 residents showed that intravenous drug use and history of hepatitis were associated with infection with both hbv and hcv. The relative risk for hbv in intravenous drug users was 4.4 times that in nonusers; for hcv relative risk was 3.4 times. In the group with history of hepatitis, the relative risk was 6.2 and 4.5 times for hbv and hcv, respectively. The multivariate analysis of the data showed that both intravenous drug use and a history of hepatitis were significant (P<0.0001). Tattooing or history of transfusion was not associated with increased risk for hcv, but tattooing and age were significant factors for hbv. PMID:22346493

  9. Sediment-associated aliphatic and aromatic hydrocarbons in coastal British Columbia, Canada: Concentrations, composition, and associated risks to protected sea otters

    International Nuclear Information System (INIS)

    Sediment-associated hydrocarbons can pose a risk to wildlife that rely on benthic marine food webs. We measured hydrocarbons in sediments from the habitat of protected sea otters in coastal British Columbia, Canada. Alkane concentrations were dominated by higher odd-chain n-alkanes at all sites, indicating terrestrial plant inputs. While remote sites were dominated by petrogenic polycyclic aromatic hydrocarbons (PAHs), small harbour sites within sea otter habitat and sites from an urban reference area reflected weathered petroleum and biomass and fossil fuel combustion. The partitioning of hydrocarbons between sediments and adjacent food webs provides an important exposure route for sea otters, as they consume ∼25% of their body weight per day in benthic invertebrates. Thus, exceedences of PAH sediment quality guidelines designed to protect aquatic biota at 20% of the sites in sea otter habitat suggest that sea otters are vulnerable to hydrocarbon contamination even in the absence of catastrophic oil spills. - Highlights: → Sediment hydrocarbon signatures differed between remote and impacted coastal sites. → A natural background comprised terrestrial plant alkanes and petrogenic PAHs. → Impacted sites reflected a history of petrogenic and pyrogenic hydrocarbon inputs. → Hydrocarbons at some sites exceeded guidelines for the protection of aquatic life. → Protected sea otters may thus be at risk as they rely primarily on benthic prey. - Anthropogenically-derived hydrocarbons in coastal sediments in British Columbia may pose a risk to protected sea otters.

  10. British medical students suffer an inordinate amount of stress compared to other university students: fact or fiction?

    Directory of Open Access Journals (Sweden)

    Shah S

    2015-04-01

    Full Text Available Savan Shah Faculty of Medicine, Imperial College London, London, UKHigh levels of stress in medical students are a commonly accepted phenomenon within the medical education community and as a result medical schools are often arraigned for not doing enough.1 Several studies in the UK have reported that medical students suffer significantly higher levels of stress than the age-matched general population.1 However, it can be argued that comparisons with the general population are misleading. All university students experience high levels of stress due to the demands of the course, a new environment and learning to manage financially, emotionally, and socially with less parental support. Therefore it is more pertinent to determine if medical students in the UK suffer greater levels of stress compared to age-matched peers in other university courses.

  11. Assessment of online visibility of the British Association of Oral and Maxillofacial Surgeons (BAOMS): a strategic study.

    Science.gov (United States)

    Abu-Serriah, M; Wong, L; Dhariwal, D; Banks, R J

    2014-02-01

    The Internet is a powerful method of acquiring and sharing information. In marketing and business, online visibility is vital for publicity and the reputation of an organisation. To our knowledge, the importance of such visibility in medicine in general, and in Oral and Maxillofacial Surgery (OMFS) services in the UK, has not previously been investigated. We aimed to provide a better understanding of the way that patients use the Internet by asking 450 patients to complete a questionnaire when they attended outpatient OMFS departments at 2 centres. We also assessed the online visibility of the British Association of Oral and Maxillofacial Surgeons (BAOMS) and investigated the correlation between the strength of online visibility and professional reputation. Results from the self-administered, anonymous, validated questionnaires showed that 82% of patients agreed that the Internet was a powerful source of information, and two-thirds associated online visibility with a good reputation. However, the perceived online visibility of the BAOMS was poor (2%). This study mirrors findings in business publications, and confirms the link between online visibility and professional reputation. It also shows that there is a gap between patients' perceptions and the level of uptake of professional resources. We propose various strategies to bridge this gap and to promote the online visibility and professional reputation of the BAOMS and of OMFS services in the UK.

  12. Hibernation-associated changes in persistent organic pollutant (POP) levels and patterns in British Columbia grizzly bears (ursus arctos horribilis).

    Science.gov (United States)

    Christensen, Jennie R; MacDuffee, Misty; Yunker, Mark B; Ross, Peter S

    2007-03-15

    We hypothesized that depleted fat reserves in grizzly bears (Ursus arctos horribilis) following annual hibernation would reveal increases in persistent organic pollutant (POP) concentrations compared to those present in the fall. We obtained fat and hair from British Columbia grizzly bears in early spring 2004 to compare with those collected in fall 2003, with the two tissue types providing contaminant and dietary information, respectively. By correcting for the individual feeding habits of grizzlies using a stable isotope-based approach, we found that polychlorinated biphenyls (sigmaPCBs) increased by 2.21x, polybrominated diphenylethers (sigmaPBDEs) increased by 1.58x, and chlordanes (sigmaCHL) by 1.49x in fat following hibernation. Interestingly, individual POPs elicited a wide range of hibernation-associated concentration effects (e.g., CB-153, 2.25x vs CB-169, 0.00x), resulting in POP pattern convergence in a PCA model of two distinct fall feeding groups (salmon-eating vs non-salmon-eating) into a single spring (post-hibernation) group. Our results suggest that diet dictates contaminant patterns during a feeding phase, while metabolism drives patterns during a fasting phase. This work suggests a duality of POP-associated health risks to hibernating grizzly bears: (1) increased concentrations of some POPs during hibernation; and (2) a potentially prolonged accumulation of water-soluble, highly reactive POP metabolites, since grizzly bears do not excrete during hibernation.

  13. Higher selenium status is associated with adverse blood lipid profile in British adults

    Science.gov (United States)

    Recent findings have raised concern about possible associations of high selenium exposure with diabetes and hyperlipidemia in the US, a population with high selenium status. In the UK, a population with lower selenium status, there is little data on the association of selenium status with cardio-met...

  14. Personality, behavior and environmental features associated with OXTR genetic variants in British mothers.

    Directory of Open Access Journals (Sweden)

    Jessica J Connelly

    Full Text Available It is assumed that the oxytocin receptor gene (OXTR is associated with factors that are related to features of reproduction as well as the currently emerging fields of mood and emotional response.We analysed data from over 8000 mothers who participated in the Avon Longitudinal Study of Parents and Children (ALSPAC. We determined reproductive, emotional and personality differences related to the two SNPs rs53576 and rs2254298 of the oxytocin receptor gene to determine whether there was evidence in this population for: (i associations with emotional and personality differences, and (ii behavioural or environmental links with these SNPs using a hypothesis free approach with over 1000 types of exposure.Our analyses of 7723 women showed that there were no differences in 11 mood, social or relationship characteristics associated with the rs2254298, and just one with rs53576 (with emotional loneliness--one statistically significant out of 22 tests is no more than would be expected by chance. There were no interactions with childhood abuse. Using a hypothesis-free approach we found few indicators of environmental or behavioural differences associated with rs2254298, but there was an excess of associations with eating habits with rs53576. The findings included an association with dieting to lose weight, and habits typical of bulimia for the women with GG. The nutrition of the women also showed negative associations of the GG genotype with 13 nutrients, including vitamins D, B12 and retinol, and intake of calcium, potassium and iodine.We conclude that this large database of pregnant women was unable to provide confirmation of the types of personality associated with these two OXTR SNPs, but we have shown some evidence of eating differences in those with GG on rs53576. Confirmation of our hypothesis free associations using other data sets is important.

  15. The diets of British schoolchildren. Sub-committee on Nutritional Surveillance. Committee on Medical Aspects of Food Policy.

    Science.gov (United States)

    1989-01-01

    1. Statistical analysis and interpretation 1.1 This Report deals with the dietary habits of British schoolchildren and the contribution made by school meals in 1983. Since then many Local Education Authorities have introduced active policies to encourage healthy eating, accompanied in the last 4 years by health promotion campaigns, in the light of the publication of the COMA Report on Diet and Cardiovascular Disease in 1984, and other reports on diet and health. 1.2 Data are presented on the food and nutrient intakes of a representative sample of British schoolchildren measured by a 7-day record. Most food and some nutrient intakes were not normally distributed and median values are given in the tables of results. Interpretation and commentary are restricted to findings which achieved statistical significance (p less than 0.05) by parametric analyses. No non-parametric statistical analyses were attempted but data are given in detail in the tables and for those wishing to examine them further, the computer database of the survey is also available through the National Data Archive. Full documentation of the database may be obtained from the Social Survey Division of the Office of Population Censuses and Surveys, (OPCS) London. 2. Foods consumed 2.1 The main sources of dietary energy in the diets of British schoolchildren were bread, chips, milk, biscuits, meat products, cake and puddings. Almost all children in the survey recorded consumption of chips, crisps, cakes and biscuits. Boys recorded more chips consumed than girls along with more milk, breakfast cereals and baked beans; girls recorded more fruit consumed and more girls drank fruit juice than boys. Yogurt, fizzy drinks and sweets were more popular among younger children. Older children recorded consumption of more tea and coffee (para 9.2). 2.2 Scottish primary school children appeared to have a distinctive dietary pattern. They recorded higher median consumption of beef, soups, milk, cheese, sausages

  16. IRONY AS A LIFESTYLE, OR RUSSIAN VIEW ON BRITISH MEDICAL PROBLEMS (AS EXEMPLIFIED IN D. CEPOV’S PROSE)

    OpenAIRE

    FATEEVA JULIA GENNADIEVNA; SVETLANA ALEXSANDROVNA KRAYNIKOVA

    2015-01-01

    Irony in modern medical Russian literature is analyzed in the article on D. Cepov’s prose. Different reminiscences (parallels, callings, references) both in Russian and foreign literature are main means of creating irony by the author.

  17. Medical aid provided by American, Canadian and British Nationals to the Spanish Republic during the Civil War, 1936-1939.

    Science.gov (United States)

    Shapiro, M F

    1983-01-01

    During international or civil wars, private citizens of noncombatant nations often provide medical aid to one of the contending factions, particularly when they support a participant not favored by their own government. This paper details and analyzes the prominent campaign in the United States, Canada and Great Britain to provide medical aid to the Republicans during the Spanish Civil War (1936 to 1939). The substantial medical aid that was provided clearly alleviated some suffering, but one of the major objectives of the campaign was to arouse public opinion sufficiently to end the boycott of military aid to Republicans; this objective was never achieved. Whether it be in Republican Spain, Vietnam or El Salvador, even a successful medical aid campaign to people in a military conflict may save some lives but may not affect substantially the course of the conflict. Those who are primarily interested in influencing political or military developments, hoping to advance the cause of a particular contending faction, may find tactics other than medical aid campaigns more useful in accomplishing their goals.

  18. Sexuality and the drive for muscularity: evidence of associations among British men.

    Science.gov (United States)

    Swami, Viren; Diwell, Rachel; McCreary, Donald R

    2014-09-01

    Previous studies have documented associations between sexuality and body image, but the directionality of this association is unclear among men. This study examined whether men's drive for muscularity can be considered a correlate of their sexuality. A community-based sample of 292 heterosexual men from London, UK, completed a survey consisting of measures of drive for muscularity, sociosexuality, sexual assertiveness, sexual esteem, and sexual sensation seeking. A multiple regression analysis showed that greater drive for muscularity was predicted by more unrestricted sociosexuality (i.e., a greater proclivity for short-term, transient relationships), greater sexual sensation seeking, and greater sexual assertiveness, once the effects of participant age and body mass index had been accounted for. Possible avenues for intervention based on a sex-positive approach are discussed in conclusion. PMID:25201097

  19. British and Irish Association of Law Librarians (BIALL) Legal Information Literacy Statement

    OpenAIRE

    Choolhun, N; R. Bird(School of Physics, University College Dublin, Dublin, Ireland)

    2012-01-01

    The Association hosts an annual conference which features a members’ ‘Have your say’ session. At the 2011 session, a BIALL member based in the commercial sector voiced their concern at the legal research competency of recent joiners to their firm, stating that senior partners were asking in-house law librarians to verify the research presented by new trainees. This member also queried the role of academic law librarians, questioning how legal research skills are being taught at academic and v...

  20. Association of sedative-hypnotic medications with suicidality.

    Science.gov (United States)

    Pae, Chi-Un; Koh, Jun Sung; Lee, Soo-Jung; Han, Changsu; Patkar, Ashwin A; Masand, Prakash S

    2011-03-01

    Evaluation of: Brower KJ, McCammon RJ, Wojnar M, Ilgen MA, Wojnar J, Valenstein M. Prescription sleeping pills, insomnia, and suicidality in the National Comorbidity Survey Replication. J. Clin. Psychiatry DOI: 10.4088/JCP.09m05484gry (2010) (Epub ahead of print). Several studies have investigated the association between sedative-hypnotics and suicidality, as such medications not only serve as a method for suicide, but are also involved in the usual options for treating psychiatric and medico-surgical disorders. According to population-based studies in Europe, Asia and the USA, sedative-hypnotic medications were significantly associated with suicide. However, these studies failed to address psychiatric comorbidities, new hypnotic medications, such as zolpidem, and the specific times at which such medications were used. Recently, Brower and colleagues have investigated the association of the prescription of sedative-hypnotic drugs with suicidality, to determine whether such medications were associated with suicidal ideation, suicide plans and suicide attempts in a large-cohort sample. They found that the use of sedative-hypnotic medications was significantly associated with suicidal ideation, suicide plans and suicide attempts. In addition, the use of sedative-hypnotic medications was a stronger predictor than insomnia of both suicidal ideation and suicide attempts. This article will discuss the relationship between prescription of sedative-hypnotic medications and suicide in the context of the potential limitations and significance of this recent research. PMID:21375440

  1. Acute gastro-intestinal illness and its association with hydroclimatic factors in British Columbia, Canada: A time-series analysis

    Science.gov (United States)

    Galway, L. P.; Allen, D. M.

    2013-12-01

    Rising global temperatures and expected shifts in regional hydroclimatology in a changing climate are likely to influence the risk of infectious waterborne illness. This study examines the role of hydroclimatology as an underlying driver of the epidemiology of waterborne gastro-intestinal illness and contributes to our currently limited understanding of the possible ecosystem-mediated impacts of climate change on health. Using time-series regression analysis, we examine the associations between three hydroclimatic factors (monthly temperature, precipitation, and streamflow) and the monthly occurrence of AGI illness in two communities in the province of British Columbia, Canada. The two communities were selected as study sites to represent the dominant hydroclimatic regimes that characterize the province of BC: the rainfall-dominated hydroclimatic regime and snowmelt-dominated hydroclimatic regime Our results show that the number of monthly cases of AGI increased with increasing temperature, precipitation, and streamflow in the same month in the context of a rainfall-dominated regime and with increasing streamflow in the previous month in the context of a snowfall-dominated regime. These results suggest that hydroclimatic factors play a role in driving the occurrence and variability of AGI illness in this setting. Further, this study has highlighted that the nature and magnitude of the effects of hydroclimatic factors on waterborne illness vary across different hydroclimatic settings. We conclude that the watershed may be an appropriate context within which we can and should enhance our understanding of water-related climate change impacts on health. Examining the role of hydroclimatology as an underlying driver of the epidemiology of infectious disease is key to understanding of the possible ecosystem-mediated impacts of climate change on health and developing appropriate adaptation responses.

  2. Characteristics associated with post-discharge medication errors

    Science.gov (United States)

    Mixon, Amanda S.; Myers, Amy P.; Leak, Cardella L.; Mary Lou Jacobsen, J.; Cawthon, Courtney; Goggins, Kathryn M.; Nwosu, Samuel; Schildcrout, Jonathan S.; Schnelle, John F.; Speroff, Theodore; Kripalani, Sunil

    2014-01-01

    Objective To examine the association of patient- and medication-related factors with post-discharge medication errors. Patients and Methods The Vanderbilt Inpatient Cohort Study (VICS) includes adults hospitalized with acute coronary syndromes (ACS) and/or acute decompensated heart failure (ADHF). We measured health literacy, subjective numeracy, marital status, cognition, social support, education, income, depression, global health status, and medication adherence in patients enrolled between October 2011 and August 2012. We used binomial logistic regression to determine predictors of discordance between the discharge medication list and patient-reported list during post-discharge medication review. Results Among 471 patients, mean age was 59 years; mean total number of medications reported was 12; and 17% had inadequate or marginal health literacy. Half (51%) of patients had ≥1 one discordant medication (i.e., appeared either on the discharge or patient-reported list but not both); 27% failed to report a medication on their discharge list; and 36% reported a medication not on their discharge list. Additionally, 59% had a misunderstanding in indication, dose, or frequency in a cardiac medication. In multivariable analyses, higher subjective numeracy (Odds Ratio (OR)=0.81, 95% Confidence Interval (CI) 0.67-0.98) was associated with lower odds of having discordant medications. For cardiac medications, participants with higher health literacy (OR=0.84, CI 0.74-0.95), higher subjective numeracy (OR=0.77, CI 0.63-0.95), and who were female (OR=0.60, CI 0.46-0.78) had lower odds of misunderstandings in indication, dose, or frequency. Conclusion Medication errors are present in approximately half of patients following hospital discharge and are more common among patients with lower numeracy or health literacy. PMID:24998906

  3. Association Between Sleep Hygiene and Sleep Quality in Medical Students

    OpenAIRE

    Brick, Cameron A.; Seely, Darbi L.; Palermo, Tonya M.

    2010-01-01

    The aim of this study was to determine whether subjective sleep quality was reduced in medical students, and whether demographics and sleep hygiene behaviors were associated with sleep quality. A Web-based survey was completed by 314 medical students, containing questions about demographics, sleep habits, exercise habits, caffeine, tobacco and alcohol use, and subjective sleep quality (using the Pittsburgh Sleep Quality Index). Correlation and regression analyses tested for associations among...

  4. Beverage consumption habits “24/7” among British adults: association with total water intake and energy intake

    Directory of Open Access Journals (Sweden)

    Gibson Sigrid

    2013-01-01

    Full Text Available Abstract Background Various recommendations exist for total water intake (TWI, yet it is seldom reported in dietary surveys. Few studies have examined how real-life consumption patterns, including beverage type, variety and timing relate to TWI and energy intake (EI. Methods We analysed weighed dietary records from the National Diet and Nutrition Survey of 1724 British adults aged 19–64 years (2000/2001 to investigate beverage consumption patterns over 24 hrs and 7 days and associations with TWI and EI. TWI was calculated from the nutrient composition of each item of food and drink and compared with reference values. Results Mean TWI was 2.53 L (SD 0.86 for men and 2.03 L (SD 0.71 for women, close to the European Food Safety Authority “adequate Intake” (AI of 2.5 L and 2 L, respectively. However, for 33% of men and 23% of women TWI was below AI and TWI:EI ratio was In multi-variable regression (adjusted for sex, age, body weight, smoking, dieting, activity level and mis-reporting, replacing 100 g of caloric beverages (milk, fruit juice, caloric soft drinks and alcohol with 100 g non-caloric drinks (diet soft drinks, hot beverages and water was associated with a reduction in EI of 15 kcal, or 34 kcal if food energy were unchanged. Using within-person data (deviations from 7-day mean each 100 g change in caloric beverages was associated with 29 kcal change in EI or 35 kcal if food energy were constant. By comparison the calculated energy content of caloric drinks consumed was 47 kcal/100 g. Conclusions TWI and beverage consumption are closely related, and some individuals appeared to have low TWI. Compensation for energy from beverages may occur but is partial. A better understanding of interactions between drinking and eating habits and their impact on water and energy balance would give a firmer basis to dietary recommendations.

  5. An Introduction to Ethical Dilemmas of British and American Medical Students and Their Medical Ethics Education%英美医学生伦理困境及教育问题研究简介

    Institute of Scientific and Technical Information of China (English)

    杜刚; 罗肖泉

    2014-01-01

    英美学者研究认为,医学生在医学院校学习和临床培训期间,由于其身份地位、文化冲突以及医疗管理等方面的原因而经历的种种伦理困境,易于使他们陷入情感和心理的困扰、信仰和行为的冲突、理想和现实的矛盾之中,并最终导致其价值观和伦理原则的损害。他们呼吁教育工作者应当承担起帮助学生应对复杂的矛盾问题以及学习职业伦理困境的处理经验的责任。这些成果对深入研究和积极探索我国医学伦理教育的有效路径具有重要的借鉴意义。%British and American researchers hold the fact that medical students incline to be haunted with emotional and mental problems ,religion and behavior conflicts ,as well as the ideal and realistic contradictions .All these problems are resulted from all kinds of ethical dilemmas they experienced during their studies and clinical trainings in medical schools , due to their different identities ,status ,cultural backgrounds and medical managements .These problems can destroy the values and ethical principles of these medical students . To solve the problems , the researchers appeal to educators to shoulder on the responsibility to help the students to deal with the complicated problems and learn how to compromise in ethical dilemmas .The author believed these conclusions could be taken as an important reference to further study medical ethical education in China .

  6. Chronic Obstructive Pulmonary Disease Illness and Medication Beliefs are Associated with Medication Adherence.

    Science.gov (United States)

    Krauskopf, Katherine; Federman, Alex D; Kale, Minal S; Sigel, Keith M; Martynenko, Melissa; O'Conor, Rachel; Wolf, Michael S; Leventhal, Howard; Wisnivesky, Juan P

    2015-04-01

    Almost half of patients with COPD do not adhere to their medications. Illness and medication beliefs are important determinants of adherence in other chronic diseases. Using the framework of the Common Sense Model of Self-Regulation (CSM), we determined associations between potentially modifiable beliefs and adherence to COPD medications in a cohort of English- and Spanish-speaking adults with COPD from New York and Chicago. Medication adherence was assessed using the Medication Adherence Report Scale. Illness and medication beliefs along CSM domains were evaluated using the Brief Illness Perception Questionnaire (B-IPQ) and the Beliefs about Medications Questionnaire (BMQ). Unadjusted analysis (with Cohen's d effect sizes) and multiple logistic regression were used to assess the relationship between illness and medication beliefs with adherence. The study included 188 participants (47% Black, 13% Hispanics); 109 (58%) were non-adherent. Non-adherent participants were younger (p < 0.001), more likely to be Black or Hispanic (p = 0.001), to have reported low income (p = 0.02), and had fewer years of formal education (p = 0.002). In unadjusted comparisons, non-adherent participants reported being more concerned about their COPD (p = 0.011; Cohen's d = 0.43), more emotionally affected by the disease (p = 0.001; Cohen's d = 0.54), and had greater concerns about COPD medications (p < 0.001, Cohen's d = 0.81). In adjusted analyses, concerns about COPD medications independently predicted non-adherence (odds ratio: 0.52, 95% confidence interval: 0.36-0.75). In this cohort of urban minority adults, concerns about medications were associated with non-adherence. Future work should explore interventions to influence patient adherence by addressing concerns about the safety profile and long-term effects of COPD medications.

  7. Chronic Obstructive Pulmonary Disease Illness and Medication Beliefs are Associated with Medication Adherence

    Science.gov (United States)

    Krauskopf, Katherine; Federman, Alex D; Kale, Minal S; Sigel, Keith M; Martynenko, Melissa; O’Conor, Rachel; Wolf, Michael S; Leventhal, Howard; Wisnivesky, Juan P

    2015-01-01

    Almost half of patients with COPD do not adhere to their medications. Illness and medication beliefs are important determinants of adherence in other chronic diseases. Using the framework of the Common Sense Model of Self Regulation (CSM), we determined associations between potentially modifiable beliefs and adherence to COPD medications in a cohort of English- and Spanish-speaking adults with COPD from New York and Chicago. Medication adherence was assessed using the Medication Adherence Report Scale. Illness and medication beliefs along CSM domains were evaluated using the Brief Illness Perception Questionnaire (B-IPQ) and the Beliefs about Medications Questionnaire (BMQ). Unadjusted analysis (with Cohen’s d effect sizes) and multiple logistic regression were used to assess the relationship between illness and medication beliefs with adherence. The study included 188 participants (47% Black, 13% Hispanics); 109 (58%) were adherent. Non-adherent participants were younger (p<0.001), more likely to be Black or Hispanic (p=0.001), to have reported low income (p=0.02), and had fewer years of formal education (p=0.002). In unadjusted comparisons, non-adherent participants reported being more concerned about their COPD (p=0.011; Cohen’s d=0.43), more emotionally affected by the disease (p=0.001; Cohen’s d=0.54), and had greater concerns about COPD medications (p<0.001, Cohen’s d=0.81). In adjusted analyses, concerns about COPD medications independently predicted non-adherence (odds ratio: 0.52, 95% confidence interval: 0.36–0.75). In this cohort of urban minority adults, concerns about medications were associated with non-adherence. Future work should explore interventions to influence patient adherence by addressing concerns about the safety profile and long-term effects of COPD medications. PMID:24960306

  8. The lack of integration of clinical audit and the maintenance of medical dominance within British hospital trusts.

    Science.gov (United States)

    McErlain-Burns, T L; Thomson, R

    1999-08-01

    Concerns have been expressed repeatedly about the effectiveness of clinical audit. Some have argued that this is limited by the lack of integration within day-to-day practice and with other NHS policy initiatives. We aimed to explore what mechanisms were being used to develop annual clinical audit programmes within NHS Trusts, and to describe the influence of other initiatives on this; to understand how such influences are exerted; and to understand the role of key players, in order to inform future programme development. Semi-structured face-to-face interviews were performed with Chairs of Clinical Audit Committees, Clinical Audit Managers and Co-ordinators (N = 15) in the former Yorkshire Region of the NHS in England. Concerns about the development, planning and integration of clinical audit focused upon an almost exclusive medical dominance and upon how audit leadership could be delivered within the context of hospital management structures. The lack of an overall plan for the development of clinical audit in most sites was seen as enabling the doctors' agenda to dominate. Purchasing authorities were recognized as being important, but often with limited influence. Other influences on the audit agenda, such as research and development (R&D) and clinical risk management, were rarely well co-ordinated. These findings concur with previous studies in identifying a wide range of constraints on the progress of audit. Several of these constraints operate within the internal environment, for example the doctors' agenda, and concerns about management involvement. Such constraints require resolution in order to facilitate the integration of audit with other initiatives and to achieve the goals of audit effectively. Clinical effectiveness and clinical governance may offer a means of facilitating this integration. PMID:10461584

  9. British Petroleum

    DEFF Research Database (Denmark)

    Andersen, Torben Juul; Andersen, Christine Bang

    2014-01-01

    The case deals with the rather tumultuous executive leadership changes of British Petroleum (BP) over the past decade from 2005 to 2014 in the wake of two dramatic incidents: The Texas City refinery explosion in 2005 and the explosion of the oil rig Deepwater Horizon in the Mexican Gulf in 2010...... guidelines and governance practices. The case captures the intricacies of corporate management and provides a realistic overview of the complexities that often surround leadership approaches and executive decisions. Hence, it can be used in various graduate and executive courses in strategic management......, leadership development and corporate governance that all grapple with issues of responsible ethical behaviour. This case is part of the CBS free case collection (visit www.thecasecentre.org/CBSfreecases for more information on the collection). This case can be downloaded by educators as a clean pdf...

  10. CONTENT BASED MEDICAL IMAGE RETRIEVAL USING BINARY ASSOCIATION RULES

    OpenAIRE

    Akila; Uma Maheswari

    2013-01-01

    In this study, we propose a content-based medical image retrieval framework based on binary association rules to augment the results of medical image diagnosis, for supporting clinical decision making. Specifically, this work is employed on scanned Magnetic Resonance brain Images (MRI) and the proposed Content Based Image Retrieval (CBIR) process is for enhancing relevancy rate of retrieved images. The pertinent features of a query brain image are extracted by applying third order moment inva...

  11. Non medical factors associated with psychological disorders in cancer patients

    International Nuclear Information System (INIS)

    Objective: To find out major non-medial factors associated with psychological disorders in cancer patients. Design: An observational study conducted on adult cancer patients. Place and Duration of Study: The study was conducted at Shaukat Khanum Memorial Cancer Hospital and Research Center Lahore Pakistan from January 1999. Patients and Methods: Two hundred and twenty-four newly-diagnosed adult cancer patients were interviewed by the clinical psychologist and data was collected regarding non-medical causal factors, patients age, gender family support system, general home atmosphere and marital status. Collected data was analyzed by utilizing. SPSS for windows version 10.0. Results: Of the 224 patients 142 (63.4%) reported non-medical factors causing psychological distress and 82 (36.6%) reported that medical sources are the most distressing. Ten most common non-medical sources of developing psychological disorders were identified. It was observed that family support system and general home atmosphere were significantly associated with the development of psychological disorders whereas the other variables such as age, gender and marital status had no significant relationship with the non Medical factors. Conclusion: It was concluded that non-medical factors causing psychological problems are significant in cancer patients. The results suggest that we should identify these factors and target psychosocial intervention for those patients most at risk. (author)

  12. Female genital mutilation. Council on Scientific Affairs, American Medical Association.

    Science.gov (United States)

    1995-12-01

    Female genital mutilation is the medically unnecessary modification of female genitalia. Female genital mutilation typically occurs at about 7 years of age, but mutilated women suffer severe medical complications throughout their adult lives. Female genital mutilation most frequently occurs in Africa, the Middle East, and Muslim parts of Indonesia and Malaysia, and it is generally part of a ceremonial induction into adult society. Recent political and economic problems in these regions, however, have increased the numbers of students and refugees to the United States. Consequently, US physicians are treating an increasing number of mutilated patients. The Council on Scientific Affairs recommends that US physicians join the World Health Organization, the World Medical Association, and other major health care organizations in opposing all forms of medically unnecessary surgical modification of the female genitalia. PMID:7474278

  13. The ABC of Physical Activity for Health: a consensus statement from the British Association of Sport and Exercise Sciences.

    Science.gov (United States)

    O'Donovan, Gary; Blazevich, Anthony J; Boreham, Colin; Cooper, Ashley R; Crank, Helen; Ekelund, Ulf; Fox, Kenneth R; Gately, Paul; Giles-Corti, Billie; Gill, Jason M R; Hamer, Mark; McDermott, Ian; Murphy, Marie; Mutrie, Nanette; Reilly, John J; Saxton, John M; Stamatakis, Emmanuel

    2010-04-01

    Our understanding of the relationship between physical activity and health is constantly evolving. Therefore, the British Association of Sport and Exercise Sciences convened a panel of experts to review the literature and produce guidelines that health professionals might use. In the ABC of Physical Activity for Health, A is for All healthy adults, B is for Beginners, and C is for Conditioned individuals. All healthy adults aged 18-65 years should aim to take part in at least 150 min of moderate-intensity aerobic activity each week, or at least 75 min of vigorous-intensity aerobic activity per week, or equivalent combinations of moderate- and vigorous-intensity activities. Moderate-intensity activities are those in which heart rate and breathing are raised, but it is possible to speak comfortably. Vigorous-intensity activities are those in which heart rate is higher, breathing is heavier, and conversation is harder. Aerobic activities should be undertaken in bouts of at least 10 min and, ideally, should be performed on five or more days a week. All healthy adults should also perform muscle-strengthening activities on two or more days a week. Weight training, circuit classes, yoga, and other muscle-strengthening activities offer additional health benefits and may help older adults to maintain physical independence. Beginners should work steadily towards meeting the physical activity levels recommended for all healthy adults. Even small increases in activity will bring some health benefits in the early stages and it is important to set achievable goals that provide success, build confidence, and increase motivation. For example, a beginner might be asked to walk an extra 10 min every other day for several weeks to slowly reach the recommended levels of activity for all healthy adults. It is also critical that beginners find activities they enjoy and gain support in becoming more active from family and friends. Conditioned individuals who have met the physical

  14. Medical guidelines for space passengers. Aerospace Medical Association Task Force on Space Travel.

    Science.gov (United States)

    2001-10-01

    In the foreseeable future, private companies will manufacture space vehicles with a capacity of transporting tourists into low Earth orbit. Because of the stresses of spaceflight, the effects of microgravity, and limited medical care capability, a system of medical clearance is highly recommended for these space tourists. It is our purpose to establish guidelines for use by private businesses, medical providers, and those planning on being a space tourist. Consequently, a Task Force was organized by the Aerospace Medical Association (AsMA) for the purpose of facilitating safety of passengers, fellow passengers, crew, and flight operations. The guidelines are meant to serve only as a template with the full expectation that exceptions might be made with appropriate rationale. PMID:11601561

  15. A questionnaire survey of medical cooperation by the Iwaki medical association

    International Nuclear Information System (INIS)

    It has been pointed out that currently, Iwaki City faces an insufficiency of doctors working at hospitals, compared with before. Such an insufficiency became more remarkable after the 2011 Tohoku Earthquake and Fukushima Nuclear Disaster, as about 30,000 people relocated to Iwaki City from the evacuation areas. In this regard, the Iwaki Medical Association conducted a questionnaire survey to investigate the problems of medical cooperation and utilize the data to improve medical cooperation within hospitals and clinics. A total of 159 doctors answered the questionnaires: 64% were community physicians, 36% were doctors working at hospitals, and 42% were physicians. About 60% of the doctors were satisfied with the present medical cooperation. Home health care was performed by 25% of the doctors working at hospitals and 45% of the community physicians. Approximately 80% of the doctors felt the need for additional physicians to perform home health care, although more than half of the doctors answered that they do not perform it. Various problems exist in the context of medical cooperation, but many doctors still hope for its improvement, according to the answers in the questionnaires. Efforts have to be exerted further in order to enhance medical cooperation among the health care team. (author)

  16. Factors associated with medical orders’ compliance among hyperlipidemic patients

    OpenAIRE

    Dehkordi, Leila Mardanian

    2013-01-01

    Background: Coronary artery diseases are one of the most important issues in health and social problems. One of the amendable risk factors in development of these diseases is high cholesterol which can be modified through correction of lifestyle (diet change, playing sports, and usage of lipid-lowering drugs). Patients’ compliance to therapeutic programs is the most important element to achieve this goal. This study aims to define the factors associated with compliance to medications among hy...

  17. Frequency and risk factors associated with emergency medical readmissions in Galway University Hospitals.

    LENUS (Irish Health Repository)

    Gorman, J

    2010-06-01

    Unplanned readmissions of medical hospital patients have been increasing in recent years. We examined the frequency and associates of emergency medical readmissions to Galway University Hospitals (GUH).

  18. British Sign Name Customs

    Science.gov (United States)

    Day, Linda; Sutton-Spence, Rachel

    2010-01-01

    Research presented here describes the sign names and the customs of name allocation within the British Deaf community. While some aspects of British Sign Language sign names and British Deaf naming customs differ from those in most Western societies, there are many similarities. There are also similarities with other societies outside the more…

  19. The Association of Academic Health Sciences Libraries' collaboration with the Association of American Medical Colleges, Medical Library Association, and other organizations.

    Science.gov (United States)

    Jenkins, Carol G; Bader, Shelley A

    2003-04-01

    The Association of Academic Health Sciences Libraries has made collaboration with other organizations a fundamental success strategy throughout its twenty-five year history. From the beginning its relationships with Association of American Medical Colleges and with the Medical Library Association have shaped its mission and influenced its success at promoting academic health sciences libraries' roles in their institutions. This article describes and evaluates those relationships. It also describes evolving relationships with other organizations including the National Library of Medicine and the Association of Research Libraries.

  20. Outbreak of Escherichia coli O157:H7 infections associated with drinking unpasteurized commercial apple juice--British Columbia, California, Colorado, and Washington, October 1996.

    Science.gov (United States)

    1996-11-01

    On October 30, 1996, the Seattle-King County Department of Public Health and the Washington State Department of Health reported an outbreak of Escherichia coli O157:H7 infections epidemiologically associated with drinking Odwalla brand unpasteurized apple juice or Odwalla juice mixtures containing apple juice from a coffee shop chain, grocery stores, or other locations. A case was defined as hemolytic uremic syndrome (HUS) or a stool culture yielding E. coli O157:H7 in a person who became ill after September 30, 1996, and drank Odwalla juice within 10 days before illness onset. As of November 6, British Columbia, California, Colorado, and Washington had reported a total of 45 cases. PMID:8965797

  1. MEDICAL ISSUES ASSOCIATED WITH ANABOLIC STEROID USE: ARE THEY EXAGGERATED?

    Directory of Open Access Journals (Sweden)

    Jay R. Hoffman

    2006-06-01

    Full Text Available For the past 50 years anabolic steroids have been at the forefront of the controversy surrounding performance enhancing drugs. For almost half of this time no attempt was made by sports governing bodies to control its use, and only recently have all of the major sports governing bodies in North America agreed to ban from competition and punish athletes who test positive for anabolic steroids. These punitive measures were developed with the primary concern for promotion of fair play and eliminating potential health risks associated with androgenic-anabolic steroids. Yet, controversy exists whether these testing programs deter anabolic steroid use. Although the scope of this paper does not focus on the effectiveness of testing, or the issue of fair play, it is of interest to understand why many athletes underestimate the health risks associated from these drugs. What creates further curiosity is the seemingly well-publicized health hazards that the medical community has depicted concerning anabolic steroidabuse. Is there something that the athletes know, or are they simply naïve regarding the dangers? The focus of this review is to provide a brief history of anabolic steroid use in North America, the prevalence of its use in both athletic and recreational populations and its efficacy. Primary discussion will focus on health issues associated with anabolic steroid use with an examination of the contrasting views held between the medical community and the athletes that are using these ergogenic drugs. Existing data suggest that in certain circumstances the medical risk associated with anabolic steroid use may have been somewhat exaggerated, possibly to dissuade use in athletes

  2. 'A matter of conscience': the moral authority of the World Medical Association and the readmission of the South Africans, 1976-1994.

    Science.gov (United States)

    Mbali, Mandisa

    2014-04-01

    This article describes the role of transnational anti-apartheid activism in South Africa, Britain and the United States in generating international moral outrage over the readmission of the Medical Association of South Africa (MASA) to the World Medical Association (WMA), which had taken place in 1981 after it had withdrawn from that body in 1976. It discusses an example of a controversy where an international health organisation (IHO) lost moral authority as a result of being accused of white supremacy and a pro-American engagement in Cold War politics. At the time of its readmission to the WMA, the MASA was controversial because of its failure to strike off its membership roll one of the doctors implicated the death in detention of Black Consciousness leader Steve Biko in 1977. It details how these activists viewed the American Medical Association as having campaigned for the MASA's readmission. The WMA's readmission of the MASA cost the former its relationships with the World Health Organisation (WHO) and the British Medical Association - a dispute which continued until South Africa's democratic transition of 1994. With its focus on transnational activism in relation to the WMA and the effects of activists' allegations of racism on its internal politics, this article contributes to the literature on the history of IHOs. Ultimately, this controversy shows the deficiency of international medical professional associations as ethical arbitrators of last resort.

  3. Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder : A revision of the 2005 guidelines from the British Association for Psychopharmacology

    NARCIS (Netherlands)

    Baldwin, David S.; Anderson, Ian M.; Nutt, David J.; Allgulander, Christer; Bandelow, Borwin; den Boer, Johan A.; Christmas, David M.; Davies, Simon; Fineberg, Naomi; Lidbetter, Nicky; Malizia, Andrea; McCrone, Paul; Nabarro, Daniel; O'Neill, Catherine; Scott, Jan; van der Wee, Nic; Wittchen, Hans-Ulrich

    2014-01-01

    This revision of the 2005 British Association for Psychopharmacology guidelines for the evidence-based pharmacological treatment of anxiety disorders provides an update on key steps in diagnosis and clinical management, including recognition, acute treatment, longer-term treatment, combination treat

  4. Cognitive and kidney function: results from a british birth cohort reaching retirement age.

    OpenAIRE

    Silverwood, RJ; Richards, M; Pierce, M; Hardy, R; Sattar, N.; Ferro, C.; Savage, C.; Kuh, D; Nitsch, D.; NSHD scientific and data collection teams

    2014-01-01

    Background: Previous studies have found associations between cognitive function and chronic kidney disease. We aimed to explore possible explanations for this association in the Medical Research Council National Survey of Health and Development, a prospective birth cohort representative of the general British population. Methods: Cognitive function at age 60–64 years was quantified using five measures (verbal memory, letter search speed and accuracy, simple and choice reaction tim...

  5. Polypharmacy patterns: unravelling systematic associations between prescribed medications.

    Directory of Open Access Journals (Sweden)

    Amaia Calderón-Larrañaga

    Full Text Available OBJECTIVES: The aim of this study was to demonstrate the existence of systematic associations in drug prescription that lead to the establishment of patterns of polypharmacy, and the clinical interpretation of the associations found in each pattern. METHODS: A cross-sectional study was conducted based on information obtained from electronic medical records and the primary care pharmacy database in 2008. An exploratory factor analysis of drug dispensing information regarding 79,089 adult patients was performed to identify the patterns of polypharmacy. The analysis was stratified by age and sex. RESULTS: Seven patterns of polypharmacy were identified, which may be classified depending on the type of disease they are intended to treat: cardiovascular, depression-anxiety, acute respiratory infection (ARI, chronic obstructive pulmonary disease (COPD, rhinitis-asthma, pain, and menopause. Some of these patterns revealed a clear clinical consistency and included drugs that are prescribed together for the same clinical indication (i.e., ARI and COPD patterns. Other patterns were more complex but also clinically consistent: in the cardiovascular pattern, drugs for the treatment of known risk factors-such as hypertension or dyslipidemia-were combined with other medications for the treatment of diabetes or established cardiovascular pathology (e.g., antiplatelet agents. Almost all of the patterns included drugs for preventing or treating potential side effects of other drugs in the same pattern. CONCLUSIONS: The present study demonstrated the existence of non-random associations in drug prescription, resulting in patterns of polypharmacy that are sound from the pharmacological and clinical viewpoints and that exist in a significant proportion of the population. This finding necessitates future longitudinal studies to confirm some of the proposed causal associations. The information discovered would further the development and/or adaptation of clinical

  6. The prospective association between childhood cognitive ability and somatic symptoms and syndromes in adulthood : the 1958 British birth cohort

    NARCIS (Netherlands)

    Kingma, Eva M.; Rosmalen, Judith G. M.; White, Peter D.; Stansfeld, Stephen A.; Clark, Charlotte

    2013-01-01

    BACKGROUND: Cognitive ability is negatively associated with functional somatic symptoms (FSS) in childhood. Lower childhood cognitive ability might also predict FSS and functional somatic syndromes in adulthood. However, it is unknown whether this association would be modified by subjective and obje

  7. Basic research on cancer related to radiation associated medical researches

    International Nuclear Information System (INIS)

    Basic Research on Cancer related to Radiation Associated Medical Researches including 1. Establishment of animal model of colorectal cancer liver metastasis and measurement of angiogenesis, 2. Tissue expression of Tie-1 and Tie-2 in human colorectal cancer, 3. Enhancement of G2/Mphase Cell Fraction by Adenovirus-mediated p53 Gene Transfer in Ovarian Cancer Cell Lines, 4. Clinical Characteristics of the patients with Non-B Non-C Hepatocellular Carcinoma and Frequency of HBV, HCV and TTV Viremia in these Patients, 5. Significance of serum iron and ferritin in patients with stomach cancer, 6. Telomerase assay for early detection of lung cancer, 7. Study on the Usefulness of Aldehyde dehydrogenase-2 Genotyping for Risk Group of Alcohol-related Cancer Screening, 8. Gene therapy using hepatoma specific promoter, 9. Study on the Influence of DNA repair gene, XRCC1 Genotypes on the Risk of Head and Neck Cancer were performed

  8. Basic research on cancer related to radiation associated medical researches

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong In; Hwang, Dae Yong; Bang, Ho Yoon [and others

    2000-12-01

    Basic Research on Cancer related to Radiation Associated Medical Researches including 1. Establishment of animal model of colorectal cancer liver metastasis and measurement of angiogenesis, 2. Tissue expression of Tie-1 and Tie-2 in human colorectal cancer, 3. Enhancement of G2/Mphase Cell Fraction by Adenovirus-mediated p53 Gene Transfer in Ovarian Cancer Cell Lines, 4. Clinical Characteristics of the patients with Non-B Non-C Hepatocellular Carcinoma and Frequency of HBV, HCV and TTV Viremia in these Patients, 5. Significance of serum iron and ferritin in patients with stomach cancer, 6. Telomerase assay for early detection of lung cancer, 7. Study on the Usefulness of Aldehyde dehydrogenase-2 Genotyping for Risk Group of Alcohol-related Cancer Screening, 8. Gene therapy using hepatoma specific promoter, 9. Study on the Influence of DNA repair gene, XRCC1 Genotypes on the Risk of Head and Neck Cancer were performed.

  9. SELF MEDICATION PATTERN, INCIDENCE AND FACTORS ASSOCIATED WITH IT, AMONG FIRST YEAR MBBS STUDENTS OF MEDICAL COLLEGE JAMMU

    Directory of Open Access Journals (Sweden)

    Nusrat

    2015-02-01

    Full Text Available Self - medication is quite common practice in general and particularly among medical students. Self - medication can be defined as obtaining and consuming medication without the advice of a clinician for treatment of an ailment. There can be many reasons for increased likelihood of self - medication among the medical students like easy access and senior medical student’s advice, easy access to physician’s samples, because of the white coat, from pharmacist / chemist shops. 1 However self - medication can be quite harmful and can be associated with significant morbidity and mortality. It could lead to various complications and side effects like - habituation and addiction, poisoning, hyper vitaminosis, antibiotic resistance and incorrect and delayed diagnosis, over diagnosis or under diagnosis, at times really serious and fatal consequences can occur. It results in wastage of resources, increase resistance of pathogens and can causes serious hazards like adverse drug reaction, prolonged suffering and drug dependence. This study was performed to assess and evaluate the incidence and awareness of self - medications among the medical students of first professional MBBS in medical college Ja mmu. A study on one hundred medical students of Jammu medical college was conducted to assess and evaluates the pattern of self - medication among these students. This study was done to know the frequencies and reasons and the pattern of self - medication among young medical students of Jammu region. A detail questionnaire was prepared and each student was asked to fill up the Performa and then the data was analyzed. It was found that self - medication is very common (90 % and is comparable to studies from other parts of the world. For most of them the reason for self - medication was common cold . The result emphasizes the amount of problem in the society about self - medication and lack of awareness about side effects. Hence more strict regulations are

  10. Palliative sedation : not just normal medical practice. Ethical reflections on the Royal Dutch Medical Association's guideline on palliative sedation

    NARCIS (Netherlands)

    Janssens, Rien; van Delden, Johannes J. M.; Widdershoven, Guy A. M.

    2012-01-01

    The main premise of the Royal Dutch Medical Association's (RDMA) guideline on palliative sedation is that palliative sedation, contrary to euthanasia, is normal medical practice. Although we do not deny the ethical distinctions between euthanasia and palliative sedation, we will critically analyse t

  11. 1970 British Cohort Study

    Directory of Open Access Journals (Sweden)

    Matt Brown

    2014-10-01

    Full Text Available The 1970 British Cohort Study (BCS70 is one of Britain’s world famous national longitudinal birth cohort studies, three of which are run by the Centre for Longitudinal Studies at the Institute of Education, University of London.  BCS70 follows the lives of more than 17,000 people born in England, Scotland and Wales in a single week of 1970. Over the course of cohort members lives, the BCS70 has collected information on health, physical, educational and social development, and economic circumstances among other factors. Since the birth survey in 1970, there have been nine ‘sweeps’ of all cohort members at ages 5, 10, 16, 26, 30, 34, 38 and most recently at 42. Data has been collected from a number of different sources (the midwife present at birth, parents of the cohort members, head and class teachers, school health service personnel and the cohort members themselves. The data has been collected in a variety of ways including via paper and electronic questionnaires, clinical records, medical examinations, physical measurements, tests of ability, educational assessments and diaries. The majority of BCS70 survey data can be accessed by bona fide researchers through the UK Data Service at the University of Essex.

  12. Factors associated with dropout in medical education: a literature review

    DEFF Research Database (Denmark)

    O'Neill, Lotte Dyhrberg; Wallstedt, Birgitta; Eika, Berit;

    2011-01-01

    Medical school dropout may have negative consequences for society, patients, the profession, schools and dropouts. To our knowledge, the literature dealing with dropout from medical school has never been systematically and critically appraised.......Medical school dropout may have negative consequences for society, patients, the profession, schools and dropouts. To our knowledge, the literature dealing with dropout from medical school has never been systematically and critically appraised....

  13. A high-fat, high-glycaemic index, low-fibre dietary pattern is prospectively associated with type 2 diabetes in a British birth cohort.

    Science.gov (United States)

    Pastorino, Silvia; Richards, Marcus; Pierce, Mary; Ambrosini, Gina L

    2016-05-01

    The combined association of dietary fat, glycaemic index (GI) and fibre with type 2 diabetes has rarely been investigated. The objective was to examine the relationship between a high-fat, high-GI, low-fibre dietary pattern across adult life and type 2 diabetes risk using reduced rank regression. Data were from the MRC National Survey of Health and Development. Repeated measures of dietary intake estimated using 5-d diet diaries were available at the age of 36, 43 and 53 years for 1180 study members. Associations between dietary pattern scores at each age, as well as longitudinal changes in dietary pattern z-scores, and type 2 diabetes incidence (n 106) from 53 to 60-64 years were analysed. The high-fat, high-GI, low-fibre dietary pattern was characterised by low intakes of fruit, vegetables, low-fat dairy products and whole-grain cereals, and high intakes of white bread, fried potatoes, processed meat and animal fats. There was an increasing trend in OR for type 2 diabetes with increasing quintile of dietary pattern z-scores at the age of 43 years among women but not among men. Women in the highest z-score quintile at the age of 43 years had an OR for type 2 diabetes of 5·45 (95 % CI 2·01, 14·79). Long-term increases in this dietary pattern, independently of BMI and waist circumference, were also detrimental among women: for each 1 sd unit increase in dietary pattern z-score between 36 and 53 years, the OR for type 2 diabetes was 1·67 (95 % CI 1·20, 2·43) independently of changes in BMI and waist circumference in the same periods. A high-fat, high-GI, low-fibre dietary pattern was associated with increased type 2 diabetes risk in middle-aged British women but not in men. PMID:27245103

  14. Perceived need to take medication is associated with medication non-adherence in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Zwikker HE

    2014-11-01

    Full Text Available Hanneke E Zwikker,1,2 Sandra van Dulmen,3–5 Alfons A den Broeder,1,2 Bart J van den Bemt,1,2,6 Cornelia H van den Ende1,2 1Department of Rheumatology, 2Department of Pharmacy, Sint Maartenskliniek, Nijmegen, the Netherlands; 3Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands; 4NIVEL (Netherlands Institute for Health Services Research, Utrecht, the Netherlands; 5Department of Health Science, Buskerud and Vestfold University College, Drammen, Norway; 6Department of Pharmacy, Radboud University Medical Centre, Nijmegen, the Netherlands Background: This is the first cross-sectional study that aims to examine associations between beliefs about medication and non-adherence in patients with rheumatoid arthritis (RA using disease-modifying antirheumatic drugs, taking potential psychological confounders into account.Methods: Eligible patients (diagnosed with RA for ≥1 year or ≥18 years, using greater than or equal to one disease-modifying antirheumatic drug were included by their rheumatologist during regular outpatient visits between September 2009 and September 2010. Included patients received questionnaires. The Beliefs about Medicines Questionnaire was used to measure the perceived need to take medication (necessity beliefs, the concerns about taking medication (concern beliefs, general medication beliefs, and attitudes toward taking medication. Medication non-adherence (no/yes was measured using the Compliance Questionnaire Rheumatology (CQR. Associations between beliefs and non-adherence, and the influence of demographical, clinical, and psychological factors (symptoms of anxiety/depression, illness cognitions, self-efficacy were assessed using logistic regression.Results: A total of 580 of the 820 eligible patients willing to participate were included in the analyses (68% female, mean age 63 years, 30% non-adherent to their medication. Weaker necessity beliefs (OR [odds ratio]: 0.8, 95% CI

  15. Low Calorie Beverage Consumption Is Associated with Energy and Nutrient Intakes and Diet Quality in British Adults

    OpenAIRE

    Gibson, Sigrid A.; Horgan, Graham W.; Francis, Lucy E.; Amelia A. Gibson; Stephen, Alison M

    2016-01-01

    It is unclear whether consumption of low-calorie beverages (LCB) leads to compensatory consumption of sweet foods, thus reducing benefits for weight control or diet quality. This analysis investigated associations between beverage consumption and energy intake and diet quality of adults in the UK National Diet and Nutrition Survey (NDNS) (2008–2011; n = 1590), classified into: (a) non-consumers of soft drinks (NC); (b) LCB consumers; (c) sugar-sweetened beverage (SSB) consumers; or (d) consum...

  16. Low Calorie Beverage Consumption Is Associated with Energy and Nutrient Intakes and Diet Quality in British Adults

    Directory of Open Access Journals (Sweden)

    Sigrid A. Gibson

    2016-01-01

    Full Text Available It is unclear whether consumption of low-calorie beverages (LCB leads to compensatory consumption of sweet foods, thus reducing benefits for weight control or diet quality. This analysis investigated associations between beverage consumption and energy intake and diet quality of adults in the UK National Diet and Nutrition Survey (NDNS (2008–2011; n = 1590, classified into: (a non-consumers of soft drinks (NC; (b LCB consumers; (c sugar-sweetened beverage (SSB consumers; or (d consumers of both beverages (BB, based on 4-day dietary records. Within-person data on beverage consumption on different days assessed the impact on energy intake. LCB consumers and NC consumed less energy and non-milk extrinsic sugars than other groups. Micronutrient intakes and food choices suggested higher dietary quality in NC/LCB consumers compared with SSB/BB consumers. Within individuals on different days, consumption of SSB, milk, juice, and alcohol were all associated with increased energy intake, while LCB and tea, coffee or water were associated with no change; or reduced energy intake when substituted for caloric beverages. Results indicate that NC and LCB consumers tend to have higher quality diets compared with SSB or BB consumers and do not compensate for sugar or energy deficits by consuming more sugary foods.

  17. Low Calorie Beverage Consumption Is Associated with Energy and Nutrient Intakes and Diet Quality in British Adults.

    Science.gov (United States)

    Gibson, Sigrid A; Horgan, Graham W; Francis, Lucy E; Gibson, Amelia A; Stephen, Alison M

    2016-01-02

    It is unclear whether consumption of low-calorie beverages (LCB) leads to compensatory consumption of sweet foods, thus reducing benefits for weight control or diet quality. This analysis investigated associations between beverage consumption and energy intake and diet quality of adults in the UK National Diet and Nutrition Survey (NDNS) (2008-2011; n = 1590), classified into: (a) non-consumers of soft drinks (NC); (b) LCB consumers; (c) sugar-sweetened beverage (SSB) consumers; or (d) consumers of both beverages (BB), based on 4-day dietary records. Within-person data on beverage consumption on different days assessed the impact on energy intake. LCB consumers and NC consumed less energy and non-milk extrinsic sugars than other groups. Micronutrient intakes and food choices suggested higher dietary quality in NC/LCB consumers compared with SSB/BB consumers. Within individuals on different days, consumption of SSB, milk, juice, and alcohol were all associated with increased energy intake, while LCB and tea, coffee or water were associated with no change; or reduced energy intake when substituted for caloric beverages. Results indicate that NC and LCB consumers tend to have higher quality diets compared with SSB or BB consumers and do not compensate for sugar or energy deficits by consuming more sugary foods.

  18. Low Calorie Beverage Consumption Is Associated with Energy and Nutrient Intakes and Diet Quality in British Adults.

    Science.gov (United States)

    Gibson, Sigrid A; Horgan, Graham W; Francis, Lucy E; Gibson, Amelia A; Stephen, Alison M

    2016-01-01

    It is unclear whether consumption of low-calorie beverages (LCB) leads to compensatory consumption of sweet foods, thus reducing benefits for weight control or diet quality. This analysis investigated associations between beverage consumption and energy intake and diet quality of adults in the UK National Diet and Nutrition Survey (NDNS) (2008-2011; n = 1590), classified into: (a) non-consumers of soft drinks (NC); (b) LCB consumers; (c) sugar-sweetened beverage (SSB) consumers; or (d) consumers of both beverages (BB), based on 4-day dietary records. Within-person data on beverage consumption on different days assessed the impact on energy intake. LCB consumers and NC consumed less energy and non-milk extrinsic sugars than other groups. Micronutrient intakes and food choices suggested higher dietary quality in NC/LCB consumers compared with SSB/BB consumers. Within individuals on different days, consumption of SSB, milk, juice, and alcohol were all associated with increased energy intake, while LCB and tea, coffee or water were associated with no change; or reduced energy intake when substituted for caloric beverages. Results indicate that NC and LCB consumers tend to have higher quality diets compared with SSB or BB consumers and do not compensate for sugar or energy deficits by consuming more sugary foods. PMID:26729159

  19. Childhood cognitive ability and adult mental health in the British 1946 birth cohort

    OpenAIRE

    Hatch, Stephani L; Jones, Peter B; Kuh, Diana; Hardy, Rebecca; Wadsworth, Michael E.J.; Richards, Marcus

    2007-01-01

    We examined whether childhood cognitive ability was associated with two mental health outcomes at age 53 years: the 28 item General Health Questionnaire (GHQ-28) as a measure of internalising symptoms of anxiety and depression, and the CAGE screen for potential alcohol abuse as an externalising disorder. A total of 1875 participants were included from the Medical Research Council National Survey of Health and Development, also known as the British 1946 birth cohort. The results indicated that...

  20. Lower Circulating B12 Is Associated with Higher Obesity and Insulin Resistance during Pregnancy in a Non-Diabetic White British Population.

    Directory of Open Access Journals (Sweden)

    Bridget Ann Knight

    Full Text Available Vitamin B12 and folate are critical micronutrients needed to support the increased metabolic demands of pregnancy. Recent studies from India have suggested that low vitamin B12 and folate concentrations in pregnancy are associated with increased obesity; however differences in diet, antenatal vitamin supplementation, and socioeconomic status may limit the generalisability of these findings. We aimed to explore the cross-sectional relationship of circulating serum vitamin B12 and folate at 28 weeks' gestation with maternal adiposity and related biochemical markers in a white non diabetic UK obstetric cohort.Anthropometry and biochemistry data was available on 995 women recruited at 28 weeks gestation to the Exeter Family Study of Childhood Health. Associations between B12 and folate with maternal BMI and other obesity-related biochemical factors (HOMA-R, fasting glucose, triglycerides, HDL and AST were explored using regression analysis, adjusting for potential confounders (socioeconomic status, vegetarian diet, vitamin supplementation, parity, haemodilution (haematocrit.Higher 28 week BMI was associated with lower circulating vitamin B12 (r = -0.25; P<0.001 and folate (r = -0.15; P<0.001. In multiple regression analysis higher 28 week BMI remained an independent predictor of lower circulating B12 (β (95% CI = -0.59 (-0.74, -0.44 i.e. for every 1% increase in BMI there was a 0.6% decrease in circulating B12. Other markers of adiposity/body fat metabolism (HOMA-R, triglycerides and AST were also independently associated with circulating B12. In a similar multiple regression AST was the only independent obesity-related marker associated with serum folate (β (95% CI = 0.16 (0.21, 0.51.In conclusion, our study has replicated the previous Indian findings of associations between lower serum B12 and higher obesity and insulin resistance during pregnancy in a non-diabetic White British population. These findings may have important implications for

  1. Body image and personality among British men: associations between the Big Five personality domains, drive for muscularity, and body appreciation.

    Science.gov (United States)

    Benford, Karis; Swami, Viren

    2014-09-01

    The present study examined associations between the Big Five personality domains and measures of men's body image. A total of 509 men from the community in London, UK, completed measures of drive for muscularity, body appreciation, the Big Five domains, and subjective social status, and provided their demographic details. The results of a hierarchical regression showed that, once the effects of participant body mass index (BMI) and subjective social status had been accounted for, men's drive for muscularity was significantly predicted by Neuroticism (β=.29). In addition, taking into account the effects of BMI and subjective social status, men's body appreciation was significantly predicted by Neuroticism (β=-.35) and Extraversion (β=.12). These findings highlight potential avenues for the development of intervention approaches based on the relationship between the Big Five personality traits and body image.

  2. Dilated cardiomyopathy and left bundle branch block associated with ingestion of colloidal gold and silver is reversed by British antiLewisite and vitamin E: The potential toxicity of metals used as health supplements

    OpenAIRE

    Archer, Stephen Lawrence

    2008-01-01

    A case of left bundle branch block and a dilated, nonhypertrophic cardiomyopathy associated with ingestion of colloidal gold and silver as an ‘energy tonic’ is described. The cardiac disease was reversed within two months by a course of dimercaprol (Akorn Inc, USA) (British antiLewisite) and vitamin E. This is the first case of gold and silver cardiomyopathy in humans, and highlights the risks of these colloidal metal ‘health supplements’.

  3. British Energy Operating Experience Programme

    International Nuclear Information System (INIS)

    British Energy is the major nuclear generator in the U.K. It has a market share varying between 22% and 25% of the total U.K. generation. The fleet of power stations operated by British Energy consists of one 1250 MWe Pressurised Water Reactor, six Advanced Gas Cooled reactor sites, each with two reactor units of 660 MWe, and one coal fired site with four units of 500 Mwe. In early 1999 British Energy set a strategic goal, for all its reactor units, to achieve 'World Class Performance through Cost leadership' by the end of year 2004. This would be measured against the applicable Upper Quartile performance indicators of the World Association of Nuclear Operators (WANO). Against this strategic goal six fundamental objectives were identified, one of which was to define, deploy and measure the effectiveness of a world class Operating Experience programme. British Energy has clearly re-defined its Operating Experience programme and, recognised the value of learning from Operating Experience. Commitment to the programme, and communicating the value of an effective OE programme is being clearly demonstrated by all managers throughout the organisation. Making the information easily accessible at the workplace has been achieved via the British Energy intranet, the harder step is to ensure OE is consulted before commencing an assigned task or plant evolution. Early signs of this are encouraging, but a continuous sustained effort will be required for probably the next two years. The full deployment of the OE programme is scheduled to be complete by 2004. There will however be a redefined programme identified by then to incorporate the lessons learnt and to ensure the programme is aligned with the business as it evolves. An analysis of event root causes and precursors since May 2001 will be undertaken in June 2002. These will be compared with data from previous years to ascertain the effect on the number of recurring events. The critical question, 'has this prevented recurring

  4. Associations Between Patient Characteristics and the Amount of Arthritis Medication Information Patients Receive.

    Science.gov (United States)

    Geryk, Lorie Love; Blalock, Susan; DeVellis, Robert F; Morella, Kristen; Carpenter, Delesha Miller

    2016-10-01

    Little is known about factors associated with the receipt of medication information among arthritis patients. This study explores information source receipt and associations between demographic and clinical/patient characteristics and the amount of arthritis medication information patients receive. Adult patients with osteoarthritis (OA) or rheumatoid arthritis (RA; n = 328) completed an online cross-sectional survey. Patients reported demographic and clinical/patient characteristics and the amount of arthritis medication information received from 15 information sources. Bivariate and multivariate linear regression analyses were used to investigate whether those characteristics were associated with the amount of medication information patients received. Arthritis patients received the most information from health professionals, followed by printed materials, media sources, and interpersonal sources. Greater receipt of information was associated with greater medication adherence, taking more medications, greater medication-taking concerns, more satisfaction with doctor medication-related support, and Black compared to White race. RA patients reported receiving more information compared to OA patients, and differences were found between RA patients and OA patients in characteristics associated with more information receipt. In conclusion, arthritis patients received the most medication information from professional sources, and both positive (e.g., greater satisfaction with doctor support) and negative (e.g., more medication-taking concerns) characteristics were associated with receiving more medication information.

  5. Associations Between Patient Characteristics and the Amount of Arthritis Medication Information Patients Receive.

    Science.gov (United States)

    Geryk, Lorie Love; Blalock, Susan; DeVellis, Robert F; Morella, Kristen; Carpenter, Delesha Miller

    2016-10-01

    Little is known about factors associated with the receipt of medication information among arthritis patients. This study explores information source receipt and associations between demographic and clinical/patient characteristics and the amount of arthritis medication information patients receive. Adult patients with osteoarthritis (OA) or rheumatoid arthritis (RA; n = 328) completed an online cross-sectional survey. Patients reported demographic and clinical/patient characteristics and the amount of arthritis medication information received from 15 information sources. Bivariate and multivariate linear regression analyses were used to investigate whether those characteristics were associated with the amount of medication information patients received. Arthritis patients received the most information from health professionals, followed by printed materials, media sources, and interpersonal sources. Greater receipt of information was associated with greater medication adherence, taking more medications, greater medication-taking concerns, more satisfaction with doctor medication-related support, and Black compared to White race. RA patients reported receiving more information compared to OA patients, and differences were found between RA patients and OA patients in characteristics associated with more information receipt. In conclusion, arthritis patients received the most medication information from professional sources, and both positive (e.g., greater satisfaction with doctor support) and negative (e.g., more medication-taking concerns) characteristics were associated with receiving more medication information. PMID:27668523

  6. The association between the use of parents' and childrens' medication.

    NARCIS (Netherlands)

    Dijk, L. van; Cardol, M.

    2005-01-01

    Background: Family background influences medical consumption. For example, 22% of the variance in frequencies of contact with the GP in The Netherlands can be ascribed to family influence. Up to now not much is known about family influence in one particular area of medical consumption: the use of (p

  7. Differential Drug Survival of Biologic Therapies for the Treatment of Psoriasis: A Prospective Observational Cohort Study from the British Association of Dermatologists Biologic Interventions Register (BADBIR).

    Science.gov (United States)

    Warren, Richard B; Smith, Catherine H; Yiu, Zenas Z N; Ashcroft, Darren M; Barker, Jonathan N W N; Burden, A David; Lunt, Mark; McElhone, Kathleen; Ormerod, Anthony D; Owen, Caroline M; Reynolds, Nick J; Griffiths, Christopher E M

    2015-11-01

    Drug survival reflects a drug's effectiveness, safety, and tolerability. We assessed the drug survival of biologics used to treat psoriasis in a prospective national pharmacovigilance cohort (British Association of Dermatologists Biologic Interventions Register (BADBIR)). The survival rates of the first course of biologics for 3,523 biologic-naive patients with chronic plaque psoriasis were compared using survival analysis techniques and predictors of discontinuation analyzed using a multivariate Cox proportional hazards model. Data for patients on adalimumab (n=1,879), etanercept (n=1,098), infliximab (n=96), and ustekinumab (n=450) were available. The overall survival rate in the first year was 77%, falling to 53% in the third year. Multivariate analysis showed that female gender (hazard ratio (HR) 1.22; 95% confidence interval (CI): 1.09-1.37), being a current smoker (HR 1.19; 95% CI: 1.03-1.38), and a higher baseline dermatology life quality index (HR 1.01; 95% CI: 1.00-1.02) were predictors of discontinuation. Presence of psoriatic arthritis (HR 0.82; 95% CI: 0.71-0.96) was a predictor for drug survival. As compared with adalimumab, patients on etanercept (HR 1.63; 95% CI: 1.45-1.84) or infliximab (HR 1.56; 95% CI: 1.16-2.09) were more likely to discontinue therapy, whereas patients on ustekinumab were more likely to persist (HR 0.48; 95% CI: 0.37-0.62). After accounting for relevant covariates, ustekinumab had the highest first-course drug survival. The results of this study will aid clinical decision making when choosing biologic therapy for psoriasis patients. PMID:26053050

  8. Differential Drug Survival of Biologic Therapies for the Treatment of Psoriasis: A Prospective Observational Cohort Study from the British Association of Dermatologists Biologic Interventions Register (BADBIR).

    Science.gov (United States)

    Warren, Richard B; Smith, Catherine H; Yiu, Zenas Z N; Ashcroft, Darren M; Barker, Jonathan N W N; Burden, A David; Lunt, Mark; McElhone, Kathleen; Ormerod, Anthony D; Owen, Caroline M; Reynolds, Nick J; Griffiths, Christopher E M

    2015-11-01

    Drug survival reflects a drug's effectiveness, safety, and tolerability. We assessed the drug survival of biologics used to treat psoriasis in a prospective national pharmacovigilance cohort (British Association of Dermatologists Biologic Interventions Register (BADBIR)). The survival rates of the first course of biologics for 3,523 biologic-naive patients with chronic plaque psoriasis were compared using survival analysis techniques and predictors of discontinuation analyzed using a multivariate Cox proportional hazards model. Data for patients on adalimumab (n=1,879), etanercept (n=1,098), infliximab (n=96), and ustekinumab (n=450) were available. The overall survival rate in the first year was 77%, falling to 53% in the third year. Multivariate analysis showed that female gender (hazard ratio (HR) 1.22; 95% confidence interval (CI): 1.09-1.37), being a current smoker (HR 1.19; 95% CI: 1.03-1.38), and a higher baseline dermatology life quality index (HR 1.01; 95% CI: 1.00-1.02) were predictors of discontinuation. Presence of psoriatic arthritis (HR 0.82; 95% CI: 0.71-0.96) was a predictor for drug survival. As compared with adalimumab, patients on etanercept (HR 1.63; 95% CI: 1.45-1.84) or infliximab (HR 1.56; 95% CI: 1.16-2.09) were more likely to discontinue therapy, whereas patients on ustekinumab were more likely to persist (HR 0.48; 95% CI: 0.37-0.62). After accounting for relevant covariates, ustekinumab had the highest first-course drug survival. The results of this study will aid clinical decision making when choosing biologic therapy for psoriasis patients.

  9. Divisions and diversity: the complexities of medical refuge in Britain, 1933-1948.

    Science.gov (United States)

    Decker, Karola

    2003-01-01

    The experiences of medical refugees who came to the United Kingdom from Nazi Germany and occupied Europe in the 1930s and 1940s reflect the general characteristics of the British response to the refugee crisis. This article analyzes the role of the British medical establishment and its interplay with the government and refugee aid organizations. Processes of decision making and changes of policy are revealed, drawing on the files of the "Aliens Committee" at the archive of the British Medical Association, on the private collection of Yvonne Kapp, former administrative head of the Medical Department of the Central Office for Refugees, and on the medical subseries of the archive of the Society for the Protection of Science and Learning. "Divisions" refer to differing interests and attitudes of the institutions, organizations and individuals involved; "diversity" reflects the response to the various nationalities of medical refugees, mainly German, Austrian, Czech, and Polish. PMID:14657586

  10. No Time for Nostalgia!: Asylum-Making, Medicalized Colonialism in British Columbia (1859-97) and Artistic Praxis for Social Transformation

    Science.gov (United States)

    Roman, Leslie G.; Brown, Sheena; Noble, Steven; Wainer, Rafael; Young, Alannah Earl

    2009-01-01

    This article asks: How have disability, indigenous arts and cultural praxis transformed and challenged the historical sociological archival research into relationships among asylum-making, medicalized colonialism and eugenics in the Woodlands School, formerly the Victoria Lunatic Asylum, the Provincial Asylum for the Insane in Victoria, BC 1859-72…

  11. Associations of Pass-Fail Outcomes with Psychological Health of First-Year Medical Students in a Malaysian Medical School

    OpenAIRE

    Yusoff, Muhamad S. B.

    2013-01-01

    Objectives: The demanding and intense environment of medical training can create excessive pressures on medical students that eventually lead to unfavorable consequences, either at a personal or professional level. These consequences can include poor academic performance and impaired cognitive ability. This study was designed to explore associations between pass-fail outcome and psychological health parameters (i.e. stress, anxiety, and depression symptoms). Methods: A cross-sectional study w...

  12. Fourth Medical Biotech Forum of the Chinese Medical Biotech Association. 8-10 August 2009, Dalian, China.

    Science.gov (United States)

    Felzmann, Thomas

    2009-10-01

    The Chinese Medical Biotech Association's Fourth Medical Biotech Forum held in Dalian, China included topics covering the biotechnology industry in China and new therapeutic developments in the field of immunological approaches to cancer treatment. This conference report highlights selected presentations on China's biotechnology development policy, tumor-specific antigens, clinical applications of antitumor immune therapy, and novel photodynamic tumor therapy. Investigational therapeutics discussed include astuprotimut-r (GlaxoSmithKline plc) and the dendritic cell vaccine Trivax (Trimed Biotech).

  13. Medication details documented on hospital discharge: cross-sectional observational study of factors associated with medication non-reconciliation.

    LENUS (Irish Health Repository)

    Grimes, Tamasine C

    2012-02-01

    AIMS: Movement into or out of hospital is a vulnerable period for medication safety. Reconciling the medication a patient is using before admission with the medication prescribed on discharge, and documenting any changes (medication reconciliation) is recommended to improve safety. The aims of the study were to investigate the factors contributing to medication reconciliation on discharge, and identify the prevalence of non-reconciliation. METHODS: The study was a cross-sectional, observational survey using consecutive discharges from purposively selected services in two acute public hospitals in Ireland. Medication reconciliation, potential for harm and unplanned re-admission were investigated. RESULTS: Medication non-reconciliation was identified in 50% of 1245 inpatient episodes, involving 16% of 9569 medications. The majority of non-reconciled episodes had potential to result in moderate (63%) or severe (2%) harm. Handwritten rather than computerized discharges (adjusted odds ratio (adjusted OR) 1.60, 95% CI 1.11, 2.99), increasing number of medications (adjusted OR 1.26, 95% CI 1.21, 1.31) or chronic illness (adjusted OR 2.08, 95% CI 1.33, 3.24) were associated with non-reconciliation. Omission of endocrine, central nervous system and nutrition and blood drugs was more likely on discharge, whilst omission on admission and throughout inpatient care, without documentation, was more likely for obstetric, gynaecology and urinary tract (OGU) or respiratory drugs. Documentation in the discharge communication that medication was intentionally stopped during inpatient care was less likely for cardiovascular, musculoskeletal and OGU drugs. Errors involving the dose were most likely for respiratory drugs. CONCLUSIONS: The findings inform strategies to facilitate medication reconciliation on discharge from acute hospital care.

  14. The Annual Awards of the Association of American Medical Colleges.

    Science.gov (United States)

    Journal of Medical Education, 1982

    1982-01-01

    The presentation of the Abraham Flexner Award for Distinguished Service to Medical Education to Sherman M. Mellinkoff and the AAMC Award for Distinguished Research in the Biomedical Sciences to J. Michael Bishop is described. (MLW)

  15. Prevalence of self-medication practices and its associated factors in Urban Puducherry, India

    OpenAIRE

    Kalaiselvi Selvaraj; Ganesh Kumar S; Archana Ramalingam

    2014-01-01

    Background and Objectives: Self medication is an important concern for health authorities at global level. This study was aimed to find the prevalence of self medication for allopathic drugs and associated factors among households of urban community. This study was also aimed at assessing the attitude of respondents who had experienced self-medication. Materials and Methods: This cross-sectional study was done in field practice area attached to a medical institution in urban Puducherry. A tot...

  16. Medication Regimen Complexity and Polypharmacy as Factors Associated With All-Cause Mortality in Older People

    OpenAIRE

    Wimmer, Barbara C.; Bell, J Simon; Fastbom, Johan; Wiese, Michael D; Johnell, Kristina

    2016-01-01

    Objectives: To investigate whether medication regimen complexity and/or polypharmacy are associated with all-cause mortality in older people. Methods: This was a population-based cohort study among community-dwelling and institutionalized people ≥60 years old (n = 3348). Medication regimen complexity was assessed using the 65-item Medication Regimen Complexity Index (MRCI) in 10-unit steps. Polypharmacy was assessed as a continuous variable (number of medications). Mortality data were obtaine...

  17. Study of Association of Psychological Stress and Depression among Undergraduate Medical Students in Pondicherry

    OpenAIRE

    Devi Kittu, Rohan Patil

    2013-01-01

    Background: Medical education across the globe is perceived as being inherently stressful. Studies on psychological problems such as stress, depression and anxiety among medical students have found that these disorders are under diagnosed and under treated. In this background the present study was undertaken with the objectives to assess the magni-tude of depression and its association with stress among medical students. Methods: A Cross sectional study was undertaken among 235 medical st...

  18. 76 FR 55886 - Selection Criteria-Transportation Infrastructure Improvements Associated With Medical Facilities...

    Science.gov (United States)

    2011-09-09

    ... of the Secretary Selection Criteria--Transportation Infrastructure Improvements Associated With... funding from the Office of Economic Adjustment (OEA) for construction of Transportation Infrastructure... Infrastructure Improvements associated with medical facilities related to recommendations of the 2005...

  19. Endogenous ethanol production in trauma victims associated with medical treatment.

    Science.gov (United States)

    Moriya, F; Hashimoto, Y

    1996-08-01

    Four cases of trauma, where endogenous ethanol production was suspected to have been occurred in association with medical treatment, are reported. To discriminate endogenous ethanol produced de novo by bacteria from exogenous ethanol by drinking, various tissues and body fluids, such as brain and cerebrospinal fluid, together with blood obtained from various locations, were subjected to analysis for both ethanol and n-propanol. The first individual was a 40-year-old man who had been stabbed in the abdomen with a knife and had died of bleeding about 12 h after peritoneotomy, and autopsied 12 h later. In the heart blood, 0.44 mg/g ethanol and 0.005 mg/g n-propanol were detected. Ethanol levels in the cerebrospinal fluid, vitreous humor and brain, reflecting exogenous ethanol levels, were 0.08-0.16 mg/g, and no n-propanol was detected in any of the specimens. The second individual was a 45-year-old man who had been punched hard in the head and face and had died of traumatic shock about 12 h after hospitalization, and autopsied 12 h later. The heart blood concentrations of ethanol and n-propanol were 0.15 and 0.008 mg/g respectively, and a subdural hematoma contained only 0.05 mg/g ethanol and non n-propanol. The third individual was a 34-year-old man who suffered incised wounds of the left arm and head with a sickle and had died of hemorrhagic shock. In the heart blood, 0.30 mg/g ethanol and 0.026 mg/g n-propanol were detected; there was 0.04 mg/g ethanol and no n-propanol in the brain. The fourth individual was a 76-year-old woman who had been hit by a motorcycle and had died of liver rupture about 1 h after admission to a hospital. The heart blood contained 0.22 mg/g ethanol and 0.002 mg/g n-propanol. Only a trace of ethanol and no n-propanol were detected in the pericardial sac fluid and cerebrospinal fluid.

  20. Association between Lifestyle and School Attendance in Japanese Medical Students: A Pilot Study

    Science.gov (United States)

    Tanaka, Masaaki; Watanabe, Yasuyoshi

    2012-01-01

    Objective: Lifestyle factors are thought to be associated with students' academic performance. Whether lifestyle factors were associated with medical students' school attendance was determined. Design: Cross-sectional design. Setting: The study group consisted of 157 healthy second-year medical students attending Osaka City University Graduate…

  1. Adverse drug reactions associated with asthma medications in children

    DEFF Research Database (Denmark)

    Aagaard, Lise; Hansen, Ebba Holme

    2014-01-01

    from 1 to 22 months. The most frequently reported ADRs were exacerbation of asthma, respiratory tract infection, cough, fever and headache. Only few ADRs were rated as being serious, however a number of children dropped out of the clinical trials due to serious ADRs, and, therefore, the real number......Background Respiratory medications are frequently prescribed for use in children. Several studies have reported information on the safety of asthma medications in clinical studies in adults, but information about safety in children is scarce. Objective To review published clinical trials...... on the occurrence and characteristics of adverse drug reactions (ADRs) in children, reported for asthma medications licensed for paediatric use. Methods We systematically reviewed the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. PubMed, Embase...

  2. Study of Association of Psychological Stress and Depression among Undergraduate Medical Students in Pondicherry

    Directory of Open Access Journals (Sweden)

    Devi Kittu, Rohan Patil

    2013-01-01

    Full Text Available Background: Medical education across the globe is perceived as being inherently stressful. Studies on psychological problems such as stress, depression and anxiety among medical students have found that these disorders are under diagnosed and under treated. In this background the present study was undertaken with the objectives to assess the magni-tude of depression and its association with stress among medical students. Methods: A Cross sectional study was undertaken among 235 medical students in a private medical college, Pondicherry. Tools similar to General Health Questionaire (GHQ-12 and Beck depression Inventory (BDI was used to screen psychological stress and depression respectively. Results: The prevalence of depression was 71% among medical students. Psychological stress was associated with depression. Conclusion: Emphasize should be laid on the importance of screening for depression of medical students on a regular basis for early detection and rendering appropriate intervention like group counseling, stress management training etc. to protect the future professionals.

  3. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects.

    Science.gov (United States)

    2014-01-01

    Published research in English-language journals are increasingly required to carry a statement that the study has been approved and monitored by an Institutional Review Board in conformance with 45 CFR 46 standards if the study was conducted in the United States. Alternative language attesting conformity with the Helsinki Declaration is often included when the research was conducted in Europe or elsewhere. The Helsinki Declaration was created by the World Medical Association in 1964 (ten years before the Belmont Report) and has been amended several times. The Helsinki Declaration differs from its American version in several respects, the most significant of which is that it was developed by and for physicians. The term "patient" appears in many places where we would expect to see "subject." It is stated in several places that physicians must either conduct or have supervisory control of the research. The dual role of the physician-researcher is acknowledged, but it is made clear that the role of healer takes precedence over that of scientist. In the United States, the federal government developed and enforces regulations on researcher; in the rest of the world, the profession, or a significant part of it, took the initiative in defining and promoting good research practice, and governments in many countries have worked to harmonize their standards along these lines. The Helsinki Declaration is based less on key philosophical principles and more on prescriptive statements. Although there is significant overlap between the Belmont and the Helsinki guidelines, the latter extends much further into research design and publication. Elements in a research protocol, use of placebos, and obligation to enroll trials in public registries (to ensure that negative findings are not buried), and requirements to share findings with the research and professional communities are included in the Helsinki Declaration. As a practical matter, these are often part of the work of American

  4. Recommendations for responsible monitoring and regulation of clinical software systems. American Medical Informatics Association, Computer-based Patient Record Institute, Medical Library Association, Association of Academic Health Science Libraries, American Health Information Management Association, American Nurses Association.

    Science.gov (United States)

    Miller, R A; Gardner, R M

    1997-01-01

    In mid-1996, the FDA called for discussions on regulation of clinical software programs as medical devices. In response, a consortium of organizations dedicated to improving health care through information technology has developed recommendations for the responsible regulation and monitoring of clinical software systems by users, vendors, and regulatory agencies. Organizations assisting in development of recommendations, or endorsing the consortium position include the American Medical Informatics Association, the Computer-based Patient Record Institute, the Medical Library Association, the Association of Academic Health Sciences Libraries, the American Health Information Management Association, the American Nurses Association, the Center for Healthcare Information Management, and the American College of Physicians. The consortium proposes four categories of clinical system risks and four classes of measured monitoring and regulatory actions that can be applied strategically based on the level of risk in a given setting. The consortium recommends local oversight of clinical software systems, and adoption by healthcare information system developers of a code of good business practices. Budgetary and other constraints limit the type and number of systems that the FDA can regulate effectively. FDA regulation should exempt most clinical software systems and focus on those systems posing highest clinical risk, with limited opportunities for competent human intervention. PMID:9391932

  5. Recommendations for responsible monitoring and regulation of clinical software systems. American Medical Informatics Association, Computer-based Patient Record Institute, Medical Library Association, Association of Academic Health Science Libraries, American Health Information Management Association, American Nurses Association.

    Science.gov (United States)

    Miller, R A; Gardner, R M

    1997-01-01

    In mid-1996, the FDA called for discussions on regulation of clinical software programs as medical devices. In response, a consortium of organizations dedicated to improving health care through information technology has developed recommendations for the responsible regulation and monitoring of clinical software systems by users, vendors, and regulatory agencies. Organizations assisting in development of recommendations, or endorsing the consortium position include the American Medical Informatics Association, the Computer-based Patient Record Institute, the Medical Library Association, the Association of Academic Health Sciences Libraries, the American Health Information Management Association, the American Nurses Association, the Center for Healthcare Information Management, and the American College of Physicians. The consortium proposes four categories of clinical system risks and four classes of measured monitoring and regulatory actions that can be applied strategically based on the level of risk in a given setting. The consortium recommends local oversight of clinical software systems, and adoption by healthcare information system developers of a code of good business practices. Budgetary and other constraints limit the type and number of systems that the FDA can regulate effectively. FDA regulation should exempt most clinical software systems and focus on those systems posing highest clinical risk, with limited opportunities for competent human intervention.

  6. Introducing complementary medicine into the medical curriculum.

    OpenAIRE

    Rampes, H; Sharples, F; Maragh, S; Fisher, P

    1997-01-01

    We surveyed the deans of British medical schools to determine the provision of complementary medicine in the undergraduate curriculum. We also sampled medical students at one British medical school to determine their knowledge of, and views on instruction in, complementary medicine. There is little education in complementary medicine at British medical schools, but it is an area of active curriculum development. Students' levels of knowledge vary widely between different therapies. Most medic...

  7. Knowledge, Character and Professionalisation in Nineteenth-Century British Science

    Science.gov (United States)

    Ellis, Heather

    2014-01-01

    Historians have frequently referred to the British Association for the Advancement of Science as an institution that had the professionalisation of British science as its chief aim. This article seeks to complicate this picture by asking what, if any, concept of "professionalisation" would have been understood by nineteenth-century…

  8. Perceived need to take medication is associated with medication non-adherence in patients with rheumatoid arthritis

    NARCIS (Netherlands)

    Zwikker, H.E.; Dulmen, S. van; Broeder, A.A. den; Bemt, B.J.F van den; Ende, C.H.M. van den

    2014-01-01

    BACKGROUND: This is the first cross-sectional study that aims to examine associations between beliefs about medication and non-adherence in patients with rheumatoid arthritis (RA) using disease-modifying antirheumatic drugs, taking potential psychological confounders into account. METHODS: Eligible

  9. Prevalence of self-medication practices and its associated factors in Urban Puducherry, India

    Directory of Open Access Journals (Sweden)

    Kalaiselvi Selvaraj

    2014-01-01

    Full Text Available Background and Objectives: Self medication is an important concern for health authorities at global level. This study was aimed to find the prevalence of self medication for allopathic drugs and associated factors among households of urban community. This study was also aimed at assessing the attitude of respondents who had experienced self-medication. Materials and Methods: This cross-sectional study was done in field practice area attached to a medical institution in urban Puducherry. A total of 352 subjects from 124 households were selected by random sampling. With pretested interview schedule, information regarding self-medication use in the past three months and associated sociodemographic factors, purpose, source of drug procurement, attitude toward self-medication use were collected. Results: Prevalence of self-medication was found to be 11.9%. Males, age >40 years and involving in moderate level activity of occupation, were found to be significantly associated with higher self-medication usage (P < 0.05. Fever (31%, headache (19%, and abdominal pain (16.7% are most common illnesses where self-medication is being used. Telling the symptoms to pharmacist (38.1% was the commonest method adopted to procure drugs by the users. Majority of the self-medication users expressed that self-medication is harmless (66.6% and they are going to use (90% and advice others also (73.8% to use self-medication drugs. Conclusion: Self-medication is an important health issue in this area. Health education of the public and regulation of pharmacies may help in limiting the self-medication practices.

  10. Principles for websites of the American Medical Association

    OpenAIRE

    Winker, Margaret

    2000-01-01

    The Internet has the potential to provide patients and physicians with rapid access to high quality, timely evidence regarding health and medical diagnosis and treatment. However, many barriers must be surmounted before this potential is achieved. Quality of content must be able to be verified, including the accuracy and timeliness of the information, the source of the information, and the objectivity of the source. Advertising and sponsorship must not influence content and should not be juxt...

  11. Medical and psychosocial associates of nonadherence in adolescents with cancer.

    Science.gov (United States)

    Hullmann, Stephanie E; Brumley, Lauren D; Schwartz, Lisa A

    2015-01-01

    The current study examined adherence to medication regimens among adolescents with cancer by applying the Pediatric Self-Management Model. Adolescents and their parents reported on adherence to medication, reasons for nonadherence, and patient-, family-, and community-level psychosocial variables. Adolescent- and parent-reported adherence were significantly correlated, with about half of the sample reporting perfect adherence. The majority reported "just forgot" as the most common reason for missed medication. Patient-, family-, and community-level variables were examined as predictors of adherence. With regard to individual factors, adolescents who endorsed perfect adherence reported a greater proportion of future-orientated goals and spent fewer days in outpatient clinic visits. For family factors, adolescents who endorsed perfect adherence reported greater social support from their family and were more likely to have a second caregiver who they perceived as overprotective. The community-level variable (social support from friends) tested did not emerge as a predictor of adherence. The results of this study provide direction for intervention efforts to target adolescent goals and family support in order to increase adolescent adherence to cancer treatment regimens. PMID:25366574

  12. Factors associated with dropping out of medical school: a literature review

    DEFF Research Database (Denmark)

    O'Neill, Lotte Dyhrberg

    2010-01-01

    of Aarhus; Jan Hartvigsen, PhD, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark.   Title: Factors associated with dropping out of medical school: a literature review.      Background: Considerable resources are spent on medical school selection and the competition...... for places is usually fierce. Dropping out must therefore be the worst possible performance outcome in medical education. What do we know about factors associated with dropping out of medical school? Summary of work: A systematic critical literature review of the international peer-reviewed research...... literature on medical education is ongoing. Inclusion criteria are: Study population=medical students, outcome=dropout, follow up period=minimum 1 year, study designs=cohort/case-control/experimental. An experienced research librarian performed a primary search of the databases PubMed, ERIC, Psyc...

  13. Factors associated with being overweight among Inner Mongolia medical students in China

    OpenAIRE

    Chen, Jie; Yi, He; Liu, Zhiyue; Fan, Yancun; Bian, Jiang; Guo, Wenfang; Chang, Wulantuya; Sun, Juan

    2013-01-01

    Objectives A major goal of our study was to identify the associations between lifestyle factors and obesity in adolescents and young adults at risk by surveying students in Inner Mongolia Medical University. A second goal was to determine these factors differed by gender. Design Cross-sectional study. Setting Students grade 1–3 in Inner Mongolia Medical University. Participants 5471 grade 1–3 medical students, composed of 3891 female and 1580 male students. Students with body mass index (BMI)...

  14. Factors associated with skipping breakfast among Inner Mongolia Medical students in China

    OpenAIRE

    Sun Juan; Yi He; Liu Zhiyue; Wu Yan; Bian Jiang; Wu Yanyan; Eshita Yuki; Li Gaimei; Zhang Qing; Yang Ying

    2013-01-01

    Abstract Background Few studies on the breakfast consumption habits of medical students in China have been carried out. The aim of the present study was to determine the prevalence of skipping breakfast and factors associated with skipping breakfast among medical students in Inner Mongolia of China, and to assist in the design of interventions to improve breakfast consumption habits of medical college students in this region. Methods From December 2010 to January 2011 a cross-sectional survey...

  15. Stress among Medical Students and Its Association with Substance Use and Academic Performance

    OpenAIRE

    Leta Melaku; Andualem Mossie; Alemayehu Negash

    2015-01-01

    Background. Chronic stress among medical students affects academic performance of students and leads to depression, substance use, and suicide. There is, however, a shortage of such research evidence in Ethiopia. Objective. We aimed to estimate the prevalence and severity of stress and its association with substance use and academic performance among medical students. Methods. A cross-sectional survey was conducted on a sample of 329 medical students at Jimma University. Data were collected u...

  16. Medication prescribing errors and associated factors at the pediatric wards of Dessie Referral Hospital, Northeast Ethiopia

    OpenAIRE

    Zeleke, Abebe; Chanie, Tesfahun; Woldie, Mirkuzie

    2014-01-01

    Background Medication error is common and preventable cause of medical errors and occurs as a result of either human error or a system flaw. The consequences of such errors are more harmful and frequent among pediatric patients. Objective To assess medication prescribing errors and associated factors in the pediatric wards of Dessie Referral Hospital, Northeast Ethiopia. Methods A cross-sectional study was carried out in the pediatric wards of Dessie Referral Hospital from February 17 to Marc...

  17. Chronocentrism and British criminology.

    Science.gov (United States)

    Rock, Paul

    2005-09-01

    Criminologists display a largely unexamined propensity to ignore writings that are more than fifteen or so years old, with evident consequences for the public presentation and validation of expert knowledge. A citation study was combined with detailed observations from British criminologists to ascertain quite how that disavowal of the past was accomplished.

  18. Prevent and "British Values"

    Science.gov (United States)

    Kenny, Alex; Ghale, Baljeet

    2015-01-01

    At the recent National Union of Teachers' conference the role of the Prevent strategy and the introduction of "British Values" in the Office for Standards in Education, Children's Services and Skills framework emerged as key issues for delegates. Two of the speeches made at the conference are presented here.

  19. 1927: a British eclipse

    Science.gov (United States)

    Marriott, R. A.

    1999-06-01

    The total solar eclipse of 1927 June 29 was the first to be seen over the British mainland for 203 years. It caused nationwide excitement, induced mass population movement to the towns, villages, moorlands and offshore waters of Wales and the north of England, and severely tested the country's transport and communication systems.

  20. Associations of Pass-Fail Outcomes with Psychological Health of First-Year Medical Students in a Malaysian Medical School

    Directory of Open Access Journals (Sweden)

    Muhamad S. B. Yusoff

    2013-02-01

    Full Text Available Objectives: The demanding and intense environment of medical training can create excessive pressures on medical students that eventually lead to unfavorable consequences, either at a personal or professional level. These consequences can include poor academic performance and impaired cognitive ability. This study was designed to explore associations between pass-fail outcome and psychological health parameters (i.e. stress, anxiety, and depression symptoms. Methods: A cross-sectional study was conducted on a cohort of first-year medical students in a Malaysian medical school. The depression anxiety stress scale 21-item assessment (DASS-21 was administered to them right after the final paper of the first-year final examination. Their final examination outcomes (i.e. pass or fail were traced by using their student identity code (ID through the Universiti Sains Malaysia academic office. Results: A total of 194 (98.0% of medical students responded to the DASS-21. An independent t-test showed that students who passed had significantly lower stress, anxiety, and depression symptoms than those who failed the first-year final examination (P <0.05. Those who experienced moderate to high stress were at 2.43 times higher risk for failing the examination than those who experienced normal to mild stress. Conclusion: Medical students whofailed in the final examination had higher psychological distress than those who passed the examination. Those who experienced high stress levels were more likely to fail than those who did not. Reducing the psychological distress of medical students prior to examination may help them to perform better in the examination.

  1. Essentials of nutrition education in medical schools: a national consensus. American Medical Student Association's Nutrition Curriculum Project.

    Science.gov (United States)

    1996-09-01

    Medical students of the American Medical Student Association established the Nutrition Curriculum Project (NCP) with the goals of ensuring that adequate nutrition information be taught to medical students; ensuring that there be a framework for integration of nutrition topics at all levels of medical education; and formulating and disseminating essential information for nutrition assessment and management in clinical practice. As a first step, the NCP assembled a ten-member advisory board to develop a comprehensive list of nutrition topics deemed essential for the adequate training of physicians. The advisory board consisted of medical and nutrition educators, physicians, and clinical specialists representing major U.S. professional nutrition organizations. The NCP's director co-ordinated the decision-making process through its three iterations. Final accord on 92 topics was achieved with unanimous approval of the board in 1994. These topics, organized in five major categories, are offered as a guide to the reform of nutrition education and as the basis of a satisfactory nutrition curriculum.

  2. Report of the American Medical Student Association's Nutrition Curriculum Project. Essentials of nutrition education in medical schools: a national consensus.

    Science.gov (United States)

    1997-05-01

    Medical students of the American Medical Student Association established the Nutrition Curriculum Project (NCP) with the goals of ensuring that adequate nutrition information be taught to medical students; ensuring that there be a framework for integration of nutrition topics at all levels of medical education; and formulating and disseminating essential information for nutrition assessment and management in clinical practice. As a first step, the NCP assembled a ten-member advisory board to develop a comprehensive list of nutrition topics deemed essential for the adequate training of physicians. The advisory board consisted of medical and nutrition educators, physicians, and clinical specialists representing major U.S. professional nutrition organizations. The NCP's director coordinated the decision-making process through its three iterations. Final accord on 92 topics was achieved with unanimous approval of the board in 1994. These topics, organized in five major categories, are offered as a guide to the reform of nutrition education and as the basis of a satisfactory nutrition curriculum.

  3. Workforce and Salary Survey Trends: Opportunities and Challenges for the American Association of Medical Dosimetrists

    Energy Technology Data Exchange (ETDEWEB)

    Mills, Michael D., E-mail: mdmill03@exchange.louisville.edu

    2015-07-01

    The American Association of Medical Dosimetrists (AAMD) designed and directed 2 surveys of the AAMD membership. The first was in 2011 and the second in 2014. There were a number of questions common to both surveys, and this article seeks to evaluate these common questions to determine trends among the professional membership of the AAMD. It is demonstrated that the observed trends are consistent with the goals and objectives established by the leadership of the AAMD and the Medical Dosimetry Certification Board (MDCB) for the medical dosimetry community. In addition, certain challenges and opportunities involving the scope of practice for the medical dosimetry profession are discussed.

  4. Tobacco smoking is causally associated with antipsychotic medication use and schizophrenia, but not with antidepressant medication use or depression

    DEFF Research Database (Denmark)

    Wium-Andersen, Marie Kim; Ørsted, David Dynnes; Nordestgaard, Børge Grønne

    2015-01-01

    BACKGROUND: Tobacco smoking is more common among patients with schizophrenia and depression than among healthy individuals. We tested the hypothesis that high tobacco smoking intensity is causally associated with antipsychotic medication use, schizophrenia, antidepressant medication use and....../or depression in the general population, and compared results with those for chronic obstructive pulmonary disease. METHODS: We used self-reported smoking intensity in cigarettes/day and a polymorphism in the CHRNA3 gene cluster (rs1051730) associated with smoking intensity, on 63,296 20-100-year......-old individuals from the Danish general population; 23,282 were never-smokers and 40,014 ever-smokers. For schizophrenia, we compared our results with those in the Psychiatric Genomics Consortium. RESULTS: In smokers, heterozygotes (CT) and homozygotes (TT) for rs1051730 genotype had higher smoking intensity...

  5. Factors associated with the prescription of antidepressive medication to breast cancer patients

    DEFF Research Database (Denmark)

    Suppli, Nis P; Deltour, Isabelle; Damkjaer, Lars H;

    2011-01-01

    We evaluated factors associated with use of antidepressant medication subsequent to a diagnosis of breast cancer. We also evaluated the effect of participation in a cancer rehabilitation program on use of antidepressants.......We evaluated factors associated with use of antidepressant medication subsequent to a diagnosis of breast cancer. We also evaluated the effect of participation in a cancer rehabilitation program on use of antidepressants....

  6. Medication administration error: magnitude and associated factors among nurses in Ethiopia

    OpenAIRE

    Feleke, Senafikish Amsalu; Mulatu, Muluadam Abebe; Yesmaw, Yeshaneh Seyoum

    2015-01-01

    Background The significant impact of medication administration errors affect patients in terms of morbidity, mortality, adverse drug events, and increased length of hospital stay. It also increases costs for clinicians and healthcare systems. Due to this, assessing the magnitude and associated factors of medication administration error has a significant contribution for improving the quality of patient care. The aim of this study was to assess the magnitude and associated factors of medicatio...

  7. Social workers welcome refugees to the UK – joint statement and call for action by the Association of Professors of Social Work (APSW), British Association of Social Workers (BASW), Joint University Council Social Work Education Committee (JUC SWEC) and Social Work Action Network (SWAN).

    OpenAIRE

    Smith, Kate

    2015-01-01

    In November 2015, the Association of Professors of Social Work, the British Association of Social Workers, the Joint University Council Social Work Education Committee, and the Social Work Action Network (SWAN) agreed a joint statement and call for action on the refugee crisis across the EU. This statement was also supported by colleagues from the legal community in their call for action to the UK government and appeared on Monday 12 October 2015 in The Times and The Guardian. Dr. Kate Smith ...

  8. Prevalence and associated factors of stress, anxiety and depression among prospective medical students.

    Science.gov (United States)

    Yusoff, Muhamad Saiful Bahri; Abdul Rahim, Ahmad Fuad; Baba, Abdul Aziz; Ismail, Shaiful Bahari; Mat Pa, Mohamad Najib; Esa, Ab Rahman

    2013-04-01

    Many studies have reported that the prevalence of psychological distress among medical students during medical training was high. However, there are very few studies exploring on the psychological health of prospective medical students. This study aimed to determine the prevalence and associated factors for stress, anxiety and depression symptoms among the prospective medical students. A cross-sectional study was done on two cohorts of applicants to a public medical school. A total of 839 applicants were invited to participate in the study. The 21-item Depression Anxiety Stress Scale was administered to the applicants after they completed interviews. A total of 743 (92.2%) applicants took part in the study. The prevalence of moderate to extremely severe level of stress, anxiety and depression were 3.6%, 54.5% and 1.9%, respectively. Stress was significantly associated with extra-curricular activity (pstress and depression among entering medical students was low; however prevalence of anxiety was high which could be due to worry about the interviews to enter medical course. The associated factors of psychological distress among prospective medical students were related to academic, non-academic, parent education and cultural backgrounds.

  9. Identification of Associations Between Prescribed Medications and Cancer

    DEFF Research Database (Denmark)

    Pottegård, Anton; Friis, Søren; Christensen, René dePont;

    2016-01-01

    PURPOSE: We present a systematic screening for identifying associations between prescribed drugs and cancer risk using the high quality Danish nationwide health registries. METHODS: We identified all patients (cases) with incident cancer in Denmark during 2000-2012 (n=278,485) and matched each ca...

  10. Characteristics associated with citation rate of the medical literature.

    Directory of Open Access Journals (Sweden)

    Abhaya V Kulkarni

    Full Text Available BACKGROUND: The citation rate for articles is viewed as a measure of their importance and impact; however, little is known about what features of articles are associated with higher citation rate. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a cohort study of all original articles, regardless of study methodology, published in the Lancet, JAMA, and New England Journal of Medicine, from October 1, 1999 to March 31, 2000. We identified 328 articles. Two blinded, independent reviewers extracted, in duplicate, nine variables from each article, which were analyzed in both univariable and multivariable linear least-squares regression models for their association with the annual rate of citations received by the article since publication. A two-way interaction between industry funding and an industry-favoring result was tested and found to be significant (p = 0.02. In our adjusted analysis, the presence of industry funding and an industry-favoring result was associated with an increase in annual citation rate of 25.7 (95% confidence interval, 8.5 to 42.8 compared to the absence of both industry funding and industry-favoring results. Higher annual rates of citation were also associated with articles dealing with cardiovascular medicine (13.3 more; 95% confidence interval, 3.9 to 22.3 and oncology (12.6 more; 95% confidence interval, 1.2 to 24.0, articles with group authorship (11.1 more; 95% confidence interval, 2.7 to 19.5, larger sample size and journal of publication. CONCLUSIONS/SIGNIFICANCE: Large trials, with group authorship, industry-funded, with industry-favoring results, in oncology or cardiology were associated with greater subsequent citations.

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

    Science.gov (United States)

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

    2015-01-01

    Introduction. Medicine is one of the most stressful fields of education because of its highly demanding professional and academic requirements. Psychological stress, anxiety, depression and sleep disturbances are highly prevalent in medical students. Methods. This cross-sectional study was undertaken at the Combined Military Hospital Lahore Medical College and the Institute of Dentistry in Lahore (CMH LMC), Pakistan. Students enrolled in all yearly courses for the Bachelor of Medicine and Bachelor of Surgery (MBBS) degree were included. The questionnaire consisted of four sections: (1) demographics (2) a table listing 34 potential stressors, (3) the 14-item Perceived Stress Scale (PSS-14), and (4) the Pittsburgh Quality of Sleep Index (PSQI). Logistic regression was run to identify associations between group of stressors, gender, year of study, student's background, stress and quality of sleep. Results. Total response rate was 93.9% (263/280 respondents returned the questionnaire). The mean (SD) PSS-14 score was 30 (6.97). Logistic regression analysis showed that cases of high-level stress were associated with year of study and academic-related stressors only. Univariate analysis identified 157 cases with high stress levels (59.7%). The mean (SD) PSQI score was 8.1 (3.12). According to PSQI score, 203/263 respondents (77%) were poor sleepers. Logistic regression showed that mean PSS-14 score was a significant predictor of PSQI score (OR 1.99, P academic stress and poor sleep quality among medical students. Many medical students reported using sedatives more than once a week. Academic stressors contributed significantly to stress and sleep disorders in medical students.

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

    Directory of Open Access Journals (Sweden)

    Ahmed Waqas

    2015-03-01

    Full Text Available Introduction. Medicine is one of the most stressful fields of education because of its highly demanding professional and academic requirements. Psychological stress, anxiety, depression and sleep disturbances are highly prevalent in medical students. Methods. This cross-sectional study was undertaken at the Combined Military Hospital Lahore Medical College and the Institute of Dentistry in Lahore (CMH LMC, Pakistan. Students enrolled in all yearly courses for the Bachelor of Medicine and Bachelor of Surgery (MBBS degree were included. The questionnaire consisted of four sections: (1 demographics (2 a table listing 34 potential stressors, (3 the 14-item Perceived Stress Scale (PSS-14, and (4 the Pittsburgh Quality of Sleep Index (PSQI. Logistic regression was run to identify associations between group of stressors, gender, year of study, student’s background, stress and quality of sleep. Results. Total response rate was 93.9% (263/280 respondents returned the questionnaire. The mean (SD PSS-14 score was 30 (6.97. Logistic regression analysis showed that cases of high-level stress were associated with year of study and academic-related stressors only. Univariate analysis identified 157 cases with high stress levels (59.7%. The mean (SD PSQI score was 8.1 (3.12. According to PSQI score, 203/263 respondents (77% were poor sleepers. Logistic regression showed that mean PSS-14 score was a significant predictor of PSQI score (OR 1.99, P < 0.05. Conclusion. We found a very high prevalence of academic stress and poor sleep quality among medical students. Many medical students reported using sedatives more than once a week. Academic stressors contributed significantly to stress and sleep disorders in medical students.

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

    Science.gov (United States)

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

    2015-01-01

    Introduction. Medicine is one of the most stressful fields of education because of its highly demanding professional and academic requirements. Psychological stress, anxiety, depression and sleep disturbances are highly prevalent in medical students. Methods. This cross-sectional study was undertaken at the Combined Military Hospital Lahore Medical College and the Institute of Dentistry in Lahore (CMH LMC), Pakistan. Students enrolled in all yearly courses for the Bachelor of Medicine and Bachelor of Surgery (MBBS) degree were included. The questionnaire consisted of four sections: (1) demographics (2) a table listing 34 potential stressors, (3) the 14-item Perceived Stress Scale (PSS-14), and (4) the Pittsburgh Quality of Sleep Index (PSQI). Logistic regression was run to identify associations between group of stressors, gender, year of study, student's background, stress and quality of sleep. Results. Total response rate was 93.9% (263/280 respondents returned the questionnaire). The mean (SD) PSS-14 score was 30 (6.97). Logistic regression analysis showed that cases of high-level stress were associated with year of study and academic-related stressors only. Univariate analysis identified 157 cases with high stress levels (59.7%). The mean (SD) PSQI score was 8.1 (3.12). According to PSQI score, 203/263 respondents (77%) were poor sleepers. Logistic regression showed that mean PSS-14 score was a significant predictor of PSQI score (OR 1.99, P academic stress and poor sleep quality among medical students. Many medical students reported using sedatives more than once a week. Academic stressors contributed significantly to stress and sleep disorders in medical students. PMID:25802809

  14. Careers in Medical Physics and the American Association of Physicists in Medicine

    Science.gov (United States)

    Amols, Howard

    2006-03-01

    The American Association of Physicists in Medicine (AAPM), a member society of the AIP is the largest professional society of medical physicists in the world with nearly 5700 members. Members operate in medical centers, university and community hospitals, research laboratories, industry, and private practice. Medical physics specialties include radiation therapy physics, medical diagnostic and imaging physics, nuclear medicine physics, and medical radiation safety. The majority of AAPM members is based in hospital departments of radiation oncology or radiology and provide technical support for patient diagnosis and treatment in a clinical environment. Job functions include support of clinical care, calibration and quality assurance of medical devices such as linear accelerators for cancer therapy, CT, PET, MRI, and other diagnostic imaging devices, research, and teaching. Pathways into a career in medical physics require an advanced degree in medical physics, physics, engineering, or closely related field, plus clinical training in one or more medical physics specialties (radiation therapy physics, imaging physics, or radiation safety). Most clinically based medical physicists also obtain certification from the American Board of Radiology, and some states require licensure as well.

  15. Cross-validating factors associated with discharges against medical advice.

    Science.gov (United States)

    Dalrymple, A J; Fata, M

    1993-05-01

    Between six percent and 35% of psychiatric patients discharge themselves from hospital against medical advice (AMA). The discharges may prevent patients from deriving the full benefit of hospitalization and may result in rapid rehospitalization. We examined sociodemographic and clinical characteristics of 195 irregular discharges from a 237 bed psychiatric hospital over a five year period and found that AMA discharges increased over the study period to a peak of 25% in 1986. There was a strong negative correlation between AMA discharge rates and the willingness of physicians to commit patients involuntarily. Multiple discriminant analysis revealed a set of nine variables that accurately classified 78% of cases into regular or irregular discharge categories. Further analysis revealed that there are two distinct subgroups of patients who discharge themselves AMA: those who repeatedly left the hospital AMA in a regular "revolving back door" pattern and those who left AMA only once. The repeat group exceeded the one-time group in terms of prior admissions, appearances before review boards, and percentage of Natives. The repeat group also spent twice as long in hospital, and 27% were readmitted within one-week of the index AMA discharge. Less than three percent of the one-time AMA group was readmitted within a week. These results were cross-validated on a new sample of irregular discharges and matched controls. PMID:8518982

  16. Association of medical students' reports of interactions with the pharmaceutical and medical device industries and medical school policies and characteristics: a cross-sectional study.

    Directory of Open Access Journals (Sweden)

    James S Yeh

    2014-10-01

    Full Text Available BACKGROUND: Professional societies use metrics to evaluate medical schools' policies regarding interactions of students and faculty with the pharmaceutical and medical device industries. We compared these metrics and determined which US medical schools' industry interaction policies were associated with student behaviors. METHODS AND FINDINGS: Using survey responses from a national sample of 1,610 US medical students, we compared their reported industry interactions with their schools' American Medical Student Association (AMSA PharmFree Scorecard and average Institute on Medicine as a Profession (IMAP Conflicts of Interest Policy Database score. We used hierarchical logistic regression models to determine the association between policies and students' gift acceptance, interactions with marketing representatives, and perceived adequacy of faculty-industry separation. We adjusted for year in training, medical school size, and level of US National Institutes of Health (NIH funding. We used LASSO regression models to identify specific policies associated with the outcomes. We found that IMAP and AMSA scores had similar median values (1.75 [interquartile range 1.50-2.00] versus 1.77 [1.50-2.18], adjusted to compare scores on the same scale. Scores on AMSA and IMAP shared policy dimensions were not closely correlated (gift policies, r = 0.28, 95% CI 0.11-0.44; marketing representative access policies, r = 0.51, 95% CI 0.36-0.63. Students from schools with the most stringent industry interaction policies were less likely to report receiving gifts (AMSA score, odds ratio [OR]: 0.37, 95% CI 0.19-0.72; IMAP score, OR 0.45, 95% CI 0.19-1.04 and less likely to interact with marketing representatives (AMSA score, OR 0.33, 95% CI 0.15-0.69; IMAP score, OR 0.37, 95% CI 0.14-0.95 than students from schools with the lowest ranked policy scores. The association became nonsignificant when fully adjusted for NIH funding level, whereas adjusting for year of

  17. Conservative care for end-stage kidney disease: joint medical conference with the Renal Association, British Geriatrics Society and Association for Palliative Medicine.

    Science.gov (United States)

    Alston, Helen

    2013-08-01

    Conservative care is one of the fastest-changing areas of renal medicine. Non-dialytic therapy is now established as a treatment option in most renal units in the UK. This conference reviewed the history of conservative management and examined the state of current practice. The challenges now faced include expanding the evidence base in this area, improving the information given to patients and their families to help them make a decision about treatment, and responding to changes in NHS funding to ensure continued provision of high-quality care.

  18. American and British English

    Institute of Scientific and Technical Information of China (English)

    袁波

    2004-01-01

    @@ The difficulty for the nonnative learner of English is there is no standard English form. He is confronted(面对) with two English dialects (方言) to learn: British English and American English (leaving aside Australian,Indian, South African English ete.) And despite the many cross-cultural influences, it seems that the vocabularies, spellings and pronunciations of these two dialects are diverging year by year.

  19. Medical Treatments for Endometriosis-Associated Pelvic Pain

    Directory of Open Access Journals (Sweden)

    Gabriella Zito

    2014-01-01

    Full Text Available The main sequelae of endometriosis are represented by infertility and chronic pelvic pain. Chronic pelvic pain causes disability and distress with a very high economic impact. In the last decades, an impressive amount of pharmacological agents have been tested for the treatment of endometriosis-associated pelvic pain. However, only a few of these have been introduced into clinical practice. Following the results of the controlled studies available, to date, the first-line treatment for endometriosis associated pain is still represented by oral contraceptives used continuously. Progestins represent an acceptable alternative. In women with rectovaginal lesions or colorectal endometriosis, norethisterone acetate at low dosage should be preferred. GnRH analogues may be used as second-line treatment, but significant side effects should be taken into account. Nonsteroidal anti-inflammatory drugs are widely used, but there is inconclusive evidence for their efficacy in relieving endometriosis-associated pelvic pain. Other agents such as GnRH antagonist, aromatase inhibitors, immunomodulators, selective progesterone receptor modulators, and histone deacetylase inhibitors seem to be very promising, but there is not enough evidence to support their introduction into routine clinical practice. Some other agents, such as peroxisome proliferator activated receptors-γ ligands, antiangiogenic agents, and melatonin have been proven to be efficacious in animal studies, but they have not yet been tested in clinical studies.

  20. A Competency-Based Clinical Chemistry Course for the Associate Degree Medical Laboratory Technician Graduate in a Medical Technology Baccalaureate Program.

    Science.gov (United States)

    Buccelli, Pamela

    Presented is a project that developed a competency-based clinical chemistry course for associate degree medical laboratory technicians (MLT) in a medical technology (MT) baccalaureate program. Content of the course was based upon competencies expected of medical technologists at career-entry as defined in the statements adopted in 1976 by the…

  1. Prevalence and associated factors of polypharmacy among adult Saudi medical outpatients at a tertiary care center

    Directory of Open Access Journals (Sweden)

    Salih Bin Salih

    2013-01-01

    Full Text Available Objective: The objective of this study was to assess the prevalence of polypharmacy (PP and the associated factors in medical outpatients. Materials and Methods: A cross-sectional, observational, descriptive study was carried out in adult medical outpatients attending internal medicine clinics at King Abdulaziz Medical City, Riyadh, Saudi Arabia from 1 March 2009 to 31 December 2009. PP was defined as the concomitant use of ≥5 medications daily. The number of medications being currently taken by patient was recorded. Effect of patients′ age, gender, educational level, number of prescribers, disease load and disease type on PP was assessed by multivariate analysis using Statistical Package for Social Sciences Incorporated (SPSS Inc Version 18. Results: Out of 766 patients included in the study, 683 (89% had PP. The mean number of prescribed medications, oral pills and doses was 8.8, 9.6 and 12.1, respectively. Factors significantly associated with PP included age (≥61 years, disease load and the number of prescribers. Gender had no impact on PP while education beyond primary education significantly decreased PP. Hypertension, diabetes mellitus and dyslipidemia alone and as a cluster increased PP. Conclusion: We found an extremely high level of PP in medical outpatients at our tertiary care center. The impact of PP on medication compliance and control of underlying diseases in Saudi Arabia is unknown and needs to be studied at different levels of care.

  2. The Association of Antidepressant Medication and Body Weight Gain.

    Directory of Open Access Journals (Sweden)

    Sara Ranjbar

    2013-04-01

    Full Text Available Objective: To review the literature and discover which antidepressants are responsible for weight gain and then to discuss the areas with lack of adequate knowledge. Method: An electronic search was conducted through Medline, Pubmed, Cochrane library, and ScienceDirect. Forty nine empirical researches were identified and reviewed. Results: Amitriptyline, clomipramine, and mirtazapine have been associated with more weight gain induction in clinical studies, but not in animal-based studies. All TCAs have been reported to cause weight gain except protriptyline. MAOIs have been associated with weight gain. In SSRI group, citalopram and ecitalopram induce weight, yet mixed results exist for paroxetine and fluoxetine. Researches unanimously reported weight loss effect for bupropion. Some studies suggest contributing factors in the relationship of antidepressants with body weight changes including age, gender, base-line weights and treatment duration. Various results of different treatment durations have been reported in some cases but there are not continuous time-dependent studies for the influences of antidepressants on body weight changes. Conclusion: More studies are required to discover underlying mechanisms and the time-dependent effects of antidepressants on body weight changes.

  3. Prevalence and factors associated with self-medication in rheumatology in Sub-Saharan Africa

    Science.gov (United States)

    Ouédraogo, Dieu-Donné; Zabsonré/Tiendrebeogo, Joelle W; Zongo, Enselme; Kakpovi, Kodjo Geoffroy; Kaboré, Fulgence; Drabo, Joseph Y; Guissou, Innocent Pierre

    2015-01-01

    Objective We sought to determine the prevalence of and factors associated with self-medication in patients with rheumatic diseases. Material and Methods An analytical cross-sectional study was conducted from February to July 2013 in the rheumatology department. We included all patients who consulted for a rheumatic disease during the study period and who gave their consent. Results In total, 203 patients were included; of these, 146 patients (71.92%) had practiced self-medication. Furthermore, 99 patients (48.8%) had practiced self-medication for rheumatologic problems. The mean age of the patients was 45.5 years (range: 18–75 years). State officials accounted for 44.4% of patients. Eighty-one patients were schooled. Low back pain (29.29%) was the main reason for consultation, followed by polyarthralgia (12.12%). Using a visual analogue scale, the level of pain for which patients had used self-medication was rated as >70 out of 100 in 57.6% of patients. Fifty-five patients often self-medicated and 28 patients rarely. Drugs were bought from the pharmacy in 97% of cases. The main channel of self-medication was word of mouth (43.4%). The drugs used were mainly anti-inflammatory drugs (diclofenac: 54.54% and ibuprofen: 57.57%). Ten patients were unaware of the risks of self-medication. In multivariate analysis, sex, education level, and occupation were statistically associated with self-medication. Conclusion Self-medication for a specific rheumatologic symptom appears less common than self-medication in general. The procedures for responsible self-medication should be defined in Burkina Faso in order to minimize the risks.

  4. Fourth Sino-British Local Government Seminar

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    <正>The 4th Sino-British Local Government Seminar jointly sponsored by the CPAFFC, the China International Friendship Cities Association, the China-EU Association and the Local Government International Bureau of the UK (LGIB) was held in Beijing on June 29, 2004. He Luli, vice-chairperson of the Standing Committee of the National People’s Congress, attended the seminar and delivered a speech. CPAFFC President Chen Haosu made a keynote speech. Ken Bodfish,

  5. Survey of teaching/learning of healthcare-associated infections in UK and Irish medical schools.

    LENUS (Irish Health Repository)

    O'Brien, D

    2009-10-01

    All medical doctors have an important role to play in the diagnosis, management and prevention of healthcare-associated infection (HCAI). Strengthening the contribution of medical doctors and medical students to HCAI prevention programmes should include measures that enhance knowledge, improve practice and develop appropriate attitudes to the safety and quality of patient care. The Hospital Infection Society (HIS) funded a review of medical education on HCAI throughout medical schools in the UK and the Republic of Ireland. A questionnaire was drafted and circulated to all medical schools and 31 of 38 (82%) responded. The prevalence and transmission of HCAI were taught by 97% and 100% of medical schools, respectively, but the importance of HCAI as a quality and safety issue was covered in only 60% of medical schools. Multiple choice questions (MCQs) and objective structure clinical examinations (OSCEs) were the most popular methods of assessment. Lectures, discussion of cases and practical demonstrations were considered useful by >90% of respondents and online material and log books by 67% and 60%, respectively. More than 80% were willing to share a common pool of educational resources. An agreed curriculum should be developed for educating medical students in HCAI prevention and control, to outline optimum methods for assessment and develop a shared pool of educational resources.

  6. Evaluation of medical research performance – position paper of the Association of the Scientific Medical Societies in Germany (AWMF

    Directory of Open Access Journals (Sweden)

    Herrmann-Lingen, Christoph

    2014-06-01

    Full Text Available [english] Objective: The evaluation of medical research performance is a key prerequisite for the systematic advancement of medical faculties, research foci, academic departments, and individual scientists’ careers. However, it is often based on vaguely defined aims and questionable methods and can thereby lead to unwanted regulatory effects. The current paper aims at defining the position of German academic medicine toward the aims, methods, and consequences of its evaluation. Methods: During the Berlin Forum of the Association of the Scientific Societies in Germany (AWMF held on 18 October 2013, international experts presented data on methods for evaluating medical research performance. Subsequent discussions among representatives of relevant scientific organizations and within three ad-hoc writing groups led to a first draft of this article. Further discussions within the AWMF Committee for Evaluation of Performance in Research and Teaching and the AWMF Executive Board resulted in the final consented version presented here.Results: The AWMF recommends modifications to the current system of evaluating medical research performance. Evaluations should follow clearly defined and communicated aims and consist of both summative and formative components. Informed peer reviews are valuable but feasible in longer time intervals only. They can be complemented by objective indicators. However, the Journal Impact Factor is not an appropriate measure for evaluating individual publications or their authors. The scientific “impact” rather requires multidimensional evaluation. Indicators of potential relevance in this context may include, e.g., normalized citation rates of scientific publications, other forms of reception by the scientific community and the public, and activities in scientific organizations, research synthesis and science communication. In addition, differentiated recommendations are made for evaluating the acquisition of third

  7. The association between medication adherence and treatment intensification with blood pressure control in resistant hypertension.

    Science.gov (United States)

    Daugherty, Stacie L; Powers, J David; Magid, David J; Masoudi, Frederick A; Margolis, Karen L; O'Connor, Patrick J; Schmittdiel, Julie A; Ho, P Michael

    2012-08-01

    Patients with resistant hypertension are at risk for poor outcomes. Medication adherence and intensification improve blood pressure (BP) control; however, little is known about these processes or their association with outcomes in resistant hypertension. This retrospective study included patients from 2002 to 2006 with incident hypertension from 2 health systems who developed resistant hypertension or uncontrolled BP despite adherence to ≥3 antihypertensive medications. Patterns of hypertension treatment, medication adherence (percentage of days covered), and treatment intensification (increase in medication class or dose) were described in the year after resistant hypertension identification. Then, the association between medication adherence and intensification with 1-year BP control was assessed controlling for patient characteristics. Of the 3550 patients with resistant hypertension, 49% were male, and mean age was 60 years. One year after resistance hypertension determination, fewer patients were taking diuretics (77.7% versus 92.2%; PTreatment was intensified in 21.6% of visits with elevated BP. Increasing treatment intensity was associated with 1-year BP control (adjusted odds ratio, 1.64 [95% CI, 1.58-1.71]). In this cohort of patients with resistant hypertension, treatment intensification but not medication adherence was significantly associated with 1-year BP control. These findings highlight the need to investigate why patients with uncontrolled BP do not receive treatment intensification.

  8. 78 FR 17679 - Implementation of the Updated American Veterinary Medical Association Guidelines for the...

    Science.gov (United States)

    2013-03-22

    ... Association Guidelines for the Euthanasia of Animals: 2013 Edition SUMMARY: The National Institutes of Health... the American Veterinary Medical Association (AVMA) Guidelines for the Euthanasia of Animals: 2013... updated Guidelines. DATES: Public concerns regarding the updated AVMA Guidelines for the Euthanasia...

  9. Factors Associated with the Medical Severity of Suicide Attempts in Youths and Young Adults.

    Science.gov (United States)

    Swahn, Monica H.; Potter, Lloyd B.

    2002-01-01

    This study examined factors associated with the medical severity of suicide attempts focusing on demographic characteristics, and circumstances of the suicide attempt. Results show that young age was significantly associated with a nearly lethal suicide attempt. Prior attempts, hopelessness, depression, and help-seeking were significantly and…

  10. Proceedings of the 34. annual British Columbia mine reclamation symposium and 35. annual Canadian Land Reclamation Association meeting : reclamation from planning to closure

    Energy Technology Data Exchange (ETDEWEB)

    Price, W.; Wambolt, T.; Van Zyl, D.; Riordan, B.; Hargreaves, J.; Pomeroy, K.; Beckett, P.; Giasson, M.; Polster, D.; Howell, C. (eds.)

    2010-07-01

    This conference provided an opportunity to exchange information on mine reclamation and related issues affecting coal mining in British Columbia and oil sand mining in Alberta. The reclamation of lands disturbed by mineral extraction and processing or by other industrial activity is aimed at returning the land to a level that is equivalent to its pre-industrial activity. The environmental impacts of mine development were discussed along with opportunities to rehabilitate disturbed lands using new remedial methods for soil conservation, water protection and carbon sequestration. A broad range of reclamation, restoration and remediation methods for oil sand mining, coal mining and metals in soils were also discussed. The conference featured 30 presentations, including posters, of which 9 have been catalogued separately for inclusion in this database. refs., tabs., figs.

  11. Associations of desire for change in sexual life amongst female medical students in North America

    OpenAIRE

    Shindel, AW; Breyer, BN; Smith, JF

    2012-01-01

    We analyzed associations of dissatisfaction with sexual life and desire for change in female medical students. Students enrolled in medical schools in North America between February and July 2008 were invited to participate in an internet-based survey of sexual function. The principle outcome measure was a single item question on sexual life satisfaction and desire for change. Women who reported dissatisfaction and desire for change were classified as 'sexually bothered'. The survey also asse...

  12. The Association between Non-Medical Prescription Drug Use and Suicidal Behavior among United States Adolescents

    OpenAIRE

    Amanda L. Divin; Zullig, Keith J.

    2014-01-01

    Adolescence represents a vulnerable time for the development of both drug use/abuse and mental illness. Although previous research has substantiated a relationship between drug use and suicidal behavior, little research has examined this relationship with non-medical prescription drug use. Given the growing prevalence of non-medical prescription drug use (NMPDU) among adolescents, this study explored the association between NMPDU and suicidal behavior. Nationally representative data were deri...

  13. Medical Device-Associated Candida Infections in a Rural Tertiary Care Teaching Hospital of India

    Directory of Open Access Journals (Sweden)

    Sachin C. Deorukhkar

    2016-01-01

    Full Text Available Health care associated infections (HCAIs add incrementally to the morbidity, mortality, and cost expected of the patient’s underlying diseases alone. Approximately, about half all cases of HCAIs are associated with medical devices. As Candida medical device-associated infection is highly drug resistant and can lead to serious life-threatening complications, there is a need of continuous surveillance of these infections to initiate preventive and corrective measures. The present study was conducted at a rural tertiary care hospital of India with an aim to evaluate the rate of medical device-associated Candida infections. Three commonly encountered medical device-associated infections (MDAI, catheter-associated urinary tract infection (CA-UTI, intravascular catheter-related blood stream infections (CR-BSI, and ventilator-associated pneumonia (VAP, were targeted. The overall rate of MDAI in our hospital was 2.1 per 1000 device days. The rate of Candida related CA-UTI and CR-BSI was noted as 1.0 and 0.3, respectively. Untiring efforts taken by team members of Hospital Acquired Infection Control Committee along with maintenance of meticulous hygiene of the hospital and wards may explain the low MDAI rates in our institute. The present surveillance helped us for systematic generation of institutional data regarding MDAI with special reference to role of Candida spp.

  14. The Japan Medical Association's disaster preparedness: lessons from the Great East Japan Earthquake and Tsunami.

    Science.gov (United States)

    Ishii, Masami; Nagata, Takashi

    2013-10-01

    A complex disaster, the Great East Japan Earthquake of March 11, 2011, consisted of a large-scale earthquake, tsunami, and nuclear accident, resulting in more than 15 000 fatalities, injuries, and missing persons and damage over a 500-km area. The entire Japanese public was profoundly affected by "3/11." The risk of radiation exposure initially delayed the medical response, prolonging the recovery efforts. Japan's representative medical organization, the Japan Medical Association (JMA), began dispatching Japan Medical Association Teams (JMATs) to affected areas beginning March 15, 2011. About 1400 JMATs comprising nearly 5500 health workers were launched. The JMA coordinated JMAT operations and cooperated in conducting postmortem examination, transporting large quantities of medical supplies, and establishing a multiorganizational council to provide health assistance to disaster survivors. Importantly, these response efforts contributed to the complete recovery of the health care system in affected areas within 3 months, and by July 15, 2011, JMATs were withdrawn. Subsequently, JMATs II have been providing long-term continuing medical support to disaster-affected areas. However, Japan is at great risk for future natural disasters because of its Pacific Rim location. Also, its rapidly aging population, uneven distribution of and shortage of medical resources in regional communities, and an overburdened public health insurance system highlight the need for a highly prepared and effective disaster response system.

  15. Excess Medical Care Costs Associated with Physical Inactivity among Korean Adults: Retrospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Jin-Young Min

    2016-01-01

    Full Text Available Physical inactivity is a major risk factor for chronic diseases and premature death. The increased health risks associated with physical inactivity may also generate a heavier economic burden to society. We estimated the direct medical costs attributable to physical inactivity among adultsusing data from the 2002–2010 Korean National Health Insurance Service-National Sample Cohort. A total of 68,556 adults whose reported physical activity status did not change during the study period was included for this study. Propensity scores for inactive adults were used to match 23,645 inactive groups with 23,645 active groups who had similar propensity scores. We compared medical expenditures between the two groups using generalized linear models with a gamma distribution and a log link. Direct medical costs were based on the reimbursement records of all medical facilities from 2005 to 2010. The average total medical costs for inactive individuals were $1110.5, which was estimated to be 11.7% higher than the costs for physically active individuals. With respect to specific diseases, the medical costs of inactive people were significantly higher than those of active people, accounting for approximately 8.7% to 25.3% of the excess burden. Physical inactivity is associated with considerable medical care expenditures per capita among Korean adults.

  16. Excess Medical Care Costs Associated with Physical Inactivity among Korean Adults: Retrospective Cohort Study.

    Science.gov (United States)

    Min, Jin-Young; Min, Kyoung-Bok

    2016-01-01

    Physical inactivity is a major risk factor for chronic diseases and premature death. The increased health risks associated with physical inactivity may also generate a heavier economic burden to society. We estimated the direct medical costs attributable to physical inactivity among adults using data from the 2002-2010 Korean National Health Insurance Service-National Sample Cohort. A total of 68,556 adults whose reported physical activity status did not change during the study period was included for this study. Propensity scores for inactive adults were used to match 23,645 inactive groups with 23,645 active groups who had similar propensity scores. We compared medical expenditures between the two groups using generalized linear models with a gamma distribution and a log link. Direct medical costs were based on the reimbursement records of all medical facilities from 2005 to 2010. The average total medical costs for inactive individuals were $1110.5, which was estimated to be 11.7% higher than the costs for physically active individuals. With respect to specific diseases, the medical costs of inactive people were significantly higher than those of active people, accounting for approximately 8.7% to 25.3% of the excess burden. Physical inactivity is associated with considerable medical care expenditures per capita among Korean adults. PMID:26797622

  17. The association of needlestick injury with depressive symptoms among first-year medical residents in Japan.

    Science.gov (United States)

    Wada, Koji; Sakata, Yumi; Fujino, Yoshihisa; Yoshikawa, Toru; Tanaka, Katsutoshi; Miyajima, Eriko; Watanabe, Mitsuyasu; Aizawa, Yoshiharu

    2007-12-01

    Depressive symptoms among medical residents are common. The objective of this study was to determine the association of depressive symptoms with needlestick injury among first-year medical residents (so-called "intern"). We conducted a prospective cohort study among 107 medical residents in 14 training hospitals. The baseline survey was conducted in August 2005 and the follow-up survey was conducted in March 2006. Depressive symptoms were based on the Center for Epidemiological Study of Depression. Factors associated with depressive symptoms were examined using logistic regression analysis. For medical residents without depressive symptoms at the baseline survey, needlestick injury events were associated with depressive symptoms at the follow-up survey (corrected odds ratio [cOR]=2.98; 95% confidence interval [CI], 1.16-3.70). Because it was not possible to determine when the medical residents developed depressive symptoms, it is not possible to definitely determine causality between needlestick injury and depressive symptoms, although these findings are suggestive. Therefore, it would seem prudent to suggest the provision of mental health services to medical residents sustaining a needlestick injury since this may be helpful in identifying and treating depression.

  18. Medication details documented on hospital discharge: cross-sectional observational study of factors associated with medication non-reconciliation.

    LENUS (Irish Health Repository)

    Grimes, Tamasine C

    2011-03-01

    Movement into or out of hospital is a vulnerable period for medication safety. Reconciling the medication a patient is using before admission with the medication prescribed on discharge, and documenting any changes (medication reconciliation) is recommended to improve safety. The aims of the study were to investigate the factors contributing to medication reconciliation on discharge, and identify the prevalence of non-reconciliation.

  19. Medication Persistence Rates and Factors Associated with Persistence in Patients Following Stroke: A Cohort Study

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    Joffres Michel R

    2008-07-01

    Full Text Available Abstract Background Medication nonadherence can be as high as 50% and results in suboptimal patient outcomes. Stroke patients in particular can benefit from pharmacotherapy for thrombosis, hypertension, and dyslipidemia but are at high risk for medication nonpersistence. Methods Patients who were admitted to the Queen Elizabeth II Health Sciences Centre in Halifax, Nova Scotia, with stroke between January 1, 2001 and December 31, 2002 were analyzed. Data collected were pre-stroke function, stroke subtype, stroke severity, patient outcomes, and medication use at discharge, and six and 12 months post discharge. Medication persistence at six and 12 months and the factors associated with nonpersistence at six months were examined using multivariable stepwise logistic regression. Results At discharge, 420 patients (mean age 68.2 years, 55.7% male were prescribed an average of 6.4 medications and mean prescription drug cost was $167 monthly. Antihypertensive (91% and antithrombotic (96% drug use at discharge were frequent, antilipidemic (73% and antihyperglycemic (25% drug use were less common. Self-reported persistence at six and 12 months after stroke was high (> 90% for all categories. In the multivariable model of medication nonpersistence at six months, people aged 65 to 79 years were less likely to be nonpersistent with antihypertensive medications than people aged 80 years or more (Odds ratio (OR 0.11, 95% Confidence Interval (CI 0.03–0.39. Monthly drug costs of Conclusion Patients reported high medication persistence rates six and 12 months after stroke. Identification of factors associated with nonpersistence (such as older age and prior disability will help predict which patients are at higher risk for discontinuing their medications.

  20. Number of medications is associated with outcomes in the elderly patient with metabolic syndrome

    Institute of Scientific and Technical Information of China (English)

    Akshar Y. Patel; Pratik Shah; Joseph H. Flaherty

    2012-01-01

    Background The diagnosis of metabolic syndrome indicates a clustering of metabolic imbalances which in sum have been recognized as a major predictor of cardiovascular and all-cause mortality. The aim of this study was to assess the level of under-pharmacy and poly-pharmacy and its prognostic impact in elderly patients with metabolic syndrome. Methods Retrospective chart-review at a tertiary medical center, of 324 patients greater than 65 years of age who met the International Diabetes Foundation criteria for metabolic syndrome diagnosis [Body Mass Index (BMI) > 30 kg/m2, diagnosis of type 2 diabetes, hypertension, and dyslipidemia]. Results There were 60 (18.5%) patients in the low (≤ 5) medication burden group, 159 (49.1%) in the medium (> 5 and ≤ 10) medication burden group, and 105(32.4%) in the high (> 10) medication burden group. At baseline, the groups differed only by systolic blood pressure. At two years follow-up,the medium group had significantly better improvement in high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), HbA1c, and systolic blood pressure compared to the low medication burden group and significantly better improvement in triglycerides, Haemoglobin A1c (HbA1c) and systolic blood pressure compared to the high medication group. Decrease in HDL-C was the only variable associated with strokes. High medication burden predicted hospitalization burden. The number of anti-hypertensives, history of tobacco use, low and high medication burdens and decrease in HDL-C were all associated with death. Conclusions Both poly-pharmacy and under-pharmacy are associated with a decreased therapeutic benefit among patients with metabolic syndrome in terms of important laboratory measurements as well as clinical outcomes such as myocardial infarctions, hospitalization, and death.

  1. Associations of anemia persistency with medical expenditures in Medicare ESRD patients on dialysis

    Directory of Open Access Journals (Sweden)

    Jiannong Liu

    2009-04-01

    Full Text Available Jiannong Liu1, Haifeng Guo1, David Gilbertson1, Robert Foley1,2, Allan Collins1,21Chronic Disease Research Group, Minneapolis Medical Research Foundation, Minneapolis, MN, USA; 2Department of Medicine, University of Minnesota, Minneapolis, MN, USAAbstract: Most end-stage renal disease (ESRD patients begin renal replacement therapy with hemoglobin levels below the recommended US National Kidney Foundation Dialysis Outcomes Quality Initiative Guidelines lower level of 110 g/L. Although most patients eventually reach this target, the time required varies substantially. This study aimed to determine whether length of time with below-target hemoglobin levels after dialysis initiation is associated with medical costs, and if so, whether intermediate factors underlie the associations. US patients initiating dialysis in 2002 were studied using the Centers for Medicare and Medicaid Services ESRD database. Anemia persistence (time in months with hemoglobin below 110 g/L was determined in a six-month entry period, and outcomes were assessed in the subsequent six-month follow-up period. The structural equation modeling technique was used to evaluate associations between persistent anemia and medical costs and to determine intermediate factors for these associations. The study included 28,985 patients. Mean per-patient-per-month medical cost was $6267 (standard deviation $5713 in the six-month follow-up period. Each additional month with hemoglobin below 110 g/L was associated with an 8.9% increment in medical cost. The increased cost was associated with increased erythropoietin use and blood transfusions, and increased rates of hospitalization and vascular access procedures in the follow-up period. Keywords: anemia persistency, end-stage renal disease, medical costs, structural equation modeling

  2. The association between medical education accreditation and the examination performance of internationally educated physicians seeking certification in the United States

    OpenAIRE

    van Zanten, Marta

    2015-01-01

    The purpose of this study was to investigate the performance of graduates of international medical schools who seek Educational Commission for Foreign Medical Graduates certification based on accreditation of their medical education programmes. For the self-selected population who took United States Medical Licensing Examinations during the study period (2006–2010), accreditation was associated with higher first-attempt pass rates on some examinations, especially for international medical gra...

  3. Factors associated with skipping breakfast among Inner Mongolia Medical students in China

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    Sun Juan

    2013-01-01

    Full Text Available Abstract Background Few studies on the breakfast consumption habits of medical students in China have been carried out. The aim of the present study was to determine the prevalence of skipping breakfast and factors associated with skipping breakfast among medical students in Inner Mongolia of China, and to assist in the design of interventions to improve breakfast consumption habits of medical college students in this region. Methods From December 2010 to January 2011 a cross-sectional survey was conducted among medical students in the Inner Mongolia Medical College using a self-administered questionnaire. The prevalence of skipping breakfast in relation to lifestyle habits was described and factors associated with breakfast consumption were identified using multiple logistic regression analysis. Results The overall prevalence of skipping breakfast was 41.7% and 23.5% for males and females, respectively. The Faculty of Medicine Information Management had the highest breakfast skipping prevalence. Logistic regression models found that the main factors associated with breakfast consumption habits among medical students were gender, class years of education, monthly expenses, faculty, appetite, sleeping quality, and the learning process; monthly expenses, sleeping quality, and the learning process showed a dose-dependent relationship. Conclusions Breakfast consumption was associated with many factors, most importantly monthly expenses, sleeping quality and the learning process. The prevalence of skipping breakfast is significantly higher compared recently reported figures for medical students in western countries and other areas of China. Improvement of breakfast education should be considered for students in which higher monthly expenses, poor sleeping quality, or a laborious learning process have been identified.

  4. The Examination of China’s New Medical Reform Based on Restrictive Factors in British Medical Reform%基于英国医改制约性因素审视我国新医改

    Institute of Scientific and Technical Information of China (English)

    王演艺

    2014-01-01

    As the first country established universal health insurance in the world, UK has been devoted to construct the fairness and welfare of National Health Service(NHS) with constant development and improvement. It focuses on the reform process of NHS since the beginning of this century and studies the deep factors restricted the reform, compared with the current situation of health care system under China’s new medical reform since 2006, putting forward enlightenment to China’s reform.%作为世界上最早建立全民医疗保障的国家,英国一直致力于其医疗服务系统(NHS)公平性与福利性的构建,不断进行发展与完善。文章重点关注本世纪以来NHS 的改革历程,研究影响其改革成效的深层次制约性因素,同时对照我国2006年启动新医疗改革后国内卫生医疗服务体系的现状,提出其对我国新医改的启示。

  5. Extracurricular activities associated with stress and burnout in preclinical medical students.

    Science.gov (United States)

    Fares, Jawad; Saadeddin, Zein; Al Tabosh, Hayat; Aridi, Hussam; El Mouhayyar, Christopher; Koleilat, Mohamad Karim; Chaaya, Monique; El Asmar, Khalil

    2016-09-01

    This study aims to assess the prevalence of stress and burnout among preclinical medical students in a private university in Beirut, Lebanon, and evaluate the association between extracurricular involvement and stress and burnout relief in preclinical medical students. A cross-sectional survey was conducted on a random sample of 165 preclinical medical students. Distress level was measured using the 12-item General Health Questionnaire (GHQ-12) while that of burnout was measured through the Maslach Burnout Inventory-Student Survey (MBI-SS). The MBI-SS assesses three interrelated dimensions: emotional exhaustion, cynicism, and academic efficacy. Extracurricular activities were divided into four categories: physical exercise, music, reading, and social activities. All selected participants responded. A substantial proportion of preclinical medical students suffered from stress (62%) and burnout (75%). Bivariate and multivariate regression analyses revealed that being a female or a 1st year medical student correlated with higher stress and burnout. Music-related activities were correlated with lower burnout. Social activities or living with parents were associated with lower academic efficacy. The high stress and burnout levels call for action. Addressing the studying conditions and attending to the psychological wellbeing of preclinical medical students are recommendations made in the study.

  6. Extracurricular activities associated with stress and burnout in preclinical medical students.

    Science.gov (United States)

    Fares, Jawad; Saadeddin, Zein; Al Tabosh, Hayat; Aridi, Hussam; El Mouhayyar, Christopher; Koleilat, Mohamad Karim; Chaaya, Monique; El Asmar, Khalil

    2016-09-01

    This study aims to assess the prevalence of stress and burnout among preclinical medical students in a private university in Beirut, Lebanon, and evaluate the association between extracurricular involvement and stress and burnout relief in preclinical medical students. A cross-sectional survey was conducted on a random sample of 165 preclinical medical students. Distress level was measured using the 12-item General Health Questionnaire (GHQ-12) while that of burnout was measured through the Maslach Burnout Inventory-Student Survey (MBI-SS). The MBI-SS assesses three interrelated dimensions: emotional exhaustion, cynicism, and academic efficacy. Extracurricular activities were divided into four categories: physical exercise, music, reading, and social activities. All selected participants responded. A substantial proportion of preclinical medical students suffered from stress (62%) and burnout (75%). Bivariate and multivariate regression analyses revealed that being a female or a 1st year medical student correlated with higher stress and burnout. Music-related activities were correlated with lower burnout. Social activities or living with parents were associated with lower academic efficacy. The high stress and burnout levels call for action. Addressing the studying conditions and attending to the psychological wellbeing of preclinical medical students are recommendations made in the study. PMID:26644345

  7. Indians Repulse British With Rocket

    Science.gov (United States)

    2004-01-01

    During the early introduction of rockets to Europe, they were used only as weapons. Enemy troops in India repulsed the British with rockets. Later, in Britain, Sir William Congreve developed a rocket that could fire to about 9,000 feet. The British fired Congreve rockets against the United States in the War of 1812.

  8. Exploring the association of ego defense mechanisms with problematic internet use in a Pakistani medical school.

    Science.gov (United States)

    Waqas, Ahmed; Rehman, Abdul; Malik, Aamenah; Aftab, Ramsha; Allah Yar, Aroosa; Allah Yar, Arooj; Rai, Aitzaz Bin Sultan

    2016-09-30

    The present study was designed to analyze association between problematic internet use and use of ego defense mechanisms in medical students. This cross-sectional study was undertaken at CMH Lahore Medical College (CMH LMC) in Lahore, Pakistan from 1st March, 2015 to 30th May, 2015. 522 medical and dental students were included in the study. The questionnaire consisted of three sections: a) demographic characteristics of respondent b) the Defense Style Questionnaire-40 (DSQ-40) and c) the Internet Addiction Test (IAT). All data were analyzed in SPSS v20. Chi square, Independent sample t test and One Way ANOVA were run to analyze association of different variables with scores on IAT. Multiple regression analysis was used to delineate ego defenses as predictors of problematic internet use. A total of 32 (6.1%) students reported severe problems with internet usage. Males had higher scores on IAT i.e had more problematic use of internet. Scores on internet addiction test (IAT) were negatively associated with sublimation and positively associated with projection, denial, autistic fantasy, passive aggression and displacement. There was a high prevalence of problematic use of internet among medical and dental students. It had significant associations with several defense mechanisms. PMID:27504797

  9. Coping styles and its association with sources of stress in undergraduate medical students

    Directory of Open Access Journals (Sweden)

    Sandhya Cherkil

    2013-01-01

    Full Text Available Context: The two ubiquitous factors that have been identified in medical courses to underlie mental health are stress and different coping styles adopted to combat stress. Aim: To find the association between coping styles and stress in undergraduate medical students. Settings and Design: A medical college in Central Kerala. A cross-sectional study design was adopted. Materials and Methods: Source and Severity of Stress Scale, Medical Student Version, was used to assess the source and nature of stress. Brief Cope was used to find out the coping styles adopted. Statistical Analysis: The statistical analysis was done using Statistical Package for Social Sciences version 20 and SAS. Chi-square analysis was used to find the association between coping styles and stress domains and with the overall stress score. Results: There is a significant positive association between overall stress score and coping styles ( P=0.001 of ′Negative cope′, ′Blame′, and ′Humor′. ′Positive cope′ and ′Religion′ has significant positive association with ′Academics′ ( P=0.047 and ′Self Expectations′ ( P=0.009. ′Blame′ ( P<0.001 has very high significant positive association with ′Academics′, ′Self expectation′, and ′Relationships′. Very high significant positive association is further found between ′Humor′ ( P<0.001 and ′Self expectations′, ′Living conditions′, and ′Health and Value conflict′. ′Substance Use′ is positively associated in high significance to ′Health and Value conflict′ ( P<0.001. Conclusions: The outcome of the study emphasizes the need for stress management techniques in the medical school.

  10. Associations between medical student empathy and personality: a multi-institutional study.

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    Patrício Costa

    Full Text Available BACKGROUND: More empathetic physicians are more likely to achieve higher patient satisfaction, adherence to treatments, and health outcomes. In the context of medical education, it is thus important to understand how personality might condition the empathetic development of medical students. Single institutional evidence shows associations between students' personality and empathy. This multi-institutional study aimed to assess such associations across institutions, looking for personality differences between students with high empathy and low empathy levels. METHODS: Participants were 472 students from three medical schools in Portugal. They completed validated adaptations to Portuguese of self-report measures of the NEO-Five Factor Inventory(NEO-FFI and the Jefferson Scale of Physician Empathy(JSPE-spv. Students were categorized into two groups: "Bottom" (low empathy, N = 165 and "Top" (high empathy, N = 169 according to their empathy JSPE-spv total score terciles. Correlation analysis, binary logistic regression analysis and ROC curve analysis were conducted. RESULTS: A regression model with gender, age and university had a predictive power (pseudo R2 for belonging to the top or bottom group of 6.4%. The addition of personality dimensions improved the predictive power to 16.8%. Openness to experience and Agreeableness were important to predict top or bottom empathy scores when gender, age and university were considered." Based on the considered predictors the model correctly classified 69.3% of all students. CONCLUSIONS: The present multi-institutional cross-sectional study in Portugal revealed across-school associations between the Big5 dimensions Agreeableness and Openness to experience and the empathy of medical students and that personality made a significant contribution to identify the more empathic students. Therefore, medical schools may need to pay attention to the personality of medical students to understand how to enhance

  11. For Distinguished Public Service: Medical Library Association Honors FNLM and NIH MedlinePlus Magazine | NIH ...

    Science.gov (United States)

    ... this page please turn Javascript on. For Distinguished Public Service: Medical Library Association Honors FNLM and NIH MedlinePlus Magazine Past Issues / Summer 2011 Table of Contents MLA President Ruth Holst presented FNLM ... Service Award at the MLA’s recent national conference. ...

  12. Association of Arterial Stiffness and Osteoporosis in Healthy Men Undergoing Screening Medical Examination

    OpenAIRE

    Kim, Nam Lee; Jang, Ha Min; Kim, Sul Ki; Ko, Ki Dong; Hwang, In Cheol; Suh, Heuy Sun

    2014-01-01

    Background Association of arterial stiffness and osteoporosis has been previously reported in women. However, this association is still controversial for men. Therefore, we investigated correlation of arterial stiffness and osteoporosis by measuring brachial-ankle (ba) pulse wave velocity (PWV) and bone mineral density (BMD). Methods We reviewed medical charts of 239 people (women: 128, men: 111) who visited the Health Promotion Center, retrospectively. ba-PWV was measured by automatic wave a...

  13. The role of BMI across the life course in the relationship between age at menarche and diabetes, in a British Birth Cohort

    OpenAIRE

    Pierce, M.B.; Kuh, D.; HARDY, R.

    2012-01-01

    Aims Previous research showing an inverse association between age of menarche and adult diabetes relied on recalled age at menarche and did not adjust for BMI across the life course. We investigated the relationship between age at menarche and diabetes, and whether childhood, adolescent or adult BMI attenuates this relationship. Methods We used data from the Medical Research Council National Survey of Health and Development, a British birth cohort study of men and women born in 1946, with con...

  14. Efficient replication of over 180 genetic associations with self-reported medical data.

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    Joyce Y Tung

    Full Text Available While the cost and speed of generating genomic data have come down dramatically in recent years, the slow pace of collecting medical data for large cohorts continues to hamper genetic research. Here we evaluate a novel online framework for obtaining large amounts of medical information from a recontactable cohort by assessing our ability to replicate genetic associations using these data. Using web-based questionnaires, we gathered self-reported data on 50 medical phenotypes from a generally unselected cohort of over 20,000 genotyped individuals. Of a list of genetic associations curated by NHGRI, we successfully replicated about 75% of the associations that we expected to (based on the number of cases in our cohort and reported odds ratios, and excluding a set of associations with contradictory published evidence. Altogether we replicated over 180 previously reported associations, including many for type 2 diabetes, prostate cancer, cholesterol levels, and multiple sclerosis. We found significant variation across categories of conditions in the percentage of expected associations that we were able to replicate, which may reflect systematic inflation of the effects in some initial reports, or differences across diseases in the likelihood of misdiagnosis or misreport. We also demonstrated that we could improve replication success by taking advantage of our recontactable cohort, offering more in-depth questions to refine self-reported diagnoses. Our data suggest that online collection of self-reported data from a recontactable cohort may be a viable method for both broad and deep phenotyping in large populations.

  15. Factors Associated with Follow-Up Attendance among Rape Victims Seen in Acute Medical Care

    Science.gov (United States)

    Darnell, Doyanne; Peterson, Roselyn; Berliner, Lucy; Stewart, Terri; Russo, Joan; Whiteside, Lauren; Zatzick, Douglas

    2016-01-01

    Objective Rape is associated with Posttraumatic Stress Disorder and related comorbidities. Most victims do not obtain treatment for these conditions. Acute care medical settings are well-positioned to link patients to services; however, difficulty engaging victims and low attendance at provided follow-up appointments is well documented. Identifying factors associated with follow-up can inform engagement and linkage strategies. Method Administrative, patient self-report, and provider observational data from Harborview Medical Center were combined for the analysis. Using logistic regression, we examined factors associated with follow-up health service utilization after seeking services for rape in the emergency department. Results Of the 521 diverse female (n=476) and male (n=45) rape victims, 28% attended the recommended medical/counseling follow-up appointment. In the final (adjusted) logistic regression model, having a developmental or other disability (OR=0.40, 95% CI=0.21-0.77), having a current mental illness (OR=0.25, 95% CI=0.13-0.49), and being assaulted in public (OR=0.50, 95% CI=0.28-0.87) were uniquely associated with reduced odds of attending the follow-up. Having a prior mental health condition (OR= 3.02 95% CI=1.86-4.91), a completed SANE examination (OR=2.97, 95% CI=1.84-4.81), and social support available to help cope with the assault (OR=3.54, 95% CI=1.76-7.11) were associated with an increased odds of attending the follow-up. Conclusions Findings point to relevant characteristics ascertained at the acute care medical visit for rape that may be used to identify victims less likely to obtain posttraumatic medical and mental health services. Efforts to improve service linkage among these patients is warranted and may require alternative models to engage these patients to support posttraumatic recovery. PMID:26168030

  16. Association between patients’ beliefs and oral antidiabetic medication adherence in a Chinese type 2 diabetic population

    Science.gov (United States)

    Wu, Ping; Liu, Naifeng

    2016-01-01

    Purpose The objective of this study was to identify, using the theory of planned behavior (TPB), patients’ beliefs about taking oral antidiabetic drugs (OADs) as prescribed, and to measure the correlations between beliefs and medication adherence. Patients and methods We performed a cross-sectional study of type 2 diabetic patients using structured questionnaires in a Chinese tertiary hospital. A total of 130 patients were enrolled to be interviewed about TPB variables (behavioral, normative, and control beliefs) relevant to medication adherence. Medication adherence was assessed using the eight-item Morisky Medication Adherence Scale (MMAS-8). Spearman’s rank correlation was used to assess the association between TPB and MMAS-8. Logistic regression analysis was performed to examine the relationship between different variables and MMAS-8, with statistical significance determined at PTPB is the only important determinant influencing OAD adherence among all the factors (P=0.011). Conclusion The results indicate that the TPB model could be used to examine adherence to OADs. One facilitating control belief, and most of the barrier control beliefs of TPB were related to medication adherence among Chinese type 2 diabetes inpatients. It will be helpful to understand patients’ self-medication and provide methods to develop instruments for identifying factors that influence OAD adherence. PMID:27390519

  17. Factors associated with a patient-centered medical home among children with behavioral health conditions.

    Science.gov (United States)

    Knapp, Caprice; Woodworth, Lindsey; Fernandez-Baca, Daniel; Baron-Lee, Jacqueline; Thompson, Lindsay; Hinojosa, Melanie

    2013-11-01

    At some point in their lives, nearly one-half of all American children will have a behavioral health condition. Many will not receive the care they need from a fragmented health delivery system. The patient-centered medical home is a promising model to improve their care; however, little evidence exists. Our study aim was to examine the association between several behavioral health indicators and having a patient-centered medical home. 91,642 children's parents or guardians completed the 2007 National Survey of Children's Health. An indicator for patient-centered medical home was included in the dataset. Descriptive statistics, bivariate tests, and multivariate regression models were used in the analyses. Children in the sample were mostly Male (52 %), White (78 %), non-Hispanic (87 %), and did not have a special health care need (80 %). 6.2 % of the sample had at least one behavioral health condition. Conditions ranged from ADHD (6 %) to Autism Spectrum Disorder (ASD) (1 %). Frequency of having a patient-centered medical home also varied for children with a behavioral health condition (49 % of children with ADHD and 33 % of children with ASD). Frequency of having a patient-centered medical home decreased with multiple behavioral health conditions. Higher severity of depression, anxiety, and conduct disorder were associated with a decreased likelihood of a patient-centered medical home. Results from our study can be used to target patient-centered medical home interventions toward children with one or more behavioral health conditions and consider that children with depression, anxiety, and conduct disorder are more vulnerable to these disparities.

  18. The Association between Medical Education Accreditation and Examination Performance of Internationally Educated Physicians Seeking Certification in the United States

    Science.gov (United States)

    van Zanten, Marta; Boulet, John R.

    2013-01-01

    The purposes of this research were to examine medical education accreditation practices around the world, with special focus on the Caribbean, and to explore the association between medical school accreditation and graduates' examination performance. In addition to other requirements, graduates of international medical schools seeking to…

  19. The British Columbia Positive Women's Survey: a detailed profile of 110 HIV-infected women

    OpenAIRE

    Kirkham, C M; Lobb, D J

    1998-01-01

    OBJECTIVE: To describe the health, social environment, medical care received and satisfaction with medical care of HIV-infected women in British Columbia. DESIGN: Self-administered 75-item questionnaire distributed by mail or in person between March 1994 and February 1996 through community AIDS organizations and physicians' offices. SETTING: British Columbia. PARTICIPANTS: A total of 110 HIV-positive women. OUTCOME MEASURES: Sociodemographic data, risk factors for HIV infection, details about...

  20. Premenstrual dysphoric disorder in medical students residing in hostel and its association with lifestyle factors

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    Amrita Mishra

    2015-01-01

    Full Text Available Context: There is scant research on premenstrual syndrome (PMS and its more severe counterpart, premenstrual dysphoric disorder (PMDD in Indian females. This study aimed to evaluate symptoms of PMS in medical students and to find the association of sociodemographic variables and lifestyle factors with PMDD. Subjects and Methods: A total of 179 medical students residing in the hostel of an Indian medical college and its affiliated teaching hospital were approached, of which 100 (55.8% returned the completed questionnaires. Data related to lifestyle factors was collected. Self-screening quiz for Diagnostic and Statistical Manual of Mental Disorders-IV-Text Revision PMDD and Shortened Premenstrual Assessment Form were used for diagnosis of PMDD and detection of symptomatology, respectively. Results: PMDD was present in 37% of the respondents. It was found at a higher rate in older and postgraduate students. PMDD was significantly associated with lifestyle factors, namely, sleep, physical activity, total tea/coffee intake, and change in tea/coffee and food intake under stress. The most common physical and psychological symptoms were body ache/joint pain and feeling depressed/blue, respectively. Conclusions: PMDD is fairly common in Indian medical students residing in hostel although cultural factors may influence symptom expression. This study suggests that PMDD is associated with lifestyle factors in young, professional, urban women. Modification in lifestyle may thus be an important approach for management of PMS/PMDD. Prospective studies with larger representative samples are needed to validate these findings.

  1. Factors Associated with Medication Nonadherence among Hypertensives in Ghana and Nigeria

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    Vincent Boima

    2015-01-01

    Full Text Available Background. Blood pressure (BP control is poor among hypertensives in many parts of sub-Saharan Africa. A potentially modifiable factor for control of BP is medication nonadherence (MNA; our study therefore aimed to determine factors associated with MNA among hypertensives in Ghana and Nigeria. Methodology. We conducted a multicenter cross-sectional study. Patients were recruited from Korle-Bu Hospital (n=120, Ghana; and University of Port Harcourt Teaching Hospital, (n=73 Apapa General Hospital Lagos (n=79 and University College Hospital Ibadan (n=85, Nigeria. Results. 357 hypertensive patients (42.6% males participated. MNA was found in 66.7%. Adherence showed correlation with depression (r=-0.208, P<0.001, concern about medications (r=-0.0347, P=0.002, and knowledge of hypertension (r=0.14, P=0.006. MNA was associated with formal education (P=0.001 and use of herbal preparation (P=0.014. MNA was found in 61.7% of uninsured participants versus 73.1% of insured participants (P=0.032. Poor BP control was observed in 69.7% and there was significant association between MNA and poor BP control (P=0.006. Conclusion. MNA is high among hypertensives in Ghana and Nigeria and is associated with depression, concern about hypertensive medications, formal education, and use of herbal preparations. The negative association between health insurance and MNA suggests interplay of other factors and needs further investigation.

  2. Brazilian Medical Association guidelines for the diagnosis and differential diagnosis of panic disorder

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    Michelle Nigri Levitan

    2013-12-01

    Full Text Available Objective: To present the most relevant findings regarding the Brazilian Medical Association guidelines for the diagnosis and differential diagnosis of panic disorder. Methods: We used the methodology proposed by the Brazilian Medical Association for the Diretrizes Project. The MEDLINE (PubMed, Scopus, Web of Science, and LILACS online databases were queried for articles published from 1980 to 2012. Searchable questions were structured using the PICO format (acronym for “patient” [or population], “intervention” [or exposure], “comparison” [or control], and “outcome”. Results: We present data on clinical manifestations and implications of panic disorder and its association with depression, drug abuse, dependence and anxiety disorders. In addition, discussions were held on the main psychiatric and clinical differential diagnoses. Conclusions: The guidelines are proposed to serve as a reference for the general practitioner and specialist to assist in and facilitate the diagnosis of panic disorder.

  3. Disability management: The Insurance Corporation of British Columbia experience

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    Henry Harder

    2003-01-01

    Full Text Available Insurance Corporation of British Columbia (ICBC is a Crown Corporation created by the Provincial Government in 1974 to provide compulsory auto insurance. It is a common-law or tort system with 'add-on' no-fault provisions (medical/rehabilitation and disability benefits. ICBC insures 2 million British Columbia (BC residents and pays out over $2 billion (Cdn. in claims annually. One billion of this is for injury claims. Currently, one percent of these claims are catastrophic losses (paraplegic, quadriplegic, traumatic brain injury with the remainder being non-catastrophic claims. Seventy percent of these non-catastrophic claims are soft tissue (primarily whiplash injuries.

  4. "Signs of the times": Medicine and nationhood in British India.

    Science.gov (United States)

    Chakrabarti, Pratik

    2009-01-01

    Medical practice and research in colonial India historically had been an imperial preserve, dominated by the elite members of the Indian Medical Service. This was contested from the 1900s on by the emerging Indian nationalism. This essay studies debates about the establishment of a medical research institution and how actors imposed the political identities of nationalism on British colonial practices of medical science. At the same time, Indian nationalism was also drawing from other emerging ideas around health and social welfare. The Indian nationalists and doctors sought to build the identities of the new nation and its medicine around their own ideas of its geography, people, and welfare. PMID:20027771

  5. Associations between Self-medication, Health Literacy, and Self-perceived Health Status: A Community-Based Study

    OpenAIRE

    Aziz Kamran; Gholamreza Sharifirad; Yousef Shafaeei; Siamak Mohebi

    2015-01-01

    Background: Although the frequency of self-medication has been well-documented in the public health literature, but no study has examined the relationship between health literacy and self-medication yet. This study was aimed to investigating the relationship between health literacy and self-medication in a community-based study. Methods: This cross-sectional study was conducted on 924 adults to survey association between health literacy and self-medication among peoples in Ardabil city in...

  6. Ethical orientation, functional linguistics, and the codes of ethics of the Canadian Nurses Association and the Canadian Medical Association.

    Science.gov (United States)

    Hadjistavropoulos, Thomas; Malloy, David C; Douaud, Patrick; Smythe, William E

    2002-09-01

    The literature on codes of ethics suggests that grammatical and linguistic structures as well as the theoretical ethical orientation conveyed in codes of ethics have implications for the manner in which such codes are received by those bound by them. Certain grammatical and linguistic structures, for example, tend to have an authoritarian and disempowering impact while others can be empowering. The authors analyze and compare the codes of ethics of the Canadian Nurses Association (CNA) and the Canadian Medical Association (CMA) in terms of their ethical orientation and grammatical/linguistic structures. The results suggest that the two codes differ substantially along these two dimensions. The CNA code contains proportionally more statements that provide a rationale for ethical behaviour; the statements of the CMA code tend to be more dogmatic. Functional grammar analysis suggests that both codes convey a strong deontological tone that does not enhance the addressee's ability to engage in discretionary decision-making. The nurses' code nonetheless implies a collaborative relationship with the client, whereas the medical code implies that the patient is the recipient of medical wisdom. The implications of these findings are discussed.

  7. Association between patients' beliefs and oral antidiabetic medication adherence in a Chinese type 2 diabetic population

    Directory of Open Access Journals (Sweden)

    Wu P

    2016-06-01

    Full Text Available Ping Wu,1 Naifeng Liu2 1Department of Clinical Pharmacy, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, 2Institute of Cardiovascular Disease, Southeast University Medical School, Nanjing, People’s Republic of China Purpose: The objective of this study was to identify, using the theory of planned behavior (TPB, patients’ beliefs about taking oral antidiabetic drugs (OADs as prescribed, and to measure the correlations between beliefs and medication adherence.Patients and methods: We performed a cross-sectional study of type 2 diabetic patients using structured questionnaires in a Chinese tertiary hospital. A total of 130 patients were enrolled to be interviewed about TPB variables (behavioral, normative, and control beliefs relevant to medication adherence. Medication adherence was assessed using the eight-item Morisky Medication Adherence Scale (MMAS-8. Spearman’s rank correlation was used to assess the association between TPB and MMAS-8. Logistic regression analysis was performed to examine the relationship between different variables and MMAS-8, with statistical significance determined at P<0.05.Results: From 130 eligible Chinese patients with an average age of 60.6 years and a male proportion of 50.8%, a nonsignificant relationship between behavioral, normative, and the most facilitating control beliefs and OAD adherence was found in our study. Having the OADs on hand (P=0.037 was the only facilitating control belief associated with adherence behavior. Being away from home or eating out (P=0.000, not accepting the disease (P=0.000, ignorance of life-long drug adherence (P=0.038, being busy (P=0.001, or poor memory (P=0.008 were control belief barriers found to be correlated with poor adherence. TPB is the only important determinant influencing OAD adherence among all the factors (P=0.011.Conclusion: The results indicate that the TPB model could be used to examine adherence to OADs. One

  8. Medical risk factors associated with cholangiocarcinoma in Taiwan: a population-based case-control study.

    Directory of Open Access Journals (Sweden)

    Jeffrey S Chang

    Full Text Available BACKGROUND: Cholangiocarcinoma, including intra- and extrahepatic cholangiocarcinoma, is a rare but highly lethal cancer. Despite effort in finding the risk factors of cholangiocarcinoma, the causes of most cholangiocarcinoma remain unknown. This study utilized a population-based case-control design using data from the National Health Insurance Research Database (NHIRD of Taiwan to assess the medical conditions associated with cholangiocarcinoma. METHODS: 5,157 incident cases of cholangiocarcinoma diagnosed during 2004 to 2008 and 20,628 controls matched to the cases on sex, age, and time of diagnosis (reference date for the controls were identified from the NHIRD. Medical risk factors were ascertained from the NHIRD for each individual. Conditional logistic regression was performed to evaluate the association between cholangiocarcinoma and each medical risk factor. RESULTS: The results showed that factors associated with an increased risk of cholangiocarcinoma included cholangitis, cholelithiasis, cholecystitis, cirrhosis of liver, alcoholic liver disease, chronic non-alcoholic liver disease, hepatitis B, hepatitis C, diabetes, chronic pancreatitis, inflammatory bowel disease, and peptic ulcer. In addition, sex and age differences were observed. CONCLUSIONS: This study confirms the association between cholangiocarcinoma and several less established risk factors, including diabetes, inflammatory bowel disease, hepatitis B, hepatitis C, and peptic ulcer (proxy for the presence of Helicobacter Pylori. Future studies should focus on finding additional environmental and genetic causes of cholangiocarcinoma.

  9. Association between Medication Adherence and Duration of Outpatient Treatment in Patients with Schizophrenia

    Science.gov (United States)

    Kikuyama, Hiroki; Ohta, Munehiro; Kanazawa, Tetsufumi; Okamura, Takehiko; Yoneda, Hiroshi

    2016-01-01

    Objective Medication adherence is important in the treatment of schizophrenia, and critical periods during treatment may be associated with relapse. However, the relationship between adherence and duration of outpatient treatment (DOT) remains unclear. The authors aimed to clarify the relationship between adherence and DOT at a psychiatric hospital in Japan. Methods For outpatients with schizophrenia who regularly visit Shin-Abuyama hospital, the authors conducted a single questionnaire survey (five questions covering gender, age, DOT, medication shortages, and residual medication) over one month period. Participants were divided into two groups whether DOT were from more than one year to within five years or not. Mantel-Haenszel analysis and logistic regression analysis were performed on the data regarding the medication adherence. Results Effective answers were received for 328 patients. The residual medication rate was significantly higher among those receiving outpatient treatment from more than one year to within five years than five years than those receiving outpatient treatment for more than five years or less than one year (p=0.016). Conclusion This survey suggests that there are critical periods during which patients are most prone to poor adherence. Because poor adherence increases the risk of relapse, specific measures must be taken to improve adherence during these periods.

  10. Stress among Medical Students and Its Association with Substance Use and Academic Performance

    Directory of Open Access Journals (Sweden)

    Leta Melaku

    2015-01-01

    Full Text Available Background. Chronic stress among medical students affects academic performance of students and leads to depression, substance use, and suicide. There is, however, a shortage of such research evidence in Ethiopia. Objective. We aimed to estimate the prevalence and severity of stress and its association with substance use and academic performance among medical students. Methods. A cross-sectional survey was conducted on a sample of 329 medical students at Jimma University. Data were collected using the General Health Questionnaire (GHQ-12, Medical Students Stress Questionnaire (MSSQ-20, and Drug Abuse Surveillance Test (DAST. Data were analyzed using SPSS version 20.0. Logistic regression analysis and Student’s t-test were applied. Results. The mean age of the respondents was 23.02 (SD = 2.074 years. The current prevalence of stress was 52.4%. Academic related stressor domain was the main source of stress among 281 (88.6% students. Stress was significantly associated with khat chewing [AOR = 3.03, 95% CI (1.17, 7.85], smoking [AOR = 4.55, 95% CI (1.05, 19.77], and alcohol intake [AOR = 1.93, 95% CI (1.03, 3.60]. The prevalence of stress was high during the initial three years of study. Stress was significantly (p=0.001 but negatively (r=-0.273 correlated with academic achievement. Conclusion. Stress was a significant problem among medical students and had a negative impact on their academic performance. Year of study, income, and substance use were associated with stress. Counseling and awareness creation are recommended.

  11. Alpha thalassaemia in British people.

    OpenAIRE

    Higgs, D R; Ayyub, H.; Clegg, J B; Hill, A V; Nicholls, R D; Teal, H; Wainscoat, J.S. (James S.); Weatherall, D. J.

    1985-01-01

    Although alpha thalassaemia is rare in north Europeans, it has been identified in British people with no known foreign ancestry. Twelve such patients were studied, of whom eight shared a distinctive molecular defect, which was clearly different from defects seen in subjects of Mediterranean or South East Asian origin. A rare but specific form of alpha thalassaemia is therefore present in the British population. In addition, two patients from families of mixed racial origin were encountered wh...

  12. Symptom experience associated with immunosuppressive drugs after liver transplantation in adults : possible relationship with medication non-compliance?

    NARCIS (Netherlands)

    Drent, Gerda; Moons, P.; De Geest, S.; Kleibeuker, J. H.; Haagsma, E. B.

    2008-01-01

    Symptom experience (occurrence and perceived distress) associated with side effects of immunosuppressive medications in organ transplant patients may well be associated with poorer quality of life and medication non-compliance. The aims of this study were: first, to assess symptom experience in clin

  13. Imaging movement-related activity in medicated Parkin-associated and sporadic Parkinson's disease

    DEFF Research Database (Denmark)

    van Eimeren, Thilo; Binkofski, Ferdinand; Buhmann, Carsten;

    2010-01-01

    , patients with Parkin-associated PD often show a stable long-term response to dopaminergic therapy without developing treatment-induced motor complications. Therefore, we reasoned that this difference in vulnerability to develop dyskinesias under long-term dopaminergic therapy may be associated...... with differences in movement-related activation patterns in Parkin-associated compared to sporadic PD. To test this hypothesis, medicated non-dyskinetic patients with either Parkin-associated or sporadic PD underwent functional magnetic resonance imaging (fMRI) while performing externally specified or internally...... selected movements. Patients with Parkin-associated and sporadic PD showed no difference in movement-related activation patterns. Moreover, the covariates 'age' and 'disease duration' similarly influenced brain activation in both patient groups. The present finding suggests that a stable long-term motor...

  14. The Association between Non-Medical Prescription Drug Use and Suicidal Behavior among United States Adolescents

    Directory of Open Access Journals (Sweden)

    Amanda L. Divin

    2014-11-01

    Full Text Available Adolescence represents a vulnerable time for the development of both drug use/abuse and mental illness. Although previous research has substantiated a relationship between drug use and suicidal behavior, little research has examined this relationship with non-medical prescription drug use. Given the growing prevalence of non-medical prescription drug use (NMPDU among adolescents, this study explored the association between NMPDU and suicidal behavior. Nationally representative data were derived from 16, 410 adolescents who completed the 2009 National Youth Risk Behavior Survey. Approximately 19.8% of participants reported lifetime NMPDU. NMPDU was associated with significantly increased odds of suicidal behavior (P < 0.01, with seriously considering attempting suicide and making a plan about attempting suicide representing the strongest correlates for males and females. Results suggest the importance of 1 continued reinforcement of drug education programs in high school begun at earlier ages and 2 mental health care and screenings among adolescents.

  15. Why do thin people have elevated all-cause mortality? Evidence on confounding and reverse causality in the association of adiposity and COPD from the British Women's Heart and Health Study.

    Directory of Open Access Journals (Sweden)

    Caroline Dale

    Full Text Available Low adiposity has been linked to elevated mortality from several causes including respiratory disease. However, this could arise from confounding or reverse causality. We explore the association between two measures of adiposity (BMI and WHR with COPD in the British Women's Heart and Health Study including a detailed assessment of the potential for confounding and reverse causality for each adiposity measure. Low BMI was found to be associated with increased COPD risk while low WHR was not (OR = 2.2; 95% CI 1.3-3.1 versus OR = 1.2; 95% CI 0.7-1.6. Potential confounding variables (e.g. smoking and markers of ill-health (e.g. unintentional weight loss were found to be higher in low BMI but not in low WHR. Women with low BMI have a detrimental profile across a broad range of health markers compared to women with low WHR, and women with low WHR do not appear to have an elevated COPD risk, lending support to the hypothesis that WHR is a less confounded measure of adiposity than BMI. Low adiposity does not in itself appear to increase the risk of respiratory disease, and the apparent adverse consequences of low BMI may be due to reverse causation and confounding.

  16. Familial amyloidotic polyneuropathy with severe renal involvement in association with transthyretin Gly47Glu in Dutch, British and American-Finnish families

    NARCIS (Netherlands)

    Haagsma, EB; Hawkins, PN; Benson, MD; Lachmann, HJ; Bybee, A; Hazenberg, BPC

    2004-01-01

    Familial amyloidotic polyneuropathy (FAP) is an autosomal dominant disorder associated with more than 80 different transthyretin (TTR) mutations. The clinical features of FAP are broad and variable, but knowledge of the pattern and natural history of disease associated with particular mutations neve

  17. Midbrain infarction: associations and aetiologies in the New England Medical Center Posterior Circulation Registry

    OpenAIRE

    Martin, P.; Chang, H.; Wityk, R; CAPLAN, L.

    1998-01-01

    Most reports of midbrain infarction have described clinicoanatomical correlations rather than associations and aetiologies. Thirty nine patients with midbrain infarction (9.4%) are described out of a series of 415 patients with vertebrobasilar ischaemic lesions in the New England Medical Center Posterior Circulation Registry. Patients were categorised according to the rostral-caudal extent of infarction. The "proximal" vertebrobasilar territory includes the medulla and po...

  18. Nonadherence to antihypertensive medications and associated factors in general medicine clinics

    Directory of Open Access Journals (Sweden)

    Al Ghobain M

    2016-08-01

    Full Text Available Mohammed Al Ghobain,1,2 H Alhashemi,1,2 A Aljama,3 S Bin Salih,1,2 Z Assiri,4 A Alsomali,4 Gamal Mohamed5 1Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, 2King Abdullah International Medical Research Centre, 3Department of Medicine, King Abdulaziz Medical City, 4College of Nursing, 5College of Public Health, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia Objectives: Nonadherence to antihypertensive medications has not been assessed in the Saudi population. The aim of this study was to address and evaluate the magnitude of nonadherence among hypertensive patients and the risk factors associated with it. Methods: A cross-sectional survey was conducted on hypertensive patients who attended the general internal medicine clinics at King Abdulaziz Medical City, Riyadh, Saudi Arabia, using a questionnaire that was modified after reviewing the literature. Hypertensive patients were labeled as nonadherent if they missed their medications for a total of 7 days during the previous month. Results: A total of 302 patients participated in the study, of whom 63% were females with a mean age of 64 years, and 64% were illiterate. The prevalence of nonadherence to medications among hypertensive patients was found to be 12.3%. Poor disease knowledge was reported in 80% of patients, while 66% of the patients had poor monitoring of their disease. Younger age (≤65 years, poor monitoring, and uncontrolled blood pressure (BP ≥140/90 mmHg were the predictor factors associated with nonadherence (odds ratio [OR] =2.04, P=0.025; OR=2.39, P=0.004; and OR=2.86, P=0.003, respectively. Conclusion: Nonadherence to antihypertensive medications is lower than that previously reported in the literature. Younger age, uncontrolled BP, and poor monitoring are the main risk factors associated with nonadherence. Keywords: nonadherence, hypertension, Saudi Arabia, uncontrolled blood

  19. Association of Medical Students' Reports of Interactions with the Pharmaceutical and Medical Device Industries and Medical School Policies and Characteristics: A Cross-Sectional Study

    OpenAIRE

    Yeh, James S.; Austad, Kirsten E.; Franklin, Jessica M; Susan Chimonas; Eric G Campbell; Jerry Avorn; Kesselheim, Aaron S.

    2014-01-01

    Editors' Summary Background Making and selling prescription drugs and medical devices is big business. To promote their products, pharmaceutical and medical device companies build relationships with physicians by providing information on new drugs, by organizing educational meetings and sponsored events, and by giving gifts. Financial relationships begin early in physicians' careers, with companies providing textbooks and other gifts to first-year medical students. In medical school settings,...

  20. Factors associated with stress of conscience among emergency medical technicians in China.

    Science.gov (United States)

    Zhang, Hong; Wang, Kang; Liu, Yu; Chan, Darius K-S

    2013-09-01

    The current study was designed to investigate factors related to stress of conscience among emergency medical technicians in China. One hundred and seventy-five doctors and nurses from emergency departments completed questionnaires measuring demographic information, two personality traits (i.e. responsibility and logical-affective orientation), stress of conscience and colleagues' stress of conscience. Important findings include the following: (i) Stress of conscience varied as a function of age, years of work, and marital status; (ii) Participants' stress of conscience was highly associated with colleagues' stress of conscience; and (iii) Both responsibility and a logical orientation were negatively associated with stress of conscience.

  1. Position of the American Dietetic Association: integration of medical nutrition therapy and pharmacotherapy.

    Science.gov (United States)

    2003-10-01

    It is the position of the American Dietetic Association that the application of medical nutrition therapy (MNT) and lifestyle counseling as a part of the Nutrition Care Process is an integral component of the medical treatment for management of specific disease states and conditions and should be the initial step in the management of these situations. If optimal control cannot be achieved with MNT alone and concurrent pharmacotherapy is required, then The Association promotes a team approach to care for clients receiving concurrent MNT and pharmacotherapy and encourages active collaboration among dietetics professionals and other members of the health care team. There are a number of medical conditions, many of them chronic, that will respond to MNT and, therefore, MNT should be the first intervention for these conditions. In addition to being a vital element of the optimal management and control of these conditions, MNT is also a cost-effective method of management. However, because of the long-term nature of these conditions, concurrent pharmacotherapy may become necessary to achieve or maintain optimal control. In cases where this is necessary, MNT should continue to be an integral component of the therapy because it may complement or enhance the therapeutic effectiveness of pharmacotherapy, thereby reducing or eliminating the need for multiple medications. The utilization of a coordinated multidisciplinary team approach is critical to the success of the concurrent use of MNT and pharmacotherapy because of the long-term duration of the treatments, the necessity of monitoring compliance and effectiveness, and the likelihood of multiple medication-nutrient interactions.

  2. Antihypertension medication adherence and associated factors at Dessie Hospital, North East Ethiopia, Ethiopia

    Directory of Open Access Journals (Sweden)

    Legese Chelkeba

    2013-06-01

    Full Text Available Hypertension is an overwhelming global challenge. Despite the development of many effective anti hypertensive drugs, target to reduce morbidity and mortality due to high blood pressures are reached in only a minor of patients in clinical practice. Poor adherence is one of the biggest obstacles in therapeutic control of blood pressures. There are complaints from patients and physicians that the poor result of actual antihypertensive drug therapies. Many people with age indifference are attacked by this “silent killer” or which results in target organ damage as a complication. The aim of this study was to assess the magnitude of adherence and the factors associated with non-adherence to anti-hypertensive medication. Cross sectional exclusively convenient study was conducted by using structured questionnaires consisting of open and closed-ended questions on patients diagnosed for hypertension and have already been on anti hypertensive medications at least for three months at Dessie Referral hospital from 20/01/2012 to 29/01/2012. A total of hundred hypertensive patients were screened from hundred six cases by the exclusive criteria and the overall incidence of anti-hypertensive medication non adherence was 26%. The study identifies reasons why patients don’t adherent with the drug regiments. Among Factors associated with non adherence were health system and health care provider poor interaction with patient and therapy factors like frustration and unwanted effect of the medication in the long run. There was indication of non adherence from the study area. Great emphasis should be placed on intervention strategies such as patient counseling and increasing awareness of the physicians, all other prescribers and health care providers at large about the non adherence of anti hypertensive drugs as well as the complication what comes due to this medication non adherence. [Int J Res Med Sci 2013; 1(3.000: 191-197

  3. Adolescent BMI at Northern Israel: From Trends, to Associated Variables and Comorbidities, and to Medical Signatures.

    Science.gov (United States)

    Machluf, Yossy; Fink, Daniel; Farkash, Rivka; Rotkopf, Ron; Pirogovsky, Avinoam; Tal, Orna; Shohat, Tamar; Weisz, Giora; Ringler, Erez; Dagan, David; Chaiter, Yoram

    2016-03-01

    The increasing prevalence of abnormal body mass index (BMI), mainly obesity, is becoming a significant public health problem. This cross-sectional study aimed to provide a comprehensive view of secular trends of BMI, and the associated socio-demographic variables and comorbidities among adolescents with abnormal BMI. Individuals of the study population were born mainly between 1970 and 1993, and were examined at 16 to 19 years of age during the years 1987 to 2010, at 1 conscription center in the northern district of Israel.The study population included 113,694 adolescents. Univariate and multivariable logistic regression models were used to investigate the associations between BMI categories, socio-demographic variables, and medical conditions.A downward trend in the prevalence of normal BMI among both male and female adolescents was obtained, while trends of overweight and obesity (in both genders) and underweight (only among females) rose. Socio-demographic variables such as religion, education, family-related parameters, residential environment, country of birth, and origin were all associated with different risks for abnormal BMI. Obesity was associated with higher risk for hyperlipidemia, endocrine disorders (only in males), knee disorders, and hypertension type I + II (in both genders). Overweight was associated with knee disorders (only in females). Underweight, exclusively in males, was associated with increased risk for endocrine disorders, proteinuria, and cardiac disorders. Hierarchical clustering analysis revealed the intricate relations between gender, BMI, and medical signatures. It brought to light novel clusters of diseases that were abundant among populations having above-normal BMI or underweight males. Furthermore, above-normal BMI was associated with a lower rate of cardiac anomalies and scoliosis/kyphosis, whereas being underweight was associated with a lower risk for hypertension and flat foot.This study provides a reliable and in-depth view

  4. Statistical Trends in the Journal of the American Medical Association and Implications for Training across the Continuum of Medical Education

    OpenAIRE

    Arnold, Lauren D.; Braganza, Melissa; Salih, Rondek; Graham A Colditz

    2013-01-01

    Background Statistical training across the continuum of medical education may not have advanced at the pace of statistical reporting in the medical literature, yet a comprehensive understanding of statistical concepts most commonly presented in current research is critical to the effective practice of Evidence Based Medicine. The objective of this content analysis was to describe statistical techniques used in a leading medical journal, JAMA, across a 20-year period, with a focus on implicati...

  5. Role of Lifetime Body Mass Index in the Association Between Age at Puberty and Adult Lipids: Findings From Men and Women in a British Birth Cohort

    OpenAIRE

    Pierce, Mary B.; Kuh, Diana; Hardy, Rebecca

    2010-01-01

    Purpose Why early puberty is associated with worse cardiovascular outcomes is unknown. The relationship between puberty and lipids is unclear. Our aim was to assess whether age at puberty was associated with triglyceride and total low-density lipoprotein and high-density lipoprotein cholesterol at age 53 years. Methods Participants in a national birth cohort were examined at 15 years, when pubertal stage for boys was assessed and age at menarche reported by the girls' mothers. At 53 years, 30...

  6. High mercury seafood consumption associated with fatigue at specialty medical clinics on Long Island, NY

    Directory of Open Access Journals (Sweden)

    Shivam Kothari

    2015-01-01

    Full Text Available We investigated the association between seafood consumption and symptoms related to potential mercury toxicity in patients presenting to specialty medical clinics at Stony Brook Medical Center on Long Island, New York. We surveyed 118 patients from April–August 2012 about their seafood consumption patterns, specifically how frequently they were eating each type of fish, to assess mercury exposure. We also asked about symptoms associated with mercury toxicity including depression, fatigue, balance difficulties, or tingling around the mouth. Of the 118 adults surveyed, 14 consumed high mercury seafood (tuna steak, marlin, swordfish, or shark at least weekly. This group was more likely to suffer from fatigue than other patients (p = 0.02. Logistic regression confirmed this association of fatigue with frequent high mercury fish consumption in both unadjusted analysis (OR = 5.53; 95% CI: 1.40–21.90 and analysis adjusted for age, race, sex, income, and clinic type (OR = 7.89; 95% CI: 1.63–38.15. No associations were observed between fish intake and depression, balance difficulties, or tingling around the mouth. Findings suggest that fatigue may be associated with eating high mercury fish but sample size is small. Larger studies are needed to determine whether fish intake patterns or blood mercury tests warrant consideration as part of the clinical work-up in coastal regions.

  7. Discovering disease associations by integrating electronic clinical data and medical literature.

    Directory of Open Access Journals (Sweden)

    Antony B Holmes

    Full Text Available Electronic health record (EHR systems offer an exceptional opportunity for studying many diseases and their associated medical conditions within a population. The increasing number of clinical record entries that have become available electronically provides access to rich, large sets of patients' longitudinal medical information. By integrating and comparing relations found in the EHRs with those already reported in the literature, we are able to verify existing and to identify rare or novel associations. Of particular interest is the identification of rare disease co-morbidities, where the small numbers of diagnosed patients make robust statistical analysis difficult. Here, we introduce ADAMS, an Application for Discovering Disease Associations using Multiple Sources, which contains various statistical and language processing operations. We apply ADAMS to the New York-Presbyterian Hospital's EHR to combine the information from the relational diagnosis tables and textual discharge summaries with those from PubMed and Wikipedia in order to investigate the co-morbidities of the rare diseases Kaposi sarcoma, toxoplasmosis, and Kawasaki disease. In addition to finding well-known characteristics of diseases, ADAMS can identify rare or previously unreported associations. In particular, we report a statistically significant association between Kawasaki disease and diagnosis of autistic disorder.

  8. Association between mental health screening by self-report questionnaire and insomnia in medical students

    Directory of Open Access Journals (Sweden)

    Loayza H. Maria Paz

    2001-01-01

    Full Text Available Epidemiological research points to the high prevalence of psychiatric disorders among insomniacs. We carried out a cross-sectional study with medical students with the aim of evaluating the association between insomnia and suspicion of psychiatric disorder; 302 medical students were included (184 males and 118 females; mean age = 20.47±1.89 years. The main association was tested by logistic regression analysis. The overall prevalence of positivity in a screening test for psychiatric disorder was 22.19%; and of insomnia, 28.15%. Difficulty initiating sleep (OR=3.45, difficulty maintaining sleep (OR=7.61, falling asleep later (OR=1.99 and waking up earlier (OR=1.91 were associated with suspicion of psychiatric disorder. As a group, the variables difficulty initiating sleep, difficulty maintaining sleep, falling asleep after 11 pm, and waking up before 6 am presented an odds ratio of 5.96 for positivity in the screening for psychiatric disorder. Furthermore, difficulty maintaining sleep (OR=2.24 was associated with "being female," and falling asleep later (OR=0.43 was associated with "being male". These results underscore the importance of determining in what cases difficulty sleeping may have severe clinical repercussions or affect performance.

  9. Regional futures: British Columbia

    International Nuclear Information System (INIS)

    Two paradigms that are the source of present-day economic development policies are described. The dominant paradigm is the expansionist world view that assumes economic growth is essentially unlimited, subject to certain constraints, and that the best way to monitor the human economy is through money flows. The steady-state or ecological world view assumes there are real constraints on material throughput and growth, and puts a significant emphasis on natural capital as a form of wealth which is distinct from economic or manufactured capital. Over the long term, each generation must receive from the previous generation at least an adequate stock of natural capital assets to ensure long-term sustainability. For every major category of consumption, such as food and energy, an ecological footprint can be assigned which represents the land needed to sustain a given pattern of consumption. For the lower mainland of British Columbia, this footprint would be about 22 times the actual land area; for the Netherlands, it would be about 15 times larger than the country itself. On a global basis, only about 1.7 hectares per capita of ecologically productive land is actually available, showing that Canadian material standards would not be sustainable on a global level. The steady-state approach to economic development would involve a local and regional approach from the bottom up, preferring small-scale labor-intensive enterprise. Trade would be limited to trading in real ecological surpluses, and value-added products would be made locally instead of shipping raw materials for processing elsewhere. 5 figs

  10. Community Characteristics Associated With Seeking Medical Evaluation for Suspected Child Sexual Abuse in Greater Houston.

    Science.gov (United States)

    Greeley, Christopher Spencer; Chuo, Ching-Yi; Kwak, Min Ji; Henin, Sally S; Donnaruma-Kwoh, Marcella; Ferrell, Jamie; Giardino, Angelo Peter

    2016-06-01

    Child sexual abuse (CSA) affects over 62,000 children annually in the United States. A primary obstacle to the success of a public health prevention strategy is the lack of knowledge around community level risk factors for CSA. We evaluated community level characteristics for children seeking care for suspected CSA in the Greater Houston area for 2009. There was a total incidence rate of medical evaluations for suspected CSA of 5.9/1000 children. We abstracted the medical charts of 1982 (86 %) children who sought a medical evaluation for suspected CSA at three main medical systems in the Greater Houston area for 2009. We evaluated 18 community level variables from the American Community Survey for the 396 zip codes these children lived in. The mean number of cases per Greater Houston zip code was 2.77 (range 0-27), with 62 % of zip codes not having a case at any of the three sites surveyed. Zip codes with a higher than Houston average rate of vacant houses, never married females and unemployed labor force with high family poverty rate, were associated with an increased rate of children seeking care for suspected CSA. We demonstrated zip codes level characteristics which were associated with an increased rate of children seeking care for suspected CSA. Our modelling process and our data have implications for community based strategies aimed at improved surveillance or prevention of CSA. The process of identifying locally specific community level factors suggests target areas which have particular socioeconomic characteristics which are associated with increased rate of seeking CSA evaluations. PMID:26803840

  11. Lung function and airway obstruction: associations with circulating markers of cardiac function and incident heart failure in older men-the British Regional Heart Study

    OpenAIRE

    Wannamethee, S.G.; Shaper, A. G.; Papacosta, O.; LENNON, L; Welsh, P.; Whincup, P H

    2016-01-01

    AIMS: The association between lung function and cardiac markers and heart failure (HF) has been little studied in the general older population. We have examined the association between lung function and airway obstruction with cardiac markers N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin T (cTnT) and risk of incident HF in older men. METHODS AND RESULTS: Prospective study of 3242 men aged 60-79 years without prevalent HF or myocardial infarction followed up for an ...

  12. Lung function and airway obstruction: associations with circulating markers of cardiac function and incident heart failure in older men-the British Regional Heart Study

    OpenAIRE

    Wannamethee, Goya; Shaper, Gerald; Papacosta, Olia; Lennon, Lucy; Welsh, Paul; Whincup, Peter,

    2016-01-01

    Aims The association between lung function and cardiac markers and heart failure (HF) has been little studied in the general older population. We have examined the association between lung function and airway obstruction with cardiac markers N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin T (cTnT) and risk of incident HF in older men. Methods and results Prospective study of 3242 men aged 60–79 years without prevalent HF or myocardial infarction followed up for a...

  13. Courses in Physics in Medical Colleges

    Science.gov (United States)

    Physics Education, 1975

    1975-01-01

    Provides information concerning programs in medical physics, radiation biology, and radiation physics at eight British medical colleges. Each institution is separately listed, and the provided information typically includes program descriptions, graduate programs, and main branches of research. (MLH)

  14. Sir James Elliott, medical journalist supreme.

    Science.gov (United States)

    Wright-St Clair, R

    1995-01-25

    James Sands Elliott was editor of the New Zealand Medical Journal from 1911 to 1933. He was a powerful writer in a flamboyant style, erudite and filled with classical and literary allusions and quotations. We are told that doctors of the time, on receiving their journals, would turn first to the editorial to see "what JSE has got to say." He served the profession in numerous ways, as chairman of council and president of the New Zealand Branch of the British Medical Association (BMA), as president from 1929 to 1955 of the New Zealand Branch of the British Empire Cancer Campaign (now the Cancer Society), and as a member of the Medical Council, the Board of Health and the Medical Research Council. It was his outstanding ability as a medical journalist, however, which made him one of the most powerful figures in New Zealand medicine in his time. He ardently upheld worthy causes in the interests of the medical profession as he saw them and wrote trenchant editorials on those subjects.

  15. A Survey of Nursing Home Organizational Characteristics Associated with Potentially Avoidable Hospital Transfers and Care Quality in One Large British Columbia Health Region

    Science.gov (United States)

    McGregor, Margaret J.; Baumbusch, Jennifer; Abu-Laban, Riyad B.; McGrail, Kimberlyn M.; Andrusiek, Dug; Globerman, Judith; Berg, Shannon; Cox, Michelle B.; Salomons, Kia; Volker, Jan; Ronald, Lisa

    2011-01-01

    Hospitalization of nursing home residents can be futile as well as costly, and now evidence indicates that treating nursing home residents in place produces better outcomes for some conditions. We examined facility organizational characteristics that previous research showed are associated with potentially avoidable hospital transfers and with…

  16. Gain ratio based fuzzy weighted association rule mining classifier for medical diagnostic interface

    Indian Academy of Sciences (India)

    N S Nithya; K Duraiswamy

    2014-02-01

    The health care environment still needs knowledge based discovery for handling wealth of data. Extraction of the potential causes of the diseases is the most important factor for medical data mining. Fuzzy association rule mining is wellperformed better than traditional classifiers but it suffers from the exponential growth of the rules produced. In the past, we have proposed an information gain based fuzzy association rule mining algorithm for extracting both association rules and membership functions of medical data to reduce the rules. It used a ranking based weight value to identify the potential attribute. When we take a large number of distinct values, the computation of information gain value is not feasible. In this paper, an enhanced approach, called gain ratio based fuzzy weighted association rule mining, is thus proposed for distinct diseases and also increase the learning time of the previous one. Experimental results show that there is a marginal improvement in the attribute selection process and also improvement in the classifier accuracy. The system has been implemented in Java platform and verified by using benchmark data from the UCI machine learning repository.

  17. Risk factors associated with uncomplicated peptic ulcer and changes in medication use after diagnosis.

    Directory of Open Access Journals (Sweden)

    Antonio González-Pérez

    Full Text Available BACKGROUND: Few epidemiologic studies have investigated predictors of uncomplicated peptic ulcer disease (PUD separately from predictors of complicated PUD. OBJECTIVE: To analyze risk factors associated with uncomplicated PUD and medication use after diagnosis. METHODS: Patients diagnosed with uncomplicated PUD (n = 3,914 were identified from The Health Improvement Network database among individuals aged 40-84 years during 1997-2005, with no previous history of PUD. Prescription records for the year after the date of diagnosis were reviewed and a nested case-control analysis was performed to calculate the odds ratios for the association of potential risk factors with PUD. RESULTS: Medications associated with developing uncomplicated PUD included current use of acetylsalicylic acid (ASA, nonsteroidal anti-inflammatory drugs (NSAIDs, paracetamol, selective serotonin reuptake inhibitors, antidepressants, antihypertensives or acid suppressants. Uncomplicated PUD was significantly associated with being a current or former smoker and having had a score of at least 3 on the Townsend deprivation index. Approximately 50% of patients who were users of ASA (19% of patients or chronic users of NSAIDs (7% of patients at diagnosis did not receive another prescription of the medication in the 60 days after diagnosis, and 30% were not represcribed therapy within a year. Among patients who were current users of ASA or chronic NSAIDs at the time of the PUD diagnosis and received a subsequent prescription for their ASA or NSAID during the following year, the vast majority (80-90% also received a proton pump inhibitor coprescription. CONCLUSIONS: Our results indicate that several risk factors for upper gastrointestinal bleeding are also predictors of uncomplicated PUD, and that some patients do not restart therapy with ASA or NSAIDs after a diagnosis of uncomplicated PUD. Further investigation is needed regarding the consequences for these patients in terms of

  18. Introducing DVM: DiVersity Matters (an Association of American Veterinary Medical Colleges Initiative).

    Science.gov (United States)

    Greenhill, Lisa M

    2007-01-01

    Now more than ever, colleges of veterinary medicine (CVMs) are challenged to improve the educational experience, build environments that support long-term student and faculty success, and create a diverse and competitive workforce. Additionally, the nation's fast-evolving racial and ethnic demographics demand that the veterinary medical profession be responsive to the emerging needs of this changing population. In March 2005, during the 15th Iverson Bell Symposium, the Association of American Veterinary Medical Colleges (AAVMC) unveiled its DiVersity Matters (DVM) initiative, designed to bring the CVMs closer to achieving these goals. Several key objectives of the initiative and their possible long-term significance to success of the DiVersity Matters initiative are explored here, and CVMs are encouraged to expand efforts to increase racial and ethnic diversity in academic veterinary medicine.

  19. Medical societies in modern China-China Medical Missionary Association%中国近代医学社团——博医会

    Institute of Scientific and Technical Information of China (English)

    刘远明

    2011-01-01

    In modern times, the development and exchange of scientific research were promoted greatly by establishments of scientific societies in the west. In the second half of the 17th century, medical societies such as the Berlin Royal Society of Medicine, the Paris Surgical Society, the Edinburgh Medical Society and the London Medical Society appeared in sequence, which promoted the progress of European medicine greatly by means of medical conferences and journals. At the end of the 19th century, in order to promote medical missions and education, western missionaries drew lessons from the medical society system and founded the China Medical Missionary Association (CMMA). The association was dedicated to work in four fields: terminology standardization, missionary hospitals, medical education and study on endemic disease. CMMA accelerated the development of medical missions and the spread of western medicine. As members of CMMA must be of religious orders, many scholars were not qualified to join in, which resulted in limitation of academic research and exchange. With the return of overseas students, Chinese scholars majoring in western medicine enhanced the awareness of medical knowledge. As a result, western medical societies were established one by one, including the Shanghai Medical Association, the Chinese Pharmaceutical Association, the Chinese Medical Association and the Society of Chinese Medicines of the Republic of China. Established in 1915, the Chinese Medical Association had members who also belonged to the CMMA,so the Chinese Medical Association made reference to the CMMA for its organization, function, operating mechanism, journals, etc..%从17世纪下半叶起,西欧相继出现了柏林皇家医学会、巴黎外科学会、爱丁堡和伦敦医学会等医学团体,它们通过举办会议,编辑期刊,极大地推动了当时欧洲医学的进步.19世纪末期,西方在华医学传教士为了更好地进行医学传教及医学教育工作,借鉴

  20. Lower Circulating B12 Is Associated with Higher Obesity and Insulin Resistance during Pregnancy in a Non-Diabetic White British Population

    OpenAIRE

    Bridget Ann Knight; Shields, Beverley M; Adam Brook; Anita Hill; Bhat, Dattatray S.; Hattersley, Andrew T; Yajnik, Chittaranjan S.

    2015-01-01

    Objective Vitamin B12 and folate are critical micronutrients needed to support the increased metabolic demands of pregnancy. Recent studies from India have suggested that low vitamin B12 and folate concentrations in pregnancy are associated with increased obesity; however differences in diet, antenatal vitamin supplementation, and socioeconomic status may limit the generalisability of these findings. We aimed to explore the cross-sectional relationship of circulating serum vitamin B12 and fol...

  1. Dairy intake, blood pressure and incident hypertension in a general British population: the 1946 birth cohort

    NARCIS (Netherlands)

    Heraclides, A.; Mishra, G.D.; Hardy, R.J.; Geleijnse, J.M.; Black, S.; Prynne, C.J.; Kuh, D.; Soedamah-Muthu, S.S.

    2012-01-01

    Purpose: We aimed to examine the association between intake of different subgroups of dairy products and blood pressure and incident hypertension 10 years later, adjusting for confounding factors. Methods: We studied 1,750 British men and women from the 1946 British birth cohort from 1989 to 1999 (a

  2. The Association of Academic Health Sciences Libraries' legislative activities and the Joint Medical Library Association/Association of Academic Health Sciences Libraries Legislative Task Force.

    Science.gov (United States)

    Zenan, Joan S

    2003-04-01

    The Association of Academic Health Sciences Libraries' (AAHSL's) involvement in national legislative activities and other advocacy initiatives has evolved and matured over the last twenty-five years. Some activities conducted by the Medical Library Association's (MLA's) Legislative Committee from 1976 to 1984 are highlighted to show the evolution of MLA's and AAHSL's interests in collaborating on national legislative issues, which resulted in an agreement to form a joint legislative task force. The history, work, challenges, and accomplishments of the Joint MLA/AAHSL Legislative Task Force, formed in 1985, are discussed.

  3. Association between Perceived Value and Self-Medication with Antibiotics: An Observational Study Based on Health Belief Model Theory

    OpenAIRE

    Annisa N. Insany; Dika P. Destiani; Anwar Sani; Lilik Sabdaningtyas; Ivan S. Pradipta

    2015-01-01

    High prevalence of self medication with antibiotics can increase the probability of irrational use of antibiotics which may lead antibiotics resistance. Thus, shifting of behavior is required to minimize the irrational use of antibiotics. This study was aimed to determine the association between public perceived value and self-medication with antibiotics which can be used to develop an intervention model in order to reduce the practice of self-medication with antibiotics. An observational stu...

  4. Statistical trends in the Journal of the American Medical Association and implications for training across the continuum of medical education.

    Directory of Open Access Journals (Sweden)

    Lauren D Arnold

    Full Text Available BACKGROUND: Statistical training across the continuum of medical education may not have advanced at the pace of statistical reporting in the medical literature, yet a comprehensive understanding of statistical concepts most commonly presented in current research is critical to the effective practice of Evidence Based Medicine. The objective of this content analysis was to describe statistical techniques used in a leading medical journal, JAMA, across a 20-year period, with a focus on implications for medical education. METHODS AND FINDINGS: Two issues of JAMA published each month in 1990, 2000, and 2010 were randomly selected; from these, 361 articles were reviewed. Primary focus, study design, and statistical components were abstracted and examined by year of publication. The number of published RCTs and cohort studies differed significantly across years of interest, with an increasing trend of publication. The most commonly reported statistics over the 20-year period of interest included measures of morbidity and mortality, descriptive statistics, and epidemiologic outcomes. However, between 1990 and 2010, there was an increase in reporting of more advanced methods, such as multivariable regression, multilevel modeling, survival analysis, and sensitivity analysis. While this study is limited by a focus on one specific journal, a strength is that the journal examined is widely read by a range of clinical specialties and is considered a leading journal in the medical field, setting standards for published research. CONCLUSIONS: The increases in frequency and complexity of statistical reporting in the literature over the past two decades may suggest that moving beyond basic statistical concepts to a more comprehensive understanding of statistical methods is an important component of clinicians' ability to effectively read and use the medical research. These findings provide information to consider as medical schools and graduate medical education

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

    OpenAIRE

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

    2015-01-01

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

  6. Comorbid conditions are associated with healthcare utilization, medical charges and mortality of patients with rheumatoid arthritis.

    Science.gov (United States)

    Han, Guang-Ming; Han, Xiao-Feng

    2016-06-01

    This study aims to examine the associations between comorbid conditions and healthcare utilization, medical charges, or mortality of patients with rheumatoid arthritis (RA). Nebraska state emergency department (ED) discharge, hospital discharge, and death certificate data from 2007 to 2012 were used to study the comorbid conditions of patients with RA. RA was defined using the standard International Classification of Diseases (ICD-9-CM 714 or ICD-10-CM M05, M06, and M08). There were more comorbid conditions in patients with RA than in patients without RA. Comorbid conditions were majorly related to healthcare utilization and mortality of patients with RA. In addition to injury, fracture, sprains, and strains, symptoms of cardiovascular and digestive systems, respiratory infection, and chronic obstructive pulmonary disease (COPD) were common comorbid conditions for ED visits. In addition to joint replacement and fracture, infections, COPD and cardiovascular comorbidities were common comorbid conditions for hospitalizations. Cardiovascular, cerebrovascular, and respiratory comorbidities, dementia, malignant neoplasm, and diabetes mellitus were common comorbid conditions for deaths of patients with RA. In addition, the numbers of comorbid conditions were significantly associated with the length of hospital stay and hospital charges for patients with RA. The findings in this study indicated that comorbid conditions are associated with healthcare utilization, medical charges, and mortality of patients with RA. PMID:27106546

  7. Associations between Familial Factor, Trait Conscientiousness, Gender and the Occurrence of Type 2 Diabetes in Adulthood: Evidence from a British Cohort.

    Directory of Open Access Journals (Sweden)

    Helen Cheng

    Full Text Available To investigate social, familial, and psychological factors in influencing the occurrence of type 2 diabetes in adulthood.Some 17,415 babies born in Great Britain in 1958 and followed up at 7, 11, 33, and 50 years of age. The prevalence of type 2 diabetes at age 50 years was the outcome measure.Some 5,032 participants with data on parental social class, childhood cognitive ability tests scores at age 11 years, educational qualifications at age 33 years, personality traits, occupational levels, and type 2 diabetes (all measured at age 50 years were included in the study. Available information also included whether cohort members' parents or siblings had diabetes. Using logistic regression analyses, results showed that sex (OR=0.63: 0.42-0.92, p<.05, family history (OR=3.40: 1.76-6.55, p<.01, and trait conscientiousness (OR=0.76: 0.64-0.90, p<.001 were all significantly and independently associated with the occurrence of type 2 diabetes in adulthood. It appears that the occurrence of type 2 diabetes is greater among men than women (4.3% vs 2.5%.Familial (genetic and non-genetic and psychological factors are significantly associated with the prevalence of type 2 diabetes in adulthood.

  8. Health inequalities, physician citizens and professional medical associations: an Australian case study

    Directory of Open Access Journals (Sweden)

    Naccarella Lucio

    2007-08-01

    Full Text Available Abstract Background As socioeconomic health inequalities persist and widen, the health effects of adversity are a constant presence in the daily work of physicians. Gruen and colleagues suggest that, in responding to important population health issues such as this, defining those areas of professional obligation in contrast to professional aspiration should be on the basis of evidence and feasibility. Drawing this line between obligation and aspiration is a part of the work of professional medical colleges and associations, and in doing so they must respond to members as well as a range of other interest groups. Our aim was to explore the usefulness of Gruen's model of physician responsibility in defining how professional medical colleges and associations should lead the profession in responding to socioeconomic health inequalities. Methods We report a case study of how the Royal Australian College of General Practitioners is responding to the issue of health inequalities through its work. We undertook a consultation (80 interviews with stakeholders internal and external to the College and two focus groups with general practitioners and program and policy review of core programs of College interest and responsibility: general practitioner training and setting of practice standards, as well as its work in public advocacy. Results Some strategies within each of these College program areas were seen as legitimate professional obligations in responding to socioeconomic health inequality. However, other strategies, while potentially professional obligations within Gruen's model, were nevertheless contested. The key difference between these lay in different moral orientations. Actions where agreement existed were based on an ethos of care and compassion. Actions that were contested were based on an ethos of justice and human rights. Conclusion Colleges and professional medical associations have a role in explicitly leading a debate about values

  9. Attitudes to Medication after Kidney Transplantation and Their Association with Medication Adherence and Graft Survival: A 2-Year Follow-Up Study

    Directory of Open Access Journals (Sweden)

    Mirjam Tielen

    2014-01-01

    Full Text Available Background. Nonadherence to medication is a common problem after kidney transplantation. The aim of this study was to explore attitudes towards medication, adherence, and the relationship with clinical outcomes. Method. Kidney recipients participated in a Q-methodological study 6 weeks after transplantation. As a measure of medication adherence, respondents completed the Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS©-interview. Moreover, the intrapatient variability in the pharmacokinetics of tacrolimus was calculated, which measures stability of drug intake. Data on graft survival was retrieved from patient records up to 2 years after transplantation. Results. 113 renal transplant recipients (19–75 years old participated in the study. Results revealed three attitudes towards medication adherence—attitude 1: “confident and accurate,” attitude 2: “concerned and vigilant,” and attitude 3: “appearance oriented and assertive.” We found association of attitudes with intrapatient variability in pharmacokinetics of tacrolimus, but not with self-reported nonadherence or graft survival. However, self-reported nonadherence immediately after transplantation was associated with lower two-year graft survival. Conclusion. These preliminary findings suggest that nonadherence shortly after kidney transplantation may be a risk factor for lower graft survival in the years to follow. The attitudes to medication were not a risk factor.

  10. The association of the PON1 Q192R polymorphism with coronary heart disease: findings from the British Women's Heart and Health cohort study and a meta-analysis

    Directory of Open Access Journals (Sweden)

    Kiessling Matthew

    2004-06-01

    Full Text Available Abstract Background There have been inconsistent results from case-control studies assessing the association of the PON1 Q192R polymorphism with coronary heart disease (CHD. Most studies have included predominantly men and the association in women is unclear. Since lipid levels vary between the sexes the antioxidant effect of PON1 and any genes associated with it may also vary by sex. We have examined the association of the PON1 Q192R polymorphism with CHD in a large cohort of British women and combined the results from our cohort study with those from all other published studies. Results The distribution of genotypes was the same among women with CHD and those without disease. The odds ratio (95% confidence interval of having CHD comparing those with either the QR or RR genotype to those with QQ genotype (dominant model of association was 1.03 (0.89, 1.21 and the per allele odds ratio was 0.98 (0.95, 1.01. In a meta-analysis of this and 38 other published studies (10,738 cases and 17,068 controls the pooled odds ratio for the dominant effect was 1.14 (1.08, 1.20 and for the per allele effect was 1.10 (1.06, 1.13. There was evidence of small study bias in the meta-analyses and the dominant effect among those studies with 500 or more cases was 1.05 (0.96, 1.15. Ethnicity and reporting of whether the genotyping was done blind to the participants clinical status also contributed to heterogeneity between studies, but there was no difference in effect between studies with 50% or more women compared to those with fewer women and no difference between studies of healthy populations compared to those at high risk (with diabetes, renal disease of familial hypercholesterolaemia. Conclusion There is no robust evidence that the PON1 Q192R polymorphism is associated with CHD risk in Caucasian women or men.

  11. Raman spectroscopy for rapid discrimination of Staphylococcus epidermidis clones related to medical device-associated infections

    International Nuclear Information System (INIS)

    We report on the potential application of Raman spectroscopy for the fast typing of Staphylococcus epidermidis (S. epidermidis) strains related to medical device-associated infections. In this study bacterial colonies were directly probed on culture plates and Raman spectra were recorded from volumes containing approximately 10 bacteria. The spectra contain information on the molecular composition of the whole bacteria, such as fatty acids, carbohydrates, proteins and nucleic acids, DNA as well as RNA. We demonstrate the potential to discriminate different S. epidermidis clones, even after only short Raman exposure/collection times

  12. Guideline-recommended use of asthma medication by children is associated with parental information and knowledge : the PIAMA birth cohort

    NARCIS (Netherlands)

    Wijga, Alet H.; Zuidgeest, Mira G. P.; Kerkhof, Marjan; Koppelman, Gerard H.; Smit, Henriette A.; de Jongste, Johan C.

    2014-01-01

    PurposeWe investigated the use of asthma medication by children and the association of use as recommended by guidelines with modifiable risk factors: parental attitudes, knowledge of asthma medication and information provided by health care providers. MethodsQuestionnaire data were obtained from par

  13. The Psychological and Medical Factors Associated With Untreated Binge Eating Disorder

    Science.gov (United States)

    Herman, Barry K.

    2015-01-01

    Objective: Although binge eating disorder (BED) is the most prevalent eating disorder, the impact of untreated BED is underappreciated. This review describes the relationship of BED to physical and mental health, quality of life, and functionality. Data Sources: PubMed searches were conducted on March 21, 2014; searches were limited to English-language research articles, meta-analyses, and reviews published between January 1, 2003 and March 21, 2014. Search terms included (binge eating OR binge-eating OR binge eating disorder) AND (cardiovascular OR metabolic OR metabolic syndrome OR gastrointestinal OR health OR rehabilitation OR recovery OR sleep OR pregnancy OR quality of life OR functional impairment OR activities of daily living OR QoL OR SF-12 OR ED-5D OR SF-36 OR psychosocial OR depressive OR anxiety OR self-esteem OR suicidality OR suicide OR productivity OR family). Study Selection/Data Extraction: Of 326 identified publications, 43 were relevant to the topic and reported on the association of BED with psychiatric and medical comorbidities, quality of life, and functional outcomes. Results: Individuals diagnosed with BED have increased rates of mental health comorbidities (eg, depression and anxiety) and more pronounced medical impairments (eg, cardiovascular disorders) compared with individuals without BED. BED is also associated with functional impairment and reduced quality of life. Conclusions: Binge eating disorder is associated with impairments in physical and mental health, which can decrease quality of life and functionality and lead to increased health care utilization and decreased productivity. However, some caution is warranted in interpreting these findings because it remains unclear whether BED is an antecedent condition, a complication associated with a comorbid psychiatric condition, or an unrelated feature that occurs concurrently with these comorbidities and impairments. Much of the research on BED is based on observational or

  14. The Association Between Antihypertensive Medication and Blood Pressure Control in Patients with Obstructive Sleep Apnea.

    Science.gov (United States)

    Diogo, Lucília N; Pinto, Paula; Bárbara, Cristina; Papoila, Ana L; Monteiro, Emília C

    2015-01-01

    Obstructive sleep apnea and hypertension are closely related diseases. The lowering effect of continuous positive airway pressure (CPAP) on blood pressure (BP) control is modest and concomitant antihypertensive therapy is still required. However, the best antihypertensive regimen for BP control in patients with OSA remains unknown. We aimed to investigate a hypothetical association between ongoing antihypertensive medication and BP control rates in patients with OSA. We conducted a prospective observational study in a cohort of 205 patients with OSA and hypertension who underwent a sleep study and 24-h ambulatory blood pressure monitoring (ABPM). Ongoing antihypertensive medication profile was recorded. Logistic regression models were used to investigate the association between antihypertensive regimen and BP control, before (n = 205) and, when applicable, after CPAP adaptation (n = 90). One hundred and fifty-five patients (155/205) were being treated with 31 different antihypertensive regimens. At baseline, the antihypertensive regimens and the number of antihypertensive drugs were not associated with BP control (p = 0.847; p = 0.991). After CPAP adaptation, a decrease in median night-time systolic and diastolic BP was observed (p = 0.001; p = 0.006). Nevertheless, the lack of association between antihypertensive regimens and the number of antihypertensive drugs and BP control remained (p = 0.864; p = 0.800). Our findings confirm that although CPAP improves nocturnal BP, this improvement is not sufficient to control blood pressure for 24 h. This study shows, for the first time, that in patients with OSA, there is no association between BP control and both the antihypertensive regimen and the number of antihypertensive drugs. PMID:26303482

  15. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules

    DEFF Research Database (Denmark)

    Gharib, H; Papini, E; Paschke, R;

    2010-01-01

    American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules are systematically developed statements to assist health care professionals in medical...... decision making for specific clinical conditions. Most of the content herein is based on literature reviews. In areas of uncertainty, professional judgment was applied. These guidelines are a working document that reflects the state of the field at the time of publication. Because rapid changes...

  16. Beyond fatigue: Assessing variables associated with sleep problems and use of sleep medications in multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Alyssa M Bamer

    2010-05-01

    Full Text Available Alyssa M Bamer, Kurt L Johnson, Dagmar A Amtmann, George H KraftDepartment of Rehabilitation Medicine, University of Washington, Seattle, WA, USABackground: Recent research indicates that sleep disturbances are common in persons with multiple sclerosis (MS, though research to date has primarily focused on the relationship between fatigue and sleep. In order to improve treatment of sleep disorders in MS, a better understanding of other factors that contribute to MS sleep disturbance and use of sleep medications in this population is needed.Methods: Individuals with MS (N = 473 involved in an ongoing self-report survey study were asked to report on use of over-the-counter and prescription sleep medications. Participants completed the Medical Outcomes Study Sleep (MOSS scale and other common self-report symptom measures. Multiple regression was used to evaluate factors associated with sleep problems and descriptive statistics were generated to examine use of sleep medications.Results: The mean score on the MOSS scale was 35.9 (standard deviation, 20.2 and 46.8% of the sample had moderate or severe sleep problems. The majority of participants did not use over-the-counter (78% or prescription (70% sleep medications. In a regression model variables statistically significantly associated with sleep problems included depression, nighttime leg cramps, younger age, pain, female sex, fatigue, shorter duration of MS, and nocturia. The model explained 45% of the variance in sleep problems. Of the variance explained, depression accounted for the majority of variance in sleep problems (33%, with other variables explaining significantly less variance.Conclusions: Regression results indicate that fatigue may play a minor role in sleep disturbance in MS and that clinicians should consider the interrelationship between depression and sleep problems when treating either symptom in this population. More research is needed to explore the possibility of under

  17. Restless legs syndrome: associated non-motor symptoms and medical comorbidities: a controlled study

    Directory of Open Access Journals (Sweden)

    Sanghera MK

    2015-10-01

    risk factors manifested 5 and 10 years prior, respectively, to their diagnosis. Conclusion: Primary RLS develops earlier in those patients who only have RLS compared to those who later also develop PD. Mood and sleep impairment can be present years prior to the diagnosis of RLS. Other medical comorbidities associated with RLS included hypertension, hyperlipidemia, arthritis, chronic pain, and diabetes. Keywords: restless legs syndrome, non-motor symptoms, medical comorbidities, risk factors for RLS

  18. Factors Associated With High Frequency of Suicidal Ideation in Medically Ill Veterans.

    Science.gov (United States)

    Wendell, Joel; Ratcliff, Chelsea G; Price, Elizabeth; Petersen, Nancy J; Dinapoli, Elizabeth A; Cully, Jeffrey A

    2016-09-01

    Suicide is a leading cause of death, and rates are especially high among medically ill, older individuals. Health-related psychosocial correlates of suicidal ideation (SI) may be particularly important for medically ill older adults as they may clarify who may benefit from interventions to reduce SI. This study examined whether demographic, physical health, and/or health-related psychosocial factors were associated with high frequency of SI in older, medically ill Veterans experiencing elevated anxiety or depression. This cross-sectional study included 302 Veterans with (1) a cardiopulmonary condition and functional impairment and (2) elevated symptoms of depression and/or anxiety. Participants were classified as having either no, low, or high SI, based on self-reported ideation, from the Patient Health Questionnaire-9. SI was reported in 26.8% of the full sample and high SI was reported by 12.6% of participants. Logistic regression analyses predicting high versus no SI found the odds of high SI increased 4.7 times (95% confidence interval, 2.6-8.3) for each 1-unit increase in maladaptive coping and 4.1 times (95% confidence interval, 1.2-14.3) for each 1-unit increase in physical health severity/functional limitations. Older, medically ill Veterans with comorbid depression and/or anxiety frequently reported SI and were at greater risk of experiencing a high frequency of SI if they engaged in maladaptive coping strategies and/or had high levels of functional impairment. Effective interventions to reduce SI for this population should focus on reducing maladaptive coping and minimizing negative behavioral, cognitive, and emotional reactions to functional limitations. PMID:27648503

  19. American Medical Association concepts of nutrition and health. Council on Scientific Affairs.

    Science.gov (United States)

    1979-11-23

    Although human need for various nutrients is well-established, the exact requirements for the different nutrients are not well-known. Nutrient requirements are affected by genetics; environment; nature of the diet; and hemeostatic demands under changing physiological conditions expressed as growth, reproduction and response to the stress of injury or disease. Pregnant and lactating women should be properly nourished if well-nourished infants are desired. Nutrient and energy needs are considerably increased during pregnancy and lactation. The most rapid growth of infants occurs during the 1st 4 to 6 months of life. Because of the many advantages of breast milk over artificial milk, full-term newborn infants should be breastfed, unless there are specific contraindications or breastfeeding is unsuccessful. The American Medical Association (AMA) urges that better efforts be made to educate the public and the medical profession as to the advantages of breastfeeding. The 4th to the 6th months of life constitute the transitional period in infant feeding. The baby should be introduced to single-ingredient foods in small quantities, one at a time, to isolate food sensitivities. Good eating habits can be formed early in life through the proper and gradual introduction of varied and nutritional meal patterns. Energy balance is a nutritional problem in late childhood and once maturity is achieved, while calorically and nutritionally inadequate diets are a growing concern for the elderly. Immoderate eating habits (e.g., overeating) may aggravate or contribute to the development of degenerative diseases and should be discouraged. The AMA recommends that the American public focus on the achievement and maintenance of the most desirable body weight through a proper combination of dietary control and exercise. Specific dietary modifications (sodium restriction, weight control) are necessary in the management of hypertension, diabetes, coronary heart diseases and other medical

  20. Genetic Diversity and the Presence of Two Distinct Groups in Ophiostoma clavigerum Associated with Dendroctonus ponderosae in British Columbia and the Northern Rocky Mountains.

    Science.gov (United States)

    Lee, S; Hamelin, R C; Six, D L; Breuil, C

    2007-09-01

    ABSTRACT The sapstaining fungal pathogen Ophiostoma clavigerum is associated with the mountain pine beetle (Dendroctonus ponderosae), which is currently the most destructive forest pest in North America. The genetic diversity of O. clavigerum populations collected from five sites in Canada and two sites in the United States was estimated with amplified fragment length polymorphism (AFLP) analysis. Genomic DNA from 170 O. clavigerum isolates was digested with EcoRI and PstI and amplified with six primer sets. A total of 469 AFLP markers consisting of 243 monomorphic and 226 polymorphic loci were scored. The overall genetic diversity of the O. clavigerum population was low (Hs = 0.0531) and the differentiation of the seven O. clavigerum populations was moderate (Phi = 0.143). Genetic distances among the populations were not significantly correlated with geographic distance (r = 0.3235, P = 0.074). Two genetically distinct groups in the O. clavigerum populations were shown by unique AFLP profiles and the unweighted pair group method with arithmetic averages. Further work to characterize biological differences between the two groups will be needed to confirm whether cryptic species are present in the O. clavigerum population. PMID:18944182

  1. Influenza and respiratory syncytial virus infections in British Hajj pilgrims

    OpenAIRE

    Rashid, H.; Shafi, S; Booy, R; Bashir, H El; K Ali; Zambon, MC; Memish, ZA; Ellis, J; Coen, PG; Haworth, E

    2011-01-01

    Viral respiratory infections including influenza and respiratory syncytial virus (RSV) have been reported during the Hajj among international pilgrims. To help establish the burden of these infections at the Hajj, we set up a study to confirm these diagnoses in symptomatic British pilgrims who attended the 2005 Hajj. UK pilgrims with symptoms of upper respiratory tract infection (URTI) were invited to participate; after taking medical history, nasal swabs were collected for point-of-care test...

  2. Influenza and respiratory syncytial virus infections in British Hajj pilgrims

    OpenAIRE

    Booy, R; K Ali; El Bashir, H; MC Zambon; Ellis, J; Memish ZA; PG Coen; Haworth, E; Shafi, S; Rashid, H.

    2008-01-01

    Viral respiratory infections including influenza and respiratory syncytial virus (RSV) have been reported during the Hajj among international pilgrims. To help establish the burden of these infections at the Hajj, we set up a study to confirm these diagnoses in symptomatic British pilgrims who attended the 2005 Hajj. UK pilgrims with symptoms of upper respiratory tract infection (URTI) were invited to participate; after taking medical history, nasal swabs were collected for point-of-care test...

  3. General Duties Medical Officer Role 1 remote supervision in the era of Army Contingency Operations.

    Science.gov (United States)

    Martin-Bates, Alexander James; Jefferys, S E

    2016-08-01

    The return to contingency after Operation HERRICK (2002-2014 Afghanistan conflict) has seen an emerging trend for small-scale rapidly developing expeditionary operations. The associated small, remote medical footprint for such operations, often within a coalition construct, reliant on host nation support is in direct conflict with the General Medical Council (GMC) guidelines for junior doctor supervision in an 'approved practice setting'. If a General Duties Medical Officer (GDMO) is nominated to support future operations, the provision of assured patient care and supervision within GMC guidelines, while ensuring career progression and ongoing education, may prove a challenge. Recently published British Army Policy aims to provide a framework to meet these challenges. The authors' first-hand experience in implementing this policy is explored further. The deployment of a remotely supervised GDMO, in line with British Army Policy, is both suitable and safe. This should assure quality medical care delivery during the era of Army Contingency Operations.

  4. Factors associated with self-medication among expatriate high school students: a cross-sectional survey in United Arab Emirates

    OpenAIRE

    Syed Ilyas Shehnaz; Jayadevan Sreedharan; Nelofer Khan; Khaled Jamal Issa; Mohamed Arifulla

    2013-01-01

    The study aimed to assess factors associated with self-medication (SM) among expatriate high school students of United Arab Emirates using a validated questionnaire. Most common reasons for self-medication in 324 participating students were: presence of mild illness and previous experiences. High risk practices like altering the dose, discontinuation of medication and self-medication without adult guidance were observed. The likelihood of SM was 4.9 times (95%C.I.: 2.0-12.2) in students not u...

  5. Prevalence of depression and its associated factors using Beck Depression Inventory among students of a medical college in Karnataka

    OpenAIRE

    Kumar, Ganesh S; Jain, Animesh; Hegde, Supriya

    2012-01-01

    Background and Objective: Depression among medical students is an area of increasing concern worldwide. This study aimed to assess the prevalence of depression and its associated factors among medical students. Materials and Methods: A stratified random sample of 400 students was assessed using Beck Depression Inventory by investigators. Associations between depression and class of studying, social factors like alcohol use, drug addiction, family problems, family history of depression, and st...

  6. Hybrid Medical Image Classification Using Association Rule Mining with Decision Tree Algorithm

    CERN Document Server

    Rajendran, P

    2010-01-01

    The main focus of image mining in the proposed method is concerned with the classification of brain tumor in the CT scan brain images. The major steps involved in the system are: pre-processing, feature extraction, association rule mining and hybrid classifier. The pre-processing step has been done using the median filtering process and edge features have been extracted using canny edge detection technique. The two image mining approaches with a hybrid manner have been proposed in this paper. The frequent patterns from the CT scan images are generated by frequent pattern tree (FP-Tree) algorithm that mines the association rules. The decision tree method has been used to classify the medical images for diagnosis. This system enhances the classification process to be more accurate. The hybrid method improves the efficiency of the proposed method than the traditional image mining methods. The experimental result on prediagnosed database of brain images showed 97% sensitivity and 95% accuracy respectively. The ph...

  7. Association of medications for lifestyle-related diseases with reflux esophagitis

    Science.gov (United States)

    Asaoka, Daisuke; Nagahara, Akihito; Hojo, Mariko; Matsumoto, Kenshi; Ueyama, Hiroya; Matsumoto, Kohei; Izumi, Kentaro; Takeda, Tsutomu; Komori, Hiroyuki; Akazawa, Yoichi; Shimada, Yuji; Osada, Taro; Watanabe, Sumio

    2016-01-01

    Background Because of a change in lifestyle, especially adoption of westernized eating habits, lifestyle-related diseases have become increasingly prevalent. The aim of this study was to investigate the association of medications for lifestyle-related diseases with reflux esophagitis (RE). Methods We conducted a hospital-based, cross-sectional retrospective study of consecutive outpatients who received an upper gastrointestinal endoscopy in our department from February 2008 to November 2014, which was performed by one specialist who was a member of the Japan Gastroenterological Endoscopy Society. We investigated the patient profile, Helicobacter pylori (H. pylori) infection status, medications for lifestyle-related diseases (including calcium channel blockers, statins, and bisphosphonates), and upper gastrointestinal endoscopic findings (RE, hiatal hernia, Barrett’s mucosa, and endoscopic gastric mucosal atrophy [EGA]). Patients with gastrectomy, peptic ulcer disease, gastric or esophageal malignant disease, and those who used proton pump inhibitors or histamine-2 receptor antagonists were excluded. We divided the subjects into a group without RE (RE(−)) and a RE (RE(+)) group as judged by endoscopy, and investigated the risk factors for RE. Results Of 1,744 consecutive cases, 590 cases (300 males and 290 females; mean age 60.5±13.2 years) were eligible. RE(−) and RE(+) cases numbered 507 and 83, respectively. Bivariate analysis showed significant positive associations of RE with male sex, body mass index (BMI), calcium channel blockers, Barrett’s mucosa, hiatal hernia and negative associations of RE with H. pylori positivity, EGA. Multivariate analysis showed significant positive associations of RE with BMI (odds ratio [OR]: 1.20, 95% confidence interval [95% CI]: 1.10–1.29), use of calcium channel blockers (OR: 2.12, 95% CI: 1.16–3.87), Barrett’s mucosa (OR: 2.97, 95% CI: 01.64–5.38), hiatal hernia (OR: 3.13, 95% CI: 1.79–5.47) and negative

  8. Factors Associated with Syringe Sharing Among Users of a Medically Supervised Safer Injecting Facility

    Directory of Open Access Journals (Sweden)

    Evan Wood

    2005-01-01

    Full Text Available Vancouver, Canada recently opened a medically supervised safer injecting facility (SIF in an effort to reduce HIV and overdose risk and public injection drug use. We sought to examine factors associated with syringe sharing among SIF users. SIF users were randomly recruited into a prospective cohort of SIF users known as the Scientific Evaluation of Supervised Injecting (SEOSI cohort. We examined the prevalence and correlates of used syringe borrowing among baseline HIV-negative participants and used syringe lending among baseline HIV-infected participants. Between 22 March 2004 and 22 October 2004, 479 baseline HIV-negative subjects (48 [10%] syringe borrowing events and 103 baseline HIV-infected participants (17 [16.5%] syringe lending events were recruited into the cohort. For baseline HIV negative participants, syringe borrowing was positively associated with public drug use (p<0.001 and requiring help injecting (p=0.001, whereas exclusive SIF use was inversely associated with syringe sharing (p=0.019. For baseline HIV-infected participants, syringe lending was positively associated with daily cocaine injection (p=0.022 and shooting gallery use (p=0.007. Although ongoing injection-related HIV risk behavior was reported among some SIF users, rates of syringe sharing were substantially lower than the rate observed previously in this community and it is noteworthy that exclusive SIF use was associated with reduced syringe sharing.

  9. Screening for type 2 diabetes is feasible, acceptable, but associated with increased short-term anxiety: A randomised controlled trial in British general practice

    Directory of Open Access Journals (Sweden)

    Prevost A Toby

    2008-10-01

    Full Text Available Abstract Background To assess the feasibility and uptake of a diabetes screening programme; to examine the effects of invitation to diabetes screening on anxiety, self-rated health and illness perceptions. Methods Randomised controlled trial in two general practices in Cambridgeshire. Individuals aged 40–69 without known diabetes were identified as being at high risk of having undiagnosed type 2 diabetes using patient records and a validated risk score (n = 1,280. 355 individuals were randomised in a 2 to 1 ratio into non-invited (n = 238 and invited (n = 116 groups. A stepwise screening programme confirmed the presence or absence of diabetes. Six weeks after the last contact (either test or invitation, a questionnaire was sent to all participants, including non-attenders and those who were not originally invited. Outcome measures included attendance, anxiety (short-form Spielberger State Anxiety Inventory-STAI, self-rated health and diabetes illness perceptions. Results 95 people (82% of those invited attended for the initial capillary blood test. Six individuals were diagnosed with diabetes. Invited participants were more anxious than those not invited (37.6 vs. 34.1 STAI, p-value = 0.015, and those diagnosed with diabetes were considerably more anxious than those classified free of diabetes (46.7 vs. 37.0 STAI, p-value = 0.031. Non-attenders had a higher mean treatment control sub-scale (3.87 vs. 3.56, p-value = 0.016 and a lower mean emotional representation sub-scale (1.81 vs. 2.68, p-value = 0.001 than attenders. No differences in the other five illness perception sub-scales or self-rated health were found. Conclusion Screening for type 2 diabetes in primary care is feasible but may be associated with higher levels of short-term anxiety among invited compared with non-invited participants. Trial registration ISRCTN99175498

  10. British Industrial Libraries Before 1939

    Science.gov (United States)

    Marshall, Margaret R.

    1972-01-01

    British industrial firm libraries are traced from their beginnings till 1939, by which date they had spread to many branches of industry and had been recognized as an important part of the industrial and library worlds, thus establishing standard patterns of work. The origins and significance of Aslib are discussed. (27 references) (Author/NH)

  11. Young British Art / Hanno Soans

    Index Scriptorium Estoniae

    Soans, Hanno, 1974-

    2001-01-01

    1990ndate kunsti muutumisest. Inglise kunstniku Peter Daviese maalist "Kuum esimene sada" (1996), Gavin Turki vahakujuna valminud autoportreest "Pop". "Young British Art'i" uuskunstist ja Jasper Zoova installatsioonist "F1". Eri analüüsivõimalusi pakkuvatest töödest (Marko Laimre & Ene-Liis Semperi 2000. a. novembri ühisnäituse osa töid).

  12. Impaired Fasting Glucose and Associated Anthropometry among Students of a Medical College in Coastal Kerala, India

    Directory of Open Access Journals (Sweden)

    Saritha S. Vargese

    2015-10-01

    Full Text Available Background: India being the diabetic capital need to emphasize on preventive strategies to reduce the incidence of diabetes and thus reduce the burden on health services and resources of the country. The identification of high risk group like those with impaired fasting glucose stresses the need for simple interventional measures to bring down the diabetic community in the country. Aim and Objectives: Medical students have a busy schedule for their studies due to huge syllabus and they generally do not have much physical exercise which emphasizes the need to identify the risk factors for diabetes and also to sensitize them on the need to identify the prediabetics in the community. So the study was carried out to determine the prevalence of impaired fasting glucose and the associated anthropometric measurements among medical students in a rural area in Kerala, India. Material and Methods: A cross sectional study was done to assess the fasting blood glucose using a glucometer and anthropometric measurements like waist circumference ,waist hip ratio and body mass index among the students of a medical school in coastal Kerala India. A pretested questionnaire was used to collect the data after obtaining informed consent. Results: The prevalence of impaired fasting glucose was found to be very high 55(21.6% among the study group, significantly higher among males 43(51.8% (p=0.000 and body mass index was significantly associated (p=0.044 with impaired fasting glucose which was consistent with many other studies. Conclusion: The study throws light on the fact that the prevalence of prediabetes and anthropometric risk factors are high among youth and highlights the need for immediate measures to identify the risk group right from the young age and initiate simple interventional measures to reduce the diabetic load in the community.

  13. Extracting Primary Open-Angle Glaucoma from Electronic Medical Records for Genetic Association Studies.

    Directory of Open Access Journals (Sweden)

    Nicole A Restrepo

    Full Text Available Electronic medical records (EMRs are being widely implemented for use in genetic and genomic studies. As a phenotypic rich resource, EMRs provide researchers with the opportunity to identify disease cohorts and perform genotype-phenotype association studies. The Epidemiologic Architecture for Genes Linked to Environment (EAGLE study, as part of the Population Architecture using Genomics and Epidemiology (PAGE I study, has genotyped more than 15,000 individuals of diverse genetic ancestry in BioVU, the Vanderbilt University Medical Center's biorepository linked to a de-identified version of the EMR (EAGLE BioVU. Here we develop and deploy an algorithm utilizing data mining techniques to identify primary open-angle glaucoma (POAG in African Americans from EAGLE BioVU for genetic association studies. The algorithm described here was designed using a combination of diagnostic codes, current procedural terminology billing codes, and free text searches to identify POAG status in situations where gold-standard digital photography cannot be accessed. The case algorithm identified 267 potential POAG subjects but underperformed after manual review with a positive predictive value of 51.6% and an accuracy of 76.3%. The control algorithm identified controls with a negative predictive value of 98.3%. Although the case algorithm requires more downstream manual review for use in large-scale studies, it provides a basis by which to extract a specific clinical subtype of glaucoma from EMRs in the absence of digital photographs.

  14. The Association of Shelter Veterinarians' 2016 Veterinary Medical Care Guidelines for Spay-Neuter Programs.

    Science.gov (United States)

    Griffin, Brenda; Bushby, Philip A; McCobb, Emily; White, Sara C; Rigdon-Brestle, Y Karla; Appel, Leslie D; Makolinski, Kathleen V; Wilford, Christine L; Bohling, Mark W; Eddlestone, Susan M; Farrell, Kelly A; Ferguson, Nancy; Harrison, Kelly; Howe, Lisa M; Isaza, Natalie M; Levy, Julie K; Looney, Andrea; Moyer, Michael R; Robertson, Sheilah Ann; Tyson, Kathy

    2016-07-15

    As community efforts to reduce the overpopulation and euthanasia of unwanted and unowned cats and dogs have increased, many veterinarians have increasingly focused their clinical efforts on the provision of spay-neuter services. Because of the wide range of geographic and demographic needs, a wide variety of spay-neuter programs have been developed to increase delivery of services to targeted populations of animals, including stationary and mobile clinics, MASH-style operations, shelter services, community cat programs, and services provided through private practitioners. In an effort to promote consistent, high-quality care across the broad range of these programs, the Association of Shelter Veterinarians convened a task force of veterinarians to develop veterinary medical care guidelines for spay-neuter programs. These guidelines consist of recommendations for general patient care and clinical procedures, preoperative care, anesthetic management, surgical procedures, postoperative care, and operations management. They were based on current principles of anesthesiology, critical care medicine, infection control, and surgical practice, as determined from published evidence and expert opinion. They represent acceptable practices that are attainable in spay-neuter programs regardless of location, facility, or type of program. The Association of Shelter Veterinarians envisions that these guidelines will be used by the profession to maintain consistent veterinary medical care in all settings where spay-neuter services are provided and to promote these services as a means of reducing sheltering and euthanasia of cats and dogs. PMID:27379593

  15. Non-compliance to anti-hypertensive medication and its associated factors among hypertensives

    International Nuclear Information System (INIS)

    Non-compliance to anti-hypertensive drugs can have negative impact on cardiovascular outcome. Various studies have been conducted on the issue but the factors are not yet explored properly, particularly in Pakistan. This study was conducted to determine the frequency and factors associated with non-compliance to anti-hypertensive medications in Karachi. Methods: This descriptive cross sectional study was conducted on 113 indoor hypertensive patients included by purposive sampling, aged 30 years and above diagnosed at least 6 months back in public sector tertiary care institutes of Karachi from March to October 2011. Data was collected through a questionnaire in Urdu. Demographic data, hypertension diagnosis, medical co-morbidity, current number of anti-hypertensive medicines, frequency of missing prescribed antihypertensive therapy and other factors affecting compliance pertaining to medicines, patient, physician and health care centre were included in the questionnaire. Results: This study revealed that 68.14% patients were non-compliant. Non-compliance was found to be associated with gender and socioeconomic status. Duration of hypertension, duration between follow up visits to physician, number of drugs, careless attitude, role of physician and limiting access to health care center are found to be important factors in non-compliance. Conclusions: Multiple factors including patients, medicine and health care system related, which can be prevented with simple measures, were found responsible for higher prevalence of non-compliance against anti-hypertensive medicines. (author)

  16. The British gas market; Le marche gazier britannique

    Energy Technology Data Exchange (ETDEWEB)

    Anon

    2006-03-15

    The tension observed on the British gas market has raised many worries and questions. The last meeting of the French gas association (AFG) aimed at shading light and at supplying some elements of analysis necessary for the correct understanding of the British gas market problem. The volatility of the spot market, its capacity to adjust the supply and demand and the role of long-term contracts in ensuring the security of supplies were explained and debated by a various panel of high level orators: P.W. Wright (Sheffield univ.), J. Harvard (deputy director, Gas Markets, Dept. of trade and industry), S. Caudron (manager business development, Statoil) and P. Vedrenne (managing director, Gaselys). They also examined the trends chosen by the British government to supply corrective measures. (J.S.)

  17. Labelling And Alienation In A British Secondary School

    Science.gov (United States)

    Cohen, L.

    1974-01-01

    The article reports the construction and testing of a short scale of alienation. The scale is used in a British secondary school to explore associations between the criterion measure and children's self concept of academic ability, self esteem, extraversion, and placement in high/low ability groupings. (Editor)

  18. 2012版英国制药工业协会Ⅰ期临床试验指导原则介绍%Introduction of Association The British Pharmaceutical Industry ’ s guidelines for phase 1 clinical trials of 2012

    Institute of Scientific and Technical Information of China (English)

    况赟; 黄洁; 金承怀; 华烨; 阳国平

    2014-01-01

    Phase 1 clinical trials is a key step for new drugs from basic experiments to human verification.Developed countries have formulated the corresponding laws , regulations and policies and guiding principles.Association The British Pharmaceutical Industry ( ABPI ) released a 2012 version of guidelines for phase 1 clinical trials.It provided professional guidances for some important problems in phase 1 clinical trials ( such as risk assessment , contracts and agreements , confidentiality , subjects , in-vestigational medicinal products and so on ).This paper makes a brief in-troduction of guiding principles for phase 1 clinical trials on the 2012 ver-sion of the ABPI.%Ⅰ期临床试验是新药开发从临床前研究进入人体试验的关键一步。发达国家均制定了相应的法规政策和指导原则。英国制药工业协会( ABPI)发布了2012版Ⅰ期临床试验指导原则,其对Ⅰ期临床试验中重点关注的问题(如风险评估、合同和协议、保密、试验对象及试验用药品等)提供了专业的指导。本文就2012版ABPI Ⅰ期临床试验指导原则进行简要的介绍。

  19. The Association of Health Literacy with Illness and Medication Beliefs Among Older Adults with Asthma

    Science.gov (United States)

    Federman, Alex D.; Wolf, Michael; Sofianou, Anastasia; Wilson, Elizabeth A.H.; Martynenko, Melissa; Halm, Ethan A.; Leventhal, Howard; Wisnivesky, Juan P.

    2013-01-01

    Background Suboptimal health literacy (HL) and asthma beliefs are associated with poor asthma self-management and outcomes. We tested the hypothesis that low HL is associated with inaccurate beliefs. Methods Asthmatics ≥ 60 were recruited from hospital and community practices in New York, NY and Chicago, IL (n=420). HL was measured with the Short Test of Functional Health Literacy in Adults; validated instruments derived from the Self Regulation model were used to assess beliefs. The association of beliefs with HL was evaluated with multivariate models. Results Thirty-six percent of patients had low HL; 54% believed they only have asthma when symptoms are present, 29% believed they will not always have asthma and 20% believed that their doctor can cure asthma. HL was associated with beliefs of not having asthma all the time and that asthma can be cured (OR: 1.84, 95% CI: 1.2 to 2.82; OR: 2.22, 95% CI: 1.29 to 3.82, respectively). Patients with low HL were also more likely to be concerned about medication use (β = 0.92, p = .05), despite recognizing their necessity (β = -1.36, p = .01). Conclusions Older asthmatics with low HL endorse erroneous asthma beliefs. Practice implications Health communications for improving self-management behaviors in asthma should employ both health literacy-appropriate strategies and messages to counter illness-related misconceptions. PMID:23523196

  20. One Year Medical Outcomes and ED Recidivism Following ED Observation for Cocaine-Associated Chest Pain

    Science.gov (United States)

    Cunningham, Rebecca; Walton, Maureen A.; Weber, Jim Edward; O'Broin, Samantha; Tripathi, Shanti P; Maio, Ronald F.; Booth, Brenda M.

    2010-01-01

    Chest pain is the most common complaint among cocaine users who present to the ED seeking care and many hospital resources are applied to stratify cocaine users in regard to future cardiac morbidity and mortality. Little is known about the longitudinal cardiac and non cardiac medical outcomes of cocaine users who have been stratified to an ED observation period following their ED visit. Objectives to examine one-year cardiac outcomes in a low-intermediate risk sample of patients with cocaine- associated chest pain in an urban ED, as well as to examine ED recidivism one year for cardiac and non-cardiac complaints. Methods Prospective consecutive cohort study of patients (18–60 years) who presented to an urban Level 1 ED with cocaine-associated chest pain and were risk stratified to low-intermediate cardiac risk. Exclusion criteria: EKG suggestive of AMI, elevated serum cardiac markers, history of AMI or CABG, hemodynamic instability, unstable angina. Baseline interviews using validated measures of health functioning, and substance use were conducted during CPOU stay, and 3, 6, and 12 months. ED utilization during the study year was abstracted from medical chart. Zero-Inflated Poisson regression analyses were conducted to predict recurrent ED visits. Results 219 participants (73% participation) were enrolled, 65% returned to the ED post index visit; 23% returned for chest pain, of these 66% had a positive cocaine urine screen. No patient had an AMI within the one year follow up period. Patients with continued cocaine use were more likely to have a recurrent ED visit (p<0.001) but these repeat visits were most often related to musculoskeletal pain (21%), and injury (30%) rather than potential cardiac complaints. Conclusions Patients with cocaine-associated chest pain who are low to intermediate cardiac risk and complete a CPOU protocol have less then 1% rate of MI in the subsequent 12-months. PMID:18824277

  1. Exploring the association between parental rearing styles and medical students’ critical thinking disposition in China

    OpenAIRE

    Huang, Lei; WANG, Zhaoxin; Yao, Yuhong; Shan, Chang; Wang, Haojie; Zhu, Mengyi; Lu, Yuan; Sun, Pengfei; ZHAO, Xudong

    2015-01-01

    Background Critical thinking is an essential ability for medical students. However, the relationship between parental rearing styles and medical students’ critical thinking disposition has rarely been considered. The aim of this study was to investigate whether parental rearing styles were significant predictors of critical thinking disposition among Chinese medical students. Methods 1,075 medical students from the first year to the fifth year attending one of three medical schools in China w...

  2. Incidence and factors associated with medication nonadherence in patients with mental illness: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    J M Lucca

    2015-01-01

    Full Text Available Background: In spite of the progress made in the treatment of psychiatric disorders during the last few decades, nonadherence continues to be a frequent phenomenon, often associated with potentially severe clinical consequences and increased health-care costs. There are numerous factors associated with medication nonadherence in patients with mental illness. The aim of the study was to determine the incidence and factors associated with medication nonadherence among psychiatric outpatients. Materials and Methods: A cross-sectional study was carried out in the outpatient psychiatric department of an Indian tertiary care private hospital over a period of 1 year. Patients aged 18 years and above who presented with mental illness as diagnosed by the International Classification of Diseases (ICD-10 and who were receiving at least one psychotropic medication for at least 1 month were included in the study. Medication adherence was assessed using the Medication Adherence Rating Scale (MARS. Results: Of the 400 patients, 172 (43% were nonadherent to their prescribed medications. There is a statistically significant association between the education (P = 0.001, number of drugs (P = 0.002, family income (P = 0.013, and nonadherence. Among the 172 patients, 33.5 % were nonadherent to their therapy due to patient-related factors followed by drug-related factors (32% and disease-related factors (31%. Conclusion: The overall incidence of medication nonadherence in patients with mental illness was 43%. Numerous factors contributed to medication nonadherence. Strategies need to be developed and implemented to enhance medication adherence, and thereby achieve a better therapeutic outcome in patients with mental illness.

  3. Pseudoexfoliation: normative data and associations. The Central India Eye and Medical Study.

    Directory of Open Access Journals (Sweden)

    Jost B Jonas

    Full Text Available PURPOSE: To assess the prevalence of pseudoexfoliation (PEX and its associations in a population-based setting. DESIGN: Population-based, cross-sectional study. METHODS: The Central India Eye and Medical Study included 4711 individuals. All study participants underwent a detailed ophthalmological examination. After medical pupil dilation, PEX was assessed by an experienced ophthalmologist using slit-lamp based biomicroscopy. RESULTS: Slit lamp examination results were available for 4646 (98.6% study participants with a mean age of 49.3 ± 13.3 years (range: 30-100 years. PEX was detected in 87 eyes (prevalence: 0.95 ± 0.10% (95%CI: 0.75, 1.15 of 69 subjects (prevalence: 1.49 ± 0.18% (95%CI: 1.14, 1.83. PEX prevalence increased significantly (P<0.001 from 0% in the age group of 30-39 years, to 2.85 ± 0.56% in the age group of 60-69 years, to 6.60 ± 1.21% in the age group of 70-79 years, and to 12.3 ± 4.11% in the age group of 80+ years. In multivariate analysis, PEX prevalence was associated with higher age (P<0.001; regression coefficient B:0.11; odds ratio (OR: 1.11 (95%CI: 1.09, 1.13, lower body mass index (P = 0.001; B: -0.12; OR: 0.88 (95CI: 0.82, 0.95 and higher diastolic blood pressure (P = 0.002; B: 0.02; OR: 1.03 (95%CI: 1.01, 1.04. In the multivariate analysis, PEX was not associated with retinal nerve fiber layer cross section area (P = 0.76 and presence of open-angle glaucoma (P = 0.15. CONCLUSIONS: In a rural Central Indian population aged 30+ years, PEX prevalence (mean: 1.49 ± 0.18% was significantly associated with older age, lower body mass index and higher diastolic blood pressure. It was not significantly associated with optic nerve head measurements, refractive error, any ocular biometric parameter, nuclear cataract, early age-related macular degeneration and retinal vein occlusion, diabetes mellitus, smoking, and dyslipidemia.

  4. [Hygienic risks associated with sanitary installations and medical equipment in hospitals (author's transl)].

    Science.gov (United States)

    Botzenhart, K

    1977-04-01

    The risk of transmission of nosocomial infections associated with technical installations in hospitals probably is not very important. The way of infection (e.g. airborne particles, droplets, fluids, fomites, contact with persons) must be considered and an estimation as to their importance should be tried. Transport systems and air-conditioning plants are discussed as possible transmitters of infectious particles by air and UV-radiation and air-locks in their role as preventive measures. Fluides which can allow a microbial growth are part of many sanitary installations and medical equipment. They may cause transmissions of great numbers of pathogenes to susceptible patients. In this context, ultrasonic inhalators, irrigators, dialysis equipment and faucet aerators are discussed. Concerning transmission by contact, bed-pan washers, endoscopes and anaesthetic tools are mentioned and finally the role of industrial procedures, the extent and function of which can't be supervised by the medical personn,el, must be submitted to adequate microbiological controls. Physicians should pronounce more clearly then before their interest in equipment which can easily be sterilized.

  5. The Association of Shelter Veterinarians veterinary medical care guidelines for spay-neuter programs.

    Science.gov (United States)

    Looney, Andrea L; Bohling, Mark W; Bushby, Philip A; Howe, Lisa M; Griffin, Brenda; Levy, Julie K; Eddlestone, Susan M; Weedon, James R; Appel, Leslie D; Rigdon-Brestle, Y Karla; Ferguson, Nancy J; Sweeney, David J; Tyson, Kathy A; Voors, Adriana H; White, Sara C; Wilford, Christine L; Farrell, Kelly A; Jefferson, Ellen P; Moyer, Michael R; Newbury, Sandra P; Saxton, Melissa A; Scarlett, Janet M

    2008-07-01

    As efforts to reduce the overpopulation and euthanasia of unwanted and unowned dogs and cats have increased, greater attention has been focused on spay-neuter programs throughout the United States. Because of the wide range of geographic and demographic needs, a wide variety of programs have been developed to increase delivery of spay-neuter services to targeted populations of animals, including stationary and mobile clinics, MASH-style operations, shelter services, feral cat programs, and services provided through private practitioners. In an effort to ensure a consistent level of care, the Association of Shelter Veterinarians convened a task force of veterinarians to develop veterinary medical care guidelines for spay-neuter programs. The guidelines consist of recommendations for preoperative care (eg, patient transport and housing, patient selection, client communication, record keeping, and medical considerations), anesthetic management (eg, equipment, monitoring, perioperative considerations, anesthetic protocols, and emergency preparedness), surgical care (eg, operating-area environment; surgical-pack preparation; patient preparation; surgeon preparation; surgical procedures for pediatric, juvenile, and adult patients; and identification of neutered animals), and postoperative care (eg, analgesia, recovery, and release). These guidelines are based on current principles of anesthesiology, critical care medicine, microbiology, and surgical practice, as determined from published evidence and expert opinion. They represent acceptable practices that are attainable in spay-neuter programs. PMID:18593314

  6. Effects of medications and laser on induced tooth movement and associated root resorption: four key points

    Directory of Open Access Journals (Sweden)

    Alberto Consolaro

    2013-04-01

    Full Text Available The following four fundamental points on the use of experimental models will be described to ensure an accurate evaluation of the effects of medication and laser therapy on induced tooth movement and associated root resorption: (1 If the objective is to check the effect on root resorption, the forces experimentally applied must produce a lesion on the cementoblast layer in all specimens; (2 If the objective is to optimize induced tooth movement and reduce treatment time without side effects, the forces experimentally applied should not produce a lesion in the cementoblast layer in any specimen; (3 The laser therapy operator, the person administering medication and the person that places appliances should not know which animals will effectively receive the test treatment, and the control groups should receive placebo treatments; (4 CT and microscopic analysis of the specimens should be random, and the group to which the specimen belongs should not be identified to ensure that the person reading images and the pathologists are not influenced in their evaluation of phenomena. These measures will ensure that results are more reliable and easier to extrapolate to orthodontic clinical practice.

  7. The medical antigravity suit for management of surgically uncontrollable bleeding associated with abdominal pregnancy.

    Science.gov (United States)

    Sandberg, E C; Pelligra, R

    1983-07-01

    Three patients with abdominal pregnancy have been treated at Stanford University Hospital in recent years. Common to each was surgically uncontrolled hemorrhage for which circumferential pneumatic compression (supplied by a medical antigravity suit) was used to stop the bleeding. In each patient, the hemostatic effect of treatment was dramatic. In published accounts of the use of the garment in other severely hemorrhaging patients, the effects have been similarly dramatic and equally successful. These observations lead to a compelling consideration in regard to optimum management of patients with abdominal pregnancy. If our experience is confirmed by others, optimum management in abdominal pregnancy hereafter should regularly and routinely include removal of the placenta at the primary operation. This approach would anticipate use of the medical antigravity suit to provide hemostasis if surgically uncontrollable bleeding is encountered. Theoretically, the complications and long-term morbidity associated with retention of the placenta would be eliminated by this means while the previous disadvantage of placental removal, the potential for exsanguinating hemorrhage, would be circumvented.

  8. CONTEMPORARY BRITISH RESEARCHES ON SOUTH SUDAN

    Directory of Open Access Journals (Sweden)

    Evgeniy V. MIGUNOV

    2015-01-01

    Full Text Available In this article the author attempts to study and analyze contemporary theories of the British scientists, related to South Sudan. The explored conceptions embrace different aspects of the process of its formation as independent state and include works on the following issues: development of legal basis for secession from parent state; formation and effective work of governmental institutions; settlement of internal social and political conflicts, especially interethnic collisions; assurance of internal political stability and security, including fight against corruption; elaboration of economic development strategy; support of local social and political structures, including NGOs; settlement of disputes and establishment of constructive relations with parent state before and after secession; exercising of pressure on the authorities of parent state and territory, claiming for independence, with a view of its secession from the parent state; interaction with third countries and international institutions; assurance of extensive international participation. The conducted analysis allows getting a basic idea about the actual progress of scientific debates on South Sudan in Britain, associate them with the British foreign policy in regard to this particular country and formulate strategy of the Western European states on assistance of new states formation.

  9. Medical management of levodopa-associated motor complications in patients with Parkinson's disease.

    Science.gov (United States)

    Jankovic, Joseph; Stacy, Mark

    2007-01-01

    Parkinson's disease is a neurodegenerative disorder that affects approximately 1% of people over the age of 60 years. Levodopa is standard, and often initial, therapy for patients with this condition; however, with continued treatment and as the disease progresses, up to 80% of patients experience 'wearing-off' symptoms, dyskinesias and other motor complications. These levodopa-associated problems may become disabling and profoundly affect quality of life. Medications commonly used to manage these symptoms include monoamine oxidase type B (MAO-B) inhibitors, catechol-O-methyltransferase (COMT) inhibitors, the NMDA receptor antagonist amantadine and dopamine receptor agonists. Agents that block MAO-B, such as rasagiline and selegiline, are used as both initial and adjunctive therapy in patients with Parkinson's disease. These medications increase concentrations of dopamine in the brain by blocking its reuptake from the synaptic cleft, a mechanism that can slow motor decline, increase 'on' time and improve symptoms of Parkinson's disease. Adverse events with these agents can include confusion, hallucination and orthostatic hypotension. MAO-B inhibition may elicit drug-drug interactions if administered with TCAs, SSRIs or SNRIs. Conventional oral selegiline is associated with potentially harmful plasma concentrations of three major amphetamine metabolites, although metabolite concentrations are significantly lower with a new orally disintegrating tablet (ODT) selegiline formulation. Selegiline ODT is also absorbed more efficiently and shows less pharmacokinetic variability than conventional oral selegiline.COMT mediates peripheral catabolism of levodopa. Therefore, agents that block COMT, such as tolcapone and entacapone, increase the elimination half-life of levodopa. Given adjunctively with levodopa, COMT inhibitors can decrease 'off' time and increase 'on' time, as well as lower the daily levodopa dose. Although more potent than entacapone, tolcapone requires

  10. The challenges and opportunities of multiskilling in health care. Canadian Association of Medical Radiation Technologists.

    Science.gov (United States)

    1995-08-01

    The pursuit of lower costs and greater efficiency in Canada's health care sector has led some governments and health care institutions to consider multiskilled workers as an option in health care reform and organizational restructuring. Multiskilled practitioners perform more than one main function, often in more than one discipline. This article explores various aspects of multiskilling and how it could affect, or already is affecting, medical radiation technologists and other allied health professionals. It discusses key issues and implications of multiskilling for governments, employers, educational institutions, professional associations, health care professionals, and patients. The article is based on a report released to members for discussion at the 53rd CAMRT Annual General Meeting. Copies of the full report are available on request from: CAMRT, Suite 601, 294 Albert St., Ottawa, ON K1P 6E6. Or, fax your request to: (613) 234-1097. PMID:10145068

  11. Improved Hand Hygiene Compliance is Associated with the Change of Perception toward Hand Hygiene among Medical Personnel

    OpenAIRE

    Lee, Seung Soon; Park, Se Jeong; Chung, Moon Joo; Lee, Ju Hee; Kang, Hyun Joo; Lee, Jeong-a; Kim, Yong Kyun

    2014-01-01

    Background Hand hygiene compliance has improved significantly through hand hygiene promotion programs that have included poster campaign, monitoring and performance feedback, and education with special attentions to perceived subjective norms. We investigated factors associated with improved hand hygiene compliance, focusing on whether the improvement of hand hygiene compliance is associated with changed perception toward hand hygiene among medical personnel. Materials and Methods Hand hygien...

  12. Prevalence and Associated Factors of Smoking Among Final Year Medical Students: A Multicentric Survey From Pakistan

    Science.gov (United States)

    Shahid, Zuhaib Y; Lodhi, Sameed K; Malik, Hamza; Jan, Mohsin M

    2016-01-01

    Introduction Smoking is the leading cause of lung cancer around the world. In a developing country like Pakistan with low levels of literacy and general awareness about adverse effects of smoking, doctors play a pivotal role in educating the masses about its harmful consequences and providing support for smoking cessation. However, their efficacy is affected if they smoke themselves, and oftentimes the habits cultivated during educational recourse are carried into the professional careers. The aim of this study was to document the prevalence of smoking among final year medical students of Lahore, Pakistan, and the factors associated with it. Methodology Study approval was obtained from Combined Military Hospital (CMH) Lahore Medical College, Ethics Review Committee. A cross-sectional survey was carried out in four medical colleges and hospitals of Lahore, Pakistan. A questionnaire consisting of 14 questions related to basic demographics and smoking was used after being pilot tested on 20 students of CMH. The overall response rate was 74.89%. Data was collected from 337 respondents, of which 38 forms were discarded and 299 forms were analyzed by SPSS V21. Results Among the 299 respondents, there were 128 males (42.81%) and 171 females (57.19%) with 32 (10.70%) smokers. Male students reported smoking (n = 27, 21.09%) more than their female counterparts (n = 5, 0.02%). The mean age of participants was 23.01 years. Students having an active smoker at home had statistically significant positive correlations with current smoking status and the number of cigarettes smoked per day. Students with household smoking contacts were also more likely to smoke if they belonged to the male gender. Conclusion Prevalence of smoking in medical students is lower than in the general population but still considerable in the male students. There is a need to target this particular population with interactive counseling sessions, education campaigns, and anti-smoking rules to decrease

  13. Prevalence and Associated Factors of Smoking Among Final Year Medical Students: A Multicentric Survey From Pakistan.

    Science.gov (United States)

    Khubaib, Mohammad U; Shahid, Zuhaib Y; Lodhi, Sameed K; Malik, Hamza; Jan, Mohsin M

    2016-01-01

    Introduction Smoking is the leading cause of lung cancer around the world. In a developing country like Pakistan with low levels of literacy and general awareness about adverse effects of smoking, doctors play a pivotal role in educating the masses about its harmful consequences and providing support for smoking cessation. However, their efficacy is affected if they smoke themselves, and oftentimes the habits cultivated during educational recourse are carried into the professional careers. The aim of this study was to document the prevalence of smoking among final year medical students of Lahore, Pakistan, and the factors associated with it. Methodology Study approval was obtained from Combined Military Hospital (CMH) Lahore Medical College, Ethics Review Committee. A cross-sectional survey was carried out in four medical colleges and hospitals of Lahore, Pakistan. A questionnaire consisting of 14 questions related to basic demographics and smoking was used after being pilot tested on 20 students of CMH. The overall response rate was 74.89%. Data was collected from 337 respondents, of which 38 forms were discarded and 299 forms were analyzed by SPSS V21. Results Among the 299 respondents, there were 128 males (42.81%) and 171 females (57.19%) with 32 (10.70%) smokers. Male students reported smoking (n = 27, 21.09%) more than their female counterparts (n = 5, 0.02%). The mean age of participants was 23.01 years. Students having an active smoker at home had statistically significant positive correlations with current smoking status and the number of cigarettes smoked per day. Students with household smoking contacts were also more likely to smoke if they belonged to the male gender. Conclusion Prevalence of smoking in medical students is lower than in the general population but still considerable in the male students. There is a need to target this particular population with interactive counseling sessions, education campaigns, and anti-smoking rules to decrease

  14. Chronic Medical Conditions and Negative Affect; Racial Variation in Reciprocal Associations

    Directory of Open Access Journals (Sweden)

    Shervin Assari

    2016-08-01

    Full Text Available Background: Black-White health paradox can be defined as a lower frequency of depression despite a higher prevalence of economic and social adversities as well as chronic medical conditions (CMC among American Blacks compared to American Whites. Based on this paradox, the CMC - depressive symptoms link is expected to be weaker among Blacks and Whites. We conducted a 10 year longitudinal study to compare Blacks and Whites for bidirectional associations between number of CMC and negative affect.Methods: We used data from the MIDUS (Midlife in the United States, a nationally representative longitudinal study of American adults. A total number of 7,108 individuals with age range 25 to 75 (N = 7,108 were followed for 10 years from 1995 to 2004. Age, gender, and socioeconomic status (education and income measured at baseline were controls. Negative affect and chronic medical conditions were measured at baseline and end of follow up. Race was the moderator. Linear regression analysis was used to test the moderating effect of race on the reciprocal associations between CMC and negative affect, net of covariates.Results: In the pooled sample, while baseline CMC was predictive of an increase in negative affect over time, baseline negative affect was also predictive of an increase in CMC. We found interactions between race and baseline CMC on change in depressive symptoms, as well as race with negative affect on CMC change. Conclusion: Blacks and Whites differ in reciprocal links between CMC and negative affect over time. This finding replicates recent studies on differential links between psychosocial outcomes and physical health based on race. Findings may help us better understand how Black - White health paradox develops across mid and later life.

  15. Periodontal-disease-associated biofilm: A reservoir for pathogens of medical importance.

    Science.gov (United States)

    Vieira Colombo, Ana Paula; Magalhães, Clarissa Bichara; Hartenbach, Fátima Aparecida Rocha Resende; Martins do Souto, Renata; Maciel da Silva-Boghossian, Carina

    2016-05-01

    The ecological diversity of the periodontal microenvironment may provide suitable conditions for the colonization of species not usually considered members of the oral microbiota. In this investigation, we aimed to determine the prevalence and levels of pathogenic species of medical relevance in the microbiota of individuals with distinct periodontal clinical status. Subgingival biofilm was obtained from patients with periodontal health (H, n = 81), gingivitis (G, n = 55), generalized aggressive (AgP, n = 36) or chronic periodontitis (CP, n = 98), and analyzed for 39 microbial taxa using a checkerboard DNA-DNA hybridization technique. Microbial differences among groups, as well as associations between clinical and microbiological parameters were sought by non-parametric and univariate correlation tests. Neisseria spp., Peptostreptococus anaerobius, Candida albicans, enterobacteria, Pseudomonas aeruginosa, Eubacterium saphenum, Clostridium difficile and Olsenella uli were detected in high mean prevalence and counts in the subgingival microbiota of the study population. Species that were more related to periodontal inflammation and tissue destruction at the patient and site levels included enterobacteria, C. albicans, Neisseria spp., P. aeruginosa, O. uli, Hafnia alvei, Serratia marcescens and Filifactor alocis (p contrast, Fusobacterium necrophorum, Lactobacillus acidophilus, Staphylococcus aureus and Streptococcus pneumoniae were associated with periodontal health (p < 0.05). Pathogenic species of medical importance may be detected in high prevalence and levels in the periodontal microbiota. Regardless of their role in periodontal health or disease, the periodontal biofilm may be a source for dissemination and development of systemic infections by these pathogenic microorganisms. PMID:26416306

  16. Gender Associated with the Intention to Choose a Medical Specialty in Medical Students: A Cross-Sectional Study in 11 Countries in Latin America

    Science.gov (United States)

    Mayta-Tristán, Percy; Pereyra-Elías, Reneé; Montenegro-Idrogo, Juan José; Inga-Berrospi, Fiorella; Ancalli, Felix; Bonilla-Escobar, Francisco; Diaz-Velez, Cristian; Gutierrez-Quezada, Erick; Gomez-Alhach, Jennifer; Muñoz-Medina, Carlos E.; Sanchez-Pozo, Adriana; Vidal, Milisen

    2016-01-01

    Introduction The selection of a medical specialty has been associated with multiple factors, such as personal preferences, academic exposure, motivational factors and sociodemographic factors, such as gender. The number of women in the medical field has increased in recent years. In Latin America, we have not found any studies that explore this relationship. Objective To determine whether there is an association between gender and the intention to choose a medical specialty in medical students from 11 countries in Latin America. Methods Secondary analysis of the Collaborative Working Group for the Research of Human Resources for Health (Red-LIRHUS) data; a multi-country project of students in their first year and fifth year of study, from 63 medical schools in 11 Latin American countries. All students who referred intention to choose a certain medical specialty were considered as participants. Results Of the 11073 surveyed students, 9235 indicated the name of a specific specialty. The specialties chosen most often in the fifth year were General Surgery (13.0%), Pediatrics (11.0%), Internal Medicine (10.3%) and Obstetrics/Gynecology (9.0%). For women, the top choices were Pediatrics (15.8%), Obstetrics/Gynecology (11.0%), Cardiology (8.7%), General Surgery (8.6%), and Oncology (6.4%). In the adjusted analysis, the female gender was associated with the choice of Obstetrics/Gynecology (RP: 2.75; IC95%: 2.24–3.39); Pediatric Surgery (RP: 2.19; IC95%: 1.19–4.00), Dermatology (RP: 1.91; IC95%:1.24–2.93), Pediatrics (RP: 1.83; IC95%: 1.56–2.17), and Oncology (RP: 1.37; IC95%: 1.10–1.71). Conclusions There is an association between the female gender and the intention to choose Obstetrics/Gynecology, Pediatrics, Pediatric Surgery, Dermatology, and Oncology. We recommend conducting studies that consider other factors that can influence the choice of a medical specialty. PMID:27519055

  17. British Telecom and Project Universe

    Science.gov (United States)

    Childs, G. H. L.; Morrow, G.

    1983-07-01

    Factors influencing the emergence of local area network (LANs) are covered along with British Telecom's involvement in Project Universe, an experiment to produce high-speed data links between several LANs in the United Kingdom with the Orbital Test Satellite (OTS). Other functions of Project Universe include measuring the network components performance, developing procedures for using the system for computer-computer and terminal-computer operations, and investigating the use of LAN satellites for business and computer communications. British Telecom has been involved with Project Universe since its inception. A standard Videotex system has been connected to the Cambridge Ring, consequently providing Videotex terminals attached to the ring access to a special Universe Prestel system. Future goals include replacing the OTS with a new satellite with a terminal operating at 8-10 Mbit/s. Block diagrams are provided.

  18. More in sorrow than in anger: the British nurses' strike of 1988.

    Science.gov (United States)

    Hayward, S; Fee, E

    1992-01-01

    In early 1988 the nurses of Britain's National Health Service reached a peak of frustration. They took unprecedented industrial action to bring the state of nursing, and problems within the Health Service, to the attention of the nation. Throughout the crisis there was acrimonious debate between the Royal College of Nursing, which acts as both a professional association and a negotiating unit and opposed the strike, and the trade unions, which organized it. Their conflict undermined the nurses' solidarity and highlighted deep and complex tensions within the profession. On the day of action, labor withdrawal was widespread but inconsistent. In the end, the nurses made some gains, but most of their concerns were ignored. The government promoted the divisions between nursing unions; the media were critical of the nurses' actions; however, the labor movement supported them, and the British Medical Journal voiced the merits of the nurses' case. The struggle of the British nurses exemplifies issues and dilemmas facing nurses throughout the world. The increasing militancy of nurses in many countries reflects their dissatisfaction with pay, working conditions, and career opportunities. Many nurses are torn between the ideals of professionalism and the realities of their workplace and are ambivalent about the principles of collective bargaining. This article addresses these ambivalences and stresses the need to find creative solutions to match nurses' unique place in the political economy of health care. PMID:1644505

  19. Asthma and asthma medication use among 4-year-old offspring of subfertile couples--association with IVF?

    Science.gov (United States)

    Kuiper, Derk B; Seggers, Jorien; Schendelaar, Pamela; Haadsma, Maaike L; Roseboom, Tessa J; Heineman, Maas J; Hadders-Algra, Mijna

    2015-11-01

    This study evaluated the prevalence of asthma and asthma medication use in 213 4-year-old singletons followed from birth onwards, including three groups of children born following: (i) controlled ovarian hyperstimulation IVF/intracytoplasmic sperm injection (ICSI); (ii) modified natural cycle IVF/ICSI; and (iii) natural conception in subfertile couples. The rate of asthma medication was higher in the ovarian hyperstimulation-IVF/ICSI than in the subfertile group (adjusted odds ratios [aOR]: 1.96 [1.00-3.84]). Time to pregnancy, a proxy for the severity of subfertility, was not associated with asthma and asthma medication. In conclusion, controlled ovarian hyperstimulation-IVF/ICSI is associated with the use of asthma medication in 4-year-old offspring of subfertile couples.

  20. Treatment trends in allergic rhinitis and asthma: a British ENT survey

    Directory of Open Access Journals (Sweden)

    Theochari Eva G

    2011-04-01

    Full Text Available Abstract Background Allergic Rhinitis is a common Ear, Nose and Throat disorder. Asthma and Allergic Rhinitis are diseases with similar underlying mechanism and pathogenesis. The aim of this survey was to highlight current treatment trends for Allergic Rhinitis and Asthma. Method A questionnaire was emailed to all registered consultant members of the British Association of Otorhinolaryngologists - Head and Neck Surgeons regarding the management of patients with Allergic Rhinitis and related disorders. Results Survey response rate was 56%. The results indicate a various approach in the investigation and management of Allergic Rhinitis compatible with recommendations from the Allergic Rhinitis and Its Impact on Asthma guidelines in collaboration with the World Health Organisation. Conclusion A combined management approach for patients with Allergic Rhinitis and concomitant Asthma may reduce medical treatment costs for these conditions and improve symptom control and quality of life.

  1. Association of medications for lifestyle-related diseases with reflux esophagitis

    Directory of Open Access Journals (Sweden)

    Asaoka D

    2016-10-01

    Full Text Available Daisuke Asaoka,1 Akihito Nagahara,2 Mariko Hojo,1 Kenshi Matsumoto,1 Hiroya Ueyama,1 Kohei Matsumoto,1 Kentaro Izumi,1 Tsutomu Takeda,1 Hiroyuki Komori,1 Yoichi Akazawa,1 Yuji Shimada,2 Taro Osada,1 Sumio Watanabe1 1Department of Gastroenterology, University of Juntendo, School of Medicine, Tokyo, 2Department of Gastroenterology, Juntendo University Shizuoka Hospital, Shizuoka, Japan Background: Because of a change in lifestyle, especially adoption of westernized eating habits, lifestyle-related diseases have become increasingly prevalent. The aim of this study was to investigate the association of medications for lifestyle-related diseases with reflux esophagitis (RE.Methods: We conducted a hospital-based, cross-sectional retrospective study of consecutive outpatients who received an upper gastrointestinal endoscopy in our department from February 2008 to November 2014, which was performed by one specialist who was a member of the Japan Gastroenterological Endoscopy Society. We investigated the patient profile, Helicobacter pylori (H. pylori infection status, medications for lifestyle-related diseases (including calcium channel blockers, statins, and bisphosphonates, and upper gastrointestinal endoscopic findings (RE, hiatal hernia, Barrett’s mucosa, and endoscopic gastric mucosal atrophy [EGA]. Patients with gastrectomy, peptic ulcer disease, gastric or esophageal malignant disease, and those who used proton pump inhibitors or histamine-2 receptor antagonists were excluded. We divided the subjects into a group without RE (RE(– and a RE (RE(+ group as judged by endoscopy, and investigated the risk factors for RE.Results: Of 1,744 consecutive cases, 590 cases (300 males and 290 females; mean age 60.5±13.2 years were eligible. RE(– and RE(+ cases numbered 507 and 83, respectively. Bivariate analysis showed significant positive associations of RE with male sex, body mass index (BMI, calcium channel blockers, Barrett’s mucosa, hiatal

  2. Are depressive symptoms more common among British South Asian patients compared with British White patients with cancer? A cross-sectional survey

    OpenAIRE

    Lord, Karen; Ibrahim, Kausher; Kumar, Sawan; Mitchell, Alex J; Rudd, Nicky; Symonds, R Paul

    2013-01-01

    Objectives This cross-sectional survey investigated whether there were ethnic differences in depressive symptoms among British South Asian (BSA) patients with cancer compared with British White (BW) patients during 9 months following presentation at a UK Cancer Centre. We examined associations between depressed mood, coping strategies and the burden of symptoms. Design Questionnaires were administered to 94 BSA and 185 BW recently diagnosed patients with cancer at baseline and at 3 and 9 mont...

  3. Medical students' perceptions in relation to ethnicity and gender: a qualitative study

    Directory of Open Access Journals (Sweden)

    Seale Clive

    2006-03-01

    Full Text Available Abstract Background The British medical student population has undergone rapid diversification over the last decades. This study focuses on medical students' views about their experiences in relation to ethnicity and gender during their undergraduate training within the context of the hidden curriculum in one British medical school as part of a wider qualitative research project into undergraduate medical education. Method We interviewed 36 undergraduate medical students in one British Medical School, across all five years of training using a semi-structured interview schedule. We selected them by random and quota sampling, stratified by sex and ethnicity and used the whole medical school population as a sampling frame. Data analyses involved the identification of common themes, reported by means of illustrative quotations and simple counts. Results The students provided information about variations patterned by gender in their motivation and influences when deciding to study medicine. Issues in relation to ethnicity were: gaining independence from parents, perceived limitations to career prospects, incompatibility of some religious beliefs with some medical practices and acquired open-mindedness towards students and patients from different ethnic backgrounds. Despite claiming no experiences of gender difference during medical training, female and male students expressed gender stereotypes, e.g. that women bring particularly caring and sympathetic attitudes to medicine, or that surgery requires the physical strength and competitiveness stereotypically associated with men that are likely to support the continuation of gender differentiation in medical careers. Conclusion The key themes identified in this paper in relation to ethnicity and to gender have important implications for medical educators and for those concerned with professional development. The results suggest a need to open up aspects of these relatively covert elements of student

  4. Attention deficit hyperactivity disorder in elementary school children in Rhode Island: associated psychosocial factors and medications used.

    Science.gov (United States)

    Harel, Ephat H; Brown, William D

    2003-01-01

    This study was undertaken to explore psychosocial factors associated with referral for attention deficit hyperactivity disorder (ADHD) evaluation or ADHD diagnosis among elementary school children in Rhode Island, as well as to examine the extent of drug therapy among this population. A survey was distributed to parents/guardians of 2,800 3rd- to 5th-grade public school students in 4 Rhode Island school districts. The average age of the children was 9.0 +/- 1.0 years with 52% girls. Approximately 12% of the students had been referred for ADHD evaluation (RFE). Of these, 52% (6% of all children in the survey) were receiving psychoactive prescription medications daily. While the male:female ratio in the non-RFE group was almost 1:1, there were more boys than girls in the RFE group (male/female ratio of 3:1, p medicated group (male/female ratio 4:1, p children and medicated children were older than classroom peers (p children and medicated children were significantly less likely to have parents who completed college (p children (p medicated children) followed by methylphenidate (43%). Nearly 18% of the medicated children were receiving 1 to 3 additional psychoactive prescription medications on a daily basis. In conclusion, RFE children and children medicated for ADHD were more likely to have a stepparent, have no siblings, and have parents that had not completed college. Amphetamine rather than methylphenidate accounted for the majority of medications used in this study, and simultaneous use of multiple psychoactive medications was reported in 18% of the medicated children.

  5. A Tangible Bridge-An interview with Mr.Sun Ciyi,Secretary General of Shanghai Pudong Medical Device Trade Association

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    @@ Q:As the Secretary General of Shanghai Pudong Medical Device Trade Association (referred as "the Association").you have worked in the medical industry for many years.Could you tell us your opinion about the current situation of medical device market in China?

  6. Breakfast consumption and physical activity in British adolescents

    OpenAIRE

    Corder, K.; van Sluijs, E M F; Steele, R. M.; Stephen, A M; Dunn, V.; Bamber, D.; Goodyer, I.; Griffin, S. J.; Ekelund, U.

    2011-01-01

    Studies show an inverse relationship between breakfast frequency and weight gain. This may reflect poor eating habits generally and associated low physical activity (PA) or direct impacts of breakfast on mechanisms leading to lethargy and reduced PA. The relationship between breakfast frequency and PA is inconclusive. We aimed to determine whether breakfast frequency is associated with PA levels in British adolescents independent of body composition and socio-economic status (SES). Habitual b...

  7. Medical and Surgical Treatment in Pediatric Orbital Myositis Associated with Coxsackie Virus

    Directory of Open Access Journals (Sweden)

    Pedro Gil

    2015-01-01

    Full Text Available Purpose. To report a case of orbital myositis associated with Coxsackie virus and its medical and surgical approach. Methods. Complete ophthalmological examination and imaging and analytical investigation were performed. Results. A 6-year-old male presented with subacute painless binocular horizontal diplopia. Examination revealed bilateral best-corrected visual acuity (BCVA of 20/20 and right eye 45-prism-dioptre (PD esotropia in near and distance fixations, with no motility restrictions. Serologic screening was positive for Coxsackie virus acute infection and computerized tomography (CT suggested right eye medial rectus orbital myositis. An oral corticosteroid 1.0 mg/kg/day regimen was started. A new CT after two months showed symmetrical lesions in both medial rectus muscles. Corticosteroids were increased to 1.5 mg/kg/day. After imagiological resolution on the 4th month, alternating 45 PD esotropia persisted. Bilateral 7 mm medial rectus recession was performed after 1 year without spontaneous recovery. At 1-year follow-up, the patient is orthophoric with 200′′ stereopsis and bilateral 20/20 BCVA. Conclusions. To our knowledge, this is the first reported case of orbital myositis associated with Coxsackie virus. This is also the first reported case of isolated strabismus surgery after orbital myositis in pediatric age, highlighting the favourable aesthetic and functional outcomes even in cases of late ocular motility disorders.

  8. MINING MULTIDIMENSIONAL FUZZY ASSOCIATION RULES FROM A DATABASE OF MEDICAL RECORD PATIENTS

    Directory of Open Access Journals (Sweden)

    Rolly Intan

    2008-01-01

    Full Text Available Mining association rules is one of the important tasks in the process of data mining application. In general, the input as used in the process of generating rules is taken from a certain data table by which all the corresponding values of every domain data have correlations one to each others as given in the table. A problem arises when we need to generate the rules expressing the relationship between two or more domains that belong to several different tables in a normalized database. To overcome the problem, before generating rules it is necessary to join the participant tables into a general table by a process called Denormalization Process. This paper shows a process of generating Multidimensional Fuzzy Association Rules mining from a normalized database of medical record patients. The process consists of two sub-processes, namely sub-process of join tables (Denormalization Process and sub-process of generating fuzzy rules. In general, the process of generating the fuzzy rules has been discussed in our previous papers [1, 2, 3, 4]. In addition to the process of generating fuzzy rules, this paper proposes a correlation measure of the rules as an additional consideration for evaluating interestingness of provided rules.

  9. What Medical Oncologist Residents Think about the Italian Speciality Schools: A Survey of the Italian Association of Medical Oncology (AIOM) on Educational, Clinical and Research Activities

    Science.gov (United States)

    Moretti, Anna; De Angelis, Carmine; Lambertini, Matteo; Cremolini, Chiara; Imbimbo, Martina; Berardi, Rossana; Di Maio, Massimo; Cascinu, Stefano; La Verde, Nicla

    2016-01-01

    Background and objectives Relevant heterogeneity exists among Postgraduate Schools in Medical Oncology, also within the same country. In order to provide a comprehensive overview of the landscape of Italian Postgraduate Schools in Medical Oncology, the Italian Association of Medical Oncology (AIOM) undertook an online survey, inviting all the residents to describe their daily activities and to express their overall satisfaction about their programs. Methods A team composed of five residents and three consultants in medical oncology prepared a 38 items questionnaire that was published online in a reserved section, accessible through a link sent by e-mail. Residents were invited to anonymously fill in the questionnaire that included the following sub-sections: quality of teaching, clinical and research activity, overall satisfaction. Results Three-hundred and eleven (57%) out of 547 invited residents filled in the questionnaire. Two-hundred and twenty-three (72%) participants declared that attending lessons was frequently difficult and 153 (49%) declared they did not gain substantial improvement in their knowledge from them. Fifty-five percent stated that they did not receive lessons on palliative care. Their overall judgment about didactic activity was low in 63% of the interviewed. The satisfaction for clinical activity was in 86% of cases good: 84% recognized that, during the training period, they acquired a progressive independence on patients' management. About research activity, the majority (79%) of participants in the survey was actively engaged in managing patients included in clinical trials but the satisfaction level for the involvement in research activities was quite low (54%). Overall, 246 residents (79%) gave a positive global judgment of their Medical Oncology Schools. Conclusions The landscape of Italian Postgraduate Schools in Medical Oncology is quite heterogeneous across the country. Some improvements in the organization of teaching and in the

  10. Factors Associated With False-Positive Emergency Medical Services Triage for Percutaneous Coronary Intervention

    Directory of Open Access Journals (Sweden)

    Yamamoto Swan, Pamela

    2009-11-01

    Full Text Available Background: In 2005, Orange County California Emergency Medical Services (EMS initiated a field 12-lead program to minimize time to emergency percutaneous coronary intervention (PCI for field-identified acute myocardial infarction (MI. As the program matured, “false-positive” (defined as no PCI or coronary artery occlusion upon PCI field MI activations have been identified as a problem for the program.Objectives: To identify potentially correctable factors associated with false-positive EMS triage to PCI centers.Methods: This was a retrospective, outcome study of EMS 12-lead cases from February 2006 to June 2007. The study system exclusively used cardiac monitor internal interpretation algorithms indicating an acute myocardial infarction as the basis for triage. Indicators and variables were defined prior to the study. Data, including outcome, was from the Orange County EMS database, which included copies of 12-lead ECGs used for field triage. Negative odds ratios (OR of less than 1.0 for positive PCI were the statistical measure of interest.Results: Five hundred forty-eight patients were triaged from the field for PCI. We excluded 19 cases from the study because of death prior to PCI, refusal of PCI, and co-morbid illness (sepsis, altered consciousness that precluded PCI. Three hundred ninety-three (74.3% patients had PCI with significant coronary lesions found. False-positive field triages were associated with underlying cardiac rhythm of sinus tachycardia [OR = 0.38 (95% CI 0.23, 0.62]; atrial fibrillation [OR = 0.43 (95% CI = 0.20, 0.94]; an ECG lead not recorded [OR = 0.39 (95% CI = 0.20, 0.76]; poor ECG baseline [OR = 0.59 (95% CI = 0.25, 1.37]; One of three brands of monitors used in the field [OR = 0.35 (95% CI = 0.21, 0.59]; and female gender [OR = 0.50 (95% CI = 0.34, 0.75]. Age was not associated with false-positive triage as determined by ordinal regression (p=1.00.Conclusion: For the urban-suburban EMS field 12-lead program

  11. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical guidelines for clinical practice for the diagnosis and management of thyroid nodules

    DEFF Research Database (Denmark)

    Gharib, Hossein; Papini, Enrico; Paschke, Ralf;

    2010-01-01

    American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules are systematically developed statements to assist health care professionals in medical...... decision making for specific clinical conditions. Most of the content herein is based on literature reviews. In areas of uncertainty, professional judgment was applied.These guidelines are a working document that reflects the state of the field at the time of publication. Because rapid changes in this area...

  12. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical Guidelines for Clinical Practice for the Diagnosis and Management of thyroid Nodules

    DEFF Research Database (Denmark)

    Gharib, Hossein; Papini, Enrico; Paschke, Ralf;

    2010-01-01

    American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules are systematically developed statements to assist health care professionals in medical...... decision making for specific clinical conditions. Most of the content herein is based on literature reviews. In areas of uncertainty, professional judgment was applied.These guidelines are a working document that reflects the state of the field at the time of publication. Because rapid changes in this area...

  13. [A history of Korean medical association's emblem: the caduceus of Asklepios and Hermes].

    Science.gov (United States)

    Shin, Young-Jeon

    2007-06-01

    An emblem represents the identity of an organization. Through the emblem of an organization, they differentiate the members from others and reinforce the membership, homogeneity, and pride. It is also a tool that an organization officially publicizes its mission and values. The symbol designed by Cho, Byungduk was announced as the first emblem of Korean Medical Association (KMA) on October 31st 1947. His design work has the caduceus with the Taeguk sign on the top, the symbol of Korea, and the Red Cross in the background including the name, 'KMA'. Since then, the emblem was revised three times: in 1964, 1973, and 1995. The current symbol is based on the design of the first one. Although Asklepian, the single serpent-entwined staff of Asklepios, is the one known as the symbol of medicine, this emblem takes the caduceus of Hermes who is the patron god of merchants, thieves, and travelers. The mistake comes from the unawareness of the distinction between the caduceus of Asklepios and Hermes. Moreover, it proves that U. S. Army Medical Corps (USAMC) heavily influenced the reconstruction of Korean health care system including KMA. The USAMC has used the symbol of caduceus since 1902. In 1947, the year that the first emblem of KMA was established, Southern part of Korea was governed by the United States Military Government (USMG, 1945-1948). The current emblem of KMA brings up a question whether we should continue to use the symbol that was taken from USMAC in the historical period of USMG governance. Celebrating 100th anniversary year of KMA, KMA needs to re-evaluate the appropriateness of the KMA symbol. PMID:18175460

  14. Associations between medication use and homocysteine levels in an older population, and potential mediation by vitamin B12 and folate: data from the B-PROOF study

    NARCIS (Netherlands)

    Ham, A.C.; Enneman, A.W.; Dijk, van S.C.; Wijngaarden, van J.P.; Zwaluw, van der N.L.; Brouwer, E.M.; Dhonukshe-Rutten, R.A.M.; Groot, de C.P.G.M.; Witkamp, R.F.

    2014-01-01

    Background Elevated homocysteine levels are a risk indicator for cardiovascular disease, fractures and cognitive decline. Previous studies indicated associations between homocysteine levels and medication use, including antihypertensive, lipid-lowering and antidiabetic medication. However, results w

  15. Associations between labial and whole salivary flow rates, systemic diseases and medications in a sample of older people

    DEFF Research Database (Denmark)

    Smidt, Dorte; Torpet, Lis Andersen; Nauntofte, Birgitte;

    2010-01-01

    Smidt D, Torpet LA, Nauntofte B, Heegaard KM, Pedersen AML. Associations between labial and whole salivary flow rates, systemic diseases and medications in a sample of older people. Community Dent Oral Epidemiol 2010; 38: 422-435. © 2010 John Wiley & Sons A/S Abstract - Objective: To investigate...... the associations between age, gender, systemic diseases, medications and labial and whole salivary flow rates in older people. Methods: Unstimulated labial (LS) and unstimulated (UWS) and chewing-stimulated (SWS) whole salivary flow rates were measured in 389 randomly selected community-dwelling Danish women...

  16. Multisite geriatrics clerkship for fourth-year medical students: a successful model for teaching the Association of American Medical Colleges' core competencies.

    Science.gov (United States)

    Oates, Daniel J; Norton, Lisa E; Russell, Matthew L; Chao, Serena H; Hardt, Eric J; Brett, Belle; Kimball, Patricia; Levine, Sharon A

    2009-10-01

    As the population ages, it is important that graduating medical students be properly prepared to treat older adults, regardless of their chosen specialty. To this end, the Association of American Medical Colleges (AAMC) and the John A. Hartford Foundation convened a consensus conference to establish core competencies in geriatrics for all graduating medical students. An ambulatory geriatric clerkship for fourth-year medical students that successfully teaches 24 of the 26 AAMC core competencies using an interdisciplinary, team-based approach is reported here. Graduating students (N=158) reported that the clerkship was successful at teaching the core competencies, as evidenced by positive responses on the AAMC Graduation Questionnaire (GQ). More than three-quarters (80-93%) of students agreed or strongly agreed that they learned the seven geriatrics concepts asked about on the GQ, which cover 14 of the 26 core competencies. This successful model for a geriatrics clerkship can be used in many institutions to teach the core competencies and in any constellation of geriatric ambulatory care sites that are already available to the faculty.

  17. Separation of British Gas' transportation and storage business

    International Nuclear Information System (INIS)

    In making his substantive reference of the transportation and storage business of British Gas to the Monopolies and Mergers Commission, the Director General of Gas Supply identified the following principal effects adverse to the public interest: ''The absence of provision for the establishment of an independent undertaking to operate the pipe-line system and other facilities used by British Gas for the conveyance and storage of gas which would not be subject to conflicting interests in securing (a) transparency of the prices charged, the costs incurred and the operating methods in respect of the conveyance and storage of gas; (b) proper allocation to various parts of the Gas Supply Business of costs incurred and returns by that business; and (c) protection of information relating to the conveyance and storage of gas from which British Gas might obtain unfair commercial advantage, and thereby avoid the restriction or distortion of competition between British Gas and other persons whose business consists of or includes the supply of gas''. This paper considers the structural issues associated with achieving effective competition and looks at how the relationship between the businesses of supply and transportation might be organised in the short and longer term. (Author)

  18. Mandating doctors to attend counter-terrorism workshops is medically unethical.

    Science.gov (United States)

    Summerfield, Derek

    2016-04-01

    This is a brief exploration of the ethical issues raised for psychiatrists, and for universities, schools and wider society, by the demand that they attend mandatory training as part of the UK government's Prevent counter-terrorism strategy. The silence on this matter to date on the part of the General Medical Council, medical Royal Colleges, and the British Medical Association is a failure of ethical leadership. There is also a civil liberties issue, reminiscent of the McCarthyism of 1950s USA. We should refuse to attend. PMID:27087993

  19. Factors associated with having a medical marijuana card among Veterans with recent substance use in VA outpatient treatment.

    Science.gov (United States)

    Davis, Alan K; Bonar, Erin E; Ilgen, Mark A; Walton, Maureen A; Perron, Brian E; Chermack, Stephen T

    2016-12-01

    Psychiatric symptoms, somatic problems, and co-occurring substance use have been associated with medical marijuana consumption among civilian patients with substance use disorders. It is possible that these factors may impact Veterans' ability to engage in or adhere to mental health and substance use disorder treatment. Therefore, we examined whether psychiatric functioning, substance use, and somatic problems were associated with medical marijuana use among Veterans receiving substance use disorder and/or mental health treatment. Participants (n=841) completed screening measures for a randomized controlled trial and 67 (8%) reported that they had a current medical marijuana card. Most of these participants (78%) reported using marijuana to treat severe/chronic pain. Significant bivariate differences revealed that, compared to participants without a medical marijuana card, those with a card were more likely to be in a middle income bracket, unemployed, and they had a significantly higher number of recent days of marijuana use, synthetic marijuana use, and using sedatives prescribed to them. Additionally, a significantly higher proportion of participants with a medical marijuana card scored above the clinical cutoff for posttraumatic stress disorder (PTSD) symptoms, had significantly higher severity of sleep-related problems, and reported a higher level of pain. These findings highlight the co-occurrence of substance use, PTSD symptoms, sleep-related problems, and chronic pain among Veterans who use medical marijuana. Future research should investigate the inter-relationships among medical marijuana use and other clinical issues (e.g., PTSD symptoms, sleep, pain) over time, and potential implications of medical marijuana use on treatment engagement and response. PMID:27475408

  20. In-hospital medical complications associated with patient dependency after acute ischemic stroke: data from the China National Stroke Registry

    Institute of Scientific and Technical Information of China (English)

    WANG Peng-lian; ZHAO Xing-quan; DU Wan-liang; WANG An-xin; JI Rui-jun; YANG Zhong-hua; WANG Chun-xue

    2013-01-01

    Background The mortality of stroke patients is strongly affected by medical complications.However,there are limited data investigating the effect of in-hospital medical complications on the dependency of stroke patients worldwide.We prospectively and systematically investigated the effect of medical complications on dependency of patients at 3,6 and 12 months after stroke using the China National Stroke Registry (CNSR).Methods This prospective cohort study collected data of patients age >18 years with acute ischemic stroke in 132 clinical centers distributed across 32 provinces and four municipalities (including Hong Kong region) of China,from September 2007 to August 2008.Data on medical complications,dependency and other information were obtained from paper-based registry forms.Medical complications associated with stroke outcomes were assessed using multivariable Logistic regression.Results Of 11 560 patients with acute ischemic stroke,1826 (15.80%) presented with in-hospital medical complications.In-hospital medical complications were independent risk factors for dependency of patients at 3 months (adjusted odds ratio (OR) 2.367,95% confidence interval (CI) 2.021-2.771),6 months (adjusted OR 2.257,95% CI 1.922-2.650),and 12 months (adjusted OR 1.820,95% CI 1.538-2.154) after acute ischemic stroke.Conclusion The results demonstrated that the short-term and long-term dependency of acute ischemic stroke patients is significantly associated with in-hospital medical complications in China.

  1. The Incidence of Nosocomial Toxigenic Clostridium difficile Associated Diarrhea in Tehran Tertiary Medical Centers

    Directory of Open Access Journals (Sweden)

    Norakhoda Sadeghifard

    2010-10-01

    Full Text Available Clostridium difficile is the most common cause of nosocomial diarrhea. It is usually a consequence of antibiotic treatment, But sporadic cases can occur. This study was aimed to determine the frequency of the nosocomial Clostridium difficile (C. difficile associated diarrhea in Tehran University of Medical Sciences hospitals and study of antibacterial susceptibility of isolates. In this study a total of 942 stool samples from patients with nosocomial diarrhea that were hospitalized in Imam Khomeini hospital, Shariati hospital and Children clinical center were collected. The samples were cultured on a selective cycloserine cefoxitin fructose agar (CCFA and incubated in anaerobic conditions, at 37°C for 5 days. Isolates were characterized to species level by conventional biochemical tests. Bacterial cytotoxicity was assayed on tissue culture (vero. Antimicrobial sensitivity of isolated toxigenic C. difficile were investigated by kirby Beuer method (disk diffusion. Our findings show that, of the total patients, 57 toxigenic C. difficile (6.1% were isolated. Results of statistical analysis show significant differences between the rate of isolated toxigenic C. difficile and age group of patients (P

  2. Self-Medication Practice among Amateur Runners: Prevalence and Associated Factors

    OpenAIRE

    Médéa Locquet, Charlotte Beaudart, Robert Larbuisson, Fanny Buckinx, Jean-François Kaux, Jean-Yves Reginster, Olivier Bruyère

    2016-01-01

    The term “self-medication” involves consumption, without any physician’s advice, of over-the-counter drugs but also of formerly prescribed drugs. Amateur athletes could resort frequently to self-medication for different reasons. Indeed, they may use self-medication products because they are regularly exposed to pain, tiredness, injuries and difficulties with recovery. Sometimes, they can also deliberately use medications in order to enhance their physical performance (Conrad et al., 2004). In...

  3. Variables Associated with Utilization of a Centralized Medical Post in the Andean Community of Pampas Grande, Peru

    Science.gov (United States)

    Merry, Stephen P.; Rohrer, James E.; Thacher, Thomas D.; Summers, Matthew R.; Alpern, Jonathan D.; Contino, Robert W.

    2012-01-01

    Context: Integral to the location of health resources is the distance decay of utilization observed in a population. In rural Peru, a nongovernmental organization planning to increase the availability of health services needed this information. Purpose: To determine variables associated with utilization of a central medical clinic and determine…

  4. Changes in Study Strategies of Medical Students between Basic Science Courses and Clerkships Are Associated with Performance

    Science.gov (United States)

    Ensminger, David C.; Hoyt, Amy E.; Chandrasekhar, Arcot J.; McNulty, John A.

    2013-01-01

    We tested the hypothesis that medical students change their study strategies when transitioning from basic science courses to clerkships, and that their study practices are associated with performance scores. Factor scores for three approaches to studying (construction, rote, and review) generated from student (n = 150) responses to a…

  5. Role of childhood adversity in the development of medical co-morbidities associated with bipolar disorder

    NARCIS (Netherlands)

    Post, Robert M.; Altshuler, Lori L.; Leverich, Gabriele S.; Frye, Mark A.; Suppes, Trisha; McElroy, Susan L.; Keck, Paul E.; Nolen, Willem A.; Kupka, Ralph W.; Grunze, Heinz; Rowe, Mike

    2013-01-01

    Objective: A role for childhood adversity in the development of numerous medical conditions in adults has been described in the general population, but has not been examined in patients with bipolar disorder who have multiple medical comorbidities which contribute to their premature mortality. Metho

  6. John Gregory (1724-1773) and his lectures on the duties and qualifications of a physician establishing modern medical ethics on the base of the moral philosophy and the theory of science of the empiric British Enlightenment.

    Science.gov (United States)

    Strätling, M

    1997-01-01

    In 1769/70 the Scottish physician and philosopher John Gregory (1724-1773) published Lectures On the Duties and Qualifications of a Physician. Gregory developed a truely ethical - in the sense of (moral) philosophically based - system of conduct in a physician. His concept of practising and teaching ethics in medicine and science is established on a very broad footing: combining Bacon's (1561-1626) general philosophy of nature and science with both, the general, likewise empirically based moral philosophy of his personal friend David Hume (1711-1776), and with the principles upheld by the so-called Common-Sense Philosophy. His Lectures had - particularly via the famous Code of Medical Ethics of Thomas Percival (1740-1804) - a decisive influence on our contemporary concepts of ethics in medicine and science. John Gregory is, without doubt, one of the most important and certainly the most comprehensive among the founders of what is known today as modern Bioethics.

  7. The Contemporaneity of the British Survey.

    Science.gov (United States)

    Dodson, Charles Brooks

    The seeming remoteness of material studied in a British literature survey course can be frustrating for the teacher. Students may find little relevance in the story of Beowulf or the descriptions of Gulliver's voyages. However, instructors can highlight the contemporaneity of British literary texts by drawing parallels to modern times. For…

  8. British African Caribbean Women and Depression

    Science.gov (United States)

    Adkison-Bradley, Carla; Maynard, Donna; Johnson, Phillip; Carter, Stephaney

    2009-01-01

    Depression is a common condition among women in the United Kingdom. However, little is known about the context of depression among British African Caribbean women. This article offers a preliminary discussion regarding issues and information pertaining to depression among British African Caribbean women. Characteristics and symptoms of depression…

  9. The Current Canon in British Romantics Studies.

    Science.gov (United States)

    Linkin, Harriet Kramer

    1991-01-01

    Describes and reports on a survey of 164 U.S. universities to ascertain what is taught as the current canon of British Romantic literature. Asserts that the canon may now include Mary Shelley with the former standard six major male Romantic poets, indicating a significant emergence of a feminist perspective on British Romanticism in the classroom.…

  10. British and American literatures and English education

    Institute of Scientific and Technical Information of China (English)

    田露

    2011-01-01

    British and American literature teachings and university English the teaching isn't self-contradict,can be complement each other.Strengthen British and American literature teachings,contribute to an improvement our country English education,develop high c

  11. The Falklands War and the British Stage

    Directory of Open Access Journals (Sweden)

    Radu Adrian

    2014-03-01

    Full Text Available The paper examines the way the Falklands War of 1982 was reflected in the creation of British playwrights. Officially, the war was seen as a heroic act, as another glorious page in the book of British history. But for many writers it contained nothing heroic; it was just noisy brandishing of weapons and useless loss of human lives.

  12. J.G. Crowther's War: Institutional strife at the BBC and British Council.

    Science.gov (United States)

    Jones, Allan

    2016-06-01

    Science writer, historian and administrator J.G. Crowther (1899-1983) had an uneasy relationship with the BBC during the 1920s and 1930s, and was regarded with suspicion by the British security services because of his left politics. Nevertheless the Second World War saw him working for 'establishment' institutions. He was closely associated with the BBC's Overseas Service and employed by the British Council's Science Committee. Both organizations found Crowther useful because of his wide, international knowledge of science and scientists. Crowther's political views, and his international aspirations for the British Council's Science Committee, increasingly embroiled him in an institutional conflict with the Royal Society and with its president, Sir Henry Dale, who was also chairman of the British Council's Science Committee. The conflict centred on the management of international scientific relations, a matter close Crowther's heart, and to Dale's. Dale considered that the formal conduct of international scientific relations was the Royal Society's business rather than the British Council's. Crowther disagreed, and eventually resigned from the British Council Science Committee in 1946. The article expands knowledge of Crowther by drawing on archival documents to elucidate a side of his career that is only lightly touched on in his memoirs. It shows that 'Crowther's war' was also an institutional war between the Science Committee of the British Council and the Royal Society. Crowther's unhappy experience of interference by the Royal Society plausibly accounts for a retreat from his pre-war view that institutional science should plan and manage BBC science broadcasts.

  13. Antimicrobial activity of sodium hypochlorite associated with intracanal medication for Candida albicans and Enterococcus faecalis inoculated in root canals

    Directory of Open Access Journals (Sweden)

    Marcia Carneiro Valera

    2009-12-01

    Full Text Available OBJECTIVE: The purpose of this study was to evaluate the action of sodium hypochlorite (NaOCl associated with an intracanal medication against Candida albicans and Enterococcus faecalis inoculated in root canals. MATERIAL AND METHODS: Thirty-six human single-rooted teeth with single root canals were used. The canals were contaminated with C. albicans and E. faecalis for 21 days and were then instrumented with 1% NaOCl. The roots were divided into 3 groups (n=12 according to the intracanal medication applied: calcium hydroxide paste, 2% chlorhexidine (CHX gel, and 2% CHX gel associated with calcium hydroxide. The following collections were made from the root canals: a initial sample (IS: 21 days after contamination (control, b S1: after instrumentation, c S2: 14 days after intracanal medication placement; S3: 7 days after intracanal medication removal. The results were analyzed statistically by the Kruskal-Wallis test at 5% significance level. RESULTS AND CONCLUSIONS: Both 1% NaOCl irrigation and the intracanal medications were effective in eliminating E. faecalis and C. albicans inoculated in root canals.

  14. Assessing the effect of treatment duration on the association between anti-diabetic medication and cancer risk.

    Directory of Open Access Journals (Sweden)

    Anna But

    Full Text Available Most studies that have evaluated the association between anti-diabetic medication and cancer risk have suffered from methodological drawbacks. To avoid time-related biases, we evaluated the effect of treatment duration on the cancer risk among naive users of anti-diabetic medication as compared to non-users. In addition, we addressed the influence of common risk factors such as smoking and BMI. The study population comprised 23,394 participants of FINRISK surveys. Data on cancer and anti-diabetic medication were linked with the study cohorts. We applied Lexis tabulation to the data and analyzed split records by using Poisson regression. Changes in cancer incidence in relation to treatment duration were examined by modeling the rate ratio (RR. After a median follow-up of 9 years, 53 cancer cases among users of anti-diabetic medication and 1,028 among non-users were diagnosed. No significant difference in cancer risk between users and non-users was observed after adjustment. The RR for all medication regardless of its duration was 1.01 [95% CI 0.75-1.33], and 1.37 [0.94-1.94] for period of 1-4 years. The results were similar for metformin, sulfonylurea, and insulin. This study demonstrates that evaluation of the variation in cancer risk in relation to treatment duration is of particular importance for enhancing the accuracy of conclusions on the link between exposure to anti-diabetic medication and cancer risk.

  15. Immigration Status and Victimization: Evidence from the British Crime Survey

    OpenAIRE

    Georgios Papadopoulos

    2013-01-01

    This study, using data from the British Crime Survey (BCS), examines the microrelationship between immigration and victimization. We first find that, although immigrants are more likely to suffer property crimes than natives, this is well explained by the fact that immigrants exhibit demographic characteristics associated with higher victimization. Contrary to the above, immigrants are of lower risk of violent victimization. As violence is an expressive type of crime, where interactions betwe...

  16. Estimation of coronary risk factors in British schoolchildren: a preliminary report.

    OpenAIRE

    Armstrong , N .; Balding, J; Gentle, P; Kirby, B.

    1990-01-01

    Surveys from several countries have identified the presence of risk factors known to be associated with coronary heart disease in children. Data on the distribution of coronary risk factor variables in British children are scarce. This study was therefore designed to test the feasibility of collecting coronary risk factor data from British children and to conduct a preliminary examination of the problem. One hundred and seven children (mean age 12.8 yr) had their height, weight, triceps skinf...

  17. Do Formal Inspections Ensure that British Zoos Meet and Improve on Minimum Animal Welfare Standards?

    OpenAIRE

    Stephen Harris; Chris Draper; William Browne

    2013-01-01

    Simple Summary Key aims of the formal inspections of British zoos are to assess compliance with minimum standards of animal welfare and promote improvements in animal care and husbandry. We compared reports from two consecutive inspections of 136 British zoos to see whether these goals were being achieved. Most zoos did not meet all the minimum animal welfare standards and there was no clear evidence of improving levels of compliance with standards associated with the Zoo Licensing Act 1981. ...

  18. Assessment of Obesity, Overweight and Its Association with the Fast Food Consumption in Medical Students

    Science.gov (United States)

    Purohit, Geetanjali; Nair, Sandhya Pillai; Patel, Bhavita; Rawal, Yash; Shah, R. M.

    2014-01-01

    Introduction: Obesity is a condition in which excess body fat accumulates, which leads to various adverse effects on health, particularly cardiovascular diseases (CVDs), which reduce life expectancy and/or increase health problems. Fast food consumption is one of the factors which have been reported as a cause of obesity. Body mass index (BMI) is used to assess obesity and overweight, which can be calculated by using the formula, weight in kg, divided by square of height in metres. Aim: This study focused on the relationship of body mass index with fast food consumption, associated soft drink consumption and physical activity. Methods: Descriptive cross-sectional study was conducted in Department of Biochemistry, SBKS MI and RC, and Sumandeep Vidyapeeth. This study was approved by the ethical review board .One hundred and forty seven medical students from 1st year MBBS course were included in this study. Self-structured questionnaire was used, which contained several data like information on age, height, weight, education level. The formula used for calculating BMI was, weight in kg, divided by square of height in metres (Kg/m2). Results: In our study, out of 147 students, a total of 138 students (more than 90%) used to have fast food. Among these, a total of 47 students (34.05%) were pre-obese and obese. Out of 147 students, 87 students (59.18%) were in normal weight range, while 13 (8.84%) students were underweight. Statistical Analysis: Data was compiled in an Excel worksheet and it was analyzed for percentages and proportions. Chi-square and Pearson’s correlation test were also applied wherever they were applicable and Alpha error was set at a 5% level. Conclusion: In our study, a significant relationship was found between BMI and fast food consumption, less physical activity, and intake of soft drinks. PMID:24995170

  19. Self-citation rates among medical imaging journals and a possible association with impact factor

    Energy Technology Data Exchange (ETDEWEB)

    Kurmis, Timothy P. [Department of Orthopaedics and Trauma, Royal Adelaide Hospital, South Australia (Australia)], E-mail: tim.kurmis@health.sa.gov.au; Kurmis, Andrew P. [Department of Orthopaedic Surgery, Royal Melbourne Hospital, Victoria (Australia)

    2010-02-15

    Purpose: Since conceptualisation in 1955, journal impact factors (IFs) have evolved as surrogate markers of perceived 'quality'. However, no previous research has explored the relationship between IF and journal self-citation rate, which may inflate this measure. Given Radiography's ongoing push to achieve Medline and ISI database inclusion, this paper aimed to quantitatively explore the frequency of self-citation and correlate this with ISI-reported IF. Methods: A review of articles published in two peer-reviewed, Medline and ISI-listed, imaging journals (Radiology and Academic Radiology), and Radiography, within in a 12-month period, was performed. The total number of citations and self-citations per article was recorded, and the results compared. Basic statistical and correlation analyses between listed IF ratings and self-citation indices were also performed. Results and Discussion: To our knowledge, this work represents the preliminary investigation exploring the association between ISI-listed IF and self-citation frequency. From the current results it can be suggested that such a relationship does exist, as demonstrated by the strongly positive correlation statistic (Pearson's r{sup 2} = 0.99). Radiology was noted to have a considerably larger mean number of self-citations per article than the other two journals (p < 0.01), despite near-equivalent numbers of references per article. Conclusion: Our findings suggest that there may be relationship between an ISI-listed IFs and journal self-citation rates. It is hoped that this paper will be of interest in academic and research circles, both within medical imaging and more widely, and may provide impetus for discussion relating to self-citation frequency and influence on resultant IF calculations.

  20. Factors associated with mental health status of medical residents: a model-guided study.

    Science.gov (United States)

    Anagnostopoulos, Fotios; Demerouti, Evangelia; Sykioti, Panagiota; Niakas, Dimitris; Zis, Panagiotis

    2015-03-01

    Residency is a stressful period in a physician's development, characterized by long work hours, time pressure, and excessive work load, that can exert negative effects on residents' mental health. Job burnout and negative work-home interference may play a major role in residents' mental health problems. The present study used the job demands-resources model as a theoretical framework to examine the way in which job demands (e.g., workload, emotional demands) and job resources (e.g., supervisor support, job autonomy) were associated with residents' mental health. From a pool of 290 medical residents, 264 (91 %) completed the questionnaires. Applying structural equation modeling techniques, the results showed that greater emotional exhaustion (β = -.65, SE = .09, p < .001) and more work-home interference (β = -.26, SE = .10, p < .05) were related to poor mental health. Specific job demands (i.e., high workload) and particular job resources (i.e., low opportunities for professional development and low supervisor support) were related to poor mental health not directly but only indirectly, via emotional exhaustion or work-home interference. Thus, through work-related emotional exhaustion, the impact of work conditions might be transmitted to and interfere with non-work related domains such as family life, as well as with domain-unspecific aspects of well-being, such as mental health and psychological distress. Implications of the results and suggestions for future research and practice are outlined.

  1. Enterococcus and Streptococcus spp. associated with chronic and self-medicated urinary tract infections in Vietnam

    Directory of Open Access Journals (Sweden)

    Poulsen Louise

    2012-11-01

    Full Text Available Abstract Background Urinary tract infections (UTI are one of the most common infections among women worldwide. E. coli often causes more than 75% of acute uncomplicated UTI, however, little is known about how recurrent UTIs and indiscriminate use of antimicrobials affect the aetiology of UTIs. This study aimed to establish the aetiology of UTI in a population of recurrent and self-medicated patients referred from pharmacies to a hospital in Hanoi, Vietnam and to describe genotypes and antimicrobial susceptibility of the associated bacterial pathogens. The aetiology of bacterial pathogens associated with UTI (defined as ≥ 104 CFU/ml urine was established by phenotypic and molecular methods. Enterococcus faecalis isolates were typed by Multi Locus Sequence Typing (MLST, Pulsed-Field Gel Electrophoresis (PFGE and antimicrobial susceptibility testing. Methods Urine samples from 276 patients suffering symptoms of urinary tract infection were collected and cultured on Flexicult agar® allowing for detection of the most common urine pathogens. Patients were interviewed about underlying diseases, duration of symptoms, earlier episodes of UTI, number of episodes diagnosed by doctors and treatment in relation to UTI. All tentative E. faecalis and E. faecium isolates were identified to species level by PCR, 16S rRNA and partial sequencing of the groEL gene. E. faecalis isolates were further characterized by Multi Locus Sequence Typing and antimicrobial susceptibility testing. Results Mean age of 49 patients was 48 yrs (range was 11–86 yrs and included 94% women. On average, patients reported to have suffered from UTI for 348 days (range 3 days-10 years, and experienced 2.7 UTIs during the previous year. Cephalosporins were reported the second drug of choice in treatment of UTI at the hospital. E. faecalis (55.1%, E. coli (12.2% and Streptococcus gallolyticus subsp. pasteurianus (8.2% were main bacterial pathogens. MIC testing of E. faecalis showed

  2. Does the private finance initiative promote innovation in health care? The case of the British National Health Service.

    Science.gov (United States)

    Petratos, Pythagoras

    2005-12-01

    The Private Finance Initiative (PFI) is a specific example of health care privatization within the British National Health Service. In this essay, I critically assess the ways in which various Private Finance Initiatives have increased health care efficiency and effectiveness, as well as encouraged medical innovation. Indeed, as the analysis will demonstrate, significant empirical evidence supports the conclusion that Private Finance Initiatives are a driving force of innovation within the British Health Care System. PMID:16396788

  3. Factors associated with positive attitude towards blood donation among medical students.

    Science.gov (United States)

    Gazibara, Tatjana; Kovacevic, Nikolina; Maric, Gorica; Kurtagic, Ilma; Nurkovic, Selmina; Kisic-Tepavcevic, Darija; Pekmezovic, Tatjana

    2015-12-01

    The aim of this study was to assess attitudes and practice of blood donation among medical students. Medical students were recruited at Medical Faculty, University of Belgrade, Serbia. Of 973 students, 38.4% of freshmen and 41.4% of final year students have donated blood (χ(2) = 0.918, p = 0.186). Blood donors had significantly more positive attitude towards some aspects of blood donation. Being female, residing in a city other than the capital and previous blood donation experience were independent predictors of positive attitude towards being a blood donor to an unknown person. Efforts are required to augment blood donor pool among future physicians.

  4. Sir Charles Ballance: pioneer British neurological surgeon.

    Science.gov (United States)

    Stone, J L

    1999-03-01

    Sir Charles A. Ballance (1856-1936) began his medical career at St. Thomas's Hospital the University College, London, England, in 1875, receiving honors in every subject and a gold medal in surgery. Victor Horsley (1857-1916) and Ballance were classmates at the University and in the later 1880s began work together at the Brown Institute and the National Hospital, Queen Square. In addition to important studies on vascular surgery, Ballance was involved in primate work on cerebral localization with lifelong friends Charles Beevor, Charles Sherrington, David Ferrier, and others. In June of 1887, Ballance assisted Horsley at Queen Square in the successful removal of an extramedullary spinal cord tumor. Horsley was about to abandon the operation, but his friend urged the removal of one lamina higher and the tumor was discovered. Ballance, a demonstrator in anatomy, realized the spinal cord segments lay higher in relation to the vertebral bodies than was generally appreciated. Ballance popularized the operation of radical mastoidectomy for advanced middle ear infection (1890), standardized an approach to drain or excise temporal brain abscesses, and was the first to clearly understand the neurological signs of cerebellar abscess (1894). Ballance also devised cranial base approaches to attack infectious thrombophlebitis of the lateral, petrosal, and cavernous sinuses. He was the first to completely remove an acoustic tumor (1894); 18 years later, the patient remained well. Ballance also drained a posterior fossa subdural hematoma (1906) and successfully sectioned the auditory nerve for Meniere's syndrome (1908). Ballance's operative experience with both supra- and infratentorial brain lesions included approximately 400 cases, which are detailed in his 1907 book, Some Points in the Surgery of the Brain and Its Membranes. His two-volume set, Essays on the Surgery of the Temporal Bone (1919), remains a brilliantly written and illustrated classic. Ballance was an expert on

  5. Patient and medication-related factors associated with hospital-acquired hyponatremia in patients hospitalized from heart failure.

    Science.gov (United States)

    Saepudin, S; Ball, Patrick A; Morrissey, Hana

    2016-08-01

    Background Hyponatremia has been known as an important predictor of clinical outcomes in patients with heart failure (HF). While information on hyponatremia in patients with HF has been available abundantly, information on factors associated with increased risk of developing hospital-acquired hyponatremia (HAH) is still limited. Objective To identify patients and medication-related factors associated with HAH in patients hospitalized from HF. Setting Fatmawati Hospital in Jakarta, Indonesia. Methods This is a nested case-control study with patients developing HAH served as case group and each patient in case group was matched by age and gender to three patients in control group. Patients included in this study are patients hospitalized from HF, and coded with I.50 according to ICD-10, during 2011-2013 at Fatmawati Hospital in Jakarta, Indonesia. Information retrieved from patients' medical records included demographic profiles, vital signs and symptoms at admission, past medical history, medication during hospitalization and clinical chemistry laboratory records. Multivariable logistic regression analysis was performed to find out patient and treatment-related factors associated with the development of HAH. Main outcome measures Patients and medication related factors having significant association with HAH. Results Four hundreds sixty-four patients were included in this study and 45 of them (9.7 %) met criteria of developing HAH so then, accordingly, 135 patients were selected as controls. 36 patient- and 22 treatment-related factors were analyzed in univariate logistic regression resulted in 20 factors having p value <0.2 and were included in multivariable logistic regression analysis. Final factors showing significant association with HAH are presence of ascites at admission (odds ratio = 4.7; 95 % confidence interval 1.9-11.5) and administration of amiodarone (3.2; 1.3-7.4) and heparin (3.1; 1.2-7.3) during hospital stay. Conclusion Presence of ascites at

  6. Factors associated with anti-tuberculosis medication adverse effects: a case-control study in Lima, Peru.

    Directory of Open Access Journals (Sweden)

    Kocfa Chung-Delgado

    Full Text Available BACKGROUND: Long-term exposure to anti-tuberculosis medication increases risk of adverse drug reactions and toxicity. The objective of this investigation was to determine factors associated with anti-tuberculosis adverse drug reactions in Lima, Peru, with special emphasis on MDR-TB medication, HIV infection, diabetes, age and tobacco use. METHODOLOGY AND RESULTS: A case-control study was performed using information from Peruvian TB Programme. A case was defined as having reported an anti-TB adverse drug reaction during 2005-2010 with appropriate notification on clinical records. Controls were defined as not having reported a side effect, receiving anti-TB therapy during the same time that the case had appeared. Crude, and age- and sex-adjusted models were calculated using odds ratios (OR and 95% confidence intervals (95%CI. A multivariable model was created to look for independent factors associated with side effect from anti-TB therapy. A total of 720 patients (144 cases and 576 controls were analyzed. In our multivariable model, age, especially those over 40 years (OR = 3.93; 95%CI: 1.65-9.35, overweight/obesity (OR = 2.13; 95%CI: 1.17-3.89, anemia (OR = 2.10; IC95%: 1.13-3.92, MDR-TB medication (OR = 11.1; 95%CI: 6.29-19.6, and smoking (OR = 2.00; 95%CI: 1.03-3.87 were independently associated with adverse drug reactions. CONCLUSIONS: Old age, anemia, MDR-TB medication, overweight/obesity status, and smoking history are independent risk factors associated with anti-tuberculosis adverse drug reactions. Patients with these risk factors should be monitored during the anti-TB therapy. A comprehensive clinical history and additional medical exams, including hematocrit and HIV-ELISA, might be useful to identify these patients.

  7. The british military hospitals in macedonia during the first world war.

    Science.gov (United States)

    Cvetkovski, Vladimir

    2016-01-01

    The paper focusses its attention to the medical work of the British Military hospitals stationed in Macedonia during the First World War, the surgical work carried out under very heavy conditions in improvised operating theatres as well as the treatment of the wounded and sick solders brought from the battlefields on the Macedonian Front.

  8. Separated by a Common Translation? How the British and the Dutch Communicate

    NARCIS (Netherlands)

    Rottier, Bart; Ripmeester, Nannette; Bush, Andrew

    2011-01-01

    The British and Dutch share a long naval-, war- and medical history, in good times as well as bad. Their language has a common Germanic origin, but the English people may use special ways to express values or opinions, from which the sometimes paradoxical meaning is not always clear to the other par

  9. The Association of Health Literacy with Illness and Medication Beliefs among Patients with Chronic Obstructive Pulmonary Disease.

    Directory of Open Access Journals (Sweden)

    Minal S Kale

    Full Text Available Low health literacy is associated with low adherence to self-management in many chronic diseases. Additionally, health beliefs are thought to be determinants of self-management behaviors. In this study we sought to determine the association, if any, of health literacy and health beliefs among elderly individuals with COPD.We enrolled a cohort of patients with COPD from two academic urban settings in New York, NY and Chicago, IL. Health literacy was measured using the Short Test of Functional Health Literacy in Adults. Using the framework of the Self-Regulation Model, illness and medication beliefs were measured with the Brief Illness Perception Questionnaire (B-IPQ and Beliefs about Medications Questionnaire (BMQ. Unadjusted analyses, with corresponding Cohen's d effect sizes, and multiple logistic regression were used to assess the relationships between HL and illness and medication beliefs.We enrolled 235 participants, 29% of whom had low health literacy. Patients with low health literacy were more likely to belong to a racial minority group (p<0.001, not be married (p = 0.006, and to have lower income (p<0.001 or education (p<0.001. In unadjusted analyses, patients with low health literacy were less likely to believe they will always have COPD (p = 0.003, Cohen's d = 0.42, and were more likely to be concerned about their illness ((p = 0.04, Cohen's d = 0.17. In analyses adjusted for sociodemographic factors and other health beliefs, patients with low health literacy were less likely to believe that they will always have COPD (odds ratio [OR]: 0.78, 95% confidence interval [CI]: 0.65-0.94. In addition, the association of low health literacy with expressed concern about medications remained significant (OR: 1.20, 95% CI: 1.05-1.37 though the association of low health literacy with belief in the necessity of medications was no longer significant (OR: 0.92, 95% CI: 0.82-1.04.In this cohort of urban individuals with COPD, low health literacy was

  10. The Association of Health Literacy with Illness and Medication Beliefs among Patients with Chronic Obstructive Pulmonary Disease

    Science.gov (United States)

    Kale, Minal S.; Federman, Alex D.; Krauskopf, Katherine; Wolf, Michael; O’Conor, Rachel; Martynenko, Melissa; Leventhal, Howard; Wisnivesky, Juan P.

    2015-01-01

    Background Low health literacy is associated with low adherence to self-management in many chronic diseases. Additionally, health beliefs are thought to be determinants of self-management behaviors. In this study we sought to determine the association, if any, of health literacy and health beliefs among elderly individuals with COPD. Methods We enrolled a cohort of patients with COPD from two academic urban settings in New York, NY and Chicago, IL. Health literacy was measured using the Short Test of Functional Health Literacy in Adults. Using the framework of the Self-Regulation Model, illness and medication beliefs were measured with the Brief Illness Perception Questionnaire (B-IPQ) and Beliefs about Medications Questionnaire (BMQ). Unadjusted analyses, with corresponding Cohen’s d effect sizes, and multiple logistic regression were used to assess the relationships between HL and illness and medication beliefs. Results We enrolled 235 participants, 29% of whom had low health literacy. Patients with low health literacy were more likely to belong to a racial minority group (p<0.001), not be married (p = 0.006), and to have lower income (p<0.001) or education (p<0.001). In unadjusted analyses, patients with low health literacy were less likely to believe they will always have COPD (p = 0.003, Cohen’s d = 0.42), and were more likely to be concerned about their illness ((p = 0.04, Cohen’s d = 0.17). In analyses adjusted for sociodemographic factors and other health beliefs, patients with low health literacy were less likely to believe that they will always have COPD (odds ratio [OR]: 0.78, 95% confidence interval [CI]: 0.65–0.94). In addition, the association of low health literacy with expressed concern about medications remained significant (OR: 1.20, 95% CI: 1.05–1.37) though the association of low health literacy with belief in the necessity of medications was no longer significant (OR: 0.92, 95% CI: 0.82–1.04). Conclusions In this cohort of urban

  11. Epidemiological Investigation of Lifestyle Associated Modifiable Risk Factors among Medical Students

    Directory of Open Access Journals (Sweden)

    Anurag Srivastava

    2013-06-01

    Conclusion: The study shows a high prevalence of NCD related risk factors in medical students. Primary prevention may be one way to lower the risk burden of NCDs. [Natl J Med Res 2013; 3(3.000: 210-215

  12. Novelty-seeking and avoidant coping strategies are associated with academic stress in Korean medical students.

    Science.gov (United States)

    An, Hoyoung; Chung, Seockhoon; Park, Jangho; Kim, Seong-Yoon; Kim, Kyung Mo; Kim, Ki-Soo

    2012-12-30

    High levels of stress and depression in medical students is raising concern. In this study, we sought to identify coping strategies and other factors influencing academic stress in medical students. We enrolled 157 students from the University of Ulsan College of Medicine, Korea, in November, 2010. We used the Medical Stress Scale, Temperament and Character Inventory, Hamilton Depression Scale, Beck Depression Inventory, and Coping Response Inventory to assess psychological parameters. We used Pearson's correlation and linear regression analyses to analyze the data. Novelty-seeking, self-directedness, cooperativeness, coping strategy, and depression scale scores all correlated significantly with stress level. Linear regression analysis indicated that students who are novelty-seeking, likely to use avoidant coping strategies, and unlikely to use active-cognitive and active-behavioral strategies tend to have higher stress levels. Reduction of stress in medical students may be achieved through evaluation of coping strategies and personality features and use of interventions to promote active coping strategies.

  13. Association between patients' beliefs and oral antidiabetic medication adherence in a Chinese type 2 diabetic population

    OpenAIRE

    Wu P; Liu N

    2016-01-01

    Ping Wu,1 Naifeng Liu2 1Department of Clinical Pharmacy, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, 2Institute of Cardiovascular Disease, Southeast University Medical School, Nanjing, People’s Republic of China Purpose: The objective of this study was to identify, using the theory of planned behavior (TPB), patients’ beliefs about taking oral antidiabetic drugs (OADs) as prescribed, and to measure the correlations between beliefs and...

  14. Association of Maternal Self-Medication and Over-the-Counter Analgesics for Children

    DEFF Research Database (Denmark)

    Jensen, Janne Fangel; Gottschau, Mathilde; Siersma, Volkert Dirk;

    2014-01-01

    Self-medication with over-the-counter (OTC) analgesics, such as paracetamol (PCM), among children and adolescents is increasing and constitutes an important public health issue internationally. Reasons for this development are unclear; parental influence is suggested. Our objective was to examine...... whether self-medication with OTC analgesics among school-aged children is influenced by maternal self-reported health and medicine use, taking the child's frequency of pain into account....

  15. Exploring factors associated with patients' satisfaction with medication change: a questionnaire survey.

    OpenAIRE

    Rodgers, Sarah; Avery, Anthony J; O'Neill, Ciaran

    2002-01-01

    The recent drive to encourage general practitioners (GPs) to rationalise their prescribing has implications for patients who may have their medication changed. A postal survey of such patients was conducted and it wasfound that 65% were at least reasonably satisfied with the way theyfound out about changes in their medication. Logistic analysis showed that patients were more satisfied when they had been told about the change by a GP or a pharmacist or by a letterfrom the practice.

  16. Medical Renaissance.

    Science.gov (United States)

    Toledo-Pereyra, Luis H

    2015-06-01

    The Medical Renaissance started as the regular Renaissance did in the early 1400s and ended in the late 1600s. During this time great medical personalities and scholar humanists made unique advances to medicine and surgery. Linacre, Erasmus, Leonicello and Sylvius will be considered first, because they fit the early classic Renaissance period. Andreas Vesalius and Ambroise Paré followed thereafter, making outstanding anatomical contributions with the publication of the "Human Factory" (1543) by Vesalius, and describing unique surgical developments with the publication of the "The Apologie and Treatise of Ambroise Paré." At the end of the Renaissance and beginning of the New Science, William Harvey, noted British medical doctor and cardiovascular researcher, discovered the general circulation. He published his findings in "The Motu Cordis" in 1628 (Figure 1). The Medical Renaissance, in summary, included a great number of accomplished physicians and surgeons who made especial contributions to human anatomy; Vesalius assembled detailed anatomical information; Paré advanced surgical techniques; and Harvey, a medical genius, detailed the circulatory anatomy and physiology.

  17. Self-Medication Practice among Amateur Runners: Prevalence and Associated Factors

    Directory of Open Access Journals (Sweden)

    Médéa Locquet, Charlotte Beaudart, Robert Larbuisson, Fanny Buckinx, Jean-François Kaux, Jean-Yves Reginster, Olivier Bruyère

    2016-06-01

    Full Text Available The term “self-medication” involves consumption, without any physician’s advice, of over-the-counter drugs but also of formerly prescribed drugs. Amateur athletes could resort frequently to self-medication for different reasons. Indeed, they may use self-medication products because they are regularly exposed to pain, tiredness, injuries and difficulties with recovery. Sometimes, they can also deliberately use medications in order to enhance their physical performance (Conrad et al., 2004. In 2015, we wanted to identify and better understand self-medication practices in an amateur sports population in the Province of Liège, Belgium. We focused especially on amateur runners because of the growing interest in this population. We went to 8 running events in order to interview amateur runners about their self-medication behaviors exclusively aiming at being better prepared for this specific race. Approval was granted by the Ethics Committee of the University Teaching Hospital of Liège. Data regarding consumption of self-medication drugs just before the running event (i.e. intake maximum last 24 hours before the race was collected through an anonymous self-administrated questionnaire. The level and intensity of usual sports practice, the membership to a sports club and the length of the race on that specific day (10 or 21km were also recorded. A total of 358 amateur runners, mainly composed of men (62.0% with a median age of 39 years (IQR: 29-49 have volunteered. Among the 358 respondents, 112 runners (31.3% had taken self-medication drugs during the period immediately preceding the running event (i.e. maximum last 24 hours, with the aim of being better prepared for this specific race. Athletes declared consuming self-medication drugs before the race mainly to reduce pain (36.1% and headaches (16.6% but also in order to improve their physical performance (9.9% (Table 1. The two therapeutic classes most often reported were analgesics and

  18. Factors associated with self-medication among medicine sellers in urban Vietnam.

    Science.gov (United States)

    Nguyen, Huy Van; Nguyen, Thi Hong Ngoc

    2015-01-01

    In Vietnam, many medicine sellers serving pharmacies and retail outlets do not have adequate professional qualifications, and there has been a limited institutional control. The objective of this cross-sectional study was to examine the prevalence and determinants of self-medication among medicine sellers in Hanoi, Vietnam. Although 96.55% of medicine sellers had relatively serious health problems, only 61.21% visited a healthcare facility, though self-medication was moderately high (approximately 39%). Adopting Andersen's conceptual model, it was identified that medicine sellers who reported higher professional education, had low confidence in healthcare services, had not received any professional in-service during the prior year, had less serious health problems and who perceived the current costs of healthcare as too high were more likely to report self-medication. The findings have public health policy implications for these healthcare providers in urban Vietnam and other similar developing countries.

  19. The reception of Eugen Bleuler in British psychiatry, 1892-1954.

    LENUS (Irish Health Repository)

    Dalzell, Thomas

    2012-02-01

    This article draws on over 60 years of British medical journals and psychiatry textbooks to indicate the chronological stages of the reception of Eugen Bleuler in British psychiatry. Bleuler was already well known in Britain before his schizophrenia book appeared, with the journals containing numerous references, mainly positive, to his work. The psychiatry textbooks, however, were slower to integrate his contribution. This paper argues that this was not due to Bleuler\\'s placing Freud on a par with Kraepelin, but because of the early negative reaction to Kraepelin\\'s dementia praecox concept, despite Bleuler\\'s wider and less ominous conception of the illness.

  20. Assessment of Entrepreneurial Skills and Its Association with Social Intelligence in Students of Kermanshah University of Medical Sciences

    OpenAIRE

    Yahya Safari; Fatemeh Tahmasby; Mohammad Javad Karamafrooz

    2013-01-01

    Introduction: Social intelligence and entrepreneurship are among features leading to the academic and career achievements. Due to the importance of this issue, the present study was performed to determine the level of entrepreneurial skills in students of Kermanshah University of Medical Sciences and its association with social intelligence. Methods: In this descriptive cross-sectional study by using systematic random sampling method, we selected 350 students at Kermanshah University of Me...

  1. Executive Functions and Parenting Behaviors in Association With Medical Adherence and Autonomy Among Youth With Spina Bifida

    OpenAIRE

    O’Hara, Lauren K.; Holmbeck, Grayson N.

    2013-01-01

    Objective This study was designed to examine whether executive functions and parenting behaviors (acceptance, behavioral control, and psychological control) are associated with medical adherence and autonomy among preadolescents and adolescents with spina bifida (SB). Methods Questionnaire and observational data were collected from a sample of 8–15 year olds with SB (N = 140) and their mothers, fathers, and teachers. Youth also completed neuropsychological testing. Results Youth with SB demon...

  2. A Code of Professional Ethical Conduct for the American Medical Informatics Association: An AMIA Board of Directors Approved White Paper

    OpenAIRE

    Hurdle, John F; Adams, Samantha; Brokel, Jane; Chang, Betty; Embi, Peter; Petersen, Carolyn; Terrazas, Enrique; Winkelstein, Peter

    2007-01-01

    The AMIA Board of Directors has decided to periodically publish AMIA’s Code of Professional Ethical Conduct for its members in the Journal of the American Medical Informatics Association. The Code also will be available on the AMIA Web site at www.amia.org as it continues to evolve in response to feedback from the AMIA membership. The AMIA Board acknowledges the continuing work and dedication of the AMIA Ethics Committee. AMIA is the copyright holder of this work.

  3. Associations between the Big Five Personality Traits and the Non-Medical Use of Prescription Drugs for Cognitive Enhancement

    OpenAIRE

    Sebastian eSattler; Reinhard eSchunck

    2016-01-01

    While the number of studies of the non-medical use of prescription drugs to augment cognitive functions is growing steadily, psychological factors that can potentially help explain variance in such pharmaceutical cognitive enhancement (CE) behavior are often neglected in research.This study investigates the association between the Big Five personality traits and a retrospective (prior CE-drug use) as well as a prospective (willingness to use CE drugs) measure of taking prescription drugs with...

  4. Associations Between the Big Five Personality Traits and the Non-Medical Use of Prescription Drugs for Cognitive Enhancement

    OpenAIRE

    Sattler, Sebastian; Schunck, Reinhard

    2016-01-01

    While the number of studies of the non-medical use of prescription drugs to augment cognitive functions is growing steadily, psychological factors that can potentially help explain variance in such pharmaceutical cognitive enhancement (CE) behavior are often neglected in research. This study investigates the association between the Big Five personality traits and a retrospective (prior CE-drug use) as well as a prospective (willingness to use CE drugs) measure of taking prescription drugs wit...

  5. A Conversation with David Bates, MD, MSc, Chairman of the American Medical Informatics Association

    OpenAIRE

    Raymond, Brian

    2008-01-01

    A world-renowned physician-researcher, David Bates, MD, MSc, is Chief of the Division of General Medicine at the Brigham and Women's Hospital in Boston, MA, and a Professor at Harvard Medical School and the Harvard School of Public Health, where he is codirector of the Program in Clinical Effectiveness. He is the Medical Director of Clinical and Quality Analysis, Information Systems at Partners HealthCare System, Inc. He is also the former Chair of the National Alliance for Primary Care Infor...

  6. Moderating effects of salivary testosterone levels on associations between job demand and psychological stress response in Japanese medical workers.

    Science.gov (United States)

    Hirokawa, Kumi; Miwa, Machiko; Taniguchi, Toshiyo; Tsuchiya, Masao; Kawakami, Norito

    2016-06-10

    Levels of job stress have been shown to be inversely associated with testosterone levels, but some inconsistent results have been documented. We investigated the moderating effects of testosterone levels on associations between job stress-factors and psychological stress responses in Japanese medical workers. The participants were 63 medical staff (20 males and 43 women; mean age: 30.6 years; SD=7.3) in Okayama, Japan. Their job-stress levels and psychological stress responses were evaluated using self-administered questionnaires, and their salivary testosterone collected. Multiple regression analyses showed that job demand was positively associated with stress responses in men and women. An interaction between testosterone and support from colleagues had a significant effect on depression and anxiety for women. In women with lower testosterone levels, a reducing effect of support from colleagues on depression and anxiety was intensified. In women with higher testosterone levels, depression and anxiety levels were identical regardless of support from colleagues. Testosterone may function as a moderator between perceived work environment and psychological stress responses for female medical workers.

  7. Nationaler Kompetenzbasierter Lernzielkatalog Medizin (NKLM für Deutschland: Zusammenarbeit der Gesellschaft für Medizinische Ausbildung (GMA und des Medizinischen Fakultätentages (MFT [National Competence-Based Learning Objectives for Undergraduate Medical Education (NKLM in Germany: Cooperation of the Association for Medical Education (GMA and the Association of Medical Faculties in Germany (MFT

    Directory of Open Access Journals (Sweden)

    Hahn, Eckhart G.

    2009-08-01

    Full Text Available [english] The Framework for Qualifications of the European Higher Education Area (FQ-EHEA; Bologna Process and the European Qualifications Framework for Lifelong Learning (EQF-LLL; Lisbon Process are competence-driven frameworks for vocational and higher education programmes in need for defined learning objectives. In the field of medical education, The Netherlands and Switzerland have developed national catalogues for undergraduate medical training, which are competence-based and compatible with a two-cycle curriculum comprised of a Bachelor in Medicine and a Master in Medicine. In Germany, virtually all medical organizations, last not least the Association of Medical Faculties (MFT, have voted against the application of the two-cycle (and the three-cycle curriculum to medical undergraduate education. A standstill of the European processes will not be accepted in the political arena, and a proposition was made by the Conference of German Ministers of Higher Education to develop a medical qualification framework for Germany, asking the Association for Medical Education (GMA and the MFT to join forces. This is not possible without consented national learning objectives derived from the professional context of physicians. The GMA has teamed up with the MFT to develop National Competence-Based Learning Objectives for Undergraduate Medical Education (NKLM in Germany (see Figure 1 to fulfill these needs.

  8. Retrenchment in British Universities: Lessons Learned.

    Science.gov (United States)

    Simpson, William A.

    1985-01-01

    A study of 14 British universities that underwent severe retrenchment in 1981-1984 is reported, and successful policies, procedures, philosophies, and techniques that may be applicable to institutions in many countries are outlined. (MSE)

  9. British Engineers and Africa 1875-1914

    DEFF Research Database (Denmark)

    Andersen, Casper

    the imperial diasporas, identities and networks that developed as the British engineering profession established connections on the African continent. Using a wide range of primary sources that include correspondence, diaries, technical reports, institutional minutes and periodicals, Andersen reconstructs...

  10. British Universities' Responses to Financial Reductions.

    Science.gov (United States)

    Sizer, John

    1987-01-01

    The impact on nine British universities' of substantial financial reductions in 1980-81 and the policy implications for national funding agencies are examined. Implementation of institutional retrenchment plans and the role of high-level administrators are discussed. (MSE)

  11. The Association between Observed Parental Emotion Socialization and Adolescent Self-Medication

    Science.gov (United States)

    Hersh, Matthew A.; Hussong, Andrea M.

    2009-01-01

    The current study examined the moderating influence of observed parental emotion socialization (PES) on self-medication in adolescents. Strengths of the study include the use of a newly developed observational coding system further extending the study of PES to adolescence, the use of an experience sampling method to assess the daily covariation…

  12. Patient centered primary care is associated with patient hypertension medication adherence.

    Science.gov (United States)

    Roumie, Christianne L; Greevy, Robert; Wallston, Kenneth A; Elasy, Tom A; Kaltenbach, Lisa; Kotter, Kristen; Dittus, Robert S; Speroff, Theodore

    2011-08-01

    There is increasing evidence that patient centered care, including communication skills, is an essential component to chronic illness care. Our aim was to evaluate patient centered primary care as a determinant of medication adherence. We mailed 1,341 veterans with hypertension the Short Form Primary Care Assessment Survey (PCAS) which measures elements of patient centered primary care. We prospectively collected each patient's antihypertensive medication adherence for 6 months. Patients were characterized as adherent if they had medication for >80%. 654 surveys were returned (50.7%); and 499 patients with complete data were analyzed. Antihypertensive adherence increased as scores in patient centered care increased [RR 3.18 (95% CI 1.44, 16.23) bootstrap 5000 resamples] for PCAS score of 4.5 (highest quartile) versus 1.5 (lowest quartile). Future research is needed to determine if improving patient centered care, particularly communication skills, could lead to improvements in health related behaviors such as medication adherence and health outcomes.

  13. A Qualitative Study of Factors Associated with Medical Students' Academic Success

    Directory of Open Access Journals (Sweden)

    Gholamreza S. Ardekain

    2008-01-01

    Full Text Available Problem statement: The aim of the present study was to determine the successful medical students' viewpoints on factors significant to their academic success assessed according to the students' grade point average. In this research the students with the grade point average (GPA A (17-20 were considered academically successful. Approach: The participants were 30 fifth year successful students (i.e. students with GPA, A from Shiraz Medical School. The instrument used for the qualitative data gathering was interview. The subjects were arranged into 6 groups of 5 students followed by a discussion on reasons of their success. Five educated tutors coordinated the groups. Results: Categorizing of focus group data was done and 4 general factors including "personal abilities" "attitude, beliefs and motivation", "effort and perseverance" and "supportive factors" were found to be critical to the students' success. It is clear that all factors mentioned by students play an important role in their success in general. The similarities between the results of this study and those of others support the idea that all successful medical students share some common characteristics. Conclusion/Recommendations: The results of this study would help both medical school authorities and instructors to design strategies for more effective education. The results can also help other students to find out what might lead them to more success.

  14. The moral reading of the British constitution

    OpenAIRE

    Lakin, S. J.

    2009-01-01

    This thesis investigates the philosophical assumptions which underpin established theories of the British constitution, paying particular attention to the influence of traditional (and sometimes outdated) theories of legal positivism. I attempt to identify, analyze and challenge these assumptions, exploring how recent developments in legal theory can inform and enrich our approach to British constitutional theory. Drawing, in particular, on the anti-positivist theory of Ronald Dworkin, I cont...

  15. Radon in British mines: a review

    International Nuclear Information System (INIS)

    A review of the occupational hazards experienced by non-coal miners in British mines is presented, with emphasis on the radiation hazards of radon. Topics reviewed include legislation and radiation standards, radiation monitoring methods in Britain, the geology of the Pennine range wherein the tin and fluorspar mines are located, and survey and workplace monitoring results. Lung cancer risk coefficients are derived from radon decay product data and from British epidemiology on lung cancer

  16. Two Views of the British Industrial Revolution

    OpenAIRE

    Peter Temin

    1996-01-01

    There are two views of the British Industrial Revolution in the literature today. The more traditional description, represented by the views of Ashton and Landes, sees the Industrial Revolution as a broad change in the British economy and society. This broad view of the Industrial Revolution has been challenged by Crafts and Harley who see the Industrial Revolution as a much narrower phenomenon, as the result of technical change in a few industries. This paper presents a test of these views u...

  17. Association between learning style preferences and anatomy assessment outcomes in graduate-entry and undergraduate medical students.

    Science.gov (United States)

    O'Mahony, Siobhain M; Sbayeh, Amgad; Horgan, Mary; O'Flynn, Siun; O'Tuathaigh, Colm M P

    2016-07-01

    An improved understanding of the relationship between anatomy learning performance and approaches to learning can lead to the development of a more tailored approach to delivering anatomy teaching to medical students. This study investigated the relationship between learning style preferences, as measured by Visual, Aural, Read/write, and Kinesthetic (VARK) inventory style questionnaire and Honey and Mumford's learning style questionnaire (LSQ), and anatomy and clinical skills assessment performance at an Irish medical school. Additionally, mode of entry to medical school [undergraduate/direct-entry (DEM) vs. graduate-entry (GEM)], was examined in relation to individual learning style, and assessment results. The VARK and LSQ were distributed to first and second year DEM, and first year GEM students. DEM students achieved higher clinical skills marks than GEM students, but anatomy marks did not differ between each group. Several LSQ style preferences were shown to be weakly correlated with anatomy assessment performance in a program- and year-specific manner. Specifically, the "Activist" style was negatively correlated with anatomy scores in DEM Year 2 students (rs = -0.45, P = 0.002). The "Theorist" style demonstrated a weak correlation with anatomy performance in DEM Year 2 (rs = 0.18, P = 0.003). Regression analysis revealed that, among the LSQ styles, the "Activist" was associated with poorer anatomy assessment performance (P < 0.05), while improved scores were associated with students who scored highly on the VARK "Aural" modality (P < 0.05). These data support the contention that individual student learning styles contribute little to variation in academic performance in medical students. Anat Sci Educ 9: 391-399. © 2016 American Association of Anatomists. PMID:26845590

  18. Association of Unconscious Race and Social Class Bias With Vignette-Based Clinical Assessments by Medical Students

    Science.gov (United States)

    Haider, Adil H.; Sexton, Janel; Sriram, N.; Cooper, Lisa A.; Efron, David T.; Swoboda, Sandra; Villegas, Cassandra V.; Haut, Elliott R.; Bonds, Morgan; Pronovost, Peter J.; Lipsett, Pamela A.; Freischlag, Julie A.; Cornwell, Edward E.

    2012-01-01

    Context Studies involving physicians suggest that unconscious bias may be related to clinical decision making and may predict poor patient-physician interaction. The presence of unconscious race and social class bias and its association with clinical assessments or decision making among medical students is unknown. Objective To estimate unconscious race and social class bias among first-year medical students and investigate its relationship with assessments made during clinical vignettes. Design, Setting, and Participants A secure Web-based survey was administered to 211 medical students entering classes at Johns Hopkins School of Medicine, Baltimore, Maryland, in August 2009 and August 2010. The survey included the Implicit Association Test (IAT) to assess unconscious preferences, direct questions regarding students’ explicit race and social class preferences, and 8 clinical assessment vignettes focused on pain assessment, informed consent, patient reliability, and patient trust. Adjusting for student demographics, multiple logistic regression was used to determine whether responses to the vignettes were associated with unconscious race or social class preferences. Main Outcome Measures Association of scores on an established IAT for race and a novel IAT for social class with vignette responses. Results Among the 202 students who completed the survey, IAT responses were consistent with an implicit preference toward white persons among 140 students (69%, 95% CI, 61%–75%). Responses were consistent with a preference toward those in the upper class among 174 students (86%, 95% CI, 80%–90%). Assessments generally did not vary by patient race or occupation, and multivariable analyses for all vignettes found no significant relationship between implicit biases and clinical assessments. Regression coefficient for the association between pain assessment and race IAT scores was −0.49 (95% CI, −1.00 to 0.03) and for social class, the coefficient was −0.04 (95% CI

  19. AIDS-associated diarrhea and wasting in northeast Brazil is associated with subtherapeutic plasma levels of antiretroviral medications and with both bovine and human subtypes of Cryptosporidium parvum

    Directory of Open Access Journals (Sweden)

    Richard K. Brantley

    2003-02-01

    Full Text Available Advanced HIV infection is frequently complicated by diarrhea, disruption of bowel structure and function, and malnutrition. Resulting malabsorption of or pharmacokinetic changes in antiretroviral agents might lead to subtherapeutic drug dosing and treatment failure in individual patients, and could require dose adjustment and/or dietary supplements during periods of diarrheal illness. We determined the plasma levels of antiretroviral medications in patients that had already been started on medication by their physicians in an urban infectious diseases hospital in northeast Brazil. We also obtained blood samples from patients hospitalized for diarrhea or AIDS-associated wasting, and we found reduced stavudine and didanosine levels in comparison with outpatients without diarrhea or wasting who had been treated at the same hospital clinic. There was a predominance of the protozoal pathogens Cryptosporidium and Isospora belli, typical opportunistic pathogens of AIDS-infected humans, in the stool samples of inpatients with diarrhea. We conclude that severe diarrhea and wasting in this population is associated with both protozoal pathogens and subtherapeutic levels of antiretroviral medications.

  20. Trust and British Gas partner in EPC scheme.

    Science.gov (United States)

    Bevan, Patrick

    2015-02-01

    In late August last year the St George's Healthcare NHS Trust in south-west London signed what the Trust's Estates and Facilities team described as 'a historic partnership' with British Gas for a £12 m Energy Performance Contract energy reduction scheme--via which the energy company has guaranteed to deliver £1.1 m in annual savings over the next 15 years. The agreement will see British Gas replace four 35-year-old gas-powered steam boilers and an ageing CHP plant in the boiler house at the Trust's main acute facility, the StGeorge's Hospital in Tooting, and upgrade some of the associated infrastructure. British Gas will also maintain the new plant to ensure that the projected savings are achieved while the Trust owns the new assets. The Trust should gain financially--via lower energy costs and carbon emissions, while estates personnel will be better able to complete the many other estate maintenance issues that would otherwise be contracted out at one of London's biggest acute hospitals. PMID:26268017

  1. Factors Associated with Perceived Uncertainty among Parents of Children with Undiagnosed Medical Conditions

    OpenAIRE

    Madeo, Anne C.; O'Brien, Kathleen E.; Bernhardt, Barbara A.; Biesecker, Barbara B.

    2012-01-01

    Uncertainty is a pervasive characteristic of illness. Yet little is known about the individual or situational factors that contribute to perceptions of uncertainty. The present study aims to examine the factors that contribute to perceived uncertainty among parents of a child with an undiagnosed condition. Two hundred sixty-six parents of a child, or children, affected by an undiagnosed medical condition for at least two years completed an electronically administered mixed-methods survey asse...

  2. Identifying key Effective Lifelong Learning Inventory (ELLI) dimensions associated with academic success amongst postgraduate medical students

    OpenAIRE

    Rashid-Doubell, Fiza; Cuculescu-Santana, Mirela

    2012-01-01

    Many elements have been identified as contributors of academic success amongst medical students but to group these components in order to develop guidelines for intervention strategies is atypical. One such tool which could allow this possibility is the Effective Lifelong Learning Inventory (ELLI) developed by the University of Bristol. ELLI is an online self-assessment instrument which identifies and measures the dimensions of learner development. It comprises of 90 key questions used to ...

  3. Drug interactions associated with methadone, buprenorphine, cocaine, and HIV medications: implications for pregnant women

    OpenAIRE

    McCance-Katz, Elinore F.

    2010-01-01

    Pregnancy in substance-abusing women with HIV/AIDS presents a complex clinical challenge. Opioid-dependent women need treatment with opioid therapy during pregnancy to protect the health of mother and developing fetus. However, opioid therapies, methadone and buprenorphine, may have drug interactions with some HIV medications that can have adverse effects leading to suboptimal clinical outcomes. Further, many opioid-dependent individuals have problems with other forms of substance abuse, for ...

  4. Medical Issues Associated with Radiotherapy Accidents: Some Examples and Lessons Learned

    International Nuclear Information System (INIS)

    Over the past one hundred years and longer, since the discovery of ionizing radiations, radiotherapy has made great contributions to controlling human cancer. Clinical practice has improved most dramatically over the past decade as a result of better tools/computers for the identification of clinical cancer target volumes and with more precision delivery of the radiation, with the consequent sparing of normal tissues. Unfortunately, however, radiotherapy accidents, resulting in serious physical, functional and even emotional injury to cancer patients, do occur. It is, therefore, appropriate that this symposium review some of these accidents, as an attempt to better understand how to incorporate better preventive measures and to develop better medical management of the outcomes. Prevention of such accidents is, of course, always the most important way to minimize the complex medical and social issues resulting from such accidents, which always affect the patient, their families and friends, as well as the morale of the caregiver staff. As such accidents are never planned, it is important, when they do occur, to capture and record as much information as possible. The REAC/TS has for the past 40 years maintained a radiation accident registry for this purpose. The REAC/TS registry is far from complete; data from it are used as a basis for this discussion. Our worldwide registry data consist of many types of radiation accident, including industrial, nuclear power plant and medical sources, as is shown. However, it is noteworthy that the most common cause of death listed in this registry in the United States of America is due to the misuse or misadministration of medical sources, as is noted in the ‘circled’ group. A brief review and discussion of several of the more severe radiotherapy accidents listed in the REAC/TS registry (involving both sealed and unsealed radiotherapy sources) are presented and discussed

  5. Computer Man Simulation of Incapacitation: An Automated Approach to Wound Ballistics and Associated Medical Care Assessments

    OpenAIRE

    Clare, V.; Ashman, W.; Broome, P; Jameson, J.; Lewis, J.; Merkler, J.; Mickiewicz, A.; Sacco, W.; Sturdivan, L.

    1981-01-01

    Wound ballistics assessments traditionally have been based on correlations between some quantification of “ballistic dose” and an empirical/subjective medical quantification of human functional degradation. Although complicated by the highly inhomogeneous nature of the human body and by the voluminous data handling requirements these correlation values were obtained by manual methods. The procedure required a substantial commitment of time and resources, thereby restricting the data base from...

  6. Factors associated with adherence to medication among depressed patients from Saudi Arabia: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Al Jumah K

    2014-10-01

    Full Text Available Khalaf Al Jumah,1 Mohamed Azmi Hassali,2 Dalal Al Qhatani,1 Kamal El Tahir3 1Department of Pharmacy, Al Amal Psychiatric Hospital, Riyadh, Saudi Arabia; 2School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia; 3College of Pharmacy, King Saud University, Riyadh, Saudi Arabia Background: Several studies have investigated the factors associated with adherence to antidepressants, with inconsistent conclusions. However, no similar study has investigated this issue among patients diagnosed with major depressive disorder in Saudi Arabia. The aim of this study is to explore patients’ adherence to antidepressant medications, and the factors associated with adherence.Methods: A non-experimental cross-sectional design was used to measure adherence to antidepressants among major depressive disorder patients, and the factors associated with adherence. The patients were recruited from the outpatient clinic at the Al-Amal Complex for Mental Health in Riyadh, Saudi Arabia, between August 2013 and January 2014. Eligible participants met with one of the research coordinators for assessment of their adherence. Adherence was investigated indirectly by use of the Morisky Medication Adherence Scale, and patients’ beliefs were assessed through the Beliefs about Medicine Questionnaire. Information about the severity of their depression, demographics, and other study variables were collected.Results: A total of 403 patients met the inclusion criteria and participated in the study. Of those, 203 (50.37% were females, while the remaining 200 (49.6% were males. There was an average age of 39 years (standard deviation, ±11 years. Half of the patients (52.9% reported low adherence to their antidepressant medication, with statistically significant differences between the low adherence and high adherence scores relating to sex, age, and duration of illness. Conclusion: Low medication adherence is a common problem among major depressive disorder

  7. Medically treated anorexia nervosa is associated with normal P wave parameters.

    Science.gov (United States)

    Nussinovitch, Moshe; Gur, Eitan; Nussinovitch, Naomi; Kaminer, Keren; Volovitz, Benjamin; Nussinovitch, Udi

    2012-07-30

    Anorexia nervosa (AN) is an increasingly common medical condition. Some studies have demonstrated an increased prevalence of atrial premature contractions and anatomical changes in AN patients. Our aim was to investigate P wave parameters and P wave dispersion, an electrocardiographic marker for supraventricular arrhythmias, and its effect on AN. The study group included 48 patients with AN, most hospitalized for a few weeks, and a matched control group. All participants underwent 12-lead electrocardiography (ECG) under strict standards. P wave length and P wave dispersion in each patient were computed from a randomly selected beat and an averaged beat, constructed from 7 to 12 beats, included in a 10-s ECG. There were no statistically significant differences found between the groups for minimal, maximal, average P wave duration and P wave dispersion, calculated either from a random beat or averaged beats. In conclusion, medically treated AN patients who have gained weight have normal P wave parameters, and therefore do not appear to have an increased electrocardiographic risk for atrial fibrillation compared with healthy controls. Further studies are required to evaluate the influence of different disease stages, electrolyte imbalance and other medical complications on P wave parameters and risk for supraventricular arrhythmias in AN patients. PMID:22421068

  8. Trends in health sciences library and information science research: an analysis of research publications in the Bulletin of the Medical Library Association and Journal of the Medical Library Association from 1991 to 2007*

    Science.gov (United States)

    Gore, Sally A.; Nordberg, Judith M.; Palmer, Lisa A.

    2009-01-01

    Objective: This study analyzed trends in research activity as represented in the published research in the leading peer-reviewed professional journal for health sciences librarianship. Methodology: Research articles were identified from the Bulletin of the Medical Library Association and Journal of the Medical Library Association (1991–2007). Using content analysis and bibliometric techniques, data were collected for each article on the (1) subject, (2) research method, (3) analytical technique used, (4) number of authors, (5) number of citations, (6) first author affiliation, and (7) funding source. The results were compared to a previous study, covering the period 1966 to 1990, to identify changes over time. Results: Of the 930 articles examined, 474 (51%) were identified as research articles. Survey (n = 174, 37.1%) was the most common methodology employed, quantitative descriptive statistics (n = 298, 63.5%) the most used analytical technique, and applied topics (n = 332, 70%) the most common type of subject studied. The majority of first authors were associated with an academic health sciences library (n = 264, 55.7%). Only 27.4% (n = 130) of studies identified a funding source. Conclusion: This study's findings demonstrate that progress is being made in health sciences librarianship research. There is, however, room for improvement in terms of research methodologies used, proportion of applied versus theoretical research, and elimination of barriers to conducting research for practicing librarians. PMID:19626146

  9. Associations between Medical Conditions and Breast Cancer Risk in Asians: A Nationwide Population-Based Study in Taiwan.

    Directory of Open Access Journals (Sweden)

    Shu-Chun Chuang

    Full Text Available The breast cancer incidence in Asia is rising. To explore whether the etiology of breast cancer is different from the known risk factors from studies in Western countries, we conducted a nested case-control study using data from the Taiwan National Health Insurance Research Database (NHIRD.All medical conditions based on the first three digits of the ICD-9 and a list of medical conditions based on literature review were retrieved for each case and control. The odds ratios (OR and 95% confidence intervals (CI of the associations between medical conditions and breast cancer risks were estimated using conditional logistic regression and adjusted for occupation, number of breast cancer screening, and the average number of outpatient visits prior the diagnosis. The associations were also estimated for younger (<50 years old and older subjects separately.The analyses included 4,884 breast cancer cases and 19,536 age-matched controls. Prior breast diseases (OR, 95% CI: 2.47, 2.26-2.71, obesity (1.43, 1.04-1.96, endometriosis (1.44, 1.15-1.80, uterine leiomyoma (1.20, 1.03-1.40, hypertensive diseases (1.14, 1.05-1.25, and disorders in lipid metabolism (1.13, 1.04-1.24 were associated with increased breast cancer risk. No heterogeneity was observed between age groups (<50 and ≥50 years old.In addition to benign breast diseases, obesity, endometriosis, uterine leiomyoma, hypertensive diseases, and disorders of lipid metabolism were associated with a subsequent breast cancer risk.Our results suggest that estrogen related factors may play an important role in breast cancer risks in the Taiwanese female population.

  10. The Association of HIV-Related Stigma to HIV Medication Adherence: A Systematic Review and Synthesis of the Literature.

    Science.gov (United States)

    Sweeney, Shannon M; Vanable, Peter A

    2016-01-01

    This paper provides a review of the quantitative literature on HIV-related stigma and medication adherence, including: (1) synthesis of the empirical evidence linking stigma to adherence, (2) examination of proposed causal mechanisms of the stigma and adherence relationship, and (3) methodological critique and guidance for future research. We reviewed 38 studies reporting either cross-sectional or prospective analyses of the association of HIV-related stigma to medication adherence since the introduction of antiretroviral therapies (ART). Although there is substantial empirical evidence linking stigma to adherence difficulties, few studies provided data on psychosocial mechanisms that may account for this relationship. Proposed mechanisms include: (a) enhanced vulnerability to mental health difficulties, (b) reduction in self-efficacy, and (c) concerns about inadvertent disclosure of HIV status. Future research should strive to assess the multiple domains of stigma, use standardized measures of adherence, and include prospective analyses to test mediating variables.

  11. Collaborative Family Healthcare Association commentary on the "joint principles: Integrating behavioral health care into the patient-centered medical home".

    Science.gov (United States)

    Runyan, Christine; Khatri, Parinda

    2014-06-01

    The Collaborative Family Healthcare Association (CFHA) welcomes the opportunity to comment on the complementary set of Joint Principles underscoring the Integration of Behavioral Health Care Into the Patient-Centered Medical Home (The Working Party Group on Integrated Behavioral Healthcare et al., 2014). CFHA is an organization that promotes comprehensive and cost-effective models of health care delivery that integrate mind and body, individual and family, patients, providers, and communities. CFHA appreciates that the Joint Principles do not explicitly endorse any single model of collaboration between behavioral health and medical practice. Rather, they broadly emphasize integration, affirming the only way to have a whole person orientation is to adopt a biopsychosocial-spiritual perspective. This commentary will highlight areas of notable strength within the Joint Principles, as well as challenge the language, if not perspective, on a few critical elements. PMID:24955686

  12. Incidence of Norovirus-Associated Medical Encounters among Active Duty United States Military Personnel and Their Dependents.

    Directory of Open Access Journals (Sweden)

    Brian Rha

    Full Text Available Norovirus is a leading cause of gastroenteritis episodes and outbreaks in US military deployments, but estimates of endemic disease burden among military personnel in garrison are lacking.Diagnostic codes from gastroenteritis-associated medical encounters of active duty military personnel and their beneficiaries from July 1998-June 2011 were obtained from the Armed Forces Health Surveillance Center. Using time-series regression models, cause-unspecified encounters were modeled as a function of encounters for specific enteropathogens. Model residuals (representing unexplained encounters were used to estimate norovirus-attributable medical encounters. Incidence rates were calculated using population data for both active duty and beneficiary populations.The estimated annual mean rate of norovirus-associated medically-attended visits among active duty personnel and their beneficiaries was 292 (95% CI: 258 to 326 and 93 (95% CI: 80 to 105 encounters per 10,000 persons, respectively. Rates were highest among beneficiaries <5 years of age with a median annual rate of 435 (range: 318 to 646 encounters per 10,000 children. Norovirus was estimated to cause 31% and 27% of all-cause gastroenteritis encounters in the active duty and beneficiary populations, respectively, with over 60% occurring between November and April. There was no evidence of any lag effect where norovirus disease occurred in one population before the other, or in one beneficiary age group before the others.Norovirus is a major cause of medically-attended gastroenteritis among non-deployed US military active duty members as well as in their beneficiaries.

  13. Medical education in Malaysia.

    Science.gov (United States)

    Lim, Victor K E

    2008-01-01

    Malaysia has a long history of medical education, with Singapore becoming the first medical school to serve the region after its foundation in 1905. The first school to be established in Kuala Lumpur after independence from the British was the Faculty of Medicine at the University of Malaya in 1963. Whilst today there are 21 public and private medical schools, all offering a 5 year undergraduate programme, some private schools have diversified by developing international collaboration and conduct twinning or credit-transfer programmes. All medical schools require accreditation by the National Accreditation Board and the Malaysian Medical Council. Although the criteria for accreditation is comprehensive and covers a broad range of areas of assessment, it is debatable whether it always matches the needs of the country. The dramatic increase in medical schools in the last two decades has posed challenges in terms of maintenance of quality, physical infrastructure and suitably qualified faculty.

  14. MEDICAL REVIVALISM AND THE NATIONAL MOVEMENT IN BRITISH INDIA

    OpenAIRE

    Bala, Poonam

    1990-01-01

    The author discusses here the efforts made to revive Ayurveda in the twentieth century by the protagonists of Ayurveda during the national movement and appraises how far political support and State patronage did good for the recrudescence of Ayurveda.

  15. Association between neighbourhood air pollution concentrations and dispensed medication for psychiatric disorders in a large longitudinal cohort of Swedish children and adolescents

    OpenAIRE

    Oudin, Anna; Bråbäck, Lennart; Åström, Daniel Oudin; Strömgren, Magnus; Forsberg, Bertil

    2016-01-01

    Objective To investigate associations between exposure to air pollution and child and adolescent mental health. Design Observational study. Setting Swedish National Register data on dispensed medications for a broad range of psychiatric disorders, including sedative medications, sleeping pills and antipsychotic medications, together with socioeconomic and demographic data and a national land use regression model for air pollution concentrations for NO2, PM10 and PM2.5. Participants The entire...

  16. Factors Associated With Medical and Nursing Students' Willingness to Donate Organs.

    Science.gov (United States)

    Tumin, Makmor; Tafran, Khaled; Tang, Li Yoong; Chong, Mei Chan; Mohd Jaafar, Noor Ismawati; Mohd Satar, NurulHuda; Abdullah, Nurhidayah

    2016-03-01

    Malaysia suffers from a chronic shortage of human organs for transplantation. Medical and nursing students (MaNS) are future health professionals and thus their attitude toward organ donation is vital for driving national donation rates. This study investigates MaNS' willingness to donate organs upon death and the factors influencing their willingness. A cross-sectional design was used with a sample of 500 students (264 medical and 236 nursing) at the University of Malaya. A self-administrated questionnaire was used. The responses were analyzed by using descriptive statistics and multiple logistic regression. Of all respondents, 278 (55.6%) were willing to donate organs upon death, while the remaining 222 (44.4%) were unwilling to donate. Only 44 (8.8%) had donor cards. The multiple logistic regression revealed that the minorities ethnic group was more willing to donate organs than Malay respondents (adjusted odds ratio [aOR] = 1.98, P = 0.010). In addition, medical students were more willing to donate than nursing students (aOR = 2.53, P = 0.000). Respondents who have a family member with a donor card were more willing to donate than respondents who do not (aOR = 3.48, P = 0.006). MaNS who believed that their religion permits deceased donation were more willing to donate than their counterparts (aOR = 4.96, P = 0.000). Household income and sex were not significant predictors of MaNS' willingness to donate organs upon death. MaNS have moderate willingness, but low commitment toward deceased organ donation. Strategies for improving MaNS' attitude should better educate them on organ donation, targeting the most the Malay and nursing students, and should consider the influence of family attitude and religious permissibility on MaNS' willingness. PMID:27015207

  17. High-impact medical journals and peace: a history of involvement.

    Science.gov (United States)

    Bloom, Joshua D; Sambunjak, Dario; Sondorp, Egbert

    2007-01-01

    The aim of this study is to explore the positions of five leading general medical journals (The Lancet, British Medical Journal--BMJ, Journal of American Medical Association--JAMA, New England Journal of Medicine--NEJM, and Annals of Internal Medicine--AIM) toward the issues of collective violence. We calculated the proportion of war-related articles in the total number of articles published in these five high-impact journals, and in the total number of articles indexed in PubMed during the last 60 years. The results showed a continuous increase in the proportion of war-related articles. Our findings suggest that the leading general medical journals have taken an active editorial stance toward the issues of war and peace. We conclude that high-impact medical journals can make an important contribution to efforts aimed at reducing the risks and consequences of war and violence.

  18. Cognitive and kidney function: results from a British birth cohort reaching retirement age.

    Directory of Open Access Journals (Sweden)

    Richard J Silverwood

    Full Text Available BACKGROUND: Previous studies have found associations between cognitive function and chronic kidney disease. We aimed to explore possible explanations for this association in the Medical Research Council National Survey of Health and Development, a prospective birth cohort representative of the general British population. METHODS: Cognitive function at age 60-64 years was quantified using five measures (verbal memory, letter search speed and accuracy, simple and choice reaction times and glomerular filtration rate (eGFR at the same age was estimated using cystatin C. The cross-sectional association between cognitive function and eGFR was adjusted for background confounding factors (socioeconomic position, educational attainment, prior cognition, and potential explanations for any remaining association (smoking, diabetes, hypertension, inflammation, obesity. RESULTS: Data on all the analysis variables were available for 1306-1320 study members (depending on cognitive measure. Verbal memory and simple and choice reaction times were strongly associated with eGFR. For example, the lowest quartile of verbal memory corresponded to a 4.1 (95% confidence interval 2.0, 6.2 ml/min/1.73 m(2 lower eGFR relative to the highest quartile. Some of this association was explained by confounding due to socioeconomic factors, but very little of it by prior cognition. Smoking, diabetes, hypertension, inflammation and obesity explained some but not all of the remaining association. CONCLUSIONS: These analyses support the notion of a shared pathophysiology of impaired cognitive and kidney function at older age, which precedes clinical disease. The implications of these findings for clinical care and research are important and under-recognised, though further confirmatory studies are required.

  19. Periodontal Systemic Connections-Novel Associations-A Review of the Evidence with Implications for Medical Practitioners.

    Science.gov (United States)

    Kalakonda, Butchibabu; Koppolu, Pradeep; Baroudi, Kusai; Mishra, Ashank

    2016-04-01

    Periodontal diseases, considered as inflammatory diseases have proved to have a spectrum of systemic implications. Earliest research has associated periodontal disease with common systemic aliments such as hypertension, diabetes, osteoporosis, rheumatoid arthritis to name a few. The evolution of advanced diagnostic aids let researchers make vast inroads in linking periodontal diseases to systemic diseases like Alzheimer's disease (AD) and even Schizophrenia. Our aim was to review and critically evaluate comprehensive literature and provide knowledge to medical practitioners on these associations so as to pave way for closer interactions between medical and dental practitioners in implementing better health care. Electronic databases such as PubMed, Google Scholar and Cochrane databases were used as source of the data for relevant studies published from 2005 up to 2015 with the following keywords, "'Periodontal disease", "systemic conditions", "periodontal disease and Alzheimer's", "Periodontal disease and Schizophrenia", "Periodontal disease and Psoriasis" and "Periodontal disease and erectile dysfunction". The evidence presented ascertains that a reasonable and modest association does exist between Periodontal disease and Alzheimer's, Schizophrenia, Erectile dysfunction, as well as Psoriasis and thus establishes periodontal disease as a potential risk factor. PMID:27103910

  20. A New Paradigm for Teaching Histology Laboratories in Canada's First Distributed Medical School

    Science.gov (United States)

    Pinder, Karen E.; Ford, Jason C.; Ovalle, William K.

    2008-01-01

    To address the critical problem of inadequate physician supply in rural British Columbia, The University of British Columbia (UBC) launched an innovative, expanded and distributed medical program in 2004-2005. Medical students engage in a common curriculum at three geographically distinct sites across B.C.: in Vancouver, Prince George and…

  1. [Factors associated with academic success of medical students at Buenos Aires University].

    Science.gov (United States)

    Borracci, Raúl A; Pittaluga, Roberto D; Álvarez Rodríguez, Juan E; Arribalzaga, Eduardo B; Poveda Camargo, Ricardo L; Couto, Juan L; Provenzano, Sergio L

    2014-01-01

    The aim of this study was to identify common factors relating to the academic success of medical students who were distinguished with honors at the Buenos Aires University. In 2011, 142 graduates were surveyed; the questionnaire included 59 questions on their sociodemographic environment, living conditions and social integration, motivation to study, learning capacity and health quality during their career. Compared to other students, these distinguished students more often lived in the city, far from their families; had been educated at private or universitary high schools, their economic needs were financed by their parents, who were on the whole professionals. Most of them were single and childless. The possibility of future employment oportunities (work) did not influence their choice of a medical career, academic success was important to them and they believed that success depended largely on personal effort; they knew how to handle anxiety, were sociable but independent and preferred solid experience to abstract conceptuality in order to obtain information. Our conclusion, within the current system of candidate selection, these results serve to calculate the covert self-selection mechanisms during the career, or in a more restrictive regime, to select those likely to reach academic success due to their privileged ambience. The analysis of demographic factors indicates some degree of inequality for socially disadvantaged students. Perhaps, a selection system based only on intellectual abilities would help identify and support the best candidates regardless of their social context. PMID:25555005

  2. Medical Identity

    DEFF Research Database (Denmark)

    Musaeus, Peter

    2015-01-01

    Purpose: To examine philosophical stances underpinning medical identity and assess the conceptual relationship between physician, medical practice and culture. Argument: Medical identity is about the ideals and moral positions that physicians take when justifying themselves. Medical identity...... hedonistic versus sentimentalist approaches to medical identity. The sociocultural philosophical analysis of medical identity can shed light on what it means conceptually for a physician to harbor beliefs associated with him/her being taken to be an autonomous professional. It is important because it touches...... on the meaning of being a compassionate, good and skilled physician, making its relevance to person-centered medicine self-evident. Conclusion: Medical identity should be analyzed with reference to literature, philosophy and medical practice in order for the physician to exercise a reflective position...

  3. Adherence and Associated Factors towards Antidiabetic Medication among Type II Diabetic Patients on Follow-Up at University of Gondar Hospital, Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Mastewal Abebaw

    2016-01-01

    Full Text Available Background. The prevalence of diabetes mellitus (DM is rising worldwide and is more in the developing countries which unfortunately are already suffering from communicable diseases. The aim of this study was to assess adherence and associated factors towards antidiabetic medication among type II diabetic patients in University of Gondar Hospital, Diabetic Clinic, Gondar, Northwest Ethiopia. Methods. Institutional based cross-sectional study was conducted. Systematic sampling technique was used. Morisky Medication Adherence Scale (MMAS scores were used for labeling patients as adherent or nonadherent. Data were entered and analyzed using SPSS version 20. To see the association of variables logistic regression with OR and 95% CI was done. Results. A total of 288 study participants were interviewed with response rate of 100%. The level of adherence was found to be 85.1%. Factors found to be significantly associated with antidiabetic medication adherence were level of education (AOR = 14.27, 95% CI = 3.0, 67.82, duration of diabetes (AOR = 6.10, 95% CI = 2.03, 18.34, and knowledge about DM and its medications (AOR = 28.05, 95% CI = 8.96, 87.8. Conclusions and Recommendations. Large proportion of respondents in this study were found to be adherent to their antidiabetic medications. Level of education, duration of diabetes, and knowledge about DM and its medication were significantly associated with antidiabetic medication adherence of patients. Health education including adherence counseling to create awareness towards DM and its medications is mandatory.

  4. Non-medical prescription drug and illicit street drug use among young Swiss men and associated mental health issues.

    Science.gov (United States)

    Baggio, Stéphanie; Studer, Joseph; Mohler-Kuo, Meichun; Daeppen, Jean-Bernard; Gmel, Gerhard

    2014-01-01

    Non-medical use of prescription drugs (NMUPD) is increasing among the general population, particularly among teenagers and young adults. Although prescription drugs are considered safer than illicit street drugs, NMUPD can lead to detrimental consequences. The aim of the present study was to investigate the relationship between drug use (NMUPD on the one side, illicit street drugs on the other side) with mental health issues and then compare these associations. A representative sample of 5719 young Swiss men aged around 20 years filled in a questionnaire as part of the ongoing baseline Cohort Study on Substance Use Risk Factors (C-SURF). Drug use (16 illicit street drugs and 5 NMUPDs, including sleeping pills, sedatives, pain killers, antidepressants, stimulants) and mental health issues (depression, SF12) were assessed. Simple and multiple linear regressions were employed. In simple regressions, all illicit and prescription drugs were associated with poorer mental health. In multiple regressions, most of the NMUPDs, except for stimulants, were significantly associated with poorer mental health and with depression. On the contrary, the only associations that remained significant between illicit street drugs and mental health involved cannabis. NMUPD is of growing concern not only because of its increasing occurrence, but also because of its association with depression and mental health problems, which is stronger than the association observed between these problems and illicit street drug use, excepted for cannabis. Therefore, NMUPD must be considered in screening for substance use prevention purposes. PMID:24447983

  5. Forensic medicine in South Africa: associations between medical practice and legal case progression and outcomes in female murders.

    Directory of Open Access Journals (Sweden)

    Naeemah Abrahams

    Full Text Available BACKGROUND: Forensic medicine has been largely by-passed by the tide of health systems research and evidence based medicine. Murder victims form a central part of forensic medical examiners' case load, and women murdered by intimate partners are an important subgroup, representing the most severe form and consequence of intimate partner violence. Our aim was to describe the epidemiology of female murder in South Africa (by intimate and non-intimate partners; and to describe and compare autopsy findings, forensic medical management of cases and the contribution of these to legal outcomes. METHODS: We did a retrospective national study in a proportionate random sample of 25 medico-legal laboratories to identify all homicides in 1999 of women aged 14 years and over. Data were abstracted from the mortuary file and autopsy report, and collected from a police interview. FINDINGS: In 21.5% of cases the perpetrator was convicted. Factors associated with a conviction for the female murders included having a history of intimate partner violence 1.18 (95%CI: 0.16-2.20, weapon recovered 1.36 (95% CI:0.58-2.15 and a detective visiting the crime scene 1.57 (95% CI:0.14-3.00. None of the forensic medical activities increased the likelihood of a conviction. CONCLUSION: The findings raise important questions about the role of forensic medicine in these cases.

  6. Pitfalls associated with the therapeutic reference pricing practice of asthma medication

    Directory of Open Access Journals (Sweden)

    Kalo Zoltan

    2012-07-01

    Full Text Available Abstract Background Therapeutic reference pricing (TRP based on the WHO daily defined dose (DDD is a method frequently employed for the cost-containment of pharmaceuticals. Our objective was to compare average drug use in the real world with DDD and to evaluate whether TRP based on DDD could result in cost savings on maintenance medication and the total direct health expenditures for asthma patients treated with Symbicort Turbuhaler (SYT and Seretide Diskus (SED in Hungary. Methods Real-world data were derived from the Hungarian National Health Insurance Fund database. Average doses and costs were compared between the high-dose and medium-dose SYT and SED groups. Multiple linear regressions were employed to adjust the data for differences in the gender and age distribution of patients. Results 27,779 patients with asthma were included in the analysis. Average drug use was lower than DDD in all groups, 1.38-1.95 inhalations in both SED groups, 1.28-1.97 and 1.74-2.49 inhalations in the medium and high-dose SYT groups, respectively. Although the cost of SED based on the DDD would be much lower than the cost of SYT in the medium-dose groups, no difference was found in the actual cost of the maintenance therapy. No significant differences were found between the groups in terms of total medical costs. Conclusions Cost-containment initiatives by payers may influence clinical decisions. TRP for inhalation asthma drugs raises special concern, because of differences in the therapeutic profile of pharmaceuticals and the lack of proven financial benefits after exclusion of the effect of generic price erosion. Our findings indicate that the presented TRP approach of asthma medications based on the daily therapeutic costs according to the WHO DDD does not result in reduced public healthcare spending in Hungary. Further analysis is required to show whether TRP generates additional expenditures by inducing switching costs and reducing patient compliance

  7. Survey of instructions to authors in Indian and British Dental Journals with respect to ethical guidelines

    Directory of Open Access Journals (Sweden)

    V P Mathur

    2013-01-01

    Full Text Available Background: Publication can become a symbol of presenting how meticulously a person has followed ethical principles in research. It is the duty of the investigators or authors to carefully read the instructions to authors and generate data with honesty and genuineness. In fulfillment of the basic requisite to publish, clearly defined instructions to authors should be provided by the journal. Aims: To assess the pattern of instructions regarding the ethical requirements given to authors in Indian Dental Journals and tried to compare the same with British Dental Journals. Settings and Design: A cross-sectional survey of ′instructions for authors,′ for analysis of guidelines on ethical processes, was done. Materials and Methods: Instructions to authors of Indian and British Dental Journals indexed in PubMed were reviewed for guidelines with regard to seven key ethical issues. Statistical Analysis Used: Descriptive statistics were used and results were expressed in percentages as well as numbers. Results: Of the 10 Indian Dental Journals, 7 (70% cited ethical guidelines such as International Committee of Medical Journal Editors, Committee on Publication Ethics, Indian Council of Medical Research guidelines whereas out of 27 British Dental Journals, 16 (59.25% cited these. Protection of human subjects such as approval from an institutional/independent ethics committee, obtaining informed consent and maintenance of confidentiality of patient records was covered with 8 (80% Indian and 19 (70.3% British Dental Journals. Four (40% Indian and 13 (48.1% instructed about animals welfare. Nine (90% of the Indian and 25 (92.5% British Dental Journals required declaration of conflicts of interest by authors. Publication issues and authorship/contributorship criteria were specified by all 10 Indian and 25 (92.5% and 24 (88.8% British journals respectively. 6 (60% of Indian and 11 (40.75% of British Journals explained about data management, in case of

  8. Influenza and respiratory syncytial virus infections in British Hajj pilgrims

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    R Booy

    2008-01-01

    Full Text Available Viral respiratory infections including influenza and respiratory syncytial virus (RSV have been reported during the Hajj among international pilgrims. To help establish the burden of these infections at the Hajj, we set up a study to confirm these diagnoses in symptomatic British pilgrims who attended the 2005 Hajj. UK pilgrims with symptoms of upper respiratory tract infection (URTI were invited to participate; after taking medical history, nasal swabs were collected for point-of-care testing (PoCT of influenza and for subsequent PCR analysis for influenza and RSV. Of the 205 patients recruited, 37 (18% were positive for either influenza or RSV. Influenza A (H3 accounted for 54% (20/37 of the virus-positive samples, followed by RSV 24% (9/37, influenza B 19% (7/37, and influenza A (H1 3% (1/37. Of the influenza-positive cases, 29% (8/28 had recently had a flu immunisation. Influenza was more common in those who gave a history of contact with a pilgrim with a respiratory illness than those who did not (17 versus 9%. The overall rate of RSV was 4% (9/202. This study confirms that influenza and RSV cause acute respiratory infections in British Hajj pilgrims. Continuing surveillance and a programme of interventions to contain the spread of infection are needed at the Hajj, particularly when the world is preparing for an influenza pandemic.

  9. Where are we now in British health economics?

    Science.gov (United States)

    Blaug, M

    1998-08-01

    Health economics took off in 1970 or thereabouts, just after the take-off date for the economics of education. Although early health economics made use of human capital theory as did the economics of education, it soon took a different route inspired by Arrow's work on medical insurance. The economics of education failed to live up to its promising start in the 1960s and gradually ran out of steam. The economics of health, however, has made steady theoretical and empirical progress since 1970, principally in coming to grips with the implications of supplier-induced demand and the difficulties of evaluating health care outcomes. Some of the best work on British health economics has been in the area of normative welfare economics, defining more precisely what is meant by equity in the delivery of health care and measuring the degree of success in achieving equity. Recent efforts to reform the NHS by the introduction of 'quasi markets' have improved the quantity and quality of health care in Britain. In short, British health economics has been characterised by the use of Pigovian piecemeal rather than Paretian global welfare economics, retaining a distinctive style that sets it apart from American health economics.

  10. Fluvoxamine-associated oscillopsia and a role for personalized medication dosing.

    Science.gov (United States)

    Singman, Eric L; Hocum, Brian; Yohannan, Jithin; Pearson, Virginia

    2015-12-01

    A 60-year-old woman reported horizontal "shimmering" movement while reading crossword puzzles when using fluvoxamine, bupropion, quetiapine, lithium, and levothyroxine. This visual disturbance, likely oscillopsia, started after the fluvoxamine was added and waned as the fluvoxamine was tapered, disappearing after the drug was discontinued. Genetic testing to explore how the patient metabolizes these medications combined with YouScript® interaction analysis suggest that she may have had abnormally high plasma concentrations of fluvoxamine during this time. Oscillopsia may be a novel dose-dependent side effect of fluvoxamine. Genetic testing combined with YouScript has the potential to discover novel drug side effects, elucidate drug interactions and guide future prescribing decisions. PMID:26351962

  11. Reconstruction of British Nuclear Fuel's Drigg marine outfall

    International Nuclear Information System (INIS)

    In 1985 the House of Commons Environment Committee expressed reservations over some of the waste-management procedures followed by British Nuclear Fuels Ltd at their Drigg low-level radioactive waste disposal facility near Sellafield in Cumbria. These reservations prompted the company to implement a Pound 20 million programme of improvements aimed at maximizing site usage, reducing trench leachate arisings and redirecting to the Irish Sea. This paper provides information and test results associated with design considerations and initial dilution testing, respectively, of a computer-controlled long sea outfall system designed to discharge leachate to the Irish Sea. Information is also provided on difficulties experienced during construction of the outfall. (Author)

  12. Explaining British Policy on the Euro

    Directory of Open Access Journals (Sweden)

    David Howarth

    2004-10-01

    Full Text Available Four overlapping analytical frameworks focusing upon domestic British politics are applied to explain the detailed development of the policy on the euro maintained by the Conservative Government then Party in opposition and the Labour Party opposition and then Government: intra-party politics; inter-party politics; public opinion and the nature of British democracy; and neo-pluralism (competing economic and other interests. This article posits that British government - and in particular Labour Government - reluctance to hold a referendum on euro membership and actively push a pro-euro policy can be best explained in terms of ideologically infused intra- (rather than inter- party politics and the realities of pluralist politics, while explanations rooted in an analysis of public opinion are less helpful.

  13. Convergence, divergence and realignment in British macroeconomics

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    D. COBHAM

    2013-12-01

    Full Text Available In this paper the author argues that the still frequent and simplistic distinction between Keynesians and monetarists that makes up a large part of the British popular economic debate has become seriously misleading. Changes that have taken place in British macroeconomics since the early 1970s are thus indicated and some of the theoretical and empirical factors responsible for these changes are suggested. The author presents a brief characterisation of British Keynesianism and monetarism as of late 1960s/early 1970s, arguing that there have been important elements of convergence. He proceeds to discuss some of the theoretical developments and some of the experiences of UK macroeconomic policy which have contributed to this convergence. Finally, he considers whether the labels “Keynesian” and “monetarist” continue to be relevant.

  14. ‘A Matter of Conscience’: The Moral Authority of the World Medical Association and the Readmission of the South Africans, 1976–1994

    OpenAIRE

    Mbali, Mandisa

    2014-01-01

    This article describes the role of transnational anti-apartheid activism in South Africa, Britain and the United States in generating international moral outrage over the readmission of the Medical Association of South Africa (MASA) to the World Medical Association (WMA), which had taken place in 1981 after it had withdrawn from that body in 1976. It discusses an example of a controversy where an international health organisation (IHO) lost moral authority as a result of being accused of whit...

  15. Ambient Noise Tomography of the British Isles

    Science.gov (United States)

    Nicolson, H. J.; Curtis, A.; Baptie, B.

    2009-12-01

    In recent years, surface wave tomography using empirical Green’s functions computed via the ambient noise interferometry method has become an established approach to lithospheric imaging problems. To date, ambient noise tomography has been successfully applied to seismometer arrays in the United States, Australia, Iceland, China, South Africa, Europe and the Tibetan Plateau. The basis of the ambient seismic interferometry method is that, by cross-correlating noise data between two seismic stations and stacking over a long enough time period, one can approximate the Green’s Function that would have been recorded at one of the stations if the other had actually been a source. Consequently, one of the main advantages of ambient noise interferometry is that traditional seismic sources such as earthquakes or ballistics are not required; therefore it is ideal for application to seismically quiescent areas such as the British Isles. The British Isles are an archipelago located adjacent to the Eurasian continental shelf in a typically intra-plate setting, formed by a complex amalgamation of several terranes. These range from Laurentian north of the Highland Boundary fault to Avalonian south of the Iapetus Suture and evidence of the regions turbulent geological past can be inferred from its lithospheric structure. Previous studies of the structure of the British Isles considered relatively few seismic stations and/or were limited to using offshore shots, quarry blasts or teleseismic earthquakes as seismic energy sources. We have applied the ambient noise tomography method to noise data recorded on approximately 100 broadband and short period seismometers, including many new stations, in the British Isles and mainland Europe. This dense coverage of the British Isles allows us to image the crust and upper mantle velocity structure with a horizontal resolution in the region of 100km across the North Sea and 30km in the mainland United Kingdom. Here we present the first

  16. A systematic review of the factors associated with delays in medical and psychological help-seeking among men.

    Science.gov (United States)

    Yousaf, Omar; Grunfeld, Elizabeth A; Hunter, Myra S

    2015-01-01

    Despite a growing literature on the factors associated with men's low rates of medical and psychological help-seeking, a systematic review of these is missing. Such an overview can help to inform health psychologists of the barriers to the performance of adaptive health behaviours, such as prompt help-seeking, and could inform theoretical advancements and the development of targeted interventions to facilitate prompt help-seeking among men. We systematically reviewed quantitative and qualitative empirical papers on factors associated with delays in men's medical and psychological help-seeking. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and we used the databases PsycINFO, Medline, Embase and PsycARTICLES (with keywords: men/male*/gender*, help*/seek* and health*/service*/utili*[sation]) for papers in English. 41 citations (amounting to 21,787 participants aged 15-80 + ) met the inclusion criteria. Approximately half of these used qualitative methodologies (i.e., semi-structured interviews and focus groups), while half used quantitative methodologies (i.e., questionnaires). We identify a number of recurring cognitive, emotional, health-service related and socio-demographic help-seeking factors/predictors from the 41 papers. Of these, the most prominent barriers to help-seeking were disinclination to express emotions/concerns about health, embarrassment, anxiety and fear, and poor communication with health-care professionals. PMID:26209212

  17. Assessment of Entrepreneurial Skills and Its Association with Social Intelligence in Students of Kermanshah University of Medical Sciences

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    Yahya Safari

    2013-12-01

    Full Text Available Introduction: Social intelligence and entrepreneurship are among features leading to the academic and career achievements. Due to the importance of this issue, the present study was performed to determine the level of entrepreneurial skills in students of Kermanshah University of Medical Sciences and its association with social intelligence. Methods: In this descriptive cross-sectional study by using systematic random sampling method, we selected 350 students at Kermanshah University of Medical Sciences. Data were collected using entrepreneurial skills standard and social intelligence questionnaires. Reliability and validity of two questionnaires have been already assessed in previous studies. Results analyzed by descriptive statistics and Pearson correlation coefficient test. Results: Students’ entrepreneurial skill was totally 255.69 which is assessed at poor scores range. Research findings also indicated the presence of a statistically significantly positive association between social intelligence and risk-taking (r=0.14 P=0.035, locus of control (r=0.72, P=0.019, need to achievement (r=0.54, P=0.012, mental health (r=0.53, P=0.033, pragmatism (r=0.45, P=0.04, ambiguity toleration (r=0.58, P=0.029, positive thinking (r=0.72, P=0.019, and challenging (r=0.29, P=0.016. Conclusion: Given the students’ poor entrepreneurial skills and the correlation between social intelligence and entrepreneurial components, it is recommended to strengthen social intelligence and consequently promote entrepreneurial skills.

  18. Heavy water at Trail, British Columbia

    International Nuclear Information System (INIS)

    Today Canada stands on the threshold of a nuclear renaissance, based on the CANDU reactor family, which depends on heavy water as a moderator and for cooling. Canada has a long history with heavy water, with commercial interests beginning in 1934, a mere two years after its discovery. At one time Canada was the world's largest producer of heavy water. The Second World War stimulated interest in this rather rare substance, such that the worlds largest supply (185 kg) ended up in Canada in 1942 to support nuclear research work at the Montreal Laboratories of the National Research Council. A year later commercial production began at Trail, British Columbia, to support work that later became known as the P-9 project, associated with the Manhattan Project. The Trail plant produced heavy water from 1943 until 1956, when it was shut down. During the war years the project was so secret that Lesslie Thomson, Special Liaison Officer reporting on nuclear matters to C.D. Howe, Minister of Munitions and Supply, was discouraged from visiting Trail operations. Thomson never did visit the Trail facility during the war. In 2005 the remaining large, tall concrete exchange tower was demolished at a cost of about $2.4 million, about the same as it cost to construct the facility about 60 years ago. Thus no physical evidence remains of this historic facility and another important artifact from Canada's nuclear history has disappeared forever. It is planned to place a plaque at the site at some point in the future. (author)

  19. CRITERIA OF BRITISH TEACHERS’ COMMUNICATION CULTURE FORMEDNESS

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    Михаил Алексеевич Есипов

    2013-04-01

    Full Text Available Communication culture formation belongs to most essential problems for pedagogical theory and practice. The level of a teacher’s communication culture influences greatly the efficiency of his professional communication with colleagues and students.The peculiarities of teachers’ communication culture formation in the British educational system are considered. Main characteristics of a communication-oriented teacher are mentioned. Criteria for specifying the level of British teachers’ communication culture formedness as well as brief description of these levels are given in this article.DOI: http://dx.doi.org/10.12731/2218-7405-2013-1-13

  20. Association between LEP and LEPR gene polymorphisms and dyslipidemia in patients using atypical antipsychotic medication

    NARCIS (Netherlands)

    Gregoor, Jochem G.; van der Weide, Jan; Loovers, Harriet M.; van Megen, Harold J.; Egberts, Toine C.; Heerdink, Eibert R.

    2010-01-01

    Background Treatment with atypical antipsychotic agents is often complicated by dyslipidemia, which is a risk factor for cardiovascular disease. Objectives To determine whether the LEPR Q223R, the LEP -2548G/A, and the HTR2C -759C/T polymorphisms are associated with dyslipidemia in patients using at

  1. J.G. Crowther's War: Institutional strife at the BBC and British Council.

    Science.gov (United States)

    Jones, Allan

    2016-06-01

    Science writer, historian and administrator J.G. Crowther (1899-1983) had an uneasy relationship with the BBC during the 1920s and 1930s, and was regarded with suspicion by the British security services because of his left politics. Nevertheless the Second World War saw him working for 'establishment' institutions. He was closely associated with the BBC's Overseas Service and employed by the British Council's Science Committee. Both organizations found Crowther useful because of his wide, international knowledge of science and scientists. Crowther's political views, and his international aspirations for the British Council's Science Committee, increasingly embroiled him in an institutional conflict with the Royal Society and with its president, Sir Henry Dale, who was also chairman of the British Council's Science Committee. The conflict centred on the management of international scientific relations, a matter close Crowther's heart, and to Dale's. Dale considered that the formal conduct of international scientific relations was the Royal Society's business rather than the British Council's. Crowther disagreed, and eventually resigned from the British Council Science Committee in 1946. The article expands knowledge of Crowther by drawing on archival documents to elucidate a side of his career that is only lightly touched on in his memoirs. It shows that 'Crowther's war' was also an institutional war between the Science Committee of the British Council and the Royal Society. Crowther's unhappy experience of interference by the Royal Society plausibly accounts for a retreat from his pre-war view that institutional science should plan and manage BBC science broadcasts. PMID:27076038

  2. The Diasporic Dimensions of British Caribbean Federation in the Early Twentieth Century

    Directory of Open Access Journals (Sweden)

    Eric D. Duke

    2009-12-01

    Full Text Available [Second and third pragraph] While much has been written on the significance of British Caribbean activists in various movements associated with black diaspora politics in the twentieth century, particularly their important roles in Pan-African struggles, little has been written on how the various British Caribbean colonies themselves were envisioned among diaspora activists and within the scope of black diaspora politics. Did such Caribbean activists, especially those interested in and connected to diasporic movements beyond the British Caribbean, and their African American and African counterparts forsake the British West Indies as a focus of political engagement for other lands and causes? If not, what was the place of “West Indian liberation” and nation building in the British Caribbean in relation to black diasporic struggles in the early twentieth century? This article address these questions through an examination of how the idea of a united “West Indian nation” (via a federation or closer union among British Caribbean colonies was envisioned within black diaspora politics from the turn of the twentieth century through the 1920s, and the ways in which racial consciousness and motivations informed conceptualizations of such a nation among black political activists of the British Caribbean and other parts of the diaspora. This study argues that efforts to create a federation in the Anglophone Caribbean were much more than simply imperial or regional nation-building projects. Instead, federation was also a diasporic, black nation-building endeavor intricately connected to notions of racial unity, racial uplift, and black self-determination.

  3. The British Monarch——A key element in British society and culture

    Institute of Scientific and Technical Information of China (English)

    兰艺

    2014-01-01

    <正>Although the British Monarch has already lost its true powe to govern the country,it is still a key element in British societ and culture for its specialty in the country.Admittedly,the British Monarch has no substantial right t nominate the cabinet and deal with some other important politica issues.What it can do is to work as a symbol in some importan ceremonies.Its power is just a form,or a symbol,and in essence

  4. Accountable care organization formation is associated with integrated systems but not high medical spending.

    Science.gov (United States)

    Auerbach, David I; Liu, Hangsheng; Hussey, Peter S; Lau, Christopher; Mehrotra, Ateev

    2013-10-01

    Medicare's approximately 250 accountable care organizations (ACOs) care for a growing portion of all fee-for-service beneficiaries across the United States. We examined where ACOs have formed and what regional factors are predictive of ACO formation. Understanding these factors could help policy makers foster growth in areas with limited ACO development. We found wide variation in ACO formation, with large areas, such as the Northwest, essentially empty of ACOs, and others, such as the Northeast and Midwest, dense with the organizations. Key regional factors associated with ACO formation include a greater fraction of hospital risk sharing (capitation), larger integrated hospital systems, and primary care physicians practicing in large groups. Area income, Medicare per capita spending, Medicare Advantage enrollment rates, and physician density were not associated with ACO formation. Together, these results imply that underlying provider integration in a region may help drive the formation of ACOs.

  5. Antiretroviral regimen and suboptimal medication adherence are associated with low-level human immunodeficiency virus viremia.

    Science.gov (United States)

    Konstantopoulos, Christina; Ribaudo, Heather; Ragland, Kathleen; Bangsberg, David R; Li, Jonathan Z

    2015-01-01

    Episodes of human immunodeficiency virus low-level viremia (LLV) are common in the clinical setting, but its association with antiretroviral therapy (ART) regimen and adherence remains unclear. Antiretroviral therapy adherence was evaluated in participants of the Research on Access to Care in the Homeless cohort by unannounced pill counts. Factors associated with increased risk of LLV include treatment with a protease inhibitor (PI)-based regimen (ritonavir-boosted PI vs nonnucleoside reverse-transcriptase inhibitor: adjusted hazard ratio [HR], 3.1; P = .01) and lower ART adherence over the past 3 months (HR, 1.1 per 5% decreased adherence, adjusted; P = .050). Patients with LLV may benefit from ART adherence counseling and potentially regimen modification. PMID:25884007

  6. Association between chronotype, food intake and physical activity in medical residents.

    Science.gov (United States)

    Mota, Maria Carliana; Waterhouse, Jim; De-Souza, Daurea Abadia; Rossato, Luana Thomazetto; Silva, Catarina Mendes; Araújo, Maria Bernadete Jeha; Tufik, Sérgio; de Mello, Marco Túlio; Crispim, Cibele Aparecida

    2016-01-01

    An individual's chronotype is a trait which reflects his/her diurnal preferences for the times of rest and activities, and displays a continuum from morningness to eveningness. Studies have shown that eveningness tends to be associated with a less healthy lifestyle, including increased likelihood of developing obesity. In this study, we examined the relationship between chronotype and food intake, physical sleep and activity in 72 resident physicians (52 women and 20 men). Assessments included chronotype evaluation by the Horne and Ostberg Morningness-Eveningness questionnaire (MEQ); food intake pattern through a self-administered food diary that was kept over the course of 3 non-successive days; physical activity level, using the Baecke questionnaire (BQ); sleep quality and quantity using the Pittsburgh Sleep Quality Index (PSQI); and sleepiness, Epworth Sleepiness Scale (ESS). Linear regression analyses, after adjustments for age, sex, body mass index (BMI), hours of additional work per week ESS and total physical activity score, showed that the chronotype score was negatively associated with cholesterol (coefficient = -0.24; p = 0.04), sweets (coefficient = -0.27, p = 0.03) and vegetables (coefficient = -0.26; p = 0.04) intakes. Following the same statistical adjustments, the chronotype score was positivity associated with leisure-time index (coefficient = 0.26, p = 0.03) and BQ total score (coefficient = 0.27, p = 0.03). We concluded that most issues related to nutrition problems and unhealthy lifestyle were associated with scores indicative of eveningness. These findings emphasize the importance of assessing an individual's chronotype when examining feeding behavior.

  7. Associations Between the Big Five Personality Traits and the Non-Medical Use of Prescription Drugs for Cognitive Enhancement.

    Science.gov (United States)

    Sattler, Sebastian; Schunck, Reinhard

    2015-01-01

    While the number of studies of the non-medical use of prescription drugs to augment cognitive functions is growing steadily, psychological factors that can potentially help explain variance in such pharmaceutical cognitive enhancement (CE) behavior are often neglected in research. This study investigates the association between the Big Five personality traits and a retrospective (prior CE-drug use) as well as a prospective (willingness to use CE drugs) measure of taking prescription drugs with the purpose of augmenting one's cognitive functions (e.g., concentration, memory, or vigilance) without medical necessity. We use data from a large representative survey of German employees (N = 6454, response rate = 29.8%). The Five Factor Model (FFM) of Personality was measured with a short version of the Big Five Personality Traits Inventory (BFI-S), which includes: openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism. Together with this, demographic variables such as gender, age, education, and income were used as potential confounders in multiple logistic regression models. Our results show a 2.96% lifetime prevalence of CE-drug use and a 10.45% willingness to (re)use such drugs in the future. We found that less conscientious and more neurotic respondents have a higher probability of prior CE-drug use and a greater willingness to use CE drugs in the future. No significant effects were found for openness, extraversion, or agreeableness. Prior CE-drug use was strongly associated with a greater willingness to take such drugs in the future. This study shows that specific personality traits are not only associated with prior enhancement behavior, but also affect the willingness to (re)use such drugs. It helps increase understanding of the risk factors of CE-drug use, which is a health-related behavior that can entail severe side-effects for consumers. The knowledge gathered can thus help improve interventions aimed at minimizing health

  8. Associations between the Big Five Personality Traits and the Non-Medical Use of Prescription Drugs for Cognitive Enhancement

    Directory of Open Access Journals (Sweden)

    Sebastian eSattler

    2016-01-01

    Full Text Available While the number of studies of the non-medical use of prescription drugs to augment cognitive functions is growing steadily, psychological factors that can potentially help explain variance in such pharmaceutical cognitive enhancement (CE behavior are often neglected in research.This study investigates the association between the Big Five personality traits and a retrospective (prior CE-drug use as well as a prospective (willingness to use CE drugs measure of taking prescription drugs with the purpose of augmenting one’s cognitive functions (e.g. concentration, memory, or vigilance without medical necessity. We use data from a large representative survey of German employees (N= 6,454, response rate= 29.8%. The Five Factor Model (FFM of Personality was measured with a short version of the Big Five Personality Traits Inventory (BFI-S, which includes: openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism. Together with this, demographic variables such as gender, age, education, and income were used as potential confounders in multiple logistic regression models. Our results show a 2.96% lifetime prevalence of CE-drug use and a 10.45% willingness to (reuse such drugs in the future. We found that less conscientious and more neurotic respondents have a higher probability of prior CE-drug use and a greater willingness to use CE drugs in the future. No significant effects were found for openness, extraversion, or agreeableness. Prior CE-drug use was strongly associated with a greater willingness to take such drugs in the future.This study shows that specific personality traits are not only associated with prior enhancement behavior, but also affect the willingness to (reuse such drugs. It helps increase understanding of the risk factors of CE-drug use, which is a health-related behavior that can entail severe side-effects for consumers. The knowledge gathered can thus help improve interventions aimed at minimizing

  9. Associations Between the Big Five Personality Traits and the Non-Medical Use of Prescription Drugs for Cognitive Enhancement.

    Science.gov (United States)

    Sattler, Sebastian; Schunck, Reinhard

    2015-01-01

    While the number of studies of the non-medical use of prescription drugs to augment cognitive functions is growing steadily, psychological factors that can potentially help explain variance in such pharmaceutical cognitive enhancement (CE) behavior are often neglected in research. This study investigates the association between the Big Five personality traits and a retrospective (prior CE-drug use) as well as a prospective (willingness to use CE drugs) measure of taking prescription drugs with the purpose of augmenting one's cognitive functions (e.g., concentration, memory, or vigilance) without medical necessity. We use data from a large representative survey of German employees (N = 6454, response rate = 29.8%). The Five Factor Model (FFM) of Personality was measured with a short version of the Big Five Personality Traits Inventory (BFI-S), which includes: openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism. Together with this, demographic variables such as gender, age, education, and income were used as potential confounders in multiple logistic regression models. Our results show a 2.96% lifetime prevalence of CE-drug use and a 10.45% willingness to (re)use such drugs in the future. We found that less conscientious and more neurotic respondents have a higher probability of prior CE-drug use and a greater willingness to use CE drugs in the future. No significant effects were found for openness, extraversion, or agreeableness. Prior CE-drug use was strongly associated with a greater willingness to take such drugs in the future. This study shows that specific personality traits are not only associated with prior enhancement behavior, but also affect the willingness to (re)use such drugs. It helps increase understanding of the risk factors of CE-drug use, which is a health-related behavior that can entail severe side-effects for consumers. The knowledge gathered can thus help improve interventions aimed at minimizing health

  10. Association between eating disorders and body image in athletes and non-athlete students in Qazvin University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    M. Miri

    2016-06-01

    Full Text Available Background: Body image dissatisfaction and eating disorders are of common problems in adolescence and adulthood especially among athletes. Objective: The aim of this study was to determine the association of eating disorders and body image in athletes and non-athlete students in Qazvin University of Medical Sciences. Methods: This cross-sectional study was conducted on 226 athlete students and 350 non-athlete students of Qazvin University of Medical Sciences during 2013-2014. Students who followed a specific sport field and had participated in at least one sport event were considered as athlete students. All athlete students were entered the study by census method. Non-athlete students were selected among students who had not any exercise activity and by random sampling method. Data were collected through demographic questionnaire, Eating Attitudes Test (EAT-26, and Multidimensional Body-Self Relations Questionnaire (MBSRQ. Data were analyzed using T-test and Chi-square test. Results: Mean age was 21.92±3.19 years and mean body mass index (BMI was 22.24±3.18 kg/m2. The frequency of eating disorders was 11.5% among the athlete students and 11.2% among the non-athlete students. Anorexia nervosa was found to be more prevalent than bulimia nervosa in both groups. The students with normal BMI had better body image perception and less eating disorders symptoms than other students. The association of age, educational level, and gender with eating disorders and body image was not statistically significant. The association of eating disorders and body image was not statistically significant. Eating disorders were more prevalent in males than females but the difference was not statistically significant. Conclusion: With regards to the results, it seems that eating disorders and body image dissatisfaction are relatively prevalent among both athletes and non-athlete students and BMI is predictor of eating disorders.

  11. Female sexual inversion: same-sex desires in Italian and British sexology, ca. 1870-1920

    OpenAIRE

    Beccalossi, Chiara

    2012-01-01

    Between the end of the nineteenth and the beginning of the twentieth centuries, a number of women were diagnosed as sexual inverts in Britain and Europe. This book examines the ways in which female same-sex desires were represented across a wide range of Italian and British medical writings during this period. Chiara Beccalossi has undertaken extensive archival research to bring to light new documents and give a detailed account of how the female invert was positioned alongside other figures ...

  12. The Differences between British English and American English

    Institute of Scientific and Technical Information of China (English)

    章继宁

    2013-01-01

    British English and American English are two varieties of English. American English derived from British English and they have many similarities and differences. British English and American English are different in pronunciation, spelling, vocabu⁃lary and customary usage/syntax, etc.

  13. British International Schools: The Deployment and Training of Teaching Assistants

    Science.gov (United States)

    Tarry, Estelle

    2011-01-01

    This article reports on research carried out on behalf of the Council of British International Schools (COBIS) as to the role and deployment of British international school teaching assistants. Through questionnaires and a follow up open discussion with headteachers from British international schools it was found that, due to the differing…

  14. Summary recommendations for responsible monitoring and regulation of clinical software systems. American Medical Informatics Association, The Computer-based Patient Record Institute, The Medical Library Association, The Association of Academic Health Science Libraries, The American Health Information Management Association, and The American Nurses Association.

    Science.gov (United States)

    Miller, R A; Gardner, R M

    1997-11-01

    Clinical software systems are becoming ubiquitous. A growing literature documents how these systems can improve health care delivery, but concerns about patient safety must now be formally addressed. In 1996, the U.S. Food and Drug Administration (FDA) called for discussions on regulation of software programs as medical devices. In response, a consortium of organizations dedicated to improving health care through information technology developed recommendations for the responsible regulation and monitoring of clinical software systems by users, vendors, and regulatory agencies. These recommendations were revised and approved by the American Medical informatics Association Public Policy Committee and Board. Other organizations reviewed, modified, and approved the recommendations, and the Boards of Directors of most of the organizations in the consortium endorsed the guidelines. The consortium proposes four categories of clinical system risk and four classes of monitoring and regulatory action that can be applied on the basis of the risk level. The consortium recommends that most clinical software systems be supervised locally and that developers of health care information systems adopt a code of good business practices. Budgetary and other constraints limit the type and number of systems that the FDA can regulate effectively; therefore, the FDA should exempt most clinical software systems and focus on systems that pose high clinical risk and provide limited opportunity for competent human intervention. PMID:9382409

  15. Summary recommendations for responsible monitoring and regulation of clinical software systems. American Medical Informatics Association, The Computer-based Patient Record Institute, The Medical Library Association, The Association of Academic Health Science Libraries, The American Health Information Management Association, and The American Nurses Association.

    Science.gov (United States)

    Miller, R A; Gardner, R M

    1997-11-01

    Clinical software systems are becoming ubiquitous. A growing literature documents how these systems can improve health care delivery, but concerns about patient safety must now be formally addressed. In 1996, the U.S. Food and Drug Administration (FDA) called for discussions on regulation of software programs as medical devices. In response, a consortium of organizations dedicated to improving health care through information technology developed recommendations for the responsible regulation and monitoring of clinical software systems by users, vendors, and regulatory agencies. These recommendations were revised and approved by the American Medical informatics Association Public Policy Committee and Board. Other organizations reviewed, modified, and approved the recommendations, and the Boards of Directors of most of the organizations in the consortium endorsed the guidelines. The consortium proposes four categories of clinical system risk and four classes of monitoring and regulatory action that can be applied on the basis of the risk level. The consortium recommends that most clinical software systems be supervised locally and that developers of health care information systems adopt a code of good business practices. Budgetary and other constraints limit the type and number of systems that the FDA can regulate effectively; therefore, the FDA should exempt most clinical software systems and focus on systems that pose high clinical risk and provide limited opportunity for competent human intervention.

  16. Risk factors associated with children learning disorders at school: a socio-medical problem.

    Directory of Open Access Journals (Sweden)

    Beatriz Sabina Roméu

    2010-08-01

    Full Text Available Background: At the polyclinic ´´Area I´´ in Cienfuegos there are no previous studies on learning disorders in children and no epidemiological or exploratory research on personal, family and school issues related to this problem has been conducted. Objective: To determine the differences between children with and without learning disorders in second and third grade in the schools in the area of the "Dr. José Luis Chaviano" polyclinic in Cienfuegos in order to determine the risk factors depending on the child, the school and the family. Method: A non-coupled case-control study was conducted from September 2008 to June 2009. Study group: 42 children presenting learning difficulties as to their teacher´s opinion. Control group: 40 children with normal learning selected by simple random sampling. Interviews were conducted with parents, teachers and children as well as observations of school activities. Standardized questionnaires were applied and the information obtained was processed by using the SPSS statistical program. The chi-square statistic was used and the relative risks were estimated. Results: The identified disorders were associated with mood changes, unattendance to school and poor muscle control for writing, among others mentioned by teachers. The frequent change of teachers was also an associated condition. Among the risk factors related to family issues were: parents´ low educational level, cohabitation, family history of neurotic disorders, inconsistent educational management, family violence, marginalization and understimulation at home. Conclusion: Learning disorders were associated with risk factors depending on the child, school and, in a relevant way, on the family environment factors.

  17. British Writers; Modules for Teacher Corps.

    Science.gov (United States)

    Gilliard, Fred

    This booklet, containing eight instructional modules on works by major British writers, can be used either within a lower-level literature course for non-English majors or in a survey course for English majors. The first four modules focus on works from the early English period through the Elizabethan Age: "Beowulf,""Sir Gawain and the Green…

  18. Macro and Microenvironments at the British Library.

    Science.gov (United States)

    Shenton, Helen

    This paper describes the storage of the 12 million items that have just been moved into the new British Library building. The specifications for the storage and environmental conditions for different types of library and archive material are explained. The varying environmental parameters for storage areas and public areas, including reading rooms…

  19. An American on a British Train

    Institute of Scientific and Technical Information of China (English)

    大川

    2004-01-01

    A young American entered a compartment on a British train, and discovered that all seats were occupied, including one on which a small dog was seated. To his owner, a middle-aged lady who wore a large hat, he said po-

  20. Considerations for Education Reform in British Columbia

    Science.gov (United States)

    Santos, Ana

    2012-01-01

    Countries around the world refer to twenty-first century education as essential to maintaining personal and national economic advantage and draw on this discourse to advocate for and embark on educational reform. This paper examines issues around education reform, particularly in British Columbia. It argues that reformers should give careful…

  1. British physics Newton's law of funding

    CERN Multimedia

    2007-01-01

    In Britain, fundamental physics is in a pickle ISAAC NEWTON, besides being the founder of modern physics, was also master of Britain's mint. That is a precedent which many British physicists must surely wish had become traditional. At the moment, money for physics is in short supply in Britain.

  2. The British Experience of Reform in Education.

    Science.gov (United States)

    Johnes, Geraint

    1996-01-01

    The nature and impact of reforms since 1988 in British education, both compulsory and postsecondary, are examined, focusing on changes in organizational structure and financing mechanisms. The success of these changes in meeting their objectives is assessed, and unresolved issues are identified. (MSE)

  3. African Centered Knowledge: A British Perspective.

    Science.gov (United States)

    Christian, Mark

    2001-01-01

    Considers the impact of African centered knowledge within the United Kingdom. Recent development of African Diaspora studies has forged links between various black Atlantic communities. The United Kingdom has experienced positive grassroots community response to the work of noted African centered scholars, yet within the British academy,…

  4. Four former British mining settlements on Spitsbergen

    NARCIS (Netherlands)

    Kruse, Frigga; Claughton, P.; Mills, C.

    2011-01-01

    The LASHIPA project participated in the recent International Polar Year to evaluate the large-scale historical exploitation of polar areas. This sub-project looks at the role of British actors in the economic and geopolitical development of the European High Arctic during the early twentieth century

  5. Earnings Returns to the British Education Expansion

    Science.gov (United States)

    Devereux, Paul J.; Fan, Wen

    2011-01-01

    We study the effects of the large expansion in British educational attainment that took place for cohorts born between 1970 and 1975. Using the Quarterly Labour Force Survey, we find that the expansion caused men to increase education by about a year on average and gain about 8% higher wages; women obtained a slightly greater increase in education…

  6. HIV Prevalence among Aboriginal British Columbians

    Directory of Open Access Journals (Sweden)

    Strathdee Steffanie

    2005-12-01

    Full Text Available Abstract Context There is considerable concern about the spread of HIV disease among Aboriginal peoples in British Columbia. Objective To estimate the number of Aboriginal British Columbians infected with HIV. Design and setting A population-based analysis of Aboriginal men and women in British Columbia, Canada from 1980 to 2001. Participants Epidemic curves were fit for gay and bisexual men, injection drug users, men and women aged 15 to 49 years and persons over 50 years of age. Main outcome measures HIV prevalence for the total Aboriginal population was modeled using the UNAIDS/WHO Estimation and Projection Package (EPP. Monte Carlo simulation was used to estimate potential number infected for select transmission group in 2001. Results A total of 170,025 Aboriginals resided in British Columbia in 2001, of whom 69% were 15 years and older. Of these 1,691 (range 1,479 – 1,955 men and women aged 15 years and over were living with HIV with overall prevalence ranging from 1.26% to 1.66%. The majority of the persons infected were men. Injection drug users (range 1,202 – 1,744 and gay and bisexual men (range 145, 232 contributed the greatest number of infections. Few persons infected were from low risk populations. Conclusion More than 1 in every 100 Aboriginals aged 15 years and over was living with HIV in 2001. Culturally appropriate approaches are needed to tailor effective HIV interventions to this community.

  7. Conference scene: Summary of the 6th Conference of the Romanian Association of Medical Laboratories with international participation.

    Science.gov (United States)

    Carasevici, Eugen

    2011-10-01

    The Romanian Association of Medical Laboratories (RAML) conferences have acquired a reputation for standing out as the most prominent and efficient meetings in the national community of laboratory medicine, being a landmark of the development in this field in Romania and an active affiliation to international forums. This year, the conference setting was Piatra Neamt, in the northeast part of Romania, which produced a friendly and stimulating professional environment. As in previous years, leading experts in the fields of laboratory medicine attended the event. This year, we enjoyed the opportunity to have such distinguished guests as the members of the executive board of International Federation of Clinical Chemistry and Laboratory Medicine (IFCC); Graham Beastall, IFCC President; Päivi Hannele Laitinen, IFCC secretary; and Grazyna Sypniewska, IFCC Communication and Publication Division, and editor of the electronic journal of the IFCC. As usual, the conference program included all aspects of clinical laboratory activity, with a special focus on technology development, instrumentation and laboratory management. Fully aware of the fact that the complexity and depth of laboratory practice have undergone an impressive and rapid evolution, the specific goals of the event were to increase knowledge in the fundamentals of new molecular investigation, areas which show the tendency to become routine in our daily activity. In addition, laboratory management and the place of medical laboratories in the process of translational medicine were subjects of focus. The 6th Conference of the Romanian Association of Medical Laboratories was held from Wednesday 1st to Saturday 4th of June 2011. A total of 273 participants from all local branches of the Association attended. The scientific program included seven plenary sessions where 22 lectures and 18 short communications were delivered, and three poster sessions with 44 poster presentations. Session topics covered issues of

  8. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules: Executive Summary of recommendations

    DEFF Research Database (Denmark)

    Gharib, H; Papini, E; Paschke, R;

    2010-01-01

    American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules are systematically developed statements to assist health care professionals in medical...... decision making for specific clinical conditions. Most of the content herein is based on literature reviews. In areas of uncertainty, professional judgment was applied. These guidelines are a working document that reflects the state of the field at the time of publication. Because rapid changes...

  9. Associated Roles of Perioperative Medical Directors and Anesthesia: Hospital Agreements for Operating Room Management.

    Science.gov (United States)

    Dexter, Franklin; Epstein, Richard H

    2015-12-01

    As reviewed previously, decision making can be made systematically shortly before the day of surgery based on reducing the hours of overutilized operating room (OR) time and tardiness of case starts (i.e., patient waiting). We subsequently considered in 2008 that such decision making depends on rational anesthesia-hospital agreements specifying anesthesia staffing. Since that prior study, there has been a substantial increase in understanding of the timing of decision making to reduce overutilized OR time. Most decisions substantively influencing overutilized OR time are those made within 1 workday before the day of surgery and on the day of surgery, because only then are ORs sufficiently full that case scheduling and staff assignment decisions affect overutilized OR time. Consequently, anesthesiologists can easily be engaged in such decisions, because generally they must be involved to ensure that the corresponding anesthesia staff assignments are appropriate. Despite this, at hospitals with >8 hours of OR time used daily in each OR, computerized recommendations are superior to intuition because of cognitive biases. Decisions need to be made by a Perioperative Medical Director who has knowledge of the principles of perioperative managerial decision making published in the scientific literature rather than by a committee lacking this competency. Education in the scientific literature, and when different analytical methods should be used, is important. The addition that we make in this article is to show that an agreement between an anesthesia group and a hospital can both reduce overutilized OR time and patient waiting: The anesthesia group and hospital will ensure, hourly, that, when there are case(s) waiting to start, the number of ORs in use for each service will be at least the number that maximizes the efficiency of use of OR time. Neither the anesthesia group nor the hospital will be expected to run more than that number of ORs without mutual agreement

  10. Associated Roles of Perioperative Medical Directors and Anesthesia: Hospital Agreements for Operating Room Management.

    Science.gov (United States)

    Dexter, Franklin; Epstein, Richard H

    2015-12-01

    As reviewed previously, decision making can be made systematically shortly before the day of surgery based on reducing the hours of overutilized operating room (OR) time and tardiness of case starts (i.e., patient waiting). We subsequently considered in 2008 that such decision making depends on rational anesthesia-hospital agreements specifying anesthesia staffing. Since that prior study, there has been a substantial increase in understanding of the timing of decision making to reduce overutilized OR time. Most decisions substantively influencing overutilized OR time are those made within 1 workday before the day of surgery and on the day of surgery, because only then are ORs sufficiently full that case scheduling and staff assignment decisions affect overutilized OR time. Consequently, anesthesiologists can easily be engaged in such decisions, because generally they must be involved to ensure that the corresponding anesthesia staff assignments are appropriate. Despite this, at hospitals with >8 hours of OR time used daily in each OR, computerized recommendations are superior to intuition because of cognitive biases. Decisions need to be made by a Perioperative Medical Director who has knowledge of the principles of perioperative managerial decision making published in the scientific literature rather than by a committee lacking this competency. Education in the scientific literature, and when different analytical methods should be used, is important. The addition that we make in this article is to show that an agreement between an anesthesia group and a hospital can both reduce overutilized OR time and patient waiting: The anesthesia group and hospital will ensure, hourly, that, when there are case(s) waiting to start, the number of ORs in use for each service will be at least the number that maximizes the efficiency of use of OR time. Neither the anesthesia group nor the hospital will be expected to run more than that number of ORs without mutual agreement

  11. Factors associated with medication adherence in school-aged children with asthma

    Directory of Open Access Journals (Sweden)

    Amy H.Y. Chan

    2016-03-01

    Full Text Available Adherence to preventive asthma treatment is poor, particularly in children, yet the factors associated with adherence in this age group are not well understood. Adherence was monitored electronically over 6 months in school-aged children who attended a regional emergency department in New Zealand for an asthma exacerbation and were prescribed twice-daily inhaled corticosteroids. Participants completed questionnaires including assessment of family demographics, asthma responsibility and learning style. Multivariable analysis of factors associated with adherence was conducted. 101 children (mean (range age 8.9 (6–15 years, 51% male participated. Median (interquartile range preventer adherence was 30% (17–48% of prescribed. Four explanatory factors were identified: female sex (+12% adherence, Asian ethnicity (+19% adherence, living in a smaller household (−3.0% adherence per person in the household, and younger age at diagnosis (+2.7% for every younger year of diagnosis (all p<0.02. In school-aged children attending the emergency department for asthma, males and non-Asian ethnic groups were at high risk for poor inhaled corticosteroid adherence and may benefit most from intervention. Four factors explained a small proportion of adherence behaviour indicating the difficulty in identifying adherence barriers. Further research is recommended in other similar populations.

  12. Factors associated with overcrowded emergency rooms in Thailand: a medical school setting.

    Science.gov (United States)

    Wibulpolprasert, Arrug; Sittichanbuncha, Yuwares; Sricharoen, Pungkava; Borwornsrisuk, Somporn; Sawanyawisuth, Kittisak

    2014-01-01

    Background. Overcrowding in the emergency department (ED) is a significant public health problem in the US, Europe, and Asia. Factors associated with prolonged length of stay in Thailand are still limited. Methods. This study was conducted at the ED, Ramathibodi Hospital, Mahidol University, Thailand, during July 2011. We selected 300 patients (5.77%) from a total of 5,202 who visited the ED during the study period by simple random sampling. Charts were retrospectively reviewed baseline characteristics, clinical factors, and duration of ED stay. Multivariate logistic regression analyses were performed to identify independent factors for an ED stay more than or equal to 8 hours. Results. We excluded 33 patients (11%) due to incomplete data or stroke fast track enrollment. In total, 267 patients were in the analysis and 53 patients (19.85%) had an ED visit time more than or equal to 8 hours. The number of rounds of blood testing and the type of insurance were associated with prolonged ED stay of more than or equal to 8 hours. Conclusion. ED physicians may need to consider appropriate investigations to shorten the length of stay in the ED.

  13. Factors Associated with Overcrowded Emergency Rooms in Thailand: A Medical School Setting

    Directory of Open Access Journals (Sweden)

    Arrug Wibulpolprasert

    2014-01-01

    Full Text Available Background. Overcrowding in the emergency department (ED is a significant public health problem in the US, Europe, and Asia. Factors associated with prolonged length of stay in Thailand are still limited. Methods. This study was conducted at the ED, Ramathibodi Hospital, Mahidol University, Thailand, during July 2011. We selected 300 patients (5.77% from a total of 5,202 who visited the ED during the study period by simple random sampling. Charts were retrospectively reviewed baseline characteristics, clinical factors, and duration of ED stay. Multivariate logistic regression analyses were performed to identify independent factors for an ED stay more than or equal to 8 hours. Results. We excluded 33 patients (11% due to incomplete data or stroke fast track enrollment. In total, 267 patients were in the analysis and 53 patients (19.85% had an ED visit time more than or equal to 8 hours. The number of rounds of blood testing and the type of insurance were associated with prolonged ED stay of more than or equal to 8 hours. Conclusion. ED physicians may need to consider appropriate investigations to shorten the length of stay in the ED.

  14. The Terms of Trade between the United Kingdom and British India, 1858-1947

    OpenAIRE

    Appleyard, Dennis R

    2006-01-01

    The commodity terms of trade of the United Kingdom with British India for 1858-1947 are calculated. Unit value indexes for a sample containing over three-quarters of UK/India trade indicate a slight improvement for the United Kingdom from 1858 to 1917. This improvement was likely attributable to falling transport costs for British imports and was therefore not associated with a decline in India's terms of trade with Britain. For 1917-47, there was substantial UK terms-of-trade improvement, a ...

  15. A very British spectacle? : critical reception of the fantasy genre within contemporary British cinema

    OpenAIRE

    Rickards, Carolyn

    2014-01-01

    In the period since 2001, cinema has witnessed what David Butler refers to as a ‘golden age’ of fantasy film production. The majority of fantasy films released during this time have originated from British literature, and have to some extent been produced and located within Britain, showcasing a wealth of national characters, acting talent, and landscapes on screen. Yet, despite vital revisionist work conducted on British horror, science fiction and melodrama, there remains a hesitancy to emb...

  16. Benefits and costs of impeding free trade: Revisiting British Columbia's restrictions on log exports

    NARCIS (Netherlands)

    Kooten, van G.C.

    2014-01-01

    The government of British Columbia (BC) imposes restrictions on the export of logs from public and private forestlands, primarily to promote local processing and associated employment benefits. Most economists wholeheartedly oppose BC's export restrictions, arguing that BC's citizens are worse off a

  17. Association of psycho-wellness with various blood types in young medical students

    Directory of Open Access Journals (Sweden)

    Anuradha Yadav

    2016-08-01

    Results: In the present study it was observed that majority of students belong to blood group B (39.38%, followed by blood group O (27.88%, A (27.66% and AB (7.08% respectively. Blood type A was more in red zone and more prone to PTSD (post traumatic syndrome disorders. Whereas blood type B was more prone to suicidal tendency. Proportion of psychomorbidity was found more in Rh+ than Rh (28.16% verse 15%. But these variations were statistically insignificant. Conclusions: Blood type A and Rh+ were more prone to psycho morbidity and and lsquo;B' for suicidal tendency, while O had least suicidal tendency but this variation was not found significant. So it can be concluded that there is no association between blood type and psycho wellness of individual. [Int J Res Med Sci 2016; 4(8.000: 3468-3472

  18. Medical image of the week: healthcare-associated pneumonia secondary to aspiration

    Directory of Open Access Journals (Sweden)

    Nissim L

    2015-07-01

    Full Text Available A 57 year-old bedbound paraplegic man developed a worsening productive cough after being hospitalized for several days. He was brought to the radiology suite for a CT scan of the chest, revealing a soft tissue density within his right main-stem bronchus, with volume loss of his right lung (Figure 1. Bronchoscopy was performed, yielding a 2 cm piece of broccoli, successfully removed with forceps (Figure 2. Culture from the bronchial aspirate was positive for Pseudomonas aeruginosa. The patient’s respiratory status dramatically improved after removal of the foreign body and commencement of pathogen-directed antibiotics. This study illustrates a dramatic example of healthcare-associated pneumonia (HCAP secondary to aspiration, as described by the American Thoracic Society / Infectious Diseases Society of America (1.

  19. Medical diagnoses associated with substance dependence among inpatients at a large urban hospital.

    Directory of Open Access Journals (Sweden)

    Humberto Choi

    Full Text Available There are limited data on reasons for hospital admission among patients dependent on substances other than alcohol. We compared primary discharge diagnoses for heroin- or cocaine-dependent patients to non-dependent patients.We evaluated a cohort of patients admitted to a general medicine service at a public teaching hospital during July 2005-June 2008. Through bedside interviews, we identified patients who had substance-use disorders. We categorized patients by substance used, route of administration, and dependent or non-dependent use. We grouped diagnostic codes (i.e., ICD-9 using Healthcare Utilization Project categories. We excluded HIV-infected patients.Of 11,397 patients, 341 (3.0% were dependent on inhalational heroin, 260 (2.3% on non-injection cocaine, and 106 (0.9% on injection heroin. Compared to non-dependent patients, inhalational heroin-dependent patients were over three-fold more likely to have been admitted for respiratory diseases (28% vs. 8%, p<0.01; this association was strongest for asthma exacerbation (OR=7.0; 95% CI, 4.7 to 70.4, p<0.01. Of the 225 admissions for an asthma exacerbation, 44 (19.6% had co-occurrent heroin-dependence. The most frequent diagnostic category among cocaine-dependent patients was circulatory, which was similar to non-dependent patients (22% vs. 21%, p=0.92.There is a strong association between heroin dependence and hospital admission for an asthma exacerbation. Provision of specialized substance-use treatment for inhalational heroin users will be necessary to reduce the frequency of exacerbations and repeat hospital admissions.

  20. Self-Esteem: A Cross-Cultural Comparison of British-Chinese, White British and Hong Kong Chinese Children.

    Science.gov (United States)

    Chan, Yiu Man

    2000-01-01

    Evaluates the self-esteem scores of 1303 children, including Chinese children from Britain and Hong Kong and white British children, using the Coopersmith Self-Esteem Inventory. Finds that British Chinese have significantly higher self-esteem than the Hong Kong children, but there is little difference among white British children. (CMK)

  1. Levels of patient activation among adults with schizophrenia: associations with hope, symptoms, medication adherence, and recovery attitudes.

    Science.gov (United States)

    Kukla, Marina; Salyers, Michelle P; Lysaker, Paul H

    2013-04-01

    Patient activation, defined as one's attitudes and confidence toward managing illness, has been not been thoroughly studied in consumers with schizophrenia. The current study sought to understand the relationship between patient activation and symptoms, medication adherence, recovery attitudes, and hope in a sample of 119 adults with schizophrenia. The participants were enrolled in an 18-month randomized controlled study of the Illness Management and Recovery program. Data were collected at baseline; correlations and stepwise multiple regressions were used to examine the relationships and determine the unique contribution of variables. Higher patient activation was most strongly associated with positive recovery attitudes, higher levels of hope, and fewer emotional discomfort symptoms. Patient activation was significantly related to a broad measure of illness self-management, providing evidence for the construct validity of the patient activation measure. Our findings emphasize the importance of recovery-based mental health services that recognize level of patient activation as a potential factor in consumer outcomes.

  2. Medications: Myths Versus Facts

    Science.gov (United States)

    ... High Blood Pressure Tools & Resources Stroke More Medications: Myths Versus Facts Updated:Aug 30,2016 Taking medication ... Association volunteer. Here are some of the top myths about taking cardiovascular medication: I feel OK, so ...

  3. Urological management (medical and surgical of BK-virus associated haemorrhagic cystitis in children following haematopoietic stem cell transplantation

    Directory of Open Access Journals (Sweden)

    Nikhil Vasdev

    2013-10-01

    Full Text Available Aim: Haemorrhagic cystitis (HC is uncommon and in its severe form potentially life threatening complication of Haematopoietic stem cell transplantation (HSCT in children. We present our single centre experience in the urological management of this clinically challenging condition. Patients and Methods: Fourteen patients were diagnosed with BK-Virus HC in our centre. The mean age at diagnosis was 8.8 years (range, 3.2-18.4 years. The mean number of days post-BMT until onset of HC was 20.8 (range, 1 – 51. While all patients tested urine positive for BKV at the clinical onset of HC, only four patients had viral quantification, with viral loads ranging from 97,000 to >1 billion/ml. 8 patients had clinical HC. Ten patients experienced acute GVHD (grade I: 6 patients, grade II: 3 patients, grade 4: 1 patient.Results: Four patients received medical management for their HC. Treatments included hyperhydration, MESNA, blood and platelet transfusion, premarin and oxybutynin (Table 6.  Two patients received both medical and surgical management which included cystoscopy with clot evacuation, bladder irrigation and supra-pubic catheter insertion. One patient received exclusive surgical management. Seven patients were treated conservatively. Conclusion: There is limited available evidence for other potential therapeutic strategies highlighting the need for more research into the pathophysiology of HSCT-associated HC. Commonly used interventions with possible clinical benefit (e.g. cidofovir, ciprofloxacin still require to be evaluated in multi-centre, high-quality studies. Potential future preventative and therapeutic options, such as modulation of conditioning, immunosuppression and engraftment, new antiviral and anti-inflammatory and less nephrotoxic agents need to be assessed.---------------------------Cite this article as:Vasdev N, Davidson A, Harkensee C, Slatter M, Gennery A, Willetts I, Thorpe A.Urological management (medical and surgical of BK

  4. Reducing produced water leaks and spills by improving industry compliance in British Columbia's natural gas sector

    OpenAIRE

    Notte, Chelsea Althea

    2014-01-01

    The International Energy Association asserts that natural gas is poised to enter a golden age. This is particularly true for British Columbia, which possesses world-class shale gas reserves. Produced water – the water emanating from fracturing shale - is the largest waste stream associated with oil and gas activities. Wastewater associated with natural gas extraction is highly toxic and has serious implications for environmental and human health if spilled or leaked. Because of the corrosive ...

  5. Associations between oral and ocular dryness, labial and whole salivary flow rates, systemic diseases and medications in a sample of older people

    DEFF Research Database (Denmark)

    Smidt, Dorte; Torpet, Lis Andersen; Nauntofte, Birgitte;

    2011-01-01

    Abstract – Objective: To investigate the associations between age, gender, systemic diseases, medications, labial and whole salivary flow rates and oral and ocular dryness in older people. Methods: Symptoms of oral and ocular dryness, systemic diseases, medications (coded according to the Anatomi......Abstract – Objective: To investigate the associations between age, gender, systemic diseases, medications, labial and whole salivary flow rates and oral and ocular dryness in older people. Methods: Symptoms of oral and ocular dryness, systemic diseases, medications (coded according...... to the Anatomical therapeutic chemical (ATC) classification system), tobacco and alcohol consumption were registered, and unstimulated labial (LS) and unstimulated (UWS) and chewing-stimulated (SWS) whole salivary flow rates were measured in 668 randomly selected community-dwelling elderly aged 65–95. Results...

  6. You, too, can be an international medical traveler: Reading medical travel guidebooks

    NARCIS (Netherlands)

    Ormond, M.E.; Sothern, M.

    2012-01-01

    Drawing on literature on self-help and travel guide writing, this paper interrogates five international medical travel guidebooks aimed at encouraging American and British audiences to travel abroad to purchase medical care. These guidebooks articulate a three-step self-help “program” to produce a “

  7. The Learning Objective Catalogue for Patient Safety in Undergraduate Medical Education – A Position Statement of the Committee for Patient Safety and Error Management of the German Association for Medical Education

    Science.gov (United States)

    Kiesewetter, Jan; Gutmann, Johanna; Drossard, Sabine; Gurrea Salas, David; Prodinger, Wolfgang; Mc Dermott, Fiona; Urban, Bert; Staender, Sven; Baschnegger, Heiko; Hoffmann, Gordon; Hübsch, Grit; Scholz, Christoph; Meier, Anke; Wegscheider, Mirko; Hoffmann, Nicolas; Ohlenbusch-Harke, Theda; Keil, Stephanie; Schirlo, Christian; Kühne-Eversmann, Lisa; Heitzmann, Nicole; Busemann, Alexandra; Koechel, Ansgar; Manser, Tanja; Welbergen, Lena; Kiesewetter, Isabel

    2016-01-01

    Background: Since the report “To err is human” was published by the Institute of Medicine in the year 2000, topics regarding patient safety and error management are in the focal point of interest of science and politics. Despite international attention, a structured and comprehensive medical education regarding these topics remains to be missing. Goals: The Learning Objective Catalogue for Patient Safety described below the Committee for Patient Safety and Error Management of the German Association for Medical Education (GMA) has aimed to establish a common foundation for the structured implementation of patient safety curricula at the medical faculties in German-speaking countries. Methods: The development the Learning Objective Catalogue resulted via the participation of 13 faculties in two committee meetings, two multi-day workshops, and additional judgments of external specialists. Results: The Committee of Patient Safety and Error Management of GMA developed the present Learning Objective Catalogue for Patient Safety in Undergraduate Medical Education, structured in three chapters: Basics, Recognize Causes as Foundation for Proactive Behavior, and Approaches for Solutions. The learning objectives within the chapters are organized on three levels with a hierarchical organization of the topics. Overall, the Learning Objective Catalogue consists of 38 learning objectives. All learning objectives are referenced with the National Competency-based Catalogue of Learning Objectives for Undergraduate Medical Education. Discussion: The Learning Objective Catalogue for Patient Safety in Undergraduate Medical Education is a product that was developed through collaboration of members from 13 medical faculties. In the German-speaking countries, the Learning Objective Catalogue should advance discussion regarding the topics of patient safety and error management and help develop subsequent educational structures. The Learning Objective Catalogue for Patient Safety can

  8. The Learning Objective Catalogue for Patient Safety in Undergraduate Medical Education – A Position Statement of the Committee for Patient Safety and Error Management of the German Association for Medical Education

    Directory of Open Access Journals (Sweden)

    Kiesewetter, Jan

    2016-02-01

    Full Text Available Background: Since the report “To err is human” was published by the Institute of Medicine in the year 2000, topics regarding patient safety and error management are in the focal point of interest of science and politics. Despite international attention, a structured and comprehensive medical education regarding these topics remains to be missing.Goals: The Learning Objective Catalogue for Patient Safety described below the Committee for Patient Safety and Error Management of the German Association for Medical Education (GMA has aimed to establish a common foundation for the structured implementation of patient safety curricula at the medical faculties in German-speaking countries. Methods: The development the Learning Objective Catalogue resulted via the participation of 13 faculties in two committee meetings, two multi-day workshops, and additional judgments of external specialists.Results: The Committee of Patient Safety and Error Management of GMA developed the present Learning Objective Catalogue for Patient Safety in Undergraduate Medical Education, structured in three chapters: , and . The learning objectives within the chapters are organized on three levels with a hierarchical organization of the topics. Overall, the Learning Objective Catalogue consists of 38 learning objectives. All learning objectives are referenced with the National Competency-based Catalogue of Learning Objectives for Undergraduate Medical Education.Discussion: The Learning Objective Catalogue for Patient Safety in Undergraduate Medical Education is a product that was developed through collaboration of members from 13 medical faculties. In the German-speaking countries, the Learning Objective Catalogue should advance discussion regarding the topics of patient safety and error management and help develop subsequent educational structures. The Learning Objective Catalogue for Patient Safety can serve as a common ground for an intensified, constructive, subject

  9. Life on the British Ward

    Directory of Open Access Journals (Sweden)

    Sreedhar Krishna

    2009-07-01

    Full Text Available Literally invalid/We sit for hours/The day passes/Daily purposes/ -He phones his wife/She mixes cake/ -Cannot be yours/A small, dumb place/Lacking context/White with a blind contradiction of connection/The sitting room/Hums with boredom/A crippled euphemistic kingdom/Of pills or 'medication'/Meals cooked and crockery washed'/Neighbours': drama mimics life/Has Max left Steph?/Is Skye expecting?/A concept forms unbidden:/This is what 'care' means/ Talk to me!/It doesn't matter what you say -/What are the children doing?/Have they opened the new Arcade?/How did Hillary Clinton do in the primaries?/Is Tescos cheaper than Waitrose?/I will wear a pair of reliable shoes to the wedding/Let's play charades/I will finish the crossword, then play chess/Will you come with me to Bravissimo?/Do you remember The Rolling Stones at Knebworth?/Did you prefer Paul McCartney or John Lennon?/I will tell you off-by-heart my favourite poem;/I haven't always been a lemon./The doctor's care ends this nightmare.

  10. Plasma suPAR levels are associated with mortality, admission time, and Charlson Comorbidity Index in the acutely admitted medical patient

    DEFF Research Database (Denmark)

    Haupt, Thomas Huneck; Petersen, Janne; Ellekilde, Gertrude;

    2012-01-01

    . METHODS: We included 543 patients with various diseases from a Danish Acute Medical Unit during a two month period. A triage unit ensured that only medical patients were admitted to the Acute Medical Unit. SuPAR was measured on plasma samples drawn upon admission. Patients were followed-up for three...... with these endpoints. RESULTS: Increased suPAR was significantly associated with 90-day mortality (4.87 ng/ml in survivors versus 7.29 ng/ml in non-survivors, P

  11. Medication possession ratio associated with short-term virologic response in individuals initiating antiretroviral therapy in Namibia.

    Science.gov (United States)

    Hong, Steven Y; Jerger, Logan; Jonas, Anna; Badi, Alfons; Cohen, Steven; Nachega, Jean B; Parienti, Jean-Jacques; Tang, Alice M; Wanke, Christine; Terrin, Norma; Pereko, Dawn; Blom, Abraham; Trotter, Andrew B; Jordan, Michael R

    2013-01-01

    The visual-analogue scale (VAS), Likert item (rating scale), pills identification test (PIT), and medication possession ratio (MPR) provide estimates of antiretroviral therapy (ART) adherence which correlate with HIV viral suppression. These simple adherence measures are inexpensive and easy to administer; however, require validation and adjustment prior to implementation. The objective of this study was to define the optimal adherence assessment measure in Namibia to identify patients at risk for sub-optimal adherence and poor virologic response 6 months after ART initiation. We conducted a cross-sectional survey in HIV-infected adults receiving ART for 6-12 months prior to the adherence assessment. Adherence measures included 30-day VAS, 30-day Likert item, self-reported treatment interruptions, PIT, and MPR. Association of adherence measures with 6-month HIV-1 RNA level was assessed using two thresholds (1000 copies/mL and 5000 copies/mL). Adherence was assessed in 236 patients, mean age 37.3 years, 54% female. Mean adherence was 98.1% by 30-day VAS, 84.7% by 30-day Likert item, 97.0% by self-reported treatment interruptions, 90.6% by PIT, and 98.8% by MPR. Agreement between adherence measures was poor using kappa statistic. 76% had HIV-1 RNA <1000 copies/ml, and 88% had HIV-1 RNA <5000 copies/ml. MPR (continuous) was associated with viral suppression <5000 copies/ml (p = 0.036). MPR <75% was associated with virologic failure at ≥5000 copies/ml with OR 3.89 (1.24, 12.21), p = 0.013. Adherence was high with all measures. Only MPR, was associated with short-term virologic response, suggesting its cross-culturally utility for early identification of patients at high risk for virologic failure.

  12. Differences in the volume of pharmaceutical advertisements between print general medical journals.

    Directory of Open Access Journals (Sweden)

    Jennifer Gettings

    Full Text Available BACKGROUND: Pharmaceutical advertisements have been argued to provide revenue that medical journals require but they are intended to alter prescribing behaviour and they are known to include low quality information. We determined whether a difference exists in the current level of pharmaceutical advertising in print general medical journals, and we estimated the revenue generated from print pharmaceutical advertising. METHODS: Six print general medical journals in Canada, the United States, and the United Kingdom were sampled between 2007 and 2012. The number of advertisements and other journal content in selected issues of the Canadian Medical Association Journal (CMAJ, Canadian Family Physician (CFP, Journal of the American Medical Association (JAMA, New England Journal of Medicine (NEJM, British Medical Journal (BMJ, and Lancet were determined. Revenue gained from pharmaceutical advertising was estimated using each journal's 2013 advertising price list. FINDINGS: The two Canadian journals sampled (CMAJ, CFP contained five times more advertisements than the two American journals (JAMA, NEJM, and two British journals (BMJ, Lancet (p<0.0001. The estimated annual revenue from pharmaceutical advertisements ranged from £0.025 million (for Lancet to £3.8 million (for JAMA. The cost savings due to revenue from pharmaceutical advertising to each individual subscriber ranged from £0.02 (for Lancet to £3.56 (for CFP per issue. CONCLUSION: The volume of pharmaceutical advertisements differs between general medical journals, with the two Canadian journals sampled containing the most advertisements. International and temporal variations suggest that there is an opportunity for all general medical journals to reduce the number of pharmaceutical advertisements, explore other sources of revenue, and increase transparency regarding sources of revenue.

  13. The ATXN2-SH2B3 locus is associated with peripheral arterial disease: an electronic medical record-based genome-wide association study

    Directory of Open Access Journals (Sweden)

    Iftikhar eKullo

    2014-06-01

    Full Text Available Objectives: In contrast to coronary heart disease, genetic variants that influence susceptibility to peripheral arterial disease (PAD remain unknown. Background: We performed a two-stage genomic association study leveraging an electronic medical record linked-biorepository to identify genetic variants that mediate susceptibility to PAD.Methods: PAD was defined as a resting/post-exercise ankle-brachial index (ABI ≤0.9 or ≥1.4 and/or history of lower extremity revascularization. Controls were patients without history of PAD. In Stage I we performed a genome-wide association analysis adjusting for age and sex, of 561,490 SNPs in 1641 PAD cases (66±11 y, 64% men and 1604 control subjects (61±7 y, 60% men of European ancestry. In Stage II we genotyped the top 48 SNPs that were associated with PAD in Stage I, in a replication cohort of 740 PAD cases (70±11 y, 63% men and 1051 controls (70±12 y, 61% men. Results: The SNP rs653178 in the ATXN2-SH2B3 locus was significantly associated with PAD in the discovery cohort (OR: 1.23; P=5.59x10-5, in the replication cohort (OR=1.22; 8.9x10-4 and in the combined cohort (OR=1.22; P-value: P=6.46x10-7. In the combined cohort this SNP remained associated with PAD after additional adjustment for cardiovascular risk factors including smoking (OR: 1.22; P=2.15x10-6 and after excluding patients with ABI >1.4 (OR: 1.237; P=3.98x10-7. The SNP is in near-complete linkage disequilibrium (r2=0.99 with a missense SNP (rs3184504 in SH2B3, a gene encoding an adapter protein that plays a key role in immune and inflammatory response pathways and vascular homeostasis. The SNP has pleiotropic effects and has been previously associated with multiple phenotypes including myocardial infarction. Conclusions: Our findings suggest that the ATXN2-SH2B3 locus influences susceptibility to PAD.

  14. Associations between self-medication, health literacy, and self-perceived health status: A community-based study

    Directory of Open Access Journals (Sweden)

    Aziz Kamran

    2015-01-01

    Conclusions: Self-medication had a significant relationship with health literacy and health status. Therefore, the design and implementation of training programs are necessary to increase the perception on the risk of self-medication.

  15. Medically unexplained physical symptoms and work functioning over 2 years: their association and the influence of depressive and anxiety disorders and job characteristics

    OpenAIRE

    den Boeft, Madelon; Twisk, Jos W R; Hoekstra, Trynke; Terluin, Berend; Penninx, Brenda W. J. H.; van der Wouden, Johannes C.; Numans, Mattijs E.; van der Horst, Henriette E

    2016-01-01

    Background Medically unexplained physical symptoms (MUPS) are highly prevalent and may affect work functioning. In this study we aimed to assess the longitudinal association between MUPS and work functioning over 2 years and the influence of job characteristics and depressive and anxiety disorders on this association. Methods We assessed the longitudinal association between MUPS and work functioning, operationalized in terms of absenteeism and disability at work, in 1887 working participants ...

  16. Mimulus peregrinus (Phrymaceae: A new British allopolyploid species

    Directory of Open Access Journals (Sweden)

    Mario Vallejo-Marin

    2012-07-01

    Full Text Available Polyploidization plays an important role in species formation as chromosome doubling results in strong reproductive isolation between derivative and parental taxa. In this note I describe a new species, Mimulus peregrinus (Phrymaceae, which represents the first recorded instance of a new British polyploid species of Mimulus (2n = 6x = 92 that has arisen since the introduction of this genus into the United Kingdom in the 1800’s. M. peregrinus presents floral and vegetative characteristics intermediate between M. guttatus and M. luteus, but can be distinguished from all naturalized British Mimulus species and hybrids based on a combination of reproductive and vegetative traits. M. peregrinus displays high pollen and seed fertility as well as traits usually associated with genome doubling such as increased pollen and stomata size. The intermediate characteristics of M. peregrinus between M. guttatus (2n = 2x = 28 and M. luteus (2n = 4x = 60-62, and its close affinity with the highly sterile, triploid (2n = 3x = 44-45 hybrid taxon M. × robertsii (M. guttatus × M. luteus, suggests that M. peregrinus may constitute an example of recent allopolyploid speciation.

  17. [On the problem of traumatic shock associated with a combined injury (based on the materials of one forensic medical expertise)].

    Science.gov (United States)

    Volkov, V P

    2012-01-01

    The author presents the results of the critical analysis of the materials of forensic medical expertise of a case of the serious harm to health that has led to involunry manslaughter. According to the expert opinion, the death resulted from the traumatic shock associated with the combined head and the chest injury. Such conclusion levels out the difference between the two accused persons and their "contribution" to the extent and severity of the inflicted damage to the victim's body; thereby, it equalizes the degree of their guilt and criminal responsibility. The present study showed that such interpretation of tanatogenesis associated with the combined injury is erroneous. The death of the injured person resulted from cerebral coma that developed following a severe craniocerebral injury as a constituent component of the combined trauma. It is emphasized that the thorough investigation of tanatogenesis based on the reliable elucidation of the immediate cause of death makes it possible to avoid poorly substantiated expert conclusions and their potential dire legal consequences.

  18. [On the problem of traumatic shock associated with a combined injury (based on the materials of one forensic medical expertise)].

    Science.gov (United States)

    Volkov, V P

    2012-01-01

    The author presents the results of the critical analysis of the materials of forensic medical expertise of a case of the serious harm to health that has led to involunry manslaughter. According to the expert opinion, the death resulted from the traumatic shock associated with the combined head and the chest injury. Such conclusion levels out the difference between the two accused persons and their "contribution" to the extent and severity of the inflicted damage to the victim's body; thereby, it equalizes the degree of their guilt and criminal responsibility. The present study showed that such interpretation of tanatogenesis associated with the combined injury is erroneous. The death of the injured person resulted from cerebral coma that developed following a severe craniocerebral injury as a constituent component of the combined trauma. It is emphasized that the thorough investigation of tanatogenesis based on the reliable elucidation of the immediate cause of death makes it possible to avoid poorly substantiated expert conclusions and their potential dire legal consequences. PMID:23008956

  19. Analysis of Medical Domain Using CMARM: Confabulation Mapreduce Association Rule Mining Algorithm for Frequent and Rare Itemsets

    Directory of Open Access Journals (Sweden)

    Dr. Jyoti Gautam

    2015-11-01

    Full Text Available In Human Life span, disease is a major cause of illness and death in the modern society. There are various factors that are responsible for diseases like work environment, living and working conditions, agriculture and food production, housing, unemployment, individual life style etc. The early diagnosis of any disease that frequently and rarely occurs with the growing age can be helpful in curing the disease completely or to some extent. The long-term prognosis of patient records might be useful to find out the causes that are responsible for particular diseases. Therefore, human being can take early preventive measures to minimize the risk of diseases that may supervene with the growing age and hence increase the life expectancy chances. In this paper, a new CMARM: Confabulation-MapReduce based association rule mining algorithm is proposed for the analysis of medical data repository for both rare and frequent itemsets using an iterative MapReduce based framework inspired by cogency. Cogency is the probability of the assumed facts being true if the conclusion is true, means it is based on pairwise item conditional probability, so the proposed algorithm mine association rules by only one pass through the file. The proposed algorithm is also valuable for dealing with infrequent items due to its cogency inspired approach.

  20. Truffle diversity (Tuber, Tuberaceae) in British Columbia.

    Science.gov (United States)

    Berch, Shannon M; Bonito, Gregory

    2016-08-01

    To improve baseline data for the developing truffle industry in British Columbia, we compiled existing Tuber species sequences from published and unpublished studies and generated new ITS sequences for truffles belonging to Tuber collected in the province. In doing so, we obtained evidence that 13 species of Tuber occur in the province, including six introduced and seven native species, two of which are putative undescribed species. Of the native species, the Tuber anniae species complex is widely distributed in the province while Tuber beyerlei appears to be much more restricted in distribution. Four of the introduced species have commercial value (Tuber melanosporum, Tuber aestivum, Tuber brumale, and Tuber borchii) as do two of the native species (Tuber gibbosum and Tuber oregonense). Focused sampling on likely tree hosts, both hardwood and Pinaceae species, as well as in currently unexplored parts of the province seems likely to expand our knowledge of the diversity and distribution of Tuber species in British Columbia. PMID:27083929

  1. Thermoluminescence dating of the british coversand deposits

    Science.gov (United States)

    Bateman, M. D.

    Coversand deposits, thought to be of Lateglacial age are found in Britain in North Lincolnshire, South-West Lancashire and Central East Anglia. A comprehensive dating study of them, using thermoluminescence (TL) techniques, is currently underway in an attempt to link the British coversand deposits to the European coversand chronology. Initial results from four of the British coversand sites sampled are presented. The 26 TL dates from 14 samples show that in Lincolnshire aeolian deposition took place from 12.5 ka to I1 ka. Cessation of the initial sand deposition was synchronous with this in Lancashire, but sand deposition occurred significantly earlier in East Anglia. The upper layers of aeolian sand in Lancashire are much younger and are attributed to Holocene reworking. On the basis of these dates, Lincolnshire and Lancashire coversand deposition occurred at a similar time to the Younger Coversand II, whilst East Anglian coversand deposition coincided with the Younger Coversand I phase in the European coversand chronology.

  2. Estimates of Maternal Mortality Ratio and the associated medical causes in Orissa and Rajasthan States - A cross sectional study

    Directory of Open Access Journals (Sweden)

    Abha Rani Aggarwal

    2015-03-01

    Full Text Available Background: Maternal Mortality Ratio (MMR is an important indicator of reproductive health and its reduction remains a challenge in India. Aims &Objective: This study was conducted with the aim of estimating MMR in two states Orissa and Rajasthan having high MMR as well as to identify the associated medical causes of maternal mortality. Material Methods: This survey was conducted from October 2010-June 2012 on a sample of 13 Primary Health Centres (PHCs in Orissa and 15 PHCs in Rajasthan. These numbers have been derived after estimating the total number of live births using MMR and birth rate from Sample Registration System. 1997-2003.An adapted snowball technique was adopted wherein maternal deaths were captured by snowball technique and the numbers of live births were taken from the available records from the various health facilities in the study.  Results: The overall birth rate in Orissa was found to be 19 per 1000 population while in Rajasthan it was 24 per 1000 population. The study revealed that 17% additional maternal deaths could be captured by snowball technique as against the official record. The overall weighted estimate of MMR was 252 per one lakh live births (95% CI: 246-259 per 1,00,000 live births in Orissa and 209 per one lakh live births (95% CI: 207-211 per one lakh live births in Rajasthan. The main causes of maternal deaths were post-partum haemorrhage, anaemia and septicaemia. More than 25% maternal deaths could be attributed to indirect causes including suicide, accident and infectious diseases. Conclusion: There appears to be a positive trend towards reduction of maternal mortality in Orissa and Rajasthan. Greater care is essential to reduce medical as well as incidental causes of death during pregnancy.

  3. "A Powerful Protector of the Japanese People": The History of the Japanese Hospital in Steveston, British Columbia, Canada,1896-1942.

    Science.gov (United States)

    Vandenberg, Helen

    2017-01-01

    From 1896 to 1942, a Japanese hospital operated in the village of Steveston, British Columbia, Canada. For the first 4 years, Japanese Methodist missionaries utilized a small mission building as a makeshift hospital, until a larger institution was constructed by the local Japanese Fishermen's Association in 1900. The hospital operated until the Japanese internment, after the attack on Pearl Harbor during World War II. This study offers important commentary about the relationships between health, hospitals, and race in British Columbia during a period of increased immigration and economic upheaval. From the unique perspective of Japanese leaders, this study provides new insight about how Japanese populations negotiated hospital care, despite a context of severe racial discrimination. Japanese populations utilized Christianization, fishing expertise, and hospital work to garner more equitable access to opportunities and resources. This study demonstrates that in addition to providing medical treatment, training grounds for health-care workers, and safe refuge for the sick, hospitals played a significant role in confronting broader racialized inequities in Canada's past. PMID:27502613

  4. The parliamentary representation of British Muslims

    OpenAIRE

    Martin, Shane

    2010-01-01

    Parliamentary parties in the British House of Commons tend to experience high levels of voting unity with individual MPs only occasionally dissenting from party policy. Although constituency influence has been used extensively to predict legislative behaviour in candidate-centred electoral environments, it is argued here that constituency preferences can, under certain circumstances, shape parliamentary behaviour in a strong-party, weak personal-vote, electoral environment such as the United ...

  5. Hearing care policy analysis in British Columbia

    OpenAIRE

    Fadyeyeva, Inna

    2007-01-01

    Reduced hearing is a wide spread disability. One out of ten British Columbians estimated to suffer from a variable degree of hearing loss (CASLPA, 2005). It is the most common sensory impairment affecting 50 percent of Canadians over 65 (CHHA, 2005). The hearing loss problem is expected to progress from bad to worse due to demographic changes of the society and aging population. Hearing loss problem bears serious consequences for the affected individuals and society as a whole. This paper is ...

  6. The Differences between British and American English

    Institute of Scientific and Technical Information of China (English)

    李进

    2012-01-01

    English is used as one of the most important languages in the world. As a result of the military, economic, scientific, political, and cultural influence, English has been used in many parts of the world, and the most prominent language in international business and science. It is used extensively as a second language and as an oflacial language in Commonwealth countries and many international organizations, and developed to many forms. This paper compares the differences between the British English and American English.

  7. Care credits in the British pension system

    OpenAIRE

    Vlachantoni, Athina

    2009-01-01

    The paper is a brief outline of the first stage of a comparative research project in the role and adequacy of care credits in the British and German pension systems. The provision of care credits has been an essential part of pension reforms around Europe, which significantly changes the prospects of carers to accumulate adequate pension contributions through their life course. But although the policy significance of care credits is due to rise in line with an increasing demand...

  8. Peer Victimization in British Columbia Youth

    OpenAIRE

    Van Blyderveen, Sherry Lynn

    2003-01-01

    Peer victimization is an issue which has recently received considerable attention from the media, the school system, and academic literature. The present study examines a number of expected correlates, both risk factors and outcomes, of peer victimization through the use of the Adolescent Health Survey - II conducted by the McCreary Centre Society in the province of British Columbia. Approximately 25,800 youth, from grades 7 through 12, from various regions of the province completed the quest...

  9. Dystopia in British and American literature

    OpenAIRE

    GODOVANNAYA E; FLEGONTOVA A

    2016-01-01

    The article investigates dystopian fiction in British and American literature as exemplified in the books ‘Brave New world’ by Aldous Huxley and ‘451 Fahrenheit’ by Ray Bradbury. It draws the reader’s attention to the authors’ anxious attitude towards the portrayed events which can be considered to be a warning to future generations. The research mainly concentrates on common features of dystopian novels in both cultures.

  10. A critical history of British earthquakes

    Directory of Open Access Journals (Sweden)

    R. M. W. Musson

    2004-06-01

    Full Text Available This paper reviews the history of the study of historical British earthquakes. The publication of compendia of British earthquakes goes back as early as the late 16th Century. A boost to the study of earthquakes in Britain was given in the mid 18th Century as a result of two events occurring in London in 1750 (analogous to the general increase in earthquakes in Europe five years later after the 1755 Lisbon earthquake. The 19th Century saw a number of significant studies, culminating in the work of Davison, whose book-length catalogue was published finally in 1924. After that appears a gap, until interest in the subject was renewed in the mid 1970s. The expansion of the U.K. nuclear programme in the 1980s led to a series of large-scale investigations of historical British earthquakes, all based almost completely on primary historical data and conducted to high standards. The catalogue published by BGS in 1994 is a synthesis of these studies, and presents a parametric catalogue in which historical earthquakes are assessed from intensity data points based on primary source material. Since 1994, revisions to parameters have been minor and new events discovered have been restricted to a few small events.

  11. The British Model in Britain: Failing slowly

    International Nuclear Information System (INIS)

    In 1990, Britain reorganised its electricity industry to run on competitive lines. The British reforms are widely regarded as successful and the model used provides the basis for reforms of electricity industries worldwide. The main reason for this perception of success is major reductions in the real price of electricity with no reduction in service quality. This paper examines whether the reputation of the British reforms is justified. It concludes that the reputation is not justified and that serious fundamental problems are beginning to emerge. The central question is: have the British reforms resulted in the creation of efficient wholesale and retail markets? On this criterion, the reforms have failed. The wholesale market is dominated by obscure long-term contracts, privileged access to the market and self-dealing within integrated generator/retailers, leaving the spot markets with minimal liquidity and unreliable prices. The failure to develop an efficient wholesale market places the onus on consumers to impose competitive forces on electricity companies by switching regularly. Small consumers will not do this and they are paying too much for their power. For the future, there is a serious risk that the electricity industry will become a weakly regulated oligopoly with a veneer of competition

  12. British Columbia natural gas: Core market policy

    International Nuclear Information System (INIS)

    The core market for natural gas in British Columbia is defined as all natural gas consumers in the residential, institutional, commercial, and industrial sectors not currently purchasing natural gas directly and not exempted from the core market by the British Columbia Utilities Commission (BCUC). The intent of the definition is to include all customers who must be protected by contracts which ensure long-term security of supply and stable prices. Core market customers are excluded from direct natural gas purchase and will be served by distribution utilities. A customer may apply to BCUC to leave the core market; such an application may be approved if it is demonstrated that the customer has adequate long-term natural gas supplies or alternative fuel supplies to protect him from supply interruptions. The non-core market is defined as all large industrial customers who elect to make their own natural gas supply arrangements and who can demonstrate to the BCUC sufficient long-term natural gas supply protection or alternative fuel capability to ensure security of the industry. Non-core market customers have full and open access to the competitive natural gas market. The British Columbia government will not apply its core market policy to other jurisdictions through Energy Removal Certificates

  13. The payment for performance model and its influence on British general practitioners' principles and practice

    Directory of Open Access Journals (Sweden)

    Armando Henrique Norman

    2014-01-01

    Full Text Available This article explores some effects of the British payment for performance model on general practitioners’ principles and practice, which may contribute to issues related to financial incentive modalities and quality of primary healthcare services in low and middle-income countries. Aiming to investigate what general practitioners have to say about the effect of the British payment for performance on their professional ethos we carried out semi-structured interviews with 13 general practitioner educators and leaders working in academic medicine across the UK. The results show a shift towards a more biomedical practice model and fragmented care with nurse practitioners and other health care staff focused more on specific disease conditions. There has also been an increased medicalisation of the patient experience both through labelling and the tendency to prescribe medications rather than non-pharmacological interventions. Thus, the British payment for performance has gradually strengthened a scientific-bureaucratic model of medical practice which has had profound effects on the way family medicine is practiced in the UK.

  14. American Veterinary Medical Association

    Science.gov (United States)

    ... understand and manage their pets' health. Workplace Wellness Workplace Wellness Tools Workplace wellness is good for both ... Ethics that include a broad-based statement on diversity, including gender identity. Wellness & economics take center stage ...

  15. Medical Library Association

    Science.gov (United States)

    ... www.mlanet.org/blog/scanning-the-horizon-emerging-technology-at-your-library-and-in-the-classroom Go ... 9:57AM CDT, Wed Sep 28th, 2016 Miami, Florida Health Sciences Librarian Updated 9:45AM CDT, Wed Sep 28th, ...

  16. Part of the British Mainstream? British Muslim Students and Islamic Student Associations

    Science.gov (United States)

    Song, Miri

    2012-01-01

    In recent years, fear of "the other" has focused particularly on "home grown" second-generation Muslims. In the aftermath of the 7 July 2005 bombings in London, there was particular horror and incredulity expressed about the fact that many of the bombers had been born and raised in Britain, and universities have been increasingly regarded by…

  17. British Energy privatisation - 18 months on

    International Nuclear Information System (INIS)

    The TV advertisement which launched the privatisation of British Energy in the summer of 1996 - but just how successful has that privatisation been? And who has benefited - shareholders? The nuclear industry? Our own workforce? Last year, as reported to PIME 97 that the privatisation itself had been successfully completed - following the restructuring of the UK nuclear generation industry, and the creation of British Energy, a new name in the UK - and world energy scene. In simple terms, that privatisation has certainly succeeded - our share price since privatisation has more than doubled, from 2 pounds to well over 4 ponds. Over the last year, it has consistently outperformed the UK electricity sector - particularly over the last winter; it has also out-performed the FR Share Index over the same period, and in December British Energy became one of the UK top 100 listed companies, included in the FTSE 100 having started life at around number 130. This in turn has meant that a number of high quality institutions have taken a second look at British Energy and begun to invest in us as part of a portfolio of FTSE 100 companies. Our success as a private sector company could only be built on the solid foundation of successes as a nuclear utility. Over the five years from 1992 to 1997, our output went up by 64 as Sizewell B came on line and the AGRs achieved their design load factors at last. Safety remains our top priority, and while our profitability increased, so did our safety ratings - accident frequency rates came down by 60%, and collective radiation exposure to our workforce came down 58%. As a result of all this achievement, coupled with reduction in our total workforce, our productivity went up by over 100% - surely proof that nuclear can succeed in a competitive, deregulated electricity market. For future, it has been even more important to sustain that initial success to grow and develop British Energy as a company. The results are there for all to see. In the

  18. Three types of self-efficacy associated with medication adherence in patients with co-occurring HIV and substance use disorders, but only when mood disorders are present

    Directory of Open Access Journals (Sweden)

    Reif S

    2013-06-01

    Full Text Available Susan Reif,1 Rae Jean Proeschold-Bell,1,2 Jia Yao,1 Sara LeGrand,1,2 Anna Uehara,2 Edgar Asiimwe,2 Evelyn Byrd Quinlivan31Duke Center for Health Policy and Inequalities Research, 2Duke Global Health Institute, Duke University, Durham, NC, 3Center for Infectious Diseases, University of North Carolina Chapel Hill, Chapel Hill, NC, USABackground: Adherence with medication regimens for human immunodeficiency virus (HIV is a life-saving behavior for people with HIV infection, yet adherence is challenging for many individuals with co-occurring substance use and/or mood disorders. Medication-taking self-efficacy, which is the confidence that one can take one's medication as prescribed, is associated with better adherence with HIV medication. However, little is known about the influence that other kinds of self-efficacy have on adherence with HIV medication, especially among HIV-infected individuals with co-occurring substance use and/or mood disorders. We sought to examine the relationship between adherence with HIV medication among substance users and three specific kinds of self-efficacy, ie, one's confidence that one can communicate with medical providers, get support, and manage one's mood. We further sought to examine whether symptoms of depression and anxiety moderate these relationships.Methods: Patients were recruited from three HIV clinics in the southeastern United States as part of an integrated study of treatment for HIV and substance use.Results: We interviewed 154 patients with HIV and substance use who reported taking HIV medications. Based on symptoms of depression and anxiety using the Patient Health Questionnaire-9 and the Hospital Anxiety and Depression Scale-Anxiety, 63% had probable depression and/or anxiety. Higher levels of self-efficacy in provider communication (β = 3.86, P < 0.01, getting needed support (β = 2.82, P < 0.01, and mood management (β = 2.29, P < 0.05 were related to better self-reported adherence with HIV

  19. Employee Voice and Human Resource Management: An Empirical Analysis using British Data

    OpenAIRE

    Alex Bryson; Paul Willman; Rafael Gomez; Tobias Kretschmer

    2007-01-01

    Using British workplace data we examine the relationship between human resource management (HRM) and different forms of employee voice. After controlling for observable establishment characteristics, we find voice and HRM are positively correlated, but this positive association is confined to certain voice regimes. Previous research has found no association between HRM and union voice. However, distinguishing between union-only voice regimes and dual channel (i.e. union and nonunion) voice re...

  20. Weathering the empire: meteorological research in the early British Straits Settlements.

    Science.gov (United States)

    Williamson, Fiona

    2015-09-01

    This article explores meteorological interest and experimentation in the early history of the Straits Settlements. It centres on the establishment of an observatory in 1840s Singapore and examines the channels that linked the observatory to a global community of scientists, colonial officers and a reading public. It will argue that, although the value of overseas meteorological investigation was recognized by the British government, investment was piecemeal and progress in the field often relied on the commitment and enthusiasm of individuals. In the Straits Settlements, as elsewhere, these individuals were drawn from military or medical backgrounds, rather than trained as dedicated scientists. Despite this, meteorology was increasingly recognized as of fundamental importance to imperial interests. Thus this article connects meteorology with the history of science and empire more fully and examines how research undertaken in British dependencies is revealing of the operation of transnational networks in the exchange of scientific knowledge.