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Sample records for british medical response

  1. Medical slang in British hospitals.

    Science.gov (United States)

    Fox, Adam T; Fertleman, Michael; Cahill, Pauline; Palmer, Roger D

    2003-01-01

    The usage, derivation, and psychological, ethical, and legal aspects of slang terminology in medicine are discussed. The colloquial vocabulary is further described and a comprehensive glossary of common UK terms provided in appendix. This forms the first list of slang terms currently in use throughout the British medical establishment.

  2. The British official response to Chernobyl

    International Nuclear Information System (INIS)

    Webster, D.

    1988-01-01

    The author criticizes the British authorities' response to Chernobyl fallout, briefly examines the deficiencies in monitoring arrangements in Scotland, in particular the lack of weather radar cover for that region, and comments on the new National Response Plan and monitoring network, with reference to venison, rainwater, freshwater fish and game, and milk. (U.K.)

  3. British Columbia inland oil spill response plan

    International Nuclear Information System (INIS)

    2005-01-01

    This paper presents an outline of the organization, procedures and duties of the provincial government in response to inland oil spills stemming from pipeline or tank-farm rupture, train derailment and vehicle accidents in British Columbia. Provincial response strategies were reviewed, along with their relationships to various policies and standards. Public, infrastructure and environmental protection were identified as key factors. Incident notification procedures were detailed, including outlines of roles, event criteria and call for incident management teams. Agreements and cost recovery issues were examined. The characteristics of site response were reviewed, including details of communications, tactical planning, and unified command among local and federal governments. The role of First Nations and responsible parties was also addressed. Details of shore cleanup, wildlife rescue, decontamination, and waste handling strategies were presented. The organization, missions and duties for an incident management team were outlined, along with a summary of operational guidelines and information on team positions and the establishment of joint information centres. The involvement of cooperating agencies was examined. An incident command system was also presented, including details of planning, operations, logistics, and organization. A checklist of individual duties was provided, with details of responsibilities, safety issues and general instructions for all team members. tabs., figs

  4. What factors influence British medical students' career intentions?

    Science.gov (United States)

    Ibrahim, Michael; Fanshawe, Angela; Patel, Vanash; Goswami, Karan; Chilvers, Geoffrey; Ting, Michelle; Pilavakis, Yiannis; Rao, Christopher; Athanasiou, Thanos

    2014-12-01

    The aim of this study was to identify factors that influence career choice in UK medical students. Students at seven institutions were invited to rate how important various factors were on influencing their career choices and how interested they were in pursuing different specialties. The influence of interpersonal relationship networks on career choice was also evaluated. 641 responses were collected. 44% (283) were male, 16% (105) were graduates and 41% (263) were final-year students. For Dermatology (p = 0.009), Paediatrics (p = 0.000), Radiology (p = 0.000), Emergency Medicine (p = 0.018) and Cardiothoracic Surgery (p = 0.000), there was a clear correlation between completing a clinical attachment and an interest in pursuing the specialty. Perceived characteristics of the speciality, individually and in clusters were considered important by specific subgroups of students, such as those interested in surgery. These students considered prestige (p = 0.0003), role models (p = 0.014), financial rewards after training (p = 0.0196) and technical challenge (p = 0.0011) as important factors. Demographics such as sex and age played a significant role in career choice. Interpersonal relationship networks do not have a significant influence on career intentions. This study shows that the career intentions of British medical students are influenced by their undergraduate experience and by the weight they place on different specialty-related factors.

  5. Systemic Medication and Intraocular Pressure in a British Population

    Science.gov (United States)

    Khawaja, Anthony P.; Chan, Michelle P.Y.; Broadway, David C.; Garway-Heath, David F.; Luben, Robert; Yip, Jennifer L.Y.; Hayat, Shabina; Wareham, Nicholas J.; Khaw, Kay-Tee; Foster, Paul J.

    2014-01-01

    Objective To determine the association between systemic medication use and intraocular pressure (IOP) in a population of older British men and women. Design Population-based, cross-sectional study. Participants We included 7093 participants from the European Prospective Investigation into Cancer–Norfolk Eye Study. Exclusion criteria were a history of glaucoma therapy (medical, laser, or surgical), IOP asymmetry between eyes of >5 mmHg, and missing data for any covariables. The mean age of participants was 68 years (range, 48–92) and 56% were women. Methods We measured IOP using the Ocular Response Analyzer. Three readings were taken per eye and the best signal value of the Goldmann-correlated IOP value considered. Participants were asked to bring all their medications and related documentation to the health examination, and these were recorded by the research nurse using an electronic case record form. The medication classes examined were angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, α-blockers, β-blockers, calcium channel blockers, diuretics, nitrates, statins, insulin, biguanides, sulfonylureas, aspirin, and other nonsteroidal anti-inflammatory drugs. We examined associations between medication use and IOP using multivariable linear regression models adjusted for age, sex, and body mass index. Models containing diabetic medication were further adjusted for glycosylated hemoglobin levels. Main Outcome Measures Mean IOP of the right and left eyes. Results Use of systemic β-blockers (−0.92 mmHg; 95% CI, −1.19, −0.65; Pnitrates (−0.63 mmHg; 95% CI, −1.12, −0.14; P = 0.011) were independently associated with lower IOP. The observed associations between statin or aspirin use with IOP were no longer significant after adjustment for β-blocker use. Conclusions This is the first population-based study to demonstrate and quantify clinically significant differences in IOP among participants using systemic β-blockers or

  6. 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.

  7. Requirements of British universities for higher medical degrees.

    OpenAIRE

    Johnson, R

    1991-01-01

    OBJECTIVE--To examine the requirements and opportunities for obtaining a doctor of medicine or master of surgery degree from a university in the United Kingdom other than the graduate's own, particularly in the case of foreign graduates. DESIGN--Review of regulations governing the award of doctor of medicine and master of surgery degrees in British universities. SETTING--All 19 universities in the United Kingdom offering clinical courses. MAIN OUTCOME MEASURE--Availability of degrees to gradu...

  8. A cross-cultural comparison of British and Pakistani medical students' understanding of schizophrenia.

    Science.gov (United States)

    Furnham, Adrian; Raja, Nazia; Khan, Umar Ali

    2008-06-30

    This study aimed to compare British, British Pakistani and Native Pakistani (from Pakistan) medical students' beliefs about the manifestation, causes and cures of schizophrenia, prior to any psychiatric training. A total of 305 participants completed a questionnaire on general beliefs about people with schizophrenia, causal explanations concerning the aetiology of schizophrenia and the role of hospitals and society in treating people with schizophrenia. It was predicted that compared with the British and British Pakistanis, the Pakistanis would have more negative beliefs and attitudes, considering people with schizophrenia to be more dangerous and unpredictable; they were also expected to use more superstitious beliefs to explain the cause of schizophrenia and its symptoms; as well as believe more in seeking help from God and faith healers. There was strong evidence to suggest that Pakistanis possessed more negative beliefs and attitudes about people with schizophrenia, but there was no evidence to indicate that Pakistanis believed more in superstitious causal explanations. Pakistanis were more likely to consider seeking help from faith healers, but not God, compared with British Pakistanis and the British. Results confirm previous European-Asian difference in the understanding of the cause, manifestation and cure of schizophrenia. The impact of traditional and Western cultural influences on British Pakistanis is considered.

  9. Mapping "region" in Canadian medical history: the case of British Columbia.

    Science.gov (United States)

    Davies, M J

    2000-11-01

    The notion of "region" can be a valuable analytical tool in the writing of Canadian medical history. This article explores themes in the history of British Columbia that link medicine and regional development. Employing a historiographical sweep from the colonial period to the 1970s, the author considers doctors and imperialism, medical practice and the economy, and the relationship between metropolis and periphery in shaping medical institutions and medical culture in the western province. The intent of the piece is to stimulate thought about the potential of introducing the sense of place into regional medical history in Canada.

  10. [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.

  11. 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.

  12. Systemic medication and intraocular pressure in a British population: the EPIC-Norfolk Eye Study.

    Science.gov (United States)

    Khawaja, Anthony P; Chan, Michelle P Y; Broadway, David C; Garway-Heath, David F; Luben, Robert; Yip, Jennifer L Y; Hayat, Shabina; Wareham, Nicholas J; Khaw, Kay-Tee; Foster, Paul J

    2014-08-01

    To determine the association between systemic medication use and intraocular pressure (IOP) in a population of older British men and women. Population-based, cross-sectional study. We included 7093 participants from the European Prospective Investigation into Cancer-Norfolk Eye Study. Exclusion criteria were a history of glaucoma therapy (medical, laser, or surgical), IOP asymmetry between eyes of >5 mmHg, and missing data for any covariables. The mean age of participants was 68 years (range, 48-92) and 56% were women. We measured IOP using the Ocular Response Analyzer. Three readings were taken per eye and the best signal value of the Goldmann-correlated IOP value considered. Participants were asked to bring all their medications and related documentation to the health examination, and these were recorded by the research nurse using an electronic case record form. The medication classes examined were angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, α-blockers, β-blockers, calcium channel blockers, diuretics, nitrates, statins, insulin, biguanides, sulfonylureas, aspirin, and other nonsteroidal anti-inflammatory drugs. We examined associations between medication use and IOP using multivariable linear regression models adjusted for age, sex, and body mass index. Models containing diabetic medication were further adjusted for glycosylated hemoglobin levels. Mean IOP of the right and left eyes. Use of systemic β-blockers (-0.92 mmHg; 95% CI, -1.19, -0.65; Pnitrates (-0.63 mmHg; 95% CI, -1.12, -0.14; P = 0.011) were independently associated with lower IOP. The observed associations between statin or aspirin use with IOP were no longer significant after adjustment for β-blocker use. This is the first population-based study to demonstrate and quantify clinically significant differences in IOP among participants using systemic β-blockers or nitrates. Lower IOP observed in participants using statins or aspirin was explained by concurrent

  13. Gender, money and professional identity: medical social work and the coming of the British National Health Service.

    Science.gov (United States)

    Gosling, George Campbell

    2018-01-01

    The arrival of the British National Health Service (NHS) in 1948 heralded significant changes for all health workers, but the establishment of a 'free' health service was especially meaningful for the hospital almoners-or medical social workers, as they were starting to be known-who had previously been responsible for the assessment and collection of patient payments. It was on this basis they had gained a foothold in the hospital, capitalising on gendered assumptions of financial understanding and behaviour. Yet what might have caused an identity crisis was embraced. This was a dual strategy of both repositioning the profession in alignment with the planned NHS and of asserting an enhanced professional status by distancing themselves from the handling of payment. It was an episode in the history of this distinctly female profession that speaks to women's historic relationship with money.

  14. First Response to Medical Emergency

    International Nuclear Information System (INIS)

    Manisah Saedon; Sarimah Mahat; Muhamad Nurfalah Karoji; Hasnul Nizam Osman

    2015-01-01

    Accident or medical emergencies, both minor and critical, occurs each day and can happen in any workplace. In any medical emergencies, time is a critical factor because the first person to arrive at the scene of an accident has a key role in the rescue of a victim. With the knowledge of some common medical procedures and emergency actions, this first responder can make a positive contribution to the welfare of the accident victim. In some cases, this contribution can make difference between life and death. Improper response to medical emergencies by an untrained person can result in worsen injuries or death. Therefore, first aids training are necessary to provide the information. (author)

  15. (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.

  16. Report of the BC [British Columbia] Citizens Advisory Committee on Oil Spill Prevention and Response

    International Nuclear Information System (INIS)

    1992-01-01

    The British Columbia Citizens Advisory Committee on Oil Spill Prevention and Response was established in 1991 to advise the provincial government of public concerns over oil spill prevention, preparedness, and response. The Committee also monitors provincial and joint provincial/western USA initiatives in the area. The Committee notes that the volume of oil tanker traffic through navigationally risky passages along the British Columbia coast is large and that prevention is the most useful method in dealing with oil spills. Committee concerns are summarized in the areas of government committment, design and construction of oil tankers and barges, oil spill issues related to ports, the Low Point Terminal proposal, waste oil collection and disposal, spill response capability, the Strait of Georgia Oil Spill Response Information System, the use of volunteer auxiliaries and the Youth Corps in oil spill response, wildlife rescue and rehabilitation, coordination of response activities, and the future of the Committee. Recommendations to the government are made with respect to the aforementioned areas of concern

  17. [Medical ethics and patient responsibility].

    Science.gov (United States)

    Gajda, Z

    1998-01-01

    When we say "medical ethics" we understand the responsibility of the physician for his medical education and his attitude to his patient. But Hippocrates is known to have said that the efficiency and good results of the treatment depends not only on the physician but on the patient and his engagement, his observance of the doctors' advice, his attitude to his own psyche and body, both in health as in illness. This is an ethical problem known to every practitioner, the problem of ethics of the patient, which ought to be more widely disseminated in society.

  18. Different responses of influenza epidemic to weather factors among Shanghai, Hong Kong, and British Columbia.

    Science.gov (United States)

    Wang, Xi-Ling; Yang, Lin; He, Dai-Hai; Chiu, Alice Py; Chan, Kwok-Hung; Chan, King-Pan; Zhou, Maigeng; Wong, Chit-Ming; Guo, Qing; Hu, Wenbiao

    2017-06-01

    Weather factors have long been considered as key sources for regional heterogeneity of influenza seasonal patterns. As influenza peaks coincide with both high and low temperature in subtropical cities, weather factors may nonlinearly or interactively affect influenza activity. This study aims to assess the nonlinear and interactive effects of weather factors with influenza activity and compare the responses of influenza epidemic to weather factors in two subtropical regions of southern China (Shanghai and Hong Kong) and one temperate province of Canada (British Columbia). Weekly data on influenza activity and weather factors (i.e., mean temperature and relative humidity (RH)) were obtained from pertinent government departments for the three regions. Absolute humidity (AH) was measured by vapor pressure (VP), which could be converted from temperature and RH. Generalized additive models were used to assess the exposure-response relationship between weather factors and influenza virus activity. Interactions of weather factors were further assessed by bivariate response models and stratification analyses. The exposure-response curves of temperature and VP, but not RH, were consistent among three regions/cities. Bivariate response model revealed a significant interactive effect between temperature (or VP) and RH (P weather factors in developing a universal model to explain seasonal outbreaks of influenza. However, further research is needed to assess the association between weather factors and influenza activity in a wider context of social and environmental conditions.

  19. The role and responsibilities of top executives with regard to climate change: the British Petroleum case

    International Nuclear Information System (INIS)

    Corinne Gendron; Bernard Girard; Silvester Ivanaj; Vera Ivanaj; Alice Friser

    2017-01-01

    At the same time as they massively exploit conventional energy sources, the main gas and oil companies of the world claim to be involved in the fight against climate change. This article aims to explain this ambiguity by exploring the way CEOs perceive their responsibilities towards society but also towards climate change. In order to do this, parallels are drawn between British Petroleum's public image following its famous Beyond Petroleum campaign, the official speeches of the company's former CEO's before the Deepwater Horizon tragedy, and the key elements of the subsequent disaster management programme. This analysis highlights that the main obstacle to a genuine and sustained environmental commitment from these companies resides in the firm's corporate governance which ensure that the shareholder's interests remain the CEO's number one priority. This implies that convincing shareholders to fight climate change is necessary

  20. Yaws, syphilis, sexuality, and the circulation of medical knowledge in the British Caribbean and the Atlantic world.

    Science.gov (United States)

    Paugh, Katherine

    2014-01-01

    This history of the disease categories "yaws" and "syphilis" explores the interplay between European and African medical cultures in the early modern Atlantic world. The assertion made by both early modern and modern medical authorities, that yaws and syphilis are the same disease, prompts a case study of the history of disease that reflects on a variety of issues in the history of medicine: the use of ideas about contagion to demarcate racial and sexual difference at sites around the British Empire; the contrast between persistently holistic ideas about disease causation in the Black Atlantic and the growth of ontological theories of disease among Europeans and Euro-Americans; and the controversy over the African practice of yaws inoculation, which may once have been an effective treatment but was stamped out by plantation owners who viewed it as a waste of their enslaved laborers' valuable time.

  1. Exposure-response relations of alpha-amylase sensitisation in British bakeries and flour mills

    OpenAIRE

    Nieuwenhuijsen, M. J.; Heederik, D.; Doekes, G.; Venables, K. M.; Newman, T

    1999-01-01

    OBJECTIVES: To describe the levels of exposure to fungal alpha-amylase in British bakeries and flour mills, and to describe the relation between exposure to alpha-amylase and sensitisation to fungal alpha- amylase. METHODS: 495 personal flour dust samples were taken in seven British bakeries and flour mills and analysed for alpha-amylase with an immunoassay. Workers at the sites were asked to fill out questionnaires on work related symptoms, smoking history, and work history, and they w...

  2. Oil and gas in British Columbia : 10 steps to responsible development

    International Nuclear Information System (INIS)

    2004-04-01

    The British Columbia government has proposed to double production of oil and gas, the burning of which causes global warming. West Coast Environmental Law (WCEL) claims there is a strong divide between British Columbia's plans to expand the production and use of fossil fuels, and the international scientific consensus regarding the negative aspects of global warming. The impacts of oil and gas production negatively affect the health of local citizens, First Nations rights and the environment. Offshore oil and gas development could also threaten fisheries and pollute sensitive marine ecosystems. WCEL criticizes the fact that the British Columbia government has streamlined environmental regulations, has laid off compliance monitoring staff, and has given subsidies to the highly profitable oil and gas industry. WCEL argues that the impact of fossil fuel production must be mitigated to limit the damage to lands and people in British Columbia. The organization has proposed 10 recommendations to the British Columbia government. The recommendations focus on impacts of land-based oil and gas development rather than offshore impacts. WCEL claims that adoption of the 10-point mitigation plan is vital for putting British Columbia on the path toward sustainable development. 43 refs

  3. The integration of acupuncture within medicine in the UK--the British Medical Acupuncture Society's 25th anniversary.

    Science.gov (United States)

    Baldry, Peter

    2005-03-01

    Acupuncture was first used in China, probable about 2000 years ago. When acupuncture first arrived in the West in the 17th century, the principles which the Chinese had used to explain its actions were at variance with current scientific knowledge of the body's structure and function. This led to the rejection of acupuncture by the medical profession in the UK, although individual practitioners adopted it with enthusiasm, usually needling the point of maximal tenderness to treat musculoskeletal pain. Acupuncture was more generally accepted in France and Germany, where the pioneering British physician Felix Mann encountered it in the 1950s. He then taught acupuncture to other medical practitioners and organised regular meetings in London, from which the British Medical Acupuncture Society, BMAS, emerged in 1980. The tradition of biannual scientific meetings has continued since then. The Society has many connections with prominent acupuncturists internationally and is a founder member of the International Council of Medical Acupuncture and Related Techniques (ICMART), and has hosted two world congresses. The Society was involved in standardisation of the meridian nomenclature published in 1990. The Society's scientific journal, Acupuncture in Medicine, was founded in 1981 and has gained international recognition, being indexed on several databases. The Society has established regular teaching courses at different levels, which lead to professional qualifications of Certificate and Diploma. The membership is now open to different health professionals, has grown steadily and now stands at nearly 2500. The Society is administered from offices in Cheshire and London. Many individual members have contributed to the Society's characteristic Western 'medical' approach to acupuncture in which needling is seen as a form of neuromuscular stimulation that owes little to traditional meridians or points. The Society has shown a particular interest in acupuncture for myofascial

  4. 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.

  5. Radiation oncology and medical physicists quality assurance in British Columbia Cancer Agency Provincial Prostate Brachytherapy Program.

    Science.gov (United States)

    Keyes, Mira; Morris, William James; Spadinger, Ingrid; Araujo, Cynthia; Cheung, Arthur; Chng, Nick; Crook, Juanita; Halperin, Ross; Lapointe, Vince; Miller, Stacy; Pai, Howard; Pickles, Tom

    2013-01-01

    To describe in detail British Columbia (BC) Cancer Agency (BCCA) Provincial Prostate Brachytherapy (PB) Quality Assurance (QA) Program. The BCCA PB Program was established in 1997. It operates as one system, unified and supported by electronic and information systems, making it a single PB treatment provider for province of BC and Yukon. To date, >4000 patients have received PB (450 implants in 2011), making it the largest program in Canada. The Program maintains a large provincial prospective electronic database with records on all patients, including disease characteristics, risk stratification, pathology, preplan and postimplant dosimetric data, follow-up of prostate-specific antigen, and toxicity outcomes. QA was an integral part of the program since its inception. A formal QA Program was established in 2002, with key components that include: unified eligibility criteria and planning system, comprehensive database, physics and oncologist training and mentorship programs, peer review process, individual performance outcomes and feedback process, structured continuing education and routine assessment of the program's dosimetry, toxicity and prostate-specific antigen outcomes, administration and program leadership that promotes a strong culture of patient safety. The emphasis on creating a robust, broad-based network of skilled providers has been achieved by the program's requirements for training, education, and the QA process. The formal QA process is considered a key factor for the success of cancer control outcomes achieved at BCCA. Although this QA model may not be wholly transferable to all PB programs, some of its key components may be applicable to other programs to ensure quality in PB and patient safety. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

  6. "Mended or ended?" Football injuries and the British and American medical press, 1870-1910.

    Science.gov (United States)

    Park, R J

    2001-01-01

    'Playing Hurt/Playing Tough', a dominant ideology in today's football (soccer, rugby, American 'gridiron'), is by no means new. Many books, monographs, and articles have examined the historical development of these games, but the attention given to them in the medical press during the late 1800s/early 1900s has been overlooked. The Lancet, Journal of the American Medical Association, and other turn-of-the-century medical publications regularly included accounts and descriptions of injuries and deaths. More telling were the many editorials in which physicians in both Britain and the United States expressed enthusiasm while also lamenting the games' physical and morale effects upon players, asking whether 'football' should be mended or ended.

  7. Contentious corporate social responsibility practices by British American tobacco in Cameroon

    Directory of Open Access Journals (Sweden)

    Kingsly Awang Ollong

    2017-06-01

    Full Text Available Since the mid-1980s, tobacco companies have intensified market expansion strategies in several African countries. They have used music to target youths and children. They organised fashion shows to entice women into smoking. They offered kids free cigarettes on the streets and for a very long time undermined efforts by governments to put in place effective tobacco legislation. They actively participated in the smuggling of tobacco products into the continent. Worse still, tobacco companies persuaded some African governments to promote tobacco cultivation as a major source of foreign earnings. And in recent years, the tobacco industry has resorted to using Corporate Social Responsibility (CSR to massage its image and cover its tracks. British American Tobacco (BAT, which is the focus of this paper, had a virtual monopoly in parts of Africa, both in terms of tobacco manufacturing and sales of cigarettes. In eleven African countries BAT had more than a 90% share of the cigarette market. This paper examines some of the health, social and economic impacts of BAT’s activities in Africa from 1985 to 2010 using Cameroon as a case study. The paper concludes that though the full effects of rising tobacco consumption (namely a steep rise in smoking-induced illness and premature death was at the dawn of the 21st century, Africa was already in the grip of a major tobacco epidemic. There is no doubt therefore that, BAT’s heavy footprint on the African continent wreaked havoc on the economy, health and welfare of the people, thus partially contributing to the non-realisation of the Millennium Development Goals (MDGs that were designed to help the world’s poorest people.

  8. British Standard method for determination of ISO speed and average gradient of direct-exposure medical and dental radiographic film/process combinations

    International Nuclear Information System (INIS)

    1983-01-01

    Under the direction of the Cinematography and Photography Standards Committee, a British Standard method has been prepared for determining ISO speed and average gradient of direct-exposure medical and dental radiographic film/film-process combinations. The method determines the speed and gradient, i.e. contrast, of the X-ray films processed according to their manufacturer's recommendations. (U.K.)

  9. The medical response to trench nephritis in World War One.

    Science.gov (United States)

    Atenstaedt, R L

    2006-08-01

    Around the 90-year anniversary of the Battle of the Somme, it is important to remember the international effort that went into responding to the new diseases, which appeared during the First World War, such as trench nephritis. This condition arose among soldiers in spring 1915, characterized by breathlessness, swelling of the face or legs, headache, sore throat, and the presence of albumin and renal casts in urine. It was speedily investigated by the military-medical authorities. There was debate over whether it was new condition or streptococcal nephritis, and the experts agreed that it was a new condition. The major etiologies proposed were infection, exposure, and diet (including poisons). Research pointed to the origin of the disease as being infective rather than toxic, but no definite cause was discovered. A number of labels were given to the disease, including war nephritis. However, trench nephritis was the one used most widely. Trench nephritis was a serious problem for the Allies, leading to 35 000 casualties in the British and 2000 in the American forces. There were also hundreds of deaths. The condition was treated in line with pre-war regimens designed for acute nephritis. No significant preventative methods were implemented for trench nephritis, as there was no consensus regarding causation. The medical response to trench nephritis was largely ineffective, with medical commentators recognizing that there had been a lack of medical progress.

  10. Medical futility: response to critiques.

    Science.gov (United States)

    Schneiderman, L J; Jecker, N S; Jonsen, A R

    1996-10-15

    Six years ago, we proposed a patient benefit-centered definition of medical futility that included both quantitative and qualitative components. We distinguished between an effect of a treatment that is limited to some part of a patient's body and a benefit that improves the patient as a whole. The quantitative portion of our definition stipulated that physicians should regard a treatment as futile if empirical data show that the treatment has less than a 1 in 100 chance of benefiting the patient. The qualitative portion of our definition stipulated that if a treatment merely preserves permanent unconsciousness or cannot end dependence on intensive medical care, physicians should consider the treatment futile. In this paper, we clarify and modify our original proposal and respond to the following major criticisms: 1) Medical futility is simply an attempt to increase the power of the physician over the patient and to repeal recent hard-gained advances in patient autonomy; 2) no professional or societal consensus has been achieved about the definition of futility; 3) futility is a value-laden determination, the usurpation of which by medicine is inappropriate unless only a so-called value-free or strict physiologic definition of futility is used; 4) the concept of futility is not practically useful because empirical treatment data cannot be applied with certainty to any given patient; 5) futility undermines our pluralistic society and threatens, among other things, the free exercise of religion; and 6) because cost considerations will ultimately dictate all such decisions, futility is an unnecessary concept.

  11. Medical response to effects of ionising radiation

    International Nuclear Information System (INIS)

    Crosbie, W.A.; Gittus, J.H.

    1989-01-01

    The proceedings of a conference on 'Medical Response to Effects of Ionising Radiation' in 1989 in the form of nineteen papers published as a book. Topics discussed include radiation accidents at nuclear facilities, the medical management of radiation casualties, the responsibilities, plans and resources for coping with a nuclear accident and finally the long term effects of radiation, including leukaemia epidemiology studies. All papers were selected and indexed separately. (UK)

  12. Personality, lifestyles, alcohol and drug consumption in a sample of British medical students.

    Science.gov (United States)

    Ashton, C H; Kamali, F

    1995-05-01

    Personality characteristics and lifestyle variables were assessed in two cohorts of second-year medical students at the University of Newcastle upon Tyne, UK as part of a psychopharmacology 'teach-in' in 1993 and 1994. The pooled sample included 186 students: 77 men, 109 women, mean age 20.4 +/- 1.8 years. Measures included the Eysenck Personality Questionnaire, the Hospital Anxiety Depression Scale, and a questionnaire concerning consumption of alcohol, tobacco, cannabis and other illicit drugs, and physical exercise. The results were compared, where possible, with a similar survey in Newcastle upon Tyne medical students in 1983 and 1984. Personality variables, prevalence of cigarette smoking, levels of caffeine consumption and participation in sports had not changed significantly over the decade. There appeared to be a modest overall increase in alcohol consumption and in the 1993 and 1994 cohorts of students, 25.5% of those who drank alcohol exceeded recommended low risk levels (comparable data not available for 1983 and 1984). Reported use of cannabis and other illicit drugs had more than doubled, and in the present survey 49.2% of students recorded using cannabis and 22% had tried other illicit drugs. Corresponding figures for 1983 and 1984 were 20.9% for cannabis and 3.3% for other illicit drugs. Anxiety levels were not measured in 1983 and 1984 but in the present survey 39.3% of the students had anxiety ratings within the clinically significant range. The high levels of alcohol consumption and illicit drug use, and the high anxiety ratings, in this sample of medical students are a cause for concern.(ABSTRACT TRUNCATED AT 250 WORDS)

  13. The British Airways Employee Assistance Programme: a community response to a company's problems.

    Science.gov (United States)

    Smith, K G; McKee, A D

    1992-02-01

    Employee Assistance Programmes have developed since the early 1940s, particularly in North America, and are now part of many UK companies benefits packages for their staff (particularly in North America). This article details the development, philosophy, structure and practice of the British Airways Employee Assistance Programme.

  14. Multinational Corporations and British Labour: A Review of Attitudes and Responses.

    Science.gov (United States)

    Gennard, John

    Multinational corporations operating in Great Britain, specifically American industry, are arousing fears on the part of British labor, which can be grouped into these categories: (1) a threat to the job security of union members, (2) a change in the balance of power at the collective bargaining table in favor of the employers, (3) a clash of…

  15. Fertility preservation for medical reasons in girls and women: British fertility society policy and practice guideline.

    Science.gov (United States)

    Yasmin, Ephia; Balachandren, Neerujah; Davies, Melanie C; Jones, Georgina L; Lane, Sheila; Mathur, Raj; Webber, Lisa; Anderson, Richard A

    2018-04-01

    Fertility preservation in the female poses several challenges due to the invasive nature of the techniques available to achieve it. The guideline aims to bring together the evidence available for the measures for fertility preservation and their outcome. The guideline addresses fertility preservation for medical reasons and includes both oncological and non-oncological causes. The techniques that the guideline considers are: (i) embryo and oocyte cryopreservation; (ii) ovarian tissue cryopreservation; (iii) GnRH agonist suppression and (iv) ovarian transposition. Although ovarian tissue cryopreservation is still considered experimental, the availability of this technique is gaining momentum as more live births from auto-transplanted tissue are reported. The guideline also highlights use of current treatment modalities for benign and malignant conditions that have a better fertility sparing profile. The guideline recommends a multidisciplinary approach in counselling women and girls about the risk to their fertility and available techniques. The role of psychological support in assisting women and girls with decision-making is highlighted. The guideline also highlights the risks associated with these techniques. Women need to be medically fit to undergo invasive procedures. Fertility preservation techniques are appropriate when treatment has curative intent. Fertility preservation is a subject of on-going research on outcomes of different techniques and at the time of publication, studies are still likely to emerge adding to the available literature.

  16. Medical ethics and education for social responsibility.

    Science.gov (United States)

    Roemer, M I

    1980-01-01

    The physician, said Henry Sigerist in 1940, has been acquiring an increasingly social role. For centuries, however, codes of medical ethics have concentrated on proper behavior toward individual patients and almost ignored the doctor's responsibilities to society. Major health service reforms have come principally from motivated lay leadership and citizen groups. Private physicians have been largely hostile toward movements to equalize the economic access for people to medical care and improve the supply and distribution of doctors. Medical practice in America and throughout the world has become seriously commercialized. In response, governments have applied various strategies to constrain physicians and induce more socially responsible behavior. But such external pressures should not be necessary if a broad socially oriented code of medical ethics were followed. Health care system changes would be most effective, but medical education could be thoroughly recast to clarify community health problems and policies required to meet them. Sigerist proposed such a new medical curriculum in 1941; if it had been introduced, a social code of medical ethics would not now seem utopian. An international conference might well be convened to consider how physicians should be educated to reach the inspiring goals of the World Health Organization.

  17. 'A band of brothers'-an exploration of the range of medical ethical issues faced by British senior military clinicians on deployment to Afghanistan: a qualitative study.

    Science.gov (United States)

    Bernthal, Elizabeth M; Draper, H J A; Henning, J; Kelly, J C

    2017-06-01

    To identify and explore features of ethical issues that senior clinicians faced as deployed medical directors (DMDs) to the British Field Hospital in Afghanistan as well as to determine the ethical training requirements for future deployments. A qualitative study in two phases conducted from November 2014 to June 2015. Phase 1 analysed 60 vignettes of cases that had generated ethical dilemmas for DMDs. Phase 2 included focus groups and an interview with 13 DMDs. Phase 1 identified working with limited resources, dual conflict of meeting both clinical and military obligations and consent of children as the most prevalent ethical challenges. Themes found in Phase 2 included sharing clinical responsibilities with clinicians from other countries and not knowing team members' ways of working, in addition to the themes from Phase 1. This study has drawn together examples of scenarios to form a repository that will aid future training. Recommendations included undertaking ethics training together as a team before, during and after deployment which must include all nationalities who are assigned to the same operational tour, so that different ethical views can be explored beforehand. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  18. The evolution of colour polymorphism in British winter-active Lepidoptera in response to search image use by avian predators.

    Science.gov (United States)

    Weir, Jamie Conor

    2018-05-10

    Phenotypic polymorphism in cryptic species is widespread. This may evolve in response to search image use by predators exerting negative frequency-dependent selection on intraspecific colour morphs, "apostatic selection". Evidence exists to indicate search image formation by predators and apostatic selection operating on wild prey populations, though not to demonstrate search image use directly resulting in apostatic selection. The present study attempted to address this deficiency, using British Lepidoptera active in winter as a model system. It has been proposed that the typically polymorphic wing colouration of these species represents an anti-search image adaptation against birds. To test (a) for search image driven apostatic selection, dimorphic populations of artificial moth-like models were established in woodland at varying relative morph frequencies and exposed to predation by natural populations of birds. In addition, to test (b) whether abundance and degree of polymorphism are correlated across British winter-active moths, as predicted where search image use drives apostatic selection, a series of phylogenetic comparative analyses were conducted. There was a positive relationship between artificial morph frequency and probability of predation, consistent with birds utilising search images and exerting apostatic selection. Abundance and degree of polymorphism were found to be positively correlated across British Lepidoptera active in winter, though not across all taxonomic groups analysed. This evidence is consistent with polymorphism in this group having evolved in response to search image driven apostatic selection and supports the viability of this mechanism as a means by which phenotypic and genetic variation may be maintained in natural populations. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  19. Accident at Chernobyl and the medical response

    International Nuclear Information System (INIS)

    Geiger, H.J.

    1986-01-01

    The author was in the Soviet Union in early June 1986, leading a medical lecture tour under an exchange program sponsored by Physicians for Social Responsibility. This provided an opportunity for extensive discussions with the Soviet physicians in charge of the medical response to Chernobyl, for a visit to Moscow Hospital number 6, the center of care for those acutely injured for observation of seven acutely irradiated patients and reviews of their clinical courses, and for discussion with the medical teams providing the acute care and planning the necessary long term epidemiologic and environmental investigations. This report is based on information provided by these sources and on data released in Moscow by Robert P. Gale, MD, the American physician from UCLA who, with his associates, flew to the Soviet Union within days to join the team already caring for irradiated victims of the accident

  20. Limits of negligent responsibility for medical malpractice

    Directory of Open Access Journals (Sweden)

    Marin Mrčela

    2017-01-01

    Full Text Available Criminal offence of medical malpractice is one of core medical criminal offences. Protected object is health of patients. Application of inadequate methods in health treatment can have severe consequences for patient’s health, even death. Croatian jurisprudence is familiar with such cases. However, Croatian literature until now did not deal with this sensitive area of criminal law. Scope and limits of responsibility for negligent form of medical malpractice can cause doubts in court’s practice when deciding about criminal liability. This paper is dedicated to this topic. After presentation of main characteristics of this criminal offence, the authors are making an effort to establish criteria for estimation of negligence in case of medical malpractice. They are testing their thesis on one very complicated case from recent Croatian jurisprudence.

  1. Eliminating child labour in Malawi: a British American Tobacco corporate responsibility project to sidestep tobacco labour exploitation.

    Science.gov (United States)

    Otañez, M G; Muggli, M E; Hurt, R D; Glantz, S A

    2006-06-01

    To examine British American Tobacco and other tobacco industry support of the Eliminating Child Labour in Tobacco Growing Foundation. Analyses of internal tobacco industry documents and ethnographic data. British American Tobacco co-founded the Eliminating Child Labour in Tobacco Growing Foundation (ECLT) in October 2000 and launched its pilot project in Malawi. ECLT's initial projects were budgeted at US2.3 million dollars over four years. Labour unions and leaf dealers, through ECLT funds, have undertook modest efforts such as building schools, planting trees, and constructing shallow wells to address the use of child labour in tobacco farming. In stark contrast, the tobacco companies receive nearly US40 million dollars over four years in economic benefit through the use of unpaid child labour in Malawi during the same time. BAT's efforts to combat child labour in Malawi through ECLT was developed to support the company's "corporate social responsibility agenda" rather than accepting responsibility for taking meaningful steps to eradicate child labour in the Malawi tobacco sector. In Malawi, transnational tobacco companies are using child labour projects to enhance corporate reputations and distract public attention from how they profit from low wages and cheap tobacco.

  2. A grim contradiction: the practice and consequences of corporate social responsibility by British American Tobacco in Malaysia.

    Science.gov (United States)

    Barraclough, Simon; Morrow, Martha

    2008-04-01

    In the wake of the World Health Organization Framework Convention on Tobacco Control, corporate social responsibility (CSR) is among the few remaining mechanisms for tobacco corporations publicly to promote their interests. Health advocates may be unaware of the scale, nature and implications of tobacco industry CSR. This investigation aimed to construct a typology of tobacco industry CSR through a case study of the evolution and impact of CSR activities of a particular tobacco corporation in one country - British American Tobacco, Malaysia (BATM), the Malaysian market leader. Methods included searching, compiling and critically appraising publicly available materials from British American Tobacco, BATM, published literature and other sources. The study examined BATM's CSR strategy, the issues which it raises, consequences for tobacco control and potential responses by health advocates. The investigation found that BATM's CSR activities included assistance to tobacco growers, charitable donations, scholarships, involvement in anti-smuggling measures, 'youth smoking prevention' programs and annual Social Reports. BATM has stated that its model is predominantly motivated by social and stakeholder obligations. Its CSR activities have, however, had the additional benefits of contributing to a favourable image, deflecting criticism and establishing a modus vivendi with regulators that assists BATM's continued operations and profitability. It is imperative that health advocates highlight the potential conflicts inherent in such arrangements and develop strategies to address the concerns raised.

  3. Medical response to radiation emergencies in Argentina

    International Nuclear Information System (INIS)

    Gisone, Pablo A.; Perez, Maria del R.; Dubner, Diana L.; Michelin, Severino C.; Vazquez, M.; Demayo, O.

    2006-01-01

    Although radiation accidents are not frequent, the increasing use of radioisotopes in medicine and industry increases the likelihood of such accidental situations. Additionally, risks posed by the malevolent use of radiation sources have been highlighted during the last few years. In this context, the enhancement of national capabilities for medical assistance of victims in radiation emergencies becomes relevant. This communication describes the organization of medical response to radiation emergencies existing in Argentina. A three-level system for medical response has been developed: pre-hospital response given on-site by local emergency services, assistance provided by emergency departments of local general hospitals and central reference hospitals for treatment of acute radiation syndrome, cutaneous radiation syndrome and internal contamination. An education and training program is regularly executed at the three levels, including theoretical background as well as practical training. Guidelines and protocols for medical handling of victims have been elaborated and implemented. Research and development of new strategies for diagnosis and treatment of radiation injuries are promoted by ARN in close collaboration with physicians belonging to reference hospitals. (author)

  4. Responsibility structure in medical radiation applications

    International Nuclear Information System (INIS)

    Beekman, Z.M.

    1989-01-01

    The author discusses the various aspects of the responsibilities of physicians and clinical physicists with regard to radiation protection in medical applications of ionizing radiation. It becomes still clearer that the physician, who carries out the examination or the treatment, also has to bear the responsibility. this holds for the indication assessment as well as for optimization of the quality of the examination or treatment versus radiation burden of the patient, radiologic worker and thirds. Further it is clear that the physician in these will have to delegate specific tasks and responsibilities, whether or not in the elongated-arm construction. The clinical physicist is responsible in particular for the applications of the physical methods and watches the quality of the apparatus and methods used. As such he also is responsible for the technical workers, who take care of the preventive and corrective maintenance. The principal responsibility of the clinical physicist however lies in the field of standardization and calibration of medical-physical instruments. Besides this investigation into and development of new techniques, methods and apparatus come up, while also education and training of various profession groups involved need attention. (author). 6 refs.; 1 tab

  5. The UK medical response to the Sichuan earthquake.

    Science.gov (United States)

    Redmond, A D; Li, J

    2011-06-01

    At 14:48 on 12 May 2008 an earthquake of magnitude 8.0 struck the Wenchuan area of Sichuan province, China. A decision to offer/receive UK medical assistance was agreed at a Sino/British political level and a medical team was despatched to the earthquake area. This study describes the team's experience during the immediate aftermath of the earthquake and the following 18 months, during which there have been joint developments in emergency medicine, disaster planning/preparedness and the management of spinal cord injury. The long-term disability following sudden onset natural disaster and the wider impact on healthcare delivery may prove to be a greater burden to the country than the immediate medical needs, and, accordingly, emergency international aid may need to widen its focus. Although international teams usually arrive too late to support resuscitative measures, they can respond to specific requests for specialised assistance, for example plastic and reconstructive surgery to assist with the ongoing management of complex injury, relieve those who have worked continuously through the disaster, and when required maintain routine day-to-day services while local staff continue to manage the disaster. The timing of this does not necessarily need to be immediate. To maximise its impact, the team planned from the outset to build a relationship with Chinese colleagues that would lead to a sharing of knowledge and experience that would benefit major incident responses in both countries in the future. This has been established, and the linkage of emergency humanitarian assistance to longer term development should be considered by others the next time international emergency humanitarian assistance is contemplated.

  6. Urgent medical response in CBR incidents

    International Nuclear Information System (INIS)

    Castulik, P.; Slabotinsky, J.; Kralik, L.; Bradka, S.

    2009-01-01

    During CBR incidents with releases of hazardous materials (HazMat), there is extremely urgent aim of first rescuing responders to safe the life for as much as possible victims and reducing health consequences from the exposure of the HazMat. Highest priority of the response is to be applied, if victims are exposed with chemicals through their airways and/or mucous membranes. There is general approach in the emergency medical services (EMS) stated that the victims being in critical status have to receive emergency medical care on-site even prior the transportation to a medical facility. However, in a case of CBR events the EMS prefer to provide the First Aid for victims to be already decontaminated as mass casualties, e.g. by the firemen and transferred to a safe zone. This approach is to be time consuming and thus creating delays in medical care not in the favor of a victim's successful survival. In order to overcome this approach, there are needs for eminent ceasing of the victims exposure, protection of breathing tract/ventilation support and administration of antidotes, if available. All this have to be done in shortest time since HazMat incident/accident occurs. This presentation is focusing on emergency provisions for saving victims directly in contaminated environment through the assistance by responders, concentrating on search and rescue of victims, their emergency decontamination, breathing protection, clothing removal, ventilation support, antidote administration, fixing and bandage of trauma injuries prior transportation and/or mass decontamination. This experience is shared based on a field exercise with the EMS volunteers (Red Cross), fire brigade volunteers and university's students.(author)

  7. Medical Response in Radiation Emergency in Argentina

    International Nuclear Information System (INIS)

    Vazquez, M.A.; Tadic, M.M.

    2011-01-01

    According to the Nuclear Federal Law No. 24804, the Nuclear Regulatory Authority (ARN) is empowered to regulate and control the nuclear activity with regard to radiological and nuclear safety, physical protection and nuclear non-proliferation issues. ARN has a system for intervention in radiological -and nuclear emergencies with a primary intervention group, which is on duty in weekly shifts all year round. This paper aims at describing the system as implemented at present. The Emergency Medical System has been developed into three levels: Level I: local emergency services. This level includes triage (conventional and radiological), first-aid care, and first management of contaminated victims Level II: emergency departments of local general hospitals that are in charge of performing a second triage by a biomedical approach, the treatment of conventional and/or radiocombined injuries and completing decontamination as necessary. In this way the initial triage is completed by a physical examination, timing and severity of prodromal signs and symptoms, sequential blood counts and serum enzymatic levels that allow a first-stage dosimetric approach at this level. Victims requiring higher complexity assistance shall be transferred to third-level hospitals. Level III: three central reference hospitals (Hospital Naval 'Pedro Mallo', Hospital de Quemados from Gobierno Autonomo de la Ciudad de Buenos Aires and Hospital Britanico de Ciudad de Buenos Aires) capable of providing healthcare for diagnosis and treatment of acute radiation syndrome, cutaneous radiation syndrome and internal contamination constitute this level. An educational program for medical and paramedical responders is regularly carried out at the three levels, including theoretical background as well as practical training. Guidelines and protocols for medical handling of victims have been drawn up. Research and development of new strategies for first medical response, diagnosis and treatment of radiation

  8. Medical response in radiation emergency in Argentina

    International Nuclear Information System (INIS)

    Vazquez, Marina A.; Tadic, Maria M.

    2008-01-01

    According to the Nuclear Federal Law Nr. 24804, the Nuclear Regulatory Authority (ARN) is empowered to regulate and control the nuclear activity with regard to radiological and nuclear safety, physical protection and nuclear non-proliferation issues. ARN has a system for intervention in radiological -and nuclear emergencies with a primary intervention group, which is on duty in weekly shifts all year round. This paper aims at describing the system as implemented at present. The Emergency Medical System has been developed into three levels: Level I: local emergency services. This level includes triage (conventional and radiological), first-aid care, and first management of contaminated victims. Level II: Emergency departments of local general hospitals that are in charge of performing a second triage by a biomedical approach, the treatment of conventional and/or radio-combined injuries and completing decontamination as necessary. In this way the initial triage is completed by a physical examination, timing and severity of prodromal signs and symptoms, sequential blood counts and serum enzymatic levels that allow a first-stage dosimetric approach at this level. Victims requiring higher complexity assistance shall be transferred to third-level hospitals. Level III: three central reference hospitals (Hospital Naval 'Pedro Mallo', Hospital de Quemados from Gobierno Autonomo de la Ciudad de Buenos Aires and Hospital Britanico de Ciudad de Buenos Aires) capable of providing health care for diagnosis and treatment of acute radiation syndrome, cutaneous radiation syndrome and internal contamination constitute this level. An educational program for medical and paramedical responders is regularly carried out at the three levels, including theoretical background as well as practical training. Guidelines and protocols for medical handling of victims have been drawn up. Research and development of new strategies for first medical response, diagnosis and treatment of radiation

  9. British passports

    CERN Multimedia

    IT Department

    2008-01-01

    Please note that from 01/01/2009, the passport section of the British Consulate will move from Geneva to Paris. This change is part of a global initiative to rationalize passport services and reduce administrative costs while ensuring that the quality of the service remains high. The aim is to issue new passports within 10 working days of receiving applications (excluding transit time). From 1st January 2009 passport applications should be sent by courier or registered post directly to: British Consulate General BP111-08 75363 Paris CEDEX 08 France For further information please refer to: http://ukinswitzerland.fco.gov.uk/en/passports/passport-move/

  10. NASA Medical Response to Human Spacecraft Accidents

    Science.gov (United States)

    Patlach, Robert

    2011-01-01

    This slide presentation reviews NASA's role in the response to spacecraft accidents that involve human fatalities or injuries. Particular attention is given to the work of the Mishap Investigation Team (MIT), the first response to the accidents and the interface to the accident investigation board. The MIT does not investigate the accident, but the objective of the MIT is to gather, guard, preserve and document the evidence. The primary medical objectives of the MIT is to receive, analyze, identify, and transport human remains, provide assistance in the recovery effort, and to provide family Casualty Coordinators with latest recovery information. The MIT while it does not determine the cause of the accident, it acts as the fact gathering arm of the Mishap Investigation Board (MIB), which when it is activated may chose to continue to use the MIT as its field investigation resource. The MIT membership and the specific responsibilities and tasks of the flight surgeon is reviewed. The current law establishing the process is also reviewed.

  11. Targeting brains, producing responsibilities: the use of neuroscience within British social policy.

    Science.gov (United States)

    Broer, Tineke; Pickersgill, Martyn

    2015-05-01

    Concepts and findings 'translated' from neuroscientific research are finding their way into UK health and social policy discourse. Critical scholars have begun to analyse how policies tend to 'misuse' the neurosciences and, further, how these discourses produce unwarranted and individualizing effects, rooted in middle-class values and inducing guilt and anxiety. In this article, we extend such work while simultaneously departing from the normative assumptions implied in the concept of 'misuse'. Through a documentary analysis of UK policy reports focused on the early years, adolescence and older adults, we examine how these employ neuroscientific concepts and consequently (re)define responsibility. In the documents analysed, responsibility was produced in three different but intersecting ways: through a focus on optimisation, self-governance, and vulnerability. Our work thereby adds to social scientific examinations of neuroscience in society that show how neurobiological terms and concepts can be used to construct and support a particular imaginary of citizenship and the role of the state. Neuroscience may be leveraged by policy makers in ways that (potentially) reduce the target of their intervention to the soma, but do so in order to expand the outcome of the intervention to include the enhancement of society writ large. By attending as well to more critical engagements with neuroscience in policy documents, our analysis demonstrates the importance of being mindful of the limits to the deployment of a neurobiological idiom within policy settings. Accordingly, we contribute to increased empirical specificity concerning the impacts and translation of neuroscientific knowledge in contemporary society whilst refusing to take for granted the idea that the neurosciences necessarily have a dominant role (to play). Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  12. The influence of life history traits on the phenological response of British butterflies to climate variability since the late-19th century

    OpenAIRE

    Brooks, Stephen J.; Self, Angela; Powney, Gary D.; Pearse, William D.; Penn, Malcolm; Paterson, Gordon L.J.

    2017-01-01

    Many species of plants and animals have advanced their phenology in response to climate warming in recent decades. Most of the evidence available for these shifts is based on data from the last few decades, a period coinciding with rapid climate warming. Baseline data is required to put these recent phenological changes in a long-term context. We analysed the phenological response of 51 resident British butterfly species using data from 83 500 specimens in the collections of the Natural Histo...

  13. A content analysis of the UK press response to the diagnosis of Ebola in a British healthcare worker.

    Science.gov (United States)

    Hobbs, Constance; Myles, Puja; Pritchard, Catherine

    2017-12-01

    The Ebola epidemic led to considerable media attention, which may influence public risk perception. Therefore, this study analysed the UK press response following diagnosis of a British healthcare worker (HCW) with Ebola. Using the Nexis database, the frequency of Ebola-related articles in UK national newspaper articles was mapped. This was followed by a content analysis of Ebola-related articles in the four newspapers with highest UK net readership from November 2014 to February 2015. During the 16-week study period, 1349 articles were found. The day with the highest number of Ebola-related articles was 31 December 2014, the day after the diagnosis of Ebola in a UK HCW. Seventy-seven articles were included in the content analysis. Content analysis demonstrated a shift from West African to UK-focused articles, increased discussion of border control, UK policy decisions and criticism, and an increased number of articles with a reassuring/threatening message. UK press coverage of Ebola increased following a HCW's diagnosis, particularly regarding discussion of screening measures. This is likely to have increased risk perception of Ebola in the UK population and may have contributed to subsequent strengthening of UK screening policy beyond World Health Organisation requirements. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  14. [Medical professionalism-on social responsibilities viewed from historical perspective].

    Science.gov (United States)

    Kim, Jang Han

    2015-03-01

    What is medical professionalism and does it matter to the patients? Medical professionals take responsibility for their judgements and the consequences that ensue. Traditionally medical professionalism is defined as a set of values, behaviors, and relationships which support the trust the public has in doctors. The public is well aware that absence of professionalism is harmful to their interests. However, the exercise of medical professionalism is endangered by the political and cultural environment. The values of professionalism have been changed throughout the medical history and the meaning of it was also changed according to social theories. Traditional medical professionalism was based on the virtue of autonomy, self-regulation and competency etc. However, in the new millenium era, the meaning of professionalism has changed under the concept of responsibility which includes the classical virtues. The meaning of professionalism nowadays is only based on the structure and conflicting theories which cannot solve all the issues surrounding professionalism in medical practice. The conditions of medical practice are critical determinants for the future of professionalism. The interaction between doctor and patient is central to the medical care, and medical professionalism has roots in almost every aspect of medical care. I argue that doctors have responsibility to act according to the values which have been determined by the medical profession, history and surrounding society. The new millennium medical professionalism which based on the responsibility could initiate a public dialogue about the role of the doctor in creating a fairer society.

  15. Against medical ethics: a response to Cassell

    OpenAIRE

    Seedhouse, David

    1998-01-01

    This paper responds to Dr Cassell's request for a fuller explanation of my argument in the paper, Against medical ethics: a philosopher's view. A distinction is made between two accounts of ethics in general, and the philosophical basis of health work ethics is briefly stated. The implications of applying this understanding of ethics to medical education are discussed.

  16. Medicalization of HIV and the African Response

    African Journals Online (AJOL)

    AJRH Managing Editor

    disorder, and having it treated to improve the experience and quality of life of the affected individual, is a key benefit of medicalization. Numerous examples exist where medicalization of certain problems previously confined to socio- cultural circles has helped in finding solutions. For example, Alzheimer's, a previously ...

  17. Chinese experience on medical response to radiation emergencies

    International Nuclear Information System (INIS)

    Liu, Ying; Qin, Bin; Lei, Cuiping; Chen, Huifang; Han, Yuhong

    2008-01-01

    Full text: Chinese Center for Medical Response to Radiation Emergency (CCMRRE) was established in 1992, based on the National Institute for Radiological Protection, China CDC (NIRP, China CDC). CCMRRE is a liaison of WHO/REMPAN and functions as a national and professional institute for medical preparedness and response to emergencies involving radioactive material. CCMRRE participates in drafting National Medical Assistant Program for Radiation Emergency and relevant technical documents, develops preventive measures and technique means of medical preparedness and response to radiation emergency. CCMRRE is responsible for medical response to radiological or nuclear accident on national level. CCMRRE holds training courses, organizes drills and provides technical support to local medical organizations in practicing medical preparedness and response to radiation emergency. CCMRRE collects, analyzes and exchanges information on medical response to radiological and nuclear emergency and establishes relevant database. CCMRRE also guides and participates in radiation pollution monitoring on accident sites. In the past ten years, we accumulate much knowledge and experience on medical response to radiation emergencies. In this context, we will discuss Xinzhou Accident, which took place in 1992 and involved in three deaths, and Ha'erbin Accident that took place in 2005 and involved one death. A father and two brothers in Xinzhou Accident died of over-exposed to 60 Co source and misdiagnosis and improper treatment, which indicates that most general practitioners are uncertain about the health consequences of exposure to ionizing radiation and the medical management of exposed patients. When Ha'erbin Accident happened in 2005, the local hospital gave the right diagnosis and treatment based on the clinic symptoms and signs, which prevent more people suffering from over-expose to 192 Ir source. The distinct changes comes from the education and training to primary doctors related

  18. [Delegation of medical responsibilities to non-medical personnel. Options and limits from a legal viewpoint].

    Science.gov (United States)

    Ulsenheimer, K

    2009-05-01

    Increasing specialization and growing mechanization in medicine have strongly supported the transfer of originally medical responsibilities to non-medical personnel. The enormous pressure of costs as a result of limited financial resources in the health system make the delegation of previously medical functions to cheaper non-medical ancillary staff expedient and the sometimes obvious lack of physicians also gains importance by the delegation of many activities away from medical staff. In the German health system there is no legal norm which clearly and definitively describes the field of activity of a medical doctor. Fundamental for a reform of the areas of responsibility between physicians and non-medical personnel is a terminological differentiation between instruction-dependent, subordinate, non-independent assistance and the delegation of medical responsibilities which are transferred to non-medical personnel for independent and self-determined completion under the supervision and control of a physician. The inclination towards risk of medical activities, the need of protection of the patient and the intellectual prerequisites required for carrying out the necessary measures define the limitations for the delegation of medical responsibilities to non-medical ancillary staff. These criteria demarcate by expert assessment the exclusively medical field of activity in a sufficiently exact and convincing manner.

  19. Response to Skinner, et al. on "National personality characteristics: II. Adaption-innovation in Canadian, American, and British samples".

    Science.gov (United States)

    Jenkins, Iwan

    2005-08-01

    Skinner, et al. interpreted as significant the difference between means for Canadian men and women on Kirton's inventory and those for British and American samples. The means were similar to prior values. Skinner, et al.'s groups were large and composed of very unequal numbers of men and women, which factors could account for their interpretation. As reported, their analysis is insufficient to interpret very small mean variations as differences in national character.

  20. Profit shifting in the Norwegian and British petroleum industry: Differentiating between the real and shifting response to tax changes

    OpenAIRE

    Vada, Helene

    2016-01-01

    In this master’s thesis, I explain the concept of profit shifting within multinational enterprises and investigate whether petroleum companies on the Norwegian and British continental shelves engage in tax motivated profit shifting, by applying ordinary least squares and company fixed effects estimation. To be able to distinguish between traditional tax distortions and profit shifting, I extend the model developed by James R. Hines and Eric M. Rice in their 1994 article “Fiscal Paradise: Fore...

  1. The early medical response to the Goiania accident

    International Nuclear Information System (INIS)

    Valverde, N.J.; Oliveira, A.R.

    2000-01-01

    The Goiania accident was the most severe radiological one that ever happened in the western hemisphere. The response to its human, social, environmental, economical and psychological burdens represented a huge challenge. Thanks to a multi-institutional intervention the consequences of the accident were greatly minimised. The medical response followed the same pattern and was based on a three-level system of progressive assistance. The early medical response encompassed medical and 'radiological' triage, admission to a specially prepared ward of a local hospital and treatment at a reference center in Rio de Janeiro. (author)

  2. Planning the medical response to radiological accidents

    International Nuclear Information System (INIS)

    1998-01-01

    Radioactive substances and other sources of ionizing radiation are used to assist in diagnosing and treating diseases, improving agricultural yields, producing electricity and expanding scientific knowledge. The application of sources of radiation is growing daily, and consequently the need to plan for radiological accidents is growing. While the risk of such accidents cannot be entirely eliminated, experience shows that most of the rare cases that have occurred could have been prevented, as they are often caused by human error. Recent radiological accidents such as those at Chernobyl (Ukraine 1986), Goiania (Brazil 1987), San Salvador (El Salvador 1989), Sor-Van (Israel 1990), Hanoi (Viet Nam 1992) and Tammiku (Estonia 1994) have demonstrated the importance of adequate preparation for dealing with such emergencies. Medical preparedness for radiological accidents must be considered an integral part of general emergency planning and preparedness and established within the national framework for radiation protection and safety. An IAEA Technical Committee meeting held in Istanbul in 1988 produced some initial guidance on the subject, which was subsequently developed, reviewed and updated by groups of consultants in 1989, 1992 and 1996. Special comments were provided by WHO, as co-sponsor of this publication, in 1997. This Safety Report outlines the roles and tasks of health authorities and hospital administrators in emergency preparedness for radiological accidents. Health authorities may use this document as the basis for their medical management in a radiological emergency, bearing in mind that adaptations will almost certainly be necessary to take into account the local conditions. This publication also provides information relevant to the integration of medical preparedness into emergency plans

  3. Medical response to the radioinduced burns

    International Nuclear Information System (INIS)

    Portas, Mercedes

    2001-01-01

    For over two years the Hospital for Burns in Buenos Aires has been studying the burns caused by radiation, in accordance to an agreement with the Nuclear Regulatory Authority (ARN) of Argentina. The analysis of each case showed the importance of the differential diagnosis from conventional injuries, of this early diagnosis depends the possibility of treatment from the 0 (zero) hour (time at which the accident took place) and achieve the wound healing with the best possible treatment, weather it is medical or surgical in nature. The Hospital's medical staff has developed the necessary skills to recognize this type of burns from an early stage. Most patients arrive to the consultation on their own accord due to the general practitioners inability to correctly diagnose the wounds appeared after radiotherapy has been applied. In this article, we present the general guidelines that the doctors of the Hospital for Burns follow in the presence of radio inducted injuries, objectifying the ethiopathogenic differences of the various burns. (author)

  4. Medical response to a nuclear accident

    International Nuclear Information System (INIS)

    Nenot, J.C.

    1990-01-01

    The medical handling of a severely irradiated casualty is similar to the treatment of aplasia when caused by medical diseases. The diagnosis and prognosis depend on the level of the dose absorbed by the bone marrow, which is one of the most sensitive organ to radiation, as well on the distribution of the exposure within the body and its distribution in time. Spontaneous repair from isolated patches may be sufficient for the repopulation of deserted marrow; in such cases, bone marrow grafting should not be considered as it would be hazardous. In most case the hematopoietic deficiency will be corrected by substitution therapy, mainly based on transfusions of red cells and platelets, completed with a severe prevention - and treatment when necessary - of infection resulting from immune deficiency. When large groups of individuals are involved, special attention should be given to early diagnosis through an appropriate triage, dividing the victims into main categories such as the individuals with combined injuries, the individuals likely to have received high doses and the individuals likely to have received low doses. The first classification into dose levels categories can be based on clinical signs and hematological symptoms

  5. The appropriateness of emergency medical service responses in the ...

    African Journals Online (AJOL)

    The appropriateness of emergency medical service responses in the eThekwini district of KwaZulu-Natal, South Africa. PR Newton, R Naidoo, P Brysiewicz. Abstract. Introduction. Emergency medical services (EMS) are sometimes required to respond to cases that are later found not to be emergencies, resulting in high ...

  6. Insurance of professional responsibility at medical aid rendering

    Directory of Open Access Journals (Sweden)

    Abyzova N.V.

    2011-12-01

    Full Text Available The article discusses the necessity of adoption of professional responsibility insurance act into the public health service. It is considered as the basic mechanism of compensation in case of damage to a patient at medical aid rendering

  7. A Strategic Look at the Federal Medical Response to Disasters

    National Research Council Canada - National Science Library

    Hutson, Vivian T

    2007-01-01

    ...), which has a mission of medical response to supplement state and local healthcare resources, evacuation of patients from the disaster area, and the provision of definitive care hospital beds to care for victims...

  8. Offloading social care responsibilities: recent experiences of local voluntary organisations in a remote urban centre in British Columbia, Canada.

    Science.gov (United States)

    Hanlon, Neil; Rosenberg, Mark; Clasby, Rachael

    2007-07-01

    Services offered by voluntary organisations are an integral but often overlooked component of health and social care. Of late, there has been a renewed interest in voluntary welfare provision as a viable alternative to state and market. Recent developments in welfare provision in Canada appear to have brought greater social care roles for the voluntary sector at the same time as new and arguably more restrictive funding and accountability mechanisms are being imposed by different arms of the state. To explore these issues more closely, the present paper examines the impressions and experiences of voluntary and formal sector providers of services for senior citizens and people with disabilities in a remote urban centre (population less than 100 000) in the interior of British Columbia, Canada. Two important operational pressures provide the context of the analysis: (1) reform of provincial government funding and regulation of voluntary services; and (2) the restructuring of welfare provision, especially in the areas of health care and social services. The authors found evidence of an escalating incursion of the state into local voluntary sector affairs that needs to be understood in the context of long-standing institutional links between government and 'professional' voluntary welfare provision in British Columbia. The results point to three important directions in contemporary local voluntary provision: (1) an emerging ethos of accountability, efficiency and competition in voluntary provision; (2) increasing pressure to centralise volunteer services; and consequently, (3) the potential erosion of flexibility and personalisation that are seen to characterise the voluntary sector.

  9. The Importance of the Medical Record: A Critical Professional Responsibility.

    Science.gov (United States)

    Ngo, Elizabeth; Patel, Nachiket; Chandrasekaran, Krishnaswamy; Tajik, A Jamil; Paterick, Timothy E

    2016-01-01

    Comprehensive, detailed documentation in the medical record is critical to patient care and to a physician when allegations of negligence arise. Physicians, therefore, would be prudent to have a clear understanding of this documentation. It is important to understand who is responsible for documentation, what is important to document, when to document, and how to document. Additionally, it should be understood who owns the medical record, the significance of the transition to the electronic medical record, problems and pitfalls when using the electronic medical record, and how the Health Information Technology for Economic and Clinical Health Act affects healthcare providers and health information technology.

  10. Stress response in medically important Mucorales.

    Science.gov (United States)

    Singh, Pankaj; Paul, Saikat; Shivaprakash, M Rudramurthy; Chakrabarti, Arunaloke; Ghosh, Anup K

    2016-10-01

    Mucorales are saprobes, ubiquitously distributed and able to infect a heterogeneous population of human hosts. The fungi require robust stress responses to survive in human host. We tested the growth of Mucorales in the presence of different abiotic stress. Eight pathogenic species of Mucorales, including Rhizopus arrhizus, Rhizopus microsporus, Rhizomucor pusillus, Apophysomyces elegans, Licthemia corymbifera, Cunninghamella bertholletiae, Syncephalastrum racemosum and Mucor racemosus, were exposed to different stress inducers: osmotic (sodium chloride and d-sorbitol), oxidative (hydrogen peroxide and menadione), pH, cell wall and metal ions (Cu, Zn, Fe and Mg). Wide variation in stress responses was noted: R. arrhizus showed maximum resistance to both osmotic and oxidative stresses, whereas R. pusillus and M. indicus were relatively sensitive. Rhizopus arrhizus and R. microsporus showed maximum resistance to alkaline pH, whereas C. bertholletiae, L. corymbifera, M. racemosus and A. elegans were resistant to acidic pH. Maximum tolerance was noted in R. microsporus to Cu, R. microsporus and R. arrhizus to Fe and C. bertholletiae to Zn. In contrast, L. corymbifera, A. elegans and M. indicus were sensitive to Cu, Zn and Fe respectively. In conclusion, R. arrhizus showed high stress tolerance in comparison to other species of Mucorales, and this could be the possible reason for high pathogenic potential of this fungi. © 2016 Blackwell Verlag GmbH.

  11. Medical professional responsibility for postvasectomy pregnancy.

    Science.gov (United States)

    Vargas-Blasco, C; Arimany-Manso, J; Gómez-Durán, E L; Martin Fumadó, C; Piqueras-Bartolomé, M; Capdevila-Querol, S; Laborda-Rodriguez, A

    2016-01-01

    The follow-up of patients postvasectomy is frequently limited to a seminogram at 3months if azoospermia is observed. This study evaluates a series of cases of complaints for postvasectomy pregnancy to establish follow-up recommendations that increase the clinical safety and reduce the risk of complaints. We reviewed the database of the Department of Professional Responsibility of the Council of the College of Physicians of Catalonia, finding 28 complaints for postvasectomy pregnancy between 1992 and 2011. We analysed the clinical and legal variables of the cases. A total of 13 extrajudicial complaints (46.43%), 13 civil lawsuits (46.43%) and 2 criminal lawsuits (7.14%) were recorded. Only 10 cases had a signed document of informed consent specific to vasectomy. In 26 cases, the data from the spermogram was available. A single spermogram was conducted in 20 cases (76.92%), 2 spermograms were conducted in 4 cases (15.38%) and none were performed in 2 cases (7.69%). For 9 of the cases (45%) where only a single spermogram was performed, the test was performed before 3months postvasectomy. In 17 cases (65.38%), the result of the last spermogram was azoospermia, and 3 cases had oligospermia (11.54%). There were 2 failures of interpretation of the spermogram (7.69%) and 2 of normospermia (7.69%). In 2 cases, a spermogram was not performed (7.69%). Pregnancy occurred between 4 and 50 months after the intervention. In 12 cases (42.86%), it was considered that the practitioner was responsible. It is recommended that physicians emphasise (during the patient information stage) the possibility of spontaneous recanalisation and to request 2 spermograms, whose result should be azoospermia. Performing the test in the 3months after vasectomy is risky, as is basing the waiting time on the number of ejaculations. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Development and evaluation of the British English coordinate response measure speech-in-noise test as an occupational hearing assessment tool.

    Science.gov (United States)

    Semeraro, Hannah D; Rowan, Daniel; van Besouw, Rachel M; Allsopp, Adrian A

    2017-10-01

    The studies described in this article outline the design and development of a British English version of the coordinate response measure (CRM) speech-in-noise (SiN) test. Our interest in the CRM is as a SiN test with high face validity for occupational auditory fitness for duty (AFFD) assessment. Study 1 used the method of constant stimuli to measure and adjust the psychometric functions of each target word, producing a speech corpus with equal intelligibility. After ensuring all the target words had similar intelligibility, for Studies 2 and 3, the CRM was presented in an adaptive procedure in stationary speech-spectrum noise to measure speech reception thresholds and evaluate the test-retest reliability of the CRM SiN test. Studies 1 (n = 20) and 2 (n = 30) were completed by normal-hearing civilians. Study 3 (n = 22) was completed by hearing impaired military personnel. The results display good test-retest reliability (95% confidence interval (CI) hearing impairment. The British English CRM using stationary speech-spectrum noise is a "ready to use" SiN test, suitable for investigation as an AFFD assessment tool for military personnel.

  13. Terrestrial lichen response to partial cutting in lodgepole pine forests on caribou winter range in west-central British Columbia

    Directory of Open Access Journals (Sweden)

    Michaela J. Waterhouse

    2011-09-01

    Full Text Available In west-central British Columbia, terrestrial lichens located in older, lodgepole pine (Pinus contorta forests are important winter forage for woodland caribou (Rangifer tarandus caribou. Clearcut harvesting effectively removes winter forage habitat for decades, so management approaches based on partial cutting were designed to maintain continuous lichen-bearing habitat for caribou. This study tested a group selection system, based on removal of 33% of the forest every 80 years in small openings (15 m diameter, and two irregular shelterwood treatments (whole-tree and stem-only harvesting methods where 50% of the stand area is cut every 70 years in 20 to 30 m diameter openings. The abundance of common terrestrial lichens among the partial cutting and no-harvest treatments was compared across five replicate blocks, pre-harvest (1995 and post-harvest (1998, 2000 and 2004. The initial loss of preferred forage lichens (Cladonia, Cladina, Cetraria and Stereocaulon was similar among harvesting treatments, but there was greater reduction in these lichens in the openings than in the residual forest. After eight years, forage lichens in the group selection treatment recovered to pre-harvest amounts, while lichen in the shelterwood treatments steadily increased from 49 to 57% in 1998 to about 70% of pre-harvest amounts in 2004. Although not part of the randomized block design, there was substantially less lichen in three adjacent clearcut blocks than in the partial cuts. Regression analysis pre- and post-harvest indicated that increased cover of trees, shrubs, herbs, woody debris and logging slash corresponded with decreased forage lichen abundance. In the short-term, forestry activities that minimize inputs of woody debris, control herb and shrub development, and moderate the changes in light and temperatures associated with canopy removal will lessen the impact on lichen. Implementation of stand level prescriptions is only one aspect of caribou habitat

  14. A small single-nozzle rainfall simulator to measure erosion response on different burn severities in southern British Columbia, Canada

    Science.gov (United States)

    Covert, Ashley; Jordan, Peter

    2010-05-01

    To study the effects of wildfire burn severity on runoff generation and soil erosion from high intensity rainfall, we constructed an effective yet simple rainfall simulator that was inexpensive, portable and easily operated by two people on steep, forested slopes in southern British Columbia, Canada. The entire apparatus, including simulator, pumps, hoses, collapsible water bladders and sample bottles, was designed to fit into a single full-sized pick-up truck. The three-legged simulator extended to approximately 3.3 metres above ground on steep slopes and used a single Spraying Systems 1/2HH-30WSQ nozzle which can easily be interchanged for other sized nozzles. Rainfall characteristics were measured using a digital camera which took images of the raindrops against a grid. Median drop size and velocity 5 cm above ground were measured and found to be 3/4 of the size of natural rain drops of that diameter class, and fell 7% faster than terminal velocity. The simulator was used for experiments on runoff and erosion on sites burned in 2007 by two wildfires in southern British Columbia. Simulations were repeated one and two years after the fires. Rainfall was simulated at an average rate of 67 mm hr-1 over a 1 m2 plot for 20 minutes. This rainfall rate is similar to the 100 year return period rainfall intensity for this duration at a nearby weather station. Simulations were conducted on five replicate 1 m2 plots in each experimental unit including high burn severity, moderate burn severity, unburned, and unburned with forest floor removed. During the simulation a sample was collected for 30 seconds every minute, with two additional samples until runoff ceased, resulting in 22 samples per simulation. Runoff, overland flow coefficient, infiltration and sediment yield were compared between treatments. Additional simulations were conducted immediately after a 2009 wildfire to test different mulch treatments. Typical results showed that runoff on plots with high burn

  15. Obligations and responsibilities in radiation protection in the medical field

    International Nuclear Information System (INIS)

    2011-01-01

    This document briefly presents the various obligations and responsibilities of the various actors involved in or concerned by radiation protection in the medical field: the hospital administration (with respect to workers and patients), the physician (authorization and declaration, justification, optimization), the medical electro-radiology operator, the person with expertise in medical radio-physics (PSRPM), the radio-pharmacist (he is required in nuclear medicine with internal use of pharmaceutical product), the personnel with expertise in radiation protection (PCR), and other health professionals

  16. Vesper Sparrows and Western Meadowlarks Show a Mixed Response to Cattle Grazing in the Intermountain Region of British Columbia

    Directory of Open Access Journals (Sweden)

    Megan L. Harrison

    2010-06-01

    Full Text Available Livestock grazing in the shortgrass steppe of the Intermountain region of British Columbia is predicted to have significant effects on grassland habitats and their associated ground-nesting bird communities. We tested whether grazed and ungrazed sites could be discriminated on the basis of their vegetation communities, whether the abundance of two ground-nesting bird species, Vesper Sparrow (Pooecetes gramineus and Western Meadowlark (Sturnella neglecta, differed between grazed and ungrazed sites, and whether vegetation variables found to differ between grazed and ungrazed plots could be used to predict the abundance of the two bird species at a fine scale. Grazed sites were easily distinguishable from a site that had been ungrazed for >30 years based on the structure and composition of their vegetation communities. However, more detailed grazing categories could not be distinguished on the basis of vegetation characteristics. Despite the existence of grazing effects on vegetation structure and composition, we found no consistent differences in abundance of Vesper Sparrows and Western Meadowlarks between the grazed and ungrazed sites. However, there was weak evidence that the abundance of both species was higher at fine-scale plots (100 m radius point count station with less bare ground and taller vegetation. Bare ground cover was lower on grazed plots, but vegetation was taller on ungrazed plots. Combined, our results suggest that low intensity grazing leads to grassland habitat change with both negative and positive effects on Vesper Sparrows and Western Meadowlarks, resulting in no net change in their broad-scale abundance.

  17. Addressing social responsibility in medical education: the African way.

    Science.gov (United States)

    Kwizera, Enoch N; Iputo, Jehu E

    2011-01-01

    Indigenous sub-Saharan societies have, over the millennia, lived and socialised within the unwritten 'rules' of the 'Ubuntu' or similar philosophies that emphasises holistic 'humanness', and which is a form of 'social responsibility'. This article looks into some relevant social responsibility aspects of medical education in the South African context, with particular emphasis on how these aspects have been addressed. Apartheid was, by its very nature, incompatible with social responsibility for the majority of South Africans, but one medical school that was a non-complicit product of apartheid succeeded in fulfilling a socially responsible mission. Thus, this article implicitly identifies what South Africa, Africa and the global Health Professions Education community could learn from these trail-blazing experiences.

  18. Trench foot: the medical response in the first World War 1914-18.

    Science.gov (United States)

    Atenstaedt, Robert L

    2006-01-01

    The approaching 90-year anniversary of United States entry into the Great War is an apt time to examine the response to trench foot (now called nonfreezing cold injury [NFCI]) in this conflict. Trench foot appeared in the winter of 1914, characterized by pedal swelling, numbness, and pain. It was quickly recognized by military-medical authorities. There was little debate over whether it was frostbite or new condition, and it was quickly accepted as a specific disease. The major etiologies proposed were exposure, diet, and infection. The opinion emerged that it was caused by circulatory changes in the foot caused by cold, wet, and pressure. Predisposing factors included dietary inadequacy and fatigue. A number of labels were first given to the disease. However, the name "trench foot" was eventually officially sanctioned. Trench foot became a serious problem for the Allies, leading to 75 000 casualties in the British and 2000 in the American forces. Therapy for trench foot involved a number of conventional, tried-and-tested, and conservative methods. Some more innovative techniques were used. Amputation was only used as a last resort. Prevention involved general measures to improve the trench environment; modification of the footwear worn by the men; and the provision of greases to protect them from moisture. The medical reaction to this condition seems to have been relatively effective. The causation was identified, and prophylactic measures were introduced to fit this model; these seem to have been successful in reducing the prevalence of the condition by 1917-18.

  19. The limits of parental responsibility regarding medical treatment decisions.

    Science.gov (United States)

    Woolley, Sarah L

    2011-11-01

    Parental responsibility (PR) was a concept introduced by the Children Act (CA) 1989 which aimed to replace the outdated notion of parental rights and duties which regarded children as parental possessions. Section 3(1) CA 1989 defines PR as 'all the rights, duties, powers, responsibilities and authority which by law a parent of a child has in relation to the child'. In exercising PR, individuals may make medical treatment decisions on children's behalf. Medical decision-making is one area of law where both children and the state can intercede and limit parental decision-making. Competent children can consent to treatment and the state can interfere if parental decisions are not seemingly in the child's 'best interests'. This article examines the concept, and limitations, of PR in relation to medical treatment decision-making.

  20. 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…

  1. The Biological Responses to Magnesium-Based Biodegradable Medical Devices

    Directory of Open Access Journals (Sweden)

    Lumei Liu

    2017-11-01

    Full Text Available The biocompatibility of Magnesium-based materials (MBMs is critical to the safety of biodegradable medical devices. As a promising metallic biomaterial for medical devices, the issue of greatest concern is devices’ safety as degrading products are possibly interacting with local tissue during complete degradation. The aim of this review is to summarize the biological responses to MBMs at the cellular/molecular level, including cell adhesion, transportation signaling, immune response, and tissue growth during the complex degradation process. We review the influence of MBMs on gene/protein biosynthesis and expression at the site of implantation, as well as throughout the body. This paper provides a systematic review of the cellular/molecular behavior of local tissue on the response to Mg degradation, which may facilitate a better prediction of long-term degradation and the safe use of magnesium-based implants through metal innovation.

  2. Academic disintegrity among medical students: a randomised response technique study.

    Science.gov (United States)

    Mortaz Hejri, Sameh; Zendehdel, Kazem; Asghari, Fariba; Fotouhi, Akbar; Rashidian, Arash

    2013-02-01

    Medical students, as tomorrow's doctors, are responsible for their patients' health; cheating may affect their academic knowledge and clinical skills. The main purpose of this study was to investigate the frequency of and attitudes towards academic disintegrity among medical students at Tehran University of Medical Sciences (TUMS). Anonymous questionnaires including questions about various types of academic disintegrity were distributed among medical students during the clerkship and internship phases of the curriculum. Randomised response technique (RRT) was used to maintain the responders' privacy. Because the study design guaranteed the confidentiality of respondents, the TUMS Institutional Review Board declared that formal ethical approval was not required. A total of 124 students were enrolled in this study, of whom 63 were in the clerkship phase and 61 were in the internship phase. Of these respondents, 29% (n = 36) were male. The most frequently reported type of academic disintegrity was found to be 'impersonating an absent student in a class' (93%) and the least frequent to be 'legitimising absences by using bribes' (5%). Only a small number of interns considered 'buying hospital shifts', 'selling hospital shifts', 'impersonating an absent student' and 'helping others to cheat in examinations' as representing academic disintegrity. Approximately one third of participants stated that the RRT increased their confidence in anonymity and 90% of students found the use of RRT not difficult. Academic integrity is widely disrespected in different ways among medical students. Effective policies and interventions are required to control these misbehaviours in future doctors in order to optimise medical practice. Almost all respondents found it not difficult to use the RRT; the technique proved to be an effective and easily applied method of eliciting truthful responses to sensitive questions and represents an alternative to conventional anonymising techniques.

  3. Hospital outpatients' responses to taking medications with driving warnings.

    Science.gov (United States)

    Smyth, T; Sheehan, M; Siskind, V

    2013-01-01

    The study investigates the knowledge, intentions, and driving behavior of persons prescribed medications that display a warning about driving. It also examines their confidence that they can self-assess possible impairment, as is required by the Australian labeling system. We surveyed 358 outpatients in an Australian public hospital pharmacy, representing a well-advised group taking a range of medications including those displaying a warning label about driving. A brief telephone follow-up survey was conducted with a subgroup of the participants. The sample had a median age of 53.2 years and was 53 percent male. Nearly three quarters (73.2%) had taken a potentially impairing class of medication and more than half (56.1%) had taken more than one such medication in the past 12 months. Knowledge of the potentially impairing effects of medication was relatively high for most items; however, participants underestimated the possibility of increased impairment from exceeding the prescribed dose and at commencing treatment. Participants' responses to the safety implications of taking drugs with the highest level of warning varied. Around two thirds (62.8%) indicated that they would consult a health practitioner for advice and around half would modify their driving in some way. However, one fifth (20.9%) would drive when the traffic was thought to be less heavy and over a third (37.7%) would modify their medication regime so that they could drive. The findings from the follow-up survey of a subsample taking target drugs at the time of the first interview were also of concern. Only just over half (51%) recalled seeing the warning label on their medications and, of this group, three quarters (78%) reported following the warning label advice. These findings indicated that there remains a large proportion of people who either did not notice or did not consider the warning when deciding whether to drive. There was a very high level of confidence in this group that they could

  4. Transplant ethics under scrutiny - responsibilities of all medical professionals.

    Science.gov (United States)

    Trey, Torsten; Caplan, Arthur L; Lavee, Jacob

    2013-02-01

    In this text, we present and elaborate ethical challenges in transplant medicine related to organ procurement and organ distribution, together with measures to solve such challenges. Based on internationally acknowledged ethical standards, we looked at cases of organ procurement and distribution practices that deviated from such ethical standards. One form of organ procurement is known as commercial organ trafficking, while in China the organ procurement is mostly based on executing prisoners, including killing of detained Falun Gong practitioners for their organs. Efforts from within the medical community as well as from governments have contributed to provide solutions to uphold ethical standards in medicine. The medical profession has the responsibility to actively promote ethical guidelines in medicine to prevent a decay of ethical standards and to ensure best medical practices.

  5. Transplant ethics under scrutiny – responsibilities of all medical professionals

    Science.gov (United States)

    Trey, Torsten; Caplan, Arthur L.; Lavee, Jacob

    2013-01-01

    In this text, we present and elaborate ethical challenges in transplant medicine related to organ procurement and organ distribution, together with measures to solve such challenges. Based on internationally acknowledged ethical standards, we looked at cases of organ procurement and distribution practices that deviated from such ethical standards. One form of organ procurement is known as commercial organ trafficking, while in China the organ procurement is mostly based on executing prisoners, including killing of detained Falun Gong practitioners for their organs. Efforts from within the medical community as well as from governments have contributed to provide solutions to uphold ethical standards in medicine. The medical profession has the responsibility to actively promote ethical guidelines in medicine to prevent a decay of ethical standards and to ensure best medical practices. PMID:23444249

  6. Fly-By medical care: Conceptualizing the global and local social responsibilities of medical tourists and physician voluntourists.

    Science.gov (United States)

    Snyder, Jeremy; Dharamsi, Shafik; Crooks, Valorie A

    2011-04-06

    Medical tourism is a global health practice where patients travel abroad to receive health care. Voluntourism is a practice where physicians travel abroad to deliver health care. Both of these practices often entail travel from high income to low and middle income countries and both have been associated with possible negative impacts. In this paper, we explore the social responsibilities of medical tourists and voluntourists to identify commonalities and distinctions that can be used to develop a wider understanding of social responsibility in global health care practices. Social responsibility is a responsibility to promote the welfare of the communities to which one belongs or with which one interacts. Physicians stress their social responsibility to care for the welfare of their patients and their domestic communities. When physicians choose to travel to another county to provide medical care, this social responsibility is expanded to this new community. Patients too have a social responsibility to use their community's health resources efficiently and to promote the health of their community. When these patients choose to go abroad to receive medical care, this social responsibility applies to the new community as well. While voluntourists and medical tourists both see the scope of their social responsibilities expand by engaging in these global practices, the social responsibilities of physician voluntourists are much better defined than those of medical tourists. Guidelines for engaging in ethical voluntourism and training for voluntourists still need better development, but medical tourism as a practice should follow the lead of voluntourism by developing clearer norms for ethical medical tourism. Much can be learned by examining the social responsibilities of medical tourists and voluntourists when they engage in global health practices. While each group needs better guidance for engaging in responsible forms of these practices, patients are at a

  7. [Medical social responsibility in an era of personalized medicine].

    Science.gov (United States)

    Huijer, M L M

    2017-01-01

    How much social responsibility do physicians have? Historically, care for collective health and well-being has been part and parcel of the responsibility of the medical profession. The changes in the urban environment to which physicians contributed at the end of the 19th century bear witness to this. During the 20th century, however, the medical search for extra health gain has focused increasingly on the individual. This has reached a provisional zenith in personalized medicine. This article argues that physician are letting patients, society and themselves down by paying so much attention to the individual and so little to social factors that cause disease or promote health. The exceptional position that physicians occupy in identifying and tackling pathological processes advocates an increase in societal and political engagement.

  8. Soviet medical response to the Chernobyl nuclear accident

    International Nuclear Information System (INIS)

    Linnemann, R.E.

    1987-01-01

    The nuclear accident at Chernobyl was the worst in the history of nuclear power. It tested the organized medical response to mass radiation casualties. This article reviews the Soviet response as reported at the 1986 postaccident review meeting in Vienna and as determined from interviews. The Soviets used three levels of care: rescue and first aid at the plant site; emergency treatment at regional hospitals; and definitive evaluation and treatment in Moscow. Diagnosis, triage, patient disposition, attendant exposure, and preventive actions are detailed. The United States would be well advised to organize its resources definitively to cope with future nonmilitary nuclear accidents

  9. Generic procedures for medical response during a nuclear or radiological emergency. Emergency preparedness and response

    International Nuclear Information System (INIS)

    2005-04-01

    The aim of this publication is to serve as a practical resource for planning the medical response to a nuclear or radiological emergency. It fulfils in part functions assigned to the IAEA under Article 5.a(ii) of the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency (Assistance Convention), namely, to collect and disseminate to States Parties and Member States information concerning methodologies, techniques and available results of research relating to such emergencies. Effective medical response is a necessary component of the overall response to nuclear or radiological (radiation) emergencies. In general, the medical response may represent a difficult challenge for the authorities due to the complexity of the situation, often requiring specialized expertise, and special organizational arrangements and materials. To be effective, adequate planning and preparedness are needed. This manual, if implemented, should help to contribute to coherent international response. The manual provides the practical tools and generic procedures for use by emergency medical personnel during an emergency situation. It also provides guidance to be used at the stage of preparedness for development of medical response capabilities. The manual also addresses mass casualty emergencies resulting from malicious acts involving radioactive material. This part was supported by the Nuclear Security Fund. The manual was developed based on a number of assumptions about national and local capabilities. Therefore, it must be reviewed and revised as part of the planning process to match the potential accidents, threats, local conditions and other unique characteristics of the facility where it may be used

  10. British Dance: Black Routes

    OpenAIRE

    Adair, C.; Burt, Ramsay, 1953-

    2016-01-01

    British Dance: Black Routes re-examines the distinctive contributions made to British dance by dancers who are Black. Covering the period 1946 to the present, it presents a radical re-reading of dancers and their companies, placing their achievements within a broader historical, cultural and artistic context. The result of a two year research project, British Dance and the African Diaspora, led by editors Christy Adair and Ramsay Burt, the collection looks at artists working with contempor...

  11. Assessing the ecotoxicologic hazards of a pandemic influenza medical response.

    Science.gov (United States)

    Singer, Andrew C; Colizza, Vittoria; Schmitt, Heike; Andrews, Johanna; Balcan, Duygu; Huang, Wei E; Keller, Virginie D J; Vespignani, Alessandro; Williams, Richard J

    2011-08-01

    The global public health community has closely monitored the unfolding of the 2009 H1N1 influenza pandemic to best mitigate its impact on society. However, little attention has been given to the impact of this response on the environment. Antivirals and antibiotics prescribed to treat influenza are excreted into wastewater in a biologically active form, which presents a new and potentially significant ecotoxicologic challenge to microorganisms responsible for wastewater nutrient removal in wastewater treatment plants (WWTPs) and receiving rivers. We assessed the ecotoxicologic risks of a pandemic influenza medical response. To evaluate this risk, we coupled a global spatially structured epidemic model that simulates the quantities of antivirals and antibiotics used during an influenza pandemic of varying severity and a water quality model applied to the Thames catchment to determine predicted environmental concentrations. An additional model was then used to assess the effects of antibiotics on microorganisms in WWTPs and rivers. Consistent with expectations, our model projected a mild pandemic to exhibit a negligible ecotoxicologic hazard. In a moderate and severe pandemic, we projected WWTP toxicity to vary between 0-14% and 5-32% potentially affected fraction (PAF), respectively, and river toxicity to vary between 0-14% and 0-30% PAF, respectively, where PAF is the fraction of microbial species predicted to be growth inhibited (lower and upper 95% reference range). The current medical response to pandemic influenza might result in the discharge of insufficiently treated wastewater into receiving rivers, thereby increasing the risk of eutrophication and contamination of drinking water abstraction points. Widespread drugs in the environment could hasten the generation of drug resistance. Our results highlight the need for empirical data on the effects of antibiotics and antiviral medications on WWTPs and freshwater ecotoxicity.

  12. British Columbia : an alternative design

    International Nuclear Information System (INIS)

    Ostergaard, P.

    2003-01-01

    This PowerPoint presentation outlined the British Columbia Ministry of Energy and Mines' approach to the electricity market. A brief overview of the electric system in the province was provided, examining capacity (primarily hydro based) and the utility sector with its public ownership. In British Columbia, 80 per cent of the electricity is generated by British Columbia Hydro (BC Hydro). The rates are based on cost of service. British Columbia's market is western North America. A comparison of monthly bills for several large cities, both Canadian and American, was displayed. The market reviews conducted in 1995, 1998, and 2002 were reviewed and the major recommendations discussed. The author identified the opportunities in the province, discussing natural gas and coal for electricity production, resource potential, demand, and private sector capacity. The challenges facing the province are: cost effective development of resources to meet energy demand; aging infrastructure, high reliability requirements and economic growth; evolving electricity market structure in the United States; and, monopoly. The transmission system was reviewed with reference to trade with the Pacific Northwest, flexibility and storage. The energy plan objectives for the future were presented, including low rates and public ownership, secure and reliable supply, more private sector opportunities, and environmental responsibility. The alternative market structure includes regulated market characteristics, access to trade, and customer focus. figs

  13. Responses of a macroinvertebrate community from a pristine, southern British Columbia, Canada, stream to metals in experimental mesocosms

    Energy Technology Data Exchange (ETDEWEB)

    Richardson, J.S.; Kiffney, P.M.

    2000-03-01

    Metal contamination is one of the most widespread impacts on surface waters. Experimental flumes receiving water and aquatic invertebrates from an undisturbed, forested stream were used to determine the impact of metals in a low-conductivity stream. The experimental flumes were exposed to a gradient of doses maintaining a constant ratio of metals (1995: Cu, Zn, Mn, and Pb; 1996: Cu and Zn) for 6 d. Benthos and emigration were sampled from each of the 16 troughs. The overall densities of benthos declined, but not significantly, as the dose of metals increased. On the basis of the slopes of the concentration-response curve, Baetis, Ameletus, and Paraleptophlebia were the most sensitive taxa present. Other taxa (e.g., Nemouridae and Oligochaeta) were mildly affected by high metal concentrations. Chironomidae showed no significant decrease in densities with increasing dose. Chironomids made up >80% of the benthos and is the primary reason for no significant dose effect on overall densities. No treatment effect was observed on either algal standing crop or bacterial respiration rates. The invertebrate genera most affected by exposure to metals in this study were also absent or rare in nearby urban streams with high metal concentrations.

  14. 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.

  15. Regional training course on medical response on radiological emergencies. Annex

    International Nuclear Information System (INIS)

    2000-01-01

    This short information is an annex of the documentation distributed to the participants to the International Atomic Energy Agency (IAEA) Regional Training Course on Medical Response on Radiological Emergencies, organised by the IAEA in co-operation with the Government of Argentina thought the Nuclear Regulatory Authority, held in Buenos Aires, Argentina, 16-20 October 2000. The course was intended to people from IAEA Member State in the Latin American and Caribbean region, and to professionals and workers on medicine related with the radiation protection. This annex present information about: Radioactive materials transport; Internal and external contamination; Radiation accidents; Physical dosimetry

  16. Muted response of fine-grained sediment to a wildfire in British Columbia: the role of landscape disturbances and driving forces

    Science.gov (United States)

    Owens, P. N.; Giles, T. R.; Blake, W. H.; Petticrew, E. L.; Bol, R.

    2012-04-01

    In August 2003 a severe wildfire burnt the majority of Fishtrap Creek, a 170 km2 watershed near the city of Kamloops in central British Columbia. The objective of this study was to determine the influence of the wildfire on the amount and composition of fine sediment delivery and transport in the system and to see if the wildfire altered the main sources of sediment. In addition, the findings are compared with that of a nearby watershed, Jamieson Creek, with similar characteristics that was unburnt. In both watersheds, suspended sediment concentrations and fluxes were determined using ISCO automatic water samplers. Changes in sediment sources were determined by collecting bulk sediment and source material samples, and by analysing these samples for a range of properties, including environmental radionuclides and C and N isotopes. Results suggest that following the wildfire there was no major response in fine sediment delivery and transport in Fishtrap Creek, when compared to Jamieson Creek, although there were noticeable differences in the composition of the fine sediment transported and stored in the channel bed. This muted response may be due to the fairly low rainfall amounts in the period immediately following the wildfire. Environmental fallout radionuclides (caesium-137 and unsupported lead-210) showed that there was limited increase (bank) sources of sediment. Recent changes in sediment fluxes and sediment sources relate more to bank erosion processes, probably due to loss of root strength and cohesion. The results suggest that in some situations wildfire may not produce the dramatic increases in hillslope erosion and sediment transport often documented in other watersheds. In Fishtrap Creek, channel bank erosion appears to be important in supplying fine material to the channel and this suggests that attention should be directed at managing the riparian zone in watersheds affected by wildfires.

  17. Radiological emergency response in a medical waste treatment unit

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Fabio F.; Boni-Mitake, Malvina; Vianna, Estanislau B.; Nicolau, Jose R.A.; Rodrigues, Demerval L. [Instituto de Pesquisas Energeticas e Nucleares (IPEN), Sao Paulo, SP (Brazil)

    2000-07-01

    Radioactive materials are largely used in medicine, research and industry. The amount of radioactive material employed in each application varies from negligible to large and it can be in sealed or non-sealed form. A medical waste treatment unit that deals only with A-type medical waste (ABNT-NBR 12808), which does not include radioactive waste, detected abnormal radiation levels in a collecting truck and the IPEN-CNEN/SP Nuclear and Radiological Emergency Response Team was called. The presence of radioactive material inside the truck was confirmed; however, its origin and nature were not possible to be determined because the truck had collected medical waste in several facilities. So, an operation in order to segregate and identify that material was carried out. During the operation, a second collecting truck presenting abnormal radiation levels arrived to the unit and the same procedure was carried out on that truck. In both situations, the contaminated objects found were infantile diapers. The radioactive waste was transported to IPEN-CNEN/SP to be managed. Samples of the radioactive materials were submitted to gamma spectrometry and the radionuclide was identified as Iodine-131. Since that attendance, similar occurrences have been frequent. These events suggest that it is necessary a better control of the radioactive waste at the generating facilities and there should be basic radioprotection orientations to the discharging patients that were submitted to nuclear medicine procedures. (author)

  18. Radiological emergency response in a medical waste treatment unit

    International Nuclear Information System (INIS)

    Suzuki, Fabio F.; Boni-Mitake, Malvina; Vianna, Estanislau B.; Nicolau, Jose R.A.; Rodrigues, Demerval L.

    2000-01-01

    Radioactive materials are largely used in medicine, research and industry. The amount of radioactive material employed in each application varies from negligible to large and it can be in sealed or non-sealed form. A medical waste treatment unit that deals only with A-type medical waste (ABNT-NBR 12808), which does not include radioactive waste, detected abnormal radiation levels in a collecting truck and the IPEN-CNEN/SP Nuclear and Radiological Emergency Response Team was called. The presence of radioactive material inside the truck was confirmed; however, its origin and nature were not possible to be determined because the truck had collected medical waste in several facilities. So, an operation in order to segregate and identify that material was carried out. During the operation, a second collecting truck presenting abnormal radiation levels arrived to the unit and the same procedure was carried out on that truck. In both situations, the contaminated objects found were infantile diapers. The radioactive waste was transported to IPEN-CNEN/SP to be managed. Samples of the radioactive materials were submitted to gamma spectrometry and the radionuclide was identified as Iodine-131. Since that attendance, similar occurrences have been frequent. These events suggest that it is necessary a better control of the radioactive waste at the generating facilities and there should be basic radioprotection orientations to the discharging patients that were submitted to nuclear medicine procedures. (author)

  19. Sexual harassment in the medical profession: legal and ethical responsibilities.

    Science.gov (United States)

    Mathews, Ben; Bismark, Marie M

    2015-08-17

    Sexual harassment of women in medicine has become a subject of national debate after a senior female surgeon stated that if a woman complained of unwanted advances her career would be jeopardised, and subsequent reports suggest that sexual harassment is a serious problem in the medical profession. Sexual harassment of women in the medical profession by their colleagues presents substantial legal, ethical and cultural questions for the profession. Women have enforceable legal rights to gender equality and freedom from sexual harassment in the workplace. Both individual offenders and employers face significant legal consequences for sexual harassment in every Australian state and territory, and individual medical practitioners and employers need to understand their legal and ethical rights and responsibilities in this context. An individual offender may be personally liable for criminal offences, and for breaching anti-discrimination legislation, duties owed in civil law, professional standards and codes of conduct. An employer may be liable for breaching anti-discrimination legislation, workplace safety laws, duties owed in contract law, and a duty of care owed to the employee. Employers, professional colleges and associations, and regulators should use this national debate as an opportunity to improve gender equality and professional culture in medicine; individuals and employers have clear legal and ethical obligations to minimise sexual harassment to the greatest extent possible.

  20. Protective measures and human antibody response during an avian influenza H7N3 outbreak in poultry in British Columbia, Canada.

    Science.gov (United States)

    Skowronski, Danuta M; Li, Yan; Tweed, S Aleina; Tam, Theresa W S; Petric, Martin; David, Samara T; Marra, Fawziah; Bastien, Nathalie; Lee, Sandra W; Krajden, Mel; Brunham, Robert C

    2007-01-02

    In 2004 an outbreak of avian influenza of the H7N3 subtype occurred among poultry in British Columbia, Canada. We report compliance with recommended protective measures and associated human infections during this outbreak. We sought voluntary participation by anyone (cullers, farmers and their families) involved in efforts to control the poultry outbreak. Recruitment was by advertisements at the worker deployment site, in local media and through newsletters sent directly to farmers. Sera were tested for antibody to H7N3 by microneutralization assay. A subset of 16 sera (including convalescent sera from 2 unprotected workers with conjunctivitis from whom virus had been isolated) was further tested by Western blot and routine and modified hemagglutination inhibition assays. A total of 167 people (20% to 25% of all workers) participated between May 7 and July 26, 2004. Of these, 19 had experienced influenza-like illness and 21 had experienced red or watery eyes. There was no significant association between illness reports and exposure to infected birds. Among 65 people who entered barns with infected birds, 55 (85%) had received influenza vaccine, 48 (74%) had received oseltamivir, and 55 (85%), 54 (83%) and 36 (55%) reported always wearing gloves, mask or goggles, respectively. Antibody to the H7 subtype was not detected in any sera. During the BC outbreak, compliance with recommended protective measures, especially goggles, was incomplete. Multiple back-up precautions, including oseltamivir prophylaxis, may prevent human infections and should be readily accessible and consistently used by those involved in the control of future outbreaks of avian influenza in poultry. Localized human avian influenza infections may not result in serologic response despite confirmed viral detection and culture.

  1. Fly-By medical care: Conceptualizing the global and local social responsibilities of medical tourists and physician voluntourists

    Directory of Open Access Journals (Sweden)

    Crooks Valorie A

    2011-04-01

    Full Text Available Abstract Background Medical tourism is a global health practice where patients travel abroad to receive health care. Voluntourism is a practice where physicians travel abroad to deliver health care. Both of these practices often entail travel from high income to low and middle income countries and both have been associated with possible negative impacts. In this paper, we explore the social responsibilities of medical tourists and voluntourists to identify commonalities and distinctions that can be used to develop a wider understanding of social responsibility in global health care practices. Discussion Social responsibility is a responsibility to promote the welfare of the communities to which one belongs or with which one interacts. Physicians stress their social responsibility to care for the welfare of their patients and their domestic communities. When physicians choose to travel to another county to provide medical care, this social responsibility is expanded to this new community. Patients too have a social responsibility to use their community's health resources efficiently and to promote the health of their community. When these patients choose to go abroad to receive medical care, this social responsibility applies to the new community as well. While voluntourists and medical tourists both see the scope of their social responsibilities expand by engaging in these global practices, the social responsibilities of physician voluntourists are much better defined than those of medical tourists. Guidelines for engaging in ethical voluntourism and training for voluntourists still need better development, but medical tourism as a practice should follow the lead of voluntourism by developing clearer norms for ethical medical tourism. Summary Much can be learned by examining the social responsibilities of medical tourists and voluntourists when they engage in global health practices. While each group needs better guidance for engaging in

  2. Fly-By medical care: Conceptualizing the global and local social responsibilities of medical tourists and physician voluntourists

    Science.gov (United States)

    2011-01-01

    Background Medical tourism is a global health practice where patients travel abroad to receive health care. Voluntourism is a practice where physicians travel abroad to deliver health care. Both of these practices often entail travel from high income to low and middle income countries and both have been associated with possible negative impacts. In this paper, we explore the social responsibilities of medical tourists and voluntourists to identify commonalities and distinctions that can be used to develop a wider understanding of social responsibility in global health care practices. Discussion Social responsibility is a responsibility to promote the welfare of the communities to which one belongs or with which one interacts. Physicians stress their social responsibility to care for the welfare of their patients and their domestic communities. When physicians choose to travel to another county to provide medical care, this social responsibility is expanded to this new community. Patients too have a social responsibility to use their community's health resources efficiently and to promote the health of their community. When these patients choose to go abroad to receive medical care, this social responsibility applies to the new community as well. While voluntourists and medical tourists both see the scope of their social responsibilities expand by engaging in these global practices, the social responsibilities of physician voluntourists are much better defined than those of medical tourists. Guidelines for engaging in ethical voluntourism and training for voluntourists still need better development, but medical tourism as a practice should follow the lead of voluntourism by developing clearer norms for ethical medical tourism. Summary Much can be learned by examining the social responsibilities of medical tourists and voluntourists when they engage in global health practices. While each group needs better guidance for engaging in responsible forms of these practices

  3. Assessing potential legal responses to medical ghostwriting: effectiveness and constitutionality

    Science.gov (United States)

    Chen, Chung-Lin

    2018-01-01

    Abstract Pharmaceutical companies are extensively involved in shaping medical knowledge to market their products to physicians and consumers. Specialized planning is undertaken to produce scientific articles driven by commercial interests. Rather than the listed authors, hidden analysts and publication management firms hired by pharmaceutical companies are often responsible for the content of scientific articles. Such ghostwriting practices raise serious concerns regarding the integrity of knowledge and thus demand urgent attention. This paper analyses the strategies of legal regulation on medical ghostwriting and their comparative advantages and disadvantages. Many of regulatory proposals suffer from a lack of effectiveness, whereas others are subject to constitutional concerns. The analysis in this paper offers insights into framing adequate regulation; it supports the strategy for reforming the structure of information production while calling for cautiousness in shaping its regulatory outline. In addition, this paper contributes to the analysis of First Amendment jurisprudence, suggesting that the judiciary should allow a certain amount of leeway for political branches to develop effective regulation PMID:29707217

  4. Evaluating the success of an emergency response medical information system.

    Science.gov (United States)

    Petter, Stacie; Fruhling, Ann

    2011-07-01

    STATPack™ is an information system used to aid in the diagnosis of pathogens in hospitals and state public health laboratories. STATPack™ is used as a communication and telemedicine diagnosis tool during emergencies. This paper explores the success of this emergency response medical information system (ERMIS) using a well-known framework of information systems success developed by DeLone and McLean. Using an online survey, the entire population of STATPack™ users evaluated the success of the information system by considering system quality, information quality, system use, intention to use, user satisfaction, individual impact, and organizational impact. The results indicate that the overall quality of this ERMIS (i.e., system quality, information quality, and service quality) has a positive impact on both user satisfaction and intention to use the system. However, given the nature of ERMIS, overall quality does not necessarily predict use of the system. Moreover, the user's satisfaction with the information system positively affected the intention to use the system. User satisfaction, intention to use, and system use had a positive influence on the system's impact on the individual. Finally, the organizational impacts of the system were positively influenced by use of the system and the system's individual impact on the user. The results of the study demonstrate how to evaluate the success of an ERMIS as well as introduce potential changes in how one applies the DeLone and McLean success model in an emergency response medical information system context. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  5. 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…

  6. Helicopter emergency medical services response to equestrian accidents.

    Science.gov (United States)

    Lyon, Richard M; Macauley, Ben; Richardson, Sarah; de Coverly, Richard; Russell, Malcolm

    2015-04-01

    Horse riding is a common leisure activity associated with a significant rate of injury. Helicopter emergency medical services (HEMS) may be called to equestrian accidents. Accurate HEMS tasking is important to ensure appropriate use of this valuable medical resource. We sought to review HEMS response to equestrian accidents and identify factors associated with the need for HEMS intervention or transport of the patient to a major trauma centre. Retrospective case review of all missions flown by Kent, Surrey & Sussex Air Ambulance Trust over a 1-year period (1 July 2011 to 1 July 2012). All missions were screened for accidents involving a horse. Call details, patient demographics, suspected injuries, clinical interventions and patient disposition were all analysed. In the 12-month data collection period there were 47 equestrian accidents, representing ∼3% of the total annual missions. Of the 42 cases HEMS attended, one patient was pronounced life extinct at the scene. In 15 (36%) cases the patient was airlifted to hospital. In four (10%) cases, the patient underwent prehospital anaesthesia. There were no specific predictors of HEMS intervention. Admission to a major trauma centre was associated with the rider not wearing a helmet, a fall onto their head or the horse falling onto the rider. Equestrian accidents represent a significant proportion of HEMS missions. The majority of patients injured in equestrian accidents do not require HEMS intervention, however, a small proportion have life-threatening injuries, requiring immediate critical intervention. Further research is warranted, particularly regarding HEMS dispatch, to further improve accuracy of tasking to equestrian accidents.

  7. Ebola Virus Disease: Ethics and Emergency Medical Response Policy.

    Science.gov (United States)

    Jecker, Nancy S; Dudzinski, Denise M; Diekema, Douglas S; Tonelli, Mark

    2015-09-01

    Caring for patients affected with Ebola virus disease (EVD) while simultaneously preventing EVD transmission represents a central ethical challenge of the EVD epidemic. To address this challenge, we propose a model policy for resuscitation and emergent procedure policy of patients with EVD and set forth ethical principles that lend support to this policy. The policy and principles we propose bear relevance beyond the EVD epidemic, offering guidance for the care of patients with other highly contagious, virulent, and lethal diseases. The policy establishes (1) a limited code status for patients with confirmed or suspected EVD. Limited code status means that a code blue will not be called for patients with confirmed or suspected EVD at any stage of the disease; however, properly protected providers (those already in full protective equipment) may initiate resuscitative efforts if, in their clinical assessment, these efforts are likely to benefit the patient. The policy also requires that (2) resuscitation not be attempted for patients with advanced EVD, as resuscitation would be medically futile; (3) providers caring for or having contact with patients with confirmed or suspected EVD be properly protected and trained; (4) the treating team identify and treat in advance likely causes of cardiac and respiratory arrest to minimize the need for emergency response; (5) patients with EVD and their proxies be involved in care discussions; and (6) care team and provider discretion guide the care of patients with EVD. We discuss ethical issues involving medical futility and the duty to avoid harm and propose a utilitarian-based principle of triage to address resource scarcity in the emergency setting.

  8. 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…

  9. Abstracts to be Delivered at the 2014 Annual Conference of the Association of Medical Microbiology and Infectious Disease Canada, April 3 to 5, Victoria, British Columbia, Alphabetized According to the Surname of the First Author. Full-text Abstracts Can be Accessed at www.pulsus.com

    Directory of Open Access Journals (Sweden)

    2014-01-01

    Full Text Available This document presents the titles of the abstracts to be presented at the 2014 Annual Conference of the Association of Medical Microbiology and Infectious Disease Canada (April 3 to 5, Victoria, British Columbia. The full-text abstracts are available online.

  10. Real/Life: New British Art and the Reception of Contemporary British Art in Japan

    Directory of Open Access Journals (Sweden)

    Kajiya Kenji

    2016-07-01

    Full Text Available This essay explores the ways in which the exhibition Real/Life: New British Art was conceived and received in Japan, where contemporary British art has been shown since the 1960s. Taking place at five museums in the country between 1998 and 1999, the exhibition aimed to showhow British artists in the 1990s struggled with realities, internal and external, but its response was not as satisfactory as was expected. The essay examines the exhibition as a turning point for the transformation of exhibition culture in Japan from nationally themed exhibitions to showcases of contemporary art in the global context.

  11. The 2012 derecho: emergency medical services and hospital response.

    Science.gov (United States)

    Kearns, Randy D; Wigal, Mark S; Fernandez, Antonio; Tucker, March A; Zuidgeest, Ginger R; Mills, Michael R; Cairns, Bruce A; Cairns, Charles B

    2014-10-01

    During the early afternoon of June 29, 2012, a line of destructive thunderstorms producing straight line winds known as a derecho developed near Chicago (Illinois, USA). The storm moved southeast with wind speeds recorded from 100 to 160 kilometers per hour (kph, 60 to 100 miles per hour [mph]). The storm swept across much of West Virginia (USA) later that evening. Power outage was substantial as an estimated 1,300,000 West Virginians (more than half) were without power in the aftermath of the storm and approximately 600,000 citizens were still without power a week later. This was one of the worst storms to strike this area and occurred as residents were enduring a prolonged heat wave. The wind damage left much of the community without electricity and the crippling effect compromised or destroyed critical infrastructure including communications, air conditioning, refrigeration, and water and sewer pumps. This report describes utilization of Emergency Medical Services (EMS) and hospital resources in West Virginia in response to the storm. Also reported is a review of the weather phenomena and the findings and discussion of the disaster and implications.

  12. 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.

  13. Key performance indicators in British military trauma.

    Science.gov (United States)

    Stannard, Adam; Tai, Nigel R; Bowley, Douglas M; Midwinter, Mark; Hodgetts, Tim J

    2008-08-01

    Key performance indicators (KPI) are tools for assessing process and outcome in systems of health care provision and are an essential component in performance improvement. Although KPI have been used in British military trauma for 10 years, they remain poorly defined and are derived from civilian metrics that do not adjust for the realities of field trauma care. Our aim was to modify current trauma KPI to ensure they more faithfully reflect both the military setting and contemporary evidence in order to both aid accurate calibration of the performance of the British Defence Medical Services and act as a driver for performance improvement. A workshop was convened that was attended by senior, experienced doctors and nurses from all disciplines of trauma care in the British military. "Speciality-specific" KPI were developed by interest groups using evidence-based data where available and collective experience where this was lacking. In a final discussion these were streamlined into 60 KPI covering each phase of trauma management. The introduction of these KPI sets a number of important benchmarks by which British military trauma can be measured. As part of a performance improvement programme, these will allow closer monitoring of our performance and assist efforts to develop, train, and resource British military trauma providers.

  14. Promoting social responsibility amongst health care users: medical tourists’ perspectives on an information sheet regarding ethical concerns in medical tourism

    Science.gov (United States)

    2013-01-01

    , future research implications should include the development of a website for ongoing discussion that could contribute to a raised awareness of these concerns and potentially increase social responsibility in the medical tourism industry. PMID:24314027

  15. Promoting social responsibility amongst health care users: medical tourists' perspectives on an information sheet regarding ethical concerns in medical tourism.

    Science.gov (United States)

    Adams, Krystyna; Snyder, Jeremy; Crooks, Valorie A; Johnston, Rory

    2013-12-06

    include the development of a website for ongoing discussion that could contribute to a raised awareness of these concerns and potentially increase social responsibility in the medical tourism industry.

  16. Problems of medical personnel deontology during radiation emergency response

    International Nuclear Information System (INIS)

    Poplavskij, K.K.; Popov, A.O.

    1990-01-01

    Problems of deontology in the process of liquidation of radiation accident consequences are considered in the article. It is noted, that shortages of ethical nature in the activities of physicians are related to insufficient qualification of medical personnel in the area of radiation medicine. Problems of medical personnel participation in the large scale propaganda activities among various groups of population are considered. 5 refs

  17. The appropriateness of emergency medical service responses in the ...

    African Journals Online (AJOL)

    2015-10-10

    Oct 10, 2015 ... P R Newton,1 MTech (Emergency Medical Care); R Naidoo,1 MSc (Cardiology); P Brysiewicz,2 PhD (Health Science). 1 Department of Emergency Medical Care and Rescue, Faculty of Health Sciences, Durban University of Technology, South Africa ..... tation, may include a straightforward refusal.

  18. Medical response for radiological accidents from Regional cooperation : Latin-American radiopathology networks

    International Nuclear Information System (INIS)

    Valverde, Nelson; Cardenas, Juan; Perez, Maria del Rosario; Trano, Jose Luiz Di; Gisone, Pablo

    2001-01-01

    The objective of this program is to have a system, in order to assure an appropriate medical response in the case of radiological accidents and to offer medical advice in aspects related to the biological effects of ionizing radiations in risk assessment of radiation workers, medical exposures, potential effects of prenatal irradiation

  19. Discrepancies in mother and child perceptions of spina bifida medical responsibilities during the transition to adolescence: associations with family conflict and medical adherence.

    Science.gov (United States)

    Psihogios, Alexandra M; Holmbeck, Grayson N

    2013-09-01

    This study investigated mother-child discrepancies over perceptions of who is responsible for spina bifida (SB) medical tasks in relation to family conflict and medical adherence. 140 youth with SB and their mothers completed questionnaires regarding who is responsible for specific SB medical tasks, family conflict, and medical adherence. An observational measure was also used to assess family conflict. Although children viewed themselves as more responsible for medical management than mothers did, mother-child discrepancies were not associated with family conflict or medical adherence. Interaction effects revealed that adherence was better when family conflict was low and when parents were responsible for medical tasks. Parental involvement in SB medical care is essential for optimal medical adherence during adolescence. The presence of family conflict also plays an influential role on SB medical adherence. Future research should evaluate the relations between discrepancies, family conflict, and medical adherence across time.

  20. 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.

  1. 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.

  2. Simultaneous validation of the Grandway MD2301 digital automatic blood pressure monitor by the British Hypertension Society and the Association for the Advancement of Medical Instrumentation/the International Organization for Standardization protocols.

    Science.gov (United States)

    Huang, Jinhua; Wang, Yun; Liu, Zhaoying; Wang, Yuling

    2017-02-01

    The aim of this study was to determine the accuracy of the Grandway MD2301 digital automatic blood pressure monitor by the British Hypertension Society (BHS) and the Association for the Advancement of Medical Instrumentation (AAMI)/the International Organization for Standardization (ISO) protocols. A total of 85 participants were included for evaluation based on the requirements of the BHS and the AAMI/ISO protocols. The validation procedure and data analysis followed the protocols precisely. The device achieved A/A grading for the BHS protocol and maintained A/A grading throughout the low, medium and high blood pressure ranges. The device also fulfilled the requirement of the AAMI/ISO protocol with device-observer differences of -0.9±5.6 and 0.8±5.2 mmHg for systolic and diastolic blood pressure, respectively, for criterion 1, and -0.9±4.7 and 0.8±4.2 mmHg, respectively, for criterion 2. The Grandway MD2301 digital automatic blood pressure monitor achieved A/A grade of the BHS protocol and passed the requirements of the AAMI/ISO protocol in adults.

  3. The appropriateness of emergency medical service responses in the ...

    African Journals Online (AJOL)

    2015-10-10

    Oct 10, 2015 ... in the eThekwini district of KwaZulu-Natal, South Africa ... Rescue, Faculty of Health Sciences, Durban University of Technology, South Africa ... Emergency medical services (EMS) are sometimes required to respond to cases ...

  4. Generic Procedures for Medical Response During a Nuclear or Radiological Emergency

    International Nuclear Information System (INIS)

    2009-01-01

    The aim of this manual is to provide the medical community with practical guidance for medical emergency preparedness and response, describing the tasks and actions of different members of the national, regional or local medical infrastructure in accordance with international standards. This document provides generic response procedures for medical personnel responding to different types of radiation emergencies and at the different stages of the emergency response (at the scene of the emergency, pre-hospital, hospital), and during the early post-emergency stage (about 1-2 months afterwards).

  5. Dance History Matters in British Higher Education

    Science.gov (United States)

    Carter, Alexandra

    2007-01-01

    In response to concerns about the place and nature of dance history in British higher education curricula, a database was compiled of representative but significant examples of modules which focused directly on the teaching and learning of history, or had history as a key component. An analysis is presented of these modules in terms of the place…

  6. Obligations and responsibilities in radiation protection in the medical field; Obligations et responsabilites en radioprotection dans le domaine medical

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    This document briefly presents the various obligations and responsibilities of the various actors involved in or concerned by radiation protection in the medical field: the hospital administration (with respect to workers and patients), the physician (authorization and declaration, justification, optimization), the medical electro-radiology operator, the person with expertise in medical radio-physics (PSRPM), the radio-pharmacist (he is required in nuclear medicine with internal use of pharmaceutical product), the personnel with expertise in radiation protection (PCR), and other health professionals

  7. British Museum paintings

    OpenAIRE

    Edmonds, Frances

    2011-01-01

    Frances Edmonds is one of a group of artists selected for the show ‘Territories’ taking place at Galerie Windkracht 13 in Den Helder, Holland this July 2012. This exhibition is curated by Sharon Beavan and Gethin Evans. The artists represented work across the boundaries of two and three-dimensional and time based form. The brief – to interrogate and explore the notion of territories. Frances will be showing several paintings from the British Museum series, based on imagery collected ...

  8. Simultaneous validation of the SunTech CT40 automated blood pressure measurement device by the 1993 British Hypertension Society protocol and the Association for the Advancement of Medical Instrumentation/International Organization for Standardization 81060-2: 2013 standard.

    Science.gov (United States)

    Polo Friz, Hernan; Punzi, Veronica; Petri, Francesco; Orlandi, Riccardo; Maggiolini, Daniele; Polo Friz, Melisa; Primitz, Laura; Vighi, Giuseppe

    2017-10-01

    This study aimed to perform a simultaneous, third-party, independent validation of the oscillometric SunTech CT40 device for blood pressure (BP) measurement, according to the 1993 protocol of the British Hypertension Society and the standard of the Association for the Advancement of Medical Instrumentation (AAMI)/the International Organization for Standardization (ISO) 81060-2:2013. Patient recruitment, study procedures, and data analysis followed the recommendations stated by the protocols. The study was approved by the institutional review board. A total of 94 participants were included, 52 (55.3%) women, mean±SD age: 63.1±18.0 years, mean±SD arm circumference: 35.0±9.0 cm. The average of observers' entry BPs was 146.9±37.2 mmHg for systolic blood pressure (SBP) and 82.2±22.1 mmHg for diastolic blood pressure (DBP). Differences between the standard measurement and the test device within 5, 10, and 15 mmHg, for the better observer, were 79.4, 96.5, and 100.0% for SBP and 82.6, 97.5, and 100.0% for DBP, respectively. The mean±SD differences between the readings obtained using the test device and those obtained by the observers (AAMI/ISO 81060-2:2013 standard criterion 1) were 0.3±5.0 mmHg (SBP) and -0.8±4.3 mmHg (DBP), and the mean±SD differences between average of reference readings and average of test device readings in each patient (criterion 2) were 0.3±3.9 and -0.8±3.5 mmHg for SBP and DBP, respectively. The CT40 BP device achieved A/A grade of the British Hypertension Society protocol and fulfilled the requirements (criteria 1 and 2) of the AAMI/ISO standard. CT40 can be recommended for BP measurement in adults.

  9. Electronuclear Medical Assistance Foundation: medical preparedness and response in Angra dos Reis / Brazil

    International Nuclear Information System (INIS)

    Leite, Teresa C.S.B.; Maurmo, Alexandre M.

    2009-01-01

    This paper relates the health's experience in training and response to accidents involving ionizing radiation at Almirante Alvaro Alberto's Nuclear Power Plant in Angra dos Reis. The response system is organized in the same way of others health's system with pre-hospital attendance, local hospital and referential hospital .We also discussing how we training health workers about this kid of special response. (author)

  10. Role and responsibilities of medical physicists in radiology and membership of Bulgaria in European union

    International Nuclear Information System (INIS)

    Todorov, V.; Vassileva, J.

    2006-01-01

    Full text: Medical radiology and especially the radiotherapy is the birthplace of modern medical physics. Medical physicists have proven place and important role in research and practice in radiotherapy. They share the responsibility with physicians in varied daily work in this medical speciality. The rapid development of medical imaging in last decades increases the need of competence of medical physicists. Quality assurance in Diagnostic Radiology aimed to achieve maximum diagnostic information at minimal risk and with minimal prize, which is obligatory for the members of the EU, is impossible to be implemented without medical physicists. The enforced recently Ordinance 30/2005 of the Ministry of Health forms the regulatory basis of obligatory implementation of Quality Assurance at medical use of ionizing radiation in the country. This Ordinance introduces the requirements of the EURATOM 97/43 Directive on health protection of individuals against the dangers of ionizing radiation in relation to medical exposure. It regulates also the responsibilities of medical physicists in radiology. Forthcoming is the practical implementation of these requirements, which needs the competence and efforts of Medical physics community as well as of radiologists in the country

  11. Electronuclear Medical Assistance Foundation: medical preparedness and response in Angra dos Reis / Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Leite, Teresa C.S.B.; Maurmo, Alexandre M. [Fundacao Eletronuclear de Assistencia Medica, Angra dos Reis, RJ (Brazil)], e-mail: tleite@feam-etn.org.br, e-mail: maurmo@feam-etn.org.br

    2009-07-01

    This paper relates the health's experience in training and response to accidents involving ionizing radiation at Almirante Alvaro Alberto's Nuclear Power Plant in Angra dos Reis. The response system is organized in the same way of others health's system with pre-hospital attendance, local hospital and referential hospital .We also discussing how we training health workers about this kid of special response. (author)

  12. The Ethical Perspective of British and American Preservice Teachers.

    Science.gov (United States)

    Deering, Thomas E.

    1998-01-01

    Comparison of responses from 38 U.S. and 27 British preservice teachers on the Ethics Position Questionnaire indicated that both groups had high idealism. U.S. teachers had lower relativism scores. (SK)

  13. Rapid response: email, immediacy, and medical humanitarianism in Aceh, Indonesia.

    Science.gov (United States)

    Grayman, Jesse Hession

    2014-11-01

    After more than 20 years of sporadic separatist insurgency, the Free Aceh Movement and the Indonesian government signed an internationally brokered peace agreement in August 2005, just eight months after the Indian Ocean tsunami devastated Aceh's coastal communities. This article presents a medical humanitarian case study based on ethnographic data I collected while working for a large aid agency in post-conflict Aceh from 2005 to 2007. In December 2005, the agency faced the first test of its medical and negotiation capacities to provide psychiatric care to a recently amnestied political prisoner whose erratic behavior upon returning home led to his re-arrest and detention at a district police station. I juxtapose two methodological approaches-an ethnographic content analysis of the agency's email archive and field-based participant-observation-to recount contrasting narrative versions of the event. I use this contrast to illustrate and critique the immediacy of the humanitarian imperative that characterizes the industry. Immediacy is explored as both an urgent moral impulse to assist in a crisis and a form of mediation that seemingly projects neutral and transparent transmission of content. I argue that the sense of immediacy afforded by email enacts and amplifies the humanitarian imperative at the cost of abstracting elite humanitarian actors out of local and moral context. As a result, the management and mediation of this psychiatric case by email produced a bureaucratic model of care that failed to account for complex conditions of chronic political and medical instability on the ground. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

    Haywood, J K

    1986-01-01

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

  15. The "brittle response" to Parkinson's disease medications: characterization and response to deep brain stimulation.

    Directory of Open Access Journals (Sweden)

    Daniel Martinez-Ramirez

    Full Text Available Formulate a definition and describe the clinical characteristics of PD patients with a "brittle response" (BR to medications versus a "non-brittle response" (NBR, and characterize the use of DBS for this population.An UF IRB approved protocol used a retrospective chart review of 400 consecutive PD patients presenting to the UF Center for Movement Disorders and Neurorestoration. Patient records were anonymized and de-identified prior to analysis. SPSS statistics were used to analyze data.Of 345 included patients, 19 (5.5% met criteria for BR PD. The BR group was comprised of 58% females, compared to 29% in the NBR group (P = .008. The former had a mean age of 63.4 compared to 68.1 in the latter. BR patients had lower mean weight (63.5 vs. 79.6, P = <.001, longer mean disease duration (12.6 vs. 8.9 years, P = .003, and had been on LD for more years compared to NBR patients (9.8 vs. 5.9, P = .001. UPDRS motor scores were higher (40.4 vs. 30.0, P = .001 in BR patients. No differences were observed regarding the Schwab and England scale, PDQ-39, and BDI-II. Sixty-three percent of the BR group had undergone DBS surgery compared to 18% (P = .001. Dyskinesias were more common, severe, and more often painful (P = <.001 in the BR group. There was an overall positive benefit from DBS.BR PD occurred more commonly in female patients with a low body weight. Patients with longer disease duration and longer duration of LD therapy were also at risk. The BR group responded well to DBS.

  16. U.S. Policy Responses to Calls for the Medical Use of Cannabis

    Science.gov (United States)

    Hall, Wayne

    2015-01-01

    This paper discusses the evolution of U.S. policy responses to calls to allow patients to use cannabis for medical purposes. It first summarizes the research evidence on the safety and efficacy of cannabinoids for various medical uses. It then outlines the challenges in developing new pharmaceutical cannabinoids that are safe, effective, and acceptable to patients. It briefly describes the strengths and limitations of the different ways in which U.S. states have allowed patients to use cannabis for medical purposes. These include allowing access for research trials only, allowing medical necessity as a defense against prosecution, and allowing commercial medical dispensaries to provide cannabis to approved patients. It argues that liberal definitions of indications for medical cannabis use and the commercialization of medical cannabis supply in California have produced the de facto legalization of recreational cannabis use. PMID:26339208

  17. Development of Medical Technology for Contingency Response to Marrow Toxic Agents

    Science.gov (United States)

    2018-02-28

    Program HHQ Health History Questionnaire National Marrow Donor Program® N00014-16-1-2020 Development of Medical Technology for Contingency Response to...Report 3. DATES COVERED (From - To) DEC 2015 -November 2017 4. TITLE AND SUBTITLE Development of Medical Technology for Contingency Response to Marrow...immunobiologic and clinical research activities promote studies to advance the science and technology of HCT to improve outcomes and quality of life for

  18. Medical response guide for the initial phase of a radiological emergency

    International Nuclear Information System (INIS)

    Vazquez, Marina A.; Perez, Maria del R.

    2007-01-01

    In case of a sanitary emergency, the local community and its health care system are the first aid providers. Therefore, preparedness through education and training programs would allow emergency systems to provide an appropriate first medical response. The main objective of this guide is to give basic guidelines for the medical response management after situations involving radioactive materials, in an easy and simple way. The information contained in this guide is addressed to health care personnel of any local assistance center. (author) [es

  19. The power of British Energy

    International Nuclear Information System (INIS)

    Hawley, R.

    1997-01-01

    When the power industry in Britain was privatized, British Energy plc (BE), whose head office is in Edingburgh, Scotland, was founded in July 1996. It is the only power utility in the world exclusively operating nuclear power stations. Operative business has remained the responsibility of the two regional supply companies, Nuclear Electric (NE) and Scottish Nuclear (SN) which, in addition to the modern PWR nuclear generating unit of Sizewell B, have included in the new holding company their advanced gas-cooled and gas-moderated reactor (AGR) units. The older gas-graphite reactor (GGR) plants were combined in the new Magnox Electric plc, Berkeley; at some later date, this company is to be merged with another nuclear power plant operator, British Nuclear Fuels plc (BNFL). Sizewell B, which was commissioned in 1995, is the last nuclear generating unit to be started up in the United Kingdom, for the time being. In times of low raw material prices and the need for a quick return on invested capital, BE is reluctant to run the risk associated with tying up capital for a long time. Instead, the company has backfitted its plants so that the production of electricity from nuclear power in Britain in 1996 of 92,476 GWh was increased by almost 10% over the 1995 level of 84,174 GWh. In addition to modernization and rationalization at home, BE together with Sizewell B vendor Westinghouse is engaged worldwide in the development and commercialization of future advanced reactors. This ensures that the know-how accumulated will be preserved and will be available for new nuclear power plants to be built in Britain in the next century. (orig.)

  20. Conference Proceedings: Photography and Britishness

    Directory of Open Access Journals (Sweden)

    Sean Willcock

    2016-11-01

    Full Text Available The video-recordings presented here were made at the conference Photography and Britishness, held at the Yale Center for British Art on November 4 – 5, 2016. The conference was the result of a collaboration between the Yale Center for British Art, New Haven, the Paul Mellon Centre for Studies in British Art, London, and the Huntington Library, Art Collections, and Botanical Gardens in San Marino—three research institutions that have a converging interest in British art. The conference sought to investigate the various ways in which notions of “Britishness” have been communicated, inflected, and contested through the photographic image. It was not a conference about the history of photography in Britain, or about British photography. Rather, it sought to consider the nature of the relationship between photography and Britishness: the notion that photography can capture images of Britishness, at the same time that our sense of what Britishness constitutes is produced by the photographic image. A key question for the conference was whether Britishness can have a photographic referent—or whether it is itself an effect of representation. Speakers at the conference approached these questions from a wide range of perspectives and focusing on a diverse number of photographic materials—from family albums and studio portraits to advertisements, reportage, and aerial photography—which demonstrated the complexities and instabilities not only of the term Britishness, but also of the medium of photography. The conference was opened with an introduction by John Tagg. The videos included here are presented in the order they were delivered.

  1. Privatising British electricity

    International Nuclear Information System (INIS)

    Holmes, A.

    1992-01-01

    The privatisation of the British electricity industry was intended to be the most radical change made to a European power system in the post-war period. It was of an experimental nature, imposing on electricity a way of operating which has no equivalent anywhere in the world. This report shows, however, that in the long run-up to privatisation, a number of factors combined to pull the plan far from its original aims and to produce a hybrid system which has caused many new difficulties without establishing a fully commercial market. The original ideas behind the new system - most notably the establishment of a fully competitive commercial system - have not been fulfilled. Many of them were wholly impractical. The problems of establishing a competitive market in electricity were never properly addressed until the planning for the new system was well under way. (author)

  2. Medical Preparedness and Response for a Nuclear or Radiological Emergency. Training Materials

    International Nuclear Information System (INIS)

    2014-01-01

    In almost all nuclear and radiological emergencies, local emergency services (e.g. local medical, law enforcement, and fire brigades) will have the most important role in the early response. Within hours, hospitals may also have an important role to play in the response at the local level. Since nuclear and radiological emergencies are rare, medical responders often have little or no experience in dealing with this type of emergency and inexperience may lead to an inadequate response. For this reason, training in medical preparedness and response for a nuclear or radiological emergency is an important aspect of preparedness and response activities. These materials are designed for use at a training course on medical preparedness and response for a nuclear or radiological emergency. They contain a wide range of lectures and supporting materials, which cover the basic topics and more specific areas of medical preparedness and response. Therefore, in planning their specific courses, organizers are encouraged to choose those lectures and supportive materials from the CD-ROM that best match their training priorities. Materials on the CD-ROM address the following areas: • Terrorism in Perspective; • Malicious Act Scenarios; • Providing Information to the Medical Community and the Public; • Medical Response to a Radiation Mass Casualty Event; • Handling of Contaminated Persons in Malicious Events; • Planning and Preparedness for Medical Response to Malicious Events with Radioactive Material; • Handling the Bodies of Decedents Contaminated with Radioactive Material; • Radiation Emergencies: Scope of the Problem; • Common Sources of Radiation; • Basic Concepts of Ionizing Radiation; • Basic Concepts of Radiation Protection; • Biological Effects of Ionizing Radiation – Basic Notions; • Basics of Radiopathology; • External Radioactive Contamination; • Internal Radioactive Contamination; • Acute Radiation Syndrome; • Cutaneous Radiation

  3. Emergency preparedness: a responsibility of the medical profession

    International Nuclear Information System (INIS)

    Sammons, J.H.

    1986-01-01

    There are a series of things that we might do with regard to emergency planning. Some are clearly obvious, some perhaps are less so. Obviously, we should try to prevent a disaster from occurring. But we know that disasters are going to happen. Second, we should attempt to minimize the number of casualties in the event of an emergency. A part of planning is traffic control, with the traffic control designed to prevent that particular difficulty. Clearly we need to prevent additional casualties once the natural or man-made disaster has occurred. Without question, we have to rescue the injured, we have to be able to provide first aid, and we have to make value judgments instantly on who needs aid and who does not. Obviously, the medical community has to supply the leaders in terms of the care of the injured. Equally obvious is that other people in the community, such as the governor, the mayor, the city manager, the chief of police, and the fire chief, have to be involved. When you become involved in emergency planning, remember that there are other people in the health care family. It is not just physicians who are important; the Red Cross, nurses, public health agencies, those in state radiation control programs, and many others also are important. And let us not forget the people with specialized training in nuclear medicine, as well as radiologists and radiation oncologists

  4. Explanation of procedure on site medical emergency response for nuclear accident

    International Nuclear Information System (INIS)

    Liu Yulong; Jiang Zhong

    2012-01-01

    National occupational health standard-Procedure on Site Medical Emergency Response for Nuclear Accident has been approved and issued by the Ministry of Health. This standard is formulated according to the Emergency Response Law of the People's Republic of China, Law of the People 's Republic of China on Prevention and Control of Occupational Diseases, Regulations on Emergency Measures for Nuclear Accidents at Nuclear Power Plants, and Health Emergency Plans for Nuclear and Radiological Accidents of Ministry of Health, supporting the use of On-site Medical Emergency Planning and Preparedness for Nuclear Accidents and Off-site Medical Emergency Planning and Preparedness for Nuclear Accidents. Nuclear accident on-site medical response procedure is a part of the on-site emergency plan. The standard specifies the basic content and requirements of the nuclear accident on-site medical emergency response procedures of nuclear facilities operating units to guide and regulate the work of nuclear accident on-site medical emergency response of nuclear facilities operating units. The criteria-related contents were interpreted in this article. (authors)

  5. Prediction of Response to Medication and Cognitive Therapy in the Treatment of Moderate to Severe Depression

    Science.gov (United States)

    Fournier, Jay C.; DeRubeis, Robert J.; Shelton, Richard C.; Hollon, Steven D.; Amsterdam, Jay D.; Gallop, Robert

    2009-01-01

    A recent randomized controlled trial found nearly equivalent response rates for antidepressant medications and cognitive therapy in a sample of moderate to severely depressed outpatients. In this article, the authors seek to identify the variables that were associated with response across both treatments as well as variables that predicted…

  6. Speed-accuracy trade-offs in computing spatial impulse responses for simulating medical ultrasound imaging

    DEFF Research Database (Denmark)

    Jensen, Jørgen Arendt

    2001-01-01

    sampling frequency is unnecessary in the final signals, since the transducers used in medical ultrasound are band limited. Approaches to reduce the sampling frequency are, thus, needed to make efficient simulation programs. Field II uses time integration of the spatial impulse responses using a continuous......Medical ultrasound imaging can be simulated realistically using linear acoustics. One of the most powerful approaches is to employ spatial impulse responses. Hereby both emitted fields and pulse-echo responses from point scatterers can be determined. Also any kind of dynamic focusing...

  7. Responsibility for quality improvement and patient safety: hospital board and medical staff leadership challenges.

    Science.gov (United States)

    Goeschel, Christine A; Wachter, Robert M; Pronovost, Peter J

    2010-07-01

    Concern about the quality and safety of health care persists, 10 years after the 1999 Institute of Medicine report To Err is Human. Despite growing awareness of quality and safety risks, and significant efforts to improve, progress is difficult to measure. Hospital leaders, including boards and medical staffs, are accountable to improve care, yet they often address this duty independently. Shared responsibility for quality and patient safety improvement presents unique challenges and unprecedented opportunities for boards and medical staffs. To capitalize on the pressure to improve, both groups may benefit from a better understanding of their synergistic potential. Boards should be educated about the quality of care provided in their institutions and about the challenges of valid measurement and accurate reporting. Boards strengthen their quality oversight capacity by recruiting physicians for vacant board seats. Medical staff members strengthen their role as hospital leaders when they understand the unique duties of the governing board. A quality improvement strategy rooted in synergistic efforts by the board and the medical staff may offer the greatest potential for safer care. Such a mutually advantageous approach requires a clear appreciation of roles and responsibilities and respect for differences. In this article, we review these responsibilities, describe opportunities for boards and medical staffs to collaborate as leaders, and offer recommendations for how boards and medical staff members can address the challenges of shared responsibility for quality of care.

  8. Facilitators and obstacles in pre-hospital medical response to earthquakes: a qualitative study

    Science.gov (United States)

    2011-01-01

    Background Earthquakes are renowned as being amongst the most dangerous and destructive types of natural disasters. Iran, a developing country in Asia, is prone to earthquakes and is ranked as one of the most vulnerable countries in the world in this respect. The medical response in disasters is accompanied by managerial, logistic, technical, and medical challenges being also the case in the Bam earthquake in Iran. Our objective was to explore the medical response to the Bam earthquake with specific emphasis on pre-hospital medical management during the first days. Methods The study was performed in 2008; an interview based qualitative study using content analysis. We conducted nineteen interviews with experts and managers responsible for responding to the Bam earthquake, including pre-hospital emergency medical services, the Red Crescent, and Universities of Medical Sciences. The selection of participants was determined by using a purposeful sampling method. Sample size was given by data saturation. Results The pre-hospital medical service was divided into three categories; triage, emergency medical care and transportation, each category in turn was identified into facilitators and obstacles. The obstacles identified were absence of a structured disaster plan, absence of standardized medical teams, and shortage of resources. The army and skilled medical volunteers were identified as facilitators. Conclusions The most compelling, and at the same time amenable obstacle, was the lack of a disaster management plan. It was evident that implementing a comprehensive plan would not only save lives but decrease suffering and enable an effective praxis of the available resources at pre-hospital and hospital levels. PMID:21575233

  9. Facilitators and obstacles in pre-hospital medical response to earthquakes: a qualitative study.

    Science.gov (United States)

    Djalali, Ahmadreza; Khankeh, Hamidreza; Öhlén, Gunnar; Castrén, Maaret; Kurland, Lisa

    2011-05-16

    Earthquakes are renowned as being amongst the most dangerous and destructive types of natural disasters. Iran, a developing country in Asia, is prone to earthquakes and is ranked as one of the most vulnerable countries in the world in this respect. The medical response in disasters is accompanied by managerial, logistic, technical, and medical challenges being also the case in the Bam earthquake in Iran. Our objective was to explore the medical response to the Bam earthquake with specific emphasis on pre-hospital medical management during the first days. The study was performed in 2008; an interview based qualitative study using content analysis. We conducted nineteen interviews with experts and managers responsible for responding to the Bam earthquake, including pre-hospital emergency medical services, the Red Crescent, and Universities of Medical Sciences. The selection of participants was determined by using a purposeful sampling method. Sample size was given by data saturation. The pre-hospital medical service was divided into three categories; triage, emergency medical care and transportation, each category in turn was identified into facilitators and obstacles. The obstacles identified were absence of a structured disaster plan, absence of standardized medical teams, and shortage of resources. The army and skilled medical volunteers were identified as facilitators. The most compelling, and at the same time amenable obstacle, was the lack of a disaster management plan. It was evident that implementing a comprehensive plan would not only save lives but decrease suffering and enable an effective praxis of the available resources at pre-hospital and hospital levels.

  10. MEDICAL PROFESSIONAL RESPONSIBILITY IN VIH CONTAGION AFTER BLOOD TRANSFUSIONS

    Directory of Open Access Journals (Sweden)

    R. Ortiz de Lejarazu Leonardo

    2005-01-01

    Full Text Available SUMMARYIn Spain a million and a half blood transfusions by year are carried out, that supposes between 2 and 10 cases of infection of VIH by year. The present state of science invites to do something more with tests to detect other virological and immunological markers, in order to identify seronegative carriers and thus avoid HIV transmission by them. We must consider the possibility to incur in professional responsibilities if we do not report adequate of this risk or if we do not provide patients all the cares that require, according to the state of the science so called lex artis.RESUMENEn España se realizan un millón y medio de transfusiones de sangre al año, lo que supone un riesgo de entre 2 y 10 casos de infección de VIH a través de las mismas. El estado actual de la ciencia invita a hacer algo más pudiéndose ampliar los estudios de marcadores víricos e inmunológicos, para identificar a portadores seronegativos y así tratar de evitar la transmisión del virus de inmunodeficiencia humana a través de ellos. Debemos considerar la posibilidad de incurrir en responsabilidades profesionales si no informamos adecuadamente de este riesgo o si no proporcionamos a los pacientes todos los cuidados que requieren, según el estado actual de la ciencia, lo que denominamos lex artis.

  11. British Nuclear Fuels (Warrington)

    International Nuclear Information System (INIS)

    Hoyle, D.; Cryer, B.; Bellotti, D.

    1992-01-01

    This adjournment debate is about British Nuclear Fuels plc and the 750 redundancies due to take place by the mid-1990s at BNFL, Risley. The debate was instigated by the Member of Parliament for Warrington, the constituency in which BNFL, Risley is situated. Other members pointed out that other industries, such as the textile industry are also suffering job losses due to the recession. However the MP for Warrington argued that the recent restructuring of BNFL restricted the financial flexibility of BNFL so that the benefits of contracts won for THORP at Sellafield could not help BNFL, Risley. The debate became more generally about training, apprentices and employment opportunities. The Parliamentary Under-Secretary of State for Energy explained the position as he saw it and said BNFL may be able to offer more help to its apprentices. Long- term employment prospects at BNFL are dependent on the future of the nuclear industry in general. The debate lasted about half an hour and is reported verbatim. (U.K)

  12. AN IMPECUNIOUS PILOT: BRITISH BUSINESS CULTURE AND THE CASE OF LOWELL YEREX, 1933-1946

    Directory of Open Access Journals (Sweden)

    Erik Benson

    2003-01-01

    Full Text Available This article examines the relationship between a New Zealand-born entrepreneur, Lowell Yerex, and the British government. It will give particular attention to the role of British business culture in shaping the government’s response to Yerex. During the 1930s and l940s, Yerex built an important airline network in the Caribbean Basin. A British subject, he had an affinity for the empire. However, the British rebuffed his repeated efforts to form an alliance. While they had political, economic and strategic reasons for doing so, the British also manifested a disdain for Yerex because he did not measure up to their business ideals.

  13. Role and responsibilities of medical physicists in radiological protection of patients

    International Nuclear Information System (INIS)

    Niroomand-Rad, A.

    2001-01-01

    The paper provides a brief history of the International Organization for Medical Physics (IOMP), followed by some general comments on the radiological protection of patients. The importance of establishing scientific guidelines and professional standards is emphasized, as is the need to ensure the protection of patients undergoing radiation therapy. The responsibility of qualified medical physicists in the protection of patients in nuclear medicine and in diagnostic and interventional radiology is also discussed. (author)

  14. The physician as health advocate: translating the quest for social responsibility into medical education and practice.

    Science.gov (United States)

    Dharamsi, Shafik; Ho, Anita; Spadafora, Salvatore M; Woollard, Robert

    2011-09-01

    There is a growing demand for educating future physicians to be socially responsible. It is not clear, however, how social responsibility is understood and acted on in medical education and practice, particularly within the context of a growing desire to improve health care through an equitable and sustainable delivery system. The authors conduct a concept analysis, exploring the practical philosophical understanding of social responsibility and its implications for medical education and practice. The aim is to inform curricular development, professional practice, and further research on social responsibility. The particular ways in which social responsibility is interpreted can either enhance or establish limits on how it will appear across the continuum of medical education and practice. A physician's place in society is closely tied to a moral sense of responsibility related to the agreed-on professional characteristics of physicianhood in society, the capacity to carry out that role, and the circumstances under which such professionals are called to account for failing to act appropriately according to that role. The requirement for social responsibility is a moral commitment and duty developed over centuries within societies that advanced the notion of a "profession" and the attendant social contract with society. A curriculum focused on developing social responsibility in future physicians will require pedagogical approaches that are innovative, collaborative, participatory, and transformative.

  15. Medical mitigation model: quantifying the benefits of the public health response to a chemical terrorism attack.

    Science.gov (United States)

    Good, Kevin; Winkel, David; VonNiederhausern, Michael; Hawkins, Brian; Cox, Jessica; Gooding, Rachel; Whitmire, Mark

    2013-06-01

    The Chemical Terrorism Risk Assessment (CTRA) and Chemical Infrastructure Risk Assessment (CIRA) are programs that estimate the risk of chemical terrorism attacks to help inform and improve the US defense posture against such events. One aspect of these programs is the development and advancement of a Medical Mitigation Model-a mathematical model that simulates the medical response to a chemical terrorism attack and estimates the resulting number of saved or benefited victims. At the foundation of the CTRA/CIRA Medical Mitigation Model is the concept of stock-and-flow modeling; "stocks" are states that individuals progress through during the event, while "flows" permit and govern movement from one stock to another. Using this approach, the model is able to simulate and track individual victims as they progress from exposure to an end state. Some of the considerations in the model include chemical used, type of attack, route and severity of exposure, response-related delays, detailed treatment regimens with efficacy defined as a function of time, medical system capacity, the influx of worried well individuals, and medical countermeasure availability. As will be demonstrated, the output of the CTRA/CIRA Medical Mitigation Model makes it possible to assess the effectiveness of the existing public health response system and develop and examine potential improvement strategies. Such a modeling and analysis capability can be used to inform first-responder actions/training, guide policy decisions, justify resource allocation, and direct knowledge-gap studies.

  16. Roles and Responsibilities, and Education and Training Requirements for Clinically Qualified Medical Physicists (Russian Edition)

    International Nuclear Information System (INIS)

    2014-01-01

    This publication addresses the shortfall of well trained and clinically qualified medical physicists working in radiation medicine. The roles, responsibilities and clinical training requirements of medical physicists have not always been well defined or well understood by health care professionals, health authorities and regulatory agencies. To fill this gap, this publication provides recommendations for the academic education and clinical training of clinically qualified medical physicists, including recommendations for their accreditation certification and registration, along with continuous professional development. The goal is to establish criteria that support the harmonization of education and clinical training worldwide

  17. Offshore industry: medical emergency response in the offshore oil and gas industry.

    Science.gov (United States)

    Ponsonby, Will; Mika, Frano; Irons, Greg

    2009-08-01

    The hunt for oil and gas has taken workers into new more distant locations including those offshore. The remoteness of the offshore platforms and vessels coupled with the potential risk of being cut off by bad weather presents particular challenges for medical emergency response (MER). Firstly to define the challenges for MER in terms of locations, population and epidemiology of injuries and illnesses in the offshore environment. Secondly to give examples of legal requirements and industry standards to manage MER. Thirdly to look at existing and emerging practice to manage these challenges. A review of published literature was supplemented with a summary of current practice in the industry. Medical professionals (medics) working offshore on installations and vessels are primarily responsible for the medical care of the workers. The medics have clinics with suitable medical equipment for managing emergencies as well as providing limited primary care. Some countries have legislation that stipulate minimum requirements. Where there is no national legislation, industry and company guidance is used to define the MER standards. Supervision of the offshore medics is often provided by doctors on shore via radio and phone links. These methods of communication are now being augmented with more sophisticated telemedicine solutions such as the Internet and live video links. These newer solutions allow for prompt high-quality care and provide the scope for a variety of new treatment options to be available for the offshore workforce.

  18. Regional futures: British Columbia

    International Nuclear Information System (INIS)

    Rees, W.

    1993-01-01

    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

  19. Medical and radiological aspects of emergency preparedness and response at SevRAO facilities.

    Science.gov (United States)

    Savkin, M N; Sneve, M K; Grachev, M I; Frolov, G P; Shinkarev, S M; Jaworska, A

    2008-12-01

    Regulatory cooperation between the Norwegian Radiation Protection Authority and the Federal Medical Biological Agency (FMBA) of the Russian Federation has the overall goal of promoting improvements in radiation protection in Northwest Russia. One of the projects in this programme has the objectives to review and improve the existing medical emergency preparedness capabilities at the sites for temporary storage of spent nuclear fuel and radioactive waste. These are operated by SevRAO at Andreeva Bay and in Gremikha village on the Kola Peninsula. The work is also intended to provide a better basis for regulation of emergency response and medical emergency preparedness at similar facilities elsewhere in Russia. The purpose of this paper is to present the main results of that project, implemented by the Burnasyan Federal Medical Biophysical Centre. The first task was an analysis of the regulatory requirements and the current state of preparedness for medical emergency response at the SevRAO facilities. Although Russian regulatory documents are mostly consistent with international recommendations, some distinctions lead to numerical differences in operational intervention criteria under otherwise similar conditions. Radiological threats relating to possible accidents, and related gaps in the regulation of SevRAO facilities, were also identified. As part of the project, a special exercise on emergency medical response on-site at Andreeva Bay was prepared and carried out, and recommendations were proposed after the exercise. Following fruitful dialogue among regulators, designers and operators, special regulatory guidance has been issued by FMBA to account for the specific and unusual features of the SevRAO facilities. Detailed sections relate to the prevention of accidents, and emergency preparedness and response, supplementing the basic Russian regulatory requirements. Overall it is concluded that (a) the provision of medical and sanitary components of emergency

  20. War of the British Worlds

    DEFF Research Database (Denmark)

    Mercau, Ezequiel

    2016-01-01

    The 1982 Falklands War was shrouded in symbolism, bringing to the fore divergent conceptions of Britishness, kinship, and belonging. This article casts light on the persistent purchase of the idea of Greater Britain long after the end of empire, addressing a case that would normally be deemed...... outside its spatial and temporal boundaries. By highlighting the inherent contradictions of this transnational bond, the South Atlantic conflict had a profound effect on an underexposed British community with a lingering attachment to a “British world”: the Anglo-Argentines. As they found themselves...... wedged between two irreconcilable identities, divisions threatened to derail this already enfeebled grouping. Yet leaders of the community, presuming a common Britishness with the Falkland Islanders and Britons in the United Kingdom, sought to intervene in the conflict by reaching out to both...

  1. System of medical response to radiation emergency after a terror attack in China

    International Nuclear Information System (INIS)

    Liu, Y.; Wang, Z.

    2005-01-01

    Full text: Nuclear or radiological accident is an unintended or unexpected event occurring with a radiation source or during a practice involving ionizing radiation, which may result in significant human exposure and/or material damage. Recent events involving terrorist activities have focused attention on the radiological threats. The full spectrum of radiological threats from terrorist spans the deliberate dispersal of radioactive material to the detonation of a nuclear weapon. While the most likely threat is the dispersal of radioactive materials, the use of a crude nuclear weapon against a major city cannot be dismissed. Radiological incident response requires functions similar to non-radiological incident response. Radiation emergency system in China has been established for radiological emergency preparedness and response. National coordination committee of radiation emergency has been setup in 1994, which consist of 17 ministries. The ministry is responsible for the medical assistance for radiation emergency. Chinese Center for Medical Response to Radiation Emergency (CCMRRE) was established in 1992, based on the National Institute for Radiological Protection, China CDC (NIRP, China CDC). The CCMRRE has been as one liaison institutes of WHO/REMPAN and functions as a national and professional institute for medical assistance in radiation accidents and terrorist events involving radioactive material. Under Provincial Committee of Radiation Emergency, there are local organizations of medical assistance in radiation emergency. The organizations carry out the first aid, regional clinic treatment, radiation protection and radiation monitory in nuclear accidents and radiological accidents. (author)

  2. Roles and Responsibilities, and Education and Training Requirements for Clinically Qualified Medical Physicists (Spanish Edition)

    International Nuclear Information System (INIS)

    2014-01-01

    The IAEA technical cooperation project Strengthening Medical Physics in Radiation Medicine was approved by the IAEA Board of Governors for the period 2009-2013 with the aim of ensuring the safe and effective diagnosis and treatment of patients. The IAEA, together with the World Health Organization and stakeholders from numerous medical physics professional societies worldwide, including the International Organization for Medical Physics (IOMP), the European Federation of Organisations for Medical Physics, the American Association of Physicists in Medicine (AAPM), the Latin American Medical Physics Association, the Asia-Oceania Federation of Organizations for Medical Physics, the European Society for Radiotherapy and Oncology, the European Commission and the International Radiation Protection Association, as well as regional counterparts from Africa, Asia, Europe and Latin America, met in Vienna in May 2009 to plan and coordinate the new project. A shortage of clinically qualified medical physicists (CQMPs), insufficient education and training (especially properly organized and coordinated clinical training), and lack of professional recognition were identified as the main problems to be addressed under this project. This publication was developed under the project framework in response to these findings. It aims, first, at defining appropriately and unequivocally the roles and responsibilities of a CQMP in specialties of medical physics related to the use of ionizing radiation, such as radiation therapy, nuclear medicine, and diagnostic and interventional radiology. Important, non-ionizing radiation imaging specialties, such as magnetic resonance and ultrasound, are also considered for completeness. On the basis of these tasks, this book provides recommended minimum requirements for the academic education and clinical training of CQMPs, including recommendations for their accreditation, certification and registration, along with continuing professional development

  3. Roles and Responsibilities, and Education and Training Requirements for Clinically Qualified Medical Physicists

    International Nuclear Information System (INIS)

    2013-01-01

    The IAEA technical cooperation project Strengthening Medical Physics in Radiation Medicine was approved by the IAEA Board of Governors for the period 2009-2013 with the aim of ensuring the safe and effective diagnosis and treatment of patients. The IAEA, together with the World Health Organization and stakeholders from numerous medical physics professional societies worldwide, including the International Organization for Medical Physics (IOMP), the European Federation of Organisations for Medical Physics, the American Association of Physicists in Medicine (AAPM), the Latin American Medical Physics Association, the Asia-Oceania Federation of Organizations for Medical Physics, the European Society for Radiotherapy and Oncology, the European Commission and the International Radiation Protection Association, as well as regional counterparts from Africa, Asia, Europe and Latin America, met in Vienna in May 2009 to plan and coordinate the new project. A shortage of clinically qualified medical physicists (CQMPs), insufficient education and training (especially properly organized and coordinated clinical training), and lack of professional recognition were identified as the main problems to be addressed under this project. This publication was developed under the project framework in response to these findings. It aims, first, at defining appropriately and unequivocally the roles and responsibilities of a CQMP in specialties of medical physics related to the use of ionizing radiation, such as radiation therapy, nuclear medicine, and diagnostic and interventional radiology. Important, non-ionizing radiation imaging specialties, such as magnetic resonance and ultrasound, are also considered for completeness. On the basis of these tasks, this book provides recommended minimum requirements for the academic education and clinical training of CQMPs, including recommendations for their accreditation, certification and registration, along with continuing professional development

  4. Roles and Responsibilities, and Education and Training Requirements for Clinically Qualified Medical Physicists

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-08-15

    The IAEA technical cooperation project Strengthening Medical Physics in Radiation Medicine was approved by the IAEA Board of Governors for the period 2009-2013 with the aim of ensuring the safe and effective diagnosis and treatment of patients. The IAEA, together with the World Health Organization and stakeholders from numerous medical physics professional societies worldwide, including the International Organization for Medical Physics (IOMP), the European Federation of Organisations for Medical Physics, the American Association of Physicists in Medicine (AAPM), the Latin American Medical Physics Association, the Asia-Oceania Federation of Organizations for Medical Physics, the European Society for Radiotherapy and Oncology, the European Commission and the International Radiation Protection Association, as well as regional counterparts from Africa, Asia, Europe and Latin America, met in Vienna in May 2009 to plan and coordinate the new project. A shortage of clinically qualified medical physicists (CQMPs), insufficient education and training (especially properly organized and coordinated clinical training), and lack of professional recognition were identified as the main problems to be addressed under this project. This publication was developed under the project framework in response to these findings. It aims, first, at defining appropriately and unequivocally the roles and responsibilities of a CQMP in specialties of medical physics related to the use of ionizing radiation, such as radiation therapy, nuclear medicine, and diagnostic and interventional radiology. Important, non-ionizing radiation imaging specialties, such as magnetic resonance and ultrasound, are also considered for completeness. On the basis of these tasks, this book provides recommended minimum requirements for the academic education and clinical training of CQMPs, including recommendations for their accreditation, certification and registration, along with continuing professional development

  5. How Iranian Medical Trainees Approach their Responsibilities in Clinical Settings; A Grounded Theory Research

    Directory of Open Access Journals (Sweden)

    Omid Asemani

    2015-09-01

    Full Text Available Background: It seems we are now experiencing “responsibility problems” among medical trainees (MTs and some of those recently graduated from medical schools in Iran. Training responsible professionals have always been one of the main concerns of medical educators. Nevertheless, there is a dearth of research in the literature on “responsibility” especially from the medical education point of view. Therefore, the present study was carried out with the aim of presenting a theoretical based framework for understanding how MTs approach their responsibilities in educational settings. Method: This qualitative study was conducted at Shiraz University of Medical Sciences (SUMS using the grounded theory methodology. 15 MTs and 10 clinical experts and professional nurses were purposefully chosen as participants. Data was analyzed using the methodology suggested by Corbin and Strauss, 1998. Results: “Try to find acceptance toward expectations”, “try to be committed to meet the expectations” and “try to cope with unacceptable expectations” were three main categories extracted based on the research data. Abstractly, the main objective for using these processes was “to preserve the integrity of student identity” which was the core category of this research too. Moreover, it was also found that practically, “responsibility” is considerably influenced by lots of positive and negative contextual and intervening conditions. Conclusion: “Acceptance” was the most decisive variable highly effective in MTs’ responsibility. Therefore, investigating the “process of acceptance” regarding the involved contextual and intervening conditions might help medical educators correctly identify and effectively control negative factors and reinforce the constructive ones that affect the concept of responsibility in MTs.

  6. Training for the medical response in radiological emergency experiences and results

    International Nuclear Information System (INIS)

    Cardenas Herrera, J.; Lopez Forteza, Y.

    2003-01-01

    The use of the nuclear techniques int he social practice confers a special imporatnce to the relative aspects to the safety of the practices and radiationsources, for what the implementation of efficient programs of radiation protection constitutes a priority. However in spite of the will before expressed, regrettably radiological situations happen accidental assocaited to multiple causes taht suggest the creation of response capacities to intervention before these fortuitous facts. The experiences accumulated in the last decades related with accidental exposures have evidenced the convenience of having properly qualified human resources for the Medical Response in Radiological Emergencies. The training in the medical aspects of the radiological emergencies acquires a singular character. In such a sense when valuing the national situation put onof manifest deficiences as for the training in medical aspects of the radiological emergencies that advised the development of training programs in such aspects for the different response groups linked to the topic. After identified the training necessities and the scope of the same ones, the contents of the training program were elaborated. The program has as general purpose the invigoration of the capacity of the medical response in front of accidental radiological situations, by means of actions that they bear to prepare groups of medical response in the handling of people accident victims and to the identification of potentials,accidental scenarios, as well as of the necessary resources to confront them. The program content approaches theoretical and paractical aspects to the medical aspect to radiological emergencies. The program include the different topics about fundamental of physical biological to radiation protection, radiation protection during exposure of radiological accidents, medical care for overexposed or contaminated persons, drill, exercises and concludes with designation of a strategy as preparation and

  7. Response capabilities of the National Guard: a focus on domestic disaster medical response.

    Science.gov (United States)

    Bochicchio, Daniel

    2010-01-01

    The National Guard has a 373-year history of responding to the nation's call to duty for service both at home and abroad (The National Guard Bureau Web site: Available at http://www.ngb.army.mil/default. aspx.). The National Guard (NG) is a constitutionally unique organization (United States Constitution, US Government Printing Office Web site: Available at http://www.gpoaccess.gov/constitution/index.html.). Today's Guard conducts domestic disaster response and civilian assistance missions on a daily basis. Yet, the NG's role, mission, and capabilities are not well-known or understood. The National Response Framework (NRF) places significant responsibility on the local and state disaster planners (Department of Homeland Security: National Response Framework. US Department of Homeland Security, Washington, DC, January 2008). The public health professionals are an integral component of the disaster planning community. It is critical that the public health community be knowledgeable of types and capabilities of all the response assets at their disposal.

  8. Utilisation of helicopter emergency medical services in the early medical response to major incidents: a systematic literature review.

    Science.gov (United States)

    Johnsen, Anne Siri; Fattah, Sabina; Sollid, Stephen J M; Rehn, Marius

    2016-02-09

    This systematic review identifies, describes and appraises the literature describing the utilisation of helicopter emergency medical services (HEMS) in the early medical response to major incidents. Early prehospital phase of a major incident. Systematic literature review performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the Web of Science, PsycINFO, Scopus, Cinahl, Bibsys Ask, Norart, Svemed and UpToDate were searched using phrases that combined HEMS and 'major incidents' to identify when and how HEMS was utilised. The identified studies were subjected to data extraction and appraisal. The database search identified 4948 articles. Based on the title and abstract, the full text of 96 articles was obtained; of these, 37 articles were included in the review, and an additional five were identified by searching the reference lists of the 37 articles. HEMS was used to transport medical and rescue personnel to the incident and to transport patients to the hospital, especially when the infrastructure was damaged. Insufficient air traffic control, weather conditions, inadequate landing sites and failing communication were described as challenging in some incidents. HEMS was used mainly for patient treatment and to transport patients, personnel and equipment in the early medical management of major incidents, but the optimal utilisation of this specialised resource remains unclear. This review identified operational areas with improvement potential. A lack of systematic indexing, heterogeneous data reporting and weak methodological design, complicated the identification and comparison of incidents, and more systematic reporting is needed. CRD42013004473. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. National health and medical services response to incidents of chemical and biological terrorism.

    Science.gov (United States)

    Tucker, J B

    1997-08-06

    In response to the growing threat of terrorism with chemical and biological weapons, the US government has developed a national concept of operations for emergency health and medical services response. This capability was developed and tested for the first time during the Atlanta Olympic Games in the summer of 1996. In the event of a chemical or biological terrorist incident that exceeded local and state-level response capabilities, federal agencies would provide specialized teams and equipment to help manage the consequences of the attack and treat, decontaminate, and evacuate casualties. The US Congress has also established a Domestic Preparedness Program that provides for enhanced training of local first-responders and the formation of metropolitan medical strike teams in major cities around the country. While these national response capabilities are promising, their implementation to date has been problematic and their ultimate effectiveness is uncertain.

  10. Stimulant medication use and response to growth hormone therapy: an NCGS database analysis.

    Science.gov (United States)

    Frindik, J Paul; Morales, Alba; Fowlkes, John; Kemp, Stephen; Thrailkill, Kathryn; Lippe, Barbara; Dana, Ken

    2009-01-01

    Determine (1) frequency of attention-deficit hyperactivity disorder (ADHD) treatment and (2) growth responses in growth hormone (GH)-treated children who are receiving ADHD medication versus GH alone. Prepubertal children with idiopathic short stature (ISS) or GH deficiency (IGHD) enrolled in Genentech's National Cooperative Growth Study. ADHD treatment was determined by documentation of psycho-stimulant medication use at enrollment. ADHD medication use increased from 0.8% (7/850) in 1985 to 5.8% (752/12,113) in 2005. First-year GH treatment response for ADHD + IGHD versus IGHD: 8.5 +/- 2.0 vs. 9.4 +/- 2.6 cm/year, but when adjusted for age, sex, and enrollment body mass index, the difference is clinically insignificant (-0.4 cm/year). First-year growth was similar in all ISS: 8.1 +/- 1.9 versus 8.6 +/- 2.1 cm/year (ADHD + ISS vs. ISS, an adjusted -0.2-cm/year difference). Increasing numbers of GH-treated children are taking ADHD medications and their growth responses during the first year of GH therapy are similar to those not taking ADHD medications. Copyright 2009 S. Karger AG, Basel.

  11. EXAMINATION OF THE EMERGENCY MEDICAL RESPONSE SYSTEM IN KOREA AND SUGGESTIONS FOR IMPROVEMENTS RELATING TO TRANSPORT

    Directory of Open Access Journals (Sweden)

    Sei-Chang OH, Ph.D.

    2004-01-01

    This research focuses on the examination of current emergency medical response system related to the transport of emergency vehicles and suggests some transport-related ideas to improve the system in Korea. The study aimed to investigate the present emergency medical response system and identify problems, questionnaire survey and literature review were carried. The ideas include the improvement of emergency information flow and the development of preferential treatment methods for emergency vehicles. To improve the emergency information flow, this research studied the bridge between emergency medical information center and traffic information center and proposed the efficient utilization of traffic information for the better treatment of an emergency. When it comes to the movement of emergency vehicles, various preferential treatment methods were suggested.

  12. Toward Diversity-Responsive Medical Education: Taking an Intersectionality-Based Approach to a Curriculum Evaluation

    Science.gov (United States)

    Muntinga, M. E.; Krajenbrink, V. Q.; Peerdeman, S. M.; Croiset, G.; Verdonk, P.

    2016-01-01

    Recent years have seen a rise in the efforts to implement diversity topics into medical education, using either a "narrow" or a "broad" definition of culture. These developments urge that outcomes of such efforts are systematically evaluated by mapping the curriculum for diversity-responsive content. This study was aimed at…

  13. Dignity and cost-effectiveness: analysing the responsibility for decisions in medical ethics.

    Science.gov (United States)

    Robertson, G S

    1984-01-01

    In the operation of a health care system, defining the limits of medical care is the joint responsibility of many parties including clinicians, patients, philosophers and politicians. It is suggested that changes in the potential for prolonging life make it necessary to give doctors guidance which may have to incorporate certain features of utilitarianism, individualism and patient-autonomy. PMID:6502644

  14. Propranolol medication among coronary patients: relationship to type A behavior and cardiovascular response.

    Science.gov (United States)

    Krantz, D S; Durel, L A; Davia, J E; Shaffer, R T; Arabian, J M; Dembroski, T M; MacDougall, J M

    1982-09-01

    The present correlational study compared behavioral and psychophysiological characteristics of coronary patients who were either medicated or not medicated with the beta-adrenergic blocking drug propranolol. Eighty-eight patients were given a structured Type A interview (SI) and a history quiz while heart rate and blood pressure were monitored. Data were analyzed controlling for age, sex, extent of coronary artery disease, and history of angina. Results indicated that patients taking propranolol (n = 65) were significantly lower in intensity of Type A behavior than patients not taking propranolol (n = 23). No effects were obtained for patients medicated or not medicated with diuretics, nitrates, or other CNS active drugs. Propranolol patients also showed lesser heart rate and rate-pressure product responses to the interview, but did not differ in blood pressure responses. Components of Type A which were lower in propranolol patients included speech stylistics (loud/explosive, rapid/accelerated, potential for hostility). Content of responses to the SI and scores on the Jenkins Activity Survey did not differ between the groups. An explanation for these results is offered in terms of the effects of propranolol on peripheral sympathetic responses, and evidence for a physiological substrate for Type A behavior. A conceptualization of the Type A pattern in terms of cognitive and physiological components is advanced, and implications for clinical intervention are discussed.

  15. The transplant team's support of kidney transplant recipients to take their prescribed medications: a collective responsibility.

    Science.gov (United States)

    Williams, Allison; Low, Jac Kee; Manias, Elizabeth; Crawford, Kimberley

    2016-08-01

    To obtain an understanding of how health professionals support the kidney transplant patient to take their medications as prescribed long term. Kidney transplantation requires stringent adherence to complex medication regimens to prevent graft rejection and to maintain general well-being. Medication nonadherence is common in kidney transplantation, emerging in the first few months post-transplantation, leading to poor patient outcomes. Exploratory qualitative design. Five focus groups were conducted with a total of seven renal nurse transplant coordinators, two renal transplant nurse unit managers, seven nephrologists, seven pharmacists, four social workers, and one consumer representative representing all five hospitals offering adult kidney transplantation in Victoria, Australia in 2014. The views of two general practitioners who were unable to attend the focus groups were incorporated into the data set. All data underwent thematic analysis. Analysis revealed that adherence was a collective responsibility involving the whole of the transplant team and the patient via education blitz in hospital, identifying and managing nonadherence, promotion of self-advocacy, and the partnership between the patient and health professional. Patients were directed how to take their complex medications to be self-empowered, yet the partnership between the patient and health professional limited the patient's voice. Although medication adherence was a collective responsibility, communication was often one-way chiefly as a result of staffing and time constraints, hindering effective partnerships necessary for medication adherence. Expert skills in communication and adherence counselling are necessary to identify barriers affecting medication adherence. Patients need to be systematically screened, prepared and supported long-term within an accommodating healthcare system for the reality of caring for their transplanted kidney. Kidney transplant recipients require systematic

  16. Significance of abolishing British National Oil Corporation

    Energy Technology Data Exchange (ETDEWEB)

    Mabro, R

    1985-04-01

    The decision to abolish British National Oil Corporation has greater significance than any commentator, so far, has cared to admit. Mr. Mabro says the Government has done much more than get rid of an institution it had previously weakened and emasculated; in effect, it had abdicated its responsibilities for the pricing of North Sea oil. He further observes that these moves may be consistent with the tenets of a simplistic free-market ideology: they betray, however, a lack of understanding of the economics of oil, and of the UK economic interest in oil.

  17. The humanising power of medical history: responses to biomedicine in the 20th century United States.

    Science.gov (United States)

    Warner, John Harley

    2011-12-01

    Most American historians of medicine today would be very hesitant about any claim that medical history humanises doctors, medical students or the larger health care enterprise. Yet, the idea that history can and ought to serve modern medicine as a humanising force has been a persistent refrain in American medicine. This essay explores the emergence of this idea from the end of the 19th century, precisely the moment when modern biomedicine became ascendant. At the same institutions where the new version of scientific medicine was most energetically embraced, some professional leaders warned that the allegiance to science driving the profession's technical and cultural success was endangering humanistic values fundamental to professionalism and the art of medicine. They saw in history a means for rehumanising modern medicine and countering the risk of cultural crisis. While some iteration of this vision of history was remarkably durable, the meanings attached to 'humanism' were both multiple and changing, and the role envisioned for history in a humanistic intervention was transformed. Starting in the 1960s as part of a larger cultural critique of the putative 'dehumanisation' of the medical establishment, some advocates promoted medical history as a tool to help fashion a new kind of humanist physician and to confront social inequities in the health care system. What has persisted across time is the way that the idea of history as a humanising force has almost always functioned as a discourse of deficiency-a response to perceived shortcomings of biomedicine, medical institutions and medical professionalism.

  18. Baseline Antihypertensive Drug Count and Patient Response to Hypertension Medication Management.

    Science.gov (United States)

    Crowley, Matthew J; Olsen, Maren K; Woolson, Sandra L; King, Heather A; Oddone, Eugene Z; Bosworth, Hayden B

    2016-04-01

    Telemedicine-based medication management improves hypertension control, but has been evaluated primarily in patients with low antihypertensive drug counts. Its impact on patients taking three or more antihypertensive agents is not well-established. To address this evidence gap, the authors conducted an exploratory analysis of an 18-month, 591-patient trial of telemedicine-based hypertension medication management. Using general linear models, the effect of medication management on blood pressure for patients taking two or fewer antihypertensive agents at study baseline vs those taking three or more was compared. While patients taking two or fewer antihypertensive agents had a significant reduction in systolic blood pressure with medication management, those taking three or more had no such response. The between-subgroup effect difference was statistically significant at 6 months (-6.4 mm Hg [95% confidence interval, -12.2 to -0.6]) and near significant at 18 months (-6.0 mm Hg [95% confidence interval, -12.2 to 0.2]). These findings suggest that baseline antihypertensive drug count may impact how patients respond to hypertension medication management and emphasize the need to study management strategies specifically in patients taking three or more antihypertensive medications. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

  19. A Community-Led Medical Response Effort in the Wake of Hurricane Sandy.

    Science.gov (United States)

    Kraushar, Matthew L; Rosenberg, Rebecca E

    2015-08-01

    On October 29, 2012, Hurricane Sandy made landfall in the neighborhood of Red Hook in Brooklyn, New York. The massive tidal surge generated by the storm submerged the coastal area, home to a population over 11,000 individuals, including the largest public housing development in Brooklyn. The infrastructure devastation was profound: the storm rendered electricity, heat, water, Internet, and phone services inoperative, whereas local ambulatory medical services including clinics, pharmacies, home health agencies, and other resources were damaged beyond functionality. Lacking these services or lines of communication, medically fragile individuals became isolated from the hospital and 911-emergency systems without a preexisting mechanism to identify or treat them. Medically fragile individuals primarily included those with chronic medical conditions dependent on frequent and consistent monitoring and treatments. In response, the Red Hook community established an ad hoc volunteer medical relief effort in the wake of the storm, filling a major gap that continues to exist in disaster medicine for low-income urban environments. Here we describe this effort, including an analysis of the medically vulnerable in this community, and recommend disaster risk reduction strategies and resilience measures for future disaster events.

  20. The British Monarchy On Screen

    OpenAIRE

    Merck, Mandy

    2016-01-01

    Moving images of the British monarchy, in fact and fiction, are almost as old as the moving image itself, dating back to an 1895 American drama, The Execution of Mary Queen of Scots. British monarchs even appeared in the new ‘animated photography’ from 1896, led by Queen Victoria. Half a century later, the 1953 coronation of Elizabeth II was a milestone in the adoption of television, watched by 20 million Britons and 100 million North Americans. At the century’s end, Princess Diana’s funeral ...

  1. British Values and British Identity: Muddles, Mixtures, and Ways Ahead

    Science.gov (United States)

    Richardson, Robin

    2015-01-01

    In the final eleven months of its five-year term, the Coalition Government placed much emphasis in the education system on what it called fundamental British values (FBV). The phrase had its origins in counter-terrorism strategies that were of dubious validity both conceptually and operationally, and the trigger for its introduction into the…

  2. Reinforcement and stimulant medication ameliorate deficient response inhibition in children with Attention-Deficit/Hyperactivity Disorder

    Science.gov (United States)

    Rosch, Keri S.; Fosco, Whitney D.; Pelham, William E.; Waxmonsky, James G.; Bubnik, Michelle G.; Hawk, Larry W.

    2015-01-01

    This study examined the degree to which reinforcement, stimulant medication, and their combination impact response inhibition in children with Attention-Deficit/Hyperactivity Disorder (ADHD). Across three studies, participants with ADHD (n=111, 25 girls) and typically-developing (TD) controls (n=33, 6 girls) completed a standard version of the stop signal task (SST) and/or a reinforcement-manipulation SST with performance-contingent points. In two of these studies, these tasks were performed under placebo or 0.3 and 0.6 mg/kg methylphenidate (MPH) conditions. Cross-study comparisons were conducted to test hypotheses regarding the separate and combined effects of reinforcement and methylphenidate on response inhibition among children with ADHD relative to TD controls. Baseline response inhibition was worse among children with ADHD compared to controls. MPH produced dose-related improvements in response inhibition in children with ADHD; compared to non-medicated TD controls, 0.3 mg/kg MPH normalized deficient response inhibition, and 0.6 mg/kg MPH resulted in better inhibition in children with ADHD. Reinforcement improved response inhibition to a greater extent for children with ADHD than for TD children, normalizing response inhibition. The combination of MPH and reinforcement improved response inhibition among children with ADHD compared to reinforcement alone and MPH alone, also resulting in normalization of response inhibition despite repeated task exposure. Deficient response inhibition commonly observed in children with ADHD is significantly improved with MPH and/or reinforcement, normalizing inhibition relative to TD children tested under standard conditions. PMID:25985978

  3. [The DRG responsible physician in trauma and orthopedic surgery. Surgeon, encoder, and link to medical controlling].

    Science.gov (United States)

    Ruffing, T; Huchzermeier, P; Muhm, M; Winkler, H

    2014-05-01

    Precise coding is an essential requirement in order to generate a valid DRG. The aim of our study was to evaluate the quality of the initial coding of surgical procedures, as well as to introduce our "hybrid model" of a surgical specialist supervising medical coding and a nonphysician for case auditing. The department's DRG responsible physician as a surgical specialist has profound knowledge both in surgery and in DRG coding. At a Level 1 hospital, 1000 coded cases of surgical procedures were checked. In our department, the DRG responsible physician who is both a surgeon and encoder has proven itself for many years. The initial surgical DRG coding had to be corrected by the DRG responsible physician in 42.2% of cases. On average, one hour per working day was necessary. The implementation of a DRG responsible physician is a simple, effective way to connect medical and business expertise without interface problems. Permanent feedback promotes both medical and economic sensitivity for the improvement of coding quality.

  4. Ethics of care in medical tourism: Informal caregivers' narratives of responsibility, vulnerability and mutuality.

    Science.gov (United States)

    Whitmore, Rebecca; Crooks, Valorie A; Snyder, Jeremy

    2015-09-01

    This study examines the experiences of informal caregivers in medical tourism through an ethics of care lens. We conducted semi-structured interviews with 20 Canadians who had accompanied their friends or family members abroad for surgery, asking questions that dealt with their experiences prior to, during and after travel. Thematic analysis revealed three themes central to an ethics of care: responsibility, vulnerability and mutuality. Ethics of care theorists have highlighted how care has been historically devalued. We posit that medical tourism reproduces dominant narratives about care in a novel care landscape. Informal care goes unaccounted for by the industry, as it occurs in largely private spaces at a geographic distance from the home countries of medical tourists. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Socially responsible medical education: innovations and challenges in a minority setting.

    Science.gov (United States)

    Schofield, Aurel; Bourgeois, Daniel

    2010-03-01

    Distributed medical education sites help train, recruit and retain doctors, notably in rural and isolated areas, by providing education and training in these areas and adapting their curriculum to meet the host community's health needs. The Centre de Formation Médicale du Nouveau Brunswick (CFMNB; New Brunswick Medical Education Centre) was established by a partnership between two academic institutions, the Université de Sherbrooke (University of Sherbrooke), situated in the province of Quebec, and the Université de Moncton (University of Moncton), situated in the province of New Brunswick, in Canada. The CFMNB is specifically targeting a minority community (Acadians). Working to establish a high-quality medical education programme, the CFMNB has also set community objectives to meet not only the health needs of this population, but also its social and economic needs. This paper describes the overall objectives of this project, which are: to reduce the gap between community needs and academic institutional needs; to address ethno-cultural and language differences in a defined minority population, and to develop collaboration between the partners involved, including government and community entities which are often perceived as operating in isolation from one another. We also describe why and how the CFMNB developed community-focused objectives and the challenges that came with these innovations, and present lessons from the experience that may be relevant to other sites interested in the social responsibility of medical schools. The CFMNB has produced interesting work and innovations in the field of social responsibility and has encountered many challenges. Continuing interaction between medical education, health research and health services to better address the needs of the population has been established. The information obtained by this process has been used to build a strategic plan for the CFMNB in order to ensure that it is socially responsive and has

  6. Autonomy, consent and responsibility. Part II. Informed consent in medical care and in the law.

    Science.gov (United States)

    Mellado, J M

    Legal recognition of patient's rights aspired to change clinical relationship and medical lex artis. However, its implementation has been hampered by the scarcity of resources and the abundance of regulations. For several years, autonomy, consent, and responsibility have formed one of the backbones of the medical profession. However, they have sparked controversy and professional discomfort. In the first part of this article, we examine the conceptual and regulatory limitations of the principle of autonomy as the basis of informed consent. We approach the subject from philosophical, historical, legal, bioethical, deontological, and professional standpoints. In the second part, we cover the viability of informed consent in health care and its relationship with legal responsibility. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Nuclear power in British politics

    International Nuclear Information System (INIS)

    Pocock, R.F.

    1987-01-01

    The paper concerns the subject of nuclear power in British politics in 1986. The policies of the major political parties towards nuclear power are briefly outlined, along with public attitudes to nuclear energy, Chernobyl, and the rise of the anti-nuclear campaigners. (UK)

  8. 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).

  9. Drowning of British children abroad.

    Science.gov (United States)

    Cornall, P; Howie, S; Mughal, A; Sumner, V; Dunstan, F; Kemp, A; Sibert, J

    2005-09-01

    To quantify the risks of British children drowning abroad. The numbers of British children drowning abroad were estimated for 1996-2003 using the RoSPA/RLSS press cutting database. We compared these figures with the numbers of British children going abroad from the International Passenger Survey from the Office of National Statistics. Sixty-eight children (45 boys-23 Girls) drowned in the eight-year period: 48 (71%) in swimming pools (mostly in hotels). Allowing for exposure, the rate was higher in North America [5.2 (CI 2.9-9.4)/million tourists] than the European Union [1.9 (CI 1.4-2.5)/million tourists] p = 0.002. On average eight British children drown each year abroad. This is therefore a rare but tragic event. Most of these episodes happen in swimming pools and this needs to be compared to the one child that dies each year in municipal swimming pools in the United Kingdom where there is adequate lifeguarding. It may be that parents have a false sense of security for their children in pools abroad. We believe that there needs to be action from the European Union on this important event.

  10. Utility and assessment of non-technical skills for rapid response systems and medical emergency teams.

    Science.gov (United States)

    Chalwin, R P; Flabouris, A

    2013-09-01

    Efforts are ongoing to improve outcomes from cardiac arrest and medical emergencies. A promising quality improvement modality is use of non-technical skills (NTS) that aim to address human factors through improvements in performance of leadership, communication, situational awareness and decision-making. Originating in the airline industry, NTS training has been successfully introduced into anaesthesia, surgery, emergency medicine and other acute medical specialities. Some aspects of NTS have already achieved acceptance for cardiac arrest teams. Leadership skills are emphasised in advanced life support training and have shown favourable results when employed in simulated and clinical resuscitation scenarios. The application of NTS in medical emergency teams as part of a rapid response system attending medical emergencies is less certain; however, observations of simulations have also shown promise. This review highlights the potential benefits of NTS competency for cardiac arrest teams and, more importantly, medical emergency teams because of the diversity of clinical scenarios encountered. Discussion covers methods to assess and refine NTS and NTS training to optimise performance in the clinical environment. Increasing attention should be applied to yielding meaningful patient and organisational outcomes from use of NTS. Similarly, implementation of any training course should receive appropriate scrutiny to refine team and institutional performance. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

  11. Commercial Airline In-Flight Emergency: Medical Student Response and Review of Medicolegal Issues.

    Science.gov (United States)

    Bukowski, Josh H; Richards, John R

    2016-01-01

    As the prevalence of air travel increases, in-flight medical emergencies occur more frequently. A significant percentage of these emergencies occur when there is no certified physician, nurse, or paramedic onboard. During these situations, flight crews might enlist the help of noncertified passengers, such as medical students, dentists, or emergency medical technicians in training. Although Good Samaritan laws exist, many health care providers are unfamiliar with the limited legal protections and resources provided to them after responding to an in-flight emergency. A 78-year-old woman lost consciousness and became pulseless onboard a commercial aircraft. No physician was available. A medical student responded and coordinated care with the flight crew, ground support physician, and other passengers. After receiving a packet (4 g) of sublingual sucrose and 1 L i.v. crystalloid, the patient regained pulses and consciousness. The medical student made the decision not to divert the aircraft based on the patient's initial response to therapy and, 45 min later, the patient had normal vital signs. Upon landing, she was met and taken by paramedics to the nearest emergency department for evaluation of her collapse. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians are the most qualified to assist in-flight emergencies, but they might not be aware of the medicolegal risks involved with in-flight care, the resources available, and the role of the flight crew in liability and decision making. This case, which involved a medical student who was not given explicit protection under Good Samaritan laws, illustrates the authority of the flight crew during these events and highlights areas of uncertainty in the legislation for volunteer medical professionals. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. [Organisational responsibility versus individual responsibility: safety culture? About the relationship between patient safety and medical malpractice law].

    Science.gov (United States)

    Hart, Dieter

    2009-01-01

    The contribution is concerned with the correlations between risk information, patient safety, responsibility and liability, in particular in terms of liability law. These correlations have an impact on safety culture in healthcare, which can be evaluated positively if--in addition to good quality of medical care--as many sources of error as possible can be identified, analysed, and minimised or eliminated by corresponding measures (safety or risk management). Liability influences the conduct of individuals and enterprises; safety is (probably) also a function of liability; this should also apply to safety culture. The standard of safety culture does not only depend on individual liability for damages, but first of all on strict enterprise liability (system responsibility) and its preventive effects. Patient safety through quality and risk management is therefore also an organisational programme of considerable relevance in terms of liability law.

  13. Promoting social responsibility amongst health care users: medical tourists’ perspectives on an information sheet regarding ethical concerns in medical tourism

    OpenAIRE

    Adams, Krystyna; Snyder, Jeremy; Crooks, Valorie A; Johnston, Rory

    2013-01-01

    Background Medical tourists, persons that travel across international borders with the intention to access non-emergency medical care, may not be adequately informed of safety and ethical concerns related to the practice of medical tourism. Researchers indicate that the sources of information frequently used by medical tourists during their decision-making process may be biased and/or lack comprehensive information regarding individual safety and treatment outcomes, as well as potential im...

  14. [Nutritional support response in critically ill patients; differences between medical and surgical patients].

    Science.gov (United States)

    Zamora Elson, M; Serón Arbeloa, C; Labarta Monzón, L; Garrido Ramírez de Arellano, I; Lander Azcona, A; Marquina Lacueva, M I; López Claver, J C; Escós Orta, J

    2012-01-01

    To assess the nutritional response of a group of critically ill patients, as well as the differences in the response to nutritional support between medical and surgical patients. One-year long retrospective study including critically ill patients on artificial nutrition for 7 days. Throughout the first week, three nutritional biochemical controls were done that included albumin, prealbumin, transferrin, cholesterol, and electrolytes. Other data gathered were: nutritional risk index, age, gender, weight, height, APACHE, delay of onset of nutritional support, access route, predicted and real caloric intake, medical or surgical patient, hospital stay, duration of the central venous catheter, urinary tube, and/or mechanical ventilation, incidence and density of incidence of nosocomial infections. Sixty-three patients were studied, 30 (47%) medical and 33 (53%) surgical/trauma patients, with a usage of EN higher among medical patients (16/30, 53% vs. 5/33, 15%), PN higher among surgical patients (25/33, 76%), and mixed nutrition similar in both groups (5 medical and 3 surgical patients) (p = 0.001). There were no differences between medical and surgical patients regarding: both predicted and real caloric and nitrogenous intake, APACHE, delay of onset of nutrition, phosphorus, magnesium or glucose levels, mortality and incidence of nosocomial infections. There were no differences either in hospital stay or use of mechanical ventilation, although these tended to be lower in surgical patients. The baseline biochemical parameters did not show differences between both groups, although they were worse among surgical patients. These patients presented during the study period steady albumin levels with improvement in the remaining parameters, whereas medical patients showed a decrease in albumin and transferrin levels, steady prealbumin levels, and slightly improvement in cholesterol levels. We have observed higher usage of PN among surgical patients, which showed worse

  15. Supernatural versus medical: Responses to mental illness from undergraduate university students in Trinidad.

    Science.gov (United States)

    Ramkissoon, AnMarie Kamanie; Donald, Casswina; Hutchinson, Gerard

    2017-06-01

    Background/Introduction: Perceptions about the aetiology of mental illness are likely to influence help-seeking behaviour. Understanding help-seeking behaviour will improve service provision and access. Therefore, this is likely to improve treatment outcomes. We assessed the perceptions and help-seeking behaviours surrounding mental illness in a Trinidadian population of 158 tertiary-level students (136 female, 22 male; mean age 30) by analysing their responses to a questionnaire which asked for responses regarding a case vignette of a 25-year-old young woman exhibiting symptoms suggestive of schizophrenia. Of the respondents, 32.3% attributed the symptoms to supernatural causes. Specifically, 27.8% to someone doing her bad and 24.1% to evil spirits. In all, 77.2% of respondents indicated that mental illness was caused by medical problems and 63.3% to work stress. A minimum of 9.5% of the students therefore have dual perceptions regarding causation (77.2 + 32.3 = 109.5) Those who perceived causation to be supernatural said they would seek help from both medical ( p = .000) and supernatural ( p = .000) modalities. This also applied significantly to those who said the causation was medical, that is, seeking both religious intervention ( p = .000) and medical intervention (.000) as the first path in the health-seeking pathway. Dual help-seeking behaviour seems to be the functional result of an integration of religious and medical models of mental illness causation even in respondents who clearly identified only one of these as the likely cause of the illness behaviour.

  16. Direct health care costs associated with asthma in British Columbia

    Science.gov (United States)

    Sadatsafavi, Mohsen; Lynd, Larry; Marra, Carlo; Carleton, Bruce; Tan, Wan C; Sullivan, Sean; FitzGerald, J Mark

    2010-01-01

    BACKGROUND: A better understanding of health care costs associated with asthma would enable the estimation of the economic burden of this increasingly common disease. OBJECTIVE: To determine the direct medical costs of asthma-related health care in British Columbia (BC). METHODS: Administrative health care data from the BC Linked Health Database and PharmaNet database from 1996 to 2000 were analyzed for BC residents five to 55 years of age, including the billing information for physician visits, drug dispensations and hospital discharge records. A unit cost was assigned to physician/emergency department visits, and government reimbursement fees for prescribed medications were applied. The case mix method was used to calculate hospitalization costs. All costs were reported in inflation-adjusted 2006 Canadian dollars. RESULTS: Asthma resulted in $41,858,610 in annual health care-related costs during the study period ($331 per patient-year). The major cost component was medications, which accounted for 63.9% of total costs, followed by physician visits (18.3%) and hospitalization (17.8%). When broader definitions of asthma-related hospitalizations and physician visits were used, total costs increased to $56,114,574 annually ($444 per patient-year). There was a statistically significant decrease in the annual per patient cost of hospitalizations (P<0.01) over the study period. Asthma was poorly controlled in 63.5% of patients, with this group being responsible for 94% of asthma-related resource use. CONCLUSION: The economic burden of asthma is significant in BC, with the majority of the cost attributed to poor asthma control. Policy makers should investigate the reason for lack of proper asthma control and adjust their policies accordingly to improve asthma management. PMID:20422063

  17. Understanding barriers to medication adherence in the hypertensive population by evaluating responses to a telephone survey

    Directory of Open Access Journals (Sweden)

    Nair KV

    2011-04-01

    Full Text Available Kavita V Nair1, Daniel A Belletti3, Joseph J Doyle3, Richard R Allen4, Robert B McQueen1, Joseph J Saseen1, Joseph Vande Griend1, Jay V Patel5, Angela McQueen2, Saira Jan21School of Pharmacy, University of Colorado, Aurora, CO, USA; 2Horizon Blue Cross Blue Shield of New Jersey, Newark, NJ, USA; 3Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA, 4Peakstat Statistical Services, Evergreen, CO, USA; 5Care Management International, Marlborough, MA, USABackground: Although hypertension is a major risk factor for cardiovascular disease, adherence to hypertensive medications is low. Previous research identifying factors influencing adherence has focused primarily on broad, population-based approaches. Identifying specific barriers for an individual is more useful in designing meaningful targeted interventions. Using customized telephonic outreach, we examined specific patient-reported barriers influencing hypertensive patients' nonadherence to medication in order to identify targeted interventions.Methods: A telephone survey of 8692 nonadherent hypertensive patients was conducted. The patient sample comprised health plan members with at least two prescriptions for antihypertensive medications in 2008. The telephone script was based on the "target" drug associated with greatest nonadherence (medication possession ratio [MPR] <80% during the four-month period preceding the survey.Results: The response rate was 28.2% of the total sample, representing 63.8% of commercial members and 37.2% of Medicare members. Mean age was 63.4 years. Mean MPR was 61.0% for the target drug. Only 58.2% of Medicare respondents and 60.4% of commercial respondents reported "missing a dose of medication". The primary reason given was "forgetfulness" (61.8% Medicare, 60.8% commercial, followed by "being too busy" (2.7% Medicare, 18.5% commercial and "other reasons" (21.9% Medicare, 8.1% commercial including travel, hospitalization/sickness, disruption of daily events

  18. Task force St. Bernard: operational issues and medical management of a National Guard disaster response operation.

    Science.gov (United States)

    Bonnett, Carl J; Schock, Tony R; McVaney, Kevin E; Colwell, Christopher B; Depass, Christopher

    2007-01-01

    After Hurricane Katrina struck the Gulf Coast of the United States on 29 August 2005, it became obvious that the country was facing an enormous national emergency. With local resources overwhelmed, governors across the US responded by deploying thousands of National Guard soldiers and airmen. The National Guard has responded to domestic disasters due to natural hazards since its inception, but an event with the magnitude of Hurricane Katrina was unprecedented. The deployment of >900 Army National Guard soldiers to St. Bernard Parish, Louisiana in the aftermath of the Hurricane was studied to present some of the operational issues involved with providing medical support for this type of operation. In doing so, the authors attempt to address some of the larger issues of how the National Guard can be incorporated into domestic disaster response efforts. A number of unforeseen issues with regards to medical operations, medical supply, communication, preventive medicine, legal issues, and interactions with civilians were encountered and are reviewed. A better understanding of the National Guard and how it can be utilized more effectively in future disaster response operations can be developed.

  19. Reevaluating response and failure of medical treatment of endometriosis: a systematic review.

    Science.gov (United States)

    Becker, Christian M; Gattrell, William T; Gude, Kerstin; Singh, Sukhbir S

    2017-07-01

    To assess patient response rates to medical therapies used to treat endometriosis-associated pain. A systematic review with the use of Medline and Embase. Not applicable. Women receiving medical therapy to treat endometriosis. None. The proportions of patients who: experienced no reduction in endometriosis-associated pain symptoms; had pain symptoms remaining at the end of the treatment period; had pain recurrence after treatment cessation; experienced an increase or no change in disease score during the study; were satisfied with treatment; and discontinued therapy owing to adverse events or lack of efficacy. The change in pain symptom severity experienced during and after treatment, as measured on the visual analog scale, was also assessed. In total, 58 articles describing 125 treatment arms met the inclusion criteria. Data for the response of endometriosis-associated pain symptoms to treatment were presented in only 29 articles. The median proportions of women with no reduction in pain were 11%-19%; at the end of treatment, 5%-59% had pain remaining; and after follow-up, 17%-34% had experienced recurrence of pain symptoms after treatment cessation. After median study durations of 2-24 months, the median discontinuation rates due to adverse events or lack of efficacy were 5%-16%. Few studies of medical therapies for endometriosis report outcomes that are relevant to patients, and many women gain only limited or intermittent benefit from treatment. Copyright © 2017. Published by Elsevier Inc.

  20. Evaluation of Non-Medical Services’ Responsiveness Using a National Model: Patients’ Viewpoint

    Directory of Open Access Journals (Sweden)

    Roohollah Askari

    2016-11-01

    Full Text Available Background Responsiveness is the main indicator of high performance in every health system. This study was conducted to assess non-medical services’ responsiveness from patients’ viewpoint through applying a localized responsiveness model in Iran. Methods This was a descriptive, cross-sectional study, conducted in three hospitals of Yazd province in 2015. To collect data, a standardized questionnaire was used and data were analyzed by SPSS 16 software package, through applying descriptive statistical tests, T-test, correlation and analysis of variance (ANOVA. Results The study findings revealed that a mean score for responsiveness from patients’ viewpoint was 2.48 ± 0.26 at a public hospital, 2.14 ± 0.26 at a private and 2 ± 0.27 at a charity hospital representing an average level for hospitals under study. The highest and lowest mean scores among different aspects of responsiveness belonged to dignity (2.5 ± 0.36 and informed choice (1.9 ± 0.43. Conclusions Given that responsiveness was evaluated at an average level, appropriate policy interventions and necessary reforms are proposed to increase its status in under study hospitals.

  1. Use of Multi-Response Format Test in the Assessment of Medical Students’ Critical Thinking Ability

    Science.gov (United States)

    Mafinejad, Mahboobeh Khabaz; Monajemi, Alireza; Jalili, Mohammad; Soltani, Akbar; Rasouli, Javad

    2017-01-01

    Introduction To evaluate students critical thinking skills effectively, change in assessment practices is must. The assessment of a student’s ability to think critically is a constant challenge, and yet there is considerable debate on the best assessment method. There is evidence that the intrinsic nature of open and closed-ended response questions is to measure separate cognitive abilities. Aim To assess critical thinking ability of medical students by using multi-response format of assessment. Materials and Methods A cross-sectional study was conducted on a group of 159 undergraduate third-year medical students. All the participants completed the California Critical Thinking Skills Test (CCTST) consisting of 34 multiple-choice questions to measure general critical thinking skills and a researcher-developed test that combines open and closed-ended questions. A researcher-developed 48-question exam, consisting of 8 short-answers and 5 essay questions, 19 Multiple-Choice Questions (MCQ), and 16 True-False (TF) questions, was used to measure critical thinking skills. Correlation analyses were performed using Pearson’s coefficient to explore the association between the total scores of tests and subtests. Results One hundred and fifty-nine students participated in this study. The sample comprised 81 females (51%) and 78 males (49%) with an age range of 20±2.8 years (mean 21.2 years). The response rate was 64.1%. A significant positive correlation was found between types of questions and critical thinking scores, of which the correlations of MCQ (r=0.82) and essay questions (r=0.77) were strongest. The significant positive correlations between multi-response format test and CCTST’s subscales were seen in analysis, evaluation, inference and inductive reasoning. Unlike CCTST subscales, multi-response format test have weak correlation with CCTST total score (r=0.45, p=0.06). Conclusion This study highlights the importance of considering multi-response format test in

  2. Use of Multi-Response Format Test in the Assessment of Medical Students' Critical Thinking Ability.

    Science.gov (United States)

    Mafinejad, Mahboobeh Khabaz; Arabshahi, Seyyed Kamran Soltani; Monajemi, Alireza; Jalili, Mohammad; Soltani, Akbar; Rasouli, Javad

    2017-09-01

    To evaluate students critical thinking skills effectively, change in assessment practices is must. The assessment of a student's ability to think critically is a constant challenge, and yet there is considerable debate on the best assessment method. There is evidence that the intrinsic nature of open and closed-ended response questions is to measure separate cognitive abilities. To assess critical thinking ability of medical students by using multi-response format of assessment. A cross-sectional study was conducted on a group of 159 undergraduate third-year medical students. All the participants completed the California Critical Thinking Skills Test (CCTST) consisting of 34 multiple-choice questions to measure general critical thinking skills and a researcher-developed test that combines open and closed-ended questions. A researcher-developed 48-question exam, consisting of 8 short-answers and 5 essay questions, 19 Multiple-Choice Questions (MCQ), and 16 True-False (TF) questions, was used to measure critical thinking skills. Correlation analyses were performed using Pearson's coefficient to explore the association between the total scores of tests and subtests. One hundred and fifty-nine students participated in this study. The sample comprised 81 females (51%) and 78 males (49%) with an age range of 20±2.8 years (mean 21.2 years). The response rate was 64.1%. A significant positive correlation was found between types of questions and critical thinking scores, of which the correlations of MCQ (r=0.82) and essay questions (r=0.77) were strongest. The significant positive correlations between multi-response format test and CCTST's subscales were seen in analysis, evaluation, inference and inductive reasoning. Unlike CCTST subscales, multi-response format test have weak correlation with CCTST total score (r=0.45, p=0.06). This study highlights the importance of considering multi-response format test in the assessment of critical thinking abilities of medical

  3. National Characteristics of Emergency Medical Services Responses for Older Adults in the United States.

    Science.gov (United States)

    Duong, Hieu V; Herrera, Lauren Nicholas; Moore, Justin Xavier; Donnelly, John; Jacobson, Karen E; Carlson, Jestin N; Mann, N Clay; Wang, Henry E

    2018-01-01

    Older adults, those aged 65 and older, frequently require emergency care. However, only limited national data describe the Emergency Medical Services (EMS) care provided to older adults. We sought to determine the characteristics of EMS care provided to older adults in the United States. We used data from the 2014 National Emergency Medical Services Information System (NEMSIS), encompassing EMS response data from 46 States and territories. We excluded EMS responses for children older adults as age ≥65 years. We compared patient demographics (age, sex, race, primary payer), response characteristics (dispatch time, location type, time intervals), and clinical course (clinical impression, injury, procedures, medications) between older and younger adult EMS emergency 9-1-1 responses. During the study period there were 20,212,245 EMS emergency responses. Among the 16,116,219 adult EMS responses, there were 6,569,064 (40.76%) older and 9,547,155 (59.24%) younger adults. Older EMS patients were more likely to be white and the EMS incident to be located in healthcare facilities (clinic, hospital, nursing home). Compared with younger patients, older EMS patients were more likely to present with syncope (5.68% vs. 3.40%; OR 1.71; CI: 1.71-1.72), cardiac arrest/rhythm disturbance (3.27% vs. 1.69%; OR 1.97; CI: 1.96-1.98), stroke (2.18% vs. 0.74%; OR 2.99; CI: 2.96-3.02) and shock (0.77% vs. 0.38%; OR 2.02; CI: 2.00-2.04). Common EMS interventions performed on older persons included intravenous access (32.02%), 12-lead ECG (14.37%), CPR (0.87%), and intubation (2.00%). The most common EMS drugs administered to older persons included epinephrine, atropine, furosemide, amiodarone, and albuterol or ipratropium. One of every three U.S. EMS emergency responses involves older adults. EMS personnel must be prepared to care for the older patient.

  4. Controlling health costs: physician responses to patient expectations for medical care.

    Science.gov (United States)

    Sabbatini, Amber K; Tilburt, Jon C; Campbell, Eric G; Sheeler, Robert D; Egginton, Jason S; Goold, Susan D

    2014-09-01

    Physicians have dual responsibilities to make medical decisions that serve their patients' best interests but also utilize health care resources wisely. Their ability to practice cost-consciously is particularly challenged when faced with patient expectations or requests for medical services that may be unnecessary. To understand how physicians consider health care resources and the strategies they use to exercise cost-consciousness in response to patient expectations and requests for medical care. Exploratory, qualitative focus groups of practicing physicians were conducted. Participants were encouraged to discuss their perceptions of resource constraints, and experiences with redundant, unnecessary and marginally beneficial services, and were asked about patient requests or expectations for particular services. Sixty-two physicians representing a variety of specialties and practice types participated in nine focus groups in Michigan, Ohio, and Minnesota in 2012 MEASUREMENTS: Iterative thematic content analysis of focus group transcripts Physicians reported making trade-offs between a variety of financial and nonfinancial resources, considering not only the relative cost of medical decisions and alternative services, but the time and convenience of patients, their own time constraints, as well as the logistics of maintaining a successful practice. They described strategies and techniques to educate patients, build trust, or substitute less costly alternatives when appropriate, often adapting their management to the individual patient and clinical environment. Physicians often make nuanced trade-offs in clinical practice aimed at efficient resource use within a complex flow of clinical work and patient expectations. Understanding the challenges faced by physicians and the strategies they use to exercise cost-consciousness provides insight into policy measures that will address physician's roles in health care resource use.

  5. Sialadenitis after radioiodine therapy. Analysis of factors that influence the response to medical treatment.

    Science.gov (United States)

    Geres, Alejandra E; Mereshian, Paula Szafryk; Fernández, Silvia; Rey Caro, Daniel Gonzalo; Castro, Ricardo; Podio, Ricardo; Ojeda, Silvia

    2015-12-01

    To assess the incidence of 131I-induced sialadenitis (SD) in patients with differentiated thyroid cancer (DTC), to analyze clinical and other factors related to metabolic radiotherapy that may predict the lack of response to conventional medical therapy (CMT), and to determine the effectiveness of intraductal steroid instillation in patients failing CMT. Fifty-two patients with DTC, 45 females (86.5%) and 7 males (13.5%) with a mean age of 44.21±13.3 years (r=17-74) who received ablation therapy with 131I after total thyroidectomy. Patients with diseases and/or medication causing xerostomia were excluded. Patients underwent salivary gland scintigraphy with 99Tc (10mCi). Eighteen patients (34.62%) had SD and received antibiotics, antispasmodics, and oral steroids for 15 days. They were divided into two groups: responders to medical therapy (n=12, age 44.3±14.4 years, 2 men [17%], 10 women [83%], cumulative dose 225±167.1 mCi) and non-responders to medical treatment, who underwent steroid instillation into the Stensen's duct (n=6 [33%], 2 men [33%], 4 women [67%], age 50±13.8 years, cumulative dose 138.3±61.7 mCi). Scintigraphy showed damage to the parotid and submaxillary glands. Incidence of 131I-induced sialadenitis was similar to that reported by other authors. Age, mean cumulative dose of 131I, and involvement of parotid and submaxillary glands did not condition response to CMT; however, male sex was a conditioning factor. Symptom persistence for more than 15 days makes instillation into the Stensen's duct advisable. This is an effective and safe method to avoid surgical excision of salivary glands. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  6. Latin American radio pathology net, training program for the medical response in cases of accidents

    International Nuclear Information System (INIS)

    Perez, M. R.; Valverde, N.; Sanhueza, S.; Di Tramo, J. L.; Gisone, P.; Cardenas, J.

    2003-01-01

    In Latin America exists a wide application of the nuclear techniques in different fields. These tendencies, to the increasing use of nuclear techniques, should carry out the invigoration of the infrastructures and the development of the authorities in radiation protection charge of the regulate and control the sources and practical, associated to ionizing radiation, guided to guarantee their safe use and in consequence to minimize the derived risks of the same ones. In spite of the efforts before mentioned a potential possibility of occurrence of accidental radiological events linked to human errors and violation's of the principles of the radiation protection exists. Reason that they advise to have response capacities to confront and to mitigate the consequences in situations of radiological accidents, including in the same ones the medical assistance of the accident victims. However, the radiological accidents happened in the international environment in the last decades, they have demonstrated inability paradoxically to confront with effectiveness these fortuitous events. Being characterized additionally by the insufficient training of the medical professionals to interpret and to act in consequence before the prejudicial effects to the health of the ionizing radiation. In our geographical context this situation is even more complicated, if we consider the happened radiological accidents of span that put in risk the life and the health of people involved in the same ones, for examples: Argentina (1968, 1963), Brazil (1985, 1987, 1995), Costa Rica (1996). El Salvador (1989), Mexico (1962, 1983, 1984) and Peru (1984, 1999). These reasons justify the development of an action program with the purpose of the consolidate and to integrate the capacity of response of our countries as regards radiological emergencies. Regrettably in Latin American subsist inequalities the development radiation protection programs, that propitiate the possibility of accidental situations

  7. Discovering Pediatric Asthma Phenotypes on the Basis of Response to Controller Medication Using Machine Learning.

    Science.gov (United States)

    Ross, Mindy K; Yoon, Jinsung; van der Schaar, Auke; van der Schaar, Mihaela

    2018-01-01

    Pediatric asthma has variable underlying inflammation and symptom control. Approaches to addressing this heterogeneity, such as clustering methods to find phenotypes and predict outcomes, have been investigated. However, clustering based on the relationship between treatment and clinical outcome has not been performed, and machine learning approaches for long-term outcome prediction in pediatric asthma have not been studied in depth. Our objectives were to use our novel machine learning algorithm, predictor pursuit (PP), to discover pediatric asthma phenotypes on the basis of asthma control in response to controller medications, to predict longitudinal asthma control among children with asthma, and to identify features associated with asthma control within each discovered pediatric phenotype. We applied PP to the Childhood Asthma Management Program study data (n = 1,019) to discover phenotypes on the basis of asthma control between assigned controller therapy groups (budesonide vs. nedocromil). We confirmed PP's ability to discover phenotypes using the Asthma Clinical Research Network/Childhood Asthma Research and Education network data. We next predicted children's asthma control over time and compared PP's performance with that of traditional prediction methods. Last, we identified clinical features most correlated with asthma control in the discovered phenotypes. Four phenotypes were discovered in both datasets: allergic not obese (A + /O - ), obese not allergic (A - /O + ), allergic and obese (A + /O + ), and not allergic not obese (A - /O - ). Of the children with well-controlled asthma in the Childhood Asthma Management Program dataset, we found more nonobese children treated with budesonide than with nedocromil (P = 0.015) and more obese children treated with nedocromil than with budesonide (P = 0.008). Within the obese group, more A + /O + children's asthma was well controlled with nedocromil than with budesonide (P = 0.022) or with placebo

  8. Medical planning and response for a nuclear detonation: a practical guide.

    Science.gov (United States)

    Coleman, C Norman; Adams, Steven; Adrianopoli, Carl; Ansari, Armin; Bader, Judith L; Buddemeier, Brooke; Caro, J Jaime; Casagrande, Rocco; Case, Cullen; Caspary, Kevin; Chang, Arthur S; Chang, H Florence; Chao, Nelson; Cliffer, Kenneth D; Confer, Dennis; Deitchman, Scott; Derenzo, Evan G; Dobbs, Allen; Dodgen, Daniel; Donnelly, Elizabeth H; Gorman, Susan; Grace, Marcy Beth; Hatchett, Richard; Hick, John L; Hrdina, Chad; Jones, Robert; Kane, Elleen; Knebel, Ann; Koerner, John F; Laffan, Alison M; Larson, Leon; Livinski, Alicia; Mackinney, John; Maidment, Bert W; Manning, Ronald; Marinissen, Maria J; Martin, Colleen; Michael, Gretchen; Murrain-Hill, Paula; Nemhauser, Jeffrey B; Norwood, Ann E; Nystrom, Scott; Raheem, Murad; Redlener, Irwin; Sheehan, Kevin; Simon, Steven L; Taylor, Tammy P; Toner, Eric; Wallace, Katherine S; Wieder, Jessica; Weinstock, David M; Wiley, Albert L; Yeskey, Kevin; Miller, Charles W; Whitcomb, Robert C

    2012-12-01

    This article summarizes major points from a newly released guide published online by the Office of the Assistant Secretary for Preparedness and Response (ASPR). The article reviews basic principles about radiation and its measurement, short-term and long-term effects of radiation, and medical countermeasures as well as essential information about how to prepare for and respond to a nuclear detonation. A link is provided to the manual itself, which in turn is heavily referenced for readers who wish to have more detail.

  9. Self-reported responsiveness to direct-to-consumer drug advertising and medication use: results of a national survey

    Directory of Open Access Journals (Sweden)

    Somes Grant W

    2011-09-01

    Full Text Available Abstract Background Direct-to-consumer (DTC marketing of pharmaceuticals is controversial, yet effective. Little is known relating patterns of medication use to patient responsiveness to DTC. Methods We conducted a secondary analysis of data collected in national telephone survey on knowledge of and attitudes toward DTC advertisements. The survey of 1081 U.S. adults (response rate = 65% was conducted by the Food and Drug Administration (FDA. Responsiveness to DTC was defined as an affirmative response to the item: "Has an advertisement for a prescription drug ever caused you to ask a doctor about a medical condition or illness of your own that you had not talked to a doctor about before?" Patients reported number of prescription and over-the-counter (OTC medicines taken as well as demographic and personal health information. Results Of 771 respondents who met study criteria, 195 (25% were responsive to DTC. Only 7% respondents taking no prescription were responsive, whereas 45% of respondents taking 5 or more prescription medications were responsive. This trend remained significant (p trend .0009 even when controlling for age, gender, race, educational attainment, income, self-reported health status, and whether respondents "liked" DTC advertising. There was no relationship between the number of OTC medications taken and the propensity to discuss health-related problems in response to DTC advertisements (p = .4. Conclusion There is a strong cross-sectional relationship between the number of prescription, but not OTC, drugs used and responsiveness to DTC advertising. Although this relationship could be explained by physician compliance with patient requests for medications, it is also plausible that DTC advertisements have a particular appeal to patients prone to taking multiple medications. Outpatients motivated to discuss medical conditions based on their exposure to DTC advertising may require a careful medication history to evaluate for

  10. Self-reported responsiveness to direct-to-consumer drug advertising and medication use: results of a national survey.

    Science.gov (United States)

    Dieringer, Nicholas J; Kukkamma, Lisa; Somes, Grant W; Shorr, Ronald I

    2011-09-23

    ABSTRACT: BACKGROUND: Direct-to-consumer (DTC) marketing of pharmaceuticals is controversial, yet effective. Little is known relating patterns of medication use to patient responsiveness to DTC. METHODS: We conducted a secondary analysis of data collected in national telephone survey on knowledge of and attitudes toward DTC advertisements. The survey of 1081 U.S. adults (response rate = 65%) was conducted by the Food and Drug Administration (FDA). Responsiveness to DTC was defined as an affirmative response to the item: "Has an advertisement for a prescription drug ever caused you to ask a doctor about a medical condition or illness of your own that you had not talked to a doctor about before?" Patients reported number of prescription and over-the-counter (OTC) medicines taken as well as demographic and personal health information. RESULTS: Of 771 respondents who met study criteria, 195 (25%) were responsive to DTC. Only 7% respondents taking no prescription were responsive, whereas 45% of respondents taking 5 or more prescription medications were responsive. This trend remained significant (p trend .0009) even when controlling for age, gender, race, educational attainment, income, self-reported health status, and whether respondents "liked" DTC advertising. There was no relationship between the number of OTC medications taken and the propensity to discuss health-related problems in response to DTC advertisements (p = .4). CONCLUSION: There is a strong cross-sectional relationship between the number of prescription, but not OTC, drugs used and responsiveness to DTC advertising. Although this relationship could be explained by physician compliance with patient requests for medications, it is also plausible that DTC advertisements have a particular appeal to patients prone to taking multiple medications. Outpatients motivated to discuss medical conditions based on their exposure to DTC advertising may require a careful medication history to evaluate for therapeutic

  11. Prevalence and patterns of antimicrobial resistance of fecal Escherichia coli among pigs on 47 farrow-to-finish farms with different in-feed medication policies in Ontario and British Columbia

    OpenAIRE

    Akwar, Holy T.; Poppe, Cornelis; Wilson, Jeff; Reid-Smith, Richard J.; Dyck, Monica; Waddington, Josh; Shang, Dayue; McEwen, Scott A.

    2008-01-01

    The main objectives of this study were to determine the prevalence and patterns of antimicrobial resistance in pigs on farms that medicated swine ration and those that did not. A total of 940 isolates of Escherichia coli from 188 pooled fecal samples obtained from weaner and finisher pigs on 47 farrow-to-finish swine farms (34 farms used in-feed medication and 13 did not) were tested for susceptibility to 21 antimicrobials using a breakpoint concentration method. The prevalence of resistance ...

  12. Government of Canada response to the report of the Expert Review Panel on medical isotope production

    International Nuclear Information System (INIS)

    Paradis, C.

    2010-01-01

    Recent supply disruptions have highlighted the fragility of the supply chain that delivers essential medical isotopes to patients globally. A new and more reliable way of supplying isotopes to Canadians needs to be found. That is why the Government of Canada established the Expert Review Panel on Medical Isotope Production (the Panel) in June 2009. The Government recognizes the relatively long lead times associated with the development of any new source of medical. isotopes. To ensure that appropriate action is taken now for the long term, the Government tasked the Panel with reporting to the Minister. of Natural Resources on its assessment of the most viable options for securing supplies of technetium-99m (Tc99r) for the Canadian health care system over the medium and long term and the actions that may be required by governments and others to facilitate realization of these options. The Panel reported to the Minister of Natural Resources on November 30, 2009. Since then, the Government has been carefully considering the recommendations of the Panel within the context of the broader nuclear and health care landscape. What follows is the Government's response to the Panel's thoughtful, comprehensive and insightful report, including actions that are planned based on its recommendations. (author)

  13. Early perception of medication benefit predicts subsequent antipsychotic response in schizophrenia: "the consumer has a point" revisited.

    Science.gov (United States)

    Ascher-Svanum, Haya; Weiden, Peter; Nyhuis, Allen W; Faries, Douglas E; Stauffer, Virginia; Kollack-Walker, Sara; Kinon, Bruce J

    2014-07-01

    An easy-to-administer tool for predicting response to antipsychotic treatment could improve the acute management of patients with schizophrenia. We assessed whether a patient's perception of medication benefit early in treatment could predict subsequent response or nonresponse to continued use of the same treatment. This post hoc analysis used data from a randomized, open-label trial of antipsychotics for treatment of schizophrenia in which attitudes about medication adherence were assessed after two weeks of antipsychotic treatment using the Rating of Medication Influences (ROMI) scale. The analysis included 439 patients who had Positive and Negative Syndrome Scale (PANSS) and ROMI scale data at Weeks 2 and 8. Scores on the ROMI subscale Perceived Medication Benefit factor were used to predict subsequent antipsychotic response at Week 8, defined as a .20% reduction from baseline on the PANSS. Logistic regression was used to identify a cut-off score for the Perceived Medication Benefit factor that could accurately identify antipsychotic responders vs. nonresponders at Week 8. A score of .2.75 (equal to a mean subscale score of .11.00) on the ROMI scale Perceived Medication Benefit factor at Week 2 predicted response at Week 8 with high specificity (72%) and negative predictive value (70%), moderate sensitivity (44%) and positive predictive value (47%), and with a 38% misclassification rate. A brief assessment of the patient's perception of medication benefit at two weeks into treatment appears to be a good predictor of subsequent response and nonresponse after eight weeks of treatment with the same antipsychotic.

  14. The Systemic Inflammatory Response Syndrome (SIRS in acutely hospitalised medical patients: a cohort study

    Directory of Open Access Journals (Sweden)

    Storgaard Merete

    2009-12-01

    Full Text Available Abstract Background Sepsis is an infection which has evoked a systemic inflammatory response. Clinically, the Systemic Inflammatory Response Syndrome (SIRS is identified by two or more symptoms including fever or hypothermia, tachycardia, tachypnoea and change in blood leucocyte count. The relationship between SIRS symptoms and morbidity and mortality in medical emergency ward patients is unknown. Methods We conducted a prospective cohort study of the frequency of SIRS and its relationship to sepsis and death among acutely hospitalised medical patients. In 437 consecutive patients, SIRS status, blood pressure, infection and comorbidity on admission was registered together with 28-day mortality. Results A hundred and fifty-four patients (35% had SIRS on admission, 211 patients (48% had no SIRS, and 72 patients (16% had insufficient data to evaluate their SIRS status. SIRS patients were 2.2 times more frequently infected, with 66/154 SIRS patients versus 41/211 non-SIRS patients: p Conclusion We found SIRS status on admission to be moderately associated with infection and strongly related to 28-day mortality.

  15. Speciality preferences in Dutch medical students influenced by their anticipation on family responsibilities.

    Science.gov (United States)

    Alers, Margret; Pepping, Tess; Bor, Hans; Verdonk, Petra; Hamberg, Katarina; Lagro-Janssen, Antoine

    2014-12-01

    Physician gender is associated with differences in the male-to-female ratio between specialities and with preferred working hours. We explored how graduating students' sex or full-time or part-time preference influences their speciality choice, taking work-life issues into account. Graduating medical students at Radboud University Medical Centre, the Netherlands participated in a survey (2008-2012) on career considerations. Logistic regression tested the influence of sex or working hour preference on speciality choice and whether work-life issues mediate. Of the responding students (N = 1,050, response rate 83, 73.3 % women), men preferred full-time work, whereas women equally opted for part time. More men chose surgery, more women family medicine. A full-time preference was associated with a preference for surgery, internal medicine and neurology, a part-time preference with psychiatry and family medicine. Both male and female students anticipated that foremost the career of women will be negatively influenced by family life. A full-time preference was associated with an expectation of equality in career opportunities or with a less ambitious partner whose career would affect family life. This increased the likelihood of a choice for surgery and reduced the preference for family medicine among female students. Gender specifically plays an important role in female graduates' speciality choice making, through considerations on career prospects and family responsibilities.

  16. Infectious disease control in the Ionian Islands during the British Protection (1815-1864).

    Science.gov (United States)

    Tsiamis, Costas; Thalassinou, E; Poulakou-Rebelakou, E; Anogiatis-Pelé, D; Hatzakis, A

    2013-09-01

    This review presents the medical and social role of British military doctors in the formation of the British sanitary campaign in the Ionian Islands during the period 1815-1864. They were the core of a health system based on the old sanitary model of the Venetian Republic, which was the former ruler of the region. The British innovation and reorganisation of the old lazarettos (a quarantine system for maritime travellers), the new marine sanitary procedures, the determination of quarantine duration for major infectious diseases along with the introduction of the vaccination system resulted in a satisfactory defence against epidemics in Greece during the 19th century. The British military physicians applied and established West European medical ideas, as well as the principles of preventive medicine, for the first time in the Greek territory and this is a historical example of a successful sanitary campaign based on the experience of military physicians and their collaboration with civilian physicians.

  17. Science and the British Empire.

    Science.gov (United States)

    Harrison, Mark

    2005-03-01

    The last few decades have witnessed a flowering of interest in the history of science in the British Empire. This essay aims to provide an overview of some of the most important work in this area, identifying interpretative shifts and emerging themes. In so doing, it raises some questions about the analytical framework in which colonial science has traditionally been viewed, highlighting interactions with indigenous scientific traditions and the use of network-based models to understand scientific relations within and beyond colonial contexts.

  18. Build-up forces at Military Institute of Medical Radiology and Oncology for emergency medical response to some eventualities of radiological accidents - some suggestions

    International Nuclear Information System (INIS)

    Ho Van Cu; Nguyen Huu Nghia

    2011-01-01

    Nowadays, the use of various nuclear sources in some fields of the life has brought many practical advantages in general; especially in the next several years, our country will begin construction of the first nuclear plant. However, if there were user carelessness or objective disadvantageous factors (earthquake, tsunami, etc.), that disadvantages could lead to a radiation accident or nuclear accident which causes damages not only for economy but also for public health. Therefore, the emergency response to radiation accident, especially the emergency medical response that has a great important position. To satisfy this real demand, in 1996, Vietnam Ministry of Defence made the decision to establish Center for Nuclear Medicine and Radiation Protecting (now becomes Military Institute of Medical Radiology and Oncology) with the main missions are research, applying radiation protecting methods and organizing treatments to radiation injured victims. To fulfill above main missions, with the help of Vietnam Atomic Energy Institute (VAEI), Vietnam Agency for Radiation and Nuclear Safety (VARANS), the doctors and staffs of our Institute have been participated in the international training courses and workshops that organized in Vietnam or in regional countries about emergency medical response to radiation accidents, they get valuable information, knowledge and documents from these courses and workshops. Depending on the principles of radiation emergency medical response to nuclear/ radiation accidents that International Atomic Energy Agency (IAEA) guided, and with the experience learned from other countries in Asia region, our Institute have been gradually improving on organization and curing processes for the radiation victims and also setting the preparedness for emergency medical response to radiation accidents if maybe they could occur. (author)

  19. Immunization delivery in British Columbia

    Science.gov (United States)

    Omura, John; Buxton, Jane; Kaczorowski, Janusz; Catterson, Jason; Li, Jane; Derban, Andrea; Hasselback, Paul; Machin, Shelagh; Linekin, Michelle; Morgana, Tamsin; O’Briain, Barra; Scheifele, David; Dawar, Meena

    2014-01-01

    Abstract Objective To explore the experiences of family physicians and pediatricians delivering immunizations, including perceived barriers and supports. Design Qualitative study using focus groups. Setting Ten cities throughout British Columbia. Participants A total of 46 family physicians or general practitioners, 10 pediatricians, and 2 residents. Methods A semistructured dialogue guide was used by a trained facilitator to explore participants’ experiences and views related to immunization delivery in British Columbia. Verbatim transcriptions were independently coded by 2 researchers. Key themes were analyzed and identified in an iterative manner using interpretive description. Main findings Physicians highly valued vaccine delivery. Factors facilitating physician-delivered immunizations included strong beliefs in the value of vaccines and having adequate information. Identified barriers included the large time commitment and insufficient communication about program changes, new vaccines, and the adult immunization program in general. Some physicians reported good relationships with local public health, while others reported the opposite experience, and this varied by geographic location. Conclusion These findings suggest that physicians are supportive of delivering vaccines. However, there are opportunities to improve the sustainability of physician-delivered immunizations. While compensation schemes remain under the purview of the provincial governments, local public health authorities can address the information needs of physicians. PMID:24627403

  20. Leukaemia near british nuclear installations

    International Nuclear Information System (INIS)

    Hubert, D.

    1991-01-01

    An excess of childhood leukaemia has been seen near some British nuclear installations, especially near the Sellafield reprocessing plant. The same result was found in a more general study including a large number of nuclear sites. Similar studies made in USA, Canada and France have been negative. Moreover, epidemiological studies made in England have discovered other childhood leukaemia clusters in areas far from nuclear facilities, and especially near potential sites of nuclear installations. Several explanations are suggested but no definite conclusion is yet possible. Doses from radioactive releases seem to be too low to account for the additional deaths from leukaemia by environmental contamination. A virus activation, which might be associated with population influx into rural isolated areas, has been considered. The hypothesis of genetic mutation induced by ionising radiation in the fathers of children with leukaemia has been made because a higher risk of leukaemia was observed for children of fathers employed at Sellafield. No firm conclusion is possible considering the small number of observed cases and the lack of excess leukaemias in the offspring of Hiroshima and Nagasaki survivors. The possibility of internal contamination, chemicals or even radon is discussed as other causes. Studies in progress might allow to find an answer to the problem of leukaemia in the vicinity of British nuclear installations [fr

  1. Response to depression treatment in the Aging Brain Care Medical Home model

    Directory of Open Access Journals (Sweden)

    LaMantia MA

    2016-10-01

    Full Text Available Michael A LaMantia,1–4 Anthony J Perkins,5,6 Sujuan Gao,2,7 Mary G Austrom,8,9 Cathy A Alder,10 Dustin D French,11,12 Debra K Litzelman,2,3,13 Ann H Cottingham,3 Malaz A Boustani1–3,5 1Indiana University Center for Aging Research, 2Regenstrief Institute, Inc., 3Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, 4Department of Medicine, University of Vermont College of Medicine, Burlington, VT, 5Indiana University Center for Health Innovation and Implementation Science, 6Indiana Clinical and Translational Sciences Institute, 7Department of Biostatistics, Indiana University School of Medicine, 8Department of Psychiatry, Indiana University School of Medicine, 9Indiana University Alzheimer’s Disease Center, 10Eskenazi Health, Indianapolis, IN, 11Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, 12Veterans Affairs Health Services Research and Development Service, Chicago, IL, 13Indiana University Center for Health Services and Outcomes Research, Indianapolis, IN, USA Objective: To evaluate the effect of the Aging Brain Care (ABC Medical Home program’s depression module on patients’ depression severity measurement over time.Design: Retrospective chart review.Setting: Public hospital system.Participants: Patients enrolled in the ABC Medical Home program between October 1, 2012 and March 31, 2014.Methods: The response of 773 enrolled patients who had multiple patient health questionnaire-9 (PHQ-9 scores recorded in the ABC Medical Home program’s depression care protocol was evaluated. Repeatedly measured PHQ-9 change scores were the dependent variables in the mixed effects models, and demographic and comorbid medical conditions were tested as potential independent variables while including random effects for time and intercept.Results: Among those patients with baseline PHQ-9 scores >10, there was a significant decrease in PHQ-9 scores over time (P<0.001; however, the effect

  2. British coal-down to the line

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    The long-running saga of British Coal's decline is in its final stages with virtually no change from last October when the British government announced plants to close 31 of the 50 remaining mines. That announcement produced a political outcry but having privatized the electricity industry in 1990 the government had effectively left itself up the creek without a paddle. It had no powers to force the generators to buy more coal. The status of the British coal industry is discussed

  3. Temperature dependence of the Al2O3:C response in medical luminescence dosimetry

    International Nuclear Information System (INIS)

    Edmund, Jens M.; Andersen, Claus E.

    2007-01-01

    Over the last years, attention has been given to applications of Al 2 O 3 :C in space and medical dosimetry. One such application is in vivo dose verification in radiotherapy of cancer patients and here we investigate the temperature effects on the radioluminescence (RL) and optically stimulated luminescence (OSL) signals in the room-to-body temperature region. We found that the OSL response changes with both irradiation and stimulation temperatures as well as the OSL integration time. We conclude that temperature effects on the OSL response can be removed by integration if the irradiation temperature is not varied. The RL response only depends on the irradiation temperature. We recommend that calibration should be carried out at the same irradiation temperature at which the measurement is performed (i.e. at body temperature for in vivo measurements). The overall change in the integrated OSL and RL signals with irradiation and stimulation temperature covers an interval from -0.2% to 0.6% per deg. C. This indicates the correction factor one must take into account when performing luminescence dosimetry at different temperatures. The same effects were observed regardless of crystal type, test doses and stimulation and detection wavelengths. The reported temperature dependence seems to be a general property of Al 2 O 3 :C

  4. Response Distortion on Personality Tests in Applicants: Comparing High-Stakes to Low-Stakes Medical Settings

    Science.gov (United States)

    Anglim, Jeromy; Bozic, Stefan; Little, Jonathon; Lievens, Filip

    2018-01-01

    The current study examined the degree to which applicants applying for medical internships distort their responses to personality tests and assessed whether this response distortion led to reduced predictive validity. The applicant sample (n = 530) completed the NEO Personality Inventory whilst applying for one of 60 positions as first-year…

  5. Prevalence and patterns of antimicrobial resistance of fecal Escherichia coil among pigs on 47 farrow-to-finish farms with different in-feed medication policies in Ontario and British Columbia.

    Science.gov (United States)

    Akwar, Holy T; Poppe, Cornelis; Wilson, Jeff; Reid-Smith, Richard J; Dyck, Monica; Waddington, Josh; Shang, Dayue; McEwen, Scott A

    2008-01-01

    The main objectives of this study were to determine the prevalence and patterns of antimicrobial resistance in pigs on farms that medicated swine ration and those that did not. A total of 940 isolates of Escherichia coli from 188 pooled fecal samples obtained from weaner and finisher pigs on 47 farrow-to-finish swine farms (34 farms used in-feed medication and 13 did not) were tested for susceptibility to 21 antimicrobials using a breakpoint concentration method. The prevalence of resistance varied widely (0.0% to 81.3%) among the antimicrobials tested. Ninety percent of all the isolates tested were resistant to one or more antimicrobials. The most common multi-drug resistance patterns were to 2 to 6 antimicrobials. Resistance was significantly more frequent (P pigs compared to finisher pigs. These findings indicate that resistance to a broad range of antimicrobials was prevalent among fecal E. coli isolates of pigs on study farms, and that this constitutes a potential reservoir for resistance genes that could spread to pathogens. The findings also provide further evidence that use of medication in swine rations provides selective pressure for antimicrobial resistance in E. coli in pigs.

  6. [Euthanasia and/or medically assisted suicide: Reflection on the new responsibility of the hospital pharmacist].

    Science.gov (United States)

    Boissinot, L; Benamou, M; Léglise, P; Mancret, R-C; Huchon-Bécel, D

    2014-03-01

    Concern about euthanasia and medically assisted suicide is currently growing around the world and particularly in France. Though not authorized at present in France, the role of hospital pharmacist in this issue needs to be discussed. This article aims to gather medical and legal literature of European Union member states on these issues and particularly in France. To propose a practical thinking on the possible role of hospital pharmacist. Among European Union, euthanasia and/or assisted suicide have already been introduced in some member states' laws. In France, Leonetti law currently sets the legal framework for the management of end of life. To address the society's demand on these issues, French President F. Hollande made two ethics committees responsible for working on it. Both were mainly against euthanasia and assisted suicide. Though a bit forgotten in this debate, hospital pharmacist needs to be associated in the thinking, as the main "drug-keeper". Indeed, guidelines are necessary to outline and ensure a safe drug use, complying with professional ethics, if lethal doses are voluntarily prescribed. Pharmaceutical work is in constant evolution and is addressing new issues still unanswered, including assisted suicide and euthanasia. French pharmaceutical authorities should seize upon them, in order to guarantee pharmaceutical ethics. These practices, if authorized by law, should remain exceptional, and law strictly enforced. The pharmacist could be one of these "lawkeepers". Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  7. A 'mixed reality' simulator concept for future Medical Emergency Response Team training.

    Science.gov (United States)

    Stone, Robert J; Guest, R; Mahoney, P; Lamb, D; Gibson, C

    2017-08-01

    The UK Defence Medical Service's Pre-Hospital Emergency Care (PHEC) capability includes rapid-deployment Medical Emergency Response Teams (MERTs) comprising tri-service trauma consultants, paramedics and specialised nurses, all of whom are qualified to administer emergency care under extreme conditions to improve the survival prospects of combat casualties. The pre-deployment training of MERT personnel is designed to foster individual knowledge, skills and abilities in PHEC and in small team performance and cohesion in 'mission-specific' contexts. Until now, the provision of airborne pre-deployment MERT training had been dependent on either the availability of an operational aircraft (eg, the CH-47 Chinook helicopter) or access to one of only two ground-based facsimiles of the Chinook 's rear cargo/passenger cabin. Although MERT training has high priority, there will always be competition with other military taskings for access to helicopter assets (and for other platforms in other branches of the Armed Forces). This paper describes the development of an inexpensive, reconfigurable and transportable MERT training concept based on 'mixed reality' technologies-in effect the 'blending' of real-world objects of training relevance with virtual reality reconstructions of operational contexts. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  8. THE RESPONSIBILITY OF PHYSICIAN TO PREPARE A FORENSIC AND MEDICAL REPORT

    Directory of Open Access Journals (Sweden)

    Mehmet TOYGAR

    2006-12-01

    Full Text Available Physicians have responsibilities to prepare forensic and expertise reports besides their role in treatment, diagnosis and preventive medicine. A physician who engaged in treatment should have sufficient knowledge and experience to prepare the requested forensic or medical expertise reports. These expertise reports are usually requested either by criminal law or civil law courts, besides, calculation of the physical disabilities should be demanded at the basis of Armed Forces Pension Fund (OYAK Law and monetary compensation. New Turkish Penal Code highlights the new implementations about severity of injuries caused by trauma. According to the interpretation of Military Supreme Court, the severity of injuries caused by trauma in Military Penal Code is evaluated under the light of Turkish Penal Code. Determination of the rate of disabilities in general body functions and loss of daily activity have been often requested for reports concerning the civil law. Different legislations have been used for reports at the basis of monetary compensation. The purpose of this study is to scrutinize the problems encountered while preparing forensic and medical expertise reports and implementing the relevant and appropriate legal procedure and to emphasize the important points to be considered during the preparation of these expertise reports. [TAF Prev Med Bull 2006; 5(6.000: 466-475

  9. Withholding and withdrawing life-sustaining treatment: criminal responsibility for established medical practice?

    Science.gov (United States)

    White, Ben; Willmott, Lindy; Allen, John

    2010-05-01

    The law recognises the right of a competent adult to refuse medical treatment even if this will lead to death. Guardianship and other legislation also facilitates the making of decisions to withhold or withdraw life-sustaining treatment in certain circumstances. Despite this apparent endorsement that such decisions can be lawful, doubts have been raised in Queensland about whether decisions to withhold or withdraw life-sustaining treatment would contravene the criminal law, and particularly the duty imposed by the Criminal Code (Qld) to provide the "necessaries of life". This article considers this tension in the law and examines various arguments that might allow for such decisions to be made lawfully. It ultimately concludes, however, that criminal responsibility may still arise and so reform is needed.

  10. Brain-responsive neurostimulation in patients with medically intractable mesial temporal lobe epilepsy.

    Science.gov (United States)

    Geller, Eric B; Skarpaas, Tara L; Gross, Robert E; Goodman, Robert R; Barkley, Gregory L; Bazil, Carl W; Berg, Michael J; Bergey, Gregory K; Cash, Sydney S; Cole, Andrew J; Duckrow, Robert B; Edwards, Jonathan C; Eisenschenk, Stephan; Fessler, James; Fountain, Nathan B; Goldman, Alicia M; Gwinn, Ryder P; Heck, Christianne; Herekar, Aamar; Hirsch, Lawrence J; Jobst, Barbara C; King-Stephens, David; Labar, Douglas R; Leiphart, James W; Marsh, W Richard; Meador, Kimford J; Mizrahi, Eli M; Murro, Anthony M; Nair, Dileep R; Noe, Katherine H; Park, Yong D; Rutecki, Paul A; Salanova, Vicenta; Sheth, Raj D; Shields, Donald C; Skidmore, Christopher; Smith, Michael C; Spencer, David C; Srinivasan, Shraddha; Tatum, William; Van Ness, Paul C; Vossler, David G; Wharen, Robert E; Worrell, Gregory A; Yoshor, Daniel; Zimmerman, Richard S; Cicora, Kathy; Sun, Felice T; Morrell, Martha J

    2017-06-01

    Evaluate the seizure-reduction response and safety of mesial temporal lobe (MTL) brain-responsive stimulation in adults with medically intractable partial-onset seizures of mesial temporal lobe origin. Subjects with mesial temporal lobe epilepsy (MTLE) were identified from prospective clinical trials of a brain-responsive neurostimulator (RNS System, NeuroPace). The seizure reduction over years 2-6 postimplantation was calculated by assessing the seizure frequency compared to a preimplantation baseline. Safety was assessed based on reported adverse events. There were 111 subjects with MTLE; 72% of subjects had bilateral MTL onsets and 28% had unilateral onsets. Subjects had one to four leads placed; only two leads could be connected to the device. Seventy-six subjects had depth leads only, 29 had both depth and strip leads, and 6 had only strip leads. The mean follow-up was 6.1 ± (standard deviation) 2.2 years. The median percent seizure reduction was 70% (last observation carried forward). Twenty-nine percent of subjects experienced at least one seizure-free period of 6 months or longer, and 15% experienced at least one seizure-free period of 1 year or longer. There was no difference in seizure reduction in subjects with and without mesial temporal sclerosis (MTS), bilateral MTL onsets, prior resection, prior intracranial monitoring, and prior vagus nerve stimulation. In addition, seizure reduction was not dependent on the location of depth leads relative to the hippocampus. The most frequent serious device-related adverse event was soft tissue implant-site infection (overall rate, including events categorized as device-related, uncertain, or not device-related: 0.03 per implant year, which is not greater than with other neurostimulation devices). Brain-responsive stimulation represents a safe and effective treatment option for patients with medically intractable epilepsy, including patients with unilateral or bilateral MTLE who are not candidates for

  11. [Survey about responsiveness of third-level hospitals to a medical disaster: after the pandemic influenza in Mexico].

    Science.gov (United States)

    Serna-Ojeda, Juan Carlos; Castañón-González, Jorge Alberto; Macías, Alejandro E; Mansilla-Olivares, Armando; Domínguez-Cherit, Guillermo; Polanco-González, Carlos

    2012-01-01

    The recent pandemic influenza AH1N1 virus made it clear that planning for medical disaster response is critical. To know the responsiveness of a sample of highly specialized hospitals in Mexico to a medical disaster, with the previous pandemic influenza AH1N1 as reference. A survey was conducted among the Medical Directors of a sample of highly specialized hospitals, covering: previous experience with the pandemic influenza, space considerations, material resources, staff, logistics, and current general perspectives. Descriptive statistics were used for analysis. A 95% response was obtained from the institutions (19 hospitals). Of these, 47.4% considered that the medical institution was not ready to respond to pandemic influenza. The median surge capacity for the Intensive Care Unit beds was 30% (range 0 to 32 beds). The least reserve in medication was found in the antivirals (26.3%). Only 47.4% considered having enough intensive care nurses and 57.9% enough respiratory technicians; 42.1% would not have an easy access to resources in an emergency. Prevention is key in responsiveness to medical disasters, and therefore the basic steps for planning strategies must be considered.

  12. Implication of ultrasound bladder parameters on treatment response in patients with benign prostatic hyperplasia under medical management

    Directory of Open Access Journals (Sweden)

    Rajeev Thekumpadam Puthenveetil

    2015-10-01

    Conclusion: Ultrasound bladder parameters are useful tools for measuring the treatment response in BPH patients. Our study shows that RI and DWT significantly correlate with the treatment response in BPH patients. More importantly, pretreatment values of increased IPP and PUA determines the non-improvement of symptoms in BPH patients. Our study suggests the importance of transabdominal ultrasonography (KUB–P with Doppler for evaluating treatment responses to medical management.

  13. Locating AED Enabled Medical Drones to Enhance Cardiac Arrest Response Times.

    Science.gov (United States)

    Pulver, Aaron; Wei, Ran; Mann, Clay

    2016-01-01

    Out-of-hospital cardiac arrest (OOHCA) is prevalent in the United States. Each year between 180,000 and 400,000 people die due to cardiac arrest. The automated external defibrillator (AED) has greatly enhanced survival rates for OOHCA. However, one of the important components of successful cardiac arrest treatment is emergency medical services (EMS) response time (i.e., the time from EMS "wheels rolling" until arrival at the OOHCA scene). Unmanned Aerial Vehicles (UAV) have regularly been used for remote sensing and aerial imagery collection, but there are new opportunities to use drones for medical emergencies. The purpose of this study is to develop a geographic approach to the placement of a network of medical drones, equipped with an automated external defibrillator, designed to minimize travel time to victims of out-of-hospital cardiac arrest. Our goal was to have one drone on scene within one minute for at least 90% of demand for AED shock therapy, while minimizing implementation costs. In our study, the current estimated travel times were evaluated in Salt Lake County using geographical information systems (GIS) and compared to the estimated travel times of a network of AED enabled medical drones. We employed a location model, the Maximum Coverage Location Problem (MCLP), to determine the best configuration of drones to increase service coverage within one minute. We found that, using traditional vehicles, only 4.3% of the demand can be reached (travel time) within one minute utilizing current EMS agency locations, while 96.4% of demand can be reached within five minutes using current EMS vehicles and facility locations. Analyses show that using existing EMS stations to launch drones resulted in 80.1% of cardiac arrest demand being reached within one minute Allowing new sites to launch drones resulted in 90.3% of demand being reached within one minute. Finally, using existing EMS and new sites resulted in 90.3% of demand being reached while greatly reducing

  14. Cutting Close to the Bone: Student Trauma, Free Speech, and Institutional Responsibility in Medical Education.

    Science.gov (United States)

    Kumagai, Arno K; Jackson, Brittani; Razack, Saleem

    2017-03-01

    Learning the societal roles and responsibilities of the physician may involve difficult, contentious conversations about topics such as race, gender, sexual orientation, and class, as well as violence, inequities, sexual assault, and child abuse. If not done well, these discussions may be deeply traumatizing to learners for whom these subjects "cut close to the bone." Equally traumatizing is exposure to injustice and mistreatment, as well as to the sights, sounds, and smells of suffering and pain in the clinical years. This potential for iatrogenic educational trauma remains unaddressed, and medical educators must take responsibility for attending to it. Possible solutions include trigger warnings or statements given to students before an educational activity that may cause personal discomfort. The authors of this Perspective assert, however, both that this concept does not distinguish between psychological trauma and discomfort and that well-intentioned trigger warnings target the wrong goal-the avoidance of distress. Exposure to discomfort not only is unavoidable in the practice of medicine but may be crucial to personal and professional moral development. The authors argue that a more appropriate solution is to create safe spaces for dialogues about difficult topics and jarring experiences. This approach places even the notion of free speech under a critical lens-it is not an end in itself but a means to create a professional ethic dedicated to treating all individuals with excellence and justice. Ultimately, this approach aspires to create an inclusive curriculum sensitive to the realities of teaching and learning in increasingly diverse societies.

  15. [Risk management in health care systems: the new legislative orientations in medical civil responsibility].

    Science.gov (United States)

    Tomassini, A; Signorelli, C; Colzani, E

    2004-01-01

    The recent radical change in the relationships between physicians and patients has increased the frequency of malpractice. Consequently, on one hand, many physicians got used to avoiding any possible risk of denunciation by applying the so called "defensive medicine", while on the other hand, the insurance companies raised the prices of their premiums for policies concerning civil responsibility of health operators. In order to avoid this "vicious circle", some health structures created Units for the Risk Management related to malpractice, while others took advantage of the collaboration of Associations for Patients' Rights to create database about the most frequent medical mistakes. The need for a legislative change has been accepted by the Parliament which expects with the proposal n.108 (approved in spring 2002 by the Commission for Hygiene and Health of the Senate) to attribute the civil responsibility of the physicians to the hospitals (both private and public) for which they work, to constitute a Register of experts and to accelerate the legal disputes. The problem is complex and still to be solved, but it seems that time for a strong intervention in order to improve the situation has to come.

  16. Response of a hybrid pixel detector (MEDIPIX3) to different radiation sources for medical applications

    Energy Technology Data Exchange (ETDEWEB)

    Chumacero, E. Miguel; De Celis Alonso, B.; Martínez Hernández, M. I.; Vargas, G.; Moreno Barbosa, E., E-mail: emoreno.emb@gmail.com [Facultad de Ciencias Físico Matemáticas, Benemérita Universidad Autónoma de Puebla, Av. San Claudio y Rio Verde, Puebla (Mexico); Moreno Barbosa, F. [Hospital General del Sur Hospital de la Mujer, Puebla (Mexico)

    2014-11-07

    The development in semiconductor CMOS technology has enabled the creation of sensitive detectors for a wide range of ionizing radiation. These devices are suitable for photon counting and can be used in imaging and tomography X-ray diagnostics. The Medipix[1] radiation detection system is a hybrid silicon pixel chip developed for particle tracking applications in High Energy Physics. Its exceptional features (high spatial and energy resolution, embedded ultra fast readout, different operation modes, etc.) make the Medipix an attractive device for applications in medical imaging. In this work the energy characterization of a third-generation Medipix chip (Medipix3) coupled to a silicon sensor is presented. We used different radiation sources (strontium 90, iron 55 and americium 241) to obtain the response curve of the hybrid detector as a function of energy. We also studied the contrast of the Medipix as a measure of pixel noise. Finally we studied the response to fluorescence X rays from different target materials (In, Pd and Cd) for the two data acquisition modes of the chip; single pixel mode and charge summing mode.

  17. 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.…

  18. British Box Business: A History of OCL

    DEFF Research Database (Denmark)

    Poulsen, René Taudal

    2018-01-01

    Book review of British Box Business: A History of OCL / edited by A. Bott SCARA, Goldaming, 2009, £17 (hb) 288 pages, illustrations, bibliography, index iSBn 139780955922701......Book review of British Box Business: A History of OCL / edited by A. Bott SCARA, Goldaming, 2009, £17 (hb) 288 pages, illustrations, bibliography, index iSBn 139780955922701...

  19. British Celtic influence on English phonology

    NARCIS (Netherlands)

    Laker, Stephen

    2010-01-01

    The dissertation assesses the influence of British Celtic on the phonological development of English during and shortly after the Anglo-Saxon settlement period, ca. AD 450–700. By reconstructing and then comparing the phonological systems of both British Celtic and English at the time of contact, an

  20. There's No Such Thing as British Art

    Directory of Open Access Journals (Sweden)

    Richard Johns

    2015-11-01

    Full Text Available “Conversation Piece” is a British Art Studies series that draws together a group of contributors to respond to an idea, provocation or question. The conversation will develop as more respondents enter the debate. Fifteen contributors respond to the provocation "There's No Such Thing as British Art".

  1. African Journals Online: Virgin Islands (British)

    African Journals Online (AJOL)

    African Journals Online: Virgin Islands (British). Home > African Journals Online: Virgin Islands (British). Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Browse By Category · Browse Alphabetically · Browse By Country · List All Titles · Free to read Titles This Journal ...

  2. Mortality of British radiologists. A lecture Note+

    International Nuclear Information System (INIS)

    Doll, R.

    2005-01-01

    The precautions introduced after the first 23 years experience of the use of x-rays for medical diagnosis proved adequate to eliminate the acute hazards of exposure, but it was much longer before it was realized that small doses that did not produce any acute effect could increase the risk of cancer. British radiologists who took up the specialty at different periods have, therefore, been studied to see if the risk has now been adequately controlled. Four groups have been studied starting respectively before 1921, in 1921-34, 1935-54, and 1955-77, corresponding approximately to periods when different limits of exposure were applied. Altogether 2698 male radiologists have been identified and all but 27 followed successfully to emigration, death, or survival to January 1 st 1997. Of the 1198 who had died, 228 are known to have died of cancer. Two problems arise in evaluating the carcinogenic hazard to which they were exposed: the assessment of the doses received and the selection of an appropriate control group with which to compare their mortality. The most appropriate comparison group would seem to be medical practitioners in general. In comparison with them, radiologists entering in the first 3 periods had increased risks of death from cancer though appreciably less than would have been predicted from the expected effect of the radiation they had received. Those who joined in the latest period had a relatively reduced risk, irrespective of any effect of the small dose of radiation they are likely to have received. Independent evidence suggests, however, that since 1951 radiologists have smoked less than other doctors and the lower than predicted risk in the groups exposed since 1920 is limited to smoking related cancers, the mortality from other cancers being higher than in doctors generally. In assessing the risk of occupational exposure to radiation, life-style has to be taken into consideration, as well as dose of radiation. (author)

  3. British Columbia Power Export Corporation: Operational review for operating year, October 1989 to September 1990

    International Nuclear Information System (INIS)

    1990-01-01

    The British Columbia Power Export Corporation (POWEREX) is a wholly owned subsidiary of British Columbia Hydro, established in 1988 as the single agency responsible for implementing the provincial policy of international electricity trade. POWEREX objectives are to conduct long term firm electricity trade utilizing private sector financing, operating capabilities, and generating sources. Short term electricity transactions are handled by the part of POWEREX called the Powerex Pool Operation. An operational review of POWEREX for 1989-90 is presented, giving information on export contracts, license approvals, export sales negotiations, pool operation revenues and sales, British Columbia Hydro generation and integrated system performance, and operational planning. 15 figs

  4. The British Museum: An Imperial Museum in a Post-Imperial World

    Directory of Open Access Journals (Sweden)

    Emily Duthie

    2011-12-01

    Full Text Available This article examines the British Museum’s imperialist attitudes towards classical heritage. Despite considerable pressure from foreign governments, the museum has consistently refused to return art and antiquities that it acquired under the aegis of empire. It is the contention of this article that the British Museum remains an imperialist institution. The current debates over the British Museum’s collections raise profound questions about the relationship between museums and modern nation states and their nationalist claims to ancient heritage. The museum’s inflexible response to repatriation claims also encapsulates the challenges inherent in presenting empire and its legacy to contemporary, post-imperial audiences.

  5. Heroines of lonely outposts or tools of the empire? British nurses in Britain's model colony: Ceylon, 1878-1948.

    Science.gov (United States)

    Jones, Margaret

    2004-09-01

    In 1878 two 'Nightingale' nurses arrived in the British colony of Ceylon to initiate a training programme for indigenous women in the skills and values of what was then termed 'scientific nursing'. These two women were the first of a succession of British women who went to the colony to nurse in its hospitals and to train Ceylonese women for the profession. Using the official records of the colonial government held in the National Archives, Kew and the records of the Overseas Nursing Association in the Rhodes House Collection, Oxford, this paper explores both the professional and social experiences of these women. This paper also analyses the role that these representatives of the colonial state played in the development of an indigenous nursing profession and concludes that their presence in the colony ultimately left an ambiguous legacy. In their role as trainers of indigenous women, they furthered the development and spread of a Western nursing profession in the colony's hospitals. At the same time, however, their continuing dominance of training and the positions of responsibility was an inhibiting factor in the ability of indigenous nurses to organise and professionalise. Whereas the doctors, trained in the colony's Medical College, achieved registration as early as 1905, the nurses had to wait until 1949, a year after independence, before their qualification was recognised and protected. Nursing remained throughout the colonial period therefore, even more so than at the metropolitan centre, the 'Cinderella' of the medical professions.

  6. Predicting the long-term effects of human-robot interaction: a reflection on responsibility in medical robotics.

    Science.gov (United States)

    Datteri, Edoardo

    2013-03-01

    This article addresses prospective and retrospective responsibility issues connected with medical robotics. It will be suggested that extant conceptual and legal frameworks are sufficient to address and properly settle most retrospective responsibility problems arising in connection with injuries caused by robot behaviours (which will be exemplified here by reference to harms occurred in surgical interventions supported by the Da Vinci robot, reported in the scientific literature and in the press). In addition, it will be pointed out that many prospective responsibility issues connected with medical robotics are nothing but well-known robotics engineering problems in disguise, which are routinely addressed by roboticists as part of their research and development activities: for this reason they do not raise particularly novel ethical issues. In contrast with this, it will be pointed out that novel and challenging prospective responsibility issues may emerge in connection with harmful events caused by normal robot behaviours. This point will be illustrated here in connection with the rehabilitation robot Lokomat.

  7. The medical reshaping of disabled bodies as a response to stigma and a route to normality.

    Science.gov (United States)

    McLaughlin, Janice

    2017-12-01

    Disabled people are said to experience stigma because their embodied presence in the world does not fit with how others interact and use their bodies to be social participants. In response they can turn to medical procedures, such as surgery or physiotherapy, in order to reshape their bodies to more closely approximate norms of social interaction and embodiment. This paper explores how medicine plays a role in attempts to be recognised by others as normal and acceptable by minimising disability. It will do so via a focus on disabled young people, in order to explore how their emerging identities and aspirations for the future influence how they think about their bodies, what normality means and their participation in multiple activities that work on their bodies. The paper draws from an Economic and Social Research Council (ESRC) project that used a range of qualitative research methods with a group of disabled young people. The project explored ways in which participants actively worked on their bodies to be more normal and examined the disciplinary and agency dynamics involved in this work. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  8. Incapacity of the Mind Secondary to Medication Misuse as a Not Criminally Responsible Defense.

    Science.gov (United States)

    Prat, Sebastien S; Losier, Bruno J; Moulden, Heather M; Chaimowitz, Gary A

    2017-01-01

    The manifestations of disorders of the mind may play a role in the occurrence of criminal behavior. In the majority of the cases, the presence of a psychiatric disorder is cited as the reason that an individual was not fully aware of his behavior. However, other conditions, such as seizure disorders or hypoglycemia, have also been linked to an inability to understand the nature and consequences of one's actions. On occasion, these situations can be explained by a state of automatism that may be described as insane or noninsane. In this article, we describe the case of a 77-year-old man, suffering from Parkinson's disease, where the issue of criminal responsibility associated with incapacity of the mind secondary to medication misuse was raised. We elaborate on the thinking behind this opinion and the implications according to Canadian law. Although the legal outcome of this case is specific to our jurisdiction, the clinical implication may be common to any patient suffering from a similar condition and may inform physicians, families, and lawyers. © 2016 American Academy of Forensic Sciences.

  9. 802.11 Wireless Infrastructure To Enhance Medical Response to Disasters

    Science.gov (United States)

    Arisoylu, Mustafa; Mishra, Rajesh; Rao, Ramesh; Lenert, Leslie A.

    2005-01-01

    802.11 (WiFi) is a well established network communications protocol that has wide applicability in civil infrastructure. This paper describes research that explores the design of 802.11 networks enhanced to support data communications in disaster environments. The focus of these efforts is to create network infrastructure to support operations by Metropolitan Medical Response System (MMRS) units and Federally-sponsored regional teams that respond to mass casualty events caused by a terrorist attack with chemical, biological, nuclear or radiological weapons or by a hazardous materials spill. In this paper, we describe an advanced WiFi-based network architecture designed to meet the needs of MMRS operations. This architecture combines a Wireless Distribution Systems for peer-to-peer multihop connectivity between access points with flexible and shared access to multiple cellular backhauls for robust connectivity to the Internet. The architecture offers a high bandwidth data communications infrastructure that can penetrate into buildings and structures while also supporting commercial off-the-shelf end-user equipment such as PDAs. It is self-configuring and is self-healing in the event of a loss of a portion of the infrastructure. Testing of prototype units is ongoing. PMID:16778990

  10. Dentists' perceptions of difficulties encountered in providing dental care for British Asians.

    Science.gov (United States)

    Williams, S A; Godson, J H; Ahmed, I A

    1995-03-01

    British Asians represent a substantial proportion of the population in some parts of the United Kingdom, yet many fail to use dental services regularly. This study aimed to investigate dentists' concerns about providing care for this client group. Following a pilot study, a postal questionnaire was sent to general dental practitioners and community dental officers working in seven family health services authority localities. Of 1546 questionnaires circulated, 639 (41 per cent) were returned. The language barrier was most frequently identified as a major impediment to care (78 per cent), followed by patients' understanding of treatment proposed (67 per cent), while 64 per cent found difficulty obtaining medical histories. Only 20 per cent considered that gaining consent for treatment was a problem. Other issues concerned attendance as casual patients (65 per cent) and, in terms of treatment provided, difficulties with preventive (77 per cent), periodontal (66 per cent) and orthodontic care (27 per cent). The proportion of dentists identifying barriers to care reflected the English-speaking abilities of different Asian populations. Compared with the high percentage mentioning language, understanding and medical history, the small proportion of dentists who thought that consent was of concern suggests that concepts of consent may need to be questioned. Despite the low response rate, the high proportion of respondents identifying these issues implies that the present position may put patients' health at risk, restrict treatment options and offer a potential for litigation. Future initiatives to overcome barriers to appropriate care must address the perspectives of dentists treating British Asians, as well as that of the client group.

  11. British power generation/delivery handbook

    Energy Technology Data Exchange (ETDEWEB)

    Bagley, R.

    1986-01-01

    Describes the British electricity-supply system and covers: the CEGB, nuclear power - AGR design, boiler plant development coal-fired boilers and oil-fired boilers, steam turbine/generators, boiler-feed pumps, pumped storage, gas turbine plants, transmission system including the link to France, the Sizewell-BPWR, future AGR development, future coal-fired stations, fluidized bed combustion, coal gasification, and wind energy developments. Also included is a list of British equipment suppliers to the electricity supply industry, and a buyer's guide to British equipment and services.

  12. French Intervention: British Failure To Anticipate Transition In The American War of Independence

    Science.gov (United States)

    2016-05-26

    responsibility of the war, especially because the colonists benefited greatly from the outcome of the conflict.26 In 1764, Parliament implemented the...coercive taxes were being placed on them to benefit wealthy British businessmen who had influence in Parliament and financial interest in the East...elite recognized the importance of the colonies to the British economy and feared tax hikes if the colonies were lost. Britain faced a difficult set

  13. Accounting for medical communication: parents' perceptions of communicative roles and responsibilities in the pediatric intensive care unit.

    Science.gov (United States)

    Gordon, Cynthia; Barton, Ellen; Meert, Kathleen L; Eggly, Susan; Pollacks, Murray; Zimmerman, Jerry; Anand, K J S; Carcillo, Joseph; Newth, Christopher J L; Dean, J Michael; Willson, Douglas F; Nicholson, Carol

    2009-01-01

    Through discourse analysis of transcribed interviews conducted over the phone with parents whose child died in the Pediatric Intensive Care Unit (PICU) (n = 51), this study uncovers parents' perceptions of clinicians' and their own communicative roles and responsibilities in the context of team-based care. We examine parents' descriptions and narratives of communicative experiences they had with PICU clinicians, focusing on how parents use accounts to evaluate the communicative behaviors they report (n = 47). Findings indicate that parental perceptions of communicative responsibilities are more nuanced than assumed in previous research: Parents identified their own responsibilities as participating as part of the team of care, gathering information, interacting with appropriate affect, and working to understand complex and uncertain medical information. Complementarily, parents identified clinician responsibilities as communicating professionally, providing medical information clearly, managing parents' hope responsibly, and communicating with appropriate affect. Through the accounts they provide, parents evaluate both parental and clinician role-responsibilities as fulfilled and unfulfilled. Clinicians' management of prognostic uncertainty and parents' struggles to understand that uncertainty emerged as key, complementary themes with practical implications for incorporating parents into the PICU care team. The study also highlights insights retrospective interview data bring to the examination of medical communication.

  14. Fusion Analytics: A Data Integration System for Public Health and Medical Disaster Response Decision Support

    Science.gov (United States)

    Passman, Dina B.

    2013-01-01

    Objective The objective of this demonstration is to show conference attendees how they can integrate, analyze, and visualize diverse data type data from across a variety of systems by leveraging an off-the-shelf enterprise business intelligence (EBI) solution to support decision-making in disasters. Introduction Fusion Analytics is the data integration system developed by the Fusion Cell at the U.S. Department of Health and Human Services (HHS), Office of the Assistant Secretary for Preparedness and Response (ASPR). Fusion Analytics meaningfully augments traditional public and population health surveillance reporting by providing web-based data analysis and visualization tools. Methods Fusion Analytics serves as a one-stop-shop for the web-based data visualizations of multiple real-time data sources within ASPR. The 24-7 web availability makes it an ideal analytic tool for situational awareness and response allowing stakeholders to access the portal from any internet-enabled device without installing any software. The Fusion Analytics data integration system was built using off-the-shelf EBI software. Fusion Analytics leverages the full power of statistical analysis software and delivers reports to users in a secure web-based environment. Fusion Analytics provides an example of how public health staff can develop and deploy a robust public health informatics solution using an off-the shelf product and with limited development funding. It also provides the unique example of a public health information system that combines patient data for traditional disease surveillance with manpower and resource data to provide overall decision support for federal public health and medical disaster response operations. Conclusions We are currently in a unique position within public health. One the one hand, we have been gaining greater and greater access to electronic data of all kinds over the last few years. On the other, we are working in a time of reduced government spending

  15. The Joint Military Medical Executive Skills initiative: an impressive response to changing human resource management rules of engagement.

    Science.gov (United States)

    Kerr, Bernard J

    2007-01-01

    Confronted with a sudden and substantial change in the rules regarding who could command a military medical treatment facility (MTF), the Military Health System (MHS) responded to the challenge with an impressive human resource management solution-the Joint Medical Executive Skills Program. The history, emergence, and continuing role of this initiative exemplifies the MHS's capacity to fulfill the spirit and intent of an arduous Congressional mandate while enhancing professional development and sustaining the career opportunities of medical officers. The MHS response to the Congressional requirement that candidates for MTF command demonstrate professional administrative skills was decisive, creative, and consistent with the basic principles of human resource management. The Joint Medical Executive Skills Program is a management success story that demonstrates how strategic planning, well-defined skills requirements, and structured training can assure a ready supply of qualified commanders for the military's MTFs.

  16. British Columbia at the crossroads: clean energy or more pollution?

    International Nuclear Information System (INIS)

    Foley, D.; Hertzog, S.; Scott, G.

    2001-11-01

    Some of the challenges facing policy makers as we enter this century are related to regional air pollution and global climate change, where both are a consequence of the combustion of fossil fuels. Data on smog and particulates has been compiled for decades by medical authorities and regulators, thereby documenting the causes, the characteristics and the impact of global warming. Sustainable energy policies are required. A historic compromise was forged in July 2001 on how to implement the 1997 Kyoto Protocol. It is increasingly important for Canada to make energy policy decisions that support the protection of the climate. Key aspects of human activity, such as tourism, forestry, fishing, agriculture, water supplies and flows, infrastructure reliability and costs, and public health factors are at risk in British Columbia. For British Columbia to comply with the Kyoto Protocol, some sources would be able to expand emissions while others would have to reduce them much more to achieve an overall reduction. This document represents an outline and a vision for new opportunities and analyses the challenges facing energy patterns in British Columbia. It was presented to the British Columbia (BC) Energy Policy Task Force. This broad policy review is an ideal opportunity to build energy policies and related economic initiatives leading to new industries, new jobs, and increased energy security. The document is divided in five parts: the BC situation: trends and impacts, BC Hydro and the rush to gas, the BC gas turbine experience: conflict and controversy, gas and the changing dynamics of the BC energy market, and the clean energy path: lessons and policy recommendations. refs., 1 tab., 4 figs

  17. British Columbia at the crossroads: clean energy or more pollution?

    Energy Technology Data Exchange (ETDEWEB)

    Foley, D.; Hertzog, S.; Scott, G. (eds.)

    2001-11-01

    Some of the challenges facing policy makers as we enter this century are related to regional air pollution and global climate change, where both are a consequence of the combustion of fossil fuels. Data on smog and particulates has been compiled for decades by medical authorities and regulators, thereby documenting the causes, the characteristics and the impact of global warming. Sustainable energy policies are required. A historic compromise was forged in July 2001 on how to implement the 1997 Kyoto Protocol. It is increasingly important for Canada to make energy policy decisions that support the protection of the climate. Key aspects of human activity, such as tourism, forestry, fishing, agriculture, water supplies and flows, infrastructure reliability and costs, and public health factors are at risk in British Columbia. For British Columbia to comply with the Kyoto Protocol, some sources would be able to expand emissions while others would have to reduce them much more to achieve an overall reduction. This document represents an outline and a vision for new opportunities and analyses the challenges facing energy patterns in British Columbia. It was presented to the British Columbia (BC) Energy Policy Task Force. This broad policy review is an ideal opportunity to build energy policies and related economic initiatives leading to new industries, new jobs, and increased energy security. The document is divided in five parts: the BC situation: trends and impacts, BC Hydro and the rush to gas, the BC gas turbine experience: conflict and controversy, gas and the changing dynamics of the BC energy market, and the clean energy path: lessons and policy recommendations. refs., 1 tab., 4 figs.

  18. Treatment of ADHD with Stimulant Medications: Response to Nissen Perspective in the New England Journal of Medicine

    Science.gov (United States)

    Biederman, Joseph; Spencer, Thomas J.; Wilens, Timothy E.; Prince, Jefferson B.; Faraone, Stephen V.

    2006-01-01

    This article is a response to Dr. Steven E. Nissen's comments (Nissen, 2006) about attention deficit/hyperactivity disorder (ADHD) and its treatment with stimulant medications. In this article, the authors refute his arguments and provide accurate information. Here, they answer the questions, such as: (1) Do stimulants increase the risk for sudden…

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  20. Predictors and Moderators of Response to Cognitive Behavioral Therapy and Medication for the Treatment of Binge Eating Disorder

    Science.gov (United States)

    Grilo, Carlos M.; Masheb, Robin M.; Crosby, Ross D.

    2012-01-01

    Objective: To examine predictors and moderators of response to cognitive behavioral therapy (CBT) and medication treatments for binge-eating disorder (BED). Method: 108 BED patients in a randomized double-blind placebo-controlled trial testing CBT and fluoxetine treatments were assessed prior, throughout, and posttreatment. Demographic factors,…

  1. How the doc should (not) talk: When breaking bad news with negations influences patients' immediate responses and medical adherence intentions

    NARCIS (Netherlands)

    Burgers, C.F.; Beukeboom, C.J.; Sparks, L

    2012-01-01

    Objective: We investigate the role of specific formulations in a doctor's bad news delivery. We focus on the effects of negations and message framing on patients' immediate responses to the message and the doctor, and long-term consequences including quality of life and medical adherence intentions.

  2. Early response in cognitive-behavior therapy for syndromes of medically unexplained symptoms.

    Science.gov (United States)

    Kleinstäuber, Maria; Lambert, Michael J; Hiller, Wolfgang

    2017-05-25

    Early dramatic treatment response suggests a subset of patients who respond to treatment before most of it has been offered. These early responders tend to be over represented among those who are well at termination and at follow-up. Early response patterns in psychotherapy have been investigated only for a few of mental disorders so far. The main aim of the current study was to examine early response after five therapy-preparing sessions of a cognitive behavior therapy (CBT) for syndromes of medically unexplained symptoms (MUS). In the context of a randomized, waiting-list controlled trial 48 patients who suffered from ≥3 MUS over ≥6 months received 5 therapy-preparing sessions and 20 sessions of CBT for somatoform disorders. They completed self-report scales of somatic symptom severity (SOMS-7 T), depression (BDI-II), anxiety (BSI), illness anxiety and behavior (IAS) at pre-treatment, after 5 therapy-preparing sessions (FU-5P) and at therapy termination (FU-20 T). The current analyses are based on data from the treatment arm only. Repeated measure ANOVAs revealed a significant decrease of depression (d = 0.34), anxiety (d = 0.60), illness anxiety (d = 0.38) and illness behavior (d = 0.42), but no change of somatic symptom severity (d = -0.03) between pre-treatment and FU-5P. Hierarchical linear multiple regression analyses showed that symptom improvements between pre-treatment and FU-5P predict a better outcome at therapy termination for depression and illness anxiety, after controlling for pre-treatment scores. Mixed-effect ANOVAs revealed significant group*time interaction effects indicating differences in the course of symptom improvement over the therapy between patients who fulfilled a reliable change (i.e., early response) during the 5 therapy-preparing sessions and patients who did not reach an early reliable change. Demographic or clinical variables at pre-treatment were not significantly correlated with differential scores between pre

  3. Safety and licensing: the British perspective

    Energy Technology Data Exchange (ETDEWEB)

    Anthony, R D

    1986-02-01

    The legal framework of British regulatory practice is described, with emphasis on its flexibility and the fact that responsibility rests with the licensee, leaving the NII to monitor his implementation of that duty. The UK regulatory philosophy, the mixture of selective and random sampling used and the organization of the regulatory bodies as it interacts with that of the nuclear industry are outlined. This is followed by a resume of the current nuclear safety issues and of the NII's attitude to them, including the continued operation of the aging Magnox reactors, the extended transition of the AGR from the prototype to the 'tried and tested' stage of its existence, the problems of licensing nuclear chemical plant, the CEGB's proposed introduction of the PWR into this country, the availability of increasingly sophisticated means of assessing safety, and the steadily rising public interest in nuclear power issues. The Lecture ends by noting the problems of risk perception and cost/benefit analysis, emphasizing that in striking the right balance the regulatory body must be open, prepared to justify its reasoning, and productive of conclusions which are acceptable to the public.

  4. Inflight Pharmacokinetic and Pharmacodynamic Responses to Medications Commonly Used in Spaceflight

    Science.gov (United States)

    Wotring, V. E.; Derendorf, H.; Kast, J.; Barger, L.; Basner, M.

    2016-01-01

    Researchers do not know if medications act the same in the spaceflight environment as they do on Earth. Aspects of the spaceflight environment (low gravity, radiation exposure, closed environment, stress) have been shown to alter human physiology. Some of these physiological changes could be expected to alter either pharmacokinetics (PK, how the body absorbs, distributes, metabolizes and excretes administered medications) or pharmacodynamics (PD, receptors or signaling systems that are the targets of medication action). Anecdotal data has suggested that, at least for certain medications or indications, inflight medication efficacy is poor. In order to prepare for exploration missions where speedy evacuation to Earth may not be a possibility, the likelihood of unexpected medication action must be determined.

  5. British women's attitudes to surrogacy.

    Science.gov (United States)

    Poote, A E; van den Akker, O B A

    2009-01-01

    There has been little interest in the research literature on public opinions regarding assisted conception and surrogacy, particularly in European countries, despite the growing evidence showing that problems in adaptation and coping may be related to perceived normative values. This study investigated British women's attitudes to surrogacy using components of the theory of planned behaviour (TPB). Questionnaires on attitudes to surrogacy and reasons for parenthood were completed by 187 women from the general public. Significant socio-demographic differences were found between women who were possibly willing (n = 76) and those who were unwilling (n = 111) to become surrogate mothers. General attitudes to surrogacy also differed between groups (P = 0.000). This study supported the predictive utility of components of the TPB, and differentiated adequately between groups on attitudes to recruitment for surrogacy (P = 0.000), the consequences of surrogacy (P = 0.000), factors that induce people to become surrogates (P = 0.000), social support (P = 0.000), having personal control (P = 0.002) and reasons for parenthood (P = 0.000). Age (P = 0.000), attitudes to advertising (P = 0.02) and the consequences of surrogacy (P = 0.05) predicted (un)willingness to become a potential surrogate mother. Further research is needed with larger sample sizes of potential surrogates to determine whether the predictive attitudes reported here translate to actual behaviours. The larger group which was not interested in considering becoming a surrogate scored significantly more negatively on all attitudes towards surrogacy. The negative attitudes reported by the 'unwilling to consider being a surrogate' group may reflect attitudes held by the majority of the population and are likely to be influenced by reports of stigma associated with surrogacy.

  6. Medical students' perceptions in relation to ethnicity and gender: A qualitative study

    OpenAIRE

    Seale, C; Lempp, H

    2006-01-01

    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 Medica...

  7. Effects of motivation and medication on electrophysiological markers of response inhibition in children with attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Groom, Madeleine J; Scerif, Gaia; Liddle, Peter F; Batty, Martin J; Liddle, Elizabeth B; Roberts, Katherine L; Cahill, John D; Liotti, Mario; Hollis, Chris

    2010-04-01

    Theories of attention-deficit/hyperactivity disorder (ADHD) posit either executive deficits and/or alterations in motivational style and reward processing as core to the disorder. Effects of motivational incentives on electrophysiological correlates of inhibitory control and relationships between motivation and stimulant medication have not been explicitly tested. Children (9-15 years) with combined-type ADHD (n = 28) and matched typically developing children (CTRL) (n = 28) performed a go/no-go task. Electroencephalogram data were recorded. Amplitude of two event-related potentials, the N2 and P3 (markers of response conflict and attention), were measured. The ADHD children were all stimulant responders tested on and off their usual dose of methylphenidate; CTRLs were never medicated. All children performed the task under three motivational conditions: reward; response cost; and baseline, in which points awarded/deducted for inhibitory performance varied. There were effects of diagnosis (CTRL > ADHD unmedicated), medication (on > off), and motivation (reward and/or response cost > baseline) on N2 and P3 amplitude, although the N2 diagnosis effect did not reach statistical significance (p = .1). Interactions between motivation and diagnosis/medication were nonsignificant (p > .1). Motivational incentives increased amplitudes of electrophysiological correlates of response conflict and attention in children with ADHD, towards the baseline (low motivation) amplitudes of control subjects. These results suggest that, on these measures, motivational incentives have similar effects in children with ADHD as typically developing CTRLs and have additive effects with stimulant medication, enhancing stimulus salience and allocation of attentional resources during response inhibition. Copyright 2010 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  8. Healthcare professionals' perceptions on the emotional impact of having an inadequate response to antidepressant medications: survey and prospective patient audit.

    Science.gov (United States)

    Mago, Rajnish; Fagiolini, Andrea; Weiller, Emmanuelle; Weiss, Catherine

    2018-01-01

    Despite the availability of effective antidepressants, about half of patients with major depressive disorder (MDD) display an inadequate response to their initial treatment. A large patient survey recently reported that 29.8% of MDD patients experiencing an inadequate treatment response felt frustrated about their medication and 19.2% were frustrated with their healthcare provider. This survey and chart audit evaluated healthcare professionals' (HCP) views on the emotional impact of having an inadequate response to antidepressant medication. HCPs who frequently treat patients with MDD completed a survey and chart audit of their MDD patients currently experiencing an inadequate response to antidepressant treatment. 287 HCPs completed 1336 chart audits. HCPs reported that 38% of their patients were trusting/accepting of their MDD medications and 41% of their patients trusted/felt confident with their healthcare provision. Conversely, HCPs reported that 11% of their patients were frustrated with their medication and 5% with their healthcare benefits. HCPs cited impact on daily life (53%) and treatment issues (lack of efficacy and side effects; 50%) as the main drivers for their patients' feelings of frustration. When HCPs recognized patients' feelings of frustration, the top concerns of the HCPs were worsening of symptoms (43%) and non-compliance (41%). This survey and chart audit highlights the emotional burden associated with inadequate responses to MDD treatment in addition to persistent symptoms. Differences between the views of the HCPs and patients are highlighted and suggest that HCPs may underestimate the full impact that having to try numerous medications has on their patients.

  9. British and American attitudes toward credit cards.

    Science.gov (United States)

    Yang, Bijou; James, Simon; Lester, David

    2006-04-01

    American university students owned more than twice as many credit cards as British university students. However, scores on a credit card attitude scale predicted the number of cards owned by respondents in both countries.

  10. The British Empire and the English Curriculum.

    Science.gov (United States)

    Thron, E. Michael

    1987-01-01

    Examines the recent call for English departments to recognize literature that falls outside the British and American tradition. Suggests that we recognize English as a world language and choose books to teach accordingly. (JC)

  11. Efficiency Studies in the British Universities.

    Science.gov (United States)

    Lockwood, Geoffrey

    1986-01-01

    The background, purposes, and methods of institutional efficiency studies conducted at selected British universities are discussed. The evaluations focused on financial management, purchasing, and building maintenance and space utilization. (MSE)

  12. Growth Disparity between Medical Research and Medical Services ...

    Indian Academy of Sciences (India)

    Growth Disparity between Medical Research and Medical Services in India. British rulers opened hospitals for modern medicine; medical colleges; nurses schools etc. in the 19th century to the joyous welcome of natives. During the same period, they set up Indian Research Fund Association two years ahead of the MRC of ...

  13. Psychological intervention in medical preparedness and response to nuclear and radiological emergency

    International Nuclear Information System (INIS)

    Lei, Cuiping; Liu, Ying

    2008-01-01

    Full text: Although the incidence rate of nuclear or radiological accident and their terror attack is very low, their influence is tremendous because of the unexpected of their occurrence and uncertainty of their damage degree. An attack involving the release of radiation will create uncertainty, fear, and terror. Therefore, the management of acute psychological and behavioral responses is likely to be as important and challenging as the treatment of radiation-related injuries and illnesses. In this paper, we introduce the principle of psychological intervention at the preparation stage and during and after emergency. At the preparation stage, people should be educated by various means to prevent them from the impact of accident. When accident happens, effective action should be taken immediately to reduce the psychological influence. Special groups such as children and pregnant women must be considered. Furthermore, we analyze the symptom of different groups including victims, the public and responders and put forward the methods to prevent and treat psychological damage. After radiation accident, victims who have been exposed or anticipate possible exposure may experience feelings of vulnerability, anxiety, and lack of control. The most important element is providing good medical care. Moreover, communication between patients and their family is very important too. The public in the affected community is likely to be anxious and terrified. Trusted and informed leadership should be assigned to give psychological support in counselling center established at monitoring and evacuation centers. Government must be honest in communication with public and media. Responders have to perform their duty under stressful condition. Some of them are unable to deal with such stress could develop mental health problems such as post traumatic stress disorder, substance abuse or depression. Protective clothing and dosimeters must be provided to ensure responders' safety. Moreover

  14. Criminal law as a response to medical malpractice: pluses and minuses--comparing Italian and U.S. experiences.

    Science.gov (United States)

    Di Landro, Andrea R

    2012-06-01

    The paper is divided into three parts. The first part sets out the comparative differences between the tort of malpractice in common law and the criminal negligence in civil law: while the common law takes for mens rea only the "gross" negligence, and rarely medical negligence, other law systems instead (and particularly Italian law) criminalize also ordinary negligence, frequently in medical malpractice cases. The second part of the paper addresses the pluses of using criminal law as response to medical malpractice: inadequate medical self-policing and "repeat offenders" problems are analysed, in the perspective of the patient, of the doctor, of the insurance company, and of the community. The third part addresses the minuses of the criminal law as response: medical "shame and blame" mentality, criminal stigma and culture of fear are disincentives to incident reporting and to system analysis (the most important means of prevention); "defensive medicine" and "courts-abiding medicine" are managed not yet in the patient's exclusive interest, but in the egoistic/utilitarian aim to avoid denunciations; finally, the uncertainty of the medicine, the accusatory system and the proof "beyond a reasonable doubt" seem hardly compatible with each other.

  15. What’s where? Why there? And why care? A geography of responsibility in medical tourism

    NARCIS (Netherlands)

    Ormond, M.E.

    2015-01-01

    Flushed with excitement over the panacea medical tourism seems to promise for so many, have stakeholders paused long enough in the construction of the medical tourism industry to reflect on the striking economic, social, political and technological imbalances in both home and destination countries

  16. Dupilumab with concomitant topical corticosteroid treatment in adults with atopic dermatitis with an inadequate response or intolerance to ciclosporin A or when this treatment is medically inadvisable: a placebo-controlled, randomized phase III clinical trial (LIBERTY AD CAFÉ).

    Science.gov (United States)

    de Bruin-Weller, M; Thaçi, D; Smith, C H; Reich, K; Cork, M J; Radin, A; Zhang, Q; Akinlade, B; Gadkari, A; Eckert, L; Hultsch, T; Chen, Z; Pirozzi, G; Graham, N M H; Shumel, B

    2018-05-01

    events (1·8%, 1·9% and 1·9%, respectively). Conjunctivitis was more frequent with dupilumab + TCS; skin infections were more frequent with placebo + TCS. Dupilumab + TCS significantly improved signs and symptoms of atopic dermatitis and QoL in adults with a history of inadequate response to/intolerance of CsA, or for whom CsA treatment was medically inadvisable. No new safety signals were identified. © 2017 The Authors. British Journal of Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.

  17. Outbound medical tourism from Mongolia: a qualitative examination of proposed domestic health system and policy responses to this trend.

    Science.gov (United States)

    Snyder, Jeremy; Byambaa, Tsogtbaatar; Johnston, Rory; Crooks, Valorie A; Janes, Craig; Ewan, Melanie

    2015-05-03

    Medical tourism is the practice of traveling across international boundaries in order to access medical care. Residents of low-to-middle income countries with strained or inadequate health systems have long traveled to other countries in order to access procedures not available in their home countries and to take advantage of higher quality care elsewhere. In Mongolia, for example, residents are traveling to China, Japan, Thailand, South Korea, and other countries for care. As a result of this practice, there are concerns that travel abroad from Mongolia and other countries risks impoverishing patients and their families. In this paper, we present findings from 15 interviews with Mongolian medical tourism stakeholders about the impacts of, causes of, and responses to outbound medical tourism. These findings were developed using a case study methodology that also relied on tours of health care facilities and informal discussions with citizens and other stakeholders during April, 2012. Based on these findings, health policy changes are needed to address the outflow of Mongolian medical tourists. Key areas for reform include increasing funding for the Mongolian health system and enhancing the efficient use of these funds, improving training opportunities and incentives for health workers, altering the local culture of care to be more supportive of patients, and addressing concerns of corruption and favouritism in the health system. While these findings are specific to the Mongolian health system, other low-to-middle income countries experiencing outbound medical tourism will benefit from consideration of how these findings apply to their own contexts. As medical tourism is increasing in visibility globally, continued research on its impacts and context-specific policy responses are needed.

  18. Co-operation of medical and chemical services to provide radiation safety in special zone during Chernobyl' accident response

    International Nuclear Information System (INIS)

    Terent'ev, V.I.

    1990-01-01

    Cooperation of medical and chemical services of the operation group in the special zone during intensive decontamination of the site and neighboring herritories at the Chernobyl NPP are considered. Responsibilities of medical and chemical services, their relations with civie and millitary organizations within the ChNPP region and 30-km zone are reviewed. Cooperation of the services mentioned above consisted in information exchange aimed at overall comprehension of the situation, cooperative activities in the commision and at elaboration of recommendations with an account of radiation safety measures

  19. Audience responses to television news coverage of medical advances: The mediating role of audience emotions and identification.

    Science.gov (United States)

    Hong, Hyehyun

    2015-08-01

    Exemplifying a real person in news stories has become a popular journalistic technique to describe an event or issue. With the frequent appearance of medical news reports in local television in recent years, this news presentation style is widely believed to help audiences better engage in and understand complex medical information and to influence their perceptions and judgments. In terms of television news coverage of medical advances, this study investigates how audiences respond to embedded human examples (mainly patients who experience benefits from the advances) and to overall news stories, and how such responses are related to their perception of portrayed medical advances. The experimental results indicate that news stories with a human example were more likely to intensify the audience's positive emotions than those without, which in turn influenced favorable perceptions of the described medical advance. In addition, the extent to which the audience identified with a human example (in particular, sympathy) mediated the relationship between the audience's involvement in the news story and its perception of the portrayed medical advance. © The Author(s) 2014.

  20. What is good medical ethics? A very personal response to a difficult question.

    Science.gov (United States)

    Farsides, Bobbie

    2015-01-01

    A personal reflection upon a career in medical ethics leads to four conclusions on what makes for 'good medical ethics'. Good medical ethics is practical in approach, philosophically well grounded, cross disciplinary, and while it might not be a necessary feature, the experience of the author suggests that it is the work of 'good people'. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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

    Science.gov (United States)

    Cvetkovski, Vladimir

    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.

  2. Preparing for terrorism: tools for evaluating the Metropolitan Medical Response System Program

    National Research Council Canada - National Science Library

    Manning, Frederick J; Goldfrank, Lewis R

    2002-01-01

    ...) provides funds to major U. S. cities to help them develop plans for coping with the health and medical consequences of a terrorist attack with chemical, biological, or radiological (CBR) agents...

  3. L-027: EPR-First Responders: First Medical Response in a radiological emergency

    International Nuclear Information System (INIS)

    2011-01-01

    The main topics covered in this conference are the tasks and the roles of medical emergency services and the local hospital such as firsts aid in a radiological emergency, protective measures, contamination level of the victims and lifesaving

  4. Clinical aspects of Chernobyl's accidents response (the researches of Military-medical academy)

    International Nuclear Information System (INIS)

    Shevchenko, Yu.L.

    1996-01-01

    The results of medical examinations of the persons taking part in elimination of consequences of Chernobyl's disaster obtained by the specialists of Military-medical academy allowed to verify the conseption of damage action of radiation and nonradiation complex of injury factors, to estimate well-information of stale and new biological indicators of radiation dose, to plan the ways of rescuers reabilitation during stationary, policlinic and sanatorium stages of treatment

  5. The art of medicine: arts-based training in observation and mindfulness for fostering the empathic response in medical residents.

    Science.gov (United States)

    Zazulak, Joyce; Sanaee, May; Frolic, Andrea; Knibb, Nicole; Tesluk, Eve; Hughes, Edward; Grierson, Lawrence E M

    2017-09-01

    Empathy is an essential attribute for medical professionals. Yet, evidence indicates that medical learners' empathy levels decline dramatically during medical school. Training in evidence-based observation and mindfulness has the potential to bolster the acquisition and demonstration of empathic behaviours for medical learners. In this prospective cohort study, we explore the impact of a course in arts-based visual literacy and mindfulness practice ( Art of Seeing ) on the empathic response of medical residents engaged in obstetrics and gynaecology and family medicine training. Following this multifaceted arts-based programme that integrates the facilitated viewing of art and dance, art-making, and mindfulness-based practices into a practitioner-patient context, 15 resident trainees completed the previously validated Interpersonal Reactivity Index, Compassion, and Mindfulness Scales. Fourteen participants also participated in semistructured interviews that probed their perceived impacts of the programme on their empathic clinical practice. The results indicated that programme participants improved in the Mindfulness Scale domains related to self-confidence and communication relative to a group of control participants following the arts-based programme. However, the majority of the psychometric measures did not reveal differences between groups over the duration of the programme. Importantly, thematic qualitative analysis of the interview data revealed that the programme had a positive impact on the participants' perceived empathy towards colleagues and patients and on the perception of personal and professional well-being. The study concludes that a multifaceted arts-based curriculum focusing on evidence-based observation and mindfulness is a useful tool in bolstering the empathic response, improving communication, and fostering professional well-being among medical residents. Published by the BMJ Publishing Group Limited. For permission to use (where not already

  6. The ecology and evolution of animal medication: genetically fixed response versus phenotypic plasticity.

    Science.gov (United States)

    Choisy, Marc; de Roode, Jacobus C

    2014-08-01

    Animal medication against parasites can occur either as a genetically fixed (constitutive) or phenotypically plastic (induced) behavior. Taking the tritrophic interaction between the monarch butterfly Danaus plexippus, its protozoan parasite Ophryocystis elektroscirrha, and its food plant Asclepias spp. as a test case, we develop a game-theory model to identify the epidemiological (parasite prevalence and virulence) and environmental (plant toxicity and abundance) conditions that predict the evolution of genetically fixed versus phenotypically plastic forms of medication. Our model shows that the relative benefits (the antiparasitic properties of medicinal food) and costs (side effects of medicine, the costs of searching for medicine, and the costs of plasticity itself) crucially determine whether medication is genetically fixed or phenotypically plastic. Our model suggests that animals evolve phenotypic plasticity when parasite risk (a combination of virulence and prevalence and thus a measure of the strength of parasite-mediated selection) is relatively low to moderately high and genetically fixed medication when parasite risk becomes very high. The latter occurs because at high parasite risk, the costs of plasticity are outweighed by the benefits of medication. Our model provides a simple and general framework to study the conditions that drive the evolution of alternative forms of animal medication.

  7. [Responsibility due to medication errors in France: a study based on SHAM insurance data].

    Science.gov (United States)

    Theissen, A; Orban, J-C; Fuz, F; Guerin, J-P; Flavin, P; Albertini, S; Maricic, S; Saquet, D; Niccolai, P

    2015-03-01

    The safe medication practices at the hospital constitute a major public health problem. Drug supply chain is a complex process, potentially source of errors and damages for the patient. SHAM insurances are the biggest French provider of medical liability insurances and a relevant source of data on the health care complications. The main objective of the study was to analyze the type and cause of medication errors declared to SHAM and having led to a conviction by a court. We did a retrospective study on insurance claims provided by SHAM insurances with a medication error and leading to a condemnation over a 6-year period (between 2005 and 2010). Thirty-one cases were analysed, 21 for scheduled activity and 10 for emergency activity. Consequences of claims were mostly serious (12 deaths, 14 serious complications, 5 simple complications). The types of medication errors were a drug monitoring error (11 cases), an administration error (5 cases), an overdose (6 cases), an allergy (4 cases), a contraindication (3 cases) and an omission (2 cases). Intravenous route of administration was involved in 19 of 31 cases (61%). The causes identified by the court expert were an error related to service organization (11), an error related to medical practice (11) or nursing practice (13). Only one claim was due to the hospital pharmacy. The claim related to drug supply chain is infrequent but potentially serious. These data should help strengthen quality approach in risk management. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  8. Medication practice and feminist thought: a theoretical and ethical response to adherence in HIV/AIDS.

    Science.gov (United States)

    Broyles, Lauren M; Colbert, Alison M; Erlen, Judith A

    2005-08-01

    Accurate self-administration of antiretroviral medication therapy for HIV/AIDS is a significant clinical and ethical concern because of its implications for individual morbidity and mortality, the health of the public, and escalating healthcare costs. However, the traditional construction of patient medication adherence is oversimplified, myopic, and ethically problematic. Adherence relies on existing social power structures and western normative assumptions about the proper roles of patients and providers, and principally focuses on patient variables, obscuring the powerful socioeconomic and institutional influences on behaviour. Some professionals advocate for alternate approaches to adherence, but many of the available alternatives remain conceptually underdeveloped. Using HIV/AIDS as an exemplar, this paper presents medication practice as a theoretical reconstruction and explicates its conceptual and ethical evolution. We first propose that one of these alternatives, medication practice, broadens the understanding of individuals' medication-taking behaviour, speaks to the inherent power inequities in the patient-provider interaction, and addresses the ethical shortcomings in the traditional construal. We then integrate medication practice with feminist thought, further validating individuals' situated knowledge, choices, and multiple roles; more fully recognizing the individual as a multidiminsional, autonomous human being; and reducing notions of obedience and deference to authority. Blame is thus extricated from the healthcare relationship, reshaping the traditionally adversarial components of the interaction, and eliminating the view of adherence as a patient problem in need of patient-centred interventions.

  9. “MIDDLE GROUND,” “DUALITY,” AND “DIVERSIMILARITY” AS RESPONSES TO POSTCOLONIAL AND GLOBAL CHALLENGES IN CHINUA ACHEBE’S "THE EDUCATION OF A BRITISH-PROTECTED CHILD" AND "NO LONGER AT EASE"

    Directory of Open Access Journals (Sweden)

    Mihaela Culea

    2013-10-01

    Full Text Available This paper discusses two literary works by Chinua Achebe—"No Longer at Ease" (1960 and "The Education of a British-Protected Child" (2011—in the context of the issue of diversity in the postcolonial setting. It aims to approach Achebe’s work from a new perspective, by applying a theoretical paradigm employed in business to the study of literature and culture. The “diversimilarity” paradigm, used for managing cultural diversity in organisations, is applied and shown to be pertinent to the investigation of literature, too. The methodology employed combines theoretical data with the practical implications of the conceptual framework on Achebe’s work. The paper starts with a discussion of the diversity concept and then moves on to tackle the diversimilarity paradigm in business. Then the investigation focuses on Achebe’s “duality” and “middle ground” concepts as they assist diversimilarity, concepts which work together at the levels of mentality, ideology, and identity. Finally, the paper focuses on language and the methods proposed by Achebe to manage and solve the existing linguistic diversity problems in Nigeria. The findings show that in the works explored, the diversimilarity paradigm is assisted by other concepts as solutions for the Nigerian people to cope with diversity. Moreover, Achebe shows that the other conceptions that support diversimilarity are still effective, even though they are rooted in the ancestral values of his Igbo people. The originality of the paper results from placing Achebe’s literary work in the context of contemporary concerns related to human identity in the postcolonial globalized environment and from expanding the scope and methods of literary research by employing concepts from other areas of human activity. Thus, the intersection between the worlds of the economy and culture seems fruitful for the investigation of cultural diversity.

  10. Living with risk. The British Medical Association guide

    Energy Technology Data Exchange (ETDEWEB)

    1987-01-01

    Personal risk estimation is discussed under the following headings: history and background of risk study, the nature and measurement of risk, the main causes of death, major risk factors (smoking, alcohol and other drugs, diet), occupational risks, transport, risks in the home, recreational risks, medicine and surgery, natural disasters, chemical risks, the perception, acceptability and management of risk, and risks and energy production. The latter chapter includes consideration of comparative risks in electricity generation. The extraction of fuel for, construction and operation of nuclear power stations is discussed, including references to Sellafield, leukemia clustering, and the Three Mile Island and Chernobyl disasters.

  11. Medical revivalism and the national movement in british India.

    Science.gov (United States)

    Bala, P

    1990-07-01

    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.

  12. An exploratory study on the elements that might affect medical students’ and residents’ responsibility during clinical training

    Science.gov (United States)

    Asemani, Omid; Iman, Mohammad Taghi; Moattari, Marzieh; Tabei, Seyed Ziaadin; Sharif, Farkhondeh; Khayyer, Mohammad

    2014-01-01

    We are now more or less confronting a “challenge of responsibility” among both undergraduate and postgraduate medical students and some recent alumni from medical schools in Iran. This ethical problem calls for urgent etiologic and pathologic investigations into the problem itself and the issues involved. This study aimed to develop a thematic conceptual framework to study factors that might affect medical trainees’ (MTs) observance of responsibility during clinical training. A qualitative descriptive methodology involving fifteen in-depth semi-structured interviews was used to collect the data. Interviews were conducted with both undergraduate and postgraduate MTs as well as clinical experts and experienced nurses. Interviews were audio-recorded and then transcribed. The data was analyzed using thematic content analysis. The framework derived from the data included two main themes, namely “contextual conditions” and “intervening conditions”. Within each theme, participants recurrently described “individual” and “non-individual or system” based factors that played a role in medical trainees’ observance of responsibility. Overall, contextual conditions provide MTs with a “primary or basic responsibility” which is then transformed into a “secondary or observed responsibility” under the influence of intervening conditions. In conclusion three measures were demonstrated to be very important in enhancing Iranian MTs’ observance of responsibility: a) to make and implement stricter and more exact admission policies for medical colleges, b) to improve and revise the education system in its different dimensions such as management, structure, etc. based on regular and systematic evaluations, and c) to establish, apply and sustain higher standards throughout the educational environment. PMID:25512829

  13. British Teachers' Transnational Work within and beyond the British Empire after the Second World War

    Science.gov (United States)

    Whitehead, Kay

    2017-01-01

    Focusing on British graduates from Gipsy Hill Training College (GHTC) in London, this article illustrates transnational history's concerns with the reciprocal flows of people and ideas within and beyond the British Empire. GHTC's progressive curriculum and culture positioned women teachers as agents of change, and the article highlights the lives…

  14. The View from the Trenches Part 1: Emergency Medical Response Plans and the Need for EPR Screening

    Science.gov (United States)

    Gougelet, Robert M.; Rea, Michael E.; Nicolalde, Roberto J.; Geiling, James A.; Swartz, Harold M.

    2014-01-01

    Few natural disasters or intentional acts of war or terrorism have the potential for such severe impact upon a population and infrastructure as the intentional detonation of a nuclear device within a major U.S. city. In stark contrast to other disasters or even a “dirty bomb,” hundreds of thousands will be affected and potentially exposed to a clinically significant dose of ionizing radiation. This will result in immediate deaths and injuries and subsequently the development of Acute Radiation Syndrome (ARS). Additionally, millions more who are unlikely to develop ARS will seek medical evaluation and treatment, overwhelming the capacity of an already compromised medical system. In this paper, we propose that in vivo electron paramagnetic resonance (EPR) dosimetry be utilized to screen large numbers of potentially exposed victims, and that this screening process be incorporated into the medical-surge framework that is currently being implemented across the nation for other catastrophic public health emergencies. The National Incident Management System (NIMS), the National Response Framework (NRF), the Target Capabilities list (TCL), Homeland Security Presidential Directives (HSPD), as well as additional guidance from multiple federal agencies provides a solid framework for this response. The effective screening of potentially exposed victims directly following a nuclear attack could potentially decrease the number of patients seeking immediate medical care by greater than 90%. PMID:20065673

  15. Simulation as an ethical imperative and epistemic responsibility for the implementation of medical guidelines in health care.

    Science.gov (United States)

    Garbayo, Luciana; Stahl, James

    2017-03-01

    Guidelines orient best practices in medicine, yet, in health care, many real world constraints limit their optimal realization. Since guideline implementation problems are not systematically anticipated, they will be discovered only post facto, in a learning curve period, while the already implemented guideline is tweaked, debugged and adapted. This learning process comes with costs to human health and quality of life. Despite such predictable hazard, the study and modeling of medical guideline implementation is still seldom pursued. In this article we argue that to systematically identify, predict and prevent medical guideline implementation errors is both an epistemic responsibility and an ethical imperative in health care, in order to properly provide beneficence, minimize or avoid harm, show respect for persons, and administer justice. Furthermore, we suggest that implementation knowledge is best achieved technically by providing simulation modeling studies to anticipate the realization of medical guidelines, in multiple contexts, with system and scenario analysis, in its alignment with the emerging field of implementation science and in recognition of learning health systems. It follows from both claims that it is an ethical imperative and an epistemic responsibility to simulate medical guidelines in context to minimize (avoidable) harm in health care, before guideline implementation.

  16. Using item response theory to explore the psychometric properties of extended matching questions examination in undergraduate medical education

    Directory of Open Access Journals (Sweden)

    Lawton Gemma

    2005-03-01

    Full Text Available Abstract Background As assessment has been shown to direct learning, it is critical that the examinations developed to test clinical competence in medical undergraduates are valid and reliable. The use of extended matching questions (EMQ has been advocated to overcome some of the criticisms of using multiple-choice questions to test factual and applied knowledge. Methods We analysed the results from the Extended Matching Questions Examination taken by 4th year undergraduate medical students in the academic year 2001 to 2002. Rasch analysis was used to examine whether the set of questions used in the examination mapped on to a unidimensional scale, the degree of difficulty of questions within and between the various medical and surgical specialties and the pattern of responses within individual questions to assess the impact of the distractor options. Results Analysis of a subset of items and of the full examination demonstrated internal construct validity and the absence of bias on the majority of questions. Three main patterns of response selection were identified. Conclusion Modern psychometric methods based upon the work of Rasch provide a useful approach to the calibration and analysis of EMQ undergraduate medical assessments. The approach allows for a formal test of the unidimensionality of the questions and thus the validity of the summed score. Given the metric calibration which follows fit to the model, it also allows for the establishment of items banks to facilitate continuity and equity in exam standards.

  17. Rethinking the Response to Emerging Microbes: Vaccines and Therapeutics in the Ebola Era--a Conference at Harvard Medical School.

    Science.gov (United States)

    Knipe, David M; Whelan, Sean P

    2015-08-01

    Harvard Medical School convened a meeting of biomedical and clinical experts on 5 March 2015 on the topic of "Rethinking the Response to Emerging Microbes: Vaccines and Therapeutics in the Ebola Era," with the goals of discussing the lessons from the recent Ebola outbreak and using those lessons as a case study to aid preparations for future emerging infections. The speakers and audience discussed the special challenges in combatting an infectious agent that causes sporadic outbreaks in resource-poor countries. The meeting led to a call for improved basic medical care for all and continued support of basic discovery research to provide the foundation for preparedness for future outbreaks in addition to the targeted emergency response to outbreaks and targeted research programs against Ebola virus and other specific emerging pathogens. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

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

    LENUS (Irish Health Repository)

    Deasy, C

    2012-02-03

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

  19. British Columbia Utilities Commission 2001 annual report

    International Nuclear Information System (INIS)

    2002-06-01

    The main responsibility of the British Columbia Utilities Commission is to regulate energy utilities under its jurisdiction to ensure that energy rates are fair and that utility operators in the province provide safe, adequate and secure service to their customers. The Commission also approves the construction of new facilities planned by utilities. It also participates in the review of utility and energy projects under the Environmental Assessment Act. Several successes were achieved in 2001 as the utility implemented its first performance plan. Oral public hearings were held for applications by Pacific Northern Gas and by Pembina Pipelines, owners of the common carrier oil pipeline from Taylor to Kamloops. A review of BC Gas' rate design to apportion utility revenue requirements fairly to different classes of customers was successfully achieved by a negotiated settlement process. In 2001, there was also a high level of proposed mergers, acquisitions and divestitures. Duke Energy Corporation's share acquisition of Westcoast Energy's two affiliated gas utilities was approved. BC Gas' application to divest its customer care activities to a joint venture company with Enbridge was also reviewed, and an oral hearing was held to review a West Kootenay Power application to sell its Kootenay River hydroelectric generation assets to Columbia Basin Trust and the Columbia Power Corp. In this case, the decision rendered was that the sale terms had to be changed so that customers could share the proceeds. The utility therefore, decided not to proceed with the sale under these conditions. The BC Hydro legislated rate freeze, which was due to expire on September 30, 2001, was extended for an additional 18 months to allow the new provincial government time to implement a new energy policy. The new energy policy is expected to give the province an energy advantage by facilitating growth and diversification in energy production while providing competition and more choice for

  20. Teaching Laboratory Management Principles and Practices Through Mentorship and Graduated Responsibility: The Assistant Medical Directorship.

    Science.gov (United States)

    Hanley, Timothy; Sowder, Aleksandra M; Palmer, Cheryl Ann; Weiss, Ronald L

    2016-01-01

    With the changing landscape of medicine in general, and pathology in particular, a greater emphasis is being placed on laboratory management as a means of controlling spiraling medical costs and improving health-care efficiency. To meet this challenge, pathology residency programs have begun to incorporate formal laboratory management training into their curricula, using institutional curricula and/or online laboratory management courses offered by professional organizations. At the University of Utah, and its affiliated national reference laboratory, ARUP Laboratories, Inc, interested residents are able to supplement the departmental lecture-based and online laboratory management curriculum by participating in assistant medical directorship programs in one of several pathology subspecialty disciplines. The goals of many of the assistant medical directorship positions include the development of laboratory management skills and competencies. A survey of current and recent assistant medical directorship participants revealed that the assistant medical directorship program serves as an excellent means of improving laboratory management skills, as well as improving performance as a fellow and practicing pathologist.

  1. Medical futility in the care of non-competent terminally ill patient: nursing perspectives and responsibilities.

    Science.gov (United States)

    Scanlon, Andrew; Murphy, Maria

    2014-05-01

    Debate continues on the use of medical technology to prolong life independent of the quality of the outcomes. As a consequence, acute care nurses often find themselves in situations where they are asked to carry out physician's orders, in the context of a patient's deteriorating condition, which may be at odds with professional and personal ethical standards. This can cause nurses to become distressed when struggling with the ethical dilemmas involved with medical futility. This paper is a perspective on nursing considerations of our Code of Ethics and the concept of medical futility in acute nursing care. The utility of the Code is examined through a clinical vignette. A database search using the keywords medical futility and acute care limited to 2008 to 2012 and a secondary hand search of these references identified thirty journal publications. The Code of Ethics was examined via a clinical scenario pertinent to an acute environment. This paper examines the ethical principles that underpin nursing and illustrates how the code of ethics may serve as sign posts when faced with caring for a terminally ill patient that is inappropriately managed. Understanding how individual nurses may address ethical dilemmas when faced with medical futility can better enable the nurse to fulfil their role as patient advocate, health promoter and alleviator of suffering. Ongoing education and communication to decrease any ambiguity or anguish associated with a patient's impending death optimises apt outcomes. Copyright © 2012 Australian College of Critical Care Nurses Ltd. All rights reserved.

  2. 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.

  3. Phonemic Transcriptions in British and American Dictionaries

    Directory of Open Access Journals (Sweden)

    Rastislav Šuštaršič

    2005-06-01

    Full Text Available In view of recent criticisms concerning vowel symbols in some British English dictionaries (in particular by J. Windsor Lewis in JIPA (Windsor Lewis, 2003, with regard to the Oxford Dictionary of Pronunciation (Upton, 2001, this article extends the discussion on English phonemic transcriptions by including those that typically occur in standard American dictionaries, and by comparing the most common conventions of British and American dictionaries. In addition to symbols for both vowels and consonants, the paper also deals with the different representations of word accentuation and the issue of consistency regarding application of phonemic (systemic, broad, rather than phonetic (allophonic, narrow transcription. The different transcriptions are assessed from the points of view of their departures from the International Phonetic Alphabet, their overlapping with orthographic representation (spelling and their appropriateness in terms of reflecting actual pronunciation in standard British and/or American pronunciation.

  4. British firms mark progress off Viet Nam

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    British companies are making more inroads in exploring for oil and gas off Viet Nam. British Gas plc won a 25 year production sharing contract for a license off southern Viet Nam in the South China Sea. Meantime, London independent Lasmo plc started seismic surveys on the block adjoining the British Gas block. Separately, Thailand and Viet Nam have reached agreement to jointly explore for and develop oil and gas found in waters claimed by both countries. Plans call for the two countries to draw up joint development plans covering oil and gas resources in the southeastern fringe of the Gulf of Thailand. Bangkok officials say they would have preferred to delineate maritime boundaries with Hanoi, but opted for the joint development accord, noting that Thailand and Malaysia had taken 12 years to resolve a similar dispute

  5. Factors influencing nurse and pharmacist willingness to take or not take responsibility for non-medical prescribing.

    Science.gov (United States)

    Maddox, C; Halsall, D; Hall, J; Tully, M P

    2016-01-01

    In the UK, the majority of non-medical prescribers (NMPs) are nurses or pharmacists working in community or primary care. However, little is known about what influences their decisions to prescribe, unlike with medical prescribing. It is also unclear whether the medical findings can be extrapolated, given their very different prescribing training. To explore the factors influencing whether nurse and pharmacist NMPs in community and primary care settings take responsibility for prescribing. Initially, 20 NMPs (15 nurses and 5 pharmacists) were purposively selected and interviewed using the critical incident technique about situations where they felt it was inappropriate for them to take responsibility for prescribing or where they were uneasy about doing so. In addition, more general factors influencing their decision to take or not take prescribing responsibility were discussed. Subsequently, the themes from the interview analysis were validated in three focus groups with a total of 10 nurse NMPs. All data were analyzed using a constant comparison approach. Fifty-two critical incidents were recorded--12 from pharmacist NMPs and 40 from nurse NMPs. Participants experienced situations where they were reluctant to accept responsibility for prescribing. Perceptions of competency, role and risk influenced their decision to prescribe. Workarounds such as delaying the prescribing decision or refer the patient to a doctor were used. For NMPs to feel more confident about taking responsibility for prescribing, these issues of competency, role and perceived risk need to be addressed. Roles of NMPs must be clear to colleagues, doctors and patients. Training and support must be provided to enable professional development and increasing competence of NMPs. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Lupines, manganese, and devil-sickness: an Anglo-Saxon medical response to epilepsy.

    Science.gov (United States)

    Dendle, P

    2001-01-01

    The most frequently prescribed herb for "devil-sickness" in the vernacular medical books from Anglo-Saxon England, the lupine, is exceptionally high in manganese. Since manganese depletion has been linked with recurring seizures in both clinical and experimental studies, it is possible that lupine administration responded to the particular pathophysiology of epilepsy. Lupine is not prescribed for seizures in classical Mediterranean medical sources, implying that the Northern European peoples (if not the Anglo-Saxons themselves) discovered whatever anticonvulsive properties the herb may exhibit.

  7. The Problems of the Status of British Troops in Egypt After the Occupation in 1882

    Directory of Open Access Journals (Sweden)

    Khizriev Ali Khizrievich

    2016-04-01

    Full Text Available The article covers the issues of defining the status of the British occupational troops in Egypt from 1882 to 1922 and the diplomatic struggle of the great European states of that time over this problem. This whole problem is described in detail in its development since the establishment of the “veiled protectorate” designed to hide the true purpose of the British Government in the region, to the formal approval of the Protectorate status of the British Empire. It attempts to find the motives and methods of management of the British Foreign Office in this difficult situation considering counter of such powers as Russia and France. Herewith it provides data from the archives of the British Foreign Office, confirming all these facts. The evidences of the contemporaries of those events – Lord Milner and Cromer – who were representatives of the occupation authorities and published their memoirs, complete the picture. In addition to these documents we used the archival materials of India Records Office in the British Library. All these sources indicate that the official declaration of the Protectorate in 1914 only temporarily solved the problems creating additional difficulties for those officials who were responsible for the situation in the country. This decision allowed the British officials to conceal the explicit nature of the occupation and the British military presence in the Suez Canal zone. However, such policy aroused some problems, which led to a new round of the Egyptian national liberation movement in the future, and needed new solutions which were made only after the World War I and the fall of the Ottoman Empire.

  8. Alternative strategies for the British coal industry

    Energy Technology Data Exchange (ETDEWEB)

    Manners, G

    1973-01-01

    The Green Paper, 'Energy Policy - a Consultative Document' (HC-Cmnd--7101) affords a valuable insight into official attitudes towards the future of the British energy market. The present author challenges some of the energy supply and demand forecasts that are presented in the Working Document; in particular, he questions the optimistic market forecasts that continue to dominate official thinking about the coal industry; and he proposes that an alternative strategy is required for the British coal industry, one that involves quite painful choices of an economic, geographical, social and environmental nature.

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

    Science.gov (United States)

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

    2010-09-21

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

  10. Real-time Medical Emergency Response System: Exploiting IoT and Big Data for Public Health.

    Science.gov (United States)

    Rathore, M Mazhar; Ahmad, Awais; Paul, Anand; Wan, Jiafu; Zhang, Daqiang

    2016-12-01

    Healthy people are important for any nation's development. Use of the Internet of Things (IoT)-based body area networks (BANs) is increasing for continuous monitoring and medical healthcare in order to perform real-time actions in case of emergencies. However, in the case of monitoring the health of all citizens or people in a country, the millions of sensors attached to human bodies generate massive volume of heterogeneous data, called "Big Data." Processing Big Data and performing real-time actions in critical situations is a challenging task. Therefore, in order to address such issues, we propose a Real-time Medical Emergency Response System that involves IoT-based medical sensors deployed on the human body. Moreover, the proposed system consists of the data analysis building, called "Intelligent Building," depicted by the proposed layered architecture and implementation model, and it is responsible for analysis and decision-making. The data collected from millions of body-attached sensors is forwarded to Intelligent Building for processing and for performing necessary actions using various units such as collection, Hadoop Processing (HPU), and analysis and decision. The feasibility and efficiency of the proposed system are evaluated by implementing the system on Hadoop using an UBUNTU 14.04 LTS coreTMi5 machine. Various medical sensory datasets and real-time network traffic are considered for evaluating the efficiency of the system. The results show that the proposed system has the capability of efficiently processing WBAN sensory data from millions of users in order to perform real-time responses in case of emergencies.

  11. Benign epilepsy with centrotemporal spikes: Relationship between type of seizures and response to medication in a Greek population

    Directory of Open Access Journals (Sweden)

    Anastasia Gkampeta

    2015-01-01

    Full Text Available Purpose: Benign epilepsy with centrotemporal spikes (BECTS is considered to be the most common childhood epileptic syndrome. We studied the relationship between the type of seizures and response to medication in a Greek population. Materials and Methods: We studied 60 neurodevelopmentally normal children diagnosed with BECTS. Children were subdivided into three groups, based on type of seizures: Group A comprised 32 children with generalized tonic-clonic seizures, Group B 19 children with focal seizures and Group C 9 children with focal seizures with secondary generalization. All patients in the present study were started on an antiepileptic medication after the third seizure (sodium valproate, carbamazepine, and oxcarbazepine, and we studied the response to medication. Results: 10 from 13 (76.92% of patients in Group A, 13 from 15 (86.66% patients in Group B, and all 6 patients (100% in Group C started carbamazepine or oxcarbazepine had a favorable respond. Similarly, 16 from 19 (84.2% of patients in Group A, 3 from 4 patients (75% in Group B, and 1 from 3 patients (33.3% in Group C, started sodium valproate responded well to medication. Conclusions: The majority of children responded well to the first antiepileptic treatment and had a favorable outcome, regardless of type of seizures. 88.3% of children became seizure free by 1 or 2 years after seizure onset. These findings are indicative that the type of seizures has no major effect neither in response to antiepileptic treatment or in the final outcome. Further research in a larger number of children is needed.

  12. An Overview of the Roles and Responsibilities of Chinese Medical Colleges in Body Donation Programs

    Science.gov (United States)

    Zhang, Luqing; Xiao, Ming; Gu, Mufeng; Zhang, Yongjie; Jin, Jianliang; Ding, Jiong

    2014-01-01

    The use of human tissue is critical for gross anatomy education in the health professions. Chinese medical colleges have faced a shortage of anatomical specimens over the past decade. While body donation plays an important role in overcoming this gap, this practice has only recently been introduced in China, and the donation rate is relatively low…

  13. Locating helicopter emergency medical service bases to optimise population coverage versus average response time

    NARCIS (Netherlands)

    Garner, A.A. (Alan A.); P.L. van den Berg (Pieter)

    2017-01-01

    textabstractBackground: New South Wales (NSW), Australia has a network of multirole retrieval physician staffed helicopter emergency medical services (HEMS) with seven bases servicing a jurisdiction with population concentrated along the eastern seaboard. The aim of this study was to estimate

  14. The impact of assessing simulated bad news consultations on medical students' stress response and communication performance.

    NARCIS (Netherlands)

    Dulmen, S. van; Tromp, F.; Grosfeld, F.; Cate, O. ten; Bensing, J.M.

    2007-01-01

    Seventy second-year medical students volunteered to participate in a study with the aim of evaluating the impact of the assessment of simulated bad news consultations on their physiological and psychological stress and communication performance. Measurements were taken of salivary cortisol, systolic

  15. Medication Responsiveness of Motor Symptoms in a Population-Based Study of Parkinson Disease

    Directory of Open Access Journals (Sweden)

    Yvette M. Bordelon

    2011-01-01

    Full Text Available We assessed degree of Parkinson disease motor symptom improvement with medication among subjects enrolled in an ongoing, population-based study in Central California. The motor section of the unified Parkinson disease rating scale (UPDRS was performed on subjects in both OFF and ON medication states, and difference between these scores was used as an indicator of symptomatic benefit. Higher OFF minus ON scores correlated with more severe baseline symptoms. There was equivalent improvement on the motor UPDRS scale for subjects divided according to medication classes used: levodopa alone 7.3 points, levodopa plus other medications 8.5 points, and dopamine agonists but not levodopa 6.1 points. In addition, there was no difference in the magnitude of improvement when subjects were divided according to Parkinson disease subtype, defined as tremor dominant, akinetic-rigid, or mixed. In this community-based sample, these values are within the range of a clinically important difference as defined by previous studies.

  16. The cross-sectional relation between medically unexplained physical symptoms (MUPS) and the Cortisol Awakening Response

    NARCIS (Netherlands)

    Claassen-van Dessel, Nikki; van der Wouden, Johannes C.; Dekker, Joost; Rosmalen, Judith G. M.; van der Horst, Henriette E.

    Objectives: We aimed to assess the cross-sectional relation between levels of cortisol and specific symptom clusters, symptom severity and duration of symptoms in patients with medically unexplained physical symptoms (MUPS). Methods: Baseline data of a cohort of MUPS patients were used. We chose the

  17. Telemedicine and international disaster response. Medical consultation to Armenia and Russia via a Telemedicine Spacebridge.

    Science.gov (United States)

    Houtchens, B A; Clemmer, T P; Holloway, H C; Kiselev, A A; Logan, J S; Merrell, R C; Nicogossian, A E; Nikogossian, H A; Rayman, R B; Sarkisian, A E

    1993-01-01

    The Telemedicine Spacebridge, a satellite-mediated, audio-video-fax link between four United States and two Armenian and Russian medical centers, permitted remote American consultants to assist Armenian and Russian physicians in the management of medical problems following the December 1988 earthquake in Armenia and the June 1989 gas explosion near Ufa. During 12 weeks of operations, 247 Armenian and Russian and 175 American medical professionals participated in 34 half-day clinical conferences. A total of 209 patients were discussed, requiring expertise in 20 specialty areas. Telemedicine consultations resulted in altered diagnoses for 54, new diagnostic studies for 70, altered diagnostic processes for 47, and modified treatment plans for 47 of 185 Armenian patients presented. Simultaneous participation of several US medical centers was judged beneficial; quality of data transmission was judged excellent. These results suggest that interactive consultation by remote specialists can provide valuable assistance to on-site physicians and favorably influence clinical decisions in the aftermath of major disasters.

  18. Telemedicine and international disaster response: medical consultation to Armenia and Russia via a Telemedicine Spacebridge.

    Science.gov (United States)

    Houtchens, B A; Clemmer, T P; Holloway, H C; Kiselev, A A; Logan, J S; Merrell, R C; Nicogossian, A E; Nikogossian, H A; Rayman, R B; Sarkisian, A E; Siegel, J H

    1993-01-01

    The Telemedicine Spacebridge, a satellite-mediated, audio-video-fax link between four United States and two Armenian and Russian medical centers, permitted remote American consultants to assist Armenian and Russian physicians in the management of medical problems following the December 1988 earthquake in Armenia and the June 1989 gas explosion near Ufa. During 12 weeks of operations, 247 Armenian and Russian and 175 American medical professionals participated in 34 half-day clinical conferences. A total of 209 patients were discussed, requiring expertise in 20 specialty areas. Telemedicine consultations resulted in altered diagnoses for 54, new diagnostic studies for 70, altered diagnostic processes for 47, and modified treatment plans for 47 of 185 Armenian patients presented. Simultaneous participation of several US medical centers was judged beneficial; quality of data transmission was judged excellent. These results suggest that interactive consultation by remote specialists can provide valuable assistance to on-site physicians and favorably influence clinical decisions in the aftermath of major disasters.

  19. U.S. Strategy for Bioterrorism Emergency Medical Preparedness and Response

    National Research Council Canada - National Science Library

    Lugo, Angel

    2003-01-01

    ... diseases and mass casualty dangers. The 2002 National Strategy for Homeland Security includes numerous emergency preparedness and response initiatives as part of the overall homeland security strategy...

  20. Application of qualitative response models in a relevance study of older adults' health depreciation and medical care demand.

    Science.gov (United States)

    Weng, Shuo-Chun; Chen, Yu-Chi; Chen, Ching-Yu; Cheng, Yuan-Yang; Tang, Yih-Jing; Yang, Shu-Hui; Lin, Jwu-Rong

    2017-04-01

    The effect of health depreciation in older people on medical care demand is not well understood. We tried to assess the medical care demand with length of hospitalization and their impact on profits as a result of health depreciation. All participants who underwent comprehensive geriatric assessment were from a prospective cohort study at a tertiary hospital. A total of 1191 cases between September 2008 to October 2012 were investigated. Three sets of qualitative response models were constructed to estimate the impact of older adults' health depreciation on multidisciplinary geriatric care services. Furthermore, we analyzed the factors affecting the composite end-point of rehospitalization within 14 days, re-admission to the emergency department within 3 days and patient death. Greater health depreciation in elderly patients was positively correlated with greater medical care demand. Three major components were defined as health depreciation: elderly adaptation function, geriatric syndromes and multiple chronic diseases. On admission, the better the basic living functions, the shorter the length of hospitalization (coefficient = -0.35, P age and length of hospitalization. However, factors that correlated with relatively good outcome were functional improvement after medical care services and level of disease education. An optimal allocation system for selection of cases into multidisciplinary geriatric care is required because of limited resources. Outcomes will improve with health promotion and preventive care services. Geriatr Gerontol Int 2017; 17: 645-652. © 2016 Japan Geriatrics Society.

  1. Identifying deficiencies in national and foreign medical team responses through expert opinion surveys: implications for education and training.

    Science.gov (United States)

    Djalali, Ahmadreza; Ingrassia, Pier Luigi; Corte, Francesco Della; Foletti, Marco; Gallardo, Alba Ripoll; Ragazzoni, Luca; Kaptan, Kubilay; Lupescu, Olivera; Arculeo, Chris; von Arnim, Gotz; Friedl, Tom; Ashkenazi, Michael; Heselmann, Deike; Hreckovski, Boris; Khorram-Manesh, Amir; Khorrram-Manesh, Amir; Komadina, Radko; Lechner, Kostanze; Patru, Cristina; Burkle, Frederick M; Fisher, Philipp

    2014-08-01

    Unacceptable practices in the delivery of international medical assistance are reported after every major international disaster; this raises concerns about the clinical competence and practice of some foreign medical teams (FMTs). The aim of this study is to explore and analyze the opinions of disaster management experts about potential deficiencies in the art and science of national and FMTs during disasters and the impact these opinions might have on competency-based education and training. This qualitative study was performed in 2013. A questionnaire-based evaluation of experts' opinions and experiences in responding to disasters was conducted. The selection of the experts was done using the purposeful sampling method, and the sample size was considered by data saturation. Content analysis was used to explore the implications of the data. This study shows that there is a lack of competency-based training for disaster responders. Developing and performing standardized training courses is influenced by shortcomings in budget, expertise, and standards. There is a lack of both coordination and integration among teams and their activities during disasters. The participants of this study emphasized problems concerning access to relevant resources during disasters. The major findings of this study suggest that teams often are not competent during the response phase because of education and training deficiencies. Foreign medical teams and medically related nongovernmental organizations (NGOs) do not always provide expected capabilities and services. Failures in leadership and in coordination among teams are also a problem. All deficiencies need to be applied to competency-based curricula.

  2. The responsible use of online social networking: who should mentor medical students.

    Science.gov (United States)

    Patel, Pradip D; Roberts, John L; Miller, Karen Hughes; Ziegler, Craig; Ostapchuk, Michael

    2012-01-01

    As medical students become more active in online social networking (OSN), there are increasing concerns regarding violations of patient privacy and a lack of professionalism. Students need to be mentored, but who is best suited to the task? We hypothesized that residents are closer to students in usage and attitudes toward online communication than are faculty. If so, they would be more credible as mentors. We surveyed faculty (N = 16), 1st-year residents (N = 120), and 3rd-year medical students (N = 130) to compare attitudes about OSN and the online usage patterns. We found residents to be more like students in usage patterns of personal electronic media and in their choice of the mentoring techniques that should be used. Residents say they were not prepared to mentor students without additional guidance but were more confident than faculty members that they had the knowledge to do so.

  3. British Higher Education and Its Older Clients.

    Science.gov (United States)

    Woodley, Alan; Wilson, Jane

    2002-01-01

    Using results from a survey of British graduates, examined outcomes of higher education for older students, including their current employment situation, relationship of degree to job, and student satisfaction. Found that mature students are an extremely heterogeneous group, with differences in outcomes by age and mode of study. (EV)

  4. 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…

  5. Spitsbergen - Imperialists beyond the British Empire

    NARCIS (Netherlands)

    Kruse, Frigga; Hacquebord, Louwrens

    2012-01-01

    This paper looks at the relationship between Spitsbergen in the European High Arctic and the global British Empire in the first quarter of the twentieth century. Spitsbergen was an uninhabited no man's land and comprised an unknown quantity of natural resources. The concepts of geopolitics and New

  6. British Nuclear Fuels - a dirty business

    International Nuclear Information System (INIS)

    Bunyard, P.

    1983-01-01

    The radioactive discharges from British Nuclear Fuels Sellafield, Cumbria, reprocessing plant to the sea are discussed. Statements that have been made by various individuals and groups about the contamination of the sea, the coast and places inland, and the biological effects of plutonium and americium, are discussed in detail. Particular stress is placed on statements about increased incidence of cancers. (U.K.)

  7. 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

  8. Academic Advising in British Columbia. Executive Summary

    Science.gov (United States)

    British Columbia Council on Admissions and Transfer, 2016

    2016-01-01

    "Advising" consists of those activities and tasks that result in providing information to students. British Columbia's (BC) post-secondary education has evolved over the past number of years and student advising has changed along with it. Post-secondary institutions are currently challenged to increase student engagement, improve…

  9. 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.

  10. Uncertainty analysis of accident notification time and emergency medical service response time in work zone traffic accidents.

    Science.gov (United States)

    Meng, Qiang; Weng, Jinxian

    2013-01-01

    Taking into account the uncertainty caused by exogenous factors, the accident notification time (ANT) and emergency medical service (EMS) response time were modeled as 2 random variables following the lognormal distribution. Their mean values and standard deviations were respectively formulated as the functions of environmental variables including crash time, road type, weekend, holiday, light condition, weather, and work zone type. Work zone traffic accident data from the Fatality Analysis Report System between 2002 and 2009 were utilized to determine the distributions of the ANT and the EMS arrival time in the United States. A mixed logistic regression model, taking into account the uncertainty associated with the ANT and the EMS response time, was developed to estimate the risk of death. The results showed that the uncertainty of the ANT was primarily influenced by crash time and road type, whereas the uncertainty of EMS response time is greatly affected by road type, weather, and light conditions. In addition, work zone accidents occurring during a holiday and in poor light conditions were found to be statistically associated with a longer mean ANT and longer EMS response time. The results also show that shortening the ANT was a more effective approach in reducing the risk of death than the EMS response time in work zones. To shorten the ANT and the EMS response time, work zone activities are suggested to be undertaken during non-holidays, during the daytime, and in good weather and light conditions.

  11. The effect of work shift configurations on emergency medical dispatch center response.

    Science.gov (United States)

    Montassier, Emmanuel; Labady, Julien; Andre, Antoine; Potel, Gilles; Berthier, Frederic; Jenvrin, Joel; Penverne, Yann

    2015-01-01

    It has been proved that emergency medical dispatch centers (EMDC) save lives by promoting an appropriate allocation of emergency medical service resources. Indeed, optimal dispatcher call duration is pivotal to reduce the time gap between the time a call is placed and the delivery of medical care. However, little is known about the impact of work shift configurations (i.e., work shift duration and work shift rotation throughout the day) and dispatcher call duration. Thus, the objective of our study was to assess the effect of work shift configurations on dispatcher call duration. During a 1-year study period, we analyzed the dispatcher call durations for medical and trauma calls during the 4 different work shift rotations (day, morning, evening, and night) and during the 10-hour work shift of each dispatcher in the EMDC of Nantes. We extracted dispatcher call durations from our advanced telephone system, configured with CC Pulse + (Genesys, Alcatel Lucent), and collected them in a custom designed database (Excel, Microsoft). Afterward, we analyzed these data using linear mixed effects models. During the study period, our EMDC received 408,077 calls. Globally, the mean dispatcher call duration was 107 ± 45 seconds. Based on multivariate linear mixed effects models, the dispatcher call duration was affected by night work shift and work shift duration greater than 8 hours, increasing it by about 10 ± 1 seconds and 4 ± 1 seconds, respectively (both p work shift rotation and duration, with longer durations seen over night shifts and shifts over 8 hours. While these differences are small and may not have clinical significance, they may have implications for EMDC efficiency.

  12. Development of Medical Technology for Contingency Response to Marrow Toxic Agents

    Science.gov (United States)

    2010-09-30

    Group SLW STAR Link ® Web SNP Single Nucleotide Polymorphism SNS Strategic National Stockpile SOA Service Oriented Architecture SOP Standard...The group prepared a white paper detailing recommendations/guidelines for the assessment of new assays (potency or other assays) relevant to cord...adverse medical affects. The BRT course contains four sections and a 29 question exam that is submitted via the Internet. At the conclusion of this

  13. Automatic extraction and identification of users' responses in Facebook medical quizzes.

    Science.gov (United States)

    Rodríguez-González, Alejandro; Menasalvas Ruiz, Ernestina; Mayer Pujadas, Miguel A

    2016-04-01

    In the last few years the use of social media in medicine has grown exponentially, providing a new area of research based on the analysis and use of Web 2.0 capabilities. In addition, the use of social media in medical education is a subject of particular interest which has been addressed in several studies. One example of this application is the medical quizzes of The New England Journal of Medicine (NEJM) that regularly publishes a set of questions through their Facebook timeline. We present an approach for the automatic extraction of medical quizzes and their associated answers on a Facebook platform by means of a set of computer-based methods and algorithms. We have developed a tool for the extraction and analysis of medical quizzes stored on Facebook timeline at the NEJM Facebook page, based on a set of computer-based methods and algorithms using Java. The system is divided into two main modules: Crawler and Data retrieval. The system was launched on December 31, 2014 and crawled through a total of 3004 valid posts and 200,081 valid comments. The first post was dated on July 23, 2009 and the last one on December 30, 2014. 285 quizzes were analyzed with 32,780 different users providing answers to the aforementioned quizzes. Of the 285 quizzes, patterns were found in 261 (91.58%). From these 261 quizzes where trends were found, we saw that users follow trends of incorrect answers in 13 quizzes and trends of correct answers in 248. This tool is capable of automatically identifying the correct and wrong answers to a quiz provided on Facebook posts in a text format to a quiz, with a small rate of false negative cases and this approach could be applicable to the extraction and analysis of other sources after including some adaptations of the information on the Internet. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Medical response in the initial phase of a radiological or nuclear emergency

    International Nuclear Information System (INIS)

    Vazquez, M.; Perez, M.R.; Dubner, D.; Michelin, S.; Malvicini, M.

    2006-01-01

    The frequency of radiological and nuclear accidents is low with relationship to another type of have an accident, but the use of radioactive sources has been increased in the finish decades. Additionally, a growing world concern exists by the eventual use of radioactive material with malevolent ends. These facts put in relevance the necessity to have an appropriate preparation for the medical answer in this type of emergencies. The medical answer consists of different phases: Initial: pre-hospital and in local general hospitals; Intermediate: in local general hospitals and central reference hospitals. Late: in central reference hospitals and the pursuit to long term. The presence of conventional injuries (radio combined injuries) modifies in substantial form the assignment in the priority of the attention, the prediction and the evolution. The establishment of an appropriate triage is outstanding in the initial phase. The present communication approaches the early medical answer, sustained in the anamnesis, the chronology and severity of the symptoms and prodromal signs besides the laboratory results and complementary exams arisen during the first ones 24 to 72 hours. (Author)

  15. Personal health records in the preclinical medical curriculum: modeling student responses in a simple educational environment utilizing Google Health

    Directory of Open Access Journals (Sweden)

    Karamanlis Dimokratis A

    2012-09-01

    Full Text Available Abstract Background Various problems concerning the introduction of personal health records in everyday healthcare practice are reported to be associated with physicians’ unfamiliarity with systematic means of electronically collecting health information about their patients (e.g. electronic health records - EHRs. Such barriers may further prevent the role physicians have in their patient encounters and the influence they can have in accelerating and diffusing personal health records (PHRs to the patient community. One way to address these problems is through medical education on PHRs in the context of EHR activities within the undergraduate medical curriculum and the medical informatics courses in specific. In this paper, the development of an educational PHR activity based on Google Health is reported. Moreover, student responses on PHR’s use and utility are collected and presented. The collected responses are then modelled to relate the satisfaction level of students in such a setting to the estimation about their attitude towards PHRs in the future. Methods The study was conducted by designing an educational scenario about PHRs, which consisted of student instruction on Google Health as a model PHR and followed the guidelines of a protocol that was constructed for this purpose. This scenario was applied to a sample of 338 first-year undergraduate medical students. A questionnaire was distributed to each one of them in order to obtain Likert-like scale data on the sample’s response with respect to the PHR that was used; the data were then further analysed descriptively and in terms of a regression analysis to model hypothesised correlations. Results Students displayed, in general, satisfaction about the core PHR functions they used and they were optimistic about using them in the future, as they evaluated quite high up the level of their utility. The aspect they valued most in the PHR was its main role as a record-keeping tool, while

  16. Training of medical teams on-site for individual and coordinated response in emergency management

    DEFF Research Database (Denmark)

    Andersen, Verner

    2003-01-01

    A system for training of coordination and cooperation of decision makers in emergency management has been under construction for some time. A first prototype of the system was developed in the MUSTER system. The system is being developed modularly with one module for each of the suborganisations...... involved in the complete preparedness: fire brigade, police, medical team, civil defence, etc. All these modules will in the end be integrated on a common integration platform, either to a fully-fledged system covering all aspects of training for the complete preparedness, or for creating a dedicated...

  17. Marine Corps Counterterrorism: Determining Medical Supply Needs for the Chemical Biological Incident Response Force

    Science.gov (United States)

    2004-03-04

    80.33 6505009269197 Ipecac Syrup USP 7% 30ml 1 BT 0.01 0.30 $0.93 0.01 0.3 $0.93 6505001326904 Isoniazid Tablets USP 300 Mg 100s...Administer Appropriate Medication 6505000648724 Acetazolamide Sodium Sterile USP 500mg Vial 0.5 VI 29 6505001009985 Aspirin Tablets USP 0.324gm 100s...6505012149062 Ibuprofen Tablets USP 800 Mg 500 Tablets Per Bottle 1 EA 7 6515013448487 Injector Tube Reusable 1ml & 2ml Ndl Units 1 EA

  18. Psychological Stress In First Year Medical Students In Response To The Dissection Of A Human Corpse

    Science.gov (United States)

    Bernhardt, Veronika; Rothkötter, Hermann Josef; Kasten, Erich

    2012-01-01

    Objectives: Gross anatomy is one of the most important and time consuming subjects in the first preclinical part of medical school in Germany. In October 2007 186 students started the dissection course at Otto-von-Guericke-University Magdeburg. The objective of this study is to analyze the emotional aspect relating to the gross anatomy course. In order to address this issue, we investigated how medical students experience the first confrontation and the following exposure to the dead bodies and whether there are any differences between various groups (age, gender, experience) of students. Methods: The study was carried out with a group of 155 first year medical students (112 female, 43 male, 21.4±2.9 years). Self-composed questionnaires were used to distinguish between concerns related to dissection and individual experiences and anxiety because of deceasing or death. In order to detect the changes of attitudes towards the dissection course, one questionnaire was answered by participants in the beginning of the course and one in the end (n=94, 66 female, 28 male). Additionally, personality traits of the students were analyzed using two scales of the “Freiburger Persönlichkeitsinventar (FPI-R)”. Results: The self-composed questionnaires showed high reliability. For some students dissection was emotional stress; about 50% became anxious when coping the first confrontation, however, only 12% to large extent. Concerning the anxiety of dissection of individual body parts it was less for limbs, internal organs and skin and increased for head and genitals. Although hypothesized before, the correlation between age, extraversion, emotionality and the extent of anxiety were small. Almost 90% of the students approve the early beginning of the gross anatomy course. The follow-up study showed a marked decline of anxiety. Conclusion: Our results show that about 50% of the students started the course with emotional stress and about one-tenth of them were very worried about

  19. Response of the New Mexico Disaster Medical Assistance Team in St. Croix after Hurricane Hugo.

    Science.gov (United States)

    Lewis-Rakestraw, L

    1991-06-01

    Our DMAT pulled together with the energy, flexibility, and adaptability necessary to make things work. Sally Coan expressed it best, saying, "I was with a group of people who would do anything [that was] needed." Dedication and trust within the DMAT helped create lasting friendships. The islanders were appreciative and we formed attachments to them that made them too dear to leave without sadness. The DMAT did leave, but we left in place an established medical system that the island would not otherwise have had a standard of care of which we felt proud.

  20. Exercise CAPITAL SHIELD Towards Medical Response Integration in the National Capital Region

    Science.gov (United States)

    2011-01-24

    provided JTF the authority to develop Interagency partnerships  CY09/10: JTF CapMed executed (12) DSCA missions with Fed/State/Local partners...incident site at Lorton Youth Detention Center, VA – admin medical support 4-5 days  FY10, JTF CapMed inserted two-day MASCAL training (onsite only...Use exercise as test-bed for structure/tools: – Joint Critical Care ATLS Team: Modification of ATLS Team w/ attached triage and evac sections

  1. Local responses to French medical imperialism in late nineteenth-century Algeria.

    Science.gov (United States)

    Gallois, William

    2007-08-01

    This article offers the first account of the lives of Algerian-born doctors working in the French colonial medical service between 1870 and 1900. Their stories reveal the manner in which the idea of medical imperialism had collapsed in Algeria, as a result of maladministration, racial policies, competition between civil and military authorities, budgetary constraints and the rise of the colons. The article also indicates the way in which medicine became a locus of opposition to French rule. It shows how the first decades of the Third Republic were critical in terms of a shift from the earlier idea of medicine serving as an emblem of the mission civilisatrice to the ideological potential of medicine being seen in much more nuanced terms by both French settlers and Algerian locals. It is argued that the notion of cultural resistance to imperialism through medicine emerges in the 1870s and 1880s, thereby prefiguring the work of Fanon and the Front de Liberation Nationale's later analysis of the 'sickness' of colonial Algerian society.

  2. Do Family Responsibilities and a Clinical Versus Research Faculty Position Affect Satisfaction with Career and Work–Life Balance for Medical School Faculty?

    OpenAIRE

    Beckett, Laurel; Nettiksimmons, Jasmine; Howell, Lydia Pleotis; Villablanca, Amparo C.

    2015-01-01

    Background: Balancing career and family obligations poses challenges to medical school faculty and contributes to dissatisfaction and attrition from academics. We examined the relationship between family setting and responsibilities, rank, and career and work–life satisfaction for faculty in a large U.S. medical school.

  3. Opinions of patients with type 2 diabetes about responsibility, setting targets and willingness to take medication: a cross-sectional survey.

    NARCIS (Netherlands)

    Gorter, K.J.; Tuytel, G.J.; Leeuw, R.R. de; Bensing, J.M.; Rutten, G.E.H.M.

    2011-01-01

    OBJECTIVE: To assess opinions and their determinants of patients with type 2 diabetes about responsibility for managing their diabetes, setting treatment targets and willingness taking medication. METHODS: Questionnaire survey carried out in general practices and outpatient clinics across the

  4. Item response analysis on an examination in anesthesiology for medical students in Taiwan: A comparison of one- and two-parameter logistic models

    Directory of Open Access Journals (Sweden)

    Yu-Feng Huang

    2013-06-01

    Conclusion: Item response models are useful for medical test analyses and provide valuable information about model comparisons and identification of differential items other than test reliability, item difficulty, and examinee's ability.

  5. An ontology of geo-reasoning to support medical response to attacks with weapons of mass destruction.

    Science.gov (United States)

    Kirsh, David; Peterson, Nichole; Lenert, Leslie A

    2005-01-01

    We study how Metropolitan Medical Response System units conceptualize the physical space of a disaster and their organized response. Using a variety of ethnographic methods before, during, and after a disaster drill, we have developed an initial ontology for geospatial and context-aware technology. The conceptual map of first responders is far more complex than a geographical map. Zones and Areas are used to describe documented concepts critical to MMRS operations. Ad hoc locations also play a critical role, helping first responders communicate tactics in spatial terms. Such distinctions play an important role in the way our experts think about their activity. Successful geoaware alerting systems must incorporate these notions if they are to seamlessly fit into the work flow of first responders.

  6. The West African currency board and economic integration of British ...

    African Journals Online (AJOL)

    WACB) as an economic integration effort in British West Africa. Through a collaborative effort between this public institution and a private company, the Bank of British West Africa, British West African colonies were not only unified but also the way ...

  7. [Judicial and medical/legal aspects of the responsibility of workers appointed to carry out first aid].

    Science.gov (United States)

    Caprioli, L C; Ciavarella, M; Sacco, A

    2005-01-01

    One of the innovations introduced by law 626/94 [the Italian law on occupational health and safety of workers] is the obligation of the employer to designate workers responsible for first aid. To identify and discuss the duties, the role and the medical and legal responsibility of workers appointed to carry out first aid measures. Analysis of legislation and current practice concerning medical and legal responsibility in first aid procedures. The worker appointed to carry out first aid measures is, by virtue of his appointment, obliged to take action. Therefore, he could commit an illegitimate act both by "acting" and by "omitting" to carry out a duty that is his responsibility. In the first case the worker could be accused of committing an unpremeditated criminal offence when his actions involve negligence, imprudence, inexperience or violation of regulations concerning his duties. A "serious criminal offence" is committed when the most elementary rules of diligence, prudence and skill are violated; the offence is "slight" when negligence, imprudence or inexperience are involved in particularly complex situations. The reference parameter for inexperience is not a first aid volunteer, nor a member of the public, but a worker designated to carry out first aid possessing "average" attitudes, training and ability. Briefly, a guilty error by the appointed worker consists of the following: i) the professional conduct of the operator was clearly wrong, serious and unjustifiable; ii) the operator clearly omitted doing his/her duty; iii) the consequence of the error is physical personal damage. The observations made clearly illustrate the delicacy of the tasks of the worker appointed to carry out first aid measures. Essential elements for minimizing wrong and/or negligent conduct are appropriate choice of the designated workers and their adequate training.

  8. Evaluation of the British Columbia AIDS Information Line.

    Science.gov (United States)

    Parsons, D C; Bell, M A; Gilchrist, L D

    1991-01-01

    We evaluated implementation of the British Columbia AIDS Information Line during its initial 15 weeks of operation. Data collected during daily operation of the line included call frequency, caller characteristics, response patterns, caller concerns and community referrals. Information on activities and resources required to implement the AIDS Line was also assembled. The study concluded that the advertising campaign sponsored by the provincial government and other AIDS-related media events had a strong impact on the frequency of calls made to the AIDS Line. However, the effect of both advertising and media events was of relatively short duration, suggesting that utilization of an AIDS information line is dependent on continuing promotional activities. The evaluation results demonstrate the importance of continuous collection of data online utilization, to track public awareness of and response to AIDS-related issues, and to facilitate planning of public education.

  9. A Paramedic-staffed Helicopter Emergency Medical Service's Response to Winch Missions in Victoria, Australia.

    Science.gov (United States)

    Meadley, Ben; Heschl, Stefan; Andrew, Emily; de Wit, Anthony; Bernard, Stephen A; Smith, Karen

    2016-01-01

    Winching emergency medical care providers from a helicopter to the scene enables treatment of patients in otherwise inaccessible locations, but is not without risks. The objective of this study was to define characteristics of winch missions undertaken by Intensive Care Flight Paramedics (ICFP) in Victoria, Australia with a focus on extraction methods and clinical care delivered at the scene. A retrospective data analysis was performed to identify all winch missions between November 2010 and March 2014. Demographic data, winch characteristics, physiological parameters, and interventions undertaken on scene by the ICFP were extracted. Out of 5,003 missions in the study period, 125 were identified as winch operations. Winter missions were significantly less frequent than those of any other season. Patients were predominantly male (78.4%) and had a mean age of 38 years (±17.6). A total of 109 (87.2%) patients were identified as experiencing trauma with a mean Revised Trauma Score of 7.5288, and isolated limb fractures were the most frequently encountered injury. Falls and vehicle-related trauma were the most common mechanisms of injury. The total median scene duration was 49 minutes (IQR 23-91). Sixty-three patients (50.4%) were extracted using a stretcher, 45 (36.0%) using a hypothermic strop, and 6 (4.8%) via normal rescue strop. Eleven patients (8.8%) were not winched to the helicopter. Vascular access (38.4%), analgesia (44.0%), and anti-emetic administration (28.8%) were the most frequent clinical interventions. Forty-nine patients (39.2%) did not receive any clinical intervention prior to winch extraction. Winch operations in Victoria, Australia consisted predominantly of patients with minor to moderate traumatic injuries. A significant proportion of patients did not require any clinical treatment prior to winching, and among those who did, analgesia was the most frequent intervention. Advanced medical procedures were rarely required prior to winch extraction.

  10. Pakistan: the new target of terrorism. Are Karachi's emergency medical response systems adequately prepared?

    Science.gov (United States)

    Siddiqui, Muhammad Ahmed; Jawad, Ahmed; Minhas, Saeed; Ansari, Asma; Siddiqui, Afrah; Mehtab, Sana

    2009-07-01

    To assess the efficacy and preparedness of the pre-hospital and hospital emergency medical systems and post graduate trainees in the city to deal with a massive terrorist strike. A cross-sectional survey of postgraduate trainees was conducted at Jinnah Postgraduate Medical Center and Civil Hospital Karachi from 21st July 2007 to 24th July 2007, to evaluate the preparedness and self identified deficiencies of doctors involved in massive trauma casualty management. To assess the pre-hospital care in Karachi, structured telephonic interviews were conducted of administrators of two private run charity based ambulance services. Out of the 90 respondents questioned regarding a self assessment of their training, only 3 (3.3%) of them were confident about their management of bomb blast victims. Eighty-seven (96.6%) of the respondents felt they required some further training (44.4%) or comprehensive training (52.2%). No simulated drills or courses had been conducted for disaster management in the emergency department of the surveyed Hospitals. Most of the ambulance drivers had no paramedic training. Ambulances are equipped with a stretcher and an oxygen cylinder only. No resuscitation measures are available in the ambulances. With an increasing number of terrorist attacks in the country, massive influx of casualties in a relatively short time span has become a regular feature of the Pakistani hospital system. Lack of adequate training at pre-hospital and in hospital levels may translate into increasing morbidities and mortalities. It is imperative that training of junior doctors and paramedical staff be conducted regularly and an effective regional communication base established for efficient interdepartmental coordination.

  11. The British Concentration Camp Policy during the Anglo-Boer War

    African Journals Online (AJOL)

    fighting, the British military, and in particular the two men who were in command, .... Well aware of the criticism of the governments' actions, the editor stated, "It has ..... early on in the move toward the city, the Boer forces simply abandoned it. ... Between the two of them they came up with a two-fold response to stopping.

  12. British Students' Perceptions of Ethical Issues in International Marketing: An Empirical Investigation.

    Science.gov (United States)

    Amin, Sammy G.

    1996-01-01

    A survey investigated 122 British business students' perceptions of ethics in international marketing practices, particularly as they are affected by demographic characteristics. In response to 12 specific scenarios, students indicated relatively liberal attitudes. Implications for global marketing specialists and for business education are…

  13. A Comparative Study of Moral Development of Korean and British Children.

    Science.gov (United States)

    Baek, Hye-Jeong

    2002-01-01

    Explores Lawrence Kohlberg's theory of moral development in relation to Korean and British children. Illustrates cultural differences in moral orientations. Notes it was not possible to match responses from Korean children to Kohlberg's manual. Suggests that interpretation of children's moral reasoning should be based on consideration of cultural…

  14. Flood Hazard Management: British and International Perspectives

    Science.gov (United States)

    James, L. Douglas

    This proceedings of an international workshop at the Flood Hazard Research Centre (Queensway, Enfield, Middlesex, U.K.) begins by noting how past British research on flood problems concentrated on refining techniques to implement established policy. In contrast, research covered in North American and Australian publications involved normative issues on policy alternatives and administrative implementation. The workshop's participants included 16 widely recognized scientists, whose origins were about equally divided between Britain and overseas; from this group the workshop's organizers expertly drew ideas for refining British urban riverine flood hazard management and for cultivating links among researchers everywhere. Such intellectual exchange should be of keen interest to flood hazard program managers around the world, to students of comparative institutional performance, to those who make policy on protecting people from hazards, and to hydrologists and other geophysicists who must communicate descriptive information for bureaucratic, political, and public decision- making.

  15. Provincial land use planning in British Columbia

    International Nuclear Information System (INIS)

    Mitchell, W.

    1998-01-01

    The efforts being made to include Aboriginal communities in land use planning in British Columbia are discussed. British Columbia is in the midst of historic changes with respect to land and resource allocation, use and management. Historic trends in land use allocation and management are contrasted with land use planning and resource management of today. The impact of provincial government moves to double park space within the province, and the Protected Areas Strategy initiative will have on the natural gas and petroleum industry is discussed. New efforts being made to include First Nations directly in land use planning discussions in ways that do not prejudice treaty negotiations, are reviewed. Creation of a new Oil and Gas Commission in the Fort St. John area, is cited as the most recent example of the interconnections between First Nations communities and other public and industry stakeholders in land use planning in the province

  16. Experiences within British Steel since 1989

    International Nuclear Information System (INIS)

    Harvey, D.S.

    1999-01-01

    The experience of British steel is that there is a serious and continuing threat of radioactive material being included in scrap delivered to steelworks. All scrap entering the steelworks is monitored for radioactivity. The scrap suppliers and the national authorities have recognized the difficulties caused by the presence of radioactivity in scrap, and are working to minimise the problem. Both domestic and imported scrap has been found to contain radioactivity, but the imported scrap is much more likely to contain radioactivity. If radioactivity is found the Environmental Agency is informed, and established procedures are used to minimise the hazard, and to isolate the radioactivity. Detecting, and isolating radioactive scrap, and preventing it being re-melted in the steelmaking process, is part of the overall commitment of British Steel to work safely, and to provide a safe, good quality, product (author)

  17. British Columbia's untapped wind export potential

    International Nuclear Information System (INIS)

    Kaplan, M.

    2008-01-01

    This presentation discussed wind energy developments in British Columbia (BC). There are currently more than 5000 MW of wind power development activities in British Columbia, but only 325 MW of wind power purchase agreements (PPAs). Various renewable portfolio standards and greenhouse gas (GHG) initiatives are now being use to create demand for additional renewable energy development in the northwestern United States. Studies have demonstrated that BC wind export initiatives have the potential to deliver wind power to markets in the Pacific northwest. Canadian transmission export proposals are now examining methods of bringing renewable energy to areas with high load demands. However, the United States has more than 240,000 MW of proposed wind projects for key markets in the northwestern region. It was concluded that activities in United States wind development are now posing a challenge to Canadian wind energy exporters. Various transmission projects in the United States are now looking at developing renewable energy sources close to BC. tabs., figs

  18. Development of Medical Technology for Contingency Response to Marrow Toxic Agents

    Science.gov (United States)

    2018-01-18

    Antigen will Result in Robust Serologic Response to H-Y Antigens in Male HSC transplantation Recipients D. Miklos 288 pairs H-Y Antigen ELISA ...Arai, D. Miklos 200 pairs Anti-body ELISA , Protein array Yes Detection of Donor- Directed, HLA-Specific Alloantibodies in Recipients of...SNPs ELISA and Taqman Yes Natural killer cell genomics and outcomes after allogeneic transplantation for lymphoma V. Bachanova, J. Miller

  19. Increasing the Response Rate of the Patient Satisfaction Survey of Inpatients at National Naval Medical Center

    Science.gov (United States)

    1993-08-01

    identify a method to improve the effectiveness of the current survey process to increase the response rate of the patients being sampled. As health care... consumer must have adequate representation to provide meaningful information for decision making by the health care organization. Background of the...the Total Quality Management (TQM) philosophy into the health care industry has increased the importance of listening to the customer (Matthews, 1992

  20. Temperature dependence of the Al2O3:C response in medical luminescence dosimetry

    DEFF Research Database (Denmark)

    Edmund, Jens Morgenthaler; Andersen, Claus Erik

    2007-01-01

    is not varied. The RL response only depends on the irradiation temperature. We recommend that calibration should be carried out at the same irradiation temperature at which the measurement is performed (i.e. at body temperature for in vivo measurements). The overall change in the integrated OSL and RL signals...... and detection wavelengths. The reported temperature dependence seems to be a general property of Al2O3:C. (C) 2006 Elsevier Ltd. All rights reserved....

  1. Dirty Pop: Contemporary British Painting, Group Exhibition

    OpenAIRE

    Stubbs, Michael

    2013-01-01

    Phil Allen, Peter Ashton Jones, Jake Clark, Richard Clegg, Dan Coombs, Nelson Diplexcito, Nadine Feinson, Mick Finch, Richard Hamilton, Dan Hays, Gavin Lockheart, Andrea Medjesi Jones, David Leeson, Duncan Newton, Sarah Pickstone, Colin Smith, John Stark, Michael Stubbs, James White, Mark Wright.\\ud \\ud Dirty Pop, curated for &Model by Mark Wright, presents twenty contemporary painters whose work connects with Pop Art of the 1960’s, and particularly the legacy of the important British artist ...

  2. Electricity trade: Generating benefits for British Columbians

    International Nuclear Information System (INIS)

    1994-01-01

    Electricity has been traded in British Columbia since the turn of the century. In 1988, the provincial government established the British Columbia Power Exchange Corporation (Powerex) to conduct electricity trade activities in order to make the most efficient use of the electrial system and generate benefits for British Columbians. The trade is made possible by an interconnected system linking producers and consumers in western Canada and the USA. Provincial participants in the trade include British Columbia Hydro, independent power producers, and cogenerators. Benefits of the electricity trade include generation of revenue from sale of surplus power, being able to buy electricity when the mainly hydroelectric provincial system is in a drought condition or when major shutdowns occur, and enabling postponement of development of new power projects. Powerex conducts its trade under provincial and federal permits and licenses. Different types of trade contracts are negotiated depending on the amount and availability of electricity and the kind of trade being conducted. Exchanges and coordination agreements allow transfer and return between utilities with no net export occurring, allowing balancing of loads between different reigons. Surplus electricity is bought or sold on a short- or long-term basis and on firm or non-firm terms. Electricity exports are not subsidized and are only allowed if the electricity is surplus to provincial needs and can be sold at a profit. A new provincial policy allows private industry to export long-term firm electricity; this involves construction of new private-sector generating facilities solely for the purpose of export. 1 fig

  3. Young British readers' engagement with manga

    OpenAIRE

    Tsai, Yi-Shan

    2015-01-01

    This thesis presents young British readers’ engagement with manga regarding literary, aesthetic, social, and cultural dimensions. The study explores young readers’ points of views of their reading preference – manga. I investigated how children interpreted manga, with respect to the artistic techniques, the embedded ideologies, and the cultural elements therein. I also looked into children’s participation in manga fandom and its social meanings. This allowed me to explore what attracted Briti...

  4. 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...... the networks and activities of Britain's engineers while focusing on London as a centre of imperial expansion. By treating Britain and the empire as an interconnected zone heanalyses the ways in whichideas , people and technologies circulated during the critical period....

  5. 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)

  6. Marketing wholesale electricity in British Columbia

    Energy Technology Data Exchange (ETDEWEB)

    Moghadam, B. [Powerex, Vancouver, BC (Canada)

    2002-03-14

    An open access wholesale transmission tariff (WTS) has been in place in British Columbia since 1997, and wholesale electricity can be sold to wholesale purchasers by independent producers located within the province. Customers range from municipalities to British Columbia Hydro (BC Hydro), to Powerex, to UtiliCorp Networks Corporation (UNC). Provided that the necessary approvals and transmission services have been acquired, the energy may be transmitted anywhere in Canada or the United States. The generation and sale of electricity within British Columbia and the United States is subject to government and regulatory approvals. Several buyers and sellers that come together to trade a product are part of a hub. The largest such hub in the Pacific Northwest is called the Mid-Columbia (Mid-C) hub in Washington. The commodity is traded in 25 MW standard blocks. The credit requirements of the purchaser must be satisfied by the generating party. BC Hydro wholesale transmission service can be purchased by any wholesale power marketer or generator to transmit the power to market. It is imperative that scheduling personnel be available at all times. The Western System Coordinating Council (WSCC) insists that an operating reserve of 5 per cent hydro generation and 7 per cent thermal generation to support the electrical system in the face of an emergency be available for the electricity marketed through the hub. Powerex has been successful since 1988 in the marketing of electricity throughout the WSCC. An example was provided to help make the rules a bit easier to comprehend. refs.

  7. The British Model in Britain: Failing slowly

    International Nuclear Information System (INIS)

    Thomas, Steve

    2006-01-01

    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

  8. British Columbia natural gas: Core market policy

    International Nuclear Information System (INIS)

    1988-06-01

    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

  9. Marketing wholesale electricity in British Columbia

    International Nuclear Information System (INIS)

    Moghadam, B.

    2002-01-01

    An open access wholesale transmission tariff (WTS) has been in place in British Columbia since 1997, and wholesale electricity can be sold to wholesale purchasers by independent producers located within the province. Customers range from municipalities to British Columbia Hydro (BC Hydro), to Powerex, to UtiliCorp Networks Corporation (UNC). Provided that the necessary approvals and transmission services have been acquired, the energy may be transmitted anywhere in Canada or the United States. The generation and sale of electricity within British Columbia and the United States is subject to government and regulatory approvals. Several buyers and sellers that come together to trade a product are part of a hub. The largest such hub in the Pacific Northwest is called the Mid-Columbia (Mid-C) hub in Washington. The commodity is traded in 25 MW standard blocks. The credit requirements of the purchaser must be satisfied by the generating party. BC Hydro wholesale transmission service can be purchased by any wholesale power marketer or generator to transmit the power to market. It is imperative that scheduling personnel be available at all times. The Western System Coordinating Council (WSCC) insists that an operating reserve of 5 per cent hydro generation and 7 per cent thermal generation to support the electrical system in the face of an emergency be available for the electricity marketed through the hub. Powerex has been successful since 1988 in the marketing of electricity throughout the WSCC. An example was provided to help make the rules a bit easier to comprehend. refs

  10. Privatisation of the British coal industry

    Energy Technology Data Exchange (ETDEWEB)

    Cowles, R.V. (Norton Rose, London (UK))

    1991-01-01

    The article discusses the possible consequences of the impending privatisation of British Coal. It seems likely that deep mine operations will probably be divided up geographically but opencast mines may be left in single ownership. Freehold ownership of coal is likely to be transferred to the Crown and British Coal's powers to license small mines and opencast sites are likely to be absorbed into a general licensing system under control of the Department of Energy. Possible difficulties of public share issues are discussed - subsidence, environmental problems and also the uncertainty of the future market for British coal are mentioned. As an alternative, a series of contract sales of groups of mine properties could be made. Issues of common concern to future owners of the coal industry may lead to the creation of a new mineowner's trade association. Constraints in the areas of procurement and coal sales are discusssed briefly. Although a gloomy scenario is presented, it is suggested that some mines could become highly profitable. 1 ref.

  11. A Change of Heart? British Policies towards Tubercular Refugees during 1959 World Refugee Year.

    Science.gov (United States)

    Taylor, Becky

    2015-01-01

    This article looks at Britain's response to the World Refugee Year (1959-60), and in particular the government's decision to allow entry to refugees with tuberculosis and other chronic illnesses. In doing so, it broke the practice established by the 1920 Aliens' Order which had barred entry to immigrants with a range of medical conditions. This article uses the entry of these sick refugees as an opportunity to explore whether government policy represented as much of a shift in attitude and practice as contemporary accounts suggested. It argues for the importance of setting the reception of tubercular and other 'disabled' refugees in 1959-61 in its very particular historical context, showing it was a case less of the government thinking differently about refugees, and more of how, in a post-Suez context, the government felt obliged to take into account international and public opinion. The work builds on and adds to the growing literature surrounding refugees and disease. It also places the episode within the specificity of the post-war changing epidemiological climate; the creation of the National Health Service; and the welfare state more broadly. In looking at the role of refugee organizations in the Year, the article also contributes to debates over the place of voluntary agencies within British society.

  12. Foucault's contributions for understanding power relations in British classical political economy

    Directory of Open Access Journals (Sweden)

    Danielle Guizzo

    2015-05-01

    Full Text Available This paper analyzes the strategic role played by British classical political economy in constructing new technologies of power. Michel Foucault drew attention to a change that political economists promoted concerning the role of the state, which has been overlooked by historians of economic thought. This paper explores the main arguments provided by the most important British political economists of the 18th and 19th centuries on what concerns population management, State's role and economic dynamics in order to examine Foucault's considerations. Although British classical political economy consolidated the mechanism of markets and economic individuality, thus creating a system of truth that changed economic norms and practices, its discourse also established a political conduct that was responsible for creating mechanisms of control that disseminated new forms of power relations.

  13. Culture and psychosocial function in british and Japanese people with an ostomy.

    Science.gov (United States)

    Simmons, Kingsley L; Maekawa, Atsuko; Smith, Jane A

    2011-01-01

    We compared social and psychological adjustment to surgery ending with an ostomy in British and Japanese patients. In response to a postal survey, 948 ostomy patients (464 British and 484 Japanese), selected at random from respective national databases, provided assessable data on the Ostomy Adjustment Inventory-23 (OAI-23), a validated scale for measurement of psychosocial adjustment to an ostomy. Analysis of variance revealed that country of residence (F1,876 = 50.9, P ostomy. British persons with an ostomy experienced higher psychosocial adjustment to an ostomy than did Japanese respondents. Multivariate analysis based on acceptance, social engagement, anxious-preoccupation, and anger also found that country of residence and time since surgery influenced psychosocial adjustment (Pillai's Trace: V = 0.22, F = 67.15, P ostomy, suggesting that culture influences psychosocial adjustment to life with an ostomy. These findings support the need for culturally informed ostomy care.

  14. Medical simulation: a tool for recognition of and response to risk

    International Nuclear Information System (INIS)

    Ruddy, Richard M.; Deffner Patterson, Mary

    2008-01-01

    The use of simulation and team training has become an excellent tool to reduce errors in high-risk industry such as the commercial airlines and in the nuclear energy field. The health care industry has begun to use similar tools to improve the outcome of high-risk areas where events are relatively rare but where practice with a tactical team can significantly reduce the chance of bad outcome. There are two parts to this review: first, we review the rationale of why simulation is a key element in improving our error rate, and second, we describe specific tools that have great use at the clinical bedside for improving the care of patients. These cross different (i.e. medical and surgical) specialties and practices within specialties in the health care setting. Tools described will include the pinch, brief/debriefing, read-backs, call-outs, dynamic skepticism, assertive statements, two-challenge rules, checklists and step back (hold points). Examples will assist the clinician in practical daily use to improve their bedside care of children. (orig.)

  15. Medically unexplained symptom reports are associated with a decreased response to the rubber hand illusion.

    Science.gov (United States)

    Miles, Eleanor; Poliakoff, Ellen; Brown, Richard J

    2011-10-01

    Medically unexplained symptoms (MUS) have been hypothesized to result from a distortion in perception, whereby top-down factors influence the process of body representation. Perceptual illusions provide a novel method of investigating this hypothesis. This study aimed to investigate whether self-reported unexplained symptoms are associated with altered experience of the rubber hand illusion (RHI). A non-clinical MUS group with high scores on the Somatoform Dissociation Questionnaire (SDQ), and a control group with low scores on this scale, were exposed to the RHI. Illusion experience was measured by self-reports and by proprioceptive alteration. After controlling for somatosensory amplification and trait anxiety, the low-SDQ group responded significantly more strongly to the RHI on both questionnaire and proprioceptive measures of the illusion. In contrast, the high-SDQ group scored significantly higher on the Perceptual Aberrations Scale, a measure of bodily distortions in daily life. These findings support the proposed link between MUS and disturbances in body representation, and suggest that a decreased reliance on current sensory inputs may contribute to symptom experience in susceptible individuals. Copyright © 2011 Elsevier Inc. All rights reserved.

  16. Medical simulation: a tool for recognition of and response to risk.

    Science.gov (United States)

    Ruddy, Richard M; Patterson, Mary Deffner

    2008-11-01

    The use of simulation and team training has become an excellent tool to reduce errors in high-risk industry such as the commercial airlines and in the nuclear energy field. The health care industry has begun to use similar tools to improve the outcome of high-risk areas where events are relatively rare but where practice with a tactical team can significantly reduce the chance of bad outcome. There are two parts to this review: first, we review the rationale of why simulation is a key element in improving our error rate, and second, we describe specific tools that have great use at the clinical bedside for improving the care of patients. These cross different (i.e. medical and surgical) specialties and practices within specialties in the health care setting. Tools described will include the pinch, brief/debriefing, read-backs, call-outs, dynamic skepticism, assertive statements, two-challenge rules, checklists and step back (hold points). Examples will assist the clinician in practical daily use to improve their bedside care of children.

  17. Medical education, social responsibility and praxis: Responding to the needs of all children.

    Science.gov (United States)

    Martimianakis, Maria Athina

    2016-01-01

    While poverty is a recognized risk factor for ill health, directly intervening on the effects of poverty has traditionally been considered to fall outside the realm of a physician's daily practice. Yet, to appropriately respond to the health needs of all children, we have the social responsibility to help our trainees become competent health advocates. Experiential learning approaches can be used to aid students in developing identities and competencies as health advocates. Experiencing illness outside the sterility of the clinic, from the patient's point of view, encourages students to seek the knowledge they need to care for patients who are disenfranchised, socially vulnerable and/or marginalized.

  18. A pH-, salt- and solvent-responsive carboxymethylcellulose-g-poly(sodium acrylate/medical stone superabsorbent composite with enhanced swelling and responsive properties

    Directory of Open Access Journals (Sweden)

    2011-05-01

    Full Text Available Free-radical graft copolymerization among sodium carboxymethylcellulose (CMC, partially neutralized acrylic acid (NaA, medical stone (MS and crosslinker N,N'-methylene-bis-acrylamide (MBA was performed to prepare new carboxymethylcellulose-g-poly(sodium acrylate/medical stone (CMC-g-PNaA/MS superabsorbent composites. Fourier transform infrared (FTIR spectra, thermogravimetry- differential scanning calorimetry (TG-DSC and field emission scanning electromicrsocopic (FESEM analysis confirmed that NaA had been grafted onto CMC backbone and MS participated in polymerization, and the thermal stability and surface morphologies were improved by the addition of MS. Energy dispersive spectrometer (EDS and elemental map (EM analyses revealed the better distribution of MS in the CMC-g-PNaA matrix. The incorporation of 20 wt% MS clearly enhanced the water absorption by 100% (from 317 to 634 g/g. The developed composites showed enhanced swelling rate and On-Off switching swelling characteristics in various pH solutions, saline solutions and hydrophilic organic solvents, which represented interesting and reversible pH-, saline- and hydrophilic organic solvent-responsive characteristics. In addition, the composite exhibited intriguing time-dependent kinetic swelling properties in various heavy metal solutions.

  19. "Essentially Christian, eminently philanthropic": the Mission to Lepers in British India.

    Science.gov (United States)

    Joseph, D George

    2003-01-01

    The early history of the Mission to Lepers in India is an interplay between politics, religion, and medicine in the context of British imperialism. The Mission pursued the dual but inseparable goals of evangelization and civilization, advancing not only a religious program but also a political and cultural one. These activities and their consequences were multi-faceted because while the missionaries pursued their religious calling, they also provided medical care to people and in places that the colonial government was unable or unwilling. Within the context of the British imperial program, the work imparted Western social and cultural ideals on the colonial populations they served, inculcated patients with Christian beliefs, and provided medical care to individuals who had been expelled from their own communities. Physical healing was intimately tied to religious salvation, spiritual healing, and the civilizing process.

  20. British Energy privatisation - 18 months on

    International Nuclear Information System (INIS)

    McRoberts, Doug

    1998-01-01

    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

  1. 'Thinking on my feet': an improvisation course to enhance students' confidence and responsiveness in the medical interview.

    Science.gov (United States)

    Shochet, Robert; King, Julie; Levine, Rachel; Clever, Sarah; Wright, Scott

    2013-02-01

    accreditation and expert panel consensus guidelines have stressed the importance and framed the structure for best communication practices. Exemplary curricula for teaching medical trainees in core communication strategies to use with patients have been published; many emphasise patient-centred and/or relationshipcentred strategies. Simulated patient technologies with video review can allow learners to practise their skills through both self-assessment and feedback from others. However, despite these newer learning resources, frameworks and behavioural checklists, learners naïve to clinical patient encounters must still learn how to function and adapt within the interpersonal communicative space that is created by the learner and patient. At its core, this is an iterative, spontaneous process created by the dyad and yielding, from moment to moment, to unique and unanticipated outcomes. Thus, repetitive practice will improve confidence but may miss the mark in learning the essential skills of intuitive and improvised interpersonal responsiveness. One could argue that existing approaches in teaching medical learners communication skills may promote rigid and stereotyped responses. Haidet proposes that there are significant parallels between the patient-physician dialogue (when a physician attempts to learn details about a patient and their illness) and improvisational jazz. 11 He contends that effective clinicians who are committed to relationship-centred practice depart from overarching principles of biomedical inquiry when necessary to respond spontaneously and without script to the particular circumstances of each encounter. It is believed that successful doctor-patient relationships are founded upon trusting and open communication, as well as genuine respect that can be shown by a willingness to listen or respond to the issues raised by patients. 12 The nature of the comprehensive care in family medicine makes it likely that GPs will regularly be surprised by concerns raised

  2. Personal responsibility, regret, and medical stigma among individuals living with lung cancer.

    Science.gov (United States)

    Criswell, Kevin R; Owen, Jason E; Thornton, Andrea A; Stanton, Annette L

    2016-04-01

    Understanding the degree to which adults with lung cancer perceive personal responsibility for their disease, personal regret for actions that may have contributed to lung cancer, and potential stigmatization from others is important, because these perceptions and experiences may be linked with treatment nonadherence, feelings of isolation, avoidance of healthcare providers, and poor quality of life. The purpose of this study was to evaluate rates and intensity of these types of experiences and to characterize the extent to which they are linked with smoking status and psychological adjustment in those living with lung cancer. Adults with lung cancer (N = 213) were recruited from two major cancer centers to complete a mail survey. Perceived responsibility was frequent in those who had ever smoked (74-80%), whereas regret and feelings of stigmatization were less frequent. When present, however, personal regret and stigmatization were associated with adverse psychological outcomes, particularly for never smokers. These results are consistent with the theory of stereotype threat and have clinical implications for management of people with lung cancer.

  3. Biomedicine, holism and general medical practice: responses to the 2004 General Practitioner contract.

    Science.gov (United States)

    Checkland, Kath; Harrison, Stephen; McDonald, Ruth; Grant, Suzanne; Campbell, Stephen; Guthrie, Bruce

    2008-07-01

    In 2004 a new contract was introduced for General Practitioners in the UK, which introduced a significant element of 'pay-for-performance', including both clinical and organisational targets. The introduction of this contract has caused interest across the world, particularly amongst those responsible for commissioning primary care services. It can be argued that the clinical targets in the contract (known as the Quality and Outcomes Framework, QOF) represent a move towards a more biomedical model of health and illness, which is contrary to the ideal of providing holistic (or biopsychosocial) care that has been traditionally espoused by GPs. This paper reports results from two linked studies (in England and Scotland) investigating the early stages of the new contract. We describe the way in which four practices with different organisational approaches and espoused identities have all changed their practice structures, consultations and clinical care in response to QOF in ways which will result in patients receiving a more biomedical type of care. In spite of these observed changes, respondents continued to maintain discursive claims to holism. We discuss how this disconnection between rhetoric and reality can be maintained, and consider its implications for the future development of GPs' claims to a professional identity.

  4. Biological response of Sr-containing coating with various surface treatments on titanium substrate for medical applications

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Shih-Ping [Department of Materials Science and Engineering, National Cheng Kung University, Tainan, Taiwan (China); Lee, Tzer-Min, E-mail: tmlee@mail.ncku.edu.tw [Institute of Oral Medicine, National Cheng Kung University, Tainan, Taiwan (China); School of Dentistry, Kaohsiung Medical University, Kaohsiung, Taiwan (China); Lui, Truan-Sheng [Department of Materials Science and Engineering, National Cheng Kung University, Tainan, Taiwan (China)

    2015-08-15

    Graphical abstract: - Highlights: • Sr-containing coating prepared by plasma spraying and micro-arc oxidation process, respectively. • MAO coating stimulated high ECM-like structures of cells on early stage. • Sr-containing specimens had high cell responses on late stage. • Sr-MAO coating is a desirable implant surface treatment for clinical applications. - Abstract: An implant requires a suitable surface to trigger osteointegration. The surface characteristics and chemical composition are important factors in this process. Plasma spraying and micro-arc oxidation can be used to fabricate rough and porous structures for medical applications. Strontium (Sr) has been shown to prevent osteoporosis in vitro and in vivo. However, few scientists have evaluated the biological response of Sr-containing coatings on different surface treatments. In this study, a sand-blasted (SB) surface (as the control), plasma-sprayed hydroxyapatite (HA) and Sr-substituted HA coatings (HAPS and SrHAPS, respectively), calcium phosphate and Sr-containing calcium phosphate micro-arc oxidation surface (CPM and SrCPM, respectively) were analyzed in terms of human osteoblastic cell (MG63) response. Sr was confirmed to be incorporated into the surface. SrHAPS and SrCPM specimens had higher cell responses than those of the HAPS and CPM groups, respectively. The cells cultured on SrCPM and SrHAPS specimens exhibited high proliferation and differentiation. However, CPM and SrCPM specimens stimulated more ECM-like structures than other specimens. The results show that Sr-containing coatings have good characteristics that enhance cell response. The SrCPM coating is a suitable implant surface treatment for clinical applications.

  5. Biological response of Sr-containing coating with various surface treatments on titanium substrate for medical applications

    International Nuclear Information System (INIS)

    Yang, Shih-Ping; Lee, Tzer-Min; Lui, Truan-Sheng

    2015-01-01

    Graphical abstract: - Highlights: • Sr-containing coating prepared by plasma spraying and micro-arc oxidation process, respectively. • MAO coating stimulated high ECM-like structures of cells on early stage. • Sr-containing specimens had high cell responses on late stage. • Sr-MAO coating is a desirable implant surface treatment for clinical applications. - Abstract: An implant requires a suitable surface to trigger osteointegration. The surface characteristics and chemical composition are important factors in this process. Plasma spraying and micro-arc oxidation can be used to fabricate rough and porous structures for medical applications. Strontium (Sr) has been shown to prevent osteoporosis in vitro and in vivo. However, few scientists have evaluated the biological response of Sr-containing coatings on different surface treatments. In this study, a sand-blasted (SB) surface (as the control), plasma-sprayed hydroxyapatite (HA) and Sr-substituted HA coatings (HAPS and SrHAPS, respectively), calcium phosphate and Sr-containing calcium phosphate micro-arc oxidation surface (CPM and SrCPM, respectively) were analyzed in terms of human osteoblastic cell (MG63) response. Sr was confirmed to be incorporated into the surface. SrHAPS and SrCPM specimens had higher cell responses than those of the HAPS and CPM groups, respectively. The cells cultured on SrCPM and SrHAPS specimens exhibited high proliferation and differentiation. However, CPM and SrCPM specimens stimulated more ECM-like structures than other specimens. The results show that Sr-containing coatings have good characteristics that enhance cell response. The SrCPM coating is a suitable implant surface treatment for clinical applications

  6. The Responses of Medical General Practitioners to Unreasonable Patient Demand for Antibiotics - A Study of Medical Ethics Using Immersive Virtual Reality

    Science.gov (United States)

    Pan, Xueni; Slater, Mel; Beacco, Alejandro; Navarro, Xavi; Bellido Rivas, Anna I.; Swapp, David; Hale, Joanna; Forbes, Paul Alexander George; Denvir, Catrina; de C. Hamilton, Antonia F.; Delacroix, Sylvie

    2016-01-01

    Background Dealing with insistent patient demand for antibiotics is an all too common part of a General Practitioner’s daily routine. This study explores the extent to which portable Immersive Virtual Reality technology can help us gain an accurate understanding of the factors that influence a doctor’s response to the ethical challenge underlying such tenacious requests for antibiotics (given the threat posed by growing anti-bacterial resistance worldwide). It also considers the potential of such technology to train doctors to face such dilemmas. Experiment Twelve experienced GPs and nine trainees were confronted with an increasingly angry demand by a woman to prescribe antibiotics to her mother in the face of inconclusive evidence that such antibiotic prescription is necessary. The daughter and mother were virtual characters displayed in immersive virtual reality. The specific purposes of the study were twofold: first, whether experienced GPs would be more resistant to patient demands than the trainees, and second, to investigate whether medical doctors would take the virtual situation seriously. Results Eight out of the 9 trainees prescribed the antibiotics, whereas 7 out of the 12 GPs did so. On the basis of a Bayesian analysis, these results yield reasonable statistical evidence in favor of the notion that experienced GPs are more likely to withstand the pressure to prescribe antibiotics than trainee doctors, thus answering our first question positively. As for the second question, a post experience questionnaire assessing the participants’ level of presence (together with participants’ feedback and body language) suggested that overall participants did tend towards the illusion of being in the consultation room depicted in the virtual reality and that the virtual consultation taking place was really happening. PMID:26889676

  7. The Responses of Medical General Practitioners to Unreasonable Patient Demand for Antibiotics--A Study of Medical Ethics Using Immersive Virtual Reality.

    Science.gov (United States)

    Pan, Xueni; Slater, Mel; Beacco, Alejandro; Navarro, Xavi; Bellido Rivas, Anna I; Swapp, David; Hale, Joanna; Forbes, Paul Alexander George; Denvir, Catrina; Hamilton, Antonia F de C; Delacroix, Sylvie

    2016-01-01

    Dealing with insistent patient demand for antibiotics is an all too common part of a General Practitioner's daily routine. This study explores the extent to which portable Immersive Virtual Reality technology can help us gain an accurate understanding of the factors that influence a doctor's response to the ethical challenge underlying such tenacious requests for antibiotics (given the threat posed by growing anti-bacterial resistance worldwide). It also considers the potential of such technology to train doctors to face such dilemmas. Twelve experienced GPs and nine trainees were confronted with an increasingly angry demand by a woman to prescribe antibiotics to her mother in the face of inconclusive evidence that such antibiotic prescription is necessary. The daughter and mother were virtual characters displayed in immersive virtual reality. The specific purposes of the study were twofold: first, whether experienced GPs would be more resistant to patient demands than the trainees, and second, to investigate whether medical doctors would take the virtual situation seriously. Eight out of the 9 trainees prescribed the antibiotics, whereas 7 out of the 12 GPs did so. On the basis of a Bayesian analysis, these results yield reasonable statistical evidence in favor of the notion that experienced GPs are more likely to withstand the pressure to prescribe antibiotics than trainee doctors, thus answering our first question positively. As for the second question, a post experience questionnaire assessing the participants' level of presence (together with participants' feedback and body language) suggested that overall participants did tend towards the illusion of being in the consultation room depicted in the virtual reality and that the virtual consultation taking place was really happening.

  8. The Responses of Medical General Practitioners to Unreasonable Patient Demand for Antibiotics--A Study of Medical Ethics Using Immersive Virtual Reality.

    Directory of Open Access Journals (Sweden)

    Xueni Pan

    Full Text Available Dealing with insistent patient demand for antibiotics is an all too common part of a General Practitioner's daily routine. This study explores the extent to which portable Immersive Virtual Reality technology can help us gain an accurate understanding of the factors that influence a doctor's response to the ethical challenge underlying such tenacious requests for antibiotics (given the threat posed by growing anti-bacterial resistance worldwide. It also considers the potential of such technology to train doctors to face such dilemmas.Twelve experienced GPs and nine trainees were confronted with an increasingly angry demand by a woman to prescribe antibiotics to her mother in the face of inconclusive evidence that such antibiotic prescription is necessary. The daughter and mother were virtual characters displayed in immersive virtual reality. The specific purposes of the study were twofold: first, whether experienced GPs would be more resistant to patient demands than the trainees, and second, to investigate whether medical doctors would take the virtual situation seriously.Eight out of the 9 trainees prescribed the antibiotics, whereas 7 out of the 12 GPs did so. On the basis of a Bayesian analysis, these results yield reasonable statistical evidence in favor of the notion that experienced GPs are more likely to withstand the pressure to prescribe antibiotics than trainee doctors, thus answering our first question positively. As for the second question, a post experience questionnaire assessing the participants' level of presence (together with participants' feedback and body language suggested that overall participants did tend towards the illusion of being in the consultation room depicted in the virtual reality and that the virtual consultation taking place was really happening.

  9. Toward phase 4 trials in heart failure: A social and corporate responsibility of the medical profession.

    Science.gov (United States)

    Iyngkaran, Pupalan; Beneby, Glen S

    2015-12-26

    Congestive heart failure (CHF) is a chronic condition, requiring polypharmacy, allied health supports and regular monitoring. All these factors are needed to ensure compliance and to deliver the positive outcomes demonstrated from randomized controlled trials. Unfortunately many centers around the world are unable to match trial level support. The outcomes for many communities are thus unclear. Research design factors in post-marketing surveillance to address this issue. Phase 4 studies is the name given to trials designed to obtain such community level data and thus address issues of external validity. CHF phase 4 studies are relatively underutilized. We feel the onus for this research lies with the health profession. In this commentary we provide arguments as to why phase 4 studies should be viewed as a social and corporate responsibility of health professional that care for clients with CHF.

  10. Toward phase 4 trials in heart failure: A social and corporate responsibility of the medical profession

    Science.gov (United States)

    Iyngkaran, Pupalan; Beneby, Glen S

    2015-01-01

    Congestive heart failure (CHF) is a chronic condition, requiring polypharmacy, allied health supports and regular monitoring. All these factors are needed to ensure compliance and to deliver the positive outcomes demonstrated from randomized controlled trials. Unfortunately many centers around the world are unable to match trial level support. The outcomes for many communities are thus unclear. Research design factors in post-marketing surveillance to address this issue. Phase 4 studies is the name given to trials designed to obtain such community level data and thus address issues of external validity. CHF phase 4 studies are relatively underutilized. We feel the onus for this research lies with the health profession. In this commentary we provide arguments as to why phase 4 studies should be viewed as a social and corporate responsibility of health professional that care for clients with CHF. PMID:26713277

  11. CLINICIAN SENSITIZATION ON INTEGRATED DISEASE SURVEILLANCE AND RESPONSE IN FEDERAL MEDICAL CENTRE OWO, ONDO STATE, NIGERIA, 2016

    Directory of Open Access Journals (Sweden)

    Olayinka Stephen Ilesanmi

    2017-06-01

    Full Text Available Background: For effective Integrated Disease Surveillance and Response (IDSR all health care workers involvement is required. Most trainings have often neglected the clinicians. Aim: This study aimed to identify gaps requiring capacity building in preventing infectious disease outbreak among health care workers in Federal Medical Centre, Owo, Ondo State. Methods: A cross sectional study of clinicians at the Federal Medical Centre, Owo was done. Data was collected using semi structured interviewer administered questionnaire. Data collected were analysed with SPSS version 21. Summary statistics was conducted to identify training need requirements. Results: The mean age of participant was 43 ± 5.9 years, 14(70% were male. Respondents who have worked for 10 years and above were 12(60%. In all, 5(25% respondent understood disease surveillance to be systematic collection of data and analysis in order to prevent diseases. Regarding respondent’s knowledge of notifiable diseases. Only 4(20% of the respondents knew malaria as a notifiable disease, Cholera knew by 11(55%, Ebola by 15(75% and Lassa by 13(65%. The main factor identified to be affecting prompt disease notification in Federal Medical Centre, Owo was lack of adequate training 12(60% while communication gap was identified by 7(35%. In all, 18(90% felt they do not know all that they needed about disease surveillance. Conclusion: Rapid notification of infectious diseases is essential for prompt public health action and for monitoring of disease trends. Trainings that will improve the level of knowledge of clinician and communication channels will improve disease surveillance and notification.

  12. Evaluation of a community-based training to promote responsible self-medication in East Java, Indonesia.

    Science.gov (United States)

    Setiadi, Adji P; Wibowo, Yosi; Setiawan, Eko; Presley, Bobby; Mulyono, Ika; Wardhani, Ari S; Sunderland, Bruce

    2018-05-24

    To explore pharmacist/pharmacy staff trainers' perspectives on conducting community-based training to promote responsible self-medication, and to evaluate knowledge gained among community representatives participating in the training. Training was conducted in four districts/cities in East Java, Indonesia in 2016. A pre-test/post-test study was used to evaluate the knowledge of 129 community representatives (participants) before/after the training; pre-test and post-test scores as well as absolute gain were determined. Four focus group discussions with 20 pharmacist/pharmacy staff (trainers) were conducted after the training, and the data were thematically analysed. Overall mean test scores for community representatives significantly improved from 14.11 to 15.70 after the training (P < 0.001). The average total absolute gain was 1.85 (95% CI 1.29 to 2.39). To reach local communities, trainers suggested improvements to the content and structure of the module, training aids, trainer competency, approach and time allocation. Community-based training provides a potential strategy to improve community knowledge of medications. Findings from this study should inform strategies for a broader uptake amongst local communities in Indonesia. © 2018 Royal Pharmaceutical Society.

  13. The Technical Efficiency of Earthquake Medical Rapid Response Teams Following Disasters: The Case of the 2010 Yushu Earthquake in China.

    Science.gov (United States)

    Liu, Xu; Tang, Bihan; Yang, Hongyang; Liu, Yuan; Xue, Chen; Zhang, Lulu

    2015-12-04

    Performance assessments of earthquake medical rapid response teams (EMRRTs), particularly the first responders deployed to the hardest hit areas following major earthquakes, should consider efficient and effective use of resources. This study assesses the daily technical efficiency of EMRRTs in the emergency period immediately following the 2010 Yushu earthquake in China. Data on EMRRTs were obtained from official daily reports of the general headquarters for Yushu earthquake relief, the emergency office of the National Ministry of Health, and the Health Department of Qinghai Province, for a sample of data on 15 EMRRTs over 62 days. Data envelopment analysis was used to examine the technical efficiency in a constant returns to scale model, a variable returns to scale model, and the scale efficiency of EMRRTs. Tobit regression was applied to analyze the effects of corresponding influencing factors. The average technical efficiency scores under constant returns to scale, variable returns to scale, and the scale efficiency scores of the 62 units of analysis were 77.95%, 89.00%, and 87.47%, respectively. The staff-to-bed ratio was significantly related to global technical efficiency. The date of rescue was significantly related to pure technical efficiency. The type of institution to which an EMRRT belonged and the staff-to-bed ratio were significantly related to scale efficiency. This study provides evidence that supports improvements to EMRRT efficiency and serves as a reference for earthquake emergency medical rapid assistance leaders and teams.

  14. Influence of stimulant medication and response speed on lateralization of movement-related potentials in attention-deficit/hyperactivity disorder.

    Directory of Open Access Journals (Sweden)

    Stephan Bender

    Full Text Available BACKGROUND: Hyperactivity is one of the core symptoms in attention deficit hyperactivity disorder (ADHD. However, it remains unclear in which way the motor system itself and its development are affected by the disorder. Movement-related potentials (MRP can separate different stages of movement execution, from the programming of a movement to motor post-processing and memory traces. Pre-movement MRP are absent or positive during early childhood and display a developmental increase of negativity. METHODS: We examined the influences of response-speed, an indicator of the level of attention, and stimulant medication on lateralized MRP in 16 children with combined type ADHD compared to 20 matched healthy controls. RESULTS: We detected a significantly diminished lateralisation of MRP over the pre-motor and primary motor cortex during movement execution (initial motor potential peak, iMP in patients with ADHD. Fast reactions (indicating increased visuo-motor attention led to increased lateralized negativity during movement execution only in healthy controls, while in children with ADHD faster reaction times were associated with more positive amplitudes. Even though stimulant medication had some effect on attenuating group differences in lateralized MRP, this effect was insufficient to normalize lateralized iMP amplitudes. CONCLUSIONS: A reduced focal (lateralized motor cortex activation during the command to muscle contraction points towards an immature motor system and a maturation delay of the (pre- motor cortex in children with ADHD. A delayed maturation of the neuronal circuitry, which involves primary motor cortex, may contribute to ADHD pathophysiology.

  15. Shaken but prepared: Analysis of disaster response at an academic medical centre following the Boston Marathon bombings.

    Science.gov (United States)

    Osgood, Robert; Scanlon, Courtney; Jotwani, Rohan; Rodkey, Daniel; Arshanskiy, Maria; Salem, Deeb

    Over the last decade, there has been a rise in the number of mass casualty incidences (MCIs) and their subsequent effect on hospital systems. While there has been much discussion over improving procedures to treat victims of MCIs, there has not been a thorough, systems-based analysis concerning the costs incurred by hospitals during such events. Here the authors examine the history of the Hospital Incident Command Center and how its evolution at Tufts Medical Center helped mitigate the damage following the Boston Marathon Bombings. Tufts' unique variations to the Hospital Incident Command Center include strategic communication hierarchies and a 'zero cost centre' financial system which both provided for a quick and adaptive response. Operating in collaboration with the Conference of Boston Teaching Hospitals encouraged coordination and preparation during emergency situations such as mass casualty events. The direct and indirect effects on Tufts Medical Center stemming from the Boston Marathon Bombings were analysed. Tufts MC treated 36 victims immediately following the MCI. The estimated total cost during the week of April 15 to April 19, 2013 was $776,051. The cost was primarily comprised of lost revenue from cancelled outpatient and inpatient hospital services, as well as expenses incurred due to overtime pay, salary expenses, PPE kits and hospitality services. Finally, the authors examine ways to reduce the future costs during emergency situations through increasing communication with employees, understanding the source of all direct expenses, and mitigating excess risk by developing partnerships with other hospital systems.

  16. The Technical Efficiency of Earthquake Medical Rapid Response Teams Following Disasters: The Case of the 2010 Yushu Earthquake in China

    Directory of Open Access Journals (Sweden)

    Xu Liu

    2015-12-01

    Full Text Available Purpose: Performance assessments of earthquake medical rapid response teams (EMRRTs, particularly the first responders deployed to the hardest hit areas following major earthquakes, should consider efficient and effective use of resources. This study assesses the daily technical efficiency of EMRRTs in the emergency period immediately following the 2010 Yushu earthquake in China. Methods: Data on EMRRTs were obtained from official daily reports of the general headquarters for Yushu earthquake relief, the emergency office of the National Ministry of Health, and the Health Department of Qinghai Province, for a sample of data on 15 EMRRTs over 62 days. Data envelopment analysis was used to examine the technical efficiency in a constant returns to scale model, a variable returns to scale model, and the scale efficiency of EMRRTs. Tobit regression was applied to analyze the effects of corresponding influencing factors. Results: The average technical efficiency scores under constant returns to scale, variable returns to scale, and the scale efficiency scores of the 62 units of analysis were 77.95%, 89.00%, and 87.47%, respectively. The staff-to-bed ratio was significantly related to global technical efficiency. The date of rescue was significantly related to pure technical efficiency. The type of institution to which an EMRRT belonged and the staff-to-bed ratio were significantly related to scale efficiency. Conclusions: This study provides evidence that supports improvements to EMRRT efficiency and serves as a reference for earthquake emergency medical rapid assistance leaders and teams.

  17. Analysing data from observer studies in medical imaging research: An introductory guide to free-response techniques

    International Nuclear Information System (INIS)

    Thompson, J.D.; Manning, D.J.; Hogg, P.

    2014-01-01

    Observer performance methods maintain their place in radiology research, particularly in the assessment of the diagnostic accuracy of new and existing techniques, despite not being fully embraced by the wider audience in medical imaging. The receiver operating characteristic (ROC) paradigm has been widely used in research and the latest location sensitive methods allow an analysis that is closer to the clinical scenario. This paper discusses the underpinning theories behind observer performance assessment, exploring the potential sources of error and the development of the ROC method. The paper progresses by explaining the clinical relevance and statistical suitability of the free-response ROC (FROC) paradigm, and the methodological considerations for those wishing to perform an observer performance study

  18. Physical and Digital Design of the BlueBio Biomonitoring System Prototype, to be used in Emergency Medical Response

    DEFF Research Database (Denmark)

    Kramp, Gunnar; Kristensen, Margit; Pedersen, Jacob Frølund

    2007-01-01

    This paper presents the physical and digital design of a wireless biomonitoring system meant to be used especially in the prehospital medical emergency response. The handling of many patients with a minimum of ressources at major incidents is an immense challenge for the emergency personnel at work...... on an accident site. New technology such as the BlueBio biomonitoring system, can help emergency personnel monitor the patients and support them in making priorities of treatment and transport of patients. However, if new technology is to be introduced in such a complex and stressed situation it must relate...... to the palpable aspects of pervasive computing. It must be able to comply with the scale of the situation and still be understandable. It must also be able to comply with change of location and users and yet still be stable, and it must comply with the shifting requirements from the users regarding automation...

  19. Digitoxin medication and cancer; case control and internal dose-response studies

    International Nuclear Information System (INIS)

    Haux, Johan; Klepp, Olbjørn; Spigset, Olav; Tretli, Steinar

    2001-01-01

    Digitoxin induces apoptosis in different human malignant cell lines in vitro. In this paper we investigated if patients taking digitoxin for cardiac disease have a different cancer incidence compared to the general population. Computer stored data on digitoxin concentrations in plasma from 9271 patients with cardiac disease were used to define a user population. Age and sex matched controls from the Norwegian Cancer Registry were used to calculate the number of expected cancer cases. The population on digitoxin showed a higher incidence of cancer compared to the control population. However, an additional analysis showed that the population on digitoxin had a general increased risk of cancer already, before the start on digitoxin. Leukemia/lymphoma were the cancer types which stood out with the highest risk in the digitoxin population before starting on digitoxin. This indicates that yet unknown risk factors exist for cardiovascular disease and lymphoproliferative cancer. An internal dose-response analysis revealed a relationship between high plasma concentration of digitoxin and a lower risk for leukemia/lymphoma and for cancer of the kidney/urinary tract. Morbidity and mortality are high in the population on digitoxin, due to high age and cardiac disease.These factors disturb efforts to isolate an eventual anticancer effect of digitoxin in this setting. Still, the results may indicate an anticancer effect of digitoxin for leukemia/lymphoma and kidney/urinary tract cancers. Prospective clinical cancer trials have to be done to find out if digitoxin and other cardiac glycosides are useful as anticancer agents

  20. Traumatic Stress, Depression, and Recovery: Child and Parent Responses After Emergency Medical Care for Unintentional Injury.

    Science.gov (United States)

    Kassam-Adams, Nancy; Bakker, Anne; Marsac, Meghan L; Fein, Joel A; Winston, Flaura Koplin

    2015-11-01

    To assess psychological symptoms in injured children (aged 8-17 years) and their parents after emergency department (ED) care to examine the relationship between posttraumatic stress and depression symptoms, co-occurrence of symptoms within families, and the relationship of these symptoms to parent-reported overall recovery. Children and parents (n = 263 child-parent dyads) were enrolled during ED treatment for unintentional injury. Approximately 5 months later, children and parents (n = 178 dyads) completed standardized measures of posttraumatic stress and depression symptoms and parents reported on child overall recovery. Follow-up assessments found significant posttraumatic stress symptoms in 15% of children and 5% of parents, significant depression symptoms in 13% of children and 16% of parents, and problematic overall recovery in 17% of children. For both children and parents, posttraumatic stress and depression symptom severity were strongly associated. Child and parent symptoms were only modestly associated with each other, and there were few families in which both child and parent had significant posttraumatic stress or depression. Parent symptoms, but not child symptoms, were inversely associated with children's overall recovery. For about 1 in 6 children and parents, unintentional injury treated in the ED can be associated with negative psychological sequelae and suboptimal recovery. Within families, child and parent responses may differ; their relative association with overall recovery deserves additional research. To promote emotional recovery, ED clinicians should be aware of the potential psychological impact of unintentional injury, provide timely evidence-based anticipatory guidance, and communicate these concerns to primary care clinicians.

  1. CPR and the RCP (2). Training of students and doctors in UK medical schools.

    Science.gov (United States)

    Gillard, J H; Dent, T H; Jolly, B C; Wallis, D A; Hicks, B H

    1993-10-01

    We asked British medical schools and teaching hospitals about the training they offer to medical students and hospital doctors in cardiopulmonary resuscitation. The response rate was 96%. Training that is practical and consistent with guidelines is offered to nearly all students and house officers, often by consultants. Training for other junior doctors and consultants is much less common. The organisation of training is haphazard, and many hospitals have no resuscitation training officers. As a result, few doctors receive the frequent retraining needed to maintain competence in managing cardiopulmonary arrest.

  2. Attention-Deficit/Hyperactivity Disorder Medication Treatment Impact on Response to Growth Hormone Therapy: Results from the ANSWER Program, a Non-Interventional Study.

    Science.gov (United States)

    Rose, Susan R; Reeves, Grafton; Gut, Robert; Germak, John

    2015-12-01

    To examine whether attention-deficit/hyperactivity disorder (ADHD) stimulant medication modified the linear growth response to growth hormone (GH) treatment in children enrolled in the American Norditropin Studies: Web-Enabled Research Program. Short, GH treatment-naive children with or without GH deficiency (GHD) received GH therapy. A subset also received ADHD stimulant medication (n = 1190), and others did not (n = 7230). Linear mixed models (adjusted means) examined height SDS (HSDS) and body mass index (BMI) SDS from baseline through year 4. Analyses were repeated with ADHD groups matched for baseline age, height, weight, BMI, and sex. Groups with and without GHD were compared between ADHD groups. Adjusted change in HSDS for the group receiving ADHD stimulant medication was slightly lower than that for patients not receiving stimulant medication at years 1 to 4 (P -2. Year 4 adjusted change in BMI SDS was greater in the patients receiving ADHD stimulant medication compared with both groups not receiving ADHD stimulant medication (P growth response of children treated with GH when those receiving or not receiving ADHD stimulant medication were matched for baseline measurements. Underlying reasons for the observed greater increase in BMI in patients with GHD concomitantly treated with ADHD medication remain to be elucidated. ClinicalTrials.gov: NCT01009905. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  3. The nature and causes of attrition in the British Household Panel Study

    OpenAIRE

    Uhrig, S.C. Noah

    2008-01-01

    Panel attrition is a process producing data absent from panel records due to survey non-participation or other data unavailability. I examine the nature and causes of attrition resulting from non-contact and survey refusal in the British Household Panel Study. Focusing on non-response transitions amongst Wave 1 respondents using discrete time transition models, I locate attrition at first non-response over the first 14 waves. Physical impediments to contact, less time spent at home and high l...

  4. Digitoxin medication and cancer; case control and internal dose-response studies

    Directory of Open Access Journals (Sweden)

    Spigset Olav

    2001-08-01

    Full Text Available Abstract Background Digitoxin induces apoptosis in different human malignant cell lines in vitro. In this paper we investigated if patients taking digitoxin for cardiac disease have a different cancer incidence compared to the general population. Methods Computer stored data on digitoxin concentrations in plasma from 9271 patients with cardiac disease were used to define a user population. Age and sex matched controls from the Norwegian Cancer Registry were used to calculate the number of expected cancer cases. Results The population on digitoxin showed a higher incidence of cancer compared to the control population. However, an additional analysis showed that the population on digitoxin had a general increased risk of cancer already, before the start on digitoxin. Leukemia/lymphoma were the cancer types which stood out with the highest risk in the digitoxin population before starting on digitoxin. This indicates that yet unknown risk factors exist for cardiovascular disease and lymphoproliferative cancer. An internal dose-response analysis revealed a relationship between high plasma concentration of digitoxin and a lower risk for leukemia/lymphoma and for cancer of the kidney/urinary tract. Conclusion Morbidity and mortality are high in the population on digitoxin, due to high age and cardiac disease.These factors disturb efforts to isolate an eventual anticancer effect of digitoxin in this setting. Still, the results may indicate an anticancer effect of digitoxin for leukemia/lymphoma and kidney/urinary tract cancers. Prospective clinical cancer trials have to be done to find out if digitoxin and other cardiac glycosides are useful as anticancer agents.

  5. Mortality from cancer and all causes among British radiologists

    International Nuclear Information System (INIS)

    Smith, P.G.; Doll, R.

    1981-01-01

    The mortality of men who joined a British radiological society between 1897 and 1954 has been compared with that of (i) all men in England and Wales, (ii) men in social class 1, and (iii) male medical practitioners. Radiologists who entered the profession before 1921 suffered a death rate from cancer 75% higher than that of medical practitioners. Among these men there was a statistically significant excess of deaths from cancers of the pancreas (6 against 1.9 expected), lung (8 against 3.7), and skin (6 against 0.8), and from leukaemia (4 against 0.7). There were 72 deaths from cancer among men who entered the study after 1920 and 68.6 deaths were expected, based upon rates among medical practitioners. For no individual cancer site did the observed number of deaths exceed the expected number. There was some evidence, however, that the ratio of observed to expected cancer increased with the duration of time that men were included in the study. Among those followed for more than 30 years there were 30 deaths against 22.1 expected. It is not possible to make a close estimate of the dose of radiation received by the men in this study, but those who entered between 1920 and 1945 could have received an accumulated whole-body dose of the order of 1-5 Gy(100 to 500 rad). For all non-cancer causes of death combined, the death rate among radiologists is lower than that among all men in England and Wales, men in social class 1, and male medical practitioners. The data offer no support for the concept of a non-specific aging effect of radiation. (author)

  6. Malaria in inter-war British India.

    Science.gov (United States)

    Bynum, W F

    2000-06-01

    British India was an important site of much important malaria research. Although Ronald Ross left India in 1899, a number of malariologists continued the task of evaluating the incidence and distribution of malaria in the country. Implementing practical solutions was hampered by formidable social and economic problems. This paper examines the Indian situation in the late 1920s, through a retrospective selection of writings chosen by J.A. Sinton for reproduction in an early issue of 'The records of the malaria survey of India', and the analysis of the Indian malaria situation through a visit of the League of Nations Malaria Commission in 1929.

  7. The Labour Party and British Republicanism

    Directory of Open Access Journals (Sweden)

    Kenneth O. MORGAN

    2003-10-01

    Full Text Available The famous detective, Sherlock Holmes, once solved a case by referring to “the dog that did not bark.” In the past 250 years of British history, republicanism is another dog that did not bark. This is particularly true of supposedly our most radical major political party, the Labour Party. Over the monarchy, as over constitutional matters generally, Labour’s instincts have been conservative. Even after 1997, when the party, led by Lord Irvine, has indeed embarked upon major constitutional ref...

  8. Race, history, and black British jazz

    OpenAIRE

    Toynbee, Jason

    2013-01-01

    This article traces the history of black British jazz across five moments from 1920 to the present. It also makes a theoretical argument about the nature of race and its connection both with music and belonging to the nation. Race is indeed a musical-discursive construction, as has been argued in the literature about culture and ethnicity over the last thirty years or so. But it is a social structure too, and the contradictions that result are key to understanding the race-music relationship.

  9. Relationship Between Emergency Medical Services Response Time and Bystander Intervention in Patients With Out-of-Hospital Cardiac Arrest.

    Science.gov (United States)

    Goto, Yoshikazu; Funada, Akira; Goto, Yumiko

    2018-04-27

    The response time of emergency medical services (EMS) is an important determinant of survival after out-of-hospital cardiac arrest. We sought to identify upper limits of EMS response times and bystander interventions associated with neurologically intact survival. We analyzed the records of 553 426 patients with out-of-hospital cardiac arrest in a Japanese registry between 2010 and 2014. The primary study end point was 1-month neurologically intact survival (Cerebral Performance Category scale 1 or 2). Increased EMS response time was associated with significantly decreased adjusted odds of 1-month neurologically intact survival (adjusted odds ratio [aOR] for each 1-minute increase, 0.89; 95% confidence interval [CI], 0.89-0.90), although this relationship was modified by bystander interventions. The bystander interventions and the ranges of EMS response times that were associated with increased adjusted 1-month neurologically intact survival were as follows: bystander defibrillation, from ≤2 minutes (aOR, 3.10 [95% CI, 1.25-7.31]) to 13 minutes (aOR, 5.55 [95% CI, 2.66-11.2]); bystander conventional cardiopulmonary resuscitation, from 3 minutes (aOR 1.48 [95% CI, 1.02-2.12]) to 11 minutes (aOR 2.41 [95% CI, 1.61-3.56]); and bystander chest-compression-only cardiopulmonary resuscitation, from ≤2 minutes (aOR 1.57 [95% CI, 1.01-2.25]) to 11 minutes (aOR 1.92 [95% CI, 1.45-2.56]). However, the increase in neurologically intact survival of those receiving bystander interventions became statistically insignificant compared with no bystander interventions when the EMS response time was outside these ranges. The upper limits of the EMS response times associated with improved 1-month neurologically intact survival were 13 minutes when bystanders provided defibrillation (typically with cardiopulmonary resuscitation) and 11 minutes when bystanders provided cardiopulmonary resuscitation without defibrillation. © 2018 The Authors. Published on behalf of the

  10. [Medical technology and medical education].

    Science.gov (United States)

    von Mallek, D; Biersack, H-J; Mull, R; Wilhelm, K; Heinz, B; Mellert, F

    2010-08-01

    The education of medical professionals is divided into medical studies, postgraduate training leading to the qualification as a specialist, and continuing professional development. During education, all scientific knowledge and practical skills are to be acquired, which enable the physician to practice responsibly in a specialized medical area. In the present article, relevant curricula are analyzed regarding the consideration of medical device-related topics, as the clinical application of medical technology has reached a central position in modern patient care. Due to the enormous scientific and technical progress, this area has become as important as pharmacotherapy. Our evaluation shows that medical device-related topics are currently underrepresented in the course of medical education and training and should be given greater consideration in all areas of medical education. Possible solutions are presented.

  11. The truth behind british politeness: some misinterpretations

    Directory of Open Access Journals (Sweden)

    Peixoto, Rafael Marcos Tort

    2014-01-01

    Full Text Available The purpose of this paper is to analyse a chart published by the British newspaper The Telegraphabout the most common misunderstandings foreigners face while making use of English as their second language. L2 speakers are said to take every word at face value and therefore making some pragmatic mistakes. Sometimes there can be another meaning behind the spoken words, like it is unsaid for a reason. The pragmatics theories of irony in Attardo (1999 shed light on these translating and intercultural awareness issues by explaining what is behind the misunderstanding which is the secret ofthe so famous British politeness. Some considerations will be made upon the chart so as to understand it, such as an analysis of irony and native speakers’ perspectives on it. In addition to that, we will take into account the opinion of some native speakers of English to unveil some details and clarify how meaningful some sentences may be and if the researched chart is actually accurate

  12. The Ruins of the British Welfare State

    Directory of Open Access Journals (Sweden)

    Tahl Kaminer

    2014-08-01

    Full Text Available The subjects of Owen Hatherley’s A Guide to the New Ruins of Great Britain are architecture and urban development. The book addresses also some broader cultural, political and economic references, as well as personal anecdotes and memories. It includes many encounters with the remnants of the British welfare state.As an extension to his blog postings and a sequel of sorts to his previous Militant Modernism, Hatherley’s antagonist here is the semi-official architecture of New Labour, which he terms ‘pseudomodernism’: an unimaginative, inferior, and, in its own specific way, also tacky architecture of white stucco, steel and glass. He attacks the Faustian bargain of Richard Rogers and his allies with neoliberalism, a pact that produces a modernism devoid of social content, reflected by the unimaginative, speculation-driven architectural design. While Hatherley produces the promised indictment of recent British architecture, the book is, at the end of the day, primarily a eulogy to the disappearing postwar architecture he so evidently loves.

  13. Precocious albion: A new interpretation of the British Industrial Revolution

    OpenAIRE

    Kelly, Morgan; Mokyr, Joel; Ó Gráda, Cormac

    2013-01-01

    Many explanations have been offered for the British Industrial Revolution. This article points to the importance of human capital (broadly defined) and the quality of the British labor force on the eve of the Industrial Revolution. It shows that in terms of both physical quality and mechanical skills, British workers around 1750 were at a much higher level than their continental counterparts. As a result, new inventions—no matter where they originated—were adopted earlier, faster, and on a la...

  14. Glocal routes in British Asian drama: Between adaptation and tradaptation

    OpenAIRE

    Buonanno, Giovanna; Sams, Victoria; Schlote, Christiane

    2011-01-01

    In the context of British Asian theatre and the search for a diasporic theatre aesthetics the practice of adaptation has emerged as a recurring feature. Over the last decades, British Asian theatre has sought to create a language of the theatre that can reflect the cultural heritage of Asians in Britain; this search has taken different directions testified also by the plurality of voices that today make up British Asian theatre and has responded to the need to challenge the conceptual binary ...

  15. (Mismanaging labour markets? The decline of the contemporary global labour market for British seafarers.

    Directory of Open Access Journals (Sweden)

    S. Ruggunan

    2010-12-01

    Full Text Available Purpose: The purpose of this article is to investigate the ways in which states are still significant actors in creating and shaping the nature and characteristics of global labour markets. My argument is demonstrated through an empirical case study of the global labour market for British seafarers. Problem Investigated: The last 30 years has witnessed a decimation of the number of employed British seafarers, particularly at lower rank levels, such as ratings. I contend that despite Britain's long and rich maritime history, the British state has not acted meaningfully to reverse the decline of British seafarers. The lack of meaningful action I contend is an attempt to crew British owned ships with cheaper seafaring labour from Asia, particularly south east Asia. In so doing the British state has contributed to the decline of a once thriving labour market. There has simultaneously been an upsurge in the employment of seafarers of other nationalities, and thus the creation of new labour markets in countries such as the Philippines. This paper is an attempt to understand some of the factors responsible for the decline of the British labour market for seafarers. Methodology and Approach: This paper is the outcome of a larger qualitative study undertaken for my doctoral thesis in industrial sociology which examined the transformation of the global labour market for South African, Filipino and British seafarers. The methodology consists of in depth interviews with maritime officials and trade union leaders. These were conducted in person in London, United Kingdom between 2005 and 2008. These interviews are supported by extensive literature and documentary research, to validate, support and test claims made by my interviewees. Implications and Value of the Research: The theoretical contribution of this paper is to reinsert the state more critically into the literature on labour markets. Empirically, seafaring labour markets are largely ignored by the

  16. Attitudes and diagnostic practice in low back pain: A qualitative study amongst Greek and British physiotherapists.

    Science.gov (United States)

    Billis, Evdokia; McCarthy, Christopher J; Gliatis, John; Matzaroglou, Charalampos; Oldham, Jacqueline A

    2016-09-18

    To explore current diagnostic practice and attitudes of Greek and United Kingdom physiotherapists (PTs) on assessing low back pain (LBP) patients. Three focus groups were undertaken, followed by a structured questionnaire-type survey comprising 23 health professionals and a random stratified sample of 150 PTs, respectively. Twenty-nine themes relating to LBP diagnostic practice emerged. These were then given to 30 British PTs assessing their level of agreement with their Greek counterparts. Analysis was performed by percentage agreements and χ (2) tests. The survey was divided into three subsections; PTs' attitudes on LBP assessment, patients' attitudes and diagnostic/healthcare issues, each constituting 14, 7 and 8 statements, respectively. Over half of the statements fell within the 30%-80% agreement between Greece and United Kingdom whereas, 5 statements reported low ( 90%) PT percentage agreement. Similarities across British and Greek PTs were detected in history taking methods and in the way PTs feel patients perceive physiotherapy practice whereas, re-assessment was undertaken less frequently in Greece. Diagnosis according to 91% of the Greek PTs is considered a "privilege" which is exclusive for doctors in Greece (only 17% British PTs agreed) and is accompanied with a great overuse of medical investigations. Forty percent of Greek PTs (compared to 0% of British) consider themselves as "executers", being unable to interfere with treatment plan, possibly implying lack of autonomy. Although similarities on history taking methods and on patients' attitudes were detected across both groups, gross differences were found in re-assessment procedures and diagnostic issues between Greek and British physiotherapists, highlighting differences in service delivery and professional autonomy.

  17. The payment for performance model and its influence on British general practitioners' principles and practice.

    Science.gov (United States)

    Norman, Armando Henrique; Russell, Andrew J; Macnaughton, Jane

    2014-01-01

    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.

  18. On the road to becoming a responsible leader: A simulation-based training approach for final year medical students.

    Science.gov (United States)

    Schmidt-Huber, Marion; Netzel, Janine; Kiesewetter, Jan

    2017-01-01

    Background and objective: There is a need for young physicians to take a responsible role in clinical teams, comparable to a leadership role. However, today's medical curricula barely consider the development of leadership competencies. Acquisition of leadership skills are currently a by-product of medical education, even though it seems to be a competency relevant for physicians' success. Therefore, an innovative leadership training program for young physicians was developed and validated. Training conceptualisation were based upon findings of critical incidents interviews ( N =19) with relevant personnel (e.g. experienced doctors/nurses, residents) and upon evidence-based leadership contents focusing on ethical leadership behaviors. Method: The training consists of four sessions (3-4 hours each) and provided evidence-based lectures of leadership theory and effective leader behaviors, interactive training elements and a simulation-based approach with professional role players focusing on interprofessional collaboration with care staff. Training evaluation was assessed twice after completion of the program ( N =37). Assessments included items from validated and approved evaluation instruments regarding diverse learning outcomes (satisfaction/reaction, learning, self-efficacy, and application/transfer) and transfer indicators. Furthermore, training success predictors were assessed based on stepwise regression analysis. In addition, long-term trainings effects and behavioral changes were analysed. Results: Various learning outcomes are achieved (self-reported training satisfaction, usefulness of the content and learning effects) and results show substantial transfer effects of the training contents and a strengthened awareness for the leadership role (e.g. self-confidence, ideas dealing with work-related problems in a role as responsible physician). We identified competence of trainer, training of applied tools, awareness of job expectations, and the opportunity to

  19. On the road to becoming a responsible leader: A simulation-based training approach for final year medical students

    Directory of Open Access Journals (Sweden)

    Schmidt-Huber, Marion

    2017-08-01

    Full Text Available Background and objective: There is a need for young physicians to take a responsible role in clinical teams, comparable to a leadership role. However, today’s medical curricula barely consider the development of leadership competencies. Acquisition of leadership skills are currently a by-product of medical education, even though it seems to be a competency relevant for physicians’ success. Therefore, an innovative leadership training program for young physicians was developed and validated. Training conceptualisation were based upon Method: The training consists of four sessions (3-4 hours each and provided evidence-based lectures of leadership theory and effective leader behaviors, interactive training elements and a simulation-based approach with professional role players focusing on interprofessional collaboration with care staff. Training evaluation was assessed twice after completion of the program (=37. Assessments included items from validated and approved evaluation instruments regarding diverse learning outcomes (satisfaction/reaction, learning, self-efficacy, and application/transfer and transfer indicators. Furthermore, training success predictors were assessed based on stepwise regression analysis. In addition, long-term trainings effects and behavioral changes were analysed. Results: Various learning outcomes are achieved (self-reported training satisfaction, usefulness of the content and learning effects and results show substantial transfer effects of the training contents and a strengthened awareness for the leadership role (e.g. self-confidence, ideas dealing with work-related problems in a role as responsible physician. We identified competence of trainer, training of applied tools, awareness of job expectations, and the opportunity to learn from experiences of other participants as predictors of training success. Additionally, we found long-term training effects and participants reported an increase in specific

  20. The broad spectrum of preclinical radiobiology: British contributions

    International Nuclear Information System (INIS)

    Denekamp, Juliana

    1996-01-01

    British radiobiologists have often been at the forefront in taking clinical questions into the laboratory and in taking the results back into the clinic, i.e., what is nowadays labeled as Translational Research. They have published widely and have been very active in lectures, workshops, and discussions, forming an important component of the international communication web, both within the basic science aspects and in the translation from science to medicine, and back again. Major contributions have been made at the cellular and subcellular level, and at the level of multicellular structures, both normal and malignant. The common features of the response of cells to single doses in well-defined conditions have been used to interpret the much greater complexity of tissue and tumor responses treated with repeated small doses in a fractionated course, both of photons and other radiations, with and without chemical modifiers. The many contributions to the field of cell kinetics have provided the tools with which an understanding has been gained of the latency and evolution of radiation damage in different tissues. The prolonged interest in microenvironmental gradients and compensatory responses to injury have provided a framework for designing better radiotherapy schedules, and considerable spin-off to other branches of cancer therapy

  1. Development and evaluation of a new simulation model for interactive training of the medical response to major incidents and disasters.

    Science.gov (United States)

    Lennquist Montán, K; Hreckovski, B; Dobson, B; Örtenwall, P; Montán, C; Khorram-Manesh, A; Lennquist, S

    2014-08-01

    The need for and benefit of simulation models for interactive training of the response to major incidents and disasters has been increasingly recognized during recent years. One of the advantages with such models is that all components of the chain of response can be trained simultaneously. This includes the important communication/coordination between different units, which has been reported as the most common cause of failure. Very few of the presently available simulation models have been suitable for the simultaneous training of decision-making on all levels of the response. In this study, a new simulation model, originally developed for the scientific evaluation of methodology, was adapted to and developed for the postgraduate courses in Medical Response to Major Incidents (MRMI) organized under the auspices of the European Society for Trauma and Emergency Surgery (ESTES). The aim of the present study was to describe this development process, the model it resulted in, and the evaluation of this model. The simulation model was based on casualty cards giving all information normally available for the triage and primary management of traumatized patients. The condition of the patients could be changed by the instructor according to the time passed since the time of injury and treatments performed. Priority of the casualties as well as given treatments could be indicated on the cards by movable markers, which also gave the time required for every treatment. The exercises were run with real consumption of time and resources for all measures performed. The magnetized cards were moved by the trainees through the scene, through the transport lines, and through the hospitals where all functions were trained. For every patient was given the definitive diagnosis and the times within certain treatments had to be done to avoid preventable mortality and complications, which could be related to trauma-scores. The methodology was tested in nine MRMI courses with a total of

  2. Training for the medical response in radiological emergency experiences and results; Capacitacion para la respuesta medica en emergencias radiologicas experiencias y resultados

    Energy Technology Data Exchange (ETDEWEB)

    Cardenas Herrera, J.; Lopez Forteza, Y.

    2003-07-01

    The use of the nuclear techniques in the social practice confers a special imporatnce to the relative aspects to the safety of the practices and radiationsources, for what the implementation of efficient programs of radiation protection constitutes a priority. However in spite of the will before expressed, regrettably radiological situations happen accidental assocaited to multiple causes taht suggest the creation of response capacities to intervention before these fortuitous facts. The experiences accumulated in the last decades related with accidental exposures have evidenced the convenience of having properly qualified human resources for the Medical Response in Radiological Emergencies. The training in the medical aspects of the radiological emergencies acquires a singular character. In such a sense when valuing the national situation put onof manifest deficiences as for the training in medical aspects of the radiological emergencies that advised the development of training programs in such aspects for the different response groups linked to the topic. After identified the training necessities and the scope of the same ones, the contents of the training program were elaborated. The program has as general purpose the invigoration of the capacity of the medical response in front of accidental radiological situations, by means of actions that they bear to prepare groups of medical response in the handling of people accident victims and to the identification of potentials,accidental scenarios, as well as of the necessary resources to confront them. The program content approaches theoretical and paractical aspects to the medical aspect to radiological emergencies. The program include the different topics about fundamental of physical biological to radiation protection, radiation protection during exposure of radiological accidents, medical care for overexposed or contaminated persons, drill, exercises and concludes with designation of a strategy as preparation and

  3. 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.

  4. Strategies to Maximize Data Collection Response Rates in a Randomized Control Trial Focused on Children with Medical Complexity.

    Science.gov (United States)

    Finkelstein, Stanley M; Celebrezze, Margaret; Cady, Rhonda; Lunos, Scott; Looman, Wendy S

    2016-04-01

    Obtaining complete and timely subject data is key to the success of clinical trials, particularly for studies requiring data collected from subjects at home or other remote sites. A multifaceted strategy for data collection in a randomized controlled trial (RCT) focused on care coordination for children with medical complexity is described. The influences of data collection mode, incentives, and study group membership on subject response patterns are analyzed. Data collection included monthly healthcare service utilization (HCSU) calendars and annual surveys focused on care coordination outcomes. One hundred sixty-three families were enrolled in the 30-month TeleFamilies RCT. Subjects were 2-15 years of age at enrollment. HCSU data were collected by parent/guardian self-report using mail, e-mail, telephone, or texting. Surveys were collected by mail. Incentives were provided for completed surveys after 8 months to improve collection returns. Outcome measures were the number of HCSU calendars and surveys returned, the return interval, data collection mode, and incentive impact. Return rates of 90% for HCSU calendars and 82% for annual surveys were achieved. Mean return intervals were 72 and 65 days for HCSU and surveys, respectively. Survey response increased from 55% to 95% after introduction of a gift card and added research staff. High return rates for HCSU calendars and health-related surveys are attainable but required a flexible and personnel-intensive approach to collection methods. Family preference for data collection approach should be obtained at enrollment, should be modified as needed, and requires flexible options, training, intensive staff/family interaction, and patience.

  5. Using Audience Response Technology to provide formative feedback on pharmacology performance for non-medical prescribing students - a preliminary evaluation

    Science.gov (United States)

    2012-01-01

    Background The use of anonymous audience response technology (ART) to actively engage students in classroom learning has been evaluated positively across multiple settings. To date, however, there has been no empirical evaluation of the use of individualised ART handsets and formative feedback of ART scores. The present study investigates student perceptions of such a system and the relationship between formative feedback results and exam performance. Methods Four successive cohorts of Non-Medical Prescribing students (n=107) had access to the individualised ART system and three of these groups (n=72) completed a questionnaire about their perceptions of using ART. Semi-structured interviews were carried out with a purposive sample of seven students who achieved a range of scores on the formative feedback. Using data from all four cohorts of students, the relationship between mean ART scores and summative pharmacology exam score was examined using a non-parametric correlation. Results Questionnaire and interview data suggested that the use of ART enhanced the classroom environment, motivated students and promoted learning. Questionnaire data demonstrated that students found the formative feedback helpful for identifying their learning needs (95.6%), guiding their independent study (86.8%), and as a revision tool (88.3%). Interviewees particularly valued the objectivity of the individualised feedback which helped them to self-manage their learning. Interviewees’ initial anxiety about revealing their level of pharmacology knowledge to the lecturer and to themselves reduced over time as students focused on the learning benefits associated with the feedback. A significant positive correlation was found between students’ formative feedback scores and their summative pharmacology exam scores (Spearman’s rho = 0.71, N=107, pstudents rated the helpfulness of the individualised handsets and personalised formative feedback highly. The significant correlation between ART

  6. Effects of racial and ethnic group and health literacy on responses to genomic risk information in a medically underserved population.

    Science.gov (United States)

    Kaphingst, Kimberly A; Stafford, Jewel D; McGowan, Lucy D'Agostino; Seo, Joann; Lachance, Christina R; Goodman, Melody S

    2015-02-01

    Few studies have examined how individuals respond to genomic risk information for common, chronic diseases. This randomized study examined differences in responses by type of genomic information (genetic test/family history) and disease condition (diabetes/heart disease), and by race/ethnicity in a medically underserved population. 1,057 English-speaking adults completed a survey containing 1 of 4 vignettes (2-by-2 randomized design). Differences in dependent variables (i.e., interest in receiving genomic assessment, discussing with doctor or family, changing health habits) by experimental condition and race/ethnicity were examined using chi-squared tests and multivariable regression analysis. No significant differences were found in dependent variables by type of genomic information or disease condition. In multivariable models, Hispanics were more interested in receiving a genomic assessment than Whites (OR = 1.93; p literacy had greater interest than those with adequate health literacy. Blacks (OR = 1.78; p = .001) and Hispanics (OR = 1.85; p = .001) had greater interest in discussing information with family than Whites. Non-Hispanic Blacks (OR = 1.45; p = .04) had greater interest in discussing genomic information with a doctor than Whites. Blacks (β = -0.41; p literacy was negatively associated with number of health habits participants intended to change. Findings suggest that race/ethnicity may affect responses to genomic risk information. Additional research could examine how cognitive representations of this information differ across racial/ethnic groups. Health literacy is also critical to consider in developing approaches to communicating genomic information.

  7. Planning developments in British Nuclear Fuels Ltd

    Energy Technology Data Exchange (ETDEWEB)

    Roper, D A [British Nuclear Fuels Ltd., Risley

    1978-10-01

    The state of the corporate planning art in British Nuclear Fuels Ltd. was described by N.R.Geary (Long Range Planning, September (1973)) just 2 years after Company formation. This article discusses more recent planning developments over the period to date during which the Company adopted a Divisionalized structure (from October 1974) and has been required to submit an annual Company plan to the Department of Energy (from November 1975). Background information on the origin and nature of the BNFL and its business, and the particular features of the Company which reflect into the nature and method of its planning were given in the 1973 article and only a brief introductory updating of the Company position is included here. Subsequently the features and problems of BNFL's operating and development planning system are described. Finally, messages arising from BNFL's planning experience to date which may be of general application and therefore of value to other practitioners of planning are listed.

  8. Metaphyseal osteopathy in a British Shorthair cat.

    Science.gov (United States)

    Adagra, Carl; Spielman, Derek; Adagra, Angela; Foster, Darren J

    2015-04-01

    Metaphyseal osteopathy, otherwise known as hypertrophic osteodystrophy, is a disease that causes pyrexia and lethargy accompanied by pain in the thoracic and pelvic limbs of rapidly growing large-breed dogs. While metaphyseal osteopathy has been descibed in association with slipped capital femoral epiphysis in cats, it has not previously been reported as a cause of limb pain and pyrexia in this species. A 7-month-old British Shorthair cat presented with a 1 month history of pyrexia, lethargy and pain in all limbs. Investigation included radiographs of the limbs and chest, abdominal ultrasound, serum biochemical analysis, haematology, bone biopsy, joint fluid aspiration and cytology. Findings were consistent with a diagnosis of metaphyseal osteopathy. The cat's clinical signs resolved following the administration of prednisolone. Symptoms recurred 1 month after the cessation of prednisolone therapy, but resolved when administration was resumed. © ISFM and AAFP 2014.

  9. British Coal and the energy scene

    Energy Technology Data Exchange (ETDEWEB)

    Cruttenden, M G [British Coal Corporation, London (United Kingdom)

    1992-01-01

    This paper attempts to describe British Coal's (BCC) present position in a rapidly changing UK Energy Market where competition, with imported coal and with other fuels, particularly natural gas is likely to continue to increase. As a relatively high cost coal producer by world standards BCC, while continuing its efforts to improve productivity and lower costs, must work to enhance the value of its product in the market place both by improving quality to more closely match customers individual needs and by offering supporting services which ensure overall customer satisfaction. The paper explores each market sector and describes the steps which the Corporation is taking to improve its competitive position in each market with particular reference to quality standards and supporting services. Finally it attempts to forecast some possible new developments for the future. 3 tabs.

  10. Net metering in British Columbia : white paper

    International Nuclear Information System (INIS)

    Berry, T.

    2003-01-01

    Net metering was described as being the reverse registration of an electricity customer's revenue meter when interconnected with a utility's grid. It is a provincial policy designed to encourage small-distributed renewable power generation such as micro-hydro, solar energy, fuel cells, and larger-scale wind energy. It was noted that interconnection standards for small generation is an important issue that must be addressed. The British Columbia Utilities Commission has asked BC Hydro to prepare a report on the merits of net metering in order to support consultations on a potential net metering tariff application by the utility. This report provides information on net metering with reference to experience in other jurisdictions with net metering, and the possible costs and benefits associated with net metering from both a utility and consumer perspective. Some of the barriers and policy considerations for successful implementation of net metering were also discussed. refs., tabs., figs

  11. Tapering strategies in elite British endurance runners.

    Science.gov (United States)

    Spilsbury, Kate L; Fudge, Barry W; Ingham, Stephen A; Faulkner, Steve H; Nimmo, Myra A

    2015-01-01

    The aim of the study was to explore pre-competition training practices of elite endurance runners. Training details from elite British middle distance (MD; 800 m and 1500 m), long distance (LD; 3000 m steeplechase to 10,000 m) and marathon (MAR) runners were collected by survey for 7 days in a regular training (RT) phase and throughout a pre-competition taper. Taper duration was [median (interquartile range)] 6 (3) days in MD, 6 (1) days in LD and 14 (8) days in MAR runners. Continuous running volume was reduced to 70 (16)%, 71 (24)% and 53 (12)% of regular levels in MD, LD and MAR runners, respectively (P training (MD; 53 (45)%, LD; 67 (23)%, MAR; 64 (34)%, P training intensity was above race speed in LD and MAR runners (112 (27)% and 114 (3)%, respectively, P training undertaken prior to the taper in elite endurance runners is predictive of the tapering strategy implemented before competition.

  12. Wind energy sector in British Columbia

    International Nuclear Information System (INIS)

    2010-01-01

    British Columbia (BC) possesses significant wind energy resources, and many wind energy projects are currently in the planning phase or are already under construction. Wind power policies in the province have been designed to ensure the secure and orderly development of the wind power industry. Policies in the province include a 10-year exemption from participation rents for new projects as well as a policy that has established the maximum permissible noise levels for wind farms located near residential properties. BC's wind power development plan forms part of the province's aim to become electricity self-sufficient by 2016 while ensuring that clean or renewable energy generation accounts for at least 90 per cent of total generation. This guide provided an outline of the province's wind energy sector, and provided a listing of selected wind power operators. Details of new wind power projects were also presented. 11 fig.

  13. British American Tobacco's failure in Turkey.

    Science.gov (United States)

    Lawrence, S

    2009-02-01

    Transnational tobacco companies (TTCs) considered Turkey an important, potential investment market because of its high consumption rates and domestic commitment to tobacco. This paper outlines how British American Tobacco (BAT) attempted to establish a joint venture with the government monopoly TEKEL, while waiting for privatisation and a private tender. Analysis of tobacco industry documents from the Guildford Depository and online tobacco document sources. BAT failed to establish a market share in Turkey until 2000 despite repeated attempts to form a joint venture with Turkey's tobacco monopoly, TEKEL, once the market liberalised in the mid 1980s. BAT's failure in the Turkish market was due to a misguided investment strategy focused solely on acquiring TEKEL and is contrasted with Philip Morris success in Turkey despite both TTCs working within Turkey's unstable and corrupt investing climate.

  14. British standard (BS) 5750--quality assurance?

    Science.gov (United States)

    Pratt, D J

    1995-04-01

    BS5750 is the British Standard on "Quality Systems". Its equivalent in European Standards is EN29000 and in the International Standards Organisation ISO9000. This paper points out that these standards lay down formalised procedures and require documentation but do not ipso facto lead to quality assurance. The author points to the Japanese post-war industrial success as being an example of Total Quality Management within the framework provided by the philosophy of Dr. W. Edwards Deming (1988 and 1993). This philosophy on the management of "systems" to provide high quality products and services is briefly outlined. The author argues that improvement in prosthetic and orthotic services will not be reached through implementation of BS5750 but rather through radical rethinking and the adoption and application of the Deming philosophy.

  15. British torture in the 'war on terror'.

    Science.gov (United States)

    Blakeley, Ruth; Raphael, Sam

    2017-06-01

    Despite long-standing allegations of UK involvement in prisoner abuse during counterterrorism operations as part of the US-led 'war on terror', a consistent narrative emanating from British government officials is that Britain neither uses, condones nor facilitates torture or other cruel, inhuman or degrading treatment and punishment. We argue that such denials are untenable. We have established beyond reasonable doubt that Britain has been deeply involved in post-9/11 prisoner abuse, and we can now provide the most detailed account to date of the depth of this involvement. We argue that it is possible to identify a peculiarly British approach to torture in the 'war on terror', which is particularly well-suited to sustaining a narrative of denial. To explain the nature of UK involvement, we argue that it can be best understood within the context of how law and sovereign power have come to operate during the 'war on terror'. We turn here to the work of Judith Butler, and explore the role of Britain as a 'petty sovereign', operating under the state of exception established by the US executive. UK authorities have not themselves suspended the rule of law so overtly; indeed, they have repeatedly insisted on their commitment to it. Nevertheless, they have been able to construct a rhetorical, legal and policy 'scaffold' that has enabled them to demonstrate at least procedural adherence to human rights norms while, at the same time, allowing UK officials to acquiesce in the arbitrary exercise of sovereignty over individuals who are denied any access to appropriate representation or redress in compliance with the rule of law.

  16. Biodiesel in British Columbia : feasibility study report

    Energy Technology Data Exchange (ETDEWEB)

    Boyd, M.; Murray-Hill, A.; Schaddelee, K. [Wise Energy Co-op, Victoria, BC (Canada)

    2004-05-05

    This report evaluates the potential for biodiesel as a viable fuel in British Columbia. Biodiesel is a non-toxic, biodegradable, renewable fuel produced from recycled bio-oils that can be used to replace conventional petroleum diesel. The report also examines potential feedstock characteristics, output volumes and environmental impacts. Production of biodiesel is increasing globally due to its economic, human and environmental health benefits. Canada's Climate Change Action Plan target of 500 million litres of biodiesel production per year by 2010 will also contribute to biodiesel growth. The use of pure biodiesel as an alternative fuel results in reduced emissions of carbon dioxide, sulphur dioxide, methane, unburned hydrocarbons, carbon monoxide, particulate matter and polycyclic aromatic hydrocarbons. British Columbia's biodiesel feedstock volumes yield a total theoretical capacity of 125 million litres per year of biodiesel, or 4.5 per cent of the province's total annual diesel consumption The feedstock is enough to fuel over 3,700 transit buses annually and significantly reduce greenhouse gas emissions. This report outlines the activities needed to establish commercial biodiesel companies in the province. It also examines standards and regulatory issues; technology availability; cost and processing analysis; potential markets and distribution channels; and environmental impact comparisons. The 4 critical factors that will determine the success or failure of a commercial biodiesel project include: the ability to balance feedstock supplies, processing technology, and market penetration in an integrated system that is reliable and efficient; the ability to form stable strategic alliances with feedstock suppliers, distributors and end users; the ability to deal effectively with competitive pressures; and, the ability to generate a business plan that will attract financing. It was concluded that community-based biodiesel production at a plant scale

  17. BCASP and the Evolution of School Psychology in British Columbia

    Science.gov (United States)

    Agar, Douglas J.

    2016-01-01

    Since 1992, the British Columbia Association of School Psychologists (BCASP) has been the professional body for school psychologists in British Columbia. In the intervening 24 years, BCASP has been very successful in performing the dual roles of a certifying body and a professional development organization for school psychologists in British…

  18. Britishness as Racist Nativism: A Case of the Unnamed "Other"

    Science.gov (United States)

    Smith, Heather Jane

    2016-01-01

    The construct of Britishness, as with nationalism elsewhere in the world, although amorphous and permeable over time, continues to be used by politicians and the media as a powerful exclusionary force. Moreover in England, fundamental British values (FBV), its most recent and official incarnation, now hold particular currency in education policy…

  19. The Genesis of Public Relations in British Colonial Practice.

    Science.gov (United States)

    Smyth, Rosaleen

    2001-01-01

    Demonstrates how the British Colonial Office employed public relations strategies as they administered the British colony of Northern Rhodesia before, during, and after World War II. Demonstrates how civil servants in London and colonial officials implemented public relations policies, strategies, and tactics on an ad hoc basis, covering political…

  20. Shakespearean Intertexts and European Identities in Contemporary Black British Fiction

    Science.gov (United States)

    Muñoz-Valdivieso, Sofía

    2012-01-01

    The article analyses the presence of William Shakespeare as intertext in three recent novels by black British writers which deploy the work of the Bard as they explore British and European identities. Caryl Phillips's "The Nature of Blood" recreates an Othello-like figure who in early Modern Venice struggles to come to terms with his…

  1. Addressing Cellulose Acetate Microfilm from a British Library perspective

    Directory of Open Access Journals (Sweden)

    Helen Shenton

    2005-08-01

    Full Text Available This paper is about cellulose acetate microfilm from the British Library perspective. It traces how acetate microfilm became an issue for the British Library and describes cellulose acetate deterioration. This is followed by details of what has already been done about the situation and what action is planned for the future.

  2. Book Review: "Indigenous Peoples of the British Dominions and the ...

    African Journals Online (AJOL)

    Book Review: "Indigenous Peoples of the British Dominions and the First World War"by Timothy C. Winegard. ... Timothy Winegard saw active duty in the Canadian Reserve Force from 2001 to 2010 and served on detachment duty to the British Army for a two-year period. He obtained various academic degrees from 1999 ...

  3. Southern Cameroons' financial contributions to British Second World ...

    African Journals Online (AJOL)

    The serious damage done to the British economy during World War II compelled the leaders of the British Government to look for ways of repairing the damage. Hence, they turned to the colonies for help. Inter alia, they needed financial assistance because of their inability to pay for imports from the United States. Imports of ...

  4. British Television and Official Film, 1946-1951.

    Science.gov (United States)

    Wildy, Tom

    1988-01-01

    Discusses the relationships between the British Government's Information Services and both the British Broadcasting Corporation (BBC) and the commercial film trade after the BBC's television service resumed independent broadcasts in 1946. Examines proposals for using television as an alternative outlet for commercial and official films. (GEA)

  5. Russian perceptions of the Boer and British Armies: An introduction ...

    African Journals Online (AJOL)

    Russian-French "Entente Cordial" when British turned from bitterest enemy to ..... As it was mentioned above, the army's food supplies were provided in an ... Cronje's capitulation will be a glorious page in the history of the British Anns forever. , ...

  6. How do lay people assess the quality of physicians' communicative responses to patients' emotional cues and concerns? An international multicentre study based on videotaped medical consultations.

    NARCIS (Netherlands)

    Mazzi, M.A.; Bensing, J.; Rimondini, M.; Fletcher, I.; Vliet, L. van; Zimmermann, C.; Deveugele, M.

    2013-01-01

    Objective: To establish which kind of physician communicative responses to patient cues and concerns are appreciated by lay people. Methods: A balanced sample (259 people) was recruited in public places to participate in a full day observation of four videotaped standardized medical consultations.

  7. Cordance derived from REM sleep EEG as a biomarker for treatment response in depression--a naturalistic study after antidepressant medication

    NARCIS (Netherlands)

    Adamczyk, M.; Gazea, M.; Wollweber, B.; Holsboer, F.; Dresler, M.; Steiger, A.; Pawlowski, M.

    2015-01-01

    OBJECTIVE: To evaluate whether prefrontal cordance in theta frequency band derived from REM sleep EEG after the first week of antidepressant medication could characterize the treatment response after 4 weeks of therapy in depressed patients. METHOD: 20 in-patients (15 females, 5 males) with a

  8. Explanatory models of psychosis amongst British South Asians.

    Science.gov (United States)

    Bhikha, Aqeela; Farooq, Saeed; Chaudhry, Nasim; Naeem, Farooq; Husain, Nusrat

    2015-08-01

    A strong interest in the understanding, exploring, and extracting explanatory models of psychosis has recently arisen. Explanatory models (EMs) offer justifications and propose explanations when coping with and treating illnesses. Therefore, they may be important predictors of clinical outcome. Explanatory models of psychosis have been explored in many non-Western countries. However, very little research has examined EMs of psychosis in the UK. We therefore, aimed to elicit and describe explanatory models of psychosis amongst British South Asians, using both quantitative and qualitative methods. EMs of psychosis were examined using the Short Explanatory Model Interview (SEMI) in a cross-sectional sample of 45 patients. Most patients (55.5%) attributed their illness to supernatural causes. Few patients cited a biological (4.4%) cause. Majority of patients held dual EMs of psychosis (77.7%), combining prescribed medication and seeing a traditional healer as a treatment method. Duration of Untreated Psychosis (DUP) was not significantly associated with EMs of psychosis. The results suggest that patients hold multi-explanatory models in order to make sense of their illness and these stem from deep rooted traditional beliefs. This highlights the importance of educational intervention, culturally adapted psychological interventions and possibly working together with traditional healers in the UK to provide a positive support system. Further work is required in order to fully understand the relationship between EMs of psychosis and DUP. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Workplace violence in Alberta and British Columbia hospitals.

    Science.gov (United States)

    Hesketh, Kathryn L; Duncan, Susan M; Estabrooks, Carole A; Reimer, Marlene A; Giovannetti, Phyllis; Hyndman, Kathryn; Acorn, Sonia

    2003-03-01

    Workplace violence is a significant and widespread public health concern among health care workers, including nurses. With growing awareness of how practice environments influence patient outcomes and the retention of health professionals, it is timely to consider the impact of workplace violence in hospitals. Registered nurses in Alberta and British Columbia, Canada were surveyed on their experiences of violence in the workplace over the last five shifts. Our results suggest that nurses are experiencing many incidences of violence in a given work week, particularly in the emergency, psychiatric, and medical-surgical settings. Most violent acts are perpetrated by patients, but there is also a significant portion of violence and abuse committed by hospital co-workers, particularly emotional abuse and sexual harassment. Our results also indicate that the majority of workplace violence is not reported. We suggest that using the Broken Windows theory might be a useful tool to conceptualize why workplace violence occurs, and that this framework be used to begin to develop new violence prevention policies and strategies.

  10. Improving operation notes to meet British Orthopaedic Association guidelines.

    Science.gov (United States)

    Morgan, David; Fisher, Noel; Ahmad, Aman; Alam, Fazle

    2009-04-01

    Operation notes are an important part of medical records for clinical, academic and medicolegal reasons. This study audited the quality of operative note keeping for total knee replacements against the standards set by the British Orthopaedic Association (BOA). A prospective review of all patients undergoing total knee replacement at a district general hospital over 8 months. Data recorded were compared with those required by the BOA good-practice guidelines. Change in practice was implemented and the audit cycle completed. Data were statistically analysed. A total of 129 operation notes were reviewed. There was a significant improvement in the mean number of data points recorded from 9.6 to 13.1. The least well recorded data were diagnosis, description of findings, alignment and postoperative flexion range. All had a significant improvement except description of findings. The operating surgeon writing the note improved from 56% to 67%. Detailed postoperative instructions also improved in quality. Surgeon education and the use of a checklist produce better quality total knee replacement operation notes in line with BOA guidelines. Further improvements may be made by making the data points part of the operation note itself.

  11. The forgotten workforce: clerical and administrative staff within British Higher Education

    OpenAIRE

    Tong, Kay

    2014-01-01

    This thesis examines the employment conditions for clerical and administrative staff within the British Higher Education Sector. For this analysis a national questionnaire was distributed and 747 responses were returned and analysed. In order to further enrich the qualitative research data, 30 interviews were also conducted, mainly with clerical and secretarial staff but also with management staff who had progressed from clerical grades.\\ud \\ud The main focus of the research was to examine in...

  12. Predicting meaningful outcomes to medication and self-help treatments for binge-eating disorder in primary care: The significance of early rapid response.

    Science.gov (United States)

    Grilo, Carlos M; White, Marney A; Masheb, Robin M; Gueorguieva, Ralitza

    2015-04-01

    We examined rapid response among obese patients with binge-eating disorder (BED) in a randomized clinical trial testing antiobesity medication and self-help cognitive-behavioral therapy (shCBT), alone and in combination, in primary-care settings. One hundred four obese patients with BED were randomly assigned to 1 of 4 treatments: sibutramine, placebo, shCBT + sibutramine, or shCBT + placebo. Treatments were delivered by generalist primary-care physicians and the medications were given double-blind. Independent assessments were performed by trained and monitored doctoral research clinicians monthly throughout treatment, posttreatment (4 months), and at 6- and 12-month follow-ups (i.e., 16 months after randomization). Rapid response, defined as ≥65% reduction in binge eating by the fourth treatment week, was used to predict outcomes. Rapid response characterized 47% of patients, was unrelated to demographic and baseline clinical characteristics, and was significantly associated, prospectively, with remission from binge eating at posttreatment (51% vs. 9% for nonrapid responders), 6-month (53% vs. 23.6%), and 12-month (46.9% vs. 23.6%) follow-ups. Mixed-effects model analyses revealed that rapid response was significantly associated with greater decreases in binge-eating or eating-disorder psychopathology, depression, and percent weight loss. Our findings, based on a diverse obese patient group receiving medication and shCBT for BED in primary-care settings, indicate that patients who have a rapid response achieve good clinical outcomes through 12-month follow-ups after ending treatment. Rapid response represents a strong prognostic indicator of clinically meaningful outcomes, even in low-intensity medication and self-help interventions. Rapid response has important clinical implications for stepped-care treatment models for BED. clinicaltrials.gov: NCT00537810 (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  13. Exposure to smoking in movies among British adolescents 2001-2006.

    Science.gov (United States)

    Anderson, Stacey J; Millett, Christopher; Polansky, Jonathan R; Glantz, Stanton A

    2010-06-01

    To estimate youth exposure to smoking in movies in the UK and compare the likely effect with the USA. We collected tobacco occurrences data for 572 top-grossing films in the UK screened from 2001 to 2006 and estimated the number of on-screen tobacco impressions delivered to British youths in this time period. 91% of films in our sample that contained smoking were youth-rated films (British Board of Film Classification rating '15' and lower), delivering at least 1.10 billion tobacco impressions to British youths during theatrical release. British youths were exposed to 28% more smoking impressions in UK youth-rated movies than American youth-rated movies, because 79% of movies rated for adults in the USA ('R') are classified as suitable for youths in the UK ('15' or '12A'). Because there is a dose-response relation between the amount of on-screen exposure to smoking and the likelihood that adolescents will begin smoking, the fact that there is substantially higher exposure to smoking in youth-rated films in the UK than in the USA suggests that the fraction of all youth smoking because of films in the UK is probably larger than in the USA. Other countries with ratings systems that are less conservative (in terms of language and sexuality) than the USA will also be likely to deliver more on-screen tobacco impressions to youths. Assigning an '18' classification to movies that contain smoking would substantially reduce youth exposure to on-screen smoking and, hence, smoking initiation among British youths.

  14. Exposure to smoking in movies among British adolescents 2001–2006

    Science.gov (United States)

    Anderson, Stacey J; Millett, Christopher; Polansky, Jonathan R

    2010-01-01

    Objective To estimate youth exposure to smoking in movies in the UK and compare the likely effect with the USA. Methods We collected tobacco occurrences data for 572 top-grossing films in the UK screened from 2001 to 2006 and estimated the number of on-screen tobacco impressions delivered to British youths in this time period. Results 91% of films in our sample that contained smoking were youth-rated films (British Board of Film Classification rating ‘15’ and lower), delivering at least 1.10 billion tobacco impressions to British youths during theatrical release. British youths were exposed to 28% more smoking impressions in UK youth-rated movies than American youth-rated movies, because 79% of movies rated for adults in the USA (‘R’) are classified as suitable for youths in the UK (‘15’ or ‘12A’). Conclusion Because there is a dose-response relation between the amount of on-screen exposure to smoking and the likelihood that adolescents will begin smoking, the fact that there is substantially higher exposure to smoking in youth-rated films in the UK than in the USA suggests that the fraction of all youth smoking because of films in the UK is probably larger than in the USA. Other countries with ratings systems that are less conservative (in terms of language and sexuality) than the USA will also be likely to deliver more on-screen tobacco impressions to youths. Assigning an ‘18’ classification to movies that contain smoking would substantially reduce youth exposure to on-screen smoking and, hence, smoking initiation among British youths. PMID:20197360

  15. Information technology systems for critical care triage and medical response during an influenza pandemic: a review of current systems.

    Science.gov (United States)

    Bandayrel, Kristofer; Lapinsky, Stephen; Christian, Michael

    2013-06-01

    To assess local, state, federal, and global pandemic influenza preparedness by identifying pandemic plans at the local, state, federal, and global levels, and to identify any information technology (IT) systems in these plans to support critical care triage during an influenza pandemic in the Canadian province of Ontario. The authors used advanced MEDLINE and Google search strategies and conducted a comprehensive review of key pandemic influenza Web sites. Descriptive data extraction and analysis for IT systems were conducted on all of the included pandemic plans. A total of 155 pandemic influenza plans were reviewed: 29 local, 62 state, 63 federal, and 1 global. We found 70 plans that examined IT systems (10 local, 33 state, 26 federal, 1 global), and 85 that did not (19 local, 29 state, 37 federal). Of the 70 plans, 64 described surveillance systems (10 local, 32 state, 21 federal, 1 global), 2 described patient data collection systems (1 state, 1 federal); 4 described other types of IT systems (4 federal), and none were intended for triage. Although several pandemic plans have been drafted, the majority are high-level general documents that do not describe IT systems. The plans that discuss IT systems focus strongly on surveillance, which fails to recognize the needs of a health care system responding to an influenza pandemic. The best examples of the types of IT systems to guide decision making during a pandemic were found in the Kansas and the Czech Republic pandemic plans, because these systems were designed to collect both patient and surveillance data. Although Ontario has yet to develop such an IT system, several IT systems are in place that could be leveraged to support critical care triage and medical response during an influenza pandemic.

  16. Do questions help? The impact of audience response systems on medical student learning: a randomised controlled trial.

    Science.gov (United States)

    Mains, Tyler E; Cofrancesco, Joseph; Milner, Stephen M; Shah, Nina G; Goldberg, Harry

    2015-07-01

    Audience response systems (ARSs) are electronic devices that allow educators to pose questions during lectures and receive immediate feedback on student knowledge. The current literature on the effectiveness of ARSs is contradictory, and their impact on student learning remains unclear. This randomised controlled trial was designed to isolate the impact of ARSs on student learning and students' perception of ARSs during a lecture. First-year medical student volunteers at Johns Hopkins were randomly assigned to either (i) watch a recorded lecture on an unfamiliar topic in which three ARS questions were embedded or (ii) watch the same lecture without the ARS questions. Immediately after the lecture on 5 June 2012, and again 2 weeks later, both groups were asked to complete a questionnaire to assess their knowledge of the lecture content and satisfaction with the learning experience. 92 students participated. The mean (95% CI) initial knowledge assessment score was 7.63 (7.17 to 8.09) for the ARS group (N=45) and 6.39 (5.81 to 6.97) for the control group (N=47), p=0.001. Similarly, the second knowledge assessment mean score was 6.95 (6.38 to 7.52) for the ARS group and 5.88 (5.29 to 6.47) for the control group, p=0.001. The ARS group also reported higher levels of engagement and enjoyment. Embedding three ARS questions within a 30 min lecture increased students' knowledge immediately after the lecture and 2 weeks later. We hypothesise that this increase was due to forced information retrieval by students during the learning process, a form of the testing effect. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Expression of IL-23/Th17-related cytokines in basal cell carcinoma and in the response to medical treatments.

    Directory of Open Access Journals (Sweden)

    Cristina Pellegrini

    Full Text Available Several immune-related markers have been implicated in basal cell carcinoma (BCC pathogenesis. The BCC inflammatory infiltrate is dominated by Th2 cytokines, suggesting a specific state of immunosuppression. In contrast, regressing BCC are characterized by a Th1 immune response with IFN-γ promoting a tumor suppressive activity. IL-23/Th17-related cytokines, as interleukin (IL-17, IL-23 and IL-22, play a significant role in cutaneous inflammatory diseases, but their involvement in skin carcinogenesis is controversial and is poorly investigated in BCC. In this study we investigated the expression of IFN-γ, IL-17, IL-23 and IL-22 cytokines in BCC at the protein and mRNA level and their modulation during imiquimod (IMQ treatment or photodynamic therapy (PDT. IFN-γ, IL-17, IL-23 and IL-22 levels were evaluated by immunohistochemistry and quantitative Real Time PCR in 41 histopathologically-proven BCCs (28 superficial and 13 nodular from 39 patients. All BCC samples were analyzed at baseline and 19 of 41 also during medical treatment (9 with IMQ 5% cream and 10 with MAL-PDT. Association between cytokines expression and clinico-pathological variables was evaluated. Higher levels of IFN-γ, IL-17, IL-23 and IL-22 were found in BCCs, mainly in the peritumoral infiltrate, compared to normal skin, with the expression being correlated to the severity of the inflammatory infiltrate. IFN-γ production was higher in superficial BCCs compared to nodular BCCs, while IL-17 was increased in nodular BCCs. A significant correlation was found between IFN-γ and IL-17 expression with both cytokines expressed by CD4+ and CD8+ T-cells. An increase of all cytokines occurred during the inflammatory phase induced by IMQ and at the early time point of PDT treatment, with significant evidence for IFN-γ, IL-23, and IL-22. Our results confirm the role of IFN-γ and support the involvement of IL-23/Th17-related cytokines in BCC pathogenesis and in the inflammatory response

  18. Using Audience Response Technology to provide formative feedback on pharmacology performance for non-medical prescribing students - a preliminary evaluation

    Directory of Open Access Journals (Sweden)

    Mostyn Alison

    2012-11-01

    Full Text Available Abstract Background The use of anonymous audience response technology (ART to actively engage students in classroom learning has been evaluated positively across multiple settings. To date, however, there has been no empirical evaluation of the use of individualised ART handsets and formative feedback of ART scores. The present study investigates student perceptions of such a system and the relationship between formative feedback results and exam performance. Methods Four successive cohorts of Non-Medical Prescribing students (n=107 had access to the individualised ART system and three of these groups (n=72 completed a questionnaire about their perceptions of using ART. Semi-structured interviews were carried out with a purposive sample of seven students who achieved a range of scores on the formative feedback. Using data from all four cohorts of students, the relationship between mean ART scores and summative pharmacology exam score was examined using a non-parametric correlation. Results Questionnaire and interview data suggested that the use of ART enhanced the classroom environment, motivated students and promoted learning. Questionnaire data demonstrated that students found the formative feedback helpful for identifying their learning needs (95.6%, guiding their independent study (86.8%, and as a revision tool (88.3%. Interviewees particularly valued the objectivity of the individualised feedback which helped them to self-manage their learning. Interviewees’ initial anxiety about revealing their level of pharmacology knowledge to the lecturer and to themselves reduced over time as students focused on the learning benefits associated with the feedback. A significant positive correlation was found between students’ formative feedback scores and their summative pharmacology exam scores (Spearman’s rho = 0.71, N=107, p Conclusions Despite initial anxiety about the use of individualised ART units, students rated the helpfulness of the

  19. Updated posters to help manage medical emergencies in the dental practice.

    Science.gov (United States)

    Jevon, P

    2015-09-11

    Medical emergencies can occur in the dental practice. Medical Emergencies in the Dental Practice and Emergency Drugs in the Dental Practice posters have been designed to help dental practitioners to respond effectively and safely to a medical emergency. These posters, endorsed by the British Dental Association, are included with this issue of the British Dental Journal. Further copies can be downloaded from: https://www.walsallhealthcare.nhs.uk/medical-education.aspx.

  20. [Ethical Debates Related to the Allocation of Medical Resources During the Response to the Mass Casualty Incident at Formosa Fun Coast Water Park].

    Science.gov (United States)

    Tang, Jing-Shia; Chen, Chia-Jung; Huang, Mei-Chih

    2017-02-01

    Disasters are unpredictable and often result in mass casualties. Limited medical resources often affect the response to mass casualty incidents, undermining the ability of responders to adequately protect all of the casualties. Thus, the injuries of casualties are classified in hopes of fully utilizing medical resources efficiently in order to save the maximum possible number of people. However, as opinions on casualty prioritization are subjective, disagreements and disputes often arise regarding allocating medical resources. The present article focused on the 2015 explosion at Formosa Fun Coast, a recreational water park in Bali, New Taipei City, Taiwan as a way to explore the dilemma over the triage and resource allocation for casualties with burns over 90% and 50-60% of their bodies. The principles of utilitarianism and deontology in Western medicine were used to discuss the reasons and rationale behind the allocation of medical resources during this incident. Confucianism, a philosophical mindset that significantly influences Taiwanese society today, was then discussed to describe the "miracles" that happened during the incident, including the acquisition of assistance from the public and medical professionals. External supplies and professional help (social resources) were provided voluntarily after this incident, which had a profound impact on both the immediate response and the longer-term recovery efforts.

  1. Medical physics in radiotherapy: The importance of preserving clinical responsibilities and expanding the profession's role in research, education, and quality control.

    Science.gov (United States)

    Malicki, Julian

    2015-01-01

    Medical physicists have long had an integral role in radiotherapy. In recent decades, medical physicists have slowly but surely stepped back from direct clinical responsibilities in planning radiotherapy treatments while medical dosimetrists have assumed more responsibility. In this article, I argue against this gradual withdrawal from routine therapy planning. It is essential that physicists be involved, at least to some extent, in treatment planning and clinical dosimetry for each and every patient; otherwise, physicists can no longer be considered clinical specialists. More importantly, this withdrawal could negatively impact treatment quality and patient safety. Medical physicists must have a sound understanding of human anatomy and physiology in order to be competent partners to radiation oncologists. In addition, they must possess a thorough knowledge of the physics of radiation as it interacts with body tissues, and also understand the limitations of the algorithms used in radiotherapy. Medical physicists should also take the lead in evaluating emerging challenges in quality and safety of radiotherapy. In this sense, the input of physicists in clinical audits and risk assessment is crucial. The way forward is to proactively take the necessary steps to maintain and advance our important role in clinical medicine.

  2. Medical physics in radiotherapy: The importance of preserving clinical responsibilities and expanding the profession's role in research, education, and quality control

    Science.gov (United States)

    Malicki, Julian

    2015-01-01

    Medical physicists have long had an integral role in radiotherapy. In recent decades, medical physicists have slowly but surely stepped back from direct clinical responsibilities in planning radiotherapy treatments while medical dosimetrists have assumed more responsibility. In this article, I argue against this gradual withdrawal from routine therapy planning. It is essential that physicists be involved, at least to some extent, in treatment planning and clinical dosimetry for each and every patient; otherwise, physicists can no longer be considered clinical specialists. More importantly, this withdrawal could negatively impact treatment quality and patient safety. Medical physicists must have a sound understanding of human anatomy and physiology in order to be competent partners to radiation oncologists. In addition, they must possess a thorough knowledge of the physics of radiation as it interacts with body tissues, and also understand the limitations of the algorithms used in radiotherapy. Medical physicists should also take the lead in evaluating emerging challenges in quality and safety of radiotherapy. In this sense, the input of physicists in clinical audits and risk assessment is crucial. The way forward is to proactively take the necessary steps to maintain and advance our important role in clinical medicine. PMID:25949219

  3. Assessing Changes in Medical Student Attitudes toward Non-Traditional Human Sexual Behaviors Using a Confidential Audience Response System

    Science.gov (United States)

    Tucker, Phebe; Candler, Chris; Hamm, Robert M.; Smith, E. Michael; Hudson, Joseph C.

    2010-01-01

    Medical students encountering patients with unfamiliar, unconventional sexual practices may have attitudes that can affect open communication during sexual history-taking. We measured changes in first-year US medical student attitudes toward 22 non-traditional sexual behaviors before and after exposure to human sexuality instruction. An…

  4. Cordance derived from REM sleep EEG as a biomarker for treatment response in depression--a naturalistic study after antidepressant medication.

    Science.gov (United States)

    Adamczyk, Marek; Gazea, Mary; Wollweber, Bastian; Holsboer, Florian; Dresler, Martin; Steiger, Axel; Pawlowski, Marcel

    2015-04-01

    To evaluate whether prefrontal cordance in theta frequency band derived from REM sleep EEG after the first week of antidepressant medication could characterize the treatment response after 4 weeks of therapy in depressed patients. 20 in-patients (15 females, 5 males) with a depressive episode and 20 healthy matched controls were recruited into 4-week, open label, case-control study. Patients were treated with various antidepressants. No significant differences in age (responders (mean ± SD): 45 ± 22) years; non-responders: 49 ± 12 years), medication or Hamilton Depression Rating Scale (HAM-D) score (responders: 23.8 ± 4.5; non-responders 24.5 ± 7.6) at inclusion into the study were found between responders and non-responders. Response to treatment was defined as a ≥50% reduction of HAM-D score at the end of four weeks of active medication. Sleep EEG of patients was recorded after the first and the fourth week of medication. Cordance was computed for prefrontal EEG channels in theta frequency band during tonic REM sleep. The group of 8 responders had significantly higher prefrontal theta cordance in relation to the group of 12 non-responders after the first week of antidepressant medication. This finding was significant also when controlling for age, gender and number of previous depressive episodes (F1,15 = 6.025, P = .027). Furthermore, prefrontal cordance of all patients showed significant positive correlation (r = 0.52; P = .019) with the improvement of HAM-D score between the inclusion week and fourth week of medication. The results suggest that prefrontal cordance derived from REM sleep EEG could provide a biomarker for the response to antidepressant treatment in depressed patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. State of the air in British Columbia

    Energy Technology Data Exchange (ETDEWEB)

    McDonald, S.; Furberg, M.; Rother, P. [British Columbia Lung Association, Vancouver, BC (Canada)

    2005-08-15

    Scientific evidence is rising regarding the danger of air pollution. Poor air quality can pose a problem in British Columbia, particularly in interior communities when temperature inversions, during certain times of the year, trap pollutants in mountain valleys. This document described where pollutants come from, ambient levels in the atmosphere and how they affect human health. Particular focus was on fine particulate matter, ozone and oxides of nitrogen, as these 3 pollutants have been linked to health impacts. The cost of air pollution through increased health care costs and the economic impact of lost productivity from missed work days was also discussed along with the influence of poor air quality on crop damage and forestry production losses. The document also outlined government and community initiatives to protect public health and listed some measures that individuals can do to keep air clean. Air pollution stems from activities such as land development, burning fossil fuels for energy and transportation, industrial operations, residential wood burning and backyard burning of debris and burning from forestry and agricultural operations. The health impacts range from irritation, to coughing and worsening of existing heart and lung conditions. The document states that despite all measures being taken to reduce emissions and to maintain levels of air pollutants at current low levels, health effects are still observed and still pose a burden to health care cost. Scientific evidence indicates that a further reduction in air pollution will result in health benefits. refs., figs.

  6. State of the air in British Columbia

    International Nuclear Information System (INIS)

    McDonald, S.; Furberg, M.; Rother, P.

    2005-08-01

    Scientific evidence is rising regarding the danger of air pollution. Poor air quality can pose a problem in British Columbia, particularly in interior communities when temperature inversions, during certain times of the year, trap pollutants in mountain valleys. This document described where pollutants come from, ambient levels in the atmosphere and how they affect human health. Particular focus was on fine particulate matter, ozone and oxides of nitrogen, as these 3 pollutants have been linked to health impacts. The cost of air pollution through increased health care costs and the economic impact of lost productivity from missed work days was also discussed along with the influence of poor air quality on crop damage and forestry production losses. The document also outlined government and community initiatives to protect public health and listed some measures that individuals can do to keep air clean. Air pollution stems from activities such as land development, burning fossil fuels for energy and transportation, industrial operations, residential wood burning and backyard burning of debris and burning from forestry and agricultural operations. The health impacts range from irritation, to coughing and worsening of existing heart and lung conditions. The document states that despite all measures being taken to reduce emissions and to maintain levels of air pollutants at current low levels, health effects are still observed and still pose a burden to health care cost. Scientific evidence indicates that a further reduction in air pollution will result in health benefits. refs., figs

  7. British cruisers of the victorian era

    CERN Document Server

    Friedman, Norman

    2015-01-01

    Gradually evolving from the masted steam frigates of the mid-nineteenth century, the first modern cruiser is not easy to define, but for the sake of this book the starting point is taken to be Iris and Mercury of 1875. They were the RN's first steel-built warships; were designed primarily to be steamed rather than sailed; and formed the basis of a line of succeeding cruiser classes. The story ends with the last armoured cruisers, which were succeeded by the first battlecruisers (originally called armoured cruisers), and with the last Third Class Cruisers (Topaze class), all conceived before 1906. Coverage, therefore, dovetails precisely with Friedman's previous book on British cruisers, although this one also includes the wartime experience of the earlier ships.rn The two central themes are cruisers for the fleet and cruisers for overseas operations, including (but not limited to) trade protection. The distant-waters aspect covers the belted cruisers, which were nearly capital ships, intended to deal with for...

  8. British Gas plans global gas unit expansion

    International Nuclear Information System (INIS)

    Vielvoye, R.

    1991-01-01

    This paper reports on developing a global gas business, a British Gas plc's strategy for evolving a state owned U.K. gas company to a privatized worldwide oil and gas giant. By 2000, BG's global gas business is expected to provide 20% of its revenues, compared with 40% each from its exploration and production operations and its U.K. gas business. The global gas unit (GGU) plans to meet its targets mainly through acquiring holdings in gas transmission and distribution companies around the world. In the 12 months since GGU was established, it has made two such major acquisitions in this area. BG acquired Consumers Gas Co., Ltd., Ontario, Canada's biggest natural gas distribution company, for $943.5 million. It also took a 10% stake in Catalana de Gas SA, Barcelona, the largest privately owned gas utility in Spain and in terms of number of customers, the fourth largest in western Europe. BG also is targeting additional revenues from developing gas fired cogeneration systems in developing countries with gas reserves but no established transmission and distribution systems

  9. Climate change and health in British Columbia

    International Nuclear Information System (INIS)

    Ostry, A.; Ogborn, M.; British Columbia Univ., Vancouver, BC; Takaro, T.; Bassil, K.; Allen, D.

    2008-11-01

    This document described the models that scientists use to investigate the links between climate change and health. It then reviewed the evidence for possible impacts of climate change on human health. Most models conceptualize that climate change will affect the health of British Columbians directly through physical and biological pathways, and indirectly through complex socio-economic and environmental pathways. The direct physical and biological pathways will be the easiest to investigate, monitor and attribute to climate change, while the indirect socio-economic pathways will be more complex to investigate but will have the most impact. This document also provided guidance for a program of research and policy directions to better predict future impacts of climate change on health in BC and to enhance adaptation to these changes. The document suggested that basic research is needed to develop a made in BC model and infrastructure for climate change and health investigations. Currently, rural and remote forestry-dependent and Aboriginal communities in mountain pine infected zones are particularly vulnerable. However, it was concluded that although there is strong evidence for shifts in climate in BC, no direct evidence exists on the impact of climate change on human health in BC. refs., tabs., figs

  10. British Columbia's new coalbed methane royalty regime

    International Nuclear Information System (INIS)

    Molinski, D.

    2002-01-01

    The British Columbia Ministry of Energy and Mines is promoting the development of the coalbed methane (CBM) industry in the province in order to make CBM a viable and competitive investment option for industry. It is establishing a regulatory and fiscal regime for CBM development. Issues of concern regarding CBM development include water production, gas production rates, well numbers, and marginal economics. The features of the CBM royalty regime include a new producer cost of service allowance, the creation of a CBM royalty tax bank to collect excess PCOS allowances, and a royalty tax credit for wells drilled by the end of February, 2004. The marginal well adjustment factor threshold has been raised from 180 mcf per day to 600 mcf per day for CBM only. It was noted that royalties will probably not be payable for several years following the first commercial well because royalties are very depending on capital and operating costs, local infrastructure and price. Royalty regimes cannot save CBM from low gas prices, poor resources or economics. 2 figs

  11. Utopianism in the British evolutionary synthesis.

    Science.gov (United States)

    Esposito, Maurizio

    2011-03-01

    In this paper I propose a new interpretation of the British evolutionary synthesis. The synthetic work of J. B. S. Haldane, R. A. Fisher and J. S. Huxley was characterized by both an integration of Mendelism and Darwinism and the unification of different biological subdisciplines within a coherent framework. But it must also be seen as a bold and synthetic Darwinian program in which the biosciences served as a utopian blueprint for the progress of civilization. Describing the futuristic visions of these three scientists in their synthetic heydays, I show that, despite a number of important divergences, their biopolitical ideals could be biased toward a controlled and regimented utopian society. Their common ideals entailed a social order where liberal and democratic principles were partially or totally suspended in favor of bioscientific control and planning for the future. Finally, I will argue that the original redefinition of Darwinism that modern synthesizers proposed is a significant historical example of how Darwinism has been used and adapted in different contexts. The lesson I draw from this account is a venerable one: that, whenever we wish to define Darwinism, we need to recognize not only its scientific content and achievements but expose the other traditions and ideologies it may have supported. Copyright © 2010 Elsevier Ltd. All rights reserved.

  12. Effect of Concomitant Pain Medications on Response to Pregabalin in Patients with Postherpetic Neuralgia or Spinal Cord Injury-Related Neuropathic Pain.

    Science.gov (United States)

    Schug, Stephan A; Parsons, Bruce; Almas, Mary; Whalen, Ed

    2017-01-01

    Patients with neuropathic pain (NeP) often receive combination therapy with multiple agents in the hopes of improving both pain and any comorbidities that may be present. While pregabalin is often recommended as a first-line treatment of NeP, few studies have examined the effects of concomitant medications on the efficacy of pregabalin. To examine the effects of concomitant medications on the efficacy and safety of pregabalin for the treatment of NeP. Data were derived from 7 randomized placebo-controlled trials of pregabalin (150, 300, 600, and flexible 150 - 600 mg/d) for the treatment of postherpetic neuralgia (PHN) and 2 randomized placebo-controlled trials for the treatment of NeP due to spinal cord injury (SCI-NeP). On each day, patients rated the severity of their pain and pain-related sleep interference (PRSI) over the previous 24 hours on a scale from 0 to 10, with higher scores indicating greater severity. Patients were also continually monitored for the occurrence of adverse events. A pooled retrospective analyses of data from randomized clinical trials. Changes from baseline in mean weekly pain and PRSI scores were compared between patients who received concomitant NeP medications and patients who did not receive concomitant NeP medications. Results of these comparisons are presented separately for the PHN (through 4, 8, and 12 weeks) and SCI-NeP (through 12 weeks) cohorts. Common adverse events are also presented for each treatment group. Pregabalin significantly improved both pain and PRSI scores relative to placebo at most dose levels and time points examined. Notably, little difference was observed in the extent of therapeutic response to pregabalin between patients who received concomitant NeP medications and patients who did not receive concomitant NeP medications. Additionally, the profile of treatment-emergent adverse events appeared to be largely unaffected by the use of concomitant NeP medications in the pooled patient population. Our analysis

  13. Laparoscopic splenectomy for medically refractory immune thrombocytopenia (ITP): a retrospective cohort study on longtime response predicting factors based on consensus criteria.

    Science.gov (United States)

    Rijcken, Emile; Mees, Soeren Torge; Bisping, Guido; Krueger, Kristin; Bruewer, Matthias; Senninger, Norbert; Mennigen, Rudolf

    2014-12-01

    Laparoscopic splenectomy has been proposed to be the standard therapy for adult patients with medically refractory immune thrombocytopenia (ITP). However, due to inconsistent definitions of response, variable rates of long term response have been reported. Furthermore, new medical treatment options are currently challenging the role of splenectomy. The aims of this study were to (1) analyze long term response after splenectomy according to recently defined consensus criteria, (2) identify possible predictive response factors. A case series of 72 consecutive patients with ITP undergoing laparoscopic splenectomy was retrospectively studied using univariate and multivariate analysis as well as logrank tests. Median follow-up was 32 (2-110) months. Mortality was 0% and morbidity was 8.2%. Response to splenectomy was achieved in of 63/72 patients (87.5%). Loss of response occurred in 19/63 (30.2%) in median after 3 (range 2-42) months. Preoperative platelet counts after boosting with steroids and immunoglobulins as well as the postoperative rise in platelet counts were statistically significant factors for response upon both univariate and multivariate analysis, whereas age, gender, body mass index, ASA classification, disease duration, accessory spleens, splenic weight, conversion to open surgery, or perioperative complications were not. Patients with a postoperative rise in platelet counts >150,000/μL had a significant better chance on stable long term response than those with a smaller increment (P splenectomy is an effective and safe treatment option in order to obtain stable long term response in patients with ITP. Perioperative platelet counts are predictive factors of long term response. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  14. Do people with and without medical conditions respond similarly to the short health anxiety inventory? An assessment of differential item functioning using item response theory.

    Science.gov (United States)

    LeBouthillier, Daniel M; Thibodeau, Michel A; Alberts, Nicole M; Hadjistavropoulos, Heather D; Asmundson, Gordon J G

    2015-04-01

    Individuals with medical conditions are likely to have elevated health anxiety; however, research has not demonstrated how medical status impacts response patterns on health anxiety measures. Measurement bias can undermine the validity of a questionnaire by overestimating or underestimating scores in groups of individuals. We investigated whether the Short Health Anxiety Inventory (SHAI), a widely-used measure of health anxiety, exhibits medical condition-based bias on item and subscale levels, and whether the SHAI subscales adequately assess the health anxiety continuum. Data were from 963 individuals with diabetes, breast cancer, or multiple sclerosis, and 372 healthy individuals. Mantel-Haenszel tests and item characteristic curves were used to classify the severity of item-level differential item functioning in all three medical groups compared to the healthy group. Test characteristic curves were used to assess scale-level differential item functioning and whether the SHAI subscales adequately assess the health anxiety continuum. Nine out of 14 items exhibited differential item functioning. Two items exhibited differential item functioning in all medical groups compared to the healthy group. In both Thought Intrusion and Fear of Illness subscales, differential item functioning was associated with mildly deflated scores in medical groups with very high levels of the latent traits. Fear of Illness items poorly discriminated between individuals with low and very low levels of the latent trait. While individuals with medical conditions may respond differentially to some items, clinicians and researchers can confidently use the SHAI with a variety of medical populations without concern of significant bias. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Unity is strength: staff college and the British officer corps.

    Science.gov (United States)

    King, Anthony

    2009-03-01

    Utilizing Bourdieu's concept of the habitus, Keith Macdonald has recently examined the elite social origins of the British officer corps. His analysis is valid as far at it goes but it ignores the professional practices of British officers. This article examines Britain's Joint Services Command and Staff College to assess the unification of the three services around common forms of military practice. It argues that while the new staff college has been effective in disseminating new forms of professional expertise among British officers, various practices have been institutionalized which actively undermine the unity of the officer corps.

  16. British Gas marks progress in drive for global operations

    International Nuclear Information System (INIS)

    Kennedy, J.L.

    1992-01-01

    This paper reports that British Gas plc, London, is driving to boost the share of its business that comes form outside the U.K. Non-U.K. activities accounted for about 10% of the company's business last year. By the turn of the century earnings form British Gas's non-U.K. exploration and production activities are expected to be about in line with those form the U.K. core business. In addition, the company's global gas business unit-acquisitions, sales, of British Gas technology worldwide, and power generation form gas-will contribute significantly to overseas earnings

  17. Battling Bullying in the British Army 1987 – 2004

    Directory of Open Access Journals (Sweden)

    James K. Wither

    2004-09-01

    Full Text Available This article explores the attempts by the UK MOD to eradicate bullying in the British Army. Although British recruits are not confronted by mistreatment that compares with the phenomenon of dedovshchina, the Army has struggled to eliminate incidents of bullying from the ranks, which have tarnished the image of the British Army. The article examines the nature and extent of the problem, the efficacy of official policy to combat it, and suggests reasons why bullying persists even in a long- standing professional army. It also seeks to provide instructive insights for those militaries of the successor states of the Soviet Union that are currently blighted by dedovshchina.

  18. Colonialism, Education and Social Change in the British Empire: The Cases of Australia, Papua New Guinea and Ireland

    Science.gov (United States)

    O'Donoghue, Tom

    2009-01-01

    This paper focuses on the history of relations between colonialism, schooling and social change in Australia, Papua New Guinea and Ireland, countries that were once part of the British Empire. It indicates that responses to schooling ranged from acceptance and tolerance, to modification and rejection, depending on the country, the issue, and the…

  19. Does an offer for a free on-line continuing medical education (CME) activity increase physician survey response rate? A randomized trial.

    Science.gov (United States)

    Viera, Anthony J; Edwards, Teresa

    2012-03-07

    Achieving a high response rate in a physician survey is challenging. Monetary incentives increase response rates but obviously add cost to a survey project. We wondered whether an offer of a free continuing medical education (CME) activity would be effective in improving survey response rate. As part of a survey of a national sample of physicians, we randomized half to an offer for a free on-line CME activity upon completion of a web-based survey and the other half to no such offer. We compared response rates between the groups. A total of 1214 out of 8477 potentially eligible physicians responded to our survey, for an overall response rate of 14.3%. The response rate among the control group (no offer of CME credit) was 16.6%, while among those offered the CME opportunity, the response rate was 12.0% (p offer for a free on-line CME activity did not improve physician survey response rate. On the contrary, the offer for a free CME activity actually appeared to worsen the response rate. © 2011 Viera et al; licensee BioMed Central Ltd.

  20. Apology, responsibility, memory. Coming to terms with Nazi medical crimes: the example of the Max Planck Society.

    Science.gov (United States)

    Sachse, Carola

    2011-11-01

    In June 2001, the then president of the Max Planck Society addressed a formal apology to survivors of Nazi medical crimes. Starting from this ritual of repentance, the paper examines the participants' diverse views of how to deal with the medical crimes of National Socialism. In comparison with the DGPPN, it asks about possibilities of going beyond historical retrospection to fulfil the imperative of remembrance.

  1. British nuclear power: protest and legitimation 1945 - 1980

    International Nuclear Information System (INIS)

    Welsh, I.

    1988-02-01

    This thesis traces the development of British civil nuclear power policy between 1945 and 1982. Throughout particular attention is paid to the methods of legitimation which have been used to justify this policy in the public arena. By tracing this legitimation process, and public responses to it, the modern anti nuclear movement and crisis of public acceptability are placed within an historical context. It is argued that public concern and disquiet have always required the active legitimation of nuclear policy from the inception of the technology. The initial base of this legitimation was largely symbolic and associated nuclear power with the future of civilisation and a second of Elizabethan splendour for Britain. Symbolic legitimacy was underpinned by the twin pillars of expert hegemony and political authority. As these became increasingly prominent due to internal disputes within the industry secrecy was applied as a means of preserving legitimacy. Having tried conventional avenues of opposition the anti nuclear movement then embarked upon a campaign of direct action. The links between this campaign and the pervasive sense of public unease which had always existed are explored. It is argued here that the anti nuclear movement produces and sustains a cogent critique of nuclear power. Campaigning around this critique wins the movement increasing legitimacy as its arguments are increasingly accepted. (author)

  2. Gender violence news in British and American press

    Directory of Open Access Journals (Sweden)

    Sara Bustinduy

    2016-03-01

    Full Text Available This study aims to prove which qualities, from the British and United States actual press, are more adequate for gender violence issues, comparing news on the same stories. It is evident the influence of mass media on public opinion and, therefore, the responsibility that written press has on gender violence messages, avoiding sensationalism. Psycholinguistic studies have established the relation language-thought, so language used in journalism is crucial. Following the belief that newspapers considered more liberal and independent will lead to a better treatment than traditional ones considered to be more reluctant to change, journals have been selected. Furthermore, different cultures can be as objective and respectful but maybe less committed with the issue, as it may arise from the samples. There have been emerging ethic codes giving guidelines to journalists, including discrimination, and more specific on gender sensitive reporting. Therefore, the objective to improve public opinion information, stepping away from stereotypes and oversimplifications, is substantial, and will undoubtedly result in a better understanding of equality.

  3. Physical soil quality indicators for monitoring British soils

    Science.gov (United States)

    Corstanje, Ron; Mercer, Theresa G.; Rickson, Jane R.; Deeks, Lynda K.; Newell-Price, Paul; Holman, Ian; Kechavarsi, Cedric; Waine, Toby W.

    2017-09-01

    Soil condition or quality determines its ability to deliver a range of functions that support ecosystem services, human health and wellbeing. The increasing policy imperative to implement successful soil monitoring programmes has resulted in the demand for reliable soil quality indicators (SQIs) for physical, biological and chemical soil properties. The selection of these indicators needs to ensure that they are sensitive and responsive to pressure and change, e.g. they change across space and time in relation to natural perturbations and land management practices. Using a logical sieve approach based on key policy-related soil functions, this research assessed whether physical soil properties can be used to indicate the quality of British soils in terms of their capacity to deliver ecosystem goods and services. The resultant prioritised list of physical SQIs was tested for robustness, spatial and temporal variability, and expected rate of change using statistical analysis and modelling. Seven SQIs were prioritised: soil packing density, soil water retention characteristics, aggregate stability, rate of soil erosion, depth of soil, soil structure (assessed by visual soil evaluation) and soil sealing. These all have direct relevance to current and likely future soil and environmental policy and are appropriate for implementation in soil monitoring programmes.

  4. British Columbia Petroleum Corporation annual report 1992-1993

    International Nuclear Information System (INIS)

    1993-01-01

    The British Columbia Petroleum Corporation is a provincial Crown agency whose principal mandate is to facilitate and monitor the sale of natural gas, and to act as a central source of information specific to the natural gas industry for the benefit of all industry participants. The Corporation's activities for the year ending March 31, 1993 are summarized. With the devolution of the Corporation's marketing functions in 1990 to CanWest Gas Supply Inc. and the deregulation of the natural gas market, the Corporation no longer markets natural gas and byproducts, but performs a number of administrative functions on behalf of the province. These include issuing acquisition orders and determining the respective netback prices for the purpose of calculating royalties; collection of a production-related levy; collection of data regarding all sale transactions; monitoring of all production, sales and marketing costs; and information gathering for all sectors of the industry. In 1992/93, a total of 27 companies remained with the Corporation, representing 111 individual gas purchase agreements for a combined deliverability of 1,769,300 m 3 /d. At fiscal year end, a total of 713 acquisition orders were being monitored and 20 findings of producer support were issued in response to netback sales applications. Industry volume throughputs increased 8.7% over the previous year and the average netback price rose to $44.87 per 1,000 m 3 . Financial statements are included. 2 figs., 1 tab

  5. Physical soil quality indicators for monitoring British soils

    Directory of Open Access Journals (Sweden)

    R. Corstanje

    2017-09-01

    Full Text Available Soil condition or quality determines its ability to deliver a range of functions that support ecosystem services, human health and wellbeing. The increasing policy imperative to implement successful soil monitoring programmes has resulted in the demand for reliable soil quality indicators (SQIs for physical, biological and chemical soil properties. The selection of these indicators needs to ensure that they are sensitive and responsive to pressure and change, e.g. they change across space and time in relation to natural perturbations and land management practices. Using a logical sieve approach based on key policy-related soil functions, this research assessed whether physical soil properties can be used to indicate the quality of British soils in terms of their capacity to deliver ecosystem goods and services. The resultant prioritised list of physical SQIs was tested for robustness, spatial and temporal variability, and expected rate of change using statistical analysis and modelling. Seven SQIs were prioritised: soil packing density, soil water retention characteristics, aggregate stability, rate of soil erosion, depth of soil, soil structure (assessed by visual soil evaluation and soil sealing. These all have direct relevance to current and likely future soil and environmental policy and are appropriate for implementation in soil monitoring programmes.

  6. Heavy water at Trail, British Columbia

    Energy Technology Data Exchange (ETDEWEB)

    Arsenault, J.E. [Ontario (Canada)

    2006-09-15

    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)

  7. Heavy water at Trail, British Columbia

    International Nuclear Information System (INIS)

    Arsenault, J.E.

    2006-01-01

    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)

  8. 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

  9. Recovery and resilience after a nuclear power plant disaster: a medical decision model for managing an effective, timely, and balanced response.

    Science.gov (United States)

    Coleman, C Norman; Blumenthal, Daniel J; Casto, Charles A; Alfant, Michael; Simon, Steven L; Remick, Alan L; Gepford, Heather J; Bowman, Thomas; Telfer, Jana L; Blumenthal, Pamela M; Noska, Michael A

    2013-04-01

    Resilience after a nuclear power plant or other radiation emergency requires response and recovery activities that are appropriately safe, timely, effective, and well organized. Timely informed decisions must be made, and the logic behind them communicated during the evolution of the incident before the final outcome is known. Based on our experiences in Tokyo responding to the Fukushima Daiichi nuclear power plant crisis, we propose a real-time, medical decision model by which to make key health-related decisions that are central drivers to the overall incident management. Using this approach, on-site decision makers empowered to make interim decisions can act without undue delay using readily available and high-level scientific, medical, communication, and policy expertise. Ongoing assessment, consultation, and adaption to the changing conditions and additional information are additional key features. Given the central role of health and medical issues in all disasters, we propose that this medical decision model, which is compatible with the existing US National Response Framework structure, be considered for effective management of complex, large-scale, and large-consequence incidents.

  10. Idealism to Realism- Representing London in Black British Writing ...

    African Journals Online (AJOL)

    ... self denigration, exploitation and discrimination meted on them by the British as well as their feeling of alienation, cultural dislocation and their struggle for self ... adaptation through which these immigrants will make the best out of London ...

  11. British sounding-rocket programme and the Esrange Special Project

    International Nuclear Information System (INIS)

    Eastwood, G.W.

    1975-01-01

    British participation in the Esrange Special Project has developed very satisfactorily since the programme was reviewed at the last Esrange Symposium [Eastwood, 1973; Acton, 1973]. Two campaigns have been undertaken at Andoya and several more are projected

  12. A Little Known Utraquist Gradual in the British Library London

    Czech Academy of Sciences Publication Activity Database

    Šárovcová, Martina

    2014-01-01

    Roč. 62, Suppl. 1 (2014), s. 250-278 ISSN 0015-1831 Institutional support: RVO:68378033 Keywords : illuminated manuscripts * British library * London Subject RIV: AL - Art, Architecture, Cultural Heritage

  13. SPECIES RICHNESS AND BIODIVERSITY CONSERVATION PRIORITIES IN BRITISH COLUMBIA

    Science.gov (United States)

    Patterns in the geographic distribution of seven species groups were used to identify important areas for conservation in British Columbia, Canada. Potential priority sites for conservation were determined using an integer programming algorithm that maximized the number of speci...

  14. Geothermal prospects in British Columbia: Resource, market and regulatory aspects

    International Nuclear Information System (INIS)

    Ghomshei, M.M.; Brown, T.L.S.; MacRae, J.M.

    1992-01-01

    British Columbia is host to about 15 young volcanic centres and 60 hot springs, all evidence of presence of geothermal resources. Most high-grade geothermal prospects in British Columbia are located along 3 volcanic belts in the south-western region of the province. It is estimated that a minimum of 800 MWe can be generated from the known prospects in this region. Significant low-grade geothermal resources exist in several provincial regions. Market applications consistent with the geothermal resources known and expected to occur in British Columbia include electrical generation, process and other direct heat uses and recreation. Leasing, exploration and development operations for high-grade geothermal resources are addressed by the British Columbia open-quotes Geothermal Resources Actclose quotes which defines geothermal resources and reserves all rights to the Crown in the right of the Province

  15. British scientists and the Manhattan Project: the Los Alamos years

    International Nuclear Information System (INIS)

    Szasz, F.M.

    1992-01-01

    This is a study of the British scientific mission to Los Alamos, New Mexico, from 1943 to 1947, and the impact it had on the early history of the atomic age. In the years following the Manhattan Project and the production of the world's first atomic explosion in 1945, the British contribution to the Project was played down or completely ignored leaving the impression that all the atomic scientists had been American. However, the two dozen or so British scientists contributed crucially to the development of the atomic bomb. First, the initial research and reports of British scientists convinced American scientists that an atomic weapons could be constructed before the likely end of hostilities. Secondly their contribution insured the bomb was available in the shortest possible time. Also, because these scientists became involved in post-war politics and in post-war development of nuclear power, they also helped forge the nuclear boundaries of the mid-twentieth century. (UK)

  16. developed algorithm for the application of british method of concret

    African Journals Online (AJOL)

    t-iyke

    Most of the methods of concrete mix design developed over the years were geared towards manual approach. ... Key words: Concrete mix design; British method; Manual Approach; Algorithm. ..... Statistics for Science and Engineering.

  17. British Military Intervention into Sierra Leone: A Case Study

    National Research Council Canada - National Science Library

    Roberson, Walter G

    2007-01-01

    .... The successful British intervention led to the defeat of the Revolutionary United Front (RUF) and final peace accords, restored order to a failed state, and allowed the democratic restoration of the government of Sierra Leone...

  18. British Columbia, Canada Tsunami Forecast Grids for MOST Model

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The British Columbia, Canada Forecast Model Grids provides bathymetric data strictly for tsunami inundation modeling with the Method of Splitting Tsunami (MOST)...

  19. British Columbia 3 arc-second Bathymetric Digital Elevation Model

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The 3 arc-second British Columbia DEM will be used to support NOAA's tsunami forecast system and for tsunami inundation modeling. This DEM covers the coastal area...

  20. Shared Concerns: Thoughts on British Literature and British Music in the Long Nineteenth Century

    Directory of Open Access Journals (Sweden)

    Michael Allis

    2005-10-01

    Full Text Available As part of the growth of interdisciplinary studies, a number of recent writings have focused upon links between music and literature in the long nineteenth century. In addition to the general significance of music in the work of individual authors and poets, scholars have highlighted particular imagery used in the literary representation of music (charting its effect on narrative and characterisation, and explored the literary reception of several composers. Within this growing body of literature, references to nineteenth- and early twentieth-century British music are significant by their absence. This article therefore aims to redress the balance by suggesting that there are connections between British music and literature in this period, and that these connections are significant. A number of approaches are discussed to highlight their potential, including composer-author affinities, collaborations, generic parallels, hidden narratives, and the suggestion that musical settings of texts can represent critical ‘readings' of those texts. A range of examples (with musical illustrations and sound clips suggest how this particular interdisciplinary focus can lead to the reassessment of individual musical and literary works, and help to explore wider cultural connections within the Victorian and Edwardian era.