WorldWideScience

Sample records for current medical experience

  1. [Regulatory Program for Medical Devices in Cuba: experiences and current challenges].

    Science.gov (United States)

    Pereira, Dulce María Martínez; Rodríguez, Yadira Álvarez; Valdés, Yamila Cedeño; Ribas, Silvia Delgado

    2016-05-01

    Regulatory control of medical devices in Cuba is conducted through a system based on the Regulatory Program for Medical Devices as a way to ensure the safety, efficacy, and effectiveness of these technologies, which are in use by the National Health System. This program was launched in 1992, when the Regulations for State Evaluation and Registration of Medical Devices were approved. Its successive stages and the merging of regulatory activities for drugs and medical equipment have meant progress toward stronger, more transparent strategies and greater control of industry and the National Health System. Throughout its course the Cuban program has met with challenges and difficulties that it has addressed by drawing on its own experiences. During the new period, the greatest challenges revolve around ensuring that regulatory systems incorporate scientific evaluation, risk levels, maximum rigor through the use of technical standards, and the implementation of international recommendations, together with the application of the ISO 13485 certification scheme, enhanced market monitoring, and classification of medical devices in accordance with their relevance to the country's national health policies. From the regional standpoint, the greatest challenge lies in working toward regulatory convergence. The Collaborating Centre for the Regulation of Health Technologies will support the proposed regulatory strategy and established regional priorities, in particular in connection with the implementation of actions involving medical devices.

  2. The value of postmortem experience in undergraduate medical education: current perspectives

    Directory of Open Access Journals (Sweden)

    Bamber AR

    2015-03-01

    Full Text Available Andrew R Bamber,1 Thelma A Quince2 1UCL Institute of Child Health, London, UK; 2Department of Public Health and Primary Care, Primary Care Unit, School of Clinical Medicine, University of Cambridge, School of Clinical Medicine, Cambridge, UK Abstract: The autopsy has traditionally been used as a tool in undergraduate medical education, but recent decades have seen a sharp decline in their use for teaching. This study reviewed the current status of the autopsy as a teaching tool by means of systematic review of the medical literature, and a questionnaire study involving UK medical schools. Teachers and students are in agreement that autopsy-based teaching has many potential benefits, including a deeper knowledge of basic clinical sciences, medical fallibility, end of life issues, audit and the “hidden curriculum”. The reasons underlying the decline in teaching are complex, but include the decreasing autopsy rate, increasing demands on teachers' time, and confusion regarding the law in some jurisdictions. Maximal use of autopsies for teaching may be achieved by involvement of anatomical pathology technologists and trainee pathologists in teaching, the development of alternative teaching methods using the principles of the autopsy, and clarification of the law. Students gain most benefit from repeated attendance at autopsies, being taught by enthusiastic teachers, when they have been effectively prepared for the esthetic of dissection and the mortuary environment. Keywords: medical education, autopsy, postmortem 

  3. CBD-enriched medical cannabis for intractable pediatric epilepsy: The current Israeli experience.

    Science.gov (United States)

    Tzadok, Michal; Uliel-Siboni, Shimrit; Linder, Ilan; Kramer, Uri; Epstein, Orna; Menascu, Shay; Nissenkorn, Andrea; Yosef, Omer Bar; Hyman, Eli; Granot, Dorit; Dor, Michael; Lerman-Sagie, Tali; Ben-Zeev, Bruria

    2016-02-01

    To describe the experience of five Israeli pediatric epilepsy clinics treating children and adolescents diagnosed as having intractable epilepsy with a regimen of medical cannabis oil. A retrospective study describing the effect of cannabidiol (CBD)-enriched medical cannabis on children with epilepsy. The cohort included 74 patients (age range 1-18 years) with intractable epilepsy resistant to >7 antiepileptic drugs. Forty-nine (66%) also failed a ketogenic diet, vagal nerve stimulator implantation, or both. They all started medical cannabis oil treatment between 2-11/2014 and were treated for at least 3 months (average 6 months). The selected formula contained CBD and tetrahydrocannabinol at a ratio of 20:1 dissolved in olive oil. The CBD dose ranged from 1 to 20mg/kg/d. Seizure frequency was assessed by parental report during clinical visits. CBD treatment yielded a significant positive effect on seizure load. Most of the children (66/74, 89%) reported reduction in seizure frequency: 13 (18%) reported 75-100% reduction, 25 (34%) reported 50-75% reduction, 9 (12%) reported 25-50% reduction, and 19 (26%) reported epilepsy in a population of children and adolescents are highly promising. Further prospective, well-designed clinical trials using enriched CBD medical cannabis are warranted. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  4. [Current issues in medical liability].

    Science.gov (United States)

    Kaatsch, H J

    1987-01-01

    Currently, liability discussions are being dominated by AIDS and the legal problems associated with birth and death. The introduction of routine AIDS tests without the knowledge of those concerned is disputed heatedly and, in fact, may well constitute bodily assault and render those responsible liable to prosecution. In AIDS cases, the apparent breach of the Hippocratic oath of secrecy by Physicians can be justified on the grounds of both the extraordinary circumstances prevailing and conflicting duties. The transmission of AIDS could give rise to prosecution for causing bodily injury or manslaughter. The drawing up of a law to protect embryos is designed to establish legal constraints in the fields of reproduction and gene technology. In reframing section 168 StGB, which provides protection to the dead embryo, legislators assume that the head of a medical clinic is the lawful custodian of the corpse of a person who has died in his institution. This should help to resolve many of the problems arising from post-mortem examinations. The questions of euthanasia and medical assistance in cases of suicide were raised at the 1986 Conference of German Lawyers. Whereas medical treatment that could be considered as interference with the natural process of dying may be withdrawn in the case of irreversible terminal suffering, active euthanasia, i.e. the deliberate killing of a terminal patient, was rejected. With regard to noninterference in a suicide attempt by a third party, the free decision of the person wishing to commit suicide should be respected. In general, however, the maxim in dubio pro vita should be respected and where any doubt exists, an attempt should be made to save the person's life.

  5. Current issues in medical education

    African Journals Online (AJOL)

    ing, virtual reality, the use ol' simulated subjects, e learn- ing, and the new .... leges (AAMCÏ proposed a group oi' leaming objectives as guide- lines for medical schools. .... Suggestions for action research studies of cli- mates in medical ...

  6. [Current problems in medical entomology].

    Science.gov (United States)

    Alekseev, A N

    1999-01-01

    The major problems facing medical entomology as a science and practical health care facilities in the Russian Federations allows to outline the tasks to be solved in order of their priority and significance. These include the study and monitoring of tick-borne infections, resurrecting malaria, gnat-induced diseases, acariases, allergosis and pediculosis. It is emphasized that medical entomology as a science cannot develop since the man-made changes of the environment and the predicted global warming of the Earth climate are not taken into account. The present status of medical entomological service is considered to be poor. Governmental support is required.

  7. Medical Robots: Current Systems and Research Directions

    OpenAIRE

    Beasley, Ryan A.

    2012-01-01

    First used medically in 1985, robots now make an impact in laparoscopy, neurosurgery, orthopedic surgery, emergency response, and various other medical disciplines. This paper provides a review of medical robot history and surveys the capabilities of current medical robot systems, primarily focusing on commercially available systems while covering a few prominent research projects. By examining robotic systems across time and disciplines, trends are discernible that imply future capabilities ...

  8. Medical Robots: Current Systems and Research Directions

    Directory of Open Access Journals (Sweden)

    Ryan A. Beasley

    2012-01-01

    Full Text Available First used medically in 1985, robots now make an impact in laparoscopy, neurosurgery, orthopedic surgery, emergency response, and various other medical disciplines. This paper provides a review of medical robot history and surveys the capabilities of current medical robot systems, primarily focusing on commercially available systems while covering a few prominent research projects. By examining robotic systems across time and disciplines, trends are discernible that imply future capabilities of medical robots, for example, increased usage of intraoperative images, improved robot arm design, and haptic feedback to guide the surgeon.

  9. Influenza: A current medical problem

    Directory of Open Access Journals (Sweden)

    Bojić Ivanko

    2007-01-01

    Full Text Available Introduction. Acute respiratory infections are the most common infections in the human population. Among them, virus infections, especially those caused by influenza viruses, have an important place. Type A influenza. Type A influenza virus caused three epidemics during the last century. A high percetage of deceased in pandemics of 1918, and 1919 were young, healthy persons, with many of the deaths due to an unusually severe, hemorrhagic pneumonia. At the end of 2003, and the beginning of 2004, an epidemic emerged in South East Asia of poultry influenza caused by animal (avian virus. Later it spread to the human population, with a high death rate of 73% and with a possibility of interhuman transmission. This review article provides an overview of the clinical manifestations, laboratory findings and chest radiographs. Apart from the symptomatic and supportive therapy, there are antiviral drugs and corticosteriods. Conclusion. The use of vaccine containing subtypes of virus hemagglutinins and neuraminidase from an influenza virus currently infecting the population has a great importance. .

  10. Current Direct Neutrino Mass Experiments

    Directory of Open Access Journals (Sweden)

    G. Drexlin

    2013-01-01

    Full Text Available In this contribution, we review the status and perspectives of direct neutrino mass experiments, which investigate the kinematics of β-decays of specific isotopes (3H, 187Re, 163Ho to derive model-independent information on the averaged electron (antineutrino mass. After discussing the kinematics of β-decay and the determination of the neutrino mass, we give a brief overview of past neutrino mass measurements (SN1987a-ToF studies, Mainz and Troitsk experiments for 3H, cryobolometers for 187Re. We then describe the Karlsruhe Tritium Neutrino (KATRIN experiment currently under construction at Karlsruhe Institute of Technology, which will use the MAC-E-Filter principle to push the sensitivity down to a value of 200 meV (90% C.L.. To do so, many technological challenges have to be solved related to source intensity and stability, as well as precision energy analysis and low background rate close to the kinematic endpoint of tritium β-decay at 18.6 keV. We then review new approaches such as the MARE, ECHO, and Project8 experiments, which offer the promise to perform an independent measurement of the neutrino mass in the sub-eV region. Altogether, the novel methods developed in direct neutrino mass experiments will provide vital information on the absolute mass scale of neutrinos.

  11. [Current states and future aspects of graduate schools for adult graduate students: experiences of the master's course as a medical technologist].

    Science.gov (United States)

    Obara, Takehiro; Suwabe, Akira

    2012-12-01

    The educational system for medical technologists (MTs) has gradually shifted from a three-year technical school system to a four-year university system. It is worthwhile for MTs to advance to a graduate school, in order to improve their routine-work skills, performances, and also to advance their own research as well as to learn how to direct younger MTs. Recently, MTs who advance to the graduate school as adult graduate students are increasing. In this article, the current states and future aspects of the graduate school of Iwate Medical University are reported. In our Department of Central Clinical Laboratory in Iwate Medical University Hospital, three of my colleagues have completed the master's course of the graduate school as adult graduate students, and three are currently attending the school. Nevertheless, none of them has advanced to the doctor's course yet. The primary reason why they do not advance is the heavy burden on any adult graduate students physically, mentally, and financially to study in the graduate school and carry out routine duties at the same time. Thus, in order to encourage MTs to go or to graduate school education, it is important to arrange systems which will enable MTs to advance to the graduate school as adult graduate students. I believe there are three key elements to make this possible. Firstly, prepare easier access to curriculums for MTs to study special fields and learn special skills. Secondly, arrange an increase in the salary scheme depending on the degree attained from the graduate school. Thirdly, provide financial support for graduate school expenses. In conclusion, it is expected that a large number of MTs will advance to the graduate school if these changes for a better educational environment are made.

  12. Current Direct Neutrino Mass Experiments

    CERN Document Server

    Drexlin, G; Mertens, S; Weinheimer, C

    2013-01-01

    In this contribution we review the status and perspectives of direct neutrino mass experiments. These experiments investigate the kinematics of $\\beta$-decays of specific isotopes ($^3$H, $^{187}$Re, $^{163}$Ho) to derive model-independent information on the averaged electron (anti-) neutrino mass, which is formed by the incoherent sum of the neutrino mass eigenstates contributing to the electron neutrino. We first review the kinematics of $\\beta$-decay and the determination of the neutrino mass, before giving a brief overview of past neutrino mass measurements (SN1987a-ToF studies, Mainz and Troitsk experiments for $^3$H, cryo-bolometers for $^{187}$Re). We then describe the Karlsruhe Tritium Neutrino (KATRIN) experiment which is currently under construction at Karlsruhe Institute of Technology. The large-scale setup will use the MAC-E-Filter principle pioneered earlier to push the sensitivity down to a value of 200 meV(90% C.L.). KATRIN faces many technological challenges that have to be resolved with regar...

  13. Undergraduate medical students' empathy: current perspectives.

    Science.gov (United States)

    Quince, Thelma; Thiemann, Pia; Benson, John; Hyde, Sarah

    2016-01-01

    Empathy is important to patient care. It enhances patients' satisfaction, comfort, self-efficacy, and trust which in turn may facilitate better diagnosis, shared decision making, and therapy adherence. Empathetic doctors experience greater job satisfaction and psychological well-being. Understanding the development of empathy of tomorrow's health care professionals is important. However, clinical empathy is poorly defined and difficult to measure, while ways to enhance it remain unclear. This review examines empathy among undergraduate medical students, focusing upon three main questions: How is empathy measured? This section discusses the problems of assessing empathy and outlines the utility of the Jefferson Scale of Empathy - Student Version and Davis's Interpersonal Reactivity Index. Both have been used widely to assess medical students' empathy. Does empathy change during undergraduate medical education? The trajectory of empathy during undergraduate medical education has been and continues to be debated. Potential reasons for contrasting results of studies are outlined. What factors may influence the development of empathy? Although the influence of sex is widely recognized, the impact of culture, psychological well-being, and aspects of undergraduate curricula are less well understood. This review identifies three interrelated issues for future research into undergraduate medical students' empathy. First, the need for greater clarity of definition, recognizing that empathy is multidimensional. Second, the need to develop meaningful ways of measuring empathy which include its component dimensions and which are relevant to patients' experiences. Medical education research has generally relied upon single, self-report instruments, which have utility across large populations but are limited. Finally, there is a need for greater methodological rigor in investigating the possible determinants of clinical empathy in medical education. Greater specificity of context

  14. Undergraduate medical students' empathy: current perspectives

    Directory of Open Access Journals (Sweden)

    Quince T

    2016-08-01

    Full Text Available Thelma Quince, Pia Thiemann, John Benson, Sarah Hyde Primary Care Unit, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK Abstract: Empathy is important to patient care. It enhances patients’ satisfaction, comfort, self-efficacy, and trust which in turn may facilitate better diagnosis, shared decision making, and therapy adherence. Empathetic doctors experience greater job satisfaction and psychological well-being. Understanding the development of empathy of tomorrow's health care professionals is important. However, clinical empathy is poorly defined and difficult to measure, while ways to enhance it remain unclear. This review examines empathy among undergraduate medical students, focusing upon three main questions: How is empathy measured? This section discusses the problems of assessing empathy and outlines the utility of the Jefferson Scale of Empathy – Student Version and Davis's Interpersonal Reactivity Index. Both have been used widely to assess medical students' empathy. Does empathy change during undergraduate medical education? The trajectory of empathy during undergraduate medical education has been and continues to be debated. Potential reasons for contrasting results of studies are outlined. What factors may influence the development of empathy? Although the influence of sex is widely recognized, the impact of culture, psychological well-being, and aspects of undergraduate curricula are less well understood. This review identifies three interrelated issues for future research into undergraduate medical students' empathy. First, the need for greater clarity of definition, recognizing that empathy is multidimensional. Second, the need to develop meaningful ways of measuring empathy which include its component dimensions and which are relevant to patients' experiences. Medical education research has generally relied upon single, self-report instruments, which have

  15. CURRENT LEVELS OF MEDICAL EXPOSURE IN RUSSIA

    Directory of Open Access Journals (Sweden)

    M. I. Balonov

    2015-01-01

    Full Text Available We considered conditions of patients’ medical radiation exposure in Russian diagnostic radiology and nuclear medicine basing on the data of our own research, of the Unified system of individual dose control and of some relevant literature. We analyzed the data on the number of diagnostic examinations, patients’ individual and collective doses and their distribution by examination types. Time trends of the studied parameters are presented for the period between 1999 and 2013. Current level of Russian patients’ medical exposure is the lowest over the whole observation period and one of the lowest among the developed countries. The annual number of X-ray diagnostic examinations is 1.8 per capita. In 2013 median effective dose of medical exposure per capita in Russia was 0.45 mSv and median dose per procedure was 0.25 mSv. The major contribution to collective dose of medical exposure was from computed tomography and radiography; the largest individual doses were caused by interventional radiology, computed X-Ray and nuclear medicine tomographic examinations. The range of median doses comprises about four orders of magnitude, i.e. from several microSv in dental X-ray examinations up to several tens of milliSv in interventional and multistage tomographic examinations. The median effective dose of adult patients increases by about an order of magnitude with each transition from dental X-ray examinations to conventional radiology and further to computed tomography and interventional radiology examinations. During interventional X-Ray examinations, absorbed skin doses at radiation beam entrance site may reach several Gray, which may lead to deterministic radiation effects in skin and subcutaneous tissues. Due to replacement of low-dose ‘functional’ nuclear medicine examinations with more informative modern scintigraphy and tomography examination, patient doses substantially increased over the last decade. With current trend for re-equipment of

  16. Medical photography: a Trinidad experience.

    Science.gov (United States)

    Spence, Richard

    2004-06-01

    In 1991, the creation of the Media Unit at the St. Augustine Campus, University of West Indies, first established medical illustration as an organized profession within the public healthcare provision of Trinidad and Tobago. Since then the Unit has overcome many difficulties, some of them unusual for medical illustrators in the developed world, not least in obtaining equipment unavailable in the country, in finding suitable working facilities, and in developing practices for veterinary work. Today the Media Unit services a wide range of the University's schools, clinics and media services, and has been instrumental in educating a new generation of healthcare professionals.

  17. [How do asylum seekers experience access to medical care?

    Science.gov (United States)

    Spura, Anke; Kleinke, Matthias; Robra, Bernt-Peter; Ladebeck, Nadine

    2017-04-01

    In Germany basic medical care for asylum seekers is organized outside the statutory health insurance system. Currently there are few empirically based statements on how asylum seekers experience their access to healthcare. The aim is therefore to evaluate their experiences with healthcare focussing on subjective health, utilisation and access to medical care, and experiences with medical care. Between August and November 2015, we performed 16 qualitative problem-oriented guided interviews with asylum seekers, who received or sought medical care in Saxony-Anhalt. The interpreter-assisted interviews were evaluated with content analysis. Access begins with a voucher for medical treatment issued by the social security office. Asylum seekers experience that procedure as onerous and incapacitating. These experiences influence subjective health and utilisation of medical help. If their efforts for treatment certificates are rejected, people increasingly resign. If medical treatment is achieved, they experience medical staff mostly as competent and friendly, in spite of language difficulties and time pressure. Reducing the "voucher bureaucracy" by uniform rules and practices may bring about a relief to access and utilisation of healthcare. Introducing an electronic health insurance card for asylum seekers would retransfer decision making about treatment needs from the welfare system into the medical system.

  18. The Current State of Medical Education in Chinese Medical Schools

    Science.gov (United States)

    Kosik, Russell Oliver; Huang, Lei; Cai, Qiaoling; Xu, Guo-Tong; Zhao, Xudong; Guo, Li; Tang, Wen; Chen, Qi; Fan, Angela Pei-Chen

    2014-01-01

    Today's doctor is as much a humanist as a scientist. Medical schools have responded to this change by introducing a variety of courses, most notably those concerning the humanities and ethics. Thus far, no one has examined the extent of use of these subjects in Chinese medical schools. The goal of this study is to determine how many and in…

  19. Current Issues and the Veterinary Medical Library

    Science.gov (United States)

    Nault, Andre J.

    2010-01-01

    Veterinary medical libraries and librarians are unique. There are now 33 veterinary colleges in North America, and in accordance with American Veterinary Medical Association accreditation, each has a library managed by an accredited librarian. Colleges with veterinary programs often maintain specialized branch libraries to support the degree,…

  20. Current Issues and the Veterinary Medical Library

    Science.gov (United States)

    Nault, Andre J.

    2010-01-01

    Veterinary medical libraries and librarians are unique. There are now 33 veterinary colleges in North America, and in accordance with American Veterinary Medical Association accreditation, each has a library managed by an accredited librarian. Colleges with veterinary programs often maintain specialized branch libraries to support the degree,…

  1. Investigation and Analysis on Current Condition of Medical Ethics Consciousness in Animal Experiments in Nursing Students%医护学生在动物实验中的伦理意识调查和分析

    Institute of Scientific and Technical Information of China (English)

    潘丽; 涂腊根; 江婉明; 钟翠芬; 阳小雅; 林小珊

    2013-01-01

    Objective:To investigate the status of current ethical attitudes and animal ethics education in animal experiments in medical nursing students and to discuss and find the methods for solving their psychological confusions. Methods;The self - designed questionnaire was used in 247 medical nursing students. The content involves attitudes toward animal experiments, the understanding of animal protection, present situation of ethical consciousness in animal experiments and the understanding of relationships between animal experiments and clinical work, and part of the students reveived psychological interview. Results: 64. 7% of the nursing students accept animal experiments, and 35. 3% of the medical students feel confused or direct against animal experiments. Ethical education in animal experiments was at shortage, most students were not clear for the purpose of opening animal experiment and how to study and so forth. Conclusion; Teachers should help medical students to analyze the rationality of the animal experiments; doing more work in animal ethical regulations propaganda; continuous research for nursing experimental projects.%目的 了解医护学生对于动物实验的态度和动物伦理教育的现状,探讨解决医护学生心理困惑的途径及方法.方法 采用自制调查问卷的方法,对247名医护学生进行问卷调查,调查内容涉及医护学生对动物实验的基本看法、对实验动物保护法规的了解、医护学生动物实验的伦理意识现状以及对于动物实验与临床工作的关系四个方面,并对部分医护学生进行心理访谈.结果 64.7%的医护学生接受动物实验,而35.3%的医护学生对此感到困惑或直接反对动物实验.医护学生在动物实验中的伦理教育缺失严重,大部分医护学生对于开设动物实验的目的、如何进行学习等目标不明确.结论 教师必须帮助医护学生分析动物实验的合理性与不合理性;做好动物伦理法规

  2. Current experiments in elementary particle physics. Revision

    Energy Technology Data Exchange (ETDEWEB)

    Galic, H. [Stanford Linear Accelerator Center, Menlo Park, CA (United States); Armstrong, F.E. [Lawrence Berkeley Lab., CA (United States); von Przewoski, B. [Indiana Univ. Cyclotron Facility, Bloomington, IN (United States)] [and others

    1994-08-01

    This report contains summaries of 568 current and recent experiments in elementary particle physics. Experiments that finished taking data before 1988 are excluded. Included are experiments at BEPC (Beijing), BNL, CEBAF, CERN, CESR, DESY, FNAL, INS (Tokyo), ITEP (Moscow), IUCF (Bloomington), KEK, LAMPF, Novosibirsk, PNPI (St. Petersburg), PSI, Saclay, Serpukhov, SLAC, and TRIUMF, and also several underground and underwater experiments. Instructions are given for remote searching of the computer database (maintained under the SLAC/SPIRES system) that contains the summaries.

  3. Current experiments in particle physics, 1996

    CERN Document Server

    Lawrence Berkeley Nat. Laboratory. Berkeley; Lehár, F; Klioukhine, V I; Ryabov, Yu; Bilak, S V; Illarionova, N S; Khachaturov, B A; Strokovsky, E A; Hoffman, C M; Kettle, P R; Olin, A; Armstrong, F E

    1996-01-01

    Contains more than 1,800 experiments in elementary particle physics from the Experience database. Search and browse by author; title; experiment number or prefix; institution; date approved, started or completed; accelerator or detector; polarization, reaction, final state or particle; or by papers produced. Maintained at SLAC for the Particle Data Group. Supplies the information for Current Experiments in Particle Physics (LBL-91). Print version updated every second year.

  4. Current experiments in elementary particle physics, 1989

    CERN Document Server

    Lawrence Berkeley Nat. Laboratory. Berkeley; Armstrong, F E; Trippe, T G; Yost, G P; Oyanagi, Y; Dodder, D C; Ryabov, Yu G; Slabospitsky, S R; Frosch, R; Olin, A; Lehar, F; Klumov, I A; Ivanov, I I

    1989-01-01

    Contains more than 1,800 experiments in elementary particle physics from the Experience database. Search and browse by author; title; experiment number or prefix; institution; date approved, started or completed; accelerator or detector; polarization, reaction, final state or particle; or by papers produced. Maintained at SLAC for the Particle Data Group. Supplies the information for Current Experiments in Particle Physics (LBL-91). Print version updated every second year.

  5. Current medical diagnosis and treatment 1986

    Energy Technology Data Exchange (ETDEWEB)

    Krupp, M.A.; Chatton, M.J.; Tierney, L.M.

    1986-01-01

    This book contains 33 chapters. Some of the titles are: Nervous system; Psychiatric disorders; Medical genetics; Endocrine disorders; Introduction to infectious diseases; Disorders due to physical agents; and Anti-infective chemotherapeutic and antibiotic agents.

  6. Current trend of robotics application in medical

    Science.gov (United States)

    Olanrewaju, O. A.; Faieza, A. A.; Syakirah, K.

    2013-06-01

    The applications of robotics in recent years has emerged beyond the field of manufacturing or industrial robots itself. Robotics applications are now widely used in medical, transport, underwater, entertainment and military sector. In medical field, these applications should be emphasized in view of the increasing challenges due to the variety of findings in the field of medicine which requires new inventions to ease work process. The objective of this review paper is to study and presents the past and on-going research in medical robotics with emphasis on rehabilitation (assistive care) and surgery robotics which are certainly the two main practical fields where robots application are commonly used presently. The study found that, rehabilitation and surgery robotics applications grow extensively with the finding of new invention, as well as research that is being undertaken and to be undertaken. The importance of medical robot in medical industry is intended to offer positive outcomes to assist human business through a complicated task that involves a long period, accuracy, focus and other routines that cannot be accomplished by human ability alone.

  7. [The notion of medical responsibility. Current evolution].

    Science.gov (United States)

    Michaud, J

    1998-01-01

    Medical responsibility can be evaluated from a penal or a civil standpoint. In the first case it is referable to common law or other specific provisions, notably those included in the laws voted on July 29 1994. In the second case it is viewed within the contractual relationship, since the physician's obligation is theoretically one of means and not of results. The circumstances under which medical responsibility is questioned have evolved under the influence of three factors affecting the medical art: it is now characterized by techniques that have often become scientific; team practice; an increase in patients' demands. Nonetheless it is most important to maintain a genuine relationship of trust between physician and patient.

  8. Current Experiments in Particle Physics (September 1996)

    Energy Technology Data Exchange (ETDEWEB)

    Galic, H.; Lehar, F.; Klyukhin, V.I.; Ryabov, Yu.G.; Bilak, S.V.; Illarionova, N.S.; Khachaturov, B.A.; Strokovsky, E.A.; Hoffman, C.M.; Kettle, P.-R.; Olin, A.; Armstrong, F.E.

    1996-09-01

    This report contains summaries of current and recent experiments in Particle Physics. Included are experiments at BEPC (Beijing), BNL, CEBAF, CERN, CESR, DESY, FNAL, Frascati, ITEP (Moscow), JINR (Dubna), KEK, LAMPF, Novosibirsk, PNPI (St. Petersburg), PSI, Saclay, Serpukhov, SLAC, and TRIUMF, and also several proton decay and solar neutrino experiments. Excluded are experiments that finished taking data before 1991. Instructions are given for the World Wide Web (WWW) searching of the computer database (maintained under the SLAC-SPIRES system) that contains the summaries. This report contains full summaries of 180 approved current and recent experiments in elementary particle physics. The focus of the report is on selected experiments which directly contribute to our better understanding of elementary particles and their properties such as masses, widths or lifetimes, and branching fractions.

  9. Medical devices for the anesthetist: current perspectives

    Directory of Open Access Journals (Sweden)

    Ingrande J

    2014-03-01

    Full Text Available Jerry Ingrande, Hendrikus JM LemmensDepartment of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USAAbstract: Anesthesiologists are unique among most physicians in that they routinely use technology and medical devices to carry out their daily activities. Recently, there have been significant advances in medical technology. These advances have increased the number and utility of medical devices available to the anesthesiologist. There is little doubt that these new tools have improved the practice of anesthesia. Monitoring has become more comprehensive and less invasive, airway management has become easier, and placement of central venous catheters and regional nerve blockade has become faster and safer. This review focuses on key medical devices such as cardiovascular monitors, airway equipment, neuromonitoring tools, ultrasound, and target controlled drug delivery software and hardware. This review demonstrates how advances in these areas have improved the safety and efficacy of anesthesia and facilitate its administration. When applicable, indications and contraindications to the use of these novel devices will be explored as well as the controversies surrounding their use.Keywords: catheters, echocardiography, ultrasound, fiberoptic bronchoscope, laryngeal mask airway, closed-loop anesthesia

  10. Fasa University Medical School: a novel experience in medical education

    Directory of Open Access Journals (Sweden)

    HOSSAIN A. RONAGHY

    2014-01-01

    Full Text Available Introduction: In early 1970`s a combination of a shortage and misdistribution of health services and growing public dissatisfaction about the health care available, along with increasing expectations, has put great strain on the mind of the staff of the Department of Medicine Shiraz University School of Medicine. The purpose of this report is to give an account of what was originally planned and what has happened since the start of Fasa Medical School in April 1978. Methods: This is a case report about an experience in medical education in Iran. At the time, two major problems were facing our country. The first was gross mal-distribution of these healthcare facilities, which were mostly concentrated in Tehran and big cities of Iran, and the second problem was continuous exodus of Iranian Medical graduates to the Western countries. Results: The main idea of creating Fasa Medical School was to create a system in which primary care in small villages are provided by VHW with the middle level health workers of “Behdar Roustaee” to be supported by local physicians who reside in small towns. Conclusion: For Fasa Medical School, education was emphasized on community based, student centered, and problem based medical education located in the community and based on teamwork and cooperation.

  11. Current experiments in elementary particle physics. Revised

    Energy Technology Data Exchange (ETDEWEB)

    Galic, H. [Stanford Univ., CA (United States). Stanford Linear Accelerator Center; Wohl, C.G.; Armstrong, B. [Lawrence Berkeley Lab., CA (United States); Dodder, D.C. [Los Alamos National Lab., NM (United States); Klyukhin, V.I.; Ryabov, Yu.G. [Inst. for High Energy Physics, Serpukhov (Russian Federation); Illarionova, N.S. [Inst. of Theoretical and Experimental Physics, Moscow (Russian Federation); Lehar, F. [CEN Saclay, Gif-sur-Yvette (France); Oyanagi, Y. [Univ. of Tokyo (Japan). Faculty of Sciences; Olin, A. [TRIUMF, Vancouver, BC (Canada); Frosch, R. [Paul Scherrer Inst., Villigen (Switzerland)

    1992-06-01

    This report contains summaries of 584 current and recent experiments in elementary particle physics. Experiments that finished taking data before 1986 are excluded. Included are experiments at Brookhaven, CERN, CESR, DESY, Fermilab, Tokyo Institute of Nuclear Studies, Moscow Institute of Theoretical and Experimental Physics, KEK, LAMPF, Novosibirsk, Paul Scherrer Institut (PSI), Saclay, Serpukhov, SLAC, SSCL, and TRIUMF, and also several underground and underwater experiments. Instructions are given for remote searching of the computer database (maintained under the SLAC/SPIRES system) that contains the summaries.

  12. Current experiments in elementary particle physics

    Energy Technology Data Exchange (ETDEWEB)

    Wohl, C.G.; Armstrong, F.E.; Trippe, T.G.; Yost, G.P. (Lawrence Berkeley Lab., CA (USA)); Oyanagi, Y. (Tsukuba Univ., Ibaraki (Japan)); Dodder, D.C. (Los Alamos National Lab., NM (USA)); Ryabov, Yu.G.; Slabospitsky, S.R. (Gosudarstvennyj Komitet po Ispol' zovaniyu Atomnoj Ehnergii SSSR, Serpukhov (USSR). Inst. Fiziki Vysokikh Ehnergij); Frosch, R. (Swiss Inst. for Nuclear Research, Villigen (Switzerla

    1989-09-01

    This report contains summaries of 736 current and recent experiments in elementary particle physics (experiments that finished taking data before 1982 are excluded). Included are experiments at Brookhaven, CERN, CESR, DESY, Fermilab, Tokyo Institute of Nuclear Studies, Moscow Institute of Theoretical and Experimental Physics, Joint Institute for Nuclear Research (Dubna), KEK, LAMPF, Novosibirsk, PSI/SIN, Saclay, Serpukhov, SLAC, and TRIUMF, and also several underground experiments. Also given are instructions for searching online the computer database (maintained under the SLAC/SPIRES system) that contains the summaries. Properties of the fixed-target beams at most of the laboratories are summarized.

  13. Current experiments in elementary particle physics

    Energy Technology Data Exchange (ETDEWEB)

    Wohl, C.G.; Armstrong, F.E., Oyanagi, Y.; Dodder, D.C.; Ryabov, Yu.G.; Frosch, R.; Olin, A.; Lehar, F.; Moskalev, A.N.; Barkov, B.P.

    1987-03-01

    This report contains summaries of 720 recent and current experiments in elementary particle physics (experiments that finished taking data before 1980 are excluded). Included are experiments at Brookhaven, CERN, CESR, DESY, Fermilab, Moscow Institute of Theoretical and Experimental Physics, Tokyo Institute of Nuclear Studies, KEK, LAMPF, Leningrad Nuclear Physics Institute, Saclay, Serpukhov, SIN, SLAC, and TRIUMF, and also experiments on proton decay. Instructions are given for searching online the computer database (maintained under the SLAC/SPIRES system) that contains the summaries. Properties of the fixed-target beams at most of the laboratories are summarized.

  14. Current Experiments in Particle Physics. 1996 Edition.

    Energy Technology Data Exchange (ETDEWEB)

    Galic, Hrvoje

    2003-06-27

    This report contains summaries of current and recent experiments in Particle Physics. Included are experiments at BEPC (Beijing), BNL, CEBAF, CERN, CESR, DESY, FNAL, Frascati, ITEP (Moscow), JINR (Dubna), KEK, LAMPF, Novosibirsk, PNPI (St. Petersburg), PSI, Saclay, Serpukhov, SLAC, and TRIUMF, and also several proton decay and solar neutrino experiments. Excluded are experiments that finished taking data before 1991. Instructions are given for the World Wide Web (WWW) searching of the computer database (maintained under the SLAC-SPIRES system) that contains the summaries.

  15. COMPILATION OF CURRENT HIGH ENERGY PHYSICS EXPERIMENTS

    Energy Technology Data Exchange (ETDEWEB)

    Wohl, C.G.; Kelly, R.L.; Armstrong, F.E.; Horne, C.P.; Hutchinson, M.S.; Rittenberg, A.; Trippe, T.G.; Yost, G.P.; Addis, L.; Ward, C.E.W.; Baggett, N.; Goldschmidt-Clermong, Y.; Joos, P.; Gelfand, N.; Oyanagi, Y.; Grudtsin, S.N.; Ryabov, Yu.G.

    1981-05-01

    This is the fourth edition of our compilation of current high energy physics experiments. It is a collaborative effort of the Berkeley Particle Data Group, the SLAC library, and nine participating laboratories: Argonne (ANL), Brookhaven (BNL), CERN, DESY, Fermilab (FNAL), the Institute for Nuclear Study, Tokyo (INS), KEK, Serpukhov (SERP), and SLAC. The compilation includes summaries of all high energy physics experiments at the above laboratories that (1) were approved (and not subsequently withdrawn) before about April 1981, and (2) had not completed taking of data by 1 January 1977. We emphasize that only approved experiments are included.

  16. Laboratory Experiments of Rip Current Generation

    Science.gov (United States)

    Garnier, R.; Coco, G.; Lomonaco, P.; Dalrymple, R. A.; Alvarez, A.; Gonzalez, M.; Medina, R.

    2014-12-01

    The hypothesis of rip current generation from purely hydrodynamic processes is here investigated through laboratory experiments. The experiments have been performed at the Cantabria Coastal and Ocean Basin (CCOB) with a segmented wavemaker consisting of 64 waveboards. The basin measures 25m in the cross-shore and 32m in the alongshore direction and the water depth at the wavemaker is 1m. A concrete plane sloping (1:5) beach has been built in the opposite side of the wave machine, its toe is 15m from the waveboards. Reflective lateral walls covered the full length of the basin. The set of instruments consists of 33 wave gauges deployed along two longshore and two cross-shore transects, 7 acoustic Doppler velocimeters and 15 run-up wires. Furthermore a set of two cameras has been synchronized with the data acquisition system. Two types of experiments have been performed to specifically study the generation of rip currents under wave group forcing. First, similarly to the experiments of Fowler and Dalrymple (Proc. 22nd Int. Conf. Coast. Eng.,1990), two intersecting wave trains with opposite directions have been imposed. They give rise to the formation of a non-migrating rip current system with a wavelength that depends on wave frequency and direction. Second, single wave trains with alongshore periodic amplitude attenuation have been imposed. Although the attenuation has been set such that the incident wave field has the same envelope as in the first type of experiments, the rip current system differs due to diffraction and interference processes. The results for different wave conditions (maximum incident wave height from 0.2m to 0.4m, wave period from 1.4s to 2s) will be presented and the intensity of the rip currents will be compared to the alongshore variation in wave set-up. This research is part of the ANIMO project funded by the Spanish Government under contract BIA2012-36822.

  17. Current medical therapy of inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Kiron M. Das; Sherif A. Farag

    2000-01-01

    The current established drugs used to treat inflammatory bowel disease include glucocorticoids includingnewer agent budesonide, sulfasalazine and 5-ASA compounds such as Asacol, Pentasa, Dipentum andBalsalazide and immunomodulatory agents such as azathioprine, and 6-mercaptopurine. Additional drugswhich have been found to be useful, particularly in refractory cases of Crohn's disease including fistulizingtype of Crohn's disease, include cyclosporine A, methotrexate, humanized antibody against TNFa(cA2),FK506, IL-10, IL-11 and Probiotics. Various agents, whether used alone or in combination, have to betailored for each patient and none is ideal. Exciting new developments directed against proinflammatorypathways, cytokines, free oxygen radicals and cell surface related immune targets are areas of intense recentinvestigations and many novel therapeutic agents are expected to be available in the near future for medicaltreatment of inflammatory bowel disease.

  18. Avoiding pitfalls in overseas medical educational experiences

    Directory of Open Access Journals (Sweden)

    Kristen L Sessions

    2017-01-01

    Full Text Available In the United States, there are a growing number of medical students participating in international health electives. These experiences have the potential to be mutually beneficial to both the host country and the student. However, there is a significant risk of unethical and damaging practices during these trips, including concerns for sending trainees without appropriate pre-travel preparation with inadequate accountability to local health care providers at a stage in their education that imposes an undue burden on the local health facilities. This article describes one first year medical student’s experience in navigating common challenges faced in international health electives and offers practical advice enlightened by the literature on how to overcome them. We emphasize the need for students to ensure adequate pre-trip preparation, communicate their level of training clearly, practice cultural humility, ensure personal safety, and engage in projects needed by the host community.

  19. Otto Rank: beginnings, endings, and current experience.

    Science.gov (United States)

    Novey, R

    1983-01-01

    I have traced the theories of Otto Rank as they appeared in his major technical writings. Against this background, I have discussed references to Rank in past and contemporary psychoanalytic literature. This paper describes three important contributions of Rank--his birth trauma theory, leading to his theory of the birth of the self; his emphasis on present experience (forerunner of the current "here-and-now" theory); and his writings about the creative potential of the termination process.

  20. The experiment dashboard for medical applications

    CERN Document Server

    Andreeva, Julia; Saiz, Pablo; Sidorova, Irina; Templon, Jeff; Cirstoiu, Catalin; Da Rocha, Ricardo; Gaidioz, Benjamin; Herrala, Juha; Kan, Andrevan; Lamanna, Massimo; Maier, Gerhild; Olabarriaga, Silvia D

    2008-01-01

    The Experiment Dashboard is a monitoring system initially developed for the LHC experiments to provide the view of the Grid infrastructure from the perspective of the LHC virtual organization. The poster describes the first experience of the deployment and usage of the system outside the LHC community, for monitoring of medical applications on the Grid. Functional magnetic resonance imaging (fMRI) is a popular tool used in neuroscience research to study brain function. The Virtual Lab for fMRI (VL-fMRI) is developed as one of the activities of the ``Medical Diagnosis and Imaging'' subprogram of the Virtual Laboratory for e-Sciences Project. VL-fMRI has taken steps to enable data management and analysis tasks for fMRI studies on the Grid infrastructure. Since spring 2006 the Experiment Dashboard is used for job processing monitoring of the VL-fMRI activities. The Experiment Dashboard provides an easy way to users to follow their jobs on the distributed infrastructure. Furthermore, the system allows to detect p...

  1. [Current problems of information technologies application for forces medical service].

    Science.gov (United States)

    Ivanov, V V; Korneenkov, A A; Bogomolov, V D; Borisov, D N; Rezvantsev, M V

    2013-06-01

    The modern information technologies are the key factors for the upgrading of forces medical service. The aim of this article is the analysis of prospective information technologies application for the upgrading of forces medical service. The authors suggested 3 concepts of information support of Russian military health care on the basis of data about information technologies application in the foreign armed forces, analysis of the regulatory background, prospects of military-medical service and gathered experience of specialists. These three concepts are: development of united telecommunication network of the medical service of the Armed Forces of the Russian Federation medical service, working out and implementation of standard medical information systems for medical units and establishments, monitoring the military personnel health state and military medical service resources. It is noted that on the assumption of sufficient centralized financing and industrial implementation of the military medical service prospective information technologies, by the year 2020 the united information space of the military medical service will be created and the target information support effectiveness will be achieved.

  2. The Current Status of the WARP Experiment

    Science.gov (United States)

    Szelc, A. M.; Benetti, P.; Calligarich, E.; Calaprice, F.; Cambiaghi, M.; Carbonara, F.; Cavanna, F.; Cocco, A. G.; Dipompeo, F.; Ferrari, N.; Fiorillo, G.; Galbiati, C.; Grandi, L.; Mangano, G.; Montanari, C.; Palamara, O.; Pandola, L.; Rappoldi, A.; Raselli, G. L.; Roncadelli, M.; Rossella, M.; Rubbia, C.; Santorelli, R.; Vignoli, C.; Zhao, Y.

    2006-07-01

    The WARP detector is a new idea in Dark Matter detection using liquid noble gases, specifically argon. We believe that argon is the medium best suited to detect nuclear recoils coming from interactions with the so called WIMPs (Weakly Interacting Massive Particles). The detection technique, using two different discrimination methods, is capable of an identification power as high as one event in 108. During the second half of the year 2006 the next, 100 liter, detector will be constructed with an active veto shield to further suppress the background, while currently a 2.3 liter prototype, installed in the Gran Sasso Laboratory (Italy), has been taking data since May 2004. The small version of the detector is able to not only provide insight on the operation of a two-phase liquid argon chamber but is also able to provide physics results competitive with the current leading edge experiments.

  3. Current & future medical costs of childhood obesity in Alaska.

    Science.gov (United States)

    Guettabi, Mouhcine

    2014-09-01

    This study examines the medical costs of childhood obesity in Alaska, today and in the future. We estimate that 15.2 percent of those ages 2 to 19 in Alaska are obese. Using parameters from published reports and studies, we estimate that the total excess medical costs due to obesity for both adults and children in Alaska in 2012 were $226 million, with medical costs of obese children and adolescents accounting for about $7 million of that total. And those medical costs will get much higher over time, as today's children transition into adulthood. Aside from the 15.2 percent currently obese, another estimated 20 percent of children who aren't currently obese will become obese as adults, if current national patterns continue. We estimate that the 20-year medical costs--discounted to present value--of obesity among the current cohort of Alaska children and adolescents will be $624 million in today's dollars. But those future costs could be decreased if Alaskans found ways to reduce obesity. We consider how reducing obesity in several ways could reduce future medical costs: reducing current rates of childhood obesity, rates of obese children who become obese adults, or rates of non-obese children and adolescents who become obese adults. We undertake modest reductions to showcase the potential cost savings associated with each of these channels. Clearly the financial savings are a direct function of the obesity reductions and therefore the magnitude of the realized savings will vary accordingly. Also keep in mind that these figures are only for the current cohort of children and adolescents; over time more generations of Alaskans will grow from children into adults, repeating the same cycle unless rates of obesity decline. And finally, remember that medical costs are only part of the broader range of social and economic costs obesity creates.

  4. Introducing medical humanities in the medical curriculum in Saudi Arabia: A pedagogical experiment

    Directory of Open Access Journals (Sweden)

    Rabie E Abdel-Halim

    2012-01-01

    Full Text Available In a marked shift from the modern positivist materialist philosophy that influenced medical education for more than a century, Western medical educators are now beginning to realize the significance of the spiritual element of human nature. Consensus is currently building up in Europe and North America on the need to give more emphasis to the study of humanities disciplines such as history of medicine, ethics, religion, philosophy, medically related poetry, literature, arts and medical sociology in medical colleges with the aim of allowing graduates to reach to the heart of human learning about meaning of life and death and to become kinder, more reflective practitioners. The medicine taught and practiced during the Islamic civilization era was a vivid example of the unity of the two components of medical knowledge: natural sciences and humanities. It was also a brilliant illustration of medical ethics driven by a divine moral code. This historical fact formed the foundation for the three medical humanities courses presented in this article reporting a pedagogical experiment in preparation for starting a humanities program in Alfaisal University Medical College in Riyadh. In a series of lectures alternating with interactive sessions, active learning strategies were employed in teaching a course on history of medicine during the Islamic era and another on Islamic medical ethics. Furthermore, a third course on medically relevant Arabic poetry was designed and prepared in a similar way. The end-of-the-course feedback comments reflected effectiveness of the courses and highlighted the importance of employing student-centered learning techniques in order to motivate medical students to become critical thinkers, problem solvers, life-long learners and self-learners.

  5. Introducing medical humanities in the medical curriculum in Saudi Arabia: A pedagogical experiment.

    Science.gov (United States)

    Abdel-Halim, Rabie E; Alkattan, Khaled M

    2012-05-01

    In a marked shift from the modern positivist materialist philosophy that influenced medical education for more than a century, Western medical educators are now beginning to realize the significance of the spiritual element of human nature. Consensus is currently building up in Europe and North America on the need to give more emphasis to the study of humanities disciplines such as history of medicine, ethics, religion, philosophy, medically related poetry, literature, arts and medical sociology in medical colleges with the aim of allowing graduates to reach to the heart of human learning about meaning of life and death and to become kinder, more reflective practitioners. The medicine taught and practiced during the Islamic civilization era was a vivid example of the unity of the two components of medical knowledge: natural sciences and humanities. It was also a brilliant illustration of medical ethics driven by a divine moral code. This historical fact formed the foundation for the three medical humanities courses presented in this article reporting a pedagogical experiment in preparation for starting a humanities program in Alfaisal University Medical College in Riyadh. In a series of lectures alternating with interactive sessions, active learning strategies were employed in teaching a course on history of medicine during the Islamic era and another on Islamic medical ethics. Furthermore, a third course on medically relevant Arabic poetry was designed and prepared in a similar way. The end-of-the-course feedback comments reflected effectiveness of the courses and highlighted the importance of employing student-centered learning techniques in order to motivate medical students to become critical thinkers, problem solvers, life-long learners and self-learners.

  6. Current trends in medical image registration and fusion

    Directory of Open Access Journals (Sweden)

    Fatma El-Zahraa Ahmed El-Gamal

    2016-03-01

    Full Text Available Recently, medical image registration and fusion processes are considered as a valuable assistant for the medical experts. The role of these processes arises from their ability to help the experts in the diagnosis, following up the diseases’ evolution, and deciding the necessary therapies regarding the patient’s condition. Therefore, the aim of this paper is to focus on medical image registration as well as medical image fusion. In addition, the paper presents a description of the common diagnostic images along with the main characteristics of each of them. The paper also illustrates most well-known toolkits that have been developed to help the working with the registration and fusion processes. Finally, the paper presents the current challenges associated with working with medical image registration and fusion through illustrating the recent diseases/disorders that were addressed through such an analyzing process.

  7. Current Advances in the Medical Application of Nanotechnology

    CERN Document Server

    Slevin, Mark

    2012-01-01

    Nanotechnology promises new medical therapies, more rapid and sensitive diagnostic and investigative tools for normal and diseased tissues, and new materials for tissue engineering. This e-book highlights the major current uses, new technologies and future perspectives of nanotechnology in relation to medical applications. Sections in this e-book include nanobiological approaches to imaging, diagnosis and treatment of disease using targeted monoclonal antibodies and siRNA, the medical use of nanomaterials, to nanoelectronic biosensors, and possible future applications of molecular nanotechnolo

  8. Is current medical education adequately preparing future physicians to manage concussion: an initial evaluation.

    Science.gov (United States)

    Donaworth, Michael A; Grandhi, Ravi K; Logan, Kelsey; Gubanich, Paul J; Myer, Gregory D

    2016-01-01

    In 2010, there were 2.5 million hospitalizations, emergency room visits, or deaths associated with concussions in the United States.[1] Knowledge deficits exist among physicians regarding concussion management, which can lead to severe repercussions, including poor patient outcomes, poor patient satisfaction, and potential medical-legal issues. While concussion is a prevalent condition evaluated in the medical field, medical students continue to have a knowledge deficit regarding concussion diagnosis, prognosis, medical management, and return to play guidelines. Medical students from a mid-western medical school completed a survey on concussion diagnosis, prognosis, medical management, and return to play guidelines. The response rate was 40%. The data suggests that the vast majority of medical students are able to define concussion; however, most reported never having a lecture dedicated to concussion during medical school and also lacked clinical experience with acute concussion and post-concussive syndrome. There are clear areas of deficiency as noted by the inability of students to correctly identify symptoms and appropriate management of concussion. The current study indicates that at an individual, mid-western, top 50 medical school, current medical trainees may not be adequately educated to identify and manage concussion. Future research is warranted to determine the optimal guidelines to educate future physicians as it pertains to concussion diagnosis, management, prognosis, and return to play guidelines.

  9. Current and future medical treatments for patients with acromegaly.

    Science.gov (United States)

    Maffezzoni, Filippo; Formenti, Anna Maria; Mazziotti, Gherardo; Frara, Stefano; Giustina, Andrea

    2016-08-01

    Acromegaly is a relatively rare condition of growth hormone (GH) excess associated with significant morbidity and, when left untreated, high mortality. Therapy for acromegaly is targeted at decreasing GH and insulin-like growth hormone 1 levels, ameliorating patients' symptoms and decreasing any local compressive effects of the pituitary adenoma. The therapeutic options for acromegaly include surgery, medical therapies (such as dopamine agonists, somatostatin receptor ligands and the GH receptor antagonist pegvisomant) and radiotherapy. However, despite all these treatments option, approximately 50% of patients are not adequately controlled. In this paper, the authors discuss: 1) efficacy and safety of current medical therapy 2) the efficacy and safety of the new multireceptor-targeted somatostatin ligand pasireotide 3) medical treatments currently under clinical investigation (oral octreotide, ITF2984, ATL1103), and 4) preliminary data on the use of new injectable and transdermal/transmucosal formulations of octreotide. This expert opinion supports the need for new therapeutic agents and modalities for patients with acromegaly.

  10. How to Use Current Medical Literature and APA Format Style.

    Science.gov (United States)

    Peek, Robin

    Directives and guidance in obtaining current medical literature are provided in this publication with special emphasis given to locating material in the Portland, Oregon area. The uses and types of periodical indexes are identified and periodical index citation examples are indicated. Explanations are offered on: (1) how to conduct an effective…

  11. How to Use Current Medical Literature and APA Format Style.

    Science.gov (United States)

    Peek, Robin

    Directives and guidance in obtaining current medical literature are provided in this publication with special emphasis given to locating material in the Portland, Oregon area. The uses and types of periodical indexes are identified and periodical index citation examples are indicated. Explanations are offered on: (1) how to conduct an effective…

  12. Current status and future trends of medical physics in Mexico

    Science.gov (United States)

    Azorin Nieto, J.

    2015-01-01

    Medical Physics is an area that applies the principles of physics to medicine, particularly in the prevention, diagnosis and treatment of diseases using ionizing and nonionizing radiation. The main attractive of medical physics is that it has a direct impact on the quality and safety of medical care in humans; this social component with direct implications for the population is of high value for Mexico. This paper describes the concepts of medical physics, trends and the current status of this discipline as a profession, which is directly related to the efforts of clinical research. It is also described what is, in my opinion, the future of medical physics in Mexico, emphasizing the fact that this field requires a substantial boost from universities and hospitals to recruit highly qualified young medical physicists and the support from government agencies such as Secretaria de Salud, Instituto Mexicano del Seguro Social and Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado through clinical research projects that allow the necessary evolution of medical physics into the hospital setting.

  13. [Ethic review on clinical experiments of medical devices in medical institutions].

    Science.gov (United States)

    Shuai, Wanjun; Chao, Yong; Wang, Ning; Xu, Shining

    2011-07-01

    Clinical experiments are always used to evaluate the safety and validity of medical devices. The experiments have two types of clinical trying and testing. Ethic review must be done by the ethics committee of the medical department with the qualification of clinical research, and the approval must be made before the experiments. In order to ensure the safety and validity of clinical experiments of medical devices in medical institutions, the contents, process and approval criterions of the ethic review were analyzed and discussed.

  14. INTEGRATION POLICY TOWARDS IMMIGRANTS: CURRENT EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Nadiia Bureiko

    2012-03-01

    Full Text Available In the contemporary world the intensity of the immigration movements is constantly increasing. Countries which experience great immigrant flows are facing numerous problems which should be solved. The article studies the current immigration flows in EU countries, the United States of America and Canada and presents three main models of integration policy towards immigrants – political assimilation, functional integration and multicultural model. Separate models are distinguished for the Muslims’ integration. The author examines the peculiarities of every model and examines the conclusions provided by the Migrant Integration Policy Index (MIPEX concerning the situation of the immigrants’ integration in 31 countries in 2011. Among all the policy indicators the first that are defined are as follows: political participation, education, labour market mobility and anti-discrimination. The situation with immigrants’ integration in Ukraine is also studied as it is gaining a great attention of the authorities and the public. The measures and practical steps done regarding this situation in Ukraine in recent years are analyzed using the information offered by the State Migration Service of Ukraine.

  15. Experiments with Coler magnetic current apparatus

    Science.gov (United States)

    Ludwig, T.

    Experiments with a replica of the famous Coler "Magnetstromapparat" (magnetic current apparatus) were conducted. The replica was built at the same institute at the Technical University of Berlin where the original was tested by Prof. Kloss in 1925. The details of the setup will be presented in this paper. The investigation of the Coler device was done with modern methods. The output was measured with a digital multi meter (DMM) and a digital storage oscilloscope (DSO). The results of the measurements will be presented. Did Coler convert vacuum fluctuations via magnetic, electric and acoustic resonance into electricity? There is a strong connection between magnetism and quantum field radiation energy. The magnetic moment of the electron is in part an energy exchange with the radiation field. The energy output of the Coler apparatus is measured. Furthermore the dynamics of the ferromagnetic magnets that Coler reported as the working principle of his device was investigated with magnetic force microscopy (MFM) and the spectroscopy mode of an atomic force microscope (AFM). The magnetic and acoustic resonance was investigated with magnetic force microscopy (MFM). The connection between ZPE and magnetism will be discussed as well as the perspective of using magnetic systems as a means to convert vacuum fluctuations into usable electricity.

  16. The Declaration of Helsinki in relation to medical research: historical and current perspectives.

    Science.gov (United States)

    Shrestha, B M

    2012-09-01

    Medical research aims at improving diagnostic, therapeutic and prophylactic measures and understanding of the aetiology and pathogenesis of diseases in humans, and their application to improve the quality of life and survival. The subjects involved are exposed to hazards inherent to the experiments. In order to protect the human subjects and to maintain high ethical standards, the World Medical Association had adopted the "Declaration of Helsinki" in 1964. The aim of this article is to provide a comprehensive review on the historical and current perspectives on the Declaration of Helsinki in relation to medical research on human subjects.

  17. The effects of medical tourism: Thailand's experience.

    Science.gov (United States)

    NaRanong, Anchana; NaRanong, Viroj

    2011-05-01

    To explore the positive and negative effects of medical tourism on the economy, health staff and medical costs in Thailand. The financial repercussions of medical tourism were estimated from commerce ministry data, with modifications and extrapolations. Survey data on 4755 foreign and Thai outpatients in two private hospitals were used to explore how medical tourism affects human resources. Trends in the relative prices of caesarean section, appendectomy, hernia repair, cholecystectomy and knee replacement in five private hospitals were examined. Focus groups and in-depth interviews with hospital managers and key informants from the public and private sectors were conducted to better understand stakeholders' motivations and practices in connection with these procedures and learn more about medical tourism. Medical tourism generates the equivalent of 0.4% of Thailand's gross domestic product but has exacerbated the shortage of medical staff by luring more workers away from the private and public sectors towards hospitals catering to foreigners. This has raised costs in private hospitals substantially and is likely to raise them in public hospitals and in the universal health-care insurance covering most Thais as well. The "brain drain" may also undermine medical training in future. Medical tourism in Thailand, despite some benefits, has negative effects that could be mitigated by lifting the restrictions on the importation of qualified foreign physicians and by taxing tourists who visit the country solely for the purpose of seeking medical treatment. The revenue thus generated could then be used to train physicians and retain medical school professors.

  18. Current efforts in medical education to incorporate national health priorities.

    Science.gov (United States)

    Nair, Manisha; Fellmeth, Gracia

    2017-08-03

    As a reflection on the Edinburgh Declaration, this conceptual synthesis presents six important challenges in relation to the role of medical education in meeting current national health priorities. This paper presents a conceptual synthesis of current efforts in medical education to incorporate national health priorities as a reflection on how the field has evolved since the Edinburgh Declaration. Considering that health needs vary from country to country, our paper focuses on three broad and cross-cutting themes: health equity, health systems strengthening, and changing patterns of disease. Considering the complexity of this topic, we conducted a targeted search to broadly sample and critically review the literature in two phases. Phase 1: within each theme, we assessed the current challenges in the field of medical education to meet the health priority. Phase 2: a search for various strategies in undergraduate and postgraduate education that have been tested in an effort to address the identified challenges. We conducted a qualitative synthesis of the literature followed by mapping of the identified challenges within each of the three themes with targeted efforts. We identified six important challenges: (i) mismatch between the need for generalist models of health care and medical education curricula's specialist focus; (ii) attitudes of health care providers contributing to disparities in health care; (iii) the lack of a universal approach in preparing medical students for 21st century health systems; (iv) the inability of medical education to keep up with the abundance of new health care technologies; (v) a mismatch between educational requirements for integrated care and poorly integrated, specialised health care systems; and (vi) development of a globally interdependent education system to meet global health challenges. Examples of efforts being made to address these challenges are offered. Although strategies for combatting these challenges exist, the

  19. Interprofessional collaborative practice for medication safety: Nursing, pharmacy, and medical graduates' experiences and perspectives.

    Science.gov (United States)

    Wilson, Amanda Jane; Palmer, Lorinda; Levett-Jones, Tracy; Gilligan, Conor; Outram, Sue

    2016-09-01

    Medication errors are the second most prevalent cause of adverse patient incidents in Australian hospital settings. Although numerous strategies to address this patient safety issue have been implemented, the impact of interprofessional collaborative practice (IPCP) on medication safety has received limited attention. The aim of this article is to report the perspectives and experiences of recently graduated, currently practicing Australian nurses, pharmacists, and doctors in relation to IPCP and medication safety. Sixty-eight graduates from three Australian states participated in focus groups. Thematic analysis of transcripts was conducted using an iterative process. The findings from this study illustrate how knowing about and valuing the skills and responsibilities of other team members and respecting each person's unique contribution to the work of the team can lead to more effective communication and collaboration in the context of medication safety. Although collaborative practice is critical to safe medication prescribing, dispensing, and administration, there are recurring and pervasive challenges to its achievement. This study indicated the need for improved preparation of graduates to equip them with the knowledge and skills needed to participate in an interprofessional team; and we advocate that deliberate, structured, and meaningful interprofessional clinical education initiatives are required.

  20. Impedimetric biosensors for medical applications current progress and challenges

    CERN Document Server

    Rushworth, Jo V; Goode, Jack A; Pike, Douglas J; Ahmed, Asif; Millner, Paul

    2014-01-01

    In this monograph, the authors discuss the current progress in the medical application of impedimetric biosensors, along with the key challenges in the field. First, a general overview of biosensor development, structure and function is presented, followed by a detailed discussion of impedimetric biosensors and the principles of electrochemical impedance spectroscopy. Next, the current state-of-the art in terms of the science and technology underpinning impedance-based biosensors is reviewed in detail. The layer-by-layer construction of impedimetric sensors is described, including the design of electrodes, their nano-modification, transducer surface functionalization and the attachment of different bioreceptors. The current challenges of translating lab-based biosensor platforms into commercially-available devices that function with real patient samples at the POC are presented; this includes a consideration of systems integration, microfluidics and biosensor regeneration. The final section of this monograph ...

  1. Medical treatment of radiation injuries-Current US status

    Energy Technology Data Exchange (ETDEWEB)

    Jarrett, D.G. [OSA - CBD and CDP, 3050 Defense Pentagon, Room 3C257, Washington, DC 20301-3050 (United States)], E-mail: david.jarrett@us.army.mil; Sedlak, R.G.; Dickerson, W.E. [Uniformed Services University, Armed Forces Radiobiology Research Institute, 8901 Wisconsin Avenue, Bethesda, MD 20889-5603 (United States); Reeves, G.I. [Northrop Grumman IT, 8211 Terminal Road, Lorton, VA 22079-1421 (United States)

    2007-07-15

    A nuclear incident or major release of radioactive materials likely would result in vast numbers of patients, many of whom would require novel therapy. Fortunately, the numbers of radiation victims in the United States (USA) have been limited to date. If a mass-casualty situation occurs, there will be a need to perform rapid, accurate dose estimates and to provide appropriate medications and other treatment to ameliorate radiation injury. The medical management of radiation injury is complex. Radiation injury may include acute radiation sickness (ARS) from external and/or internal radiation exposure, internal organ damage from incorporated radioactive isotopes, and cutaneous injury. Human and animal data have shown that optimal medical care may nearly double the survivable dose of ionizing radiation. Current treatment strategies for radiation injuries are discussed with concentration on the medical management of the hematopoietic syndrome. In addition, priority areas for continuing and future research into both acute deterministic injuries and also long-term stochastic sequelae of radiation exposure have been identified. There are several near-term novel therapies that appear to offer excellent prognosis for radiation casualties, and these are also described.

  2. Air medical transportation in India: Our experience

    Directory of Open Access Journals (Sweden)

    Himanshu Khurana

    2016-01-01

    Conclusion: Cardiac and central nervous system ailments are the most common indication for air medical transportation. These patients may need attention and interventions as any critical patient in the hospital but in a difficult environment lacking space and help. Air medical transport carries no more risk than ground transportation.

  3. Terazosin, doxazosin, and prazosin: current clinical experience.

    Science.gov (United States)

    Akduman, B; Crawford, E D

    2001-12-01

    Lower urinary tract symptoms (LUTS) suggestive of benign prostatic obstruction are common in aging men. Nearly 25% of men >40 years of age have LUTS. Medical therapy with alpha-blockade is the most common method of medical therapy for benign prostatic obstruction. Multiple methods of minimally invasive surgical therapies have been introduced in the last decade. These methods include balloon dilatation, temporary and permanent urethral stents, various laser techniques, microwave thermotherapy, transurethral needle ablation, electrovaporization, and high-intensity focused ultrasound. alpha-Receptor blockers to reduce the sympathetic tone of the prostate are considered as first-line therapy to relieve the symptoms of benign prostatic hyperplasia. Selective alpha(1)-receptor blockers relax prostatic smooth muscle, relieve bladder outlet obstruction, and enhance urine flow with fewer side effects. In addition, it was determined that treating patients with alpha-blockers increases prostatic apoptosis. Pharmacokinetic activity, mode of action, clinical efficacy, and side effects of the selective alpha(1)-receptor blockers terazosin, doxazosin, and prazosin are reviewed.

  4. Current Status of Integral Medical Study on Endometriosis

    Institute of Scientific and Technical Information of China (English)

    YU Chao-qin (俞超芹); YU Jin (俞瑾)

    2003-01-01

    @@ Endometriosis (EM), an estrogen dependent disease that comes from the planting of endometrial gland and stroma outside the uterine cavity, is characterized by invasiveness, wide planting and liability to relapse. It has been proved by recent studies that the pathogenesis of EM has its genetic background and is closely related with neuro-, endocrino- and immuno-factors. There has been great progress in the treatment of EM, but the clinical effect is not yet satisfactory. Traditional Chinese medicine (TCM) has definitely played its role in EM treatment. In this article, the current status of integral medical study on EM is reviewed.

  5. The Current State of Medical Malpractice in Urology.

    Science.gov (United States)

    Sherer, Benjamin A; Coogan, Christopher L

    2015-07-01

    Medical malpractice can present an unwelcome professional, emotional, and economic burden to the practicing urologist. To date, there is a paucity of data specific to urologic malpractice in the literature. We performed a comprehensive literature search to identify and evaluate recent studies related to urologic malpractice. We also analyzed 6249 closed urologic claims from the largest available specialty-specific data set gathered by Physician Insurers Association of America from 1985 to 2012. The resulting comprehensive review seeks to raise awareness of current trends in the malpractice environment specific to urologic surgery while also helping urologists identify opportunities for risk management and improved patient care.

  6. Simulation of leakage current measurement on medical devices using helmholtz coil configuration with different current flow

    Science.gov (United States)

    Sutanto, E.; Chandra, F.; Dinata, R.

    2017-05-01

    Leakage current measurement which can follow IEC standard for medical device is one of many challenges to be answered. The IEC 60601-1 has defined that the limit for a leakage current for Medical Device can be as low as 10 µA and as high as 500 µA, depending on which type of contact (applied part) connected to the patient. Most people are using ELCB (Earth-leakage circuit breaker) for safety purpose as this is the most common and available safety device in market. One type of ELCB devices is RCD (Residual Current Device) and this RCD type can measure the leakage current directly. This work will show the possibility on how Helmholtz Coil Configuration can be made to be like the RCD. The possibility is explored by comparing the magnetic field formula from each device, then it proceeds with a simulation using software EJS (Easy Java Simulation). The simulation will make sure the concept of magnetic field current cancellation follows the RCD concept. Finally, the possibility of increasing the measurement’s sensitivity is also analyzed. The sensitivity is needed to see the possibility on reaching the minimum leakage current limit defined by IEC, 0.01mA.

  7. Medication Errors In Relation To Education & Years of Nursing Experience

    OpenAIRE

    2012-01-01

    Medication error is defined as any preventable event that might cause or lead to an inappropriate use orharming of the patient. The purpose of this study was to determine the relationship between the level ofeducation and medication errors; years of work experience and medication errors. With a betterunderstanding of these relationships, nursing professionals can learn what characteristics tend to make anurse prone to medication errors and can develop methods and procedures to reduce incidenc...

  8. Pharmacological Treatments of Alzheimer’s Disease: Current Medication,

    Directory of Open Access Journals (Sweden)

    Arash Mowla

    2010-12-01

    Full Text Available Background: Alzheimer’s disease (AD that is identified by progressive cognitive deficit and behavioral disturbances (BD are the most common form of dementia. As the population is aging, patients with AD are becoming a serious burden for societies. In this study, current medication for cognitive deficit and behavioral disturbances are reviewed. Also the new treatment strategies for cognitive dysfunction and behavioral disturbances are surveyed. Methods: The method employed in this researh was a systematic bibliographic review, in which only the double-blind placebo-controlled studies or the clinically detailed enough open-labeled studies using validated scales were retained. Results: The efficacy of cholinesterase inhibitors (Tacrine, Rivastigmine, Donapezil and Galantamine has been demonstrated in several double blind placebo controlled clinical trials. They have shown a mild efficacy in mild to moderate AD. Memantine, a NMDA antagonist is the only drug that has demonstrated mild efficacy in moderate to severe AD in controlled clinical trial. Clinical trials surveying the efficacy of active and passive immunization against B amyloid protoin has halted due to serious adverse events. Studies of inducing neurogenesis in brain of AD patients are preliminary. Antipsychotics have shown efficacy for controlling BD of AD patients but they are associated with adverse events. Except for carbamazepine, there is not enough evidence for other anticanvulsants to be effective for behavioral disturbances of AD patients. A controlled clinical trial and some open studies have shown the efficacy of citalopram for BD. Further studies are needed to confirm the efficacy of other medications like trazadon, buspiron and beta blockers for BD. Conclusion: Cholinesterase inhibitors have demonstrated disappointing results. Memantine is only mildly effective for cognitive deficit. To date, no amyloid-modifying therapy has yet been successful in phase 3 clinical trials

  9. Medical malpractice: the experience in Italy.

    Science.gov (United States)

    Traina, Francesco

    2009-02-01

    At the present time, legal actions against physicians in Italy number about 15,000 per year, and hospitals spend over 10 billion euros (approximately US$15.5 billion) to compensate patients injured from therapeutic and diagnostic errors. In a survey summary issued by the Italian Court for the Rights of the Patient, between 1996 and 2000 orthopaedic surgery was the highest-ranked specialty for the number of complaints alleging medical malpractice. Today among European countries, Italy has the highest number of physicians subject to criminal proceedings related to medical malpractice, a fact that is profoundly changing physicians' approach to medical practice. The national health system has paid increasingly higher insurance premiums and is having difficulty finding insurance companies willing to bear the risk of monetary claims alleging medical malpractice. Healthcare costs will likely worsen as Italian physicians increasingly practice defensive medicine, thereby overutilizing resources with the goal of documenting diligence, prudence, and skill as defenses against potential litigation, rather than aimed at any patient benefit. To reduce the practice of defensive medicine and healthcare costs, a possible solution could be the introduction of an extrajudicial litigation resolution, as in other civil law countries, and a reform of the Italian judicial system on matters of medical malpractice litigation.

  10. Medical Malpractice: The Experience in Italy

    Science.gov (United States)

    2008-01-01

    At the present time, legal actions against physicians in Italy number about 15,000 per year, and hospitals spend over €10 billion (~US$15.5 billion) to compensate patients injured from therapeutic and diagnostic errors. In a survey summary issued by the Italian Court for the Rights of the Patient, between 1996 and 2000 orthopaedic surgery was the highest-ranked specialty for the number of complaints alleging medical malpractice. Today among European countries, Italy has the highest number of physicians subject to criminal proceedings related to medical malpractice, a fact that is profoundly changing physicians’ approach to medical practice. The national health system has paid increasingly higher insurance premiums and is having difficulty finding insurance companies willing to bear the risk of monetary claims alleging medical malpractice. Healthcare costs will likely worsen as Italian physicians increasingly practice defensive medicine, thereby overutilizing resources with the goal of documenting diligence, prudence, and skill as defenses against potential litigation, rather than aimed at any patient benefit. To reduce the practice of defensive medicine and healthcare costs, a possible solution could be the introduction of an extrajudicial litigation resolution, as in other civil law countries, and a reform of the Italian judicial system on matters of medical malpractice litigation. PMID:18985423

  11. Percutaneous vertebroplasty: Current concepts and local experience

    Directory of Open Access Journals (Sweden)

    Hee Hwan

    2005-01-01

    Full Text Available With the aging population in our country, symptomatic osteoporotic compression fractures are increasingly common. Osteolytic compression fractures from spinal metastasis are also becoming more frequently seen because of the longer life expectancy from improvements in chemotherapy. Percutaneous vertebroplasty with PMMA has been shown to be an efficient procedure to treat pain due to these fractures. It is a minimally invasive procedure performed under local anesthesia and sedation. Injection of PMMA provides immediate stability when it hardens, and permits the patient to ambulate without pain. Appropriate patient selection is the key to clinical success. However, this procedure must be treated with respect, and has to be performed by physicians with the necessary training. Otherwise, increased pain, paralysis, and even death may occur from this seemingly innocuous procedure. In this article, I will deal with the background issues of osteoporotic and osteolytic vertebral compression fractures, patient selection, surgical technique, complications, and review of current literature on vertebroplasty. Key areas of development in this field include the use of kyphoplasty, defining the role of prophylactic augmentation, and improvements in biomaterials.

  12. Improving medical students' knowledge of genetic disease: a review of current and emerging pedagogical practices

    Directory of Open Access Journals (Sweden)

    Wolyniak MJ

    2015-10-01

    Full Text Available Michael J Wolyniak,1 Lynne T Bemis,2 Amy J Prunuske2 1Department of Biology, Hampden-Sydney College, Hampden-Sydney, VA, 2Department of Biomedical Sciences, University of Minnesota Medical School, Duluth, MN, USA Abstract: Genetics is an essential subject to be mastered by health professional students of all types. However, technological advances in genomics and recent pedagogical research have changed the way in which many medical training programs teach genetics to their students. These advances favor a more experience-based education focused primarily on developing student's critical thinking skills. In this review, we examine the current state of genetics education at both the preclinical and clinical levels and the ways in which medical and pedagogical research have guided reforms to current and emerging teaching practices in genetics. We discover exciting trends taking place in which genetics is integrated with other scientific disciplines both horizontally and vertically across medical curricula to emphasize training in scientific critical thinking skills among students via the evaluation of clinical evidence and consultation of online databases. These trends will produce future health professionals with the skills and confidence necessary to embrace the new tools of medical practice that have emerged from scientific advances in genetics, genomics, and bioinformatics. Keywords: genetics education, medical genetics, pedagogical practice, active learning, problem-based learning

  13. Current state of the art of medical foods.

    Science.gov (United States)

    Blum, Stephanie; Brito, Fernando

    2014-01-01

    Inflammatory bowel disease (IBD) is one of the five most prevalent gastrointestinal disease burdens in the US, with an overall health care cost of more than USD 1.7 billion. It commonly requires a lifetime of care, and accounts for more than 700,000 physician visits, 100,000 hospitalizations, and disability in 119,000 patients each year. IBD is a multifactorial disease and comprises genetic susceptibility, uncontrolled immune responses, and environmental factors which play a role in the pathogenesis and course of the disease. IBD patients are lifelong on medication, either for induction or maintenance therapy. Current treatment option (corticosteroids, immune suppressants, biologics), administered in mono- or combination therapy, are still unsatisfactory. Due to the nature of disease, 20-40% of patients relapse within the first 12 months. Although modern treatment algorithms have diminished the risk of surgery, the treatments harbor significant side effects, which impacts patients' quality of life. The role of nutrition in IBD has gathered high interest, especially in pediatric Crohn's disease, where studies have shown that exclusive enteral nutrition can induce remission in mild-to-moderate disease comparable to corticosteroids. Thus, gastroenterologists and patients become increasingly aware that specific nutritional interventions offered in addition to the standard of care are an appealing option for a safe long-term disease management. Such specific nutritional solutions should be based on scientific/clinical evidence and specifically designed to address the patients' distinct nutritional requirements. As per definition, these nutrition products fall under the regulatory framework of a Medical Food (Foods for Special Medical Purposes in Europe).

  14. Current experiences in applied underground coal gasification

    Science.gov (United States)

    Peters, Justyn

    2010-05-01

    The world is experiencing greater stress on its ability to mine and exploit energy resources such as coal, through traditional mining methods. The resources available by extraction from traditional mining methods will have a finite time and quantity. In addition, the high quality coals available are becoming more difficult to find substantially increasing exploration costs. Subsequently, new methods of extraction are being considered to improve the ability to unlock the energy from deep coals and improve the efficiency of the exploitation of the resources while also considering the mitigation of global warming. Underground Coal Gasification (UCG) is a leading commercial technology that is able to maximize the exploitation of the deep coal through extraction of the coal as a syngas (CO and H2) in situ. The syngas is then brought to the surface and efficiently utilized in any of combined cycle power generation, liquid hydrocarbon transport fuel production, fertilizer production or polymer production. Commercial UCG has been successfully operating for more than 50 years at the Yerostigaz facility in Angren, Uzbekistan. Yerostigaz is the only remaining UCG site in the former Soviet Union. Linc Energy currently owns 91.6% of this facility. UCG produces a high quality synthetic gas (syngas), containing carbon monoxide, hydrogen and methane. UCG produced syngas can be economically used for a variety of purposes, including: the production of liquid fuels when combined with Gas to Liquids (GTL) technology power generation in gas turbine combined cycle power stations a feedstock for different petrochemical processes, for example producing chemicals or other gases such as hydrogen, methane, ammonia, methanol and dimethyl ether Linc Energy has proven the combined use of UCG to Gas to Liquids (GTL) technologies. UCG to GTL technologies have the ability to provide energy alternatives to address increasing global demand for energy products. With these technologies, Linc Energy is

  15. Shortening a Patient Experiences Survey for Medical Homes

    Directory of Open Access Journals (Sweden)

    Judy H. Ng

    2015-12-01

    Full Text Available The Consumer Assessment of Healthcare Providers and Systems—Patient-Centered Medical Home (CAHPS PCMH Survey assesses patient experiences reflecting domains of care related to general patient experience (access to care, communication with providers, office staff interaction, provider rating and PCMH-specific aspects of patient care (comprehensiveness of care, self-management support, shared decision making. The current work compares psychometric properties of the current survey and a proposed shortened version of the survey (from 52 to 26 adult survey items, from 66 to 31 child survey items. The revisions were based on initial psychometric analysis and stakeholder input regarding survey length concerns. A total of 268 practices voluntarily submitted adult surveys and 58 submitted child survey data to the National Committee for Quality Assurance in 2013. Mean unadjusted scores, practice-level item and composite reliability, and item-to-scale correlations were calculated. Results show that the shorter adult survey has lower reliability, but still it still meets general definitions of a sound survey for the adult version, and resulted in few changes to mean scores. The impact was more problematic for the pediatric version. Further testing is needed to investigate approaches to improving survey response and the relevance of survey items in informing quality improvement.

  16. [Reform and practice on the experiment teaching of medical parasitology].

    Science.gov (United States)

    Zhao, Jin-Hong; Tang, Xiao-Niu; Gao, Xi-Yin; Wang, Shao-Sheng; Li, Chao-Pin

    2011-12-01

    A new model of education is investigated to meet the new idea of experiment teaching in university. Therefore the establishment of experiment teaching model of medical parasitology needs to be correspondently reformed. A variety of new management measures are taken to raise the efficiency of experiment teaching in training the students in the College.

  17. A "Medical Physics" Course Based Upon Hospital Field Experience

    Science.gov (United States)

    Onn, David G.

    1972-01-01

    Describes a noncalculus, medical physics'' course with a basic element of direct hospital field experience. The course is intended primarily for premedical students but may be taken by nonscience majors. (Author/PR)

  18. Patient-centered medical home cyberinfrastructure current and future landscape.

    Science.gov (United States)

    Finkelstein, Joseph; Barr, Michael S; Kothari, Pranav P; Nace, David K; Quinn, Matthew

    2011-05-01

    The patient-centered medical home (PCMH) is an approach that evolved from the understanding that a well-organized, proactive clinical team working in a tandem with well-informed patients is better able to address the preventive and disease management needs in a guideline-concordant manner. This approach represents a fundamental shift from episodic acute care models and has become an integral part of health reform supported on a federal level. The major aspects of PCMH, especially pertinent to its information infrastructure, have been discussed by an expert panel organized by the Agency for Healthcare Research and Quality at the Informatics for Consumer Health Summit. The goal of this article is to summarize the panel discussions along the four major domains presented at the summit: (1) PCMH as an Evolving Model of Healthcare Delivery; (2) Health Information Technology (HIT) Applications to Support the PCMH; (3) Current HIT Landscape of PCMH: Challenges and Opportunities; and (4) Future HIT Landscape of PCMH: Federal Initiatives on Health Informatics, Legislation, and Standardization.

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

    Science.gov (United States)

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

    2009-12-01

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

  20. Women's experiences with medication for menstrual regulation in Bangladesh.

    Science.gov (United States)

    Marlow, Heather M; Biswas, Kamal; Griffin, Risa; Menzel, Jamie

    2016-01-01

    Menstrual regulation has been legal in Bangladesh since 1974, but the use of medication for menstrual regulation is new. In this study, we sought to understand women's experiences using medication for menstrual regulation in Bangladesh. We conducted 20 in-depth interviews with rural and urban women between December 2013 and February 2014. All interviews were audiotaped, transcribed, translated, computer recorded and coded for analysis. The majority of women in our study had had positive experiences with medication for menstrual regulation and successful outcomes, regardless of whether they obtained their medication from medicine sellers/pharmacies, doctors or clinics. Women were strongly influenced by health providers when deciding which method to use. There is a need to educate not only women of reproductive age, but also communities as a whole, about medication for menstrual regulation, with a particular emphasis on cost and branding the medication. Continued efforts to improve counselling by providers about the dose, medication and side-effects of medication for menstrual regulation, along with education of the community about medication as an option for menstrual regulation, will help to de-stigmatise the procedure and the women who seek it.

  1. Medical microbiology training needs and trainee experience.

    Science.gov (United States)

    Seale, Josephine; Elamin, Wael; Millar, Michael

    2014-02-01

    Training in microbiology is continuing to evolve. Standardisation of this process has, in part, been achieved through the development of a training curriculum by the Royal College of Pathologists (RCPath). A substantial proportion of microbiology training occurs through telephone consultations. To ascertain the content of these interactions and the extent to which the necessary skills outlined by the curriculum are attainable via these consultations. Records of telephone consultations made by microbiology registrars (SpR) on the Laboratory Information Management System (LIMS) over a 6 month period were analysed with regard to who initiated contact and the type of advice provided. An average of 426 SpR entries per month were made on the LIMS following telephone consultations. These consultations were predominantly initiated by fellow clinicians as opposed to the SpR. The majority (79%) of advice entailed guidance as to the use of antimicrobials which resulted in an alteration of the current regimen in 54% of cases. This study represents the first attempt to quantify the telephone consultations of microbiology trainees. It is concluded that although such interactions provide a means of attaining some of the competencies outlined by the RCPath curriculum, the bias towards antimicrobial advice reflects a discrepancy between the needs of the service users and the broad skill set advocated by the current microbiology training programme. Future modifications will need to take this into account to ensure both the training of SpRs and the microbiology service is fit for purpose.

  2. Current experiments in elementary particle physics, 1976-87

    CERN Document Server

    Lawrence Berkeley Nat. Laboratory. Berkeley

    Contains more than 1,800 experiments in elementary particle physics from the Experience database. Search and browse by author; title; experiment number or prefix; institution; date approved, started or completed; accelerator or detector; polarization, reaction, final state or particle; or by papers produced. Maintained at SLAC for the Particle Data Group. Supplies the information for Current Experiments in Particle Physics (LBL-91). Print version updated every second year.

  3. The current medical education system in the world.

    Science.gov (United States)

    Nara, Nobuo; Suzuki, Toshiya; Tohda, Shuji

    2011-07-04

    To contribute to the innovation of the medical education system in Japan, we visited 35 medical schools and 5 institutes in 12 countries of North America, Europe, Australia and Asia in 2008-2010 and observed the education system. We met the deans, medical education committee and administration affairs and discussed about the desirable education system. We also observed the facilities of medical schools.Medical education system shows marked diversity in the world. There are three types of education course; non-graduate-entry program(non-GEP), graduate-entry program(GEP) and mixed program of non-GEP and GEP. Even in the same country, several types of medical schools coexist. Although the education methods are also various among medical schools, most of the medical schools have introduced tutorial system based on PBL or TBL and simulation-based learning to create excellent medical physicians. The medical education system is variable among countries depending on the social environment. Although the change in education program may not be necessary in Japan, we have to innovate education methods; clinical training by clinical clerkship must be made more developed to foster the training of the excellent clinical physicians, and tutorial education by PBL or TBL and simulation-based learning should be introduced more actively.

  4. A Thin Layer Chromatography Laboratory Experiment of Medical Importance

    Science.gov (United States)

    Sharma, Loretta; Desai, Ankur; Sharma, Ajit

    2006-01-01

    A thin layer chromatography experiment of medical importance is described. The experiment involves extraction of lipids from simulated amniotic fluid samples followed by separation, detection, and scanning of the lecithin and sphingomyelin bands on TLC plates. The lecithin-to-sphingomyelin ratio is calculated. The clinical significance of this…

  5. A Thin Layer Chromatography Laboratory Experiment of Medical Importance

    Science.gov (United States)

    Sharma, Loretta; Desai, Ankur; Sharma, Ajit

    2006-01-01

    A thin layer chromatography experiment of medical importance is described. The experiment involves extraction of lipids from simulated amniotic fluid samples followed by separation, detection, and scanning of the lecithin and sphingomyelin bands on TLC plates. The lecithin-to-sphingomyelin ratio is calculated. The clinical significance of this…

  6. Medical education in India: current challenges and the way forward.

    Science.gov (United States)

    Solanki, Anjali; Kashyap, Surender

    2014-12-01

    Medical education in India is suffering from various shortcomings at conceptual as well as implementation level. With the expansion in medical education, the doctor to patient ratio has increased but these numbers do not align well with the overall quality of medical care in the country. To address this issue, a comprehensive analysis of various associated factors is essential. Indian medical education is suffering from a maldistribution of resources, unregulated growth in the private sector, lack of uniform admission procedures and traditional curricula lacking innovative approaches. To achieve higher standards of medical education, our goal should be to re-evaluate each and every aspect; create an efficient accreditation system; promote an equal distribution of resources, redesign curricula with stricter implementation and improved assessment methodologies; all of which will generate efficient medical graduates and consequently better health care delivery, and resulting in desired change within the system.

  7. Medical photography: current technology, evolving issues and legal perspectives.

    Science.gov (United States)

    Harting, M T; DeWees, J M; Vela, K M; Khirallah, R T

    2015-04-01

    Medical photographic image capture and data management has undergone a rapid and compelling change in complexity over the last 20 years. This is because of multiple factors, including significant advances in ease of photograph capture, alongside an evolution of mechanisms of data portability/dissemination, combined with governmental focus on health information privacy. Literature to guide medical, legal, governmental and business professionals when dealing with issues related to medical photography is virtually nonexistent. Herein, we will address the breadth of uses of medical photography, device properties/specific devices utilised for image capture, methods of data transfer and dissemination and patient perceptions and attitudes regarding photography in a medical setting. In addition, we will address the legal implications, including legal precedent, copyright and privacy law, informed consent, protected health information and the Health Insurance Portability and Accountability Act (HIPAA), as they pertain to medical photography.

  8. Medicalization: Current concept and future directions in a Bionic Society

    Directory of Open Access Journals (Sweden)

    Antonio Maturo

    2012-01-01

    Full Text Available The article illustrates the main features of the concept of medicalization, starting from its theoretical roots. Although it is the process of extending the medical gaze on human conditions, it appears that medicalization cannot be strictly connected to medical imperialism anymore. Other "engines" of medicalization are influential: consumers, biotechnology and managed care. The growth of research and theoretical reflections on medicalization has led to the proposal of other parallel concepts like pharmaceuticalization, genetization and biomedicalization. These new theoretical tools could be useful in the analysis of human enhancement. Human enhancement can be considered as the use of biomedical technology to improve performance on a human being who is not in need of a cure: a practice that is increasingly spreading in what might be defined as a "bionic society".

  9. Clinical experience of medical students in a developing country.

    Science.gov (United States)

    Malik, Alam Sher; Seng, Quah Ban

    2003-07-01

    This paper compares the clinical experience in acute conditions of the undergraduate students of a medical school from a developing country (Malaysia) with those from a developed country (UK). This study was conducted at the School of Medical Sciences, Universiti Sains Malaysia (USM). Through questionnaire survey enquiry was made about 27 acute medical conditions (i.e. conditions related to internal medicine, paediatrics, and psychiatry), 15 acute surgical conditions (i.e. conditions related to general surgery, orthopaedics, ophthalmology, otorhinolaryngology, gynaecology and obstetrics), 15 surgical operations and 26 practical procedures. The results obtained were compared with published data from the UK. Acute medical conditions were seen by higher number of the USM students but with less frequency than the British students. The USM students saw practical procedures more frequently than the British students did, but almost an equal number performed these procedures independently. The British students attended surgical operations more frequently than the USM students did. Given the limitations of comparison (epidemiological, cultural and geographical differences, conventional curriculum (in the British medical schools) vs. problem based learning curriculum (in the Malaysian medical school)) the overall clinical experience of the medical students in the USM and the UK was comparable. The USM students had more opportunities to observe cases and procedures but "hands on" experience was similar to that of the British students.

  10. Medication Errors In Relation To Education & Years of Nursing Experience

    Directory of Open Access Journals (Sweden)

    Shweta D Singh

    2012-06-01

    Full Text Available Medication error is defined as any preventable event that might cause or lead to an inappropriate use orharming of the patient. The purpose of this study was to determine the relationship between the level ofeducation and medication errors; years of work experience and medication errors. With a betterunderstanding of these relationships, nursing professionals can learn what characteristics tend to make anurse prone to medication errors and can develop methods and procedures to reduce incidence. Thesurvey was conducted in 6 hospitals in Anand city. Approval had been obtained from the hospitalswhere the study was to be conducted. The survey form was divided into 5 different sections. Eachsection comprises of minimum 3 questions which relates to their basic information and their perceptionstowards medication error. The results of the study suggested that there is a direct relationship betweeneducation/experiences and medication errors. The study showed that medication error occurs due to lackof qualified nursing staff. The results showed that medication error were reported due to increaseworkload on nurses because of lack of number of nurses in hospitals.

  11. General practitioners' experiences as nursing home medical consultants

    OpenAIRE

    Kirsebom, Marie; Hedström, Mariann; Pöder, Ulrika; Wadensten, Barbro

    2017-01-01

    OBJECTIVE: To describe general practitioners' experiences of being the principal physician responsible for a nursing home. METHOD: Fifteen general practitioners assigned to a nursing home participated in semi-structured qualitative interviews. Data were analysed using systematic text condensation. RESULT: Medical assessment is the main duty of general practitioners. Advance care planning together with residents and family members facilitates future decisions on medical treatment and end-of-li...

  12. Women's experience of decision-making with medication abortion.

    Science.gov (United States)

    Cappiello, Joyce; Merrell, Joy; Rentschler, Dorothy

    2014-01-01

    Medication abortion received regulatory approval in 2001 in the United States with healthcare providers increasingly offering this method. However, most studies in the United States have only explored acceptability and decision-making with women who participated in clinical trials. Overall, the literature on women's experience with a method that it is now widely available is under research in the United States. To describe and analyze the women's experience as they choose the option of and experienced the process of medication abortion. A constructivist grounded theory study. Outpatient clinical offices in a three-state area in the northeast region of the United States. A purposive sample of 22 women aged 16 to 45 who experienced a medication abortion. Data were collected by in-depth, open-ended, face-to-face interviews. The constant comparative method was used for analysis. Five interwoven categories emerged regarding women's initial decision to have a medication abortion: choosing a natural process, avoiding "surgery," respecting the "baby," scheduling to meet needs, and appreciating the home setting. The enhanced sense of personal control associated with the medication abortion option was the overriding reason given for choosing this method. This study contributes to the paucity of literature on the reasons why women choose medication abortion. It is important for nurses to understand the complexity of medication abortion decision-making so that they can effectively support women through this process.

  13. Medical students' emotional development in early clinical experience: a model.

    Science.gov (United States)

    Helmich, Esther; Bolhuis, Sanneke; Laan, Roland; Dornan, Tim; Koopmans, Raymond

    2014-08-01

    Dealing with emotions is a critical feature of professional behaviour. There are no comprehensive theoretical models, however, explaining how medical students learn about emotions. We aimed to explore factors affecting their emotions and how they learn to deal with emotions in themselves and others. During a first-year nursing attachment in hospitals and nursing homes, students wrote daily about their most impressive experiences, explicitly reporting what they felt, thought, and did. In a subsequent interview, they discussed those experiences in greater detail. Following a grounded theory approach, we conducted a constant comparative analysis, collecting and then interpreting data, and allowing the interpretation to inform subsequent data collection. Impressive experiences set up tensions, which gave rise to strong emotions. We identified four 'axes' along which tensions were experienced: 'idealism versus reality', 'critical distance versus adaptation', 'involvement versus detachment' and 'feeling versus displaying'. We found many factors, which influenced how respondents relieved those tensions. Their personal attributes and social relationships both inside and outside the medical community were important ones. Respondents' positions along the different dimensions, as determined by the balance between attributes and tensions, shaped their learning outcomes. Medical students' emotional development occurs through active participation in medical practice and having impressive experiences within relationships with patients and others on wards. Tensions along four dimensions give rise to strong emotions. Gaining insight into the many conditions that influence students' learning about emotions might support educators and supervisors in fostering medical students' emotional and professional development.

  14. Current experiments in particle physics - particle data group

    Energy Technology Data Exchange (ETDEWEB)

    Galic, H. [Stanford Univ., CA (United States). Stanford Linear Accelerator Center; Lehar, F. [Centre d`Etudes Nucleaires de Saclay, Gif-sur-Yvette (France); Kettle, P.R. [Paul Scherrer Institute, Villigen (Switzerland)] [and others

    1996-09-01

    This report contains summaries of current and recent experiments in Particle Physics. Included are experiments at BEPC (Beijing), BNL, CEBAF, CERN, CESR, DESY, FNAL, Frascati, ITEP (Moscow), JINR (Dubna), KEK, LAMPF, Novosibirsk, PNPI (St. Petersburg), PSI, Saclay, Serpukhov, SLAC, and TRIUMF, and also several proton decay and solar neutrino experiments. Excluded are experiments that finished taking data before 1991. Instructions are given for the World Wide Web (WWW) searching of the computer database (maintained under the SLAC-SPIRES system) that contains the summaries.

  15. Experiences from tsunami relief activity: implications for medical training

    Directory of Open Access Journals (Sweden)

    Sudharsanam Manni Balasubramaniam

    2012-09-01

    Full Text Available A tsunami struck the coast of Tamilnadu and Pondicherry on 26 December 2004. Jawaharlal Institute of Postgraduate Medical Education & Research, (JIPMER in Pondicherry played a vital role in providing medical relief. The experiences from the relief activities revealed areas of deficiency in medical education in regards to disaster preparedness. A qualitative study using focus group discussion was employed to find the lacunae in skills in managing medical relief measures. Many skills were identified; the most important of which was addressing the psychological impact of the tsunami on the victims. Limited coordination and leadership skills were also identified. It is recommended that activity-based learning can be included in the curriculum to improve these skills.

  16. Research Training in Medical Informatics: The Stanford Experience.

    Science.gov (United States)

    Shortliffe, Edward H.; Fagan, Lawrence M.

    1989-01-01

    Stanford University created an interdisciplinary program to train researchers and academic leaders in the field of medical information sciences. The program is described, identifying experiences of interest to people developing such a program. The program's background and history, students, curriculum and philosophy, and lessons learned are…

  17. Targeting Oral and Cultural Proficiency for Medical Personnel: An Examination of Current Medical Spanish Textbooks

    Science.gov (United States)

    Hardin, Karol

    2012-01-01

    Demand for medical Spanish courses has grown with the rising needs of Spanish-speaking patients in the United States, but while there is no shortage of beginning medical Spanish textbooks, very few target the intermediate level. This article examines eighteen medical Spanish texts published in the last twenty years with respect to seven factors:…

  18. Group counseling for medical students with drop-out experiences.

    Science.gov (United States)

    Kim, Eun Kyung; Baek, Sunyong; Woo, Jae Seok; Im, Sun Ju; Lee, Sun Hee; Kam, Beesung; Lee, Sang Yeoup; Yun, So Jung

    2013-03-01

    The purpose of this research was to describe our group counseling methods for medical students with drop-out experiences. Group counseling was offered to 11 medical students with drop-out experiences in their previous second semester. All subjects provided written informed consent before participating and completed a 2-day group counseling program using the Gestalt approach. The self-assertiveness training group counseling program consisted of 6 sessions, each of which lasted 90 minutes. Experience reports by participants after the program and data from semi-structured qualitative interviews were qualitatively analyzed. Program participants reported that they were moderately satisfied with the program regarding its usefulness and helpfulness on self-awareness, understanding, and reminding them of attempts to change behavior. Most students showed heightened levels of sincerity perceptions and positive attitudes in every session. The results demonstrated significant changes in experience in self-esteem, self-recognition, and interpersonal relationships. A group counseling program using the Gestalt approach could help medical students with drop-out experiences to adjust with 1 year their juniors, enhance their self-esteem, contribute to their psychological well-being, and prevent student re-failure through effective stress management and improved interpersonal relationships.

  19. Current trends in developing medical students' critical thinking abilities.

    Science.gov (United States)

    Harasym, Peter H; Tsai, Tsuen-Chiuan; Hemmati, Payman

    2008-07-01

    Health care is fallible and prone to diagnostic and management errors. The major categories of diagnostic errors include: (1) no-fault errors--the disease is present but not detected; (2) system errors--a diagnosis is delayed or missed because of the imperfection in the health care system; and (3) cognitive errors--a misdiagnosis from faulty data collection or interpretation, flawed reasoning, or incomplete knowledge. Approximately one third of patient problems are mismanaged because of diagnostic errors. Part of the solution lies in improving the diagnostic skills and critical thinking abilities of physicians as they progress through medical school and residency training. However, this task is challenging since both medical problem-solving and the learning environments are complex and not easily understood. There are many interacting variables including the motivation of the medical student (e.g. deep versus surface learning), the acquisition and evolution of declarative and conditional knowledge (e.g. reduced, dispersed, elaborated, scheme, and scripted), problem-solving strategies (e.g. procedural knowledge-guessing, hypothetical deductive, scheme inductive, and pattern recognition), curricular models (e.g. apprenticeship, discipline-based, body system-based, case-based, clinical presentation-based), teaching strategies (e.g. teaching general to specific or specific to general), the presented learning opportunities (PBL versus scheme inductive PBL), and the nature of the learning environment (e.g. modeling critical thinking and expert problem-solving). This paper elaborates on how novices differ from experts and how novices can be educated in a manner that enhances their level of expertise and diagnostic abilities as they progress through several years of medical training.

  20. Current and Remitted Depression and Anxiety Disorders as Risk Factors for Medication Nonadherence

    NARCIS (Netherlands)

    Bet, Pierre M.; Penninx, Brenda W. J. H.; van Laer, Stag D.; Hoogendijk, Witte J. G.; Hugtenburg, Jacqueline G.

    2015-01-01

    Objective: To investigate the impact of current and remitted depression and anxiety disorders and sociodemographic and other related factors on medication nonadherence in a large cohort study. Method: The Medication Adherence Rating Scale was used to assess medication nonadherence of 1,890 medicatio

  1. User experience integrated life-style cloud-based medical application.

    Science.gov (United States)

    Serban, Alexandru; Lupşe, Oana Sorina; Stoicu-Tivadar, Lăcrămioara

    2015-01-01

    Having a modern application capable to automatically collect and process data from users, based on information and lifestyle answers is one of current challenges for researchers and medical science. The purpose of the current study is to integrate user experience design (UXD) in a cloud-based medical application to improve patient safety, quality of care and organizational efficiency. The process consists of collecting traditional and new data from patients and users using online questionnaires. A questionnaire dynamically asks questions about the user's current diet and lifestyle. After the user will introduce the data, the application will formulate a presumptive nutritional plan and will suggest different medical recommendations regarding a healthy lifestyle, and calculates a risk factor for diseases. This software application, by design and usability will be an efficient tool dedicated for fitness, nutrition and health professionals.

  2. Current ramps in tokamaks: from present experiments to ITER scenarios

    NARCIS (Netherlands)

    Imbeaux, F.; Citrin, J.; Hobirk, J.; Hogeweij, G. M. D.; Kochl, F.; Leonov, V. M.; Miyamoto, S.; Nakamura, Y.; Parail, V.; Pereverzev, G.; Polevoi, A.; Voitsekhovitch, I.; Basiuk, V.; Budny, R.; Casper, T.; Fereira, J.; Fukuyama, A.; Garcia, J.; Gribov, Y. V.; Hayashi, N.; Honda, M.; Hutchinson, I. H.; Jackson, G.; Kavin, A. A.; Kessel, C. E.; Khayrutdinov, R. R.; Labate, C.; Litaudon, X.; Lomas, P. J.; Lonnroth, J.; Luce, T.; Lukash, V. E.; Mattei, M.; Mikkelsen, D.; Nunes, I.; Peysson, Y.; Politzer, P.; Schneider, M.; Sips, G.; Tardini, G.; Wolfe, S. M.; Zhogolev, V. E.

    2011-01-01

    In order to prepare adequate current ramp-up and ramp-down scenarios for ITER, present experiments from various tokamaks have been analysed by means of integrated modelling in view of determining relevant heat transport models for these operation phases. A set of empirical heat transport models for

  3. General practitioners' experiences as nursing home medical consultants.

    Science.gov (United States)

    Kirsebom, Marie; Hedström, Mariann; Pöder, Ulrika; Wadensten, Barbro

    2017-03-01

    To describe general practitioners' experiences of being the principal physician responsible for a nursing home. Fifteen general practitioners assigned to a nursing home participated in semi-structured qualitative interviews. Data were analysed using systematic text condensation. Medical assessment is the main duty of general practitioners. Advance care planning together with residents and family members facilitates future decisions on medical treatment and end-of-life care. Registered Nurses' continuity and competence are perceived as crucial to the quality of care, but inadequate staffing, lack of medical equipment and less-than-optimal IT systems for electronic healthcare records are impediments to patient safety. The study highlights the importance of advance care planning together with residents and family members in facilitating future decisions on medical treatment and end-of-life care. To meet the increasing demands for more complex medical treatment at nursing homes and to provide high-quality palliative care, there would seem to be a need to increase Registered Nurses' staffing and acquire more advanced medical equipment, as well as to create better possibilities for Registered Nurses and general practitioners to access each other's healthcare record systems. © 2016 Nordic College of Caring Science.

  4. Point of View: Online assessment in medical education– current ...

    African Journals Online (AJOL)

    current trends and future directions ... include its costs and its inherent reliance on technology, which is sometimes ... features will be increasingly exploited in the future. In future, ... often conducted in computer-aided learning rooms; but as.

  5. Cultural minority students' experiences with intercultural competency in medical education.

    Science.gov (United States)

    Leyerzapf, Hannah; Abma, Tineke

    2017-05-01

    Medical schools increasingly value and focus on teaching students intercultural competency within present-day multicultural society. Little is known about the experiences of cultural minority students in intercultural competence activities. This article discusses the intercultural competence activities of medical education in a Dutch university from the perspective of cultural minority students. We will formulate recommendations for how to stimulate intercultural competency in, as well as inclusiveness of, medical education. A qualitative evaluation was performed within a medical school in the Netherlands. Data were collected through interviews (n = 23), a focus group (six participants) and participant observations (20 hours). Thematic analysis was performed. Cultural minority students experienced a lack of respect and understanding by cultural majority students and teachers. Education activities intended to transfer intercultural knowledge, address personal prejudice and stimulate intercultural sensitivity were perceived as stigmatising and as creating an unsafe climate for cultural minority students. Cultural minority and majority students on campus seemed segregated and the intercultural awareness of minority students was not integrated in intercultural competence activities. As cultural minority students were confronted with microaggressions, the medical school did not succeed in creating a safe education environment for all students. Contrary to their aims and intentions, intercultural competence activities had limited effect and seemed to support the polarisation of cultural minority and majority students and teachers. This can be seen as pointing towards a hidden curriculum privileging majority over minority students. For structural integration of intercultural competency in medical education, the focus must penetrate beyond curricular activities towards the critical addressing of the culture and structure of medical school. Collective commitment to

  6. [Current trends in medical and surgical treatment of epilepsy].

    Science.gov (United States)

    Ambrosetto, C; Ambrosetto, P

    1979-01-01

    The AA., after a critical review of the literature, discuss the actual problems related to the various forms of the epilepsie susceptible of an appropriate surgical treatment. The AA. consider that the modern S.E.E.G. techniques, such as the formed in the highly specialized center of Bancaud and Talairach, open new perspectives particularly for the cases resistant to medical treatment and without evidence of focalisation. The AA. discuss the criteria, justifying such limitations and auspicate the institution of a much limited number of such centers, also in Italy.

  7. Enhanced Lower Hybrid Current Drive Experiments on HT-7 Tokamak

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    Effective Lower Hybrid Current Driving (LHCD) and improved confinement exper-iments in higher plasma parameters (Ip > 200 kA, ne> 2×1013 cm-3, Te ≥ 1 keⅤ) havebeen curried out in optimized LH wave spectrum and plasma parameters in HT-7 supercon-ducting tokamak. The dependence of current driving efficiency on LH power spectrum, plasmadensity ne and toroidal magnetic field BT has been obtained under optimal conditions. A goodCD efficiency was obtained at higher plasma current and higher electron density. The improve-ment of the energy confinement time is accompanied with the increase in line averaged electrondensity, and in ion and electron temperatures. The highest current driving efficiency reachedηCD = IpneR/PRF ≈ 1.05 × 1019 Am-2/W. Wave-plasma coupling was sustained in a good stateand the reflective coefficient was less than 5%. The experiments have also demonstrated the abilityof LH wave in the start-up and ramp-up of the plasma current. The measurement of the temporaldistribution of plasma parameter shows that lower hybrid leads to a broader profile in plasmaparameter. The LH power deposition profile and the plasma current density profile were modeledwith a 2D Fokker-Planck code corresponding to the evolution process of the hard x-ray detectorarray.

  8. The Dialogue Between Medical Doctors and Bioethicists: Rethinking Experience to Improve Medical Education.

    Science.gov (United States)

    Valera, Luca; Russo, María Teresa; Curcio, Giuseppe

    2016-01-01

    More and more seems to be necessary to find new ways of communication between medical doctors and bioethicists in order to build a shared vocabulary and to prevent conflicts: many bioethical problems seem to be caused by the lack of dialogue between them, which both seem to speak two different languages. Improving this dialogue means searching new languages and innovative forms of communication: the narration could be a really effective tool to enhance the physicians' and bioethicist's moral conscience, since it facilitates reasoning on someone's particular experience, and, ultimately, on our experience. Starting from the results of a questionnaire administered to a group of students of the Faculty of Medicine and Surgery of the University Campus Bio-Medico we present a theoretical discussion about the need for more dialogue and for a shared vocabulary in medical experiences. In this regard, we suggest as a possible solution to the conflicts among medical doctors and bioethicists, an educational strategy, i.e., humanities courses for medical students, which may help them to deeply describe their practical present (and future) experience.

  9. Genomics education for medical professionals - the current UK landscape.

    Science.gov (United States)

    Slade, Ingrid; Subramanian, Deepak N; Burton, Hilary

    2016-08-01

    Genomics education in the UK is at an early stage of development, and its pace of evolution has lagged behind that of the genomics research upon which it is based. As a result, knowledge of genomics and its applications remains limited among non-specialist clinicians. In this review article, we describe the complex landscape for genomics education within the UK, and highlight the large number and variety of organisations that can influence, direct and provide genomics training to medical professionals. Postgraduate genomics education is being shaped by the work of the Health Education England (HEE) Genomics Education Programme, working in conjunction with the Joint Committee on Genomics in Medicine. The success of their work will be greatly enhanced by the full cooperation and engagement of the many groups, societies and organisations involved with medical education and training (such as the royal colleges). Without this cooperation, there is a risk of poor coordination and unnecessary duplication of work. Leadership from an organisation such as the HEE Genomics Education Programme will have a key role in guiding the formulation and delivery of genomics education policy by various stakeholders among the different disciplines in medicine.

  10. An Imposed Dynamo Current Drive Experiment: Demonstration of Confinement

    Science.gov (United States)

    Jarboe, Thomas; Hansen, Chris; Hossack, Aaron; Marklin, George; Morgan, Kyle; Nelson, Brian; Sutherland, Derek; Victor, Brian

    2014-10-01

    An experiment for studying and developing the efficient sustainment of a spheromak with sufficient confinement (current-drive power heats the plasma to its stability β-limit) and in the keV temperature range is discussed. A high- β spheromak sustained by imposed dynamo current drive (IDCD) is justified because: previous transient experiments showed sufficient confinement in the keV range with no external toroidal field coil; recent results on HIT-SI show sustainment with sufficient confinement at low temperature; the potential of IDCD of solving other fusion issues; a very attractive reactor concept; and the general need for efficient current drive in magnetic fusion. The design of a 0.55 m minor radius machine with the required density control, wall loading, and neutral shielding for a 2 s pulse is presented. Peak temperatures of 1 keV and toroidal currents of 1.35 MA and 16% wall-normalized plasma beta are envisioned. The experiment is large enough to address the key issues yet small enough for rapid modification and for extended MHD modeling of startup and code validation.

  11. History of current non-insulin medications for diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Celeste C. L. Quianzon

    2012-10-01

    Full Text Available This article is a brief review of the current non-insulin agents for diabetes mellitus in the United States, namely, sulfonylureas, biguanides, thiazolidinediones, meglitinides, α-glucosidase inhibitors, glucacon-like peptide-1 receptor agonists, dipeptidyl-peptidase-4 inhibitors, amylin agonists, bromocriptine, and colesevelam.

  12. South African medical schools: Current state of selection criteria and medical students' demographic profile.

    Science.gov (United States)

    van der Merwe, L J; van Zyl, G J; St Clair Gibson, A; Viljoen, M; Iputo, J E; Mammen, M; Chitha, W; Perez, A M; Hartman, N; Fonn, S; Green-Thompson, L; Ayo-Ysuf, O A; Botha, G C; Manning, D; Botha, S J; Hift, R; Retief, P; van Heerden, B B; Volmink, J

    2015-12-16

    Selection of medical students at South African (SA) medical schools must promote equitable and fair access to students from all population groups, while ensuring optimal student throughput and success, and training future healthcare practitioners who will fulfil the needs of the local society. In keeping with international practices, a variety of academic and non-academic measures are used to select applicants for medical training programmes in SA medical schools. To provide an overview of the selection procedures used by all eight medical schools in SA, and the student demographics (race and gender) at these medical schools, and to determine to what extent collective practices are achieving the goals of student diversity and inclusivity. A retrospective, quantitative, descriptive study design was used. All eight medical schools in SA provided information regarding selection criteria, selection procedures, and student demographics (race and gender). Descriptive analysis of data was done by calculating frequencies and percentages of the variables measured. Medical schools in SA make use of academic and non-academic criteria in their selection processes. The latter include indices of socioeconomic disadvantage. Most undergraduate medical students in SA are black (38.7%), followed by white (33.0%), coloured (13.4%) and Indian/Asian (13.6%). The majority of students are female (62.2%). The number of black students is still proportionately lower than in the general population, while other groups are overrepresented. Selection policies for undergraduate medical programmes aimed at redress should be continued and further refined, along with the provision of support to ensure student success.

  13. Acute Aortic Syndromes: Update in Current Medical Management.

    Science.gov (United States)

    Morris, Jacqueline H; Mix, Doran; Cameron, Scott J

    2017-04-01

    Advances in medical therapy and non-surgical percutaneous options to manage the specter of acute aortic syndromes have improved both patient morbidity and mortality. There are key features in the patient history and initial exam which physicians should be attuned to in order to diagnose acute aortic syndromes such as aortic dissection, penetrating aortic ulcer, and intramural hematoma. Once recognized, early initiation of the appropriate pharmacologic therapy is important, and further appreciating the limitations of such therapy before considering a surgical approach is critical to improve patient outcomes. For the undifferentiated patient with acute aortic dissection presenting to facilities who do not routinely manage this condition, adding pharmacologic agents in the correct sequence assures the best chance for a satisfactory outcome.

  14. [Current status of palliative care in medical oncology].

    Science.gov (United States)

    Sasaki, Tsubasa; Ohta, Syuji; Seki, Nobuhiko; Eguchi, Kenji

    2010-06-01

    A team approach is efficient in palliative care for cancer patients. People suffered from cancer have a right to receive high-quality palliative care earlier in cancer treatment. In Japan the National Act for Strategy against Cancer was enacted in 2007. Systematic educational programs supported by the Ministry of Health Labor and Welfare has been conducted for medical staffs, home care staffs, local pharmacists, care managers etc. at core institutes in each district. Pain control is still major target for cancer palliative medicine. Recently various types of opioids can be used routinely in daily clinical setting for Japanese cancer patients. Complementary and alternative medicine (CAM) may also effective in some patients but further study for proving scientific evidence in CAM should be warranted. Tailor-maid pain control will be established in the near future with molecular based pharmacogenomics.

  15. CURRENT SCENARIO: KNOWLEDGE OF BASIC LIFE SUPPORT IN MEDICAL COLLEGE

    Directory of Open Access Journals (Sweden)

    Asmita Chaudhary

    2011-04-01

    Full Text Available A workshop has been conducted on basic skill of Cardio-Pulmonary Resuscitation (CPR among doctors and nursing staff in medical college. Theoretical aspect was explained through power point presentation whereas practical aspect was demonstrated through skill station. The results were analyzed by using an answer key prepared from BLS manual of American Heart Association (AHA. Out of 117 participants only three participants secured 80-90% marks in pretest whereas rest of secured less than 50% marks .Post workshop assessment was done with same question papers showed 70% candidates securing more than 80%. Hence BLS workshop is essential to improve knowledge and skill of CPR. [National J of Med Res 2011; 1(2.000: 80-82

  16. Plasma medicine—current state of research and medical application

    Science.gov (United States)

    Weltmann, K.-D.; von Woedtke, Th

    2017-01-01

    Plasma medicine means the direct application of cold atmospheric plasma (CAP) on or in the human body for therapeutic purposes. Further, the field interacts strongly with results gained for biological decontamination. Experimental research as well as first practical application is realized using two basic principles of CAP sources: dielectric barrier discharges (DBD) and atmospheric pressure plasma jets (APPJ). Originating from the fundamental insights that the biological effects of CAP are most probably caused by changes of the liquid environment of cells, and are dominated by reactive oxygen and nitrogen species (ROS, RNS), basic mechanisms of biological plasma activity are identified. It was demonstrated that there is no increased risk of cold plasma application and, above all, there are no indications for genotoxic effects. The most important biological effects of cold atmospheric pressure plasma were identified: (1) inactivation of a broad spectrum of microorganisms including multidrug resistant ones; (2) stimulation of cell proliferation and tissue regeneration with lower plasma treatment intensity (treatment time); (3) inactivation of cells by initialization of programmed cell death (apoptosis) with higher plasma treatment intensity (treatment time). In recent years, the main focus of clinical applications was in the field of wound healing and treatment of infective skin diseases. First CAP sources are CE-certified as medical devices now which is the main precondition to start the introduction of plasma medicine into clinical reality. Plasma application in dentistry and, above all, CAP use for cancer treatment are becoming more and more important research fields in plasma medicine. A further in-depth knowledge of control and adaptation of plasma parameters and plasma geometries is needed to obtain suitable and reliable plasma sources for the different therapeutic indications and to open up new fields of medical application.

  17. Compilation of current high-energy-physics experiments

    Energy Technology Data Exchange (ETDEWEB)

    Wohl, C.G.; Kelly, R.L.; Armstrong, F.E.

    1980-04-01

    This is the third edition of a compilation of current high energy physics experiments. It is a collaborative effort of the Berkeley Particle Data Group, the SLAC library, and ten participating laboratories: Argonne (ANL), Brookhaven (BNL), CERN, DESY, Fermilab (FNAL), the Institute for Nuclear Study, Tokyo (INS), KEK, Rutherford (RHEL), Serpukhov (SERP), and SLAC. The compilation includes summaries of all high energy physics experiments at the above laboratories that (1) were approved (and not subsequently withdrawn) before about January 1980, and (2) had not completed taking of data by 1 January 1976.

  18. Status and Current Sensitivity of the CELESTE Experiment

    CERN Document Server

    De Naurois, Mathieu

    2000-01-01

    The CELESTE experiment uses the heliostats of an old solar farm in the French Pyrenees to detect gamma ray air showers by the atmospheric Cerenkov technique. CELESTE has been operating since November 1999 with an array of 40 heliostats fully instrumented with 1GHz flash ADCs. Significant advances have been made in the detector simulations and in the data analysis techniques. We report here on results from recent observations of the Crab nebula above an energy threshold of 50GeV. The results and simulations illustrate the current sensitivity of the experiment.

  19. Current medical and surgical management of Raynaud's syndrome.

    Science.gov (United States)

    Landry, Gregory J

    2013-06-01

    Raynaud's syndrome (RS) is characterized by episodic digital ischemia induced by cold or emotional stress. Pathophysiologic mechanisms include temporary vasospasm and fixed digital artery obstruction. A number of pharmacologic and invasive therapies have been studied to treat RS symptoms; however, there are no specific treatments that are currently approved by the U.S. Food and Drug Administration specifically for RS. Of the available pharmacologic agents, calcium-channel blockers remain the preferred initial treatment for vasospastic RS, although many vasodilators have been studied and found to be efficacious. Vasodilators are less effective in treating digital artery obstruction, and no treatments have been found to be universally beneficial, although the phosphodiesterase V inhibitors have been gaining in popularity. Invasive therapies may have a role in selective cases. In this review, the current evidence of treatment for RS is summarized. Copyright © 2013 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  20. The "nuts and bolts" of implementing shared medical appointments: the Harvard Vanguard Medical Associates experience.

    Science.gov (United States)

    Berger-Fiffy, Jill

    2012-01-01

    Harvard Vanguard Medical Associates (Harvard Vanguard) decided to develop a Shared Medical Appointment (SMA) program in 2007 for a variety of reasons. The program has launched 86 SMAs in 17 specialties at 12 sites and has exceeded 13 000 patient visits. Currently, the practice offers 54 SMAs and is believed to be the largest program in the country. This article provides an overview regarding staffing, space and equipment, project planning, promotional materials, training programs, workflow development, and the use of quality improvement (ie, LEAN) tools used to monitor the work to be completed and the metrics to date.

  1. Current profile modification experiments in EXTRAP T2R

    Science.gov (United States)

    Cecconello, M.; Malmberg, J.-A.; Spizzo, G.; Chapman, B. E.; Gravestjin, R. M.; Franz, P.; Piovesan, P.; Martin, P.; Drake, J. R.

    2004-01-01

    Pulsed poloidal current drive (PPCD) experiments have been conducted in the resistive shell EXTRAP T2R reversed-field pinch experiment. During the current profile modification phase, the fluctuation level of the m = 1 internally resonant tearing modes decreases, and the velocity of these modes increases. The m = 0 modes are not affected during PPCD, although termination occurs with a burst in the m = 0 amplitude. The PPCD phase is characterized by an increase in the central electron temperature (up to 380 eV) and in the soft x-ray signal. Spectroscopic observations confirm an increase in the central electron temperature. During PPCD, the plasma poloidal beta increases to 14%, and the estimated energy confinement time doubles, reaching 380 µs. The reduction in the fluctuation level and the corresponding increase in the energy confinement time are qualitatively consistent with a reduction in parallel transport along stochastic magnetic field lines.

  2. Current status of the LHCf experiment and future plan

    Directory of Open Access Journals (Sweden)

    Tamura T.

    2013-06-01

    Full Text Available The Large Hadron Collider forward (= LHCf experiment has successfully finished the first phase of data taking at LHC √s = 0.9 and 7 TeV proton-proton collisions in 2010. As current status, we concentrate on analyzing the obtained data. As the first result, the energy spectra of photon measured by LHCf during = 7 TeV p-p collision has been published recently. Also the study of the upgraded version of LHCf detector for future = 14TeV run scenario is developed with the GSO scintillator. Another possible plan of p-A(nuclear collision in LHC is also studied. In this paper, as the current status of the experiment, analyses, and works for foreseen detector upgrade are summarized.

  3. A novel eddy current damper: theory and experiment

    Energy Technology Data Exchange (ETDEWEB)

    Ebrahimi, Babak; Khamesee, Mir Behrad [Department of Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, Ontario, N2L 3G1 (Canada); Golnaraghi, Farid, E-mail: khamesee@mecheng1.uwaterloo.c [Mechatronic Systems Engineering, Simon Fraser University, Surrey, British Columbia, V3T 0A3 (Canada)

    2009-04-07

    A novel eddy current damper is developed and its damping characteristics are studied analytically and experimentally. The proposed eddy current damper consists of a conductor as an outer tube, and an array of axially magnetized ring-shaped permanent magnets separated by iron pole pieces as a mover. The relative movement of the magnets and the conductor causes the conductor to undergo motional eddy currents. Since the eddy currents produce a repulsive force that is proportional to the velocity of the conductor, the moving magnet and the conductor behave as a viscous damper. The eddy current generation causes the vibration to dissipate through the Joule heating generated in the conductor part. An accurate, analytical model of the system is obtained by applying electromagnetic theory to estimate the damping properties of the proposed eddy current damper. A prototype eddy current damper is fabricated, and experiments are carried out to verify the accuracy of the theoretical model. The experimental test bed consists of a one-degree-of-freedom vibration isolation system and is used for the frequency and transient time response analysis of the system. The eddy current damper model has a 0.1 m s{sup -2} (4.8%) RMS error in the estimation of the mass acceleration. A damping coefficient as high as 53 Ns m{sup -1} is achievable with the fabricated prototype. This novel eddy current damper is an oil-free, inexpensive damper that is applicable in various vibration isolation systems such as precision machinery, micro-mechanical suspension systems and structure vibration isolation.

  4. Current status of the MiniBooNE experiment

    Energy Technology Data Exchange (ETDEWEB)

    Ray, Heather L.; /Los Alamos

    2004-11-01

    MiniBooNE is an experiment designed to refute or confirm the LSND {bar {nu}}{sub {mu}} {yields} {bar {nu}}{sub e} oscillation result. MiniBooNE will look for oscillations of {nu}{sub {mu}} {yields} {nu}{sub e} in a closed-box appearance analysis. MiniBooNE began collecting data in 2002, and is expected to continue data taking through 2005. Current MiniBooNE results are presented.

  5. The Relationship Between Nursing Experience and Education and the Occurrence of Reported Pediatric Medication Administration Errors.

    Science.gov (United States)

    Sears, Kim; O'Brien-Pallas, Linda; Stevens, Bonnie; Murphy, Gail Tomblin

    2016-01-01

    Medication errors are one of the most common incidents in the hospitals. They can be harmful, and they are even more detrimental for pediatric patients. This study explored the relationship between nursing experience, education, the frequency and severity of reported pediatric medication administration errors (PMAEs). The data for this study were collected from a larger pan Canadian study. A survey tool was developed to collect self-reported data from nurses. In addition to descriptive statistics, a Poisson regression or a multiple linear regression was completed to address the research questions, and a Boneferrai correction was conducted to adjust for the small sample size. Results demonstrated that on units with more nurses with a higher level of current experience, more PMAEs were reported (p=.001), however; the PMAEs reported by these nurses were not as severe (p=.003). Implications to advance both safe medication delivery in the pediatric setting and safe culture of reporting for both actual and potential errors are identified.

  6. Beam current transformer (BCT) for experiment WA1/2

    CERN Multimedia

    CERN PhotoLab

    1978-01-01

    In experiment WA1/2, a 400 GeV proton beam from the SPS was directed at a target, downstream of which a hadron line selected, in several narrow momentum bands, a beam of either pi+ and K+ or pi- and K-. These neutrino-parent particles, before entering a 292 m long decay tunnel, passed through a set of 2 BCTs of a design seen here. They measured the hadron intensity (10^10 to 10^11 particles/pulse) with a precision of the order of 1%. There were 2 of them, for enhanced precision and confidence. After the discovery of neutral currents in the Gargamelle-experiment, WA1/2 was the first follow-up, high-precision experiment (Z.Phys.C35, 443-452, 1987 and Z.Phys.C45, 361-379, 1990). See also 7706516X.

  7. Explore and experience: mobile augmented reality for medical training.

    Science.gov (United States)

    Albrecht, Urs-Vito; Noll, Christoph; von Jan, Ute

    2013-01-01

    In medicine, especially in basic education, it may sometimes be inappropriate to integrate real patients into classes due to ethical issues that must be avoided. Nevertheless, the quality of medical education may suffer without the use of real cases. This is especially true of medical specialties such as legal medicine: survivors of a crime are already subjected to procedures that constitute a severe emotional burden and may cause additional distress even without the added presence of students. Using augmented reality based applications may alleviate this ethical dilemma by giving students the possibility to practice the necessary skills based on virtual but nevertheless almost realistic cases. The app "mARble®" that is presented in this paper follows this approach. The currently available learning module for legal medicine gives users an opportunity to learn about various wound patterns by virtually overlaying them on their own skin and is applicable in different learning settings. Preliminary evaluation results covering learning efficiency and emotional components of the learning process are promising. Content modules for other medical specialtiesare currently under construction.

  8. Surveying rip current survivors: preliminary insights into the experiences of being caught in rip currents

    Science.gov (United States)

    Drozdzewski, D.; Shaw, W.; Dominey-Howes, D.; Brander, R.; Walton, T.; Gero, A.; Sherker, S.; Goff, J.; Edwick, B.

    2012-04-01

    This paper begins a process of addressing a significant gap in knowledge about people's responses to being caught in rip currents. While rip currents are the primary hazard facing recreational ocean swimmers in Australia, debate exists about the best advice to give swimmers caught in rip currents. Such surf rescue advice - on what to do and how to respond when caught in a rip - relies on empirical evidence. However, at present, knowledge about swimmers reactions and responses to rip currents is limited. This gap is a considerable barrier to providing effective advice to beach goers and to understanding how this advice is utilised (or not) when actually caught in the rip current. This paper reports the findings of a pilot study that focussed on garnering a better understanding of swimmers' experiences when caught in rip currents. A large scale questionnaire survey instrument generated data about rip current survivors' demographics, knowledge of beach safety and their reactions and responses when caught in a rip current. A mix of online and paper surveys produced a total of 671 completed surveys. Respondents were predominantly an informed group in terms of rip current knowledge, beach experience and had a high self-rated swimming ability. Preliminary insights from the survey show that most respondents recalled a "swim across the rip/parallel to the beach" message when caught in the rip and most escaped unassisted by acting on this message. However, while nearly a quarter of respondents recalled a message of "not to panic", short answer responses revealed that the onset of panic inhibited some respondents from recalling or enacting any other type of beach safety message when caught in the rip current. Results also showed that despite the research sample being younger, competent and frequent ocean swimmers, they were more likely to swim at unpatrolled beaches and outside of the red and yellow safety flags. Moreover, they were still caught in a rip current and they

  9. Surveying rip current survivors: preliminary insights into the experiences of being caught in rip currents

    Directory of Open Access Journals (Sweden)

    D. Drozdzewski

    2012-04-01

    Full Text Available This paper begins a process of addressing a significant gap in knowledge about people's responses to being caught in rip currents. While rip currents are the primary hazard facing recreational ocean swimmers in Australia, debate exists about the best advice to give swimmers caught in rip currents. Such surf rescue advice – on what to do and how to respond when caught in a rip – relies on empirical evidence. However, at present, knowledge about swimmers reactions and responses to rip currents is limited. This gap is a considerable barrier to providing effective advice to beach goers and to understanding how this advice is utilised (or not when actually caught in the rip current.

    This paper reports the findings of a pilot study that focussed on garnering a better understanding of swimmers' experiences when caught in rip currents. A large scale questionnaire survey instrument generated data about rip current survivors' demographics, knowledge of beach safety and their reactions and responses when caught in a rip current. A mix of online and paper surveys produced a total of 671 completed surveys. Respondents were predominantly an informed group in terms of rip current knowledge, beach experience and had a high self-rated swimming ability. Preliminary insights from the survey show that most respondents recalled a "swim across the rip/parallel to the beach" message when caught in the rip and most escaped unassisted by acting on this message. However, while nearly a quarter of respondents recalled a message of "not to panic", short answer responses revealed that the onset of panic inhibited some respondents from recalling or enacting any other type of beach safety message when caught in the rip current. Results also showed that despite the research sample being younger, competent and frequent ocean swimmers, they were more likely to swim at unpatrolled beaches and outside of the red and yellow safety flags. Moreover, they were still

  10. Negotiating science and experience in medical knowledge: gynaecologists on endometriosis.

    Science.gov (United States)

    Whelan, Emma

    2009-04-01

    This paper analyses the gynaecological literature on endometriosis, particularly endometriosis classification, to evaluate the epistemological concepts it uses. A qualitative content analysis was conducted on a sample of gynaecological literature published between 1985 and 2000, a period that witnessed the explosion of both evidence-based and patient-centred models of medicine, with their dwelling emphases on science and experience. It was found that the discourse of science is used strategically in this literature as a formal epistemology to lend weight to authors' claims and to guide medical thinking and research. However, gynaecologists also use the notion of experience to assert their own credibility and to question the credibility of other experts. In fact, accounts of their own experience and the experiential accounts of their patients are foundational to gynaecologists' claims-making activities, including their engagement with scientific research.

  11. Ultrasonic medical imaging: past, current, and future (Keynote Presentation)

    Science.gov (United States)

    Reid, John M.

    2005-04-01

    Ultrasonic imaging began, like life, in the sea, with the development of sonar for detecting submarines after World-War 1. However, to begin to image soft tissues the ranging time of ocean sonars needed to be reduced, and the electronics speeded up, by a factor of about the ratio between nautical miles and centimeters. This was only possible after the electronic developments made for radar in World-War 2. The rest of our technical history closely follows the developments in semiconductors and fabrication methods that led to modern electronics. This is a largely personal story of a recently graduated engineer with radar experience, who began with fabricating equipment to be used in the hospital to diagnose breast cancer, and continued with involvement the development of echocardiography and Doppler devices. Along the way many others have contributed to the field, including work in other countries that is not covered here. In future, ultrasonic imaging may hold the key to understanding some fundamental questions in human health if adopted for screening studies. It alone offers a relatively inexpensive imaging method that is free of known hazards.

  12. Experiences of Engineering Grid-Based Medical Software

    CERN Document Server

    Estrella, F; McClatchey, R; Odeh, M; Rogulin, D; Solomonides, T

    2007-01-01

    Objectives: Grid-based technologies are emerging as potential solutions for managing and collaborating distributed resources in the biomedical domain. Few examples exist, however, of successful implementations of Grid-enabled medical systems and even fewer have been deployed for evaluation in practice. The objective of this paper is to evaluate the use in clinical practice of a Grid-based imaging prototype and to establish directions for engineering future medical Grid developments and their subsequent deployment. Method: The MammoGrid project has deployed a prototype system for clinicians using the Grid as its information infrastructure. To assist in the specification of the system requirements (and for the first time in healthgrid applications), use-case modelling has been carried out in close collaboration with clinicians and radiologists who had no prior experience of this modelling technique. A critical qualitative and, where possible, quantitative analysis of the MammoGrid prototype is presented leading...

  13. Preparation and Current Situation of Proton-ICCHIBAN-2 Experiment

    Science.gov (United States)

    Uchihori, Yukio; Yasuda, Nakahiro; Kitamura, H.; Kodaira, S.; Benton, Eric; Hajek, Michael; Berger, Thomas; Jadrnickova, Iva; Ploc, Ondrej

    The ICCHIBAN (Inter Comparison for Cosmicrays with Heavy Ion Beams at NIRS) working group has organized and performed various ICCHIBAN runs for active and passive radiation detectors at HIMAC, NIRS, Japan, Loma Linda and Brookhaven, USA and CERN, Switzer-land since the start of the ICCHIBAN project in the year 2002. One of the main focus points of this project is to understand the response of the applied detector systems (either active or passive) for personal and area dosimetry in space environment to a simulated sub-set of the space radiation environment, focusing on the heavy ion response. This is of special importance for the further intercomparison of space radiation data gathered by various international in-stitutes and universities for space radiation experiments as MATROSHKA, DOSIS, DOBIES, BRADOS, MATROSHKA-R etc. The ICCHIBAN experiments have created a big database of response data, especially for all the different passive radiation detectors and detector materials (Thermoluminescence (TLD) and Optical Luminescence (OSL)) over the last 7 years, resulting in a better understanding of how and why we still have differences in the measurement results from common space experiments -as the Space ICCHIBAN 2 experiment. One of the reasons why for the differences in the TLD/OSL results is the lack of intercomparison and response data for low LET particles up to around 10 keV/m, especially protons. Due to the fact, that the main contribution to absorbed dose in low earth orbit is due to protons, the ICCHIBAN working group has started the set-up of a Proton ICCHIBAN intercomparison experiment at NIRS. The Proton ICCHIBAN run has been performed at the cyclotron at NIRS, Chiba in February 2010. 15 institutes from 12 countries sent or brought their dosimeters and exposed them to 40 and 70 MeV proton beams with the same doses and exposure conditions. In this paper, the experiment procedures and current situation of the intercomparision experiments will be shown.

  14. Current medical treatment of estrogen receptor-positive breast cancer

    Institute of Scientific and Technical Information of China (English)

    Franco; Lumachi; Davide; A; Santeufemia; Stefano; MM; Basso

    2015-01-01

    Approximately 80% of breast cancers(BC) are estrogen receptor(ER)-positive and thus endocrine therapy(ET) should be considered complementary to surgery in the majority of patients. The advantages of oophorectomy, adrenalectomy and hypophysectomy in women with advanced BC have been demonstrated many years ago, and currently ET consist of(1) ovarian function suppression(OFS), usually obtained using gonadotropinreleasing hormone agonists(Gn RHa);(2) selective estrogen receptor modulators or down-regulators(SERMs or SERDs); and(3) aromatase inhibitors(AIs), or a combination of two or more drugs. For patients aged less than 50 years and ER+ BC, there is no conclusive evidence that the combination of OFS and SERMs(i.e., tamoxifen) or chemotherapy is superior to OFS alone. Tamoxifen users exhibit a reduced risk of BC, both invasive and in situ, especially during the first 5 years of therapy, and extending the treatment to 10 years further reduced the risk of recurrences. SERDs(i.e., fulvestrant) are especially useful in the neoadjuvant treatment of advanced BC, alone or in combination with either cytotoxic agents or AIs. There are two types of AIs: type Ⅰ are permanent steroidal inhibitors of aromatase, while type Ⅱ are reversible nonsteroidal inhibitors. Several studies demonstrated the superiority of the third-generation AIs(i.e., anastrozole and letrozole) compared with tamoxifen, and adjuvant therapy with AIs reduces the recurrence risk especially in patients with advanced BC. Unfortunately, some cancers are or became ET-resistant, and thus other drugs have been suggested in combination with SERMs or AIs, including cyclin-dependent kinase 4/6 inhibitors(palbociclib) and mammalian target of rapamycin(m TOR) inhibitors, such as everolimus. Further studies are required to confirm their real usefulness.

  15. Ethical and professional conduct of medical students: review of current assessment measures and controversies

    Science.gov (United States)

    Boon, K; Turner, J

    2004-01-01

    As medical education increasingly acknowledges the importance of the ethical and professional conduct of practitioners, and moves towards more formal assessment of these issues, it is important to consider the evidence base which exists in this area. This article discusses literature about the health needs and problems experienced by medical practitioners as a background to a review of the current efforts in medical education to promote ethical conduct and develop mechanisms for the detection and remediation of problems. PMID:15082823

  16. Electronic health records and online medical records: an asset or a liability under current conditions?

    Science.gov (United States)

    Allen-Graham, Judith; Mitchell, Lauren; Heriot, Natalie; Armani, Roksana; Langton, David; Levinson, Michele; Young, Alan; Smith, Julian A; Kotsimbos, Tom; Wilson, John W

    2017-01-20

    Objective The aim of the present study was to audit the current use of medical records to determine completeness and concordance with other sources of medical information.Methods Medical records for 40 patients from each of five Melbourne major metropolitan hospitals were randomly selected (n=200). A quantitative audit was performed for detailed patient information and medical record keeping, as well as data collection, storage and utilisation. Using each hospital's current online clinical database, scanned files and paperwork available for each patient audited, the reviewers sourced as much relevant information as possible within a 30-min time allocation from both the record and the discharge summary.Results Of all medical records audited, 82% contained medical and surgical history, allergy information and patient demographics. All audited discharge summaries lacked at least one of the following: demographics, medication allergies, medical and surgical history, medications and adverse drug event information. Only 49% of records audited showed evidence the discharge summary was sent outside the institution.Conclusions The quality of medical data captured and information management is variable across hospitals. It is recommended that medical history documentation guidelines and standardised discharge summaries be implemented in Australian healthcare services.What is known about this topic? Australia has a complex health system, the government has approved funding to develop a universal online electronic medical record system and is currently trialling this in an opt-out style in the Napean Blue Mountains (NSW) and in Northern Queensland. The system was originally named the personally controlled electronic health record but has since been changed to MyHealth Record (2016). In Victoria, there exists a wide range of electronic health records used to varying degrees, with some hospitals still relying on paper-based records and many using scanned medical records. This

  17. Compilation of current high energy physics experiments - Sept. 1978

    Energy Technology Data Exchange (ETDEWEB)

    Addis, L.; Odian, A.; Row, G. M.; Ward, C. E. W.; Wanderer, P.; Armenteros, R.; Joos, P.; Groves, T. H.; Oyanagi, Y.; Arnison, G. T. J.; Antipov, Yu; Barinov, N.

    1978-09-01

    This compilation of current high-energy physics experiments is a collaborative effort of the Berkeley Particle Data Group, the SLAC library, and the nine participating laboratories: Argonne (ANL), Brookhaven (BNL), CERN, DESY, Fermilab (FNAL), KEK, Rutherford (RHEL), Serpukhov (SERP), and SLAC. Nominally, the compilation includes summaries of all high-energy physics experiments at the above laboratories that were approved (and not subsequently withdrawn) before about June 1978, and had not completed taking of data by 1 January 1975. The experimental summaries are supplemented with three indexes to the compilation, several vocabulary lists giving names or abbreviations used, and a short summary of the beams at each of the laboratories (except Rutherford). The summaries themselves are included on microfiche. (RWR)

  18. Maximizing the DUNE early physics output with current experiments

    Energy Technology Data Exchange (ETDEWEB)

    Ghosh, Monojit; Goswami, Srubabati [Physical Research Laboratory, Ahmedabad (India); Raut, Sushant K. [Physical Research Laboratory, Ahmedabad (India); School of Engineering Sciences, KTH Royal Institute of Technology-AlbaNova University Center, Department of Theoretical Physics, Stockholm (Sweden)

    2016-03-15

    The deep underground neutrino experiment (DUNE) is a proposed next generation superbeam experiment at Fermilab. Its aims include measuring the unknown neutrino oscillation parameters - the neutrino mass hierarchy, the octant of the mixing angle θ{sub 23}, and the CP-violating phase δ{sub CP}. The current and upcoming experiments T2K, NOνA, and ICAL rate at IN will also be collecting data for the same measurements. In this paper, we explore the sensitivity reach of DUNE in combination with these other experiments. We evaluate the least exposure required by DUNE to determine the above three unknown parameters with reasonable confidence.We find that for each case, the inclusion of data from T2K, NOνA, and ICAL rate at IN help to achieve the same sensitivity with a reduced exposure from DUNE thereby helping to economize the configuration. Further, we quantify the effect of the proposed near detector on systematic errors and study the consequent improvement in sensitivity. We also examine the role played by the second oscillation cycle in furthering the physics reach of DUNE. Finally, we present an optimization study of the neutrino-antineutrino running of DUNE. (orig.)

  19. EXPERIENCES IN THE AIR SPINNING TO MANUFACTURE MEDICAL DEVICES

    Directory of Open Access Journals (Sweden)

    MARSAL Feliu

    2015-05-01

    Full Text Available The work aims to determine, with scientific rigor, differences in key parameters of the yarns produced by conventional ring spinning systems, open-end and air spinning and its interrelation with the main parameters of those products that are intended for medical-sanitary sector. The experiences have been made in a Spanish company from short fibers sector that has three spinning systems, with tradition and prestige in world market, validating the results in Innotex Center laboratories of the Polytechnic University of Catalonia. Considering the results, it shows that the technology of manufacture of yarns by air is suitable for yarn, woven fabrics and knitting, structures to textile medical-sanitary application, by specific properties as well as enhanced competitiveness, due to the high production rate and shortened spinning process. The viscose yarns manufactured by air mass are more mass regular. The new DR parameter clearly indicates a better look of the finished fabric when we work with yarns produced by air technology.The significant reduction of the hairiness means less formation of loose fibres by friction, very important in the application of these yarns in the manufacture of textile structures for medical-sanitary use. Also no-table increase of about 15% in the absorption capacity of the fluids, especially water, from the yarns made by air. In the functionalization of fabrics obtained from spun yarn by air will need to apply a permanent smoothing.

  20. Mission Possible: BioMedical Experiments on the Space Shuttle

    Science.gov (United States)

    Bopp, E.; Kreutzberg, K.

    2011-01-01

    Biomedical research, both applied and basic, was conducted on every Shuttle mission from 1981 to 2011. The Space Shuttle Program enabled NASA investigators and researchers from around the world to address fundamental issues concerning living and working effectively in space. Operationally focused occupational health investigations and tests were given priority by the Shuttle crew and Shuttle Program management for the resolution of acute health issues caused by the rigors of spaceflight. The challenges of research on the Shuttle included: limited up and return mass, limited power, limited crew time, and requirements for containment of hazards. The sheer capacity of the Shuttle for crew and equipment was unsurpassed by any other launch and entry vehicle and the Shuttle Program provided more opportunity for human research than any program before or since. To take advantage of this opportunity, life sciences research programs learned how to: streamline the complicated process of integrating experiments aboard the Shuttle, design experiments and hardware within operational constraints, and integrate requirements between different experiments and with operational countermeasures. We learned how to take advantage of commercial-off-the-shelf hardware and developed a hardware certification process with the flexibility to allow for design changes between flights. We learned the importance of end-to-end testing for experiment hardware with humans-in-the-loop. Most importantly, we learned that the Shuttle Program provided an excellent platform for conducting human research and for developing the systems that are now used to optimize research on the International Space Station. This presentation will include a review of the types of experiments and medical tests flown on the Shuttle and the processes that were used to manifest and conduct the experiments. Learning Objective: This paper provides a description of the challenges related to launching and implementing biomedical

  1. Nazi medical experiments on Australian prisoners of war: Commentary on the testimony of an Australian soldier.

    Science.gov (United States)

    Weisz, George M

    2015-12-01

    Archival research reveals that Australian prisoners of war were exposed to non-consensual medical experiments during World War II. This article discusses the first known case of an Australian soldier exposed to German medical experiments.

  2. Teaching acupuncture to medical students: the experience of Rio Preto Medical School (FAMERP), Brazil.

    Science.gov (United States)

    da Silva, João Bosco Guerreiro; Saidah, Rassen; Megid, Cecília Baccili Cury; Ramos, Neil Alvimar

    2013-09-01

    Complementary and alternative medicine, and in particular acupuncture, has been practised and taught in recent years in many universities in the Western world. Here, we relate our experiences since 1997 in teaching acupuncture to medical students at Rio Preto Medical School (Faculty of Medicine of São José do Rio Preto (FAMERP)), Brazil. Classes are given in the third and fifth years. The main goals of understanding the mechanisms of action and being able to recognise patients who may benefit from treatment and referring them have been well achieved, scoring 3.6 and 4.1, respectively, on a scale of 1-5. Also using that scale, medical students believe that acupuncture is important in the curriculum (4.6), course time is not sufficient (2.7) and they would like more information (4.6). To overcome these concerns, many students join an undergraduate study group (Acupuncture League) where they have more time to learn. We also describe the presence of foreign medical students who, since 2000, have enrolled in a course of 150 h in an exchange programme.

  3. The current situation and development of medical device testing institutes in China.

    Science.gov (United States)

    Yang, Xiaofang; Mu, Ruihong; Fan, Yubo; Wang, Chunren; Li, Deyu

    2017-04-01

    This article analyses the current situation and development of Chinese medical device testing institutes from the perspectives of the two most important functions - testing functions and medical device standardization functions. Areas Covered: The objective of the Chinese government regulations for medical device industry is to ensure the safety and effectiveness of medical devices for Chinese patients. To support the regulation system, the Chinese government has established medical device testing institutes at different levels for example, the national, provincial, and municipal levels. These testing institutes also play an important role in technical support during medical device premarket registration and post market surveillance, they are also the vital practitioners of Chinese medical device standardization. Expert Commentary: Chinese medical device testing institutes are technical departments established by government, and serve the regulatory functions of government agency. In recent years, with the rapid development of medical device industry as well as constantly increasing international and domestic medical device market, the importance of medical device testing institute is more prominent, However, there are still some problems unsolved, such as their overall capacity remains to be improved, construction of standardization is to be strengthened, etc.

  4. Impact of elective versus required medical school research experiences on career outcomes.

    Science.gov (United States)

    Weaver, Alice N; McCaw, Tyler R; Fifolt, Matthew; Hites, Lisle; Lorenz, Robin G

    2017-06-01

    Many US medical schools have added a scholarly or research requirement as a potential intervention to increase the number of medical students choosing to become academic physicians and physician scientists. We designed a retrospective qualitative survey study to evaluate the impact of medical school research at the University of Alabama at Birmingham (UAB) on career choices. A survey tool was developed consisting of 74 possible questions with built-in skip patterns to customize the survey to each participant. The survey was administered using the web-based program Qualtrics to UAB School of Medicine alumni graduating between 2000 and 2014. Alumni were contacted 3 times at 2-week intervals during the year 2015, resulting in 168 completed surveys (11.5% response rate). MD/PhD graduates were excluded from the study. Most respondents completed elective research, typically for reasons relating to career advancement. 24 per cent said medical school research increased their desire for research involvement in the future, a response that positively correlated with mentorship level and publication success. Although completion of medical school research was positively correlated with current research involvement, the strongest predictor for a physician scientist career was pre-existing passion for research (p=0.008). In contrast, students motivated primarily by curricular requirement were less likely to pursue additional research opportunities. Positive medical school research experiences were associated with increased postgraduate research in our study. However, we also identified a strong relationship between current research activity and passion for research, which may predate medical school. Copyright © 2017 American Federation for Medical Research.

  5. Serratia Infections: from Military Experiments to Current Practice

    Science.gov (United States)

    Mahlen, Steven D.

    2011-01-01

    Summary: Serratia species, in particular Serratia marcescens, are significant human pathogens. S. marcescens has a long and interesting taxonomic, medical experimentation, military experimentation, and human clinical infection history. The organisms in this genus, particularly S. marcescens, were long thought to be nonpathogenic. Because S. marcescens was thought to be a nonpathogen and is usually red pigmented, the U.S. military conducted experiments that attempted to ascertain the spread of this organism released over large areas. In the process, members of both the public and the military were exposed to S. marcescens, and this was uncovered by the press in the 1970s, leading to U.S. congressional hearings. S. marcescens was found to be a certain human pathogen by the mid-1960s. S. marcescens and S. liquefaciens have been isolated as causative agents of numerous outbreaks and opportunistic infections, and the association of these organisms with point sources such as medical devices and various solutions given to hospitalized patients is striking. Serratia species appear to be common environmental organisms, and this helps to explain the large number of nosocomial infections due to these bacteria. Since many nosocomial infections are caused by multiply antibiotic-resistant strains of S. marcescens, this increases the danger to hospitalized patients, and hospital personnel should be vigilant in preventing nosocomial outbreaks due to this organism. S. marcescens, and probably other species in the genus, carries several antibiotic resistance determinants and is also capable of acquiring resistance genes. S. marcescens and S. liquefaciens are usually identified well in the clinical laboratory, but the other species are rare enough that laboratory technologists may not recognize them. 16S rRNA gene sequencing may enable better identification of some of the less common Serratia species. PMID:21976608

  6. Unsteady magnetic reconnection in laboratory experiments with current sheets

    Science.gov (United States)

    Frank, Anna

    2009-11-01

    According to present notion, unsteady magnetic reconnection in current sheets (CS) is basic to dramatic natural phenomena: solar and stellar flares, substorms in the Earth and other planetary magnetospheres, as well as to disruptive instabilities in tokamak plasmas. We present a review of laboratory experiments studying evolution of CS formed in 3D and 2D magnetic configurations with an X line, in the CS-3D device. Usually CS exists during an extended period in a metastable stage, without essential changes of its structure and parameters. Under certain conditions this stage may be suddenly interrupted by unsteady phase of magnetic reconnection, which manifests itself in a rapid change of the magnetic field topology, current redistribution, excitation of pulsed electric fields, and other dynamic effects. The unsteady phase results in effective conversion of magnetic energy into the energy of plasma and accelerated particles, and may finally bring about the CS disruption. In the context of the solar flares, a metastable CS is associated with a pre-flare situation, while CS disruption -- with the flare itself. The physical mechanisms triggering the unsteady magnetic reconnection in the laboratory produced current sheets are discussed. Supported by the Russian Foundation for Basic Research (project # 09-02-00971).

  7. Current trends in medical English education and the Japan College of Rheumatology International School.

    Science.gov (United States)

    Jego, Eric Hajime; Amengual, Olga

    2017-04-11

    In light of the present revolution happening in medical education in Japan as medical schools implement new curricula to conform to global standards, there is a growing demand for more internationalization and higher quality practical medical English education. In response, many institutions including governmental organizations, universities and academic associations are moving ahead with new initiatives to adapt to these changing demands. This paper reviews the current trends and innovations in medical English education in Japan. This paper also describes one initiative by the Japan College of Rheumatology (JCR) known as the JCR International School held yearly in Karuizawa. By examining recent trends and innovations in medical English education in Japan, the most relevant and applicable can be elucidated to illuminate a path forward for improved medical English education within the JCR.

  8. Assessment and care for non-medical risk factors in current antenatal health care

    NARCIS (Netherlands)

    A.A. Vos (Amber); Leeman, A. (Annemiek); W. Waelput (Wim); G.J. Bonsel (Gouke); E.A.P. Steegers (Eric); S. Denktaş (Semiha)

    2015-01-01

    textabstractObjective: this study aims to identify current practice in risk assessment, current antenatal policy and referral possibilities for non-medical risk factors (lifestyle and social risk factors), and to explore the satisfaction among obstetric caregivers in their collaboration with

  9. Knowledge and Experience of Medical Students with Male Urethral ...

    African Journals Online (AJOL)

    jen

    instruction in this technique to avoid devastating consequences of performing it poorly. ... Medical students in our medical school spend four weeks in urology unit. .... Preparation of short teaching video to be shown to all medical students.

  10. International infectious diseases teaching to undergraduate medical students: A successful European collaborative experience.

    Science.gov (United States)

    Charlier, Caroline; Johannessen, Ingólfur; Mackintosh, Claire L; Wilks, David; Cauda, Roberto; Wolf, Federica I; Le Jeunne, Claire

    2017-09-01

    The emerging global-health paradigm requires medical teaching to be continuously redefined and updated; to this end, transnational approaches should be encouraged and medical training harmonized. Infectious diseases (ID) teaching in the current context of emerging infections, fast-increasing bacterial resistance and large-scale human migration, was chosen to develop a common international course. We report the successful implementation of a joint European undergraduate course aiming to (i) develop a common ID core curriculum among European medical schools; (ii) promote mobility among teachers and students (iii) promote international cooperation among European teachers. The course was built around teachers' mobility. It was delivered in English by a team of European medical educators from Paris Descartes University, Università Cattolica del Sacro Cuore in Rome and the University of Edinburgh to groups of 25-30 undergraduate medical students at each university. Partner Institutions officially recognized the course as substitutive of or additive to the regular curriculum. The course has been running for 3 years and received excellent satisfaction scores by students and staff as regards to scientific content, pedagogy and international exchanges. This cooperative approach demonstrates the feasibility of a harmonized European undergraduate medical education, having ID as a test experiment for future developments.

  11. Current experience with computed tomographic cystography and blunt trauma.

    Science.gov (United States)

    Deck, A J; Shaves, S; Talner, L; Porter, J R

    2001-12-01

    We present our experience with computed tomographic (CT) cystography for the diagnosis of bladder rupture in patients with blunt abdominal and pelvic trauma and compare the results of CT cystography to operative exploration. We identified all blunt trauma patients diagnosed with bladder rupture from January 1992 to September 1998. We also reviewed the radiology computerized information system (RIS) for all CT cystograms performed for the evaluation of blunt trauma during the same time period. The medical records and pertinent radiographs of the patients with bladder rupture who underwent CT cystography as part of their admission evaluation were reviewed. Operative findings were compared to radiographic findings. Altogether, 316 patients had CT cystograms as part of an initial evaluation for blunt trauma. Of these patients, 44 had an ultimate diagnosis of bladder rupture; 42 patients had CT cystograms indicating bladder rupture. A total of 28 patients underwent formal bladder exploration; 23 (82%) had operative findings that exactly (i.e., presence and type of rupture) matched the CT cystogram interpretation. The overall sensitivity and specificity of CT cystography for detection of bladder rupture were 95% and 100%, respectively. For intraperitoneal rupture, the sensitivity and specificity were 78% and 99%, respectively. CT cystography provides an expedient evaluation for bladder rupture caused by blunt trauma and has an accuracy comparable to that reported for plain film cystography. We recommend CT cystography over plain film cystography for patients undergoing CT evaluation for other blunt trauma-related injuries.

  12. Experience with current multiaxial diagnostic systems: a critical review.

    Science.gov (United States)

    Kastrup, Marianne

    2002-01-01

    It is difficult to capture the complexity of the psychiatric condition with a single diagnostic category, and a multiaxial approach provides a more comprehensive picture of the current disorder. The WPA section on classification has developed a multiaxial schema based on the ICD-10 family of classifications. Four axes are proposed. Axis I: on clinical disorders; axis II: on disabilities; axis III: on contextual factors, and axis IV: on quality of life. Even though the multiaxial approach has been widely taught and surveys report on its international acceptability, daily use by clinicians of the 'non-diagnostic' axes have till now been limited, despite expressed interest by the very same clinicians. The multiaxial formulation is still developing and transcultural experiences need to be gained.

  13. Investigating the Impacts of Previous and Current Learning Experiences on Student Teachers' Teaching Experiences

    Science.gov (United States)

    Ögeyik, Muhlise Cosgun

    2016-01-01

    This study investigated the impacts of the previous and current learning experiences of the student teachers on their microteaching practices. The study pursued threefold research goals: to diagnose the microteaching stance, to treat it, and to explore and evaluate the progress. The participants were 24 undergraduate third year student teachers…

  14. New Titan Saltation Threshold Experiments: Investigating Current and Past Climates

    Science.gov (United States)

    Bridges, N.; Burr, D. M.; Marshall, J.; Smith, J. K.; Emery, J. P.; Horst, S. M.; Nield, E.; Yu, X.

    2015-12-01

    Titan exhibits aeolian sand dunes that cover ~20% of its surface, attesting to significant sediment transport by the wind. Recent experiments in the Titan Wind Tunnel (TWT) at NASA Ames Research Center [1,2] found that the threshold friction speed needed to detach Titanian "sand" is about 50% higher than previous estimates based on theory alone [3], a result that might be explained by the low ratio of particle to fluid density on the body [1]. Following the successful completion of the initial Titan threshold tests, we are conducting new experiments that expand the pressure range above and below current Titan values. The basic experimental techniques are described in [1], with minor updates to the instrumentation as described in [2]. To reproduce the kinematic viscosity and particle friction Reynolds number equivalent to that expected for Titan's nitrogen atmosphere at 1.4 bars and 94 K requires that TWT be pressurized to 12.5 bars for air at 293K. In addition to running experiments at this pressure to reproduce previous results [1] and investigate low density (high density ratio) materials, TWT pressures of 3 and 8 bars are in the experimental matrix to understand threshold under past Titan conditions when the atmospheric pressure may have been lower [4]. Higher pressures, at 15 and 20 bars in TWT, are also being run to understand the putative effects of low density ratio conditions. Our experimental matrix for this follow-on work uses some of the same materials as previously used, including walnut shells, basalt, quartz, glass spheres, and various low density materials to better simulate the gravity-equivalent weight of Titan sand. For these experiments, the TWT is now equipped with a new high pressure Tavis transducer with sufficient sensitivity to measure freestream speeds of less than 0.5 m s-1 at 12.5 bars. New techniques include video documentation of the experiments. We are also investigating methods of measuring humidity of the wind tunnel environment and

  15. The SNO+ experiment. Current status and future prospects

    Energy Technology Data Exchange (ETDEWEB)

    Lozza, Valentina [Institut fuer Kern- und Teilchenphysik, Zellescher Weg 19, 01069 Dresden (Germany)

    2016-07-01

    SNO+ is a large liquid scintillator based experiment that reuses the Sudbury Neutrino Observatory detector. The detector, located 2 km underground in a mine near Sudbury, Canada, consists of a 12 m diameter acrylic vessel which will be filled with 780 tonnes of liquid scintillator. The main physics goal of SNO+ is to search for the neutrinoless double-beta (0νββ) decay of {sup 130}Te. During the double-beta phase, the liquid scintillator will be initially loaded with 0.3-0.5% natural tellurium. In 5 years of data taking, SNO+ expects to reach a sensitivity on the effective Majorana neutrino mass of 55-133 meV, just above the inverted neutrino mass hierarchy region. Recently, the possibility to deploy up to 10 times more natural tellurium has been investigated, by which SNO+ could explore deep into the parameter space for the inverted hierarchy in the near future. Designed as a general purpose neutrino experiment, SNO+ can additionally measure the reactor antineutrino oscillations, geo-neutrinos in a geologically-interesting location, watch supernova neutrinos and measure low-energy solar neutrinos. A first commissioning phase with the detector filled with water will begin soon. The scintillator phase is expected to start after few months of water data taking. The 0νββ decay phase is foreseen for the 2017. In this talk the current status and the broad physics program of SNO+ will be presented.

  16. Medical academia clinical experiences of Ward Round Teaching curriculum

    Directory of Open Access Journals (Sweden)

    Fariba Haghani

    2014-01-01

    Full Text Available Background: Medical students spend most of their time in hospital wards and it is necessary to study clinical educational opportunities. This study was aimed to explore faculty members′ experience on Ward Round Teaching content. Methods and Materials: This qualitative study was conducted by purposive sampling with the maximum variation of major clinical departments faculty members in Isfahan University of Medical Sciences (n = 9. Data gathering was based on deep and semi-structured interviews. Data gathering continued till data saturation.Data was analyzed through the Collaizzi method and validated. Strategies to ensure trustworthiness of data (credibility, dependability, conformability, transferability were employed (Guba and Lincoln. Results: Basic codes extracted from the analyzed data were categorized into two main themes and related subthemes, including (1 tangible teachings (analytic intelligence, technical intelligence, legal duties and (2 implied teachings (professionalism, professional discipline, professional difficulties. Conclusion: Ward round teaching is a valuable opportunity for learners to learn not only patient care aspects but also ethical values. By appropriate planning, opportunities can be used to teach capabilities that are expected of general practitioners.

  17. Medical academia clinical experiences of Ward Round Teaching curriculum.

    Science.gov (United States)

    Haghani, Fariba; Arabshahi, Seyed Kamran Soltani; Bigdeli, Shoaleh; Alavi, Mousa; Omid, Athar

    2014-01-01

    Medical students spend most of their time in hospital wards and it is necessary to study clinical educational opportunities. This study was aimed to explore faculty members' experience on Ward Round Teaching content. This qualitative study was conducted by purposive sampling with the maximum variation of major clinical departments faculty members in Isfahan University of Medical Sciences (n = 9). Data gathering was based on deep and semi-structured interviews. Data gathering continued till data saturation. Data was analyzed through the Collaizzi method and validated. Strategies to ensure trustworthiness of data (credibility, dependability, conformability, transferability) were employed (Guba and Lincoln). Basic codes extracted from the analyzed data were categorized into two main themes and related subthemes, including (1) tangible teachings (analytic intelligence, technical intelligence, legal duties) and (2) implied teachings (professionalism, professional discipline, professional difficulties). Ward round teaching is a valuable opportunity for learners to learn not only patient care aspects but also ethical values. By appropriate planning, opportunities can be used to teach capabilities that are expected of general practitioners.

  18. Electronic medical record in cardiology: a 10-year Italian experience

    Directory of Open Access Journals (Sweden)

    Clara Carpeggiani

    2015-08-01

    Full Text Available SummaryObjectives:the aim of this study was to report a ten years experience in the electronic medical record (EMR use. An estimated 80% of healthcare transactions are still paper-based.Methods:an EMR system was built at the end of 1998 in an Italian tertiary care center to achieve total integration among different human and instrumental sources, eliminating paper-based medical records. Physicians and nurses who used EMR system reported their opinions. In particular the hospital activity supported electronically, regarding 4,911 adult patients hospitalized in the 2004- 2008 period, was examined.Results:the final EMR product integrated multimedia document (text, images, signals. EMR presented for the most part advantages and was well adopted by the personnel. Appropriateness evaluation was also possible for some procedures. Some disadvantages were encountered, such as start-up costs, long time required to learn how to use the tool, little to no standardization between systems and the EMR technology.Conclusion:the EMR is a strategic goal for clinical system integration to allow a better health care quality. The advantages of the EMR overcome the disadvantages, yielding a positive return on investment to health care organization.

  19. High current transport experiment for heavy ion inertial fusion

    Directory of Open Access Journals (Sweden)

    L. R. Prost

    2005-02-01

    Full Text Available The High Current Experiment at Lawrence Berkeley National Laboratory is part of the U.S. program to explore heavy-ion beam transport at a scale representative of the low-energy end of an induction linac driver for fusion energy production. The primary mission of this experiment is to investigate aperture fill factors acceptable for the transport of space-charge-dominated heavy-ion beams at high intensity (line charge density ∼0.2  μC/m over long pulse durations (4  μs in alternating gradient focusing lattices of electrostatic or magnetic quadrupoles. This experiment is testing transport issues resulting from nonlinear space-charge effects and collective modes, beam centroid alignment and steering, envelope matching, image charges and focusing field nonlinearities, halo, and electron and gas cloud effects. We present the results for a coasting 1 MeV K^{+} ion beam transported through ten electrostatic quadrupoles. The measurements cover two different fill factor studies (60% and 80% of the clear aperture radius for which the transverse phase space of the beam was characterized in detail, along with beam energy measurements and the first halo measurements. Electrostatic quadrupole transport at high beam fill factor (≈80% is achieved with acceptable emittance growth and beam loss, even though the initial beam distribution is not ideal (but the emittance is low nor in thermal equilibrium. We achieved good envelope control, and rematching may only be needed every ten lattice periods (at 80% fill factor in a longer lattice of similar design. We also show that understanding and controlling the time dependence of the envelope parameters is critical to achieving high fill factors, notably because of the injector and matching section dynamics.

  20. The high current transport experiment for heavy ion inertial fusion

    Energy Technology Data Exchange (ETDEWEB)

    Prost, L.R.; Baca, D.; Bieniosek, F.M.; Celata, C.M.; Faltens, A.; Henestroza, E.; Kwan, J.W.; Leitner, M.; Seidl, P.A.; Waldron, W.L.; Cohen, R.; Friedman, A.; Grote, D.; Lund, S.M.; Molvik, A.W.; Morse, E.

    2004-05-01

    The High Current Experiment (HCX) at Lawrence Berkeley National Laboratory is part of the US program to explore heavy-ion beam transport at a scale representative of the low-energy end of an induction linac driver for fusion energy production. The primary mission of this experiment is to investigate aperture fill factors acceptable for the transport of space-charge-dominated heavy-ion beams at high intensity (line charge density {approx} 0.2 {micro}C/m) over long pulse durations (4 {micro}s) in alternating gradient focusing lattices of electrostatic or magnetic quadrupoles. This experiment is testing transport issues resulting from nonlinear space-charge effects and collective modes, beam centroid alignment and steering, envelope matching, image charges and focusing field nonlinearities, halo and, electron and gas cloud effects. We present the results for a coasting 1 MeV K{sup +} ion beam transported through ten electrostatic quadrupoles. The measurements cover two different fill factor studies (60% and 80% of the clear aperture radius) for which the transverse phase-space of the beam was characterized in detail, along with beam energy measurements and the first halo measurements. Electrostatic quadrupole transport at high beam fill factor ({approx}80%) is achieved with acceptable emittance growth and beam loss, even though the initial beam distribution is not ideal (but the emittance is low) nor in thermal equilibrium. We achieved good envelope control, and rematching may only be needed every ten lattice periods (at 80% fill factor) in a longer lattice of similar design. We also show that understanding and controlling the time dependence of the envelope parameters is critical to achieving high fill factors, notably because of the injector and matching section dynamics.

  1. Team learning in medical education: initial experiences at ten institutions.

    Science.gov (United States)

    Searle, Nancy S; Haidet, Paul; Kelly, P Adam; Schneider, Virginia F; Seidel, Charles L; Richards, Boyd F

    2003-10-01

    In the midst of curricular reforms that frequently call for reducing lectures and increasing small-group teaching, there is a crisis in faculty time for teaching. This paper describes the initial experiences of ten institutions with team learning (TL), a teaching method which fosters small-group learning in a large-class setting. After initial pilot studies at one institution, nine additional institutions implemented TL in one or more courses. Within 18 months, TL has been used in 40 courses (from.5% to 100% of the time) and all ten institutions will increase its use next year. We surmise that this relatively rapid spread of TL into the medical curriculum is due to the sound pedagogy and efficiency of TL as well as the modest financial resources and support we have provided to partner institutions.

  2. [Current status and progress of medical imaging in diagnosis of gastrointestinal stromal tumors].

    Science.gov (United States)

    Wang, Lingjie; Zhang, Ruiping; Li, Jianding

    2015-04-01

    Gastrointestinal stromal tumors (GISTs) are derived from non-directed differentiation of gastrointestinal mesenchymal tissue, which lack of typical clinical symptoms, and many asymptomatic GISTs are often found on physical examination. The tumor is primarily through implantation metastasis and blood metastasis. Currently, conventional medical imaging methods, such as X-ray barium meal, US, CT, MRI, PET/CT and ES, are still the main means of diagnosis of GISTs. Early diagnosis and early treatment are key factors of the prognosis in GISTs. Therefore, we need to be proficient in various medical imaging methods, then apply them to the diagnosis of GISTs, and to provide comprehensive and valuable information for clinical practice. Through retrieving and consulting literature of medical imaging associated with GISTs, this paper reviews the current status and progress of medical imaging in diagnosis of GISTs.

  3. The current status of orbital experiments for UHECR studies

    Science.gov (United States)

    Panasyuk, M. I.; Casolino, M.; Garipov, G. K.; Ebisuzaki, T.; Gorodetzky, P.; Khrenov, B. A.; Klimov, P. A.; Morozenko, V. S.; Sakaki, N.; Saprykin, O. A.; Sharakin, S. A.; Takizawa, Y.; Tkachev, L. G.; Yashin, I. V.; Zotov, M. Yu

    2015-08-01

    Two types of orbital detectors of extreme energy cosmic rays are being developed nowadays: (i) TUS and KLYPVE with reflecting optical systems (mirrors) and (ii) JEM-EUSO with high- transmittance Fresnel lenses. They will cover much larger areas than existing ground-based arrays and almost uniformly monitor the celestial sphere. The TUS detector is the pioneering mission developed in SINP MSU in cooperation with several Russian and foreign institutions. It has relatively small field of view (±4.5°), which corresponds to a ground area of 6.4 • 103 km2. The telescope consists of a Fresnel-type mirror-concentrator (∼ 2 m2) and a photo receiver (a matrix of 16 x 16 photomultiplier tubes). It is to be deployed on the Lomonosov satellite, and is currently at the final stage of preflight tests. Recently, SINP MSU began the KLYPVE project to be installed on board of the Russian segment of the ISS. The optical system of this detector contains a larger primary mirror (10 m2), which allows decreasing the energy threshold. The total effective field of view will be at least ±14° to exceed the annual exposure of the existing ground-based experiments. Several configurations of the detector are being currently considered. Finally, JEM-EUSO is a wide field of view (±30°) detector. The optics is composed of two curved double-sided Fresnel lenses with 2.65 m external diameter, a precision diffractive middle lens and a pupil. The ultraviolet photons are focused onto the focal surface, which consists of nearly 5000 multi-anode photomultipliers. It is developed by a large international collaboration. All three orbital detectors have multi-purpose character due to continuous monitoring of various atmospheric phenomena. The present status of development of the TUS and KLYPVE missions is reported, and a brief comparison of the projects with JEM-EUSO is given.

  4. Otolaryngology in the medical school curriculum: Current trends in the United States.

    Science.gov (United States)

    Boscoe, Elizabeth F; Cabrera-Muffly, Cristina

    2017-02-01

    To identify trends in medical school otolaryngology curriculum requirements. Survey of United States allopathic medical schools. A survey was sent to deans of curriculum at allopathic medical schools. We identified opportunities for medical students to learn basic concepts in otolaryngology during their undergraduate medical training. The opportunities were classified into preclinical and clinical as well as elective and mandatory rotations. Of the schools surveyed, 60% responded. Mean class size was 149 students. Sixty-eight percent of surveyed schools noted that 75% to 100% of their students participated in preclinical otolaryngology experiences, with 59% reporting a mandatory preclinical otolaryngology module for all students. Eighty-nine percent of schools offered otolaryngology as a clinical elective rotation, with a mean of 12 students participating yearly. Only 7% of schools required a mandatory otolaryngology clinical rotation. Our data suggest that medical students do not receive sufficient exposure to otolaryngology during medical school. Increased requirements for otolaryngology curriculum may be beneficial to all medical students, regardless of their specialty choice. NA. Laryngoscope, 00:000-000, 2016 127:346-348, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  5. 3-flavor oscillations with current and future reactor experiments

    Science.gov (United States)

    Dwyer, Dan

    2017-01-01

    Nuclear reactors have been a crucial tool for our understanding of neutrinos. The disappearance of electron antineutrinos emitted by nuclear reactors has firmly established that neutrino flavor oscillates, and that neutrinos consequently have mass. The current generation of precision measurements rely on some of the world's most intense reactor facilities to demonstrate that the electron antineutrino mixes with the third antineutrino mass eigenstate (v3-). Accurate measurements of antineutrino energies robustly determine the tiny difference between the masses-squared of the v3- state and the two more closely-spaced v1- and v2- states. These results have given us a much clearer picture of neutrino mass and mixing, yet at the same time open major questions about how to account for these small but non-zero masses in or beyond the Standard Model. These observations have also opened the door for a new generation of experiments which aim to measure the ordering of neutrino masses and search for potential violation of CP symmetry by neutrinos. I will provide a brief overview of this exciting field. Work supported under DOE OHEP DE-AC02-05CH11231.

  6. Current advances in synchrotron radiation instrumentation for MX experiments

    Energy Technology Data Exchange (ETDEWEB)

    Owen, Robin L.; Juanhuix, Jordi; Fuchs, Martin

    2016-07-01

    Following pioneering work 40 years ago, synchrotron beamlines dedicated to macromolecular crystallography (MX) have improved in almost every aspect as instrumentation has evolved. Beam sizes and crystal dimensions are now on the single micron scale while data can be collected from proteins with molecular weights over 10 MDa and from crystals with unit cell dimensions over 1000 Å. Furthermore it is possible to collect a complete data set in seconds, and obtain the resulting structure in minutes. The impact of MX synchrotron beamlines and their evolution is reflected in their scientific output, and MX is now the method of choice for a variety of aims from ligand binding to structure determination of membrane proteins, viruses and ribosomes, resulting in a much deeper understanding of the machinery of life. A main driving force of beamline evolution have been advances in almost every aspect of the instrumentation comprising a synchrotron beamline. In this review we aim to provide an overview of the current status of instrumentation at modern MX experiments. The most critical optical components are discussed, as are aspects of endstation design, sample delivery, visualisation and positioning, the sample environment, beam shaping, detectors and data acquisition and processing.

  7. Current profile control experiments in EXTRAP T2R

    Science.gov (United States)

    Brunsell, P.; Cecconello, M.; Drake, J.; Franz, P.; Malmberg, J. A.; Marrelli, L.; Martin, P.; Spizzo, G.

    2002-11-01

    EXTRAP T2R is a high aspect ratio (R=1.24 m, a = 0.183 m) reversed-field pinch device, characterised by a double, thin shell system. The simultaneous presence of many m=1, |n| > 11 tearing modes is responsible for a magnetic field turbulence, which is believed to produce the rather high energy and particle transport that is observed in this type of magnetic configuration. In this paper first results from current profile control experiments (PPCD) in a thin shell device are shown. When an edge poloidal electric field is transiently applied, an increase of the electron temperature and of the electron density is seen, which is consistent with an increase of the thermal content of the plasma. At the same time, the soft x-ray emission, measured with a newly installed miniaturised camera, shows a peaking of the profile in the core. Furthermore, the amplitudes of the m=1 tearing modes are reduced and and the rotation velocities increase during PPCD, which is also consistent with a reduction of magnetic turbulence and a heating of the plasma

  8. Nuclear aspects of neutrino energy reconstruction in current oscillation experiments

    Energy Technology Data Exchange (ETDEWEB)

    Leitner, Tina; Buss, Oliver; Mosel, Ulrich [Institut fuer Theoretische Physik, Universitaet Giessen (Germany); Alvarez-Ruso, Luis [Departamento de Fisica Teorica and IFIC, Universidad de Valencia - CSIC (Spain)

    2008-07-01

    There is an extensive experimental effort aiming at a precise determination of neutrino oscillation parameters. A critical quantity is the neutrino energy which can not be measured directly but has to be reconstructed from observables. A good knowledge of neutrino-nucleus interactions is thus necessary to minimize the systematic uncertainties in neutrino fluxes, backgrounds and detector responses. A reliable reconstruction has to account for in-medium modifications. We find that in particular final-state interactions inside the target nucleus modify considerably the distributions through rescattering, charge-exchange and absorption. These effects can be simulated with our coupled channel GiBUU transport model where the neutrino first interacts with a bound nucleon producing secondary particles which are then transported out of the nucleus. We consider, besides Fermi motion and Pauli blocking, full in-medium kinematics, mean-field potentials and in-medium spectral functions. In this contribution, we compare the reconstructed quantities obtained within our model to the ones obtained by the current experiments like MiniBooNE, which mostly rely on simple two-body kinematics. We then discuss how these uncertainties influence not only the cross section measurements but also the oscillation results.

  9. Medical marijuana users continue to experience legal barriers.

    Science.gov (United States)

    Betteridge, Glenn

    2006-04-01

    Four recent developments highlight that people continue to face significant legal and administrative barriers to using marijuana for medical purposes--despite the existence of the Marihuana Medical Access Regulations (MMAR), enacted by the federal government, as a result of court rulings, to enable people who require marijuana for medical purposes to exercise their constitutional right to such medicine.

  10. A Discrete Choice Conjoint Experiment to Evaluate Parent Preferences for Treatment of Young, Medication Naive Children with ADHD

    Science.gov (United States)

    Waschbusch, Daniel A.; Cunningham, Charles E.; Pelham, William E., Jr.; Rimas, Heather L.; Greiner, Andrew R.; Gnagy, Elizabeth M.; Waxmonsky, James; Fabiano, Gregory A.; Robb, Jessica A.; Burrows-MacLean, Lisa; Scime, Mindy; Hoffman, Martin T.

    2011-01-01

    The current study examined treatment preferences of 183 parents of young (average age = 5.8 years, SD = 0.6), medication naive children with ADHD. Preferences were evaluated using a discrete choice experiment in which parents made choices between different combinations of treatment characteristics, outcomes, and costs. Latent class analysis…

  11. The use of elearning in medical education: a review of the current situation.

    Science.gov (United States)

    Choules, A P

    2007-04-01

    Computers are increasingly used in medical education. Electronic learning (elearning) is moving from textbooks in electronic format (that are increasingly enhanced by the use of multimedia adjuncts) to a truly interactive medium that can be delivered to meet the educational needs of students and postgraduate learners. Computer technology can present reliable, reusable content in a format that is convenient to the learner. It can be used to transcend geographical boundaries and time zones. It is a valuable tool to add to the medical teacher's toolkit, but like all tools it must be used appropriately. This article endeavours to review the current "state of the art2 in use of elearning and its role in medical education alongside non-electronic methods-a combination that is currently referred to as "blended" learning.

  12. Effects of previous growth hormone excess and current medical treatment for acromegaly on cognition

    NARCIS (Netherlands)

    Brummelman, Pauline; Koerts, Janneke; Dullaart, Robin P. F.; van den Berg, Gerrit; Tucha, Oliver; Wolffenbuttel, Bruce H. R.; van Beek, Andre P.

    2012-01-01

    Background In untreated acromegaly patients, decreased cognitive functioning is reported to be associated with the degree of growth hormone (GH) and IGF-1 excess. Whether previous GH excess or current medical treatment for acromegaly specifically affects cognition remains unclear. The aim of this

  13. Effects of previous growth hormone excess and current medical treatment for acromegaly on cognition

    NARCIS (Netherlands)

    Brummelman, Pauline; Koerts, Janneke; Dullaart, Robin P. F.; van den Berg, Gerrit; Tucha, Oliver; Wolffenbuttel, Bruce H. R.; van Beek, Andre P.

    2012-01-01

    Background In untreated acromegaly patients, decreased cognitive functioning is reported to be associated with the degree of growth hormone (GH) and IGF-1 excess. Whether previous GH excess or current medical treatment for acromegaly specifically affects cognition remains unclear. The aim of this st

  14. Current status of information literacy instruction practices in medical libraries of Pakistan.

    Science.gov (United States)

    Ullah, Midrar; Ameen, Kanwal

    2014-10-01

    The research explored the current practices of information literacy (IL) instruction in medical libraries of Pakistan. A semi-structured questionnaire was mailed to the head librarians of all 114 academic medical libraries in Pakistan. It investigated the types of IL instruction provided, topics covered, methods of delivery and assessment, level of integration in the curriculum, and level of collaboration with teaching staff. The study revealed that 74% of the respondents had offered some types of IL instruction in their institutions during the previous year, ranging from library orientation to research-level skills. IL instruction is typically only offered to new students or first-time library users or on demand. A majority of the respondents developed IL instruction programs without faculty involvement. Librarians were primarily responsible for offering IL instruction in medical institutions. Face-to-face instruction in computer labs or lecture halls and individual instruction at reference desks were identified as the most common IL instruction delivery methods. The data indicated that oral feedback, written feedback, and searching in a computer lab were the most popular assessment methods that medical librarians used. IL instruction activities in medical libraries of Pakistan are in their infancy. Medical librarians also lack systematic approaches to IL instruction. Medical librarians need to develop educational partnerships with faculty for integrating IL instruction into the mainstream curriculum.

  15. [The teaching of pharmacology in medical schools: current status and future perspectives].

    Science.gov (United States)

    Rodríguez-Carranza, Rodolfo; Vidrio, Horacio; Campos-Sepúlveda, Efraín

    2008-01-01

    Pharmacology is a core course in all medical school curricula. In most medical schools, pharmacology is taught during the second year and teaching covers both basic aspects and useful drugs for the treatment of human diseases. It is assumed that relevant pharmacologic knowledge is revisited during the clinical clerkships and that students are adequately trained to prescribe drugs upon graduation. However, for many years it has been noted that pharmacological training is sometimes insufficient and that inadequate and irrational prescription of drugs is a very common problem in clinical settings. Information overload and proliferation of new drugs have been recognized as two of the major contributing factors. To address this issue, many authors have recommended the development of a core curricula in pharmacology which all students would have to complete coupled with a restricted list of drugs. Based on our own teaching experience we have identified what should constitute the core content of pharmacology courses in medical schools and have written a study guide for this discipline. Both documents provide an organizational framework to help second year medical students ascertain what part of the vast knowledge in pharmacology they need to learn. The number of drugs that students have to manage is limited to 168. Our program constitutes the first effort to medicalize the teaching of pharmacology in medical schools. We expect that most medical schools will follow our guidelines as our program is applicable to all curricula modalities.

  16. [Anthropology of medical research in developing countries: a Senegalese experience].

    Science.gov (United States)

    Ouvrier, Ashley

    2013-01-01

    Medical research is an essential tool of biomedicine that raises many social and ethical questions especially in resource-poor countries where the number of clinical trials has increased significantly over the past two decades. This article presents the way anthropology of medical research critically examines medical research in non-western countries without questioning its strategic importance for advances in scientific knowledge and in public health improvement. This article draws on observations conducted in Senegal in 2007 during a vaccine trial against meningitis and discusses, more broadly, medical research in non western-countries related to: the presence and management of medical research sites, the impact of medical research benefits on its representations and the questions raised by blood-stealing rumours regarding medical research practice itself.

  17. Sexuality education in North American medical schools: current status and future directions.

    Science.gov (United States)

    Shindel, Alan W; Parish, Sharon J

    2013-01-01

    Both the general public and individual patients expect healthcare providers to be knowledgeable and approachable regarding sexual health. Despite this expectation there are no universal standards or expectations regarding the sexuality education of medical students. To review the current state of the art in sexuality education for North American medical students and to articulate future directions for improvement. Evaluation of: (i) peer-reviewed literature on sexuality education (focusing on undergraduate medical students); and (ii) recommendations for sexuality education from national and international public health organizations. Current status and future innovations for sexual health education in North American medical schools. Although the importance of sexuality to patients is recognized, there is wide variation in both the quantity and quality of education on this topic in North American medical schools. Many sexual health education programs in medical schools are focused on prevention of unwanted pregnancy and sexually transmitted infection. Educational material on sexual function and dysfunction, female sexuality, abortion, and sexual minority groups is generally scant or absent. A number of novel interventions, many student initiated, have been implemented at various medical schools to improve the student's training in sexual health matters. There is a tremendous opportunity to mold the next generation of healthcare providers to view healthy sexuality as a relevant patient concern. A comprehensive and uniform curriculum on human sexuality at the medical school level may substantially enhance the capacity of tomorrow's physicians to provide optimal care for their patients irrespective of gender, sexual orientation, and individual sexual mores/beliefs. © 2013 International Society for Sexual Medicine.

  18. To the point: obstetrics and gynecology global health experiences for medical students.

    Science.gov (United States)

    Hampton, Brittany S; Chuang, Alice W; Abbott, Jodi F; Buery-Joyner, Samantha D; Cullimore, Amie J; Dalrymple, John L; Forstein, David A; Hueppchen, Nancy A; Kaczmarczyk, Joseph M; Page-Ramsey, Sarah; Pradhan, Archana; Wolf, Abigail; Dugoff, Lorraine

    2014-07-01

    This article, from the To the Point series prepared by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, provides educators with an overview of considerations for obstetrics and gynecology global health experiences for the medical student. Options for integration of obstetrics and gynecology global health into undergraduate medical curricula are discussed. Specific considerations for global health clinical experiences for medical students, including choosing a clinical location, oversight and mentorship, goals and objectives, predeparture preparation, and evaluation, are reviewed.

  19. Medical assistance during commercial airline flights: analysis of 11 years experience of the Paris Emergency Medical Service (SAMU) between 1989 and 1999.

    Science.gov (United States)

    Szmajer, M; Rodriguez, P; Sauval, P; Charetteur, M P; Derossi, A; Carli, P

    2001-08-01

    Emergencies arising during commercial airline flights may have serious consequences. We report the experience of the Paris Emergency Medical Service (SAMU) in providing in-flight assistance to Air France between 1989 and 1999. During this period medical advice was sought 380 times during the carriage of about 350 million passengers. Analysis of the patient files suggests that serious emergencies were rare and that cardiopulmonary resuscitation was required only exceptionally. However the relative frequency of cardiac and neurological emergencies in our analysis supports the necessity of carrying adequate medical equipment and of having direct access to expert medical advice. The results suggest the requirement for a rigorous prospective epidemiological study of in-flight emergencies to evaluate the effectiveness of current practice and possible modifications of equipment and protocols for patient management.

  20. Premedical anatomy experience and student performance in medical gross anatomy.

    Science.gov (United States)

    Kondrashov, Peter; McDaniel, Dalton J; Jordan, Rebecca M

    2017-04-01

    Gross anatomy is considered one of the most important basic science courses in medical education, yet few medical schools require its completion prior to matriculation. The effect of taking anatomy courses before entering medical school on performance in medical gross anatomy has been previously studied with inconsistent results. The effect of premedical anatomy coursework on performance in medical gross anatomy, overall medical school grade point average (GPA), and Comprehensive Osteopathic Medical Licensing Examination Level 1 (COMLEX 1) score was evaluated in 456 first-year osteopathic medical students along with a survey on its perceived benefits on success in medical gross anatomy course. No significant differences were found in gross anatomy grade, GPA, or COMLEX 1 score between students with premedical anatomy coursework and those without. However, significant differences and higher scores were observed in students who had taken three or more undergraduate anatomy courses including at least one with cadaveric laboratory. There was significantly lower perceived benefit for academic success in the medical gross anatomy course (P<.001) from those students who had taken premedical anatomy courses (5.9 of 10) compared with those who had not (8.2 of 10). Results suggest that requiring any anatomy course as a prerequisite for medical school would not have significant effect on student performance in the medical gross anatomy course. However, requiring more specific anatomy coursework including taking three or more undergraduate anatomy courses, one with cadaveric laboratory component, may result in higher medical gross anatomy grades, medical school GPA, and COMLEX 1 scores. Clin. Anat. 30:303-311, 2017. © 2017 Wiley Periodicals, Inc.

  1. Current experiments in elementary-particle physics - March 1983

    Energy Technology Data Exchange (ETDEWEB)

    Wohl, C.G.; Armstrong, F.E.; Rittenberg, A.

    1983-03-01

    Microfiche are included which contain summaries of 479 experiments in elementary particle physics. Experiments are included at the following laboratories: Brookhaven (BNL); CERN; CESR; DESY; Fermilab (FNAL); Institute for Nuclear Studies (INS); KEK; LAMPF; Serpukhov (SERP); SIN; SLAC; and TRIUMF. Also, summaries of proton decay experiments are included. A list of experiments and titles is included; and a beam-target-momentum index and a spokesperson index are given. Properties of beams at the facilities are tabulated. (WHK)

  2. Examining the End-User Experience of the National Integrated Medical Imaging System (NIMIS).

    Science.gov (United States)

    Smith, J; Kok, H K; Torreggiani, W C

    2016-01-01

    The National Integrated Medical Imaging System (NIMIS) is used to store and retrieve medical imaging studies in Ireland. The purpose of this audit was to obtain feedback from its end-users in relation to key NIMIS functionality and to understand their perception of its existing interface while identifying potential improvements. The results showed that, while the majority of respondents are satisfied with NIMIS, they identified a number of areas of concern. These included difficulty in identifying the appropriate code for a study, 88 (34%); dissatisfaction with ordering and viewing scans, 82 (32%); and a need for improved communication between end-users and local Radiology departments, with 104 (40%) unsure when to contact the department and 137 (53%) dissatisfied with the feedback they received in relation to requests. Respondents indicated that addressing these issues would improve the NIMIS end-user experience while allowing it to continue to meet current and future clinical needs.

  3. [Experience of medical support organization of the tank biathlon competition].

    Science.gov (United States)

    Fisun, A Ia; Kuvshinov, K É; Iakovlev, S V

    2013-11-01

    Authors presented information about medical support of the tank biathlon competition taking part on 12-17 August 2013 at the Alabino. Crews from Belarus, Kazakhstan and Armenia (The Collective Security Treaty Organization) were invited for the contest. On the basis of the idea of the contest and location of the Alabino, the Main military-medical board of the Ministry of Defence of the Russian Federation developed and passed the Programme of medical support of the contest, gave the word to medical service of the Western Military District and central military-medical facilities about appropriation of funds. Personnel, providing the contest, was training every day during the period of preparation. Over a period of field ambulance station 73 people sought medical advice, 12 of them were sent to hospital. Authors came to conclusion the set tasks were completely fulfilled.

  4. Medical Big Data for Research Use: Current Status and Related Issues.

    Science.gov (United States)

    Ishikawa, Koichi Benjamin

    2016-09-01

    Advances in the computerization of information and development of technology have mitigated restrictions on handling of a large amount of information. This has resulted in growth of expectations for the use of large-scale databases, or so-called "big data." This is also the case in the field of healthcare. Projects that involve building of the national receipt database (NDB) of medical fee bill (receipt) information and special health check-up information based on the Act on Assurance of Medical Care for Elderly People and the development of medical information databases have been pursued by the national government, and considerable attention has also been focused on researches conducted through the secondary uses of publicly collected data. Aside from these trends, there are numerous projects which collect diagnosis procedure combination (DPC) data to build large-scale databases for research purposes. Following to the ethics guidelines for epidemiologic studies, they collect and analyze anonymized DPC data from cooperating institutions. This communication concentrates on the use of DPC data, and outlines the scale of data currently available for research use. Examples on the use of DPC data will be shown for analysis on the current status of clinical practice from the microscopic perspective and macroscopic analysis of community medical care provision. Additionally, potential for extending studies to long-term outcomes research, limitations and issues related to the use of medical big data will also be discussed.

  5. Current experiments in elementary particle physics. Revision 1-85

    Energy Technology Data Exchange (ETDEWEB)

    Wohl, C.G.; Armstrong, F.E.; Rittenberg, A.; Trippe, T.G.; Yost, G.P.; Oyanagi, Y.; Dodder, D.C.; Grudtsin, S.N.; Ryabov, Yu.G.; Frosch, R.

    1985-01-01

    This report contains summaries of 551 approved experiments in elementary particle physics (experiments that finished taking data before 1 January 1980 are excluded). Included are experiments at Brookhaven, CERN, CESR, DESY, Fermilab, Moscow Institute of Theoretical and Experimental Physics, Tokyo Institute of Nuclear Studies, KEK, LAMPF, Leningrad Nuclear Physics Institute, Saclay, Serpukhov, SIN, SLAC, and TRIUMF, and also experiments on proton decay. Properties of the fixed-target beams at most of the laboratories are summarized. Instructions are given for searching online the computer database (maintained under the SLAC/SPIRES system) that contains the summaries.

  6. Post market surveillance in the german medical device sector - current state and future perspectives.

    Science.gov (United States)

    Zippel, Claus; Bohnet-Joschko, Sabine

    2017-08-01

    Medical devices play a central role in the diagnosis and treatment of diseases but also bring the potential for adverse events, hazards or malfunction with serious consequences for patients and users. Medical device manufacturers are therefore required by law to monitor the performance of medical devices that have been approved by the competent authorities (post market surveillance). Conducting a nationwide online-survey in the German medical device sector in Q2/2014 in order to explore the current status of the use of post market instruments we obtained a total of 118 complete data sets, for a return rate of 36%. The survey included manufacturers of different sizes, producing medical devices of all risk classes. The post market instruments most frequently reported covered the fields of production monitoring and quality management as well as literature observation, regulatory vigilance systems, customer knowledge management and market observation while Post Market Clinical Follow-up and health services research were being used less for product monitoring. We found significant differences between the different risk classes of medical devices produced and the intensity of use of post market instruments. Differences between company size and the intensity of instruments used were hardly detected. Results may well contribute to the development of device monitoring which is a crucial element of the policy and regulatory system to identify device-related safety issues. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Reversibility of ventricular dysfunction: clinical experience in a medical office

    Directory of Open Access Journals (Sweden)

    Antonio Carlos Pereira Barretto

    2001-12-01

    Full Text Available OBJECTIVE - To describe clinical observations of marked improvement in ventricular dysfunction in a medical office environment under circumstances differing from those in study protocols and multicenter studies performed in hospital or with outpatient cohorts. METHODS - Eleven cardiac failure patients with marked ventricular dysfunction receiving treatment at a doctors office between 1994 and 1999 were studied. Their ages ranged from 20 and 66 years (mean 39.42±14.05 years; 7 patients were men, 4 were women. Cardiopathic etiologies were arterial hypertension in 5 patients, peripartum cardiomyopathy in 2, nondefined myocarditis in 2, and alcoholic cardiomyopathy in 4. Initial echocardiograms revealed left ventricular dilatation (average diastolic diameter, 69.45±8.15mm, reduced left ventricular ejection fraction (0.38±0.08 and left atrial dilatation (43.36±5.16mm. The therapeutic approach followed consisted of patient orientation, elimination of etiological or causal factors of cardiac failure, and prescription of digitalis, diuretics, and angiotensinconverting enzyme inhibitors. RESULTS - Following treatment, left ventricular ejection fraction changed to 0.63±0.09; left ventricular diameters changed to 57.18±8.13mm, and left atrium diameters changed to 37.27±8.05mm. Maximum improvement was noted after 16.9±8.63 (6 to 36 months. CONCLUSION - Patients with serious cardiac failure and ventricular dysfunction caused by hypertension, alcoholism, or myocarditis can experience marked improvement in ventricular dysfunction after undergoing appropriate therapy within the venue of the doctor's office.

  8. Damping of unwanted turbulence in wave–current experiments

    DEFF Research Database (Denmark)

    Markus, D.; Jakobsen, Morten Møller; Bletzinger, K.-U.

    2015-01-01

    Laboratory testing of structures placed in combined wave–current flows is a valuable source of information for the fulfillment of offshore engineering related tasks and the development of ocean energy devices. In recirculating wave–current flumes, one of the problems encountered during...... such experimental studies is the occurrence of undesirable current induced velocity fluctuations. These fluctuations often result in significant disturbances of the generated wave profiles. In this paper, a physical flow filter is introduced that significantly reduces fluctuations in the current profile while...... permitting wave passage. This is achieved by passing the wave–current flow through a setup of perforated net tubes that allows for both horizontal and vertical flow motions. An in depth investigation of the properties of different filter configurations is presented, focusing on the reduction of turbulence...

  9. An index to medical book reviews: a computer experiment.

    Science.gov (United States)

    Atwood, R

    1967-01-01

    The experimental production of an index to book reviews of medical publications is described. Details of compilation and preparation of data for processing by an IBM 1440 computer are outlined. Results of a survey testing the response to the index in its present form by medical libraries are presented.

  10. Current drive experiments in the Helicity Injected Torus - II

    Science.gov (United States)

    Hamp, W. T.; Redd, A. J.; Jarboe, T. R.; Nelson, B. A.; O'Neill, R. G.; Raman, R.; Sieck, P. E.; Smith, R. J.; Mueller, D.

    2006-10-01

    The HIT-II spherical torus (ST) device has demonstrated four toroidal plasma current drive configurations to form and sustain a tokamak: 1) inductive (ohmic) current drive, 2) coaxial helicity injection (CHI) current drive, 3) CHI initiated plasmas with ohmic sustainment (CHI+OH), and 4) ohmically initiated plasmas with CHI edge current drive (OH+ECD). CHI discharges with a sufficiently high ratio of injector current to toroidal field current form a closed flux core, and amplify the injector poloidal flux through magnetic reconnection. CHI+OH plasmas are more robust than unassisted ohmic discharges, with a wider operating space and more efficient use of the transformer Volt-seconds. Finally, edge CHI can enhance the plasma current of an ohmic discharge without significantly degrading the quality of the discharge. Results will be presented for each HIT-II operating regime, including empirical performance scalings, applicable parametric operating spaces, and requirements to produce these discharges. Thomson scattering measurements and EFIT simulations are used to evaluate confinement in several representative plasmas. Finally, we outline extensions to the HIT-II CHI studies that could be performed with NSTX, SUNIST, or other ST devices.

  11. [Current status on storage, processing and risk communication of medical radioactive waste in Japan].

    Science.gov (United States)

    Watanabe, Hiroshi; Yamaguchi, Ichiro; Kida, Tetsuo; Hiraki, Hitoshi; Fujibuchi, Toshioh; Maehara, Yoshiaki; Tsukamoto, Atsuko; Koizumi, Mitsue; Kimura, Yumi; Horitsugi, Genki

    2013-03-01

    Decay-in-storage for radioactive waste including that of nuclear medicine has not been implemented in Japan. Therefore, all medical radioactive waste is collected and stored at the Japan Radioisotope Association Takizawa laboratory, even if the radioactivity has already decayed out. To clarify the current situation between Takizawa village and Takizawa laboratory, we investigated the radiation management status and risk communication activities at the laboratory via a questionnaire and site visiting survey in June 2010. Takizawa laboratory continues to maintain an interactive relationship with local residents. As a result, Takizawa village permitted the acceptance of new medical radioactive waste containing Sr-89 and Y-90. However, the village did not accept any non-medical radioactive waste such as waste from research laboratories. To implement decay-in-storage in Japan, it is important to obtain agreement with all stakeholders. We must continue to exert sincere efforts to acquire the trust of all stakeholders.

  12. Predicting medical school and internship success: does the quality of the research and clinical experience matter?

    Science.gov (United States)

    Paolino, Nathalie D; Artino, Anthony R; Saguil, Aaron; Dong, Ting; Durning, Steven J; DeZee, Kent J

    2015-04-01

    This article explores specific aspects of self-reported clinical and research experience and their relationship to performance in medical training. This is a retrospective cohort study conducted at the Uniformed Services University. The American Medical College Application Service application was used to discern students' self-reported clinical and research experience. Two authors applied a classification scheme for clinical and research experience to the self-reported experiences. Study outcomes included medical school grade point average (GPA), U.S. Medical Licensing Examination (USMLE) scores, and intern expertise and professionalism scores. A linear regression analysis was conducted for each outcome while controlling for prematriculation GPA. Data were retrieved on 1,020 matriculants. There were several statistically significant but small differences across outcomes when comparing the various categories of clinical experience with no clinical experience. The technician-level experience group had a decrease of 0.1 in cumulative GPA in comparison to students without self-reported clinical experience (p = 0.004). This group also performed 5 points lower on the USMLE Step 2 than students who did not report clinical experience (p = 0.013). The various levels of self-reported research experience were unrelated to success in medical school and graduate medical education. These findings indicate that self-reported technician-level clinical experience is related to a small reduction in typically reported outcomes in medical school. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  13. Wave-current interaction, experiments with controlled uniform shear

    Science.gov (United States)

    Simon, Bruno; Touboul, Julien; Rey, Vincent

    2016-04-01

    Vertically varying currents have a non negligible impact on the propagation of waves. Even though the analytical aspect of the interaction between wave and sheared current is being an active subject of research, experimental data remain rare. Here, the effects of a uniformly shear were investigated in the 10 m long by 0.3 m wide wave flume of the Université de Toulon, France. The main difficulty of the study was to produce several conditions of current with constant shear (du/dz = cst) that would persist along the channel. This was achieved by using curved wire screens upstream the channel (Dunn and Tavoularis, 2007). The geometry and properties of the screens were adjusted to deflect the streamline towards the channel bed or the free surface in order to change the velocity profile. The study focused on regular wave propagating against the current for several wave frequencies and amplitudes. Properties of the free surface and flow velocity are discussed for current with positive and negative shear in order to quantify the influence of the current on the waves. ACKNOWLEDGEMENTS The DGA (Direction Générale de l'Armement, France) is acknowledged for its financial support through the ANR grant N° ANR-13-ASTR-0007.

  14. Current Status and Future Prospects of the SNO+ Experiment

    CERN Document Server

    :,; Arushanova, E; Asahi, S; Askins, M; Auty, D J; Back, A R; Barnard, Z; Barros, N; Beier, E W; Bialek, A; Biller, S D; Blucher, E; Bonventre, R; Braid, D; Caden, E; Caravaca, J; Carvalho, J; Cavalli, L; Chauhan, D; Chen, M; Chkvorets, O; Clark, K; Cleveland, B; Coulter, I T; Cressy, D; Dai, X; Darrach, C; Davis-Purcell, B; Deen, R; Depatie, M M; Descamps, F; Di Lodovico, F; Duhaime, N; Duncan, F; Dunger, J; Falk, E; Fatemighomi, N; Ford, R; Gorel, P; Grant, C; Grullon, S; Guillian, E; Hallin, A L; Hallman, D; Hans, S; Hartnell, J; Harvey, P; Hedayatipour, M; Heintzelman, W J; Helmer, R L; Howe, M; Hreljac, B; Hu, J; Iida, T; Jackson, C M; Jelley, N A; Jillings, C; Jones, C; Jones, P G; Kamdin, K; Kaptanoglu, T; Kaspar, J; Keener, P; Khaghani, P; Kippenbrock, L; Klein, J R; Knapik, R; Kofron, J N; Kormos, L L; Korte, S; Kraus, C; Krauss, C B; Labe, K; Lam, I; Lan, C; Land, B J; Langrock, S; LaTorre, A; Lawson, I; Lefeuvre, G M; Leming, E J; Lidgard, J; Liu, X; Liu, Y; Lozza, V; Maguire, S; Maio, A; Majumdar, K; Manecki, S; Maneira, J; Marzec, E; Mastbaum, A; McCauley, N; McDonald, A B; McMillan, J E; Mekarski, P; Miller, C; Mony, E; Mottram, M J; Novikov, V; O'Keeffe, H M; O'Sullivan, E; Gann, G D Orebi; Parnell, M J; Peeters, S J M; Pershing, T; Petriw, Z; Prior, G; Prouty, J C; Quirk, S; Reichold, A; Robertson, A; Rose, J; Rosero, R; Rost, P M; Rumleskie, J; Schumaker, M A; Schwendener, M H; Scislowski, D; Secrest, J; Seddighin, M; Segui, L; Seibert, S; Shantz, T; Shokair, T M; Sibley, L; Sinclair, J R; Singh, K; Skensved, P; Sonley, T; Stainforth, R; Strait, M; Stringer, M I; Svoboda, R; Soerensen, A; Tatar, J; Tian, L; Tolich, N; Tseng, J; Tseung, H W C; Van Berg, R; Virtue, C; von Krosigk, B; Vázquez-Jáuregui, E; Walker, J M G; Walker, M; Wasalski, O; Waterfield, J; White, R F; Wilkerson, J F; Wilson, J R; Winchester, T J; Wright, A; Yeh, M; Zhao, T; Zuber, K

    2015-01-01

    SNO+ is a large liquid scintillator-based experiment located 2km underground at SNOLAB, Sudbury, Canada. It reuses the Sudbury Neutrino Observatory detector, consisting of a 12m diameter acrylic vessel which will be filled with about 780 tonnes of ultra-pure liquid scintillator. Designed as a multi-purpose neutrino experiment, the primary goal of SNO+ is a search for the neutrinoless double-beta decay (0$\

  15. Guidelines for Professional Training of Junior Medical Staff in the Context of European Experience

    Science.gov (United States)

    Sosnova, Myroslava

    2016-01-01

    The article deals with outlining guidelines for improving professional training of junior medical staff based on European experience. Consequently, guidelines and recommendations on enhancing the efficiency of medical education in general and junior medical specialists' professional training, in particular, published by European Union of Medical…

  16. A Burning Experiment Study of an Integral Medical Waste Incinerator

    OpenAIRE

    Xie, Rong; Lu, Jidong; Li,Jie

    2010-01-01

    Mass burning of the medical waste is becoming attr active in China because Chinese government has banned landfilling of medical waste. Many advantages can be found in this method, such as reduction in waste vol-ume, destruction of pathogens and transformation of waste into the form of ash. However, the medical waste with high moisture in China is not suitable to be trea ted in the present direct mass burning incinerators. In this paper, a novel integral incinera tor is developed with combinin...

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

    Directory of Open Access Journals (Sweden)

    Masoud Kianpour

    2013-02-01

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

  18. Effects of previous growth hormone excess and current medical treatment for acromegaly on cognition

    OpenAIRE

    Brummelman, Pauline; Koerts, Janneke; Dullaart, Robin P. F.; van den Berg, Gerrit; Tucha, Oliver; Wolffenbuttel, Bruce H R; van Beek, Andre P.

    2012-01-01

    Background In untreated acromegaly patients, decreased cognitive functioning is reported to be associated with the degree of growth hormone (GH) and IGF-1 excess. Whether previous GH excess or current medical treatment for acromegaly specifically affects cognition remains unclear. The aim of this study was to compare cognitive functioning of patients who are treated for acromegaly with patients with non-functioning pituitary adenomas (NFA). In addition, we assessed the influence of prolonged ...

  19. Nanomaterials and synergistic low-intensity direct current (LIDC) stimulation technology for orthopedic implantable medical devices.

    Science.gov (United States)

    Shirwaiker, Rohan A; Samberg, Meghan E; Cohen, Paul H; Wysk, Richard A; Monteiro-Riviere, Nancy A

    2013-01-01

    Nanomaterials play a significant role in biomedical research and applications because of their unique biological, mechanical, and electrical properties. In recent years, they have been utilized to improve the functionality and reliability of a wide range of implantable medical devices ranging from well-established orthopedic residual hardware devices (e.g., hip implants) that can repair defects in skeletal systems to emerging tissue engineering scaffolds that can repair or replace organ functions. This review summarizes the applications and efficacies of these nanomaterials that include synthetic or naturally occurring metals, polymers, ceramics, and composites in orthopedic implants, the largest market segment of implantable medical devices. The importance of synergistic engineering techniques that can augment or enhance the performance of nanomaterial applications in orthopedic implants is also discussed, the focus being on a low-intensity direct electric current (LIDC) stimulation technology to promote the long-term antibacterial efficacy of oligodynamic metal-based surfaces by ionization, while potentially accelerating tissue growth and osseointegration. While many nanomaterials have clearly demonstrated their ability to provide more effective implantable medical surfaces, further decisive investigations are necessary before they can translate into medically safe and commercially viable clinical applications. The article concludes with a discussion about some of the critical impending issues with the application of nanomaterials-based technologies in implantable medical devices, and potential directions to address these.

  20. Medical grand rounds in Riyadh, Saudi Arabia: Current attitudes and barriers

    Directory of Open Access Journals (Sweden)

    Mohammad Alqahtani

    2015-01-01

    Full Text Available Background: Medical grand rounds (MGRs are considered key educational tools in most academic medical institutions. In this multi-center cross-sectional survey, we tried to determine the current attitudes of local medical practitioners to MGRs, as well as perceived barriers. Methodology: A total of 120 physicians from the National Guard Hospital, King Fahad Medical City, King Khalid University Hospital and King Faisal Specialist Hospital participated in the survey. The questionnaire consisted of statements on attitudes and perceived barriers against participating in MGRs, as well as participants′ levels of agreement. Results: Most participants attend MGRs regularly (94.2%, claiming that it is mandatory (88%. Participants also agreed that MGRs were important tools for continuing medical education (89.2% and that they provided an opportunity to both present materials and interact with their colleagues in other divisions (86.7% and 81.6%, respectively. The vast majority of respondents agreed that "topic review/update" and "inviting guest speakers" were the two most preferred suggestions for improving MGRs (94.2% and 92.5%, respectively. Major barriers included constraints of time (43.3% and topics that were not patient-related (40.8%. Conclusion: MGRs in the major Tertiary Hospitals in Riyadh are well attended, and the majority of the local practitioners believe in the positive effect of MGRs in delivering quality and up to date medical knowledge. Time and physician-specific issues were identified as major barriers that needed to be addressed in order to maximize participation of medical staff.

  1. [EXPERIENCE OF DIAGNOSTICS AND MEDICAL TREATMENT OF THE DIEULAFOYS DISEASE].

    Science.gov (United States)

    P'iatykop, H I; Kravets', O V; Moskalenko, R A; Bratushka, V O

    2014-01-01

    The article is dedicated to the features of diagnostics and medical treatment of the Dieulafoys disease. Clinical description of six cases of foregoing pathology is resulted. The morphological features ulcers Dieulafoy are described. One fatal outcome of disease is analysed.

  2. Medical students' experience and perceptions of their final rotation ...

    African Journals Online (AJOL)

    led by consultants, and sessions devoted to interpersonal and microcommunication ... Objective. To evaluate medical students' perceptions of their final psychiatry rotation of 7 weeks. Methods. .... relationships between factors and individual.

  3. Exploring the relationship between self-reported research experience and performance in medical school and internship.

    Science.gov (United States)

    Dong, Ting; Durning, Steven J; Gilliland, William R; Waechter, Donna M; Cruess, David F; DeZee, Kent J; Calloway, Margaret; Artino, Anthony R

    2012-09-01

    To investigate the relationship between self-reported research experience and medical students' performance in medical school and internship. We collected data from seven year-groups (1993-1999; N = 1,112) and examined 7 performance outcomes: medical school preclinical grade point average (GPA), medical school clinical GPA, cumulative medical school GPA, U.S. Medical Licensing Examination Step 1 and 2 scores, and scores on a previously validated program director's survey of intern professionalism and expertise. We then conducted a series of multiple linear regressions to determine the relations between self-reported research experience and our seven outcomes. When compared to those who reported no prior research experience, students who reported research experience performed significantly better on U.S. Medical Licensing Examination Step 1 and had a higher medical school preclinical GPA. However, these same students scored significantly lower on intern professionalism and expertise ratings. Self-reported research experience did not show statistically significant correlations with the other outcome variables. The results from our large, multiyear, cohort study suggest that prior research experience may account for some variance in outcomes in the early stages of medical school education, but that variance explained diminishes considerably as trainees progress into the more senior phases of education. On the other hand, prior research experience may be negatively related to students' performance in internship. In all cases, however, effect sizes are small.

  4. Professional experiences of international medical graduates practicing primary care in the United States.

    Science.gov (United States)

    Chen, Peggy Guey-Chi; Nunez-Smith, Marcella; Bernheim, Susannah May; Berg, David; Gozu, Aysegul; Curry, Leslie Ann

    2010-09-01

    International medical graduates (IMGs) comprise approximately 25% of the US physician workforce, with significant representation in primary care and care of vulnerable populations. Despite the central role of IMGs in the US healthcare system, understanding of their professional experiences is limited. To characterize the professional experiences of non-US born IMGs from limited-resource nations practicing primary care in the US. Qualitative study based on in-depth in-person interviews. Purposeful sample of IMGs (n = 25) diverse in country of origin, length of practice in the US, specialty (internal medicine, family medicine and pediatrics), age and gender. Participants were currently practicing primary care physicians in New York, New Jersey or Connecticut. A standardized interview guide was used to explore professional experiences of IMGs. Four recurrent and unifying themes characterize these experiences: 1) IMGs experience both overt and subtle forms of workplace bias and discrimination; 2) IMGs recognize professional limitations as part of "the deal"; 3) IMGs describe challenges in the transition to the culture and practice of medicine in the US; 4) IMGs bring unique skills and advantages to the workplace. Our data reveal that IMGs face workplace challenges throughout their careers. Despite diversity in professional background and demographic characteristics, IMGs in our study reported common experiences in the transition to and practice of medicine in the US. Findings suggest that both workforce and workplace interventions are needed to enable IMG physicians to sustain their essential and growing role in the US healthcare system. Finally, commonalities with experiences of other minority groups within the US healthcare system suggest that optimizing IMGs' experiences may also improve the experiences of an increasingly diverse healthcare workforce.

  5. Medical supply on contingency military operations: experience from Operation GRITROCK.

    Science.gov (United States)

    Robinson, J P; Reeves, P

    2015-01-01

    Medical supply during military operations has the ability to affect the efficacy of the operation being undertaken, either negatively or positively. An appropriately-managed maritime platform with a robust medical supply chain during transit and on arrival in theatre is the main aim. A secure supply chain will reduce any implications that logistics may have with regard to capability, and negate the effects of deficiencies of short shelf life items occurring over time and during use in high tempo operations.

  6. Faculty perceptions of the strengths, weaknesses and future prospects of the current medical undergraduate experimental physiology curriculum in Gujarat, India.

    Science.gov (United States)

    Paralikar, Swapnil; Shah, Chinmay

    2015-01-01

    Over the past several years, an opinion has emerged in India that the current practical curricula in medical schools fail to meet many of the objectives for which they were instituted. Hence, this study has assessed the perception of physiology faculty members regarding the current experimental physiology curriculum in one Indian state, Gujarat. The faculty were of the opinion that many of the topics currently taught in experimental physiology (amphibian nerve-muscle and heart muscle experiments) were outdated and clinically irrelevant: Therefore, the faculty advocated that duration of teaching time devoted to some of these topics should be reduced and topics with clinical relevance should be introduced at the undergraduate level. The faculty also felt that more emphasis should be laid on highlighting the clinical aspect related to each concept taught in experimental physiology . Moreover, a majority of faculty members were in favour of replacing the current practice in Gujarat of teaching experimental physiology only by explanation of graphs obtained from experiments conducted in the previous years, with computer assisted learning in small groups.

  7. Country perspective on medical tourism: the Malaysian experience.

    Science.gov (United States)

    Abd Manaf, Noor Hazilah; Hussin, Husnayati; Jahn Kassim, Puteri Nemie; Alavi, Rokiah; Dahari, Zainurin

    2015-01-01

    The study seeks to explore the perception of international patients on Malaysia as a medical tourism destination country, as well as overall patient satisfaction, perceived value and future intention for repeat treatment and services. Self-administered questionnaire was the main method of data collection. The survey covered major private hospitals in medical tourists' states in the country, namely, Penang, Melaka, Selangor and Kuala Lumpur. Convenience sampling was used due to the condition of patients as respondents. Indonesian patients formed the largest majority of international patients in the country. Five dimensions of medical tourism in Malaysia was identified, namely, hospital and staff, country factor, combining tourism and health services, cost saving and insurance and unavailability of treatment. Of these, hospital and staff was found to be the most important factor for the patients. Perception of value, overall satisfaction and intention for future treatment was also found to be high. This indicates that Malaysia is on the right footing in this burgeoning industry. Findings from the study will enable policy-makers to better position Malaysia as a medical tourist destination country. Medical tourism is a recent phenomenon and very little empirical research has been carried out at the patient level. This study is one of the first few studies which seek to explore medical tourism from the perspective of the patients themselves.

  8. Associations between patient factors and medication adherence: A Jordanian experience

    Directory of Open Access Journals (Sweden)

    Basheti IA

    2016-03-01

    Full Text Available Objective: To explore the effect of patient characteristics and health beliefs on their medication adherence. Methods: Patients (n=167 with chronic conditions (mean age 58.9; SD=13.54, 53% males were recruited from March 2009- to March 2010 using a cross sectional study design. Data collected included patients’ demographics, medical conditions, medications therapeutic regimen, frequency of physician visits and health beliefs. Patient self-reported adherence to medications was assessed by the researcher using a validated and published scale. Treatment related problems (TRPs were evaluated for each patient by competent clinical pharmacists. Associations between patient characteristics/health beliefs with adherence were explored. Results: About half of the patients (46.1% were non-adherent. A significant association was found between lower adherence and higher number of disease states (p<0.001, higher number of medications (p=0.001, and higher number of identified TRPs (p = 0.003. Patient adherence was positively affected by older age, higher educational level, and higher number of physician visits per month, while it was negatively affected by reporting difficulties with getting prescription refills on time. Conclusion: This study identified different factors that may negatively affect adherence, including higher number of medications and disease states, higher number of identified TRPs and inability to getting prescription refills on time. Hence, more care needs to be provided to patients with complex therapeutic regimens in order to enhance adherence.

  9. Exploring users' experiences of accessing out‐of‐hours primary medical care services

    Science.gov (United States)

    Richards, S H; Pound, P; Dickens, A; Greco, M; Campbell, J L

    2007-01-01

    Background Since 2000, out‐of‐hours primary medical care services in the UK have undergone major changes in the organisation and delivery of services in response to recommendations by the Carson Review and more recently, through the new General Medical Services Contract (GMS2). People calling their general practice in the evening or at weekends are redirected to the out‐of‐hours service which may offer telephone advice, a home visit or a visit to a treatment centre. Little is known about users' experiences under the new arrangements. Aim To explore users' experiences of out‐of‐hours primary medical care. Design of study A qualitative study employing focus groups and telephone interviews. Setting Three out‐of‐hours primary medical care service providers in England. Methods Focus groups and telephone interviews were conducted with 27 recent users of out‐of‐hours services. Results Key areas of concern included the urgency with which cases are handled, and delays when waiting for a call back or home visit. Users felt that providers were reluctant to do home visits. The service was regarded as under‐resourced and frequently misused. Many expressed anxiety about calling, feeling unsure about how appropriate their call was and many were uncertain about how the service operated. Conclusions Service users need clear information on how current out‐of‐hours services operate and how it should be used. Problems with triaging need to be addressed, users should be kept informed of any delays, and care needs to be taken to ensure that the new arrangements do not alienate older people or individuals with complex health needs. PMID:18055893

  10. Comparative Analysis of the Current Status, Own Body Perception and Positive Experience From Diagnosed Breast Cancer

    Directory of Open Access Journals (Sweden)

    Zornitza Ganeva

    2013-04-01

    Full Text Available Comparative analysis of the current status, own body perception and positive experience within a period of up to 1 year from diagnosing ofwomen with breast cancer (N = 41; mean age 35.25 in the 1st, 2nd and 3rd stages of the disease progress, of Bulgarian origin, was made.Reliability and validity of the scales were described. They were analysed with respect to: 1 medical characteristics (partial or total surgery,surgical removal of lymph nodes, presence or absence of metastases in them, 2 classical therapies (chemotherapy, radiation therapy andhormonal therapy administered or not and 3 application or not of alternative therapies (herbal medicine, physical load, administration ofmassage, lymph drainage, use of nutritional supplements, observance of diet. The results showed that the more therapies the personssurveyed were undergone the more unsatisfactory they assessed their current general status. The bigger the size of the surgery performedto remove the tumour the more positive idea of their own bodies they had. The more time after the surgical treatment passed the more thepositive experience accumulated from the oncologic diagnosis grew.

  11. What Students Really Learn: Contrasting Medical and Nursing Students' Experiences of the Clinical Learning Environment

    Science.gov (United States)

    Liljedahl, Matilda; Boman, Lena Engqvist; Fält, Charlotte Porthén; Bolander Laksov, Klara

    2015-01-01

    This paper explores and contrasts undergraduate medical and nursing students' experiences of the clinical learning environment. Using a sociocultural perspective of learning and an interpretative approach, 15 in-depth interviews with medical and nursing students were analysed with content analysis. Students' experiences are described using a…

  12. Derivation of dynamo current drive in a closed-current volume and stable current sustainment in the HIT-SI experiment

    Science.gov (United States)

    Hossack, A. C.; Sutherland, D. A.; Jarboe, T. R.

    2017-02-01

    A derivation is given showing that the current inside a closed-current volume can be sustained against resistive dissipation by appropriately phased magnetic perturbations. Imposed-dynamo current drive theory is used to predict the toroidal current evolution in the helicity injected torus with steady inductive helicity injection (HIT-SI) experiment as a function of magnetic fluctuations at the edge. Analysis of magnetic fields from a HIT-SI discharge shows that the injector-imposed fluctuations are sufficient to sustain the measured toroidal current without instabilities whereas the small, plasma-generated magnetic fluctuations are not sufficiently large to sustain the current.

  13. Japanese regulation of biosimilar products: past experience and current challenges.

    Science.gov (United States)

    Arato, Teruyo

    2016-07-01

    Seven biosimilar products have been approved in Japan since the March 2009 publication of the 'Guideline for quality, safety and efficacy assurance of biosimilar products' by the Ministry of Health, Labor and Welfare (MHLW). Four years previously, the 'Guideline on similar biological medicinal products' was issued in the European Union (EU), and 13 products as of February 2016 have been approved as biosimilar. The US Food and Drug Administration (FDA) approved the first biosimilar product in the US in March 2015 and final Guidance was issued at the end of April 2015. Over the past decade, the challenges regarding the development of biosimilar products have been discussed extensively. In this article, the data packages of biosimilar products in Japan are compared with those overseas in order to clarify the concepts used by the Japanese regulatory authority, i.e., the Pharmaceuticals and Medical Devices Agency (PMDA). The challenges in the development of biosimilar products in Japan are also addressed.

  14. The experience of medical training and expectations regarding future medical practice of medical students in the Cuban-supported Medical School in Timor-Leste.

    Science.gov (United States)

    Ferrinho, Paulo; Valdes, Ana C; Cabral, Jorge

    2015-03-28

    The purpose of this paper is to describe and analyse the professional expectations and profile of medical students at the Cuban-supported School of General Medicine, in the Faculty of Medicine and Health Sciences of the National University of Timor-Leste. A piloted, standardized questionnaire, with closed- and open-ended questions, was distributed to registered medical students attending classes on the day of the survey. All data were analysed using SPSS. The statistical analysis is mostly descriptive. Students decide to study medicine at an early age. Relatives and friends seem to have an especially important influence in encouraging, reinforcing and promoting the desire to be a doctor. The degree of feminization of the student population is high. Medical students are in general satisfied with the training received, though demanding improvements in terms of systems to support their studies and training (e.g. libraries, laboratories, access to computers and the Internet). Medical students know that they will be needed in the public sector and that it would represent their opportunity to contribute to the public's welfare. Nonetheless, they report that they expect to combine public sector practice with private work, probably, in order to improve their earnings. This may be explained by their expectations for salaries, which are much higher than the current level of public sector salaries. A significant proportion of students are unsure about their future area of specialization. Of those that have determined their desired specialization, most intend to train as hospital specialists and to follow a hospital-based career. For many, specialization is equated with migration to study abroad. There are important differences between students at the start of their training compared with more advanced students. This paper gives an overview of student expectations for alignment with stated national human resources for health priorities for Timor-Leste.

  15. Associations between patient factors and medication adherence: A Jordanian experience.

    Science.gov (United States)

    Basheti, Iman A; Hait, Sami Saqf El; Qunaibi, Eyad A; Aburuz, Salah; Bulatova, Nailya

    2016-01-01

    To explore the effect of patient characteristics and health beliefs on their medication adherence. Patients (n=167) with chronic conditions (mean age 58.9; SD=13.54, 53% males) were recruited from March 2009- to March 2010 using a cross sectional study design. Data collected included patients' demographics, medical conditions, medications therapeutic regimen, frequency of physician visits and health beliefs. Patient self-reported adherence to medications was assessed by the researcher using a validated and published scale. Treatment related problems (TRPs) were evaluated for each patient by competent clinical pharmacists. Associations between patient characteristics/health beliefs with adherence were explored. About half of the patients (46.1%) were non-adherent. A significant association was found between lower adherence and higher number of disease states (pPatient adherence was positively affected by older age, higher educational level, and higher number of physician visits per month, while it was negatively affected by reporting difficulties with getting prescription refills on time. This study identified different factors that may negatively affect adherence, including higher number of medications and disease states, higher number of identified TRPs and inability to getting prescription refills on time. Hence, more care needs to be provided to patients with complex therapeutic regimens in order to enhance adherence.

  16. Early experiences with big data at an academic medical center.

    Science.gov (United States)

    Halamka, John D

    2014-07-01

    Beth Israel Deaconess Medical Center (BIDMC), an academic health care institution affiliated with Harvard University, has been an early adopter of electronic applications since the 1970s. Various departments of the medical center and the physician practice groups affiliated with it have implemented electronic health records, filmless imaging, and networked medical devices to such an extent that data storage at BIDMC now amounts to three petabytes and continues to grow at a rate of 25 percent a year. Initially, the greatest technical challenge was the cost and complexity of data storage. However, today the major focus is on transforming raw data into information, knowledge, and wisdom. This article discusses the data growth, increasing importance of analytics, and changing user requirements that have shaped the management of big data at BIDMC.

  17. Serving underserved transplant recipients: experience of the Medication Access Program

    Directory of Open Access Journals (Sweden)

    Spivey CA

    2014-05-01

    Full Text Available Christina A Spivey,1 Marie A Chisholm-Burns,1 Charlene Garrett,2 Kenneth M Duke21University of Tennessee College of Pharmacy, Memphis, TN, USA; 2University of Georgia College of Pharmacy, Athens, GA, USAObjective: Programs have been established to help underserved, solid-organ transplant recipients and other patient populations address the burden of medication regimen costs. The purpose of this study was to describe one such program, the Medication Access Program (MAP, and the population of solid-organ transplant recipients it serves. An additional objective was to compare characteristics of recipients whose MAP enrollment was continued versus those who were discontinued during the annual re-enrollment period.Methods: Enrollment into MAP is based on referral from a pharmacist or another health care professional/transplant team member. To enroll, a recipient must complete an application which includes information about demographics, health care coverage, income, and medication regimen. To maintain enrollment, patients must complete a renewal application on an annual basis. Data were collected from renewal applications for 2012 and 2011 (for those who did not return the 2012 renewal applications. Chi-square analyses and Student’s t-test for independent samples were conducted to compare the characteristics of those who renewed their MAP enrollment in 2012 and those who were discontinued because they did not return the renewal application. Multivariate stepwise logistic regression was conducted to determine variables predictive of MAP continuation status.Results: In total, 246 recipients were included. The majority qualified for Medicare (67.9%, did not qualify for Medicaid (69.9%, and did not have private health care coverage (63.8%. Significantly more continued recipients qualified for Medicare compared to discontinued recipients (P=0.002. Discontinued recipients had a greater number of past discontinuations than continued recipients

  18. Other-regarding behavior and motivation in health care provision: an experiment with medical and non-medical students.

    Science.gov (United States)

    Hennig-Schmidt, Heike; Wiesen, Daniel

    2014-05-01

    Other-regarding motivation is a fundamental determinant of public service provision. In health care, one example is physicians who act benevolently towards their patients when providing medical services. Such patient-regarding motivation seems closely associated with a personal sacrifice that health service providers are willing to make. Surprisingly, evidence on physicians' motivation is rare. This paper contributes to the literature by investigating prospective physicians', in particular, medical students', motivations and behavior. We measure the willingness to sacrifice own profit in order to increase the patients' health benefit. We conduct the same analysis for non-medical students. In a controlled incentivized laboratory experiment, participants decide, in the role of physicians, on the provision of medical services under fee-for-service or capitation schemes. Overall, 42 medical students and 44 non-medical students participated in five experimental sessions conducted between 2006 and 2008. We find substantial differences under both payment systems: compared to medical students, students of non-medical majors are less patient-regarding, less willing to sacrifice their own profit, and they state less motivation to improve patients' health. This results in significantly lower patient health benefits. Some implications for health care policies in light of physician shortage and for physician payment systems are discussed.

  19. EXPERIENCE IN DEVELOPMENT MEDICAL KITS FOR MEDICAL SERVICES OF THE RUSSIAN FEDERATION ARMED FORCES

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    E. O. Rodionov

    2016-01-01

    Full Text Available Introduction. The development of modern, complete-standard issue equipment for the Armed Forces Medical Service is an urgent organizational and management task. First aid kits, medical bags, sets of medical equipment, medical kits and packing existed until recently; no longer meet modern requirements for a number of objective reasons. The aim of the study was the formation of programs of development of modern samples of complete-standard-issue equipment. Materials and methods. The study was conducted based on the analysis of scientific literature and guidelines which regulate different aspects of the Armed Forces Medical Service complete-standard issue equipment. The study used methods like: retrospective, content analysis, comparison and description, logical, structural and functional analysis, expert assessments, decision-making, as well as the methods of the theory of constraints and other systems. Results and discussion. rmation of the range of medical property in modern conditions for inclusion into complete-standard issue equipment is connected with the need to make timely decisions on choosing the most efficient models, taking into account market conditions and economic opportunities. There are requirements established for the complete-samples standard issue equipment for their use outside a medical organization. Development program structure of complete-standard-issue equipment is shown, as well as examples of the formation of the content of medical equipment kits. On the basis of the offered program a new complete-standard issue equipment of the Armed Forces Medical Service was created. In accordance with the principles of the theory of constraints a strategy to optimize the composition of sets of medical equipment was developed. It included comprehensive solutions aimed at stabilizing the activity of the pharmaceutical industry in the interest of the Armed Forces Medical Service. Conclusions. An offered program has allowed developing

  20. The importance of health advocacy in Canadian postgraduate medical education: current attitudes and issues

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    Alexander Poulton

    2015-12-01

    Full Text Available Background: Health advocacy is currently a key component of medical education in North America. In Canada, Health Advocate is one of the seven roles included in the Royal College of Physicians and Surgeons of Canada’s CanMEDS competency framework. Method: A literature search was undertaken to determine the current state of health advocacy in Canadian postgraduate medical education and to identify issues facing educators and learners with regards to health advocacy training. Results:  The literature revealed that the Health Advocate role is considered among the least relevant to clinical practice by educators and learners and among the most challenging to teach and assess. Furthermore learners feel their educational needs are not being met in this area. A number of key barriers affecting health advocacy education were identified including limited published material on the subject, lack of clarity within the role, insufficient explicit role modeling in practice, and lack of a gold standard for assessment. Health advocacy is defined and its importance to medical practice is highlighted, using pediatric emergency medicine as an example. Conclusions: Increased published literature and awareness of the role, along with integration of the new 2015 CanMEDS framework, are important going forward to address concerns regarding the quality of postgraduate health advocacy education in Canada.

  1. Current Practices in Assessing Professionalism in United States and Canadian Allopathic Medical Students and Residents

    Science.gov (United States)

    Nittur, Nandini

    2017-01-01

    Professionalism is a critically important competency that must be evaluated in medical trainees but is a complex construct that is hard to assess. A systematic review was undertaken to give insight into the current best practices for assessment of professionalism in medical trainees and to identify new research priorities in the field. A search was conducted on PubMed for behavioral assessments of medical students and residents among the United States and Canadian allopathic schools in the last 15 years. An initial search yielded 594 results, 28 of which met our inclusion criteria. Our analysis indicated that there are robust generic definitions of the major attributes of medical professionalism. The most commonly used assessment tools are survey instruments that use Likert scales tied to attributes of professionalism. While significant progress has been made in this field in recent years, several opportunities for system-wide improvement were identified that require further research. These include a paucity of information about assessment reliability, the need for rater training, a need to better define competency in professionalism according to learner level (preclinical, clerkship, resident etc.) and ways to remediate lapses in professionalism. Student acceptance of assessment of professionalism may be increased if assessment tools are shifted to better incorporate feedback. Tackling the impact of the hidden curriculum in which students may observe lapses in professionalism by faculty and other health care providers is another priority for further study. PMID:28652951

  2. Current status of the medical expenses for the treatment of arteriosclerosis obliterans in Japan.

    Science.gov (United States)

    Isaji, T; Takayama, T; Endo, A; Akai, A; Kudo, M; Kagaya, H; Suzuki, J; Hashimoto, T; Hoshina, K; Kimura, H; Okamoto, H; Shigematsu, K; Miyata, T

    2010-04-01

    We aimed to determine the current status of the medical expenses for the treatment of arteriosclerosis obliterans (ASO) and evaluate the cost effectiveness of the medical practices employed in ASO treatment in Japan. We performed a prospective observational study using 140 ASO patients. The cost of the medical practices comprised the costs of outpatient treatment, pharmacological agents, and hospitalization. To compare the average monthly costs, the patients were divided into preintervention, postintervention, or conservative-therapy groups. To compare the total costs and effectiveness of each treatment, the patients who had first visited our division during the study period were classified into surgery, endovascular-revascularization (EVR), or conservative-therapy groups. The adverse reactions of the 4 most popular agents for ASO were investigated, and bleeding events were assessed specifically. The average monthly costs for outpatient treatment and pharmacological agents were yen 168,002 in conservative cases, yen 149,871 in preoperation cases, and yen 128,527 in postoperation cases. The mean total costs were yen 5,407,950 in conservative cases, yen 7,375,290 in surgical cases, and yen 2,631,650 in EVR cases. The average change of the gauge in clinical status was 0.57 in conservative cases, 2.13 in surgical cases, and 2.25 in EVR cases. Warfarin induced more bleeding complications than the other agents. The costs of pharmacological agents represented much of the medical costs in any treatment groups.

  3. Dealing with emotions : medical undergraduates' preferences in sharing their experiences

    NARCIS (Netherlands)

    de Vries-Erich, Joy M.; Dornan, Tim; Boerboom, Tobias B. B.; Jaarsma, A. Debbie C.; Helmich, Esther

    ContextPatient care evokes emotional responses such as uncertainty, grief and pride in medical students. There is a need for opportunities to share and express such emotions because they influence students' professional development and well-being. There is a trend towards introducing mentor

  4. MEDICAL EXPULSIVE THERAPY OF URETERIC CALCULI - OUR EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Ramesh

    2015-09-01

    Full Text Available INTRODUCTION: Uretric stones can be treated with multiple modalities including medical therapy, uretroscopy, shockwave lithotripsy (SWS, percutaneous nephrolithotomy, open/laparoscopic stone removal, and/or combinations of these modalities. The aim is to study the effectivene ss of medical management of uretric stones and to compare the effectiveness of Tamsulosin and Tamsulosin with steroid . MATERIALS & METHODS: 120 Patients who came with acute uretric colic were categorized into III categories of less than 5mm, 5mm to 7mm and more than 7mm based on NCCT. They were consecutively allotted to one of the three groups, the group I patients received Anti - Biotics with NSAIDs group II received Tamsulosin in addition Anti - Biotics and NSAIDs and III rd group received Anti - Biotics, Tamsu losin, NSAIDs in addition Deflazacart 30mg for a period of 10 days. The results were evaluated at the end of 10 days medical treatment. RESULTS : 90 out of 120 patients were re - evaluated at the end of 10 days. The calculi of 7mm should be removed as the chances of passage is <20%. The medical treatment with Tamsulosin or Tamsulosin with Deflazacart does not offer significant benefit.

  5. Monitoring the Veterinary Medical Student Experience: An Institutional Pilot Study.

    Science.gov (United States)

    Miller, RoseAnn; Mavis, Brian E; Lloyd, James W; Grabill, Chandra M; Henry, Rebecca C; Patterson, Coretta C

    2015-01-01

    Veterinary medical school challenges students academically and personally, and some students report depression and anxiety at rates higher than the general population and other medical students. This study describes changes in veterinary medical student self-esteem (SE) over four years of professional education, attending to differences between high and low SE students and the characteristics specific to low SE veterinary medical students. The study population was students enrolled at the Michigan State University College of Veterinary Medicine from 2006 to 2012. We used data from the annual anonymous survey administered college-wide that is used to monitor the curriculum and learning environment. The survey asked respondents to rate their knowledge and skill development, learning environment, perceptions of stress, skill development, and SE. Participants also provided information on their academic performance and demographics. A contrasting groups design was used: high and low SE students were compared using logistic regression to identify factors associated with low SE. A total of 1,653 respondents met inclusion criteria: 789 low SE and 864 high SE students. The proportion of high and low SE students varied over time, with the greatest proportion of low SE students during the second-year of the program. Perceived stress was associated with low SE, whereas perceived supportive learning environment and skill development were associated with high SE. These data have provided impetus for curricular and learning environment changes to enhance student support. They also provide guidance for additional research to better understand various student academic trajectories and their implications for success.

  6. Medical Informatics for the Other Ninety Percent: The Dartmouth Experience.

    Science.gov (United States)

    Beck, J. Robert; And Others

    1990-01-01

    The Dartmouth Medical school initiated a course to meet the needs of the future physician who would be able to critique the scientific basis of medicine. For physicians, clinically relevant problems might require computer-assisted decision analysis, expert systems, statistical computing, or relational database development. (MLW)

  7. The Regenstrief Medical Record System: a quarter century experience.

    Science.gov (United States)

    McDonald, C J; Overhage, J M; Tierney, W M; Dexter, P R; Martin, D K; Suico, J G; Zafar, A; Schadow, G; Blevins, L; Glazener, T; Meeks-Johnson, J; Lemmon, L; Warvel, J; Porterfield, B; Warvel, J; Cassidy, P; Lindbergh, D; Belsito, A; Tucker, M; Williams, B; Wodniak, C

    1999-06-01

    Entrusted with the records for more than 1.5 million patients, the Regenstrief Medical Record System (RMRS) has evolved into a fast and comprehensive data repository used extensively at three hospitals on the Indiana University Medical Center campus and more than 30 Indianapolis clinics. The RMRS routinely captures laboratory results, narrative reports, orders, medications, radiology reports, registration information, nursing assessments, vital signs, EKGs and other clinical data. In this paper, we describe the RMRS data model, file structures and architecture, as well as recent necessary changes to these as we coordinate a collaborative effort among all major Indianapolis hospital systems, improving patient care by capturing city-wide laboratory and encounter data. We believe that our success represents persistent efforts to build interfaces directly to multiple independent instruments and other data collection systems, using medical standards such as HL7, LOINC, and DICOM. Inpatient and outpatient order entry systems, instruments for visit notes and on-line questionnaires that replace hardcopy forms, and intelligent use of coded data entry supplement the RMRS. Physicians happily enter orders, problems, allergies, visit notes, and discharge summaries into our locally developed Gopher order entry system, as we provide them with convenient output forms, choice lists, defaults, templates, reminders, drug interaction information, charge information, and on-line articles and textbooks. To prepare for the future, we have begun wrapping our system in Web browser technology, testing voice dictation and understanding, and employing wireless technology.

  8. Dealing with emotions : medical undergraduates' preferences in sharing their experiences

    NARCIS (Netherlands)

    de Vries-Erich, Joy M.; Dornan, Tim; Boerboom, Tobias B. B.; Jaarsma, A. Debbie C.; Helmich, Esther

    2016-01-01

    ContextPatient care evokes emotional responses such as uncertainty, grief and pride in medical students. There is a need for opportunities to share and express such emotions because they influence students' professional development and well-being. There is a trend towards introducing mentor programm

  9. Exploring the experiences and coping strategies of international medical students

    Directory of Open Access Journals (Sweden)

    Malau-Aduli Bunmi S

    2011-06-01

    Full Text Available Abstract Background Few studies have addressed the challenges that international medical students face and there is a dearth of information on the behavioural strategies these students adopt to successfully progress through their academic program in the face of substantial difficulties of language barrier, curriculum overload, financial constraints and assessment tasks that require high proficiency in communication skills. Methods This study was designed primarily with the aim of enhancing understanding of the coping strategies, skill perceptions and knowledge of assessment expectations of international students as they progress through the third and fourth years of their medical degree at the School of Medicine, University of Tasmania, Australia. Results Survey, focus group discussion and individual interviews revealed that language barriers, communication skills, cultural differences, financial burdens, heavy workloads and discriminatory bottlenecks were key factors that hindered their adaptation to the Australian culture. Quantitative analyses of their examination results showed that there were highly significant (p Conclusions Despite the challenges, these students have adopted commendable coping strategies and progressed through the course largely due to their high sense of responsibility towards their family, their focus on the goal of graduating as medical doctors and their support networks. It was concluded that faculty needs to provide both academic and moral support to their international medical students at three major intervention points, namely point of entry, mid way through the course and at the end of the course to enhance their coping skills and academic progression. Finally, appropriate recommendations were made.

  10. Interpreting chronic disorders of consciousness: medical science and family experience.

    Science.gov (United States)

    Edgar, Andrew; Kitzinger, Celia; Kitzinger, Jenny

    2015-06-01

    Chronic disorders of consciousness (CDoC) pose significant problems of understanding for both medical professionals and the relatives and friends of the patient. This paper explores the tensions between the different interpretative resources that are drawn upon by lay people and professionals in their response to CDoC. A philosophical analysis of data from 51 interviews with people who have relatives who are (or have been) in a vegetative or minimally conscious state. The medical specialist and the lay person tend to draw on two different interpretative frameworks: a medical science framework, which tends to construct the patient in terms of measurable physical parameters, and an interpretative framework that encompasses the uniqueness of the patient and the relative's relationship to them as a social being. These differences potentially lead to ruptures in communication between medical professionals and relatives such that that an increased self-consciousness of the framing assumptions being made will facilitate communication and enrich understanding of CDoCs. © 2014 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

  11. Lower Hybrid Current Drive Experiments in Alcator C-Mod

    Energy Technology Data Exchange (ETDEWEB)

    J.R. Wilson, S. Bernabei, P. Bonoli, A. Hubbard, R. Parker, A. Schmidt, G. Wallace, J. Wright, and the Alcator C-Mod Team

    2007-10-09

    A Lower Hybrid Current Drive (LHCD) system has been installed on the Alcator C-MOD tokamak at MIT. Twelve klystrons at 4.6 GHz feed a 4x22 waveguide array. This system was designed for maximum flexibility in the launched parallel wave-number spectrum. This flexibility allows tailoring of the lower hybrid deposition under a variety of plasma conditions. Power levels up to 900 kW have been injected into the tokomak. The parallel wave number has been varied over a wide range, n|| ~ 1.6–4. Driven currents have been inferred from magnetic measurements by extrapolating to zero loop voltage and by direct comparison to Fisch-Karney theory, yielding an efficiency of n20IR/P ~ 0.3. Modeling using the CQL3D code supports these efficiencies. Sawtooth oscillations vanish, accompanied with peaking of the electron temperature (Te0 rises from 2.8 to 3.8 keV). Central q is inferred to rise above unity from the collapse of the sawtooth inversion radius, indicating off-axis cd as expected. Measurements of non-thermal x-ray and electron cyclotron emission confirm the presence of a significant fast electron population that varies with phase and plasma density. The x-ray emission is observed to be radialy broader than that predicted by simple ray tracing codes. Possible explanations for this broader emission include fast electron diffusion or broader deposition than simple ray tracing predictions (perhaps due to diffractive effects).

  12. Current Status and Future Prospects of the SNO+ Experiment

    Directory of Open Access Journals (Sweden)

    S. Andringa

    2016-01-01

    Full Text Available SNO+ is a large liquid scintillator-based experiment located 2 km underground at SNOLAB, Sudbury, Canada. It reuses the Sudbury Neutrino Observatory detector, consisting of a 12 m diameter acrylic vessel which will be filled with about 780 tonnes of ultra-pure liquid scintillator. Designed as a multipurpose neutrino experiment, the primary goal of SNO+ is a search for the neutrinoless double-beta decay (0νββ of 130Te. In Phase I, the detector will be loaded with 0.3% natural tellurium, corresponding to nearly 800 kg of 130Te, with an expected effective Majorana neutrino mass sensitivity in the region of 55–133 meV, just above the inverted mass hierarchy. Recently, the possibility of deploying up to ten times more natural tellurium has been investigated, which would enable SNO+ to achieve sensitivity deep into the parameter space for the inverted neutrino mass hierarchy in the future. Additionally, SNO+ aims to measure reactor antineutrino oscillations, low energy solar neutrinos, and geoneutrinos, to be sensitive to supernova neutrinos, and to search for exotic physics. A first phase with the detector filled with water will begin soon, with the scintillator phase expected to start after a few months of water data taking. The 0νββ Phase I is foreseen for 2017.

  13. Advanced robotics for medical rehabilitation current state of the art and recent advances

    CERN Document Server

    Xie, Shane

    2016-01-01

    Focussing on the key technologies in developing robots for a wide range of medical rehabilitation activities – which will include robotics basics, modelling and control, biomechanics modelling, rehabilitation strategies, robot assistance, clinical setup/implementation as well as neural and muscular interfaces for rehabilitation robot control – this book is split into two parts; a review of the current state of the art, and recent advances in robotics for medical rehabilitation. Both parts will include five sections for the five key areas in rehabilitation robotics: (i) the upper limb; (ii) lower limb for gait rehabilitation (iii) hand, finger and wrist; (iv) ankle for strains and sprains; and (v) the use of EEG and EMG to create interfaces between the neurological and muscular functions of the patients and the rehabilitation robots. Each chapter provides a description of the design of the device, the control system used, and the implementation and testing to show how it fulfils the needs of that specific ...

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

    Science.gov (United States)

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

    2015-01-01

    Introduction: In 2008, the German Council of Science had advised universities to establish a quality management system (QMS) that conforms to international standards. The system was to be implemented within 5 years, i.e., until 2014 at the latest. The aim of the present study was to determine whether a QMS suitable for electronic learning (eLearning) domain of medical education to be used across Germany has meanwhile been identified. Methods: We approached all medical universities in Germany (n=35), using an anonymous questionnaire (8 domains, 50 items). Results: Our results (response rate 46.3%) indicated very reluctant application of QMS in eLearning and a major information deficit at the various institutions. Conclusions: Authors conclude that under the limitations of this study there seems to be a considerable need to improve the current knowledge on QMS for eLearning, and that clear guidelines and standards for their implementation should be further defined. PMID:26038685

  15. Mobilizing and training academic faculty for medical mission: current status and future directions

    Directory of Open Access Journals (Sweden)

    James D Smith

    2016-01-01

    Full Text Available As more mission groups become involved with health care education, by starting medical and nursing schools, postgraduate training programs and paramedical professional training, there is a need to recruit expatriate faculty from high income countries to help start programs as there are few national health care education professionals available in the mission setting in most low- and middle-income countries. This paper outlines the current status and needs for academic faculty in health care education mission settings. A working group of medical educators met in conjunction with the Global Missions Health Conference in November 2015 and discussed the motivational factors which lead Christian academics to volunteer, both short- and long-term in mission settings. The group then looked at barriers to volunteering and made suggestions for future directions and best practices when mobilizing academics from high income countries.

  16. The UMKC medical education experiment. An alternative pathway to physicianhood.

    Science.gov (United States)

    Dimond, E G

    1988-08-19

    The UMKC plan for medical education offers an alternative pathway for motivated high achievers with early evidence of health care commitment. Essentially, such a program is an honors program for the academically elite. The UMKC plan makes a large, sustained effort to influence attitude. In our descriptive literature and in our curriculum content, we have emphasized that we seek health care talent at the earliest age possible and that we use these formative years to enhance, to influence, and to inculcate the qualities of compassion, sensitivity, honesty, integrity, dependability, and responsibility. The reason for early admission is to influence attitude. We hold to the national standards in terms of science and technology, and all graduates have been required to pass Parts I and II of the National Board of Medical Examiners examinations. The graduate of this program, using performance in the first postgraduate year as a measure, is comparable with the product of the traditional eight-year concept, with a dividend of two extra years of career time. The UMKC program is not for all students; it is not offered as a replacement for the traditional American system. However, a proper distribution of medical admissions spaces should be made that takes advantage of the high level of ability, commitment, and dedication already present in the best of our high school students. A program such as the UMKC plan offers the prospect of educating American physicians, fully prepared technically but especially concerned with the important attitudinal values sought by the American public. Ward Darley, MD, was a consultant and guide during the founding years of this medical school. In his words, "The UMKC program is aimed at humanizing medicine, lowering the cost per student for education, providing a pool of dedicated physicians educated broadly enough to provide community leadership for future changes in the function and structure of society." Dr Darley's anticipation that this six

  17. Therapeutic drug monitoring for imatinib: Current status and Indian experience.

    Science.gov (United States)

    Arora, Brijesh; Gota, Vikram; Menon, Hari; Sengar, Manju; Nair, Reena; Patial, Pankaj; Banavali, S D

    2013-07-01

    Imatinib is the current gold standard for treatment of chronic myeloid leukemia (CML). Recent pharmacokinetic studies have shown considerable variability in trough concentrations of imatinib due to variations in its metabolism, poor compliance, or drug-drug interactions and highlighted its impact on clinical response. A trough level close to 1000 ng/mL, appears to be correlated with better cytogenetic and molecular responses. Therapeutic Drug Monitoring (TDM) for imatinib may provide useful added information on efficacy, safety and compliance than clinical assessment alone and help in clinical decision making. It may be particularly helpful in patients with suboptimal response to treatment or treatment failure, severe or rare adverse events, possible drug interactions, or suspected nonadherence. Further prospective studies are needed to confirm relationship between imatinib plasma concentrations with response, and to define effective plasma concentrations in different patient populations.

  18. The opinion of undergraduate medical students on current curriculum and teaching methodology of pharmacology in four medical colleges of India: a questionnaire based study

    OpenAIRE

    Manoj Kumar Saurabh; Jitendra Agrawal

    2015-01-01

    Background: The objective of current study was to obtain an opinion from 2nd professional year passed medical students on current curriculum, teaching methodology and importance of pharmacology subject and to identify the area of improvement. Methods: A set questionnaire was distributed among randomly distributed to 2nd year passed 100 undergraduate (UG) students to each of four medical colleges. They were instructed to tick out the best possible option of each question on the basis of the...

  19. The role of the pharmacist in patient-centered medical home practices: current perspectives

    Directory of Open Access Journals (Sweden)

    Lewis NJW

    2014-06-01

    Full Text Available Nancy JW Lewis,1 Leslie A Shimp,2 Stuart Rockafellow,2 Jeffrey M Tingen,2 Hae Mi Choe,3 Marie A Marcelino21Private consultancy practice, Rochester Hills, MI, USA; 2Clinical, Social and Administrative Department, University of Michigan College of Pharmacy, Ann Arbor, MI, USA; 3Department of Pharmacy Services, University of Michigan Health System, Ann Arbor, MI, USAAbstract: Patient-centered medical homes (PCMHs are the centerpiece of primary care transformation in the US. They are intended to improve care coordination and communication, enhance health care quality and patient experiences, and lower health care costs by linking patients to a physician-led interdisciplinary health care team. PCMHs are widely supported by health care associations, payers, and employers. Health care accreditation organizations have created performance measures that promote the adoption of PCMH core attributes. Public and private payers are increasingly providing incentives and bonuses related to performance measure status. Evidence-based prescription, medication adherence, medication use coordination, and systems to support medication safety are all necessary components of PCMHs. Pharmacists have unique knowledge and skills that can complement the care provided by other PCMH team members. Their experience in drug therapy assessments, medication therapy management, and population health has documented benefits, both in terms of patient health outcomes and health care costs. Through collaborative care, pharmacists can assist physicians and other prescribers in medication management and thus improve prescriber productivity and patient access to care. Pharmacists are engaged in PCMHs through both employment and contractual arrangements. While some pharmacists serve a unique PCMH, others work within practice networks that serve practices within a geographical area. Financial support for pharmacist-provided services includes university funding, external grant funding

  20. Financial stress during medical residency training: an experience from Iran

    Directory of Open Access Journals (Sweden)

    Zamani M

    2016-02-01

    Full Text Available Mohammad Zamani,1 Vahid Zamani2 1Student Research Committee, Department of Medicine, 2Vice-Chancellery for Health, Babol University of Medical Sciences, Babol, IranWe have read with great interest the article by Abdulghani et al,1 in which they well documented the high prevalence of stress among the Saudi Arabian medical residents and its effects on their working efficacy and general physical health during the residency training. This important issue similarly applies in Iran. Previous surveys performed on the Iranian resident trainees revealed the increased levels of psychological and emotional disorders such as depression, anxiety, and stress among them.2–4View original paper by Abdulghani et al.

  1. An initial experience with "team learning" in medical education.

    Science.gov (United States)

    Haidet, Paul; O'Malley, Kimberly J; Richards, Boyd

    2002-01-01

    Team learning is an approach to large-group teaching that combines the strengths of small-group interactive learning with teacher-driven content delivery. Team learning has been used successfully in professional disciplines other than medicine. The authors describe a field test of team learning in the setting of an internal medicine residency noontime lecture in the spring of 2000 at Baylor College of Medicine. They surveyed residents on their attitudes toward the usefulness of the lecture content before and after the session and surveyed them on their engagement in learning. Residents reported their engagement as high and demonstrated favorable changes in their attitudes about the usefulness of the lecture content to their daily medical practice. The authors describe their adaptation of the team-learning approach and conclude that team learning may be a useful new pedagogic tool in medical education.

  2. The experience of medical clinicians implementing fluoride varnish in Connecticut.

    Science.gov (United States)

    O'Callaghan, Amy M; Douglass, Joanna M

    2013-01-01

    The purpose of this study was to evaluate the success and barriers encountered by Connecticut medical clinicians providing and billing for infant oral health screenings and fluoride varnish. Clinicians trained and registered in providing oral health services were surveyed about practice demographics, training effectiveness, and implementation barriers. Fifty-seven of 156 surveys (37 percent) were returned and analyzed. Most respondents were female (61 percent), worked at least 10 years (74 percent), and had at least 25 percent of their patients on Medicaid (79 percent). Respondents varied in how prepared they felt to offer services (Pfluoride varnish and billing services, respectively. Only 30 percent of respondents provided fluoride varnish. Clinicians were more likely to provide fluoride varnish and bill for the services if they felt well prepared after the training (Pfluoride varnish and bill for oral health services, despite feeling prepared to provide them. Additional support is required to help medical clinicians provide oral health services more consistently.

  3. Second trimester medical abortion – perceptions and experiences

    OpenAIRE

    Andersson, Inga-Maj

    2015-01-01

    Introduction Second-trimester abortions account for 10 - 15 % of all induced abortions worldwide with a wide variation of permits in different countries. In Sweden, second-trimester abortions account for less than 10 % of the total number of induced abortions. The indication can be fetal or socioeconomic. The medical abortion regimen with mifepristone and misoprostol, is the regimen used in Sweden. The treatment with misoprostol often causes painful contractions, and prophylactic as we...

  4. Exploring the experiences and coping strategies of international medical students

    Science.gov (United States)

    2011-01-01

    Background Few studies have addressed the challenges that international medical students face and there is a dearth of information on the behavioural strategies these students adopt to successfully progress through their academic program in the face of substantial difficulties of language barrier, curriculum overload, financial constraints and assessment tasks that require high proficiency in communication skills. Methods This study was designed primarily with the aim of enhancing understanding of the coping strategies, skill perceptions and knowledge of assessment expectations of international students as they progress through the third and fourth years of their medical degree at the School of Medicine, University of Tasmania, Australia. Results Survey, focus group discussion and individual interviews revealed that language barriers, communication skills, cultural differences, financial burdens, heavy workloads and discriminatory bottlenecks were key factors that hindered their adaptation to the Australian culture. Quantitative analyses of their examination results showed that there were highly significant (p student performances in multiple choice questions, short answer questions and objective structured clinical examinations (70.3%, 49.7% & 61.7% respectively), indicating existence of communication issues. Conclusions Despite the challenges, these students have adopted commendable coping strategies and progressed through the course largely due to their high sense of responsibility towards their family, their focus on the goal of graduating as medical doctors and their support networks. It was concluded that faculty needs to provide both academic and moral support to their international medical students at three major intervention points, namely point of entry, mid way through the course and at the end of the course to enhance their coping skills and academic progression. Finally, appropriate recommendations were made. PMID:21702988

  5. Assessing computer skills in Tanzanian medical students: an elective experience

    Directory of Open Access Journals (Sweden)

    Melvin Rob

    2004-08-01

    Full Text Available Abstract Background One estimate suggests that by 2010 more than 30% of a physician's time will be spent using information technology tools. The aim of this study is to assess the information and communication technologies (ICT skills of medical students in Tanzania. We also report a pilot intervention of peer mentoring training in ICT by medical students from the UK tutoring students in Tanzania. Methods Design: Cross sectional study and pilot intervention study. Participants: Fourth year medical students (n = 92 attending Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania. Main outcome measures: Self-reported assessment of competence on ICT-related topics and ability to perform specific ICT tasks. Further information related to frequency of computer use (hours per week, years of computer use, reasons for use and access to computers. Skills at specific tasks were reassessed for 12 students following 4 to 6 hours of peer mentoring training. Results The highest levels of competence in generic ICT areas were for email, Internet and file management. For other skills such as word processing most respondents reported low levels of competence. The abilities to perform specific ICT skills were low – less than 60% of the participants were able to perform the core specific skills assessed. A period of approximately 5 hours of peer mentoring training produced an approximate doubling of competence scores for these skills. Conclusion Our study has found a low level of ability to use ICT facilities among medical students in a leading university in sub-Saharan Africa. A pilot scheme utilising UK elective students to tutor basic skills showed potential. Attention is required to develop interventions that can improve ICT skills, as well as computer access, in order to bridge the digital divide.

  6. The experience of linking Victorian emergency medical service trauma data

    OpenAIRE

    Boyle Malcolm J

    2008-01-01

    Abstract Background The linking of a large Emergency Medical Service (EMS) dataset with the Victorian Department of Human Services (DHS) hospital datasets and Victorian State Trauma Outcome Registry and Monitoring (VSTORM) dataset to determine patient outcomes has not previously been undertaken in Victoria. The objective of this study was to identify the linkage rate of a large EMS trauma dataset with the Department of Human Services hospital datasets and VSTORM dataset. Methods The linking o...

  7. University of North Carolina's experience with state medical assistance teams.

    Science.gov (United States)

    Strickler, Jeff; Murtaugh, Lisa; Hoffman, Randy

    2010-01-01

    Events in the last several years have shown a clear need for better preparation regarding disaster management. In an effort to improve this preparation, North Carolina implemented state medical assistant teams to provide alternative care facilities, decontamination facilities, and shelter assistance during times of disaster. This article explores these teams from the perspective of the University of North Carolina, which serves as a lead agency for one of these teams. Key components of the team, training provided, and lessons learned will be discussed.

  8. Complicated eclampsia: fifteen years' experience in a referral medical center.

    Science.gov (United States)

    Lopez-Llera, M

    1982-01-01

    The statistical study of a large number of eclamptic patients (n = 704), divided into five successive 3-year periods, was undertaken at the Hospital de Gineco-Obstetricia No. 2 del Centro Médico Nacional in Mexico City in orders to detect significant changes in therapeutic results and/or in the basic character of the disease, as it occurs in a large referral medical complex. The following variables were studied: maternal and perinatal deaths, obstetric profile, main clinical data of the eclamptic episode, frequency of cesarean operation, timing of delivery after admission, main therapeutic changes, frequency of complications in survivors of ante- and intrapartum eclampsia, and cause of death with associated complications. The study showed (1) a continuous increment in the number of cases from the first to the last period, (2) averages for maternal age (24.9 +/- 0.45 years) and for previous parity (1.7 +/- 0.19) unlike those commonly accepted, (3) a significant progression in the severity of the disease in recent years, (4) a frequency of 22.9% of important complications in survivors of ante- and intrapartum eclampsia, and (5) a very limited overall influence of some therapeutic changes on the final outcome of complicated eclampsia, and (6) the impossibility of improving morbidity figures significantly during the 15 years of the study. It was concluded that prevention, early diagnosis, and timely simple medical care offer the only perspective for true medical progress in this particular problem.

  9. FDA Experience with Medical Countermeasures under the Animal Rule

    Directory of Open Access Journals (Sweden)

    Paul Aebersold

    2012-01-01

    Full Text Available The Food and Drug Administration issued a final rule in May 2002 to permit the Agency to approve drugs or license biological products on the basis of animal efficacy studies for use in ameliorating or preventing serious or life-threatening conditions caused by exposure to lethal or permanently disabling toxic biological, chemical, radiological, or nuclear substances. Only two drugs were approved in the first nine years of the “Animal Rule” despite massive investment by the federal government since 2001 to stimulate development of medical countermeasures to biological threats. This article therefore examines the Food and Drug Administration reviews made public after approval of those two drugs and the public discussion at the Agency's Anti-Infective Drugs Advisory Committee of one biological product under development under the Animal Rule. Despite the paucity of approved drugs or licensed biological products as medical countermeasures, several investigational drugs have been placed in the National Strategic Stockpile for use as medical countermeasures, if needed.

  10. "A good career choice for women": female medical students' mentoring experiences: a multi-institutional qualitative study.

    Science.gov (United States)

    Levine, Rachel B; Mechaber, Hilit F; Reddy, Shalini T; Cayea, Danelle; Harrison, Rebecca A

    2013-04-01

    The career decisions, practice patterns, and approach to patient care of current female students, who make up close to 50% of medical school classes, will have a profound impact on the profession. This study explores the role gender plays in the mentoring experiences of female medical students. In 2011, the authors conducted focus groups with 48 third- and fourth-year female medical students at four U.S. medical schools. Using a template organizing style, they derived themes in an iterative process to explore female medical students' mentoring relationships and the impact of gender on those relationships. The authors identified four major themes: (1) Optimal mentoring relationships are highly relational. Students emphasized shared values, trust, and a personal connection in describing ideal mentoring relationships. (2) Relational mentoring is more important than gender concordance. Students identified a desire for access to female mentors but stated that when a mentor and mentee developed a personal connection, the gender of the mentor was less important. (3) Gender-based assumptions and stereotypes affect mentoring relationships. Students described gender-based assumptions and expectations for themselves and their mentors. (4) Gender-based power dynamics influence students' thinking about mentoring. Students stated that they were concerned about how their mentors might perceive their professional decisions because of their gender, which influenced what they disclosed to male mentors and mentors in positions of power. Gender appears to play a role in female medical students' expectations and experience with mentoring relationships and may influence their decision making around career planning.

  11. Alternative donor transplants for severe aplastic anemia: current experience.

    Science.gov (United States)

    Bacigalupo, Andrea; Sica, Simona

    2016-04-01

    Patients with acquired severe aplastic anemia (SAA), who lack a human leukocyte antigen (HLA) identical sibling donor (SIB), have two therapeutic options: immunosuppressive therapy with anti-thymocyte globulin (ATG) and cyclosporine (CsA), or a transplant from an alternative donor. In these patients, the current guidelines of the European Group for Blood and Marrow Transplantation (EBMT) call for a course of ATG + CsA first and transplantation in case of no response. The alternative donor source can be an unrelated donor (UD), a cord blood (CB) unit, or a family mismatched member, in most instances genetically HLA haplo-mismatched (HAPLO). In the present review, we will discuss recent results of transplants from matched UD and SIB donors, with significantly improved outcome, especially with UD in the past decade. We will also be looking at CB transplants, and the problems of limited stem cell dose. Finally HAPLO grafts have been explored in patients lacking or having rejected an unrelated or CB graft: early results seem encouraging, though the procedure should still be considered experimental.

  12. The current status of orbital experiments for UHECR studies

    CERN Document Server

    Panasyuk, M I; Garipov, G K; Ebisuzaki, T; Gorodetzky, P; Khrenov, B A; Klimov, P A; Morozenko, V S; Sakaki, N; Saprykin, O A; Sharakin, S A; Takizawa, Y; Tkachev, L G; Yashin, I V; Zotov, M Yu

    2015-01-01

    Two types of orbital detectors of extreme energy cosmic rays are being developed nowadays: (i) TUS and KLYPVE with reflecting optical systems (mirrors) and (ii) JEM-EUSO with high-transmittance Fresnel lenses. They will cover much larger areas than existing ground-based arrays and almost uniformly monitor the celestial sphere. The TUS detector is the pioneering mission developed in SINP MSU in cooperation with several Russian and foreign institutions. It has relatively small field of view (+/-4.5 deg), which corresponds to a ground area of 6.4x10^3 sq.km. The telescope consists of a Fresnel-type mirror-concentrator (~2 sq.m) and a photo receiver (a matrix of 16x16 photomultiplier tubes). It is to be deployed on the Lomonosov satellite, and is currently at the final stage of preflight tests. Recently, SINP MSU began the KLYPVE project to be installed on board of the Russian segment of the ISS. The optical system of this detector contains a larger primary mirror (10 sq.m), which allows decreasing the energy thr...

  13. LOCAL BUDGETS UNDER CURRENT DECENTRALIZATION: UKRAINE AND FOREIGN EXPERIENCE

    Directory of Open Access Journals (Sweden)

    O. Cheberyako

    2016-04-01

    Full Text Available The article is devoted to the major trends and issues of development of local budgets in Ukraine. A study of the essence of fiscal decentralization as one of the components of the management, aimed at reducing the dependence of local governments from the central government with regard to foreign experience. Particular attention is paid to local budgets under decentralization of own and delegated financial powers. The theoretical principles of fiscal decentralization and its proven impact on the socio-economic development. Studied the European countries model of local budgets. The features of formation of revenues of local budgets under decentralization. The role in shaping tax revenues of local budgets in foreign countries and Ukraine. The analysis of state policy of financial support for regional development in Ukraine. The structure of tax revenue in the context of changes in the budget and tax legislation in a decentralized tax powers. Systematized features of fiscal decentralization in Ukraine. Problems and grounded main ways of optimizing the formation of local budgets in a decentralized tax powers. Formed selection of areas targeted as ways to increase economic and financial independence of regions of Ukraine.

  14. Current characteristics associated with hereditary angioedema attacks and treatment: the home infusion based patient experience.

    Science.gov (United States)

    Tachdjian, Raffi; Banerji, Aleena; Guyer, Autumn; Morphew, Tricia

    2015-01-01

    This article presents a current perspective on the characteristics of hereditary angioedema (HAE) attacks and treatment as captured by a home infusion service. Retrospective data on 158 HAE patients who were enrolled in this acute treatment program were analyzed for factors surrounding an attack. The majority of patients had a high level of disease severity at baseline (88%), with a higher than expected likelihood of having a positive family history (87.8%). The most likely times for patients to call for home treatment were just before and during working hours (6:00 A.M.-5:00 P.M.). Eighty-three percent had more than one alternate mode of medication. Factors associated with a severe attack included an overall severe rating of HAE attacks in the previous year, an abdominal attack alone or a combination of peripheral and abdominal attacks versus a peripheral attack alone, and the use of two doses rather than one for treatment of the current attack. Average time to relief onset was 43.5 minutes. One dose of ecallantide was sufficient to treat the majority of attacks, and a second dose was needed in 23.6% of patients experiencing a severe attack. However, patients who reported both a severe attack rating during the previous year and experiencing only a peripheral current attack were more likely to experience a severe current attack. Acute treatment paradigms for HAE remain diverse. Understanding factors driving these decisions could help alleviate the overall burden of this disease and help overcome some of the challenges faced by the patients and their caretakers and improve their quality of life. Enhanced capture and analysis of prodromal factors in future studies should help us further alleviate the burden of this disease.

  15. Subjective experience of depressed mood among medical students ...

    African Journals Online (AJOL)

    should: (i) reduce the experience of time pressure and interruptions at work ... students are more vulnerable to depression and suicide than their counterparts .... lack of preparation for the shift from more academic work to more clinical work.

  16. Multiple Strategies for Studying Medical Clerkship Experiences: A Case Study.

    Science.gov (United States)

    LaPalio, Lawrence R.; And Others

    1983-01-01

    A method of evaluating clerkship experiences was developed that combined several elements: close observation of students for six consecutive days of the first and last weeks of each rotation, student diaries, and interviews. (Author/MSE)

  17. A Loop Current experiment: Field and remote measurements

    Science.gov (United States)

    Hamilton, Peter; Lugo-Fernández, Alexis; Sheinbaum, Julio

    2016-12-01

    An overview of a new comprehensive observational study of the Loop Current (LC) in the eastern Gulf of Mexico that encompassed full-depth and near-bottom moorings, pressure-equipped inverted echo sounders (PIES) and remote sensing is presented. The study array was designed to encompass the LC from the Campeche Bank to the west Florida escarpment. This overview centers about principal findings as they pertain to mesoscale dynamics. Two companion papers provide in-depth analyses. Three LC anticyclonic eddy separation events were observed with good 3D spatial coverage over the 2½ year extent of the field study; the three separations exhibited similar processes after the LC had extended into the eastern Gulf. Large scale (∼300 km wavelength, 40-60 day periods) southward propagating meanders developed on the eastern side of the LC over deep (∼3000 m) water that were the result of baroclinic instability between the upper layer meandering jet and lower layer cyclones and anticyclones. The lower layer was only highly energetic during relatively short (∼2-3 months) intervals just prior to or during eddy detachments because of baroclinic instability. The steepening of the meanders lead to a pinch-off of LC eddies. The deep lower-layer eddies, constrained by the closed topography of the southeastern Gulf, propagated westward across the detachment zone and appear to assist in achieving separation. Small scale (∼50-100 km, periods ∼10 days) frontal eddies, observed on the western side of the LC along the Campeche Bank slope, decay over the deep water of the northern part of an extended LC, and have little influence on lower layer eddies, the east side meanders and the eddy detachment processes.

  18. The current status of education and career paths of students after completion of medical physicist programs in Japan: a survey by the Japanese Board for Medical Physicist Qualification.

    Science.gov (United States)

    Kadoya, Noriyuki; Karasawa, Kumiko; Sumida, Iori; Arimura, Hidetaka; Yamada, Syogo

    2015-07-01

    To standardize educational programs and clinical training for medical physics students, the Japanese Board for Medical Physicist Qualification (JBMP) began to accredit master's, doctorate, and residency programs for medical physicists in 2012. At present, 16 universities accredited by the JBMP offer 22 courses. In this study, we aimed to survey the current status of educational programs and career paths of students after completion of the medical physicist program in Japan. A questionnaire was sent in August 2014 to 32 universities offering medical physicist programs. The questionnaire was created and organized by the educational course certification committee of the JBMP and comprised two sections: the first collected information about the university attended, and the second collected information about characteristics and career paths of students after completion of medical physicist programs from 2008 to 2014. Thirty universities (16 accredited and 14 non-accredited) completed the survey (response rate 94 %). A total of 209, 40, and 3 students graduated from the master's, doctorate, and residency programs, respectively. Undergraduates entered the medical physicist program constantly, indicating an interest in medical physics among undergraduates. A large percentage of the students held a bachelor's degree in radiological technology (master's program 94 %; doctorate program 70 %); graduates obtained a national radiological technologist license. Regarding career paths, although the number of the graduates who work as medical physicist remains low, 7 % with a master's degree and 50 % with a doctorate degree worked as medical physicists. Our results could be helpful for improving the medical physicist program in Japan.

  19. Do medical images aid understanding and recall of medical information? An experimental study comparing the experience of viewing no image, a 2D medical image and a 3D medical image alongside a diagnosis.

    Science.gov (United States)

    Phelps, Emma Elizabeth; Wellings, Richard; Griffiths, Frances; Hutchinson, Charles; Kunar, Melina

    2017-06-01

    This study compared the experience of viewing 3D medical images, 2D medical images and no image presented alongside a diagnosis. We conducted two laboratory experiments, each with 126 healthy participants. Participants heard three diagnoses; one accompanied by 3D medical images, one accompanied by 2D medical images and one with no image. Participants completed a questionnaire after each diagnosis rating their experience. In Experiment 2, half of the participants were informed that image interpretation can be susceptible to errors. Participants preferred to view 3D images alongside a diagnosis (pmedical images may aid patient understanding, recall and trust in medical information. Medical images may be a powerful resource for patients that could be utilised by clinicians during consultations. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Program experience with micronutrient powders and current evidence.

    Science.gov (United States)

    Rah, Jee Hyun; dePee, Saskia; Kraemer, Klaus; Steiger, Georg; Bloem, Martin W; Spiegel, Paul; Wilkinson, Caroline; Bilukha, Oleg

    2012-01-01

    The efficacy of micronutrient powders (MNP) in the treatment of anemia in moderately anemic children aged 6-24 mo has been clearly demonstrated. The evidence of the effectiveness of MNP in large-scale programs, however, is scarce. This article describes the program experience and findings of large-scale MNP distribution in refugee camps and in an emergency context in Bangladesh, Nepal, and Kenya. The MNP contained 15-16 micronutrients as per the WHO/World Food Programme/UNICEF joint statement, whereas the iron content was reduced to 2.5 mg from NaFeEDTA in a malaria-endemic area in Kenya. Hundreds of thousands of children aged 6-59 mo and pregnant and lactating women were targeted to consume MNP either daily or every other day over an extended period of time. Extensive social marketing campaigns were undertaken to promote regular use of the product. A number of studies were embedded in the programs to assess the impact of MNP on the nutritional status of target beneficiaries. Some improvements in anemia prevalence estimates were observed in particular subgroups, but other results did not show significant improvements. A significant decrease in the prevalence of stunting was observed in Nepal and Kenya but not in Bangladesh. Diarrhea episodes decreased significantly among children receiving MNP in Nepal. A key challenge is to ensure high MNP acceptance and adherence among beneficiaries. Investigation of non-nutritional causes of anemia is warranted in settings with high compliance but no improvement in hemoglobin status. Further investigation into the most appropriate manner to use MNP in malaria endemic settings is warranted.

  1. Nursing faculty teaching a module in clinical skills to medical students: a Lebanese experience

    Science.gov (United States)

    Abdallah, Bahia; Irani, Jihad; Sailian, Silva Dakessian; Gebran, Vicky George; Rizk, Ursula

    2014-01-01

    Nursing faculty teaching medical students a module in clinical skills is a relatively new trend. Collaboration in education among medical and nursing professions can improve students’ performance in clinical skills and consequently positively impact the quality of care delivery. In 2011, the Faculty of Medicine in collaboration with the Faculty of Health Sciences at the University of Balamand, Beirut, Lebanon, launched a module in clinical skills as part of clinical skills teaching to first-year medical students. The module is prepared and delivered by nursing faculty in a laboratory setting. It consists of informative lectures as well as hands-on clinical practice. The clinical competencies taught are hand-washing, medication administration, intravenous initiation and removal, and nasogastric tube insertion and removal. Around sixty-five medical students attend this module every year. A Likert scale-based questionnaire is used to evaluate their experience. Medical students agree that the module provides adequate opportunities to enhance clinical skills and knowledge and favor cross-professional education between nursing and medical disciplines. Most of the respondents report that this experience prepares them better for clinical rotations while increasing their confidence and decreasing anxiety level. Medical students highly appreciate the nursing faculties’ expertise and perceive them as knowledgeable and resourceful. Nursing faculty participating in medical students’ skills teaching is well perceived, has a positive impact, and shows nurses are proficient teachers to medical students. Cross professional education is an attractive model when it comes to teaching clinical skills in medical school. PMID:25419165

  2. Teaching cultural diversity: current status in U.K., U.S., and Canadian medical schools.

    Science.gov (United States)

    Dogra, Nisha; Reitmanova, Sylvia; Carter-Pokras, Olivia

    2010-05-01

    In this paper we present the current state of cultural diversity education for undergraduate medical students in three English-speaking countries: the United Kingdom (U.K.), United States (U.S.) and Canada. We review key documents that have shaped cultural diversity education in each country and compare and contrast current issues. It is beyond the scope of this paper to discuss the varied terminology that is immediately evident. Suffice it to say that there are many terms (e.g. cultural awareness, competence, sensitivity, sensibility, diversity and critical cultural diversity) used in different contexts with different meanings. The major issues that all three countries face include a lack of conceptual clarity, and fragmented and variable programs to teach cultural diversity. Faculty and staff support and development, and ambivalence from both staff and students continue to be a challenge. We suggest that greater international collaboration may help provide some solutions.

  3. Advertising of medical devices: foreign experience and Ukrainian practice.

    Science.gov (United States)

    Pashkov, Vitalii; Harkusha, Andrii; Bytiak, Oleksii

    Chosen European foreign policy vector for Ukraine establishes its obligation to enforce the process of adaptation of the EU law regulations in the internal legal policy. The approximation of Ukrainian law to the European Union (EU) "acquis communautaire" is not only the instrument for deepening our economic cooperation with the European Union, but also the important measure to enhance further development of Ukraine in general. National legislation, which regulate advertising and promotion of medical devices (MD), is not an exception. Some key points on legal regulation of abovementioned sphere is a base of this study. Ukrainian legislation, European Union`s Law Acts, EU's member-states law, WHO Acts and Recommendations, European Medical Technology Industry Association (EUCOMED) Acts. Article is based on dialectical, comparative, analytic, synthetic and comprehensive research methods. In accordance with Ukrainian legislation, there is no special law that concerns advertising on MD in Ukraine, this sphere is regulated by general law that named ≪About advertisement≫, but it doesn't take into account even main characteristics of such a special object as medical devices (MD). Moreover, the law ≪About advertisement≫ contain discrepancies in terms that are used, these contradictions, in our opinion, must be eliminated by appropriate law reforms. The advertising and promotion of MD in EU is regulated by a combination of EU and national legislation of EU Member States, national advertising and promotion of MD are not harmonized with the EU MDD for now, resulting in a fragmented legal landscape that differs from one EU Member State to the other. Practice of adopting different codes and guides that regulate advertising, including advertising of MD, is widespread in EU and EU Member States and thus must be used in Ukraine with appropriate reformation of national law.

  4. Current experience with renal transplantation across the ABO barrier.

    Science.gov (United States)

    Nelson, P W; Helling, T S; Shield, C F; Beck, M; Bryan, C F

    1992-11-01

    Solid organ transplantation has traditionally been governed by the rules of blood group compatibility. Thus, it has been demonstrated that crossing the ABO blood group barrier generally results in hyperacute rejection. However, the A2 subtype of the blood group A is a weaker antigen. Under certain circumstances, organs from donors with blood group A2 can be transplanted across the ABO blood group barrier into recipients of O or B blood type. Since 1986, 33 patients including 24 blood group O and 9 blood group B patients received A2 (30) or A2B (3) donor kidneys. Both cadaver donor (31) and living-related grafts (2) have been undertaken. The mean follow-up since transplantation for the 21 patients with functioning grafts is 36 months, with a 67.2% current graft survival. Immunosuppression for these transplants consisted of azathioprine, prednisone, and cyclosporine, often in combination with prophylactic OKT3 or antilymphocyte globulin as protocol dictated. Special immunosuppressive protocols such as splenectomy or plasmapheresis were not used. The serum of the potential recipient was analyzed for immunoglobulin G (IgG) and immunoglobulin M (IgM) forms of antibody against A1 and A2 red blood cells. There is a strong correlation between a low (less than or equal to 1:8) anti-A1 IgG titer and both early and long-term graft function. Recipients with an IgG titer greater than 1:8 in the pretransplant serum had a much higher incidence of early graft failure. We no longer recommend transplantation of A2 kidneys into O or B recipients with a pretransplant titer of greater than 1:8 but found that recipients with low titers have graft function rates essentially equal to those of ABO-compatible patients. Patients with blood group B have, over time, lower anti-A IgG titers than do blood group O patients. In addition, the graft survival among blood group B patients is 89% compared with 58% among group O recipients. This may be due to the generally low titers found in blood

  5. [Evoked potentials in intracranial operations: current status and our experiences].

    Science.gov (United States)

    Nau, H E; Hess, W; Pohlen, G; Marggraf, G; Rimpel, J

    1987-03-01

    Intraoperative neuromonitoring, especially evoked potential monitoring, has gained interest in recent years for both the anesthesiologist evaluating cerebral function and the neurosurgeon wishing to avoid neuronal lesions during intracranial operations. Before evoked potential monitoring can be introduced as a routine method of intraoperative management, experience with this method particularly in intensive care units, is imperative. We recorded evoked potentials with the Compact Four (Nicolet) and Basis 8000 (Schwarzer Picker International) computer systems. Preoperative derivations should be done with the same apparatus used intraoperatively and parameters of peri- and intraoperative derivations should not be changed. The patient's head must be fixed in a Mayfield clamp in order to avoid artefacts during trepanation. The possible artefacts due to apparatus, patient, or anesthesia are summarized in the tables. The derivations of evoked potentials should be supervised by a person who is not involved in the anesthesia or the surgical procedure; this condition may change in the future with full automatization of the recording technique and alarms. Good communication between surgeon, anesthesiologist, and neurophysiological assistant is a prerequisite. The modality is chosen in accordance with the affected neuronal system: visual-evoked potential (VEP) monitoring in the management of processes affecting the visual pathway, brain stem auditory-(BAER) and somatosensory-evoked potential (SSEP) monitoring in lesions affecting these pathways, in particular space-occupying lesions of the posterior fossa. VEP monitoring may be useful, but we observed alterations of the responses without changes in the level of anesthesia or manipulation of the visual pathways. In space-occupying processes of the cerebellopontine angle, BAER could not be developed in nearly all cases because the large underlying tumor had caused the disappearance of waves II-V. In these cases SSEP monitoring

  6. Current use of medical eponyms – a need for global uniformity in scientific publications

    Directory of Open Access Journals (Sweden)

    Arora Nalini

    2009-03-01

    Full Text Available Abstract Background Although eponyms are widely used in medicine, they arbitrarily alternate between the possessive and nonpossessive forms. As very little is known regarding extent and distribution of this variation, the present study was planned to assess current use of eponymous term taking "Down syndrome" and "Down's syndrome" as an example. Methods This study was carried out in two phases – first phase in 1998 and second phase in 2008. In the first phase, we manually searched the terms "Down syndrome" and "Down's syndrome" in the indexes of 70 medical books, and 46 medical journals. In second phase, we performed PubMed search with both the terms, followed by text-word search for the same. Results In the first phase, there was an overall tilt towards possessive form – 62(53.4% "Down's syndrome" versus 54(46.6% "Down syndrome." However, the American publications preferred the nonpossesive form when compared with their European counterpart (40/50 versus 14/66; P Conclusion Inconsistency in the use of medical eponyms remains a major problem in literature search. Because of linguistic simplicity and technical advantages, the nonpossessive form should be used uniformly worldwide.

  7. Quality or equality? The Norwegian experience with medical monopolies

    Directory of Open Access Journals (Sweden)

    Rasmussen Knut

    2007-02-01

    Full Text Available Abstract Background In order to maintain both quality and efficiency of health services in a small country with a scattered population, Norway established a monopoly system for 38 highly specialized medical services. The geographical distributions of these services, which are provided by one or two university hospitals only, were analysed. Methods The counties of residence for 2 711 patients admitted for the first time in 2001 to these 31 monopolies and 7 duopolies were identified. Results The general tendency observed was that with increasing distance from residential home to monopoly hospitals there was a declining coverage of these health services. The same pattern was found even with regard to explicit diagnoses or treatments such as organ transplantations (except renal transplantations. Duopolies seemed to yield a more even geographical distribution of the services. Conclusion Monopolies may serve as a useful means for maintaining quality in highly specialized medical services, but seem to have an inherent tendency to do this at the expense of geographical equality.

  8. An integrated ultrasound curriculum (iUSC) for medical students: 4-year experience.

    Science.gov (United States)

    Hoppmann, Richard A; Rao, Victor V; Poston, Mary Beth; Howe, Duncan B; Hunt, Patrick S; Fowler, Stanley D; Paulman, Lance E; Wells, James R; Richeson, Nancy A; Catalana, Paul V; Thomas, Lynn K; Britt Wilson, L; Cook, Thomas; Riffle, Shaun; Neuffer, Francis H; McCallum, James B; Keisler, Brian D; Brown, Rachel S; Gregg, Anthony R; Sims, Kerry M; Powell, Caroline K; Garber, Matthew D; Morrison, James E; Owens, William B; Carnevale, Kevin A; Jennings, William R; Fletcher, Sarah

    2011-04-01

    A review of the development and implementation of a 4-year medical student integrated ultrasound curriculum is presented. Multiple teaching and assessment modalities are discussed as well as results from testing and student surveys. Lessons learned while establishing the curriculum are summarized. It is concluded that ultrasound is a well received, valuable teaching tool across all 4 years of medical school, and students learn ultrasound well, and they feel their ultrasound experience enhances their medical education.

  9. Israeli Military Medical Experience: Ideas for the U.S. Air Force’s Medical Service?

    Science.gov (United States)

    1982-08-01

    To contravene this policy would cause serious problems for triage, where it would be logistically difficult and medically dangerous to attempt to...1976. Danon , Y. and T. Halel (Huler), "Hospital Disaster Planning and Exercises," Harefuah, 83:377-380, 1972. ,-CUDUG PAGN SLUM-O TILAW - 32 - The

  10. Current status of Kampo medicine curricula in all Japanese medical schools

    Directory of Open Access Journals (Sweden)

    Arai Makoto

    2012-11-01

    Full Text Available Abstract Background There have been a few but not precise surveys of the current status of traditional Japanese Kampo education at medical schools in Japan. Our aim was to identify problems and suggest solutions for a standardized Kampo educational model for all medical schools throughout Japan. Methods We surveyed all 80 medical schools in Japan regarding eight items related to teaching or studying Kampo medicine: (1 the number of class meetings, target school year(s, and type of classes; (2 presence or absence of full-time instructors; (3 curricula contents; (4 textbooks in use; (5 desire for standardized textbooks; (6 faculty development programmes; (7 course contents; and (8 problems to be solved to promote Kampo education. We conducted descriptive analyses without statistics. Results Eighty questionnaires were collected (100%. (1 There were 0 to 25 Kampo class meetings during the 6 years of medical school. At least one Kampo class was conducted at 98% of the schools, ≥4 at 84%, ≥8 at 44%, and ≥16 at 5%. Distribution of classes was 19% and 57% for third- and fourth-year students, respectively. (2 Only 29% of schools employed full-time Kampo medicine instructors. (3 Medicine was taught on the basis of traditional Japanese Kampo medicine by 81% of the schools, Chinese medicine by 19%, and Western medicine by 20%. (4 Textbooks were used by 24%. (5 Seventy-four percent considered using standardized textbooks. (6 Thirty-three percent provided faculty development programmes. (7 Regarding course contents, “characteristics” was selected by 94%, “basic concepts” by 84%, and evidence-based medicine by 64%. (8 Among the problems to be solved promptly, curriculum standardization was selected by 63%, preparation of simple textbooks by 51%, and fostering instructors responsible for Kampo education by 65%. Conclusions Japanese medical schools only offer students a short time to study Kampo medicine, and the impetus to include Kampo medicine

  11. Current situation on the reporting quality of randomized controlled trials in 5 leading Chinese medical journals

    Institute of Scientific and Technical Information of China (English)

    Xu Wei; Li Tiejun; Wu Cheng

    2009-01-01

    Objective: The Consolidated Standards for Reporting of Trials (CONSORT) statement has already proved to be an efficient standard for reporting quality of randomized controlled trials (RCTs). However, most of the Chinese medical journals have not endorsed the CONSORT statement. The current situation about the reporting quality of RCTs in Chinese medical journals is still unclear. The purpose of the study was to evaluate the reporting quality of RCTs on papers published in 5 leading Chinese medical journals. Methods: We evaluated 232 original RCT papers using a reporting quality scale based on CONSORT statement from 2001 to 2006 in 5 Chinese medical journals (Journal type 1) without adoption of CONSORT and Chinese Journal of Evidence-based Medicine (Journal type 2) which adopted CONSORT in 2004. We measured the inclusion of 26 items for the reporting quality scale and 6 core items of each RCT report, gave score to each item and calculated the total score obtained in each report and the proportion of reports including individual items. The reporting quality of RCT trials from 2001 to 2003 (pre-adoption period) was compared with that from 2004 to 2006 (post-adoption period). Results: The average reporting quality of RCTs was moderate (mean score, 15.18), and the mean score of the 6 core items was low (mean score, 1.09)in 5 leading journals. The difference in the total score and the score of the 6 core items between pre-adoption period (2001-2003) and post-adoption period (2004-2006) was statistically significant (P=0.003; P=0.000). Interaction between journal type and period was not significant (F=0.76; P=0.383). We concluded that the change tendency of reporting quality between Journal type 1 and 2 was not different. But as to the core items of sequence concealment and intention-to-treat analysis,the increases were greater for Journal type 2 when evaluated against Journal type 1 (P=0.038; P=0.016). Conclusion: The reporting quality of RCT trials in 5 leading Chinese

  12. Current medication choices in juvenile rheumatoid arthritis II--update of a survey performed in 1993.

    Science.gov (United States)

    Brunner, H I; Kim, K N; Ballinger, S H; Bowyer, S L; Griffin, T A; Higgins, G C; Mier, R; Passo, M H; Rennebohm, R; Schikler, K; Lovell, D J

    2001-10-01

    The documentation of treatments used for Juvenile Rheumatoid Arthritis (JRA) is important to allow for the evaluation of practice patterns for future outcome studies. A survey of nine pediatric rheumatologists was performed between September 1999 and February 2000. Each of the physicians prospectively recorded demographic and treatment information on consecutively sampled JRA patients (n=395). Pauciarticular onset JRA was present in 46%, polyarticular onset JRA in 35%, and systemic onset JRA in 19% of the children. Naproxen was the most frequently prescribed medication (55% of the patients), followed by methotrexate (MTX), which was used in 39% of the patients. Folic acid supplementation (1 mg/day) was provided to 69% of the patients treated with MTX. Etanercept was used in 11% of the children. Eleven percent of the patients received corticosteroids, and 13% of children on corticosteroids took calcium supplements. Uveitis was present in 8% and had a chronic course in 79% of those cases. Although systemic medications were used in 50% of the children with uveitis to control eye inflammation, severe damage to the eyes developed in 30% of them. Fourteen percent of the patients required gastroprotective medications. Compared with findings of a similar survey performed in 1993, there was no significant change in the frequency of use of naproxen, but nabumetone is now more often prescribed, and COX-2 inhibitors have been introduced in the therapy of JRA. Changes among second-line agents used for JRA have also occurred, although there was no change in the frequency of use of MTX or corticosteroids. JRA continues to be a treatment challenge for the practicing pediatric rheumatologist. Patients often show incomplete response to the currently available medications. Therefore, new therapeutic agents need to be evaluated for their use in JRA, and the treatment of JRA associated uveitis especially needs to be improved.

  13. Rewards, costs and challenges: the general practitioner's experience of teaching medical students.

    Science.gov (United States)

    Sturman, Nancy; Régo, Patricia; Dick, Marie-Louise

    2011-07-01

    Medical student attachments in general practices play an important role in undergraduate medical education internationally. The recruitment by universities of new teaching practices or an increase in the teaching commitment of existing practices will be necessary to address rising medical student numbers. General practitioners (GPs) are likely to weigh the perceived rewards of practice-based teaching against the perceived costs and challenges in deciding whether to accept a student placement and how to teach. These aspects of the 'lived experience' of the GP-teacher have not been adequately investigated. This study aims to enhance understanding of the GP clinical teacher experience in order to inform strategies for the recruitment, retention, training and support of teaching general practices. Sixty GP clinical teachers in Brisbane-based urban teaching general practices were interviewed individually face-to-face by the principal investigator, using a semi-structured interview plan. Representativeness was ensured through quota sampling. The interview data were analysed thematically by two of the investigators independently, following member checking of interview transcripts. The results demonstrate a number of key inter-related perceived rewards, costs and challenges of teaching, including intellectual stimulation, cognitive fatigue and student characteristics. The findings extend reports in the previous literature by offering a richer description of current GP-teacher experience. Participants identified teaching rewards in a manner largely consistent with previous research, with the exception of enhanced practice morale and teamwork. Findings confirm that reduced productivity and increased time pressures remain key perceived negative impacts of teaching, but also reveal a number of other important costs and challenges. They emphasise the diversity of GP experience and practice cultures, and the need for teaching to enhance both GP and patient perceptions of

  14. Attitudes of Medical Students towards Psychiatry: Effects of Training, Courses in Psychiatry, Psychiatric Experience and Gender

    Science.gov (United States)

    Kuhnigk, Olaf; Strebel, Bernd; Schilauske, Joerg; Jueptner, Markus

    2007-01-01

    Objective: The attitudes of medical students towards psychiatry and psychotherapy were examined considering the extent of their education, previous psychiatry experience, the evaluation of the course, their career intentions and socio-demographic variables. Methods: Five hundred and eight medical students in their second, fifth, ninth and tenth…

  15. How Students Experience and Navigate Transitions in Undergraduate Medical Education: An Application of Bourdieu's Theoretical Model

    Science.gov (United States)

    Balmer, Dorene F.; Richards, Boyd F.; Varpio, Lara

    2015-01-01

    Using Bourdieu's theoretical model as a lens for analysis, we sought to understand how students experience the undergraduate medical education (UME) milieu, focusing on how they navigate transitions from the preclinical phase, to the major clinical year (MCY), and to the preparation for residency phase. Twenty-two medical students participated in…

  16. Guidelines for Professional Training of Junior Medical Staff in the Context of European Experience

    Directory of Open Access Journals (Sweden)

    Sosnova Myroslava

    2016-09-01

    Full Text Available The article deals with outlining guidelines for improving professional training of junior medical staff based on European experience. Consequently, guidelines and recommendations on enhancing the efficiency of medical education in general and junior medical specialists’ professional training, in particular, published by European Union of Medical Specialists, General Medical Council, World Federation for Medical Education have been studied, analyzed, justified and presented in the paper. According to European Union of Medical Specialists it has been concluded that general aspects of medical specialists’ training are based on the selection process for the access to the medical specialists’ training, duration of training, common trunk, training program and quality assurance; requirements for training institutions involve recognition, size, quality assurance and teaching infructructure; requirements for instructors encompass qualification, training program, teacher/trainee ratio; requirements for trainees cover experience, language and logbook. In addition, the components that define the quality of junior medical specialists’ professional training based on N. Novosolova’s ideas have been indicated. Finally, based on the positive aspects of the guidelines analyzed the appropriate ones that, in our opinion, may be of use in Ukraine, have been presented.

  17. Medical specialty considerations by medical students early in their clinical experience

    Directory of Open Access Journals (Sweden)

    Weissman Charles

    2012-03-01

    Full Text Available Abstract Background Specialty selection by medical students determines the future composition of the physician workforce. Selection of career specialties begins in earnest during the clinical rotations with exposure to the clinical and intellectual environments of various specialties. Career specialty selection is followed by choosing a residency program. This is the period where insight into the decision process might help healthcare leaders ascertain whether, when, and how to intervene and attempt to influence students' decisions. The criteria students consider important in selecting a specialty and a residency program during the early phases of their clinical rotations were examined. Methods Questionnaires distributed to fifth-year medical students at two Israeli medical schools. Results 229 of 275 (83% questionnaires were returned. 80% of the students had considered specialties; 62% considered one specialty, 25% two, the remainder 3-5 specialties. Students took a long-range view; 55% considered working conditions after residency more important than those during residency, another 42% considered both equally important. More than two-thirds wanted an interesting and challenging bedside specialty affording control over lifestyle and providing a reasonable relationship between salary and lifestyle. Men were more interested in well-remunerated procedure-oriented specialties that allowed for private practice. Most students rated as important selecting a challenging and interesting residency program characterized by good relationships between staff members, with positive treatment by the institution, and that provided much teaching. More women wanted short residencies with few on-calls and limited hours. More men rated as important residencies affording much responsibility for making clinical decisions and providing research opportunities. More than 50% of the students considered it important that their residency be in a leading department, and in

  18. Preparing Medical Graduates for an Interconnected World: Current Practices and Future Possibilities for Internationalizing the Medical Curriculum in Different Contexts

    Science.gov (United States)

    Stütz, Alexander; Green, Wendy; McAllister, Lindy; Eley, Diann

    2015-01-01

    Preparing medical graduates who are competent to work in a global environment requires broad integration of international and intercultural perspectives throughout the medical curriculum. Employing Leask and Bridge's "conceptual framework of internationalisation of the curriculum," this article first highlights the emphasis placed on…

  19. Preparing Medical Graduates for an Interconnected World: Current Practices and Future Possibilities for Internationalizing the Medical Curriculum in Different Contexts

    Science.gov (United States)

    Stütz, Alexander; Green, Wendy; McAllister, Lindy; Eley, Diann

    2015-01-01

    Preparing medical graduates who are competent to work in a global environment requires broad integration of international and intercultural perspectives throughout the medical curriculum. Employing Leask and Bridge's "conceptual framework of internationalisation of the curriculum," this article first highlights the emphasis placed…

  20. A psychosocial perspective of medication side effects, experiences, coping approaches and implications for adherence in hypertension management

    National Research Council Canada - National Science Library

    Kretchy, Irene A; Owusu-Daaku, Frances T; Danquah, Samuel A; Asampong, Emmanuel

    2015-01-01

    This study examined whether psychosocial variables influenced patients' perception and experience of side effects of their medicines, how they coped with these experiences and the impact on medication...

  1. Overnight Hospital Experiences for Medical Students: Results of the 2014 Clerkship Directors in Internal Medicine National Survey.

    Science.gov (United States)

    Goren, Eric N; Leizman, Debra S; La Rochelle, Jeffrey; Kogan, Jennifer R

    2015-09-01

    Since the 2011 Accreditation Council of Graduate Medical Education (ACGME) work hour rules for residents were implemented, 24-30 h call for interns has been replaced by shift work, including night-float. The impact of these changes on undergraduate medical education experiences in internal medicine has not been described. We aimed to determine the current status of medical students' overnight experiences in Internal Medicine clerkships and sub-internships, and to assess internal medicine educators' perceptions of the importance of overnight work during internal medicine rotations. In May 2014, the Clerkship Directors in Internal Medicine (CDIM) conducted its annual survey. Twenty-eight questions about student participation in overnight work and perceptions of the importance of overnight work (rated on 1-5 Likert scale, 1 = very unimportant and 5 =  ery important) were included. Descriptive statistics were used to summarize responses. Free text results were analyzed qualitatively. The response rate was 78 %. A minority of respondents reported students having any overnight experience during the clerkship (38.7 %) or the sub-internship (40.7 %). Only 5 % of respondents reported having students assigned to night-float rotations outside of clerkships or sub-internships. Respondents agreed that overnight experiences were more important during the sub-internship than the clerkship, 4.0 ± 1.1 vs. 3.2 ± 1.2, p rated as important overnight tasks for both clerkship and sub-internship students. Overnight experiences offer students additional educational opportunities. Clerkship directors felt that the overnight experience for the sub-intern in particular was an important chance to practice providing emergency cross coverage and other intern roles. In the era of ACGME duty hours, there is a need to further examine whether there is a role for increased overnight hospital experiences for medical students.

  2. Impact and alternative metrics for medical publishing: our experience with International Orthopaedics.

    Science.gov (United States)

    Scarlat, Marius M; Mavrogenis, Andreas F; Pećina, Marko; Niculescu, Marius

    2015-08-01

    This paper compares the traditional tools of calculation for a journal's efficacy and visibility with the new tools that have arrived from the Internet, social media and search engines. The examples concern publications of orthopaedic surgery and in particular International Orthopaedics. Until recently, the prestige of publications, authors or journals was evaluated by the number of citations using the traditional citation metrics, most commonly the impact factor. Over the last few years, scientific medical literature has developed exponentially. The Internet has dramatically changed the way of sharing and the speed of flow of medical information. New tools have allowed readers from all over the world to access information and record their experience. Web platforms such as Facebook® and Twitter® have allowed for inputs from the general public. Professional sites such as LinkedIn® and more specialised sites such as ResearchGate®, BioMed Central® and OrthoEvidence® have provided specific information on defined fields of science. Scientific and professional blogs provide free access quality information. Therefore, in this new era of advanced wireless technology and online medical communication, the prestige of a paper should also be evaluated by alternative metrics (altmetrics) that measure the visibility of the scientific information by collecting Internet citations, number of downloads, number of hits on the Internet, number of tweets and likes of scholarly articles by newspapers, blogs, social media and other sources of data. This article provides insights into altmetrics and informs the reader about current tools for optimal visibility and citation of their work. It also includes useful information about the performance of International Orthopaedics and the bias between traditional publication metrics and the new alternatives.

  3. Medical genetics, public understanding and patient experiences: An exploratory qualitative study of recently pregnant women

    Science.gov (United States)

    Garman, Jamie L.

    The purpose of the study was to document how individuals' experiences and understanding of genetics concepts affects their medical experiences. Recently pregnant women were interviewed because they represent a population that needs to comprehend biological and genetic information to understand their health. Three women were designated as science experts (SE) defined as having extensive university level science education and three women were designated as science non-experts (SNE). In general, SEs described a more positive pregnancy experience. Both SEs and SNEs demonstrated a basic understanding of genetic concepts but varied in the application of concepts to personal medical issues. Participants' views and experiences of pre and postnatal tests were linked to their understanding of nature of science components such as recognition that tests have limitations. Results from this study indicate an incomplete understanding of the nature of science among participants may have led to unsatisfactory medical experiences.

  4. Nursing faculty teaching a module in clinical skills to medical students: a Lebanese experience

    Directory of Open Access Journals (Sweden)

    Abdallah B

    2014-11-01

    Full Text Available Bahia Abdallah,1 Jihad Irani,2 Silva Dakessian Sailian,1 Vicky George Gebran,1 Ursula Rizk1 1Nursing Program at the Faculty of Health Sciences, University of Balamand, 2Faculty of Medicine and Medical Sciences, University of Balamand, Beirut, Lebanon Abstract: Nursing faculty teaching medical students a module in clinical skills is a relatively new trend. Collaboration in education among medical and nursing professions can improve students' performance in clinical skills and consequently positively impact the quality of care delivery. In 2011, the Faculty of Medicine in collaboration with the Faculty of Health Sciences at the University of Balamand, Beirut, Lebanon, launched a module in clinical skills as part of clinical skills teaching to first-year medical students. The module is prepared and delivered by nursing faculty in a laboratory setting. It consists of informative lectures as well as hands-on clinical practice. The clinical competencies taught are hand-washing, medication administration, intravenous initiation and removal, and nasogastric tube insertion and removal. Around sixty-five medical students attend this module every year. A Likert scale-based questionnaire is used to evaluate their experience. Medical students agree that the module provides adequate opportunities to enhance clinical skills and knowledge and favor cross-professional education between nursing and medical disciplines. Most of the respondents report that this experience prepares them better for clinical rotations while increasing their confidence and decreasing anxiety level. Medical students highly appreciate the nursing faculties' expertise and perceive them as knowledgeable and resourceful. Nursing faculty participating in medical students' skills teaching is well perceived, has a positive impact, and shows nurses are proficient teachers to medical students. Cross professional education is an attractive model when it comes to teaching clinical skills in

  5. Ten-year experience of phototherapy in Yonsei Medical Center.

    Science.gov (United States)

    Park, S H; Hann, S K; Park, Y K

    1996-12-01

    Phototherapy with PUVA or UVB has been used to treat a wide variety of diseases such as psoriasis, vitiligo, atopic dermatitis and mycosis fungoides, etc. The present study was performed to investigate the pattern of phototherapy in the phototherapy clinic of Yonsei Medical Center. One thousand six hundred ninety two patients who received PUVA or UVB phototherapy were included in this study. We analyzed the protocols for phototherapy between 1985 and 1994. The number of phototherapy per year increased sharply until 1991 and thereafter it has remained relatively constant. The most common age group at the start of phototherapy was the third decade. The most common indications for PUVA and UVB phototherapy were vitiligo and psoriasis, respectively. Most patients had received less than 50 treatments of PUVA and less than 200 J/cm2 of cumulative UVA. Most patients had received less than 50 treatments with UVB and cumulative UVB doses were variable. We had not found any malignancy in the skin. Since the maximum safe cumulative doses of UVA or UVB have not yet been established, it is difficult to decide when phototherapy should be discontinued. The data presented in this study needs to be further analyzed in correlation with photoaging and cancer development for the safe usage of phototherapy.

  6. [Assessment for learning: experience in an undergraduate medical theoretical course].

    Science.gov (United States)

    Pérez, Gonzalo; Kattan, Eduardo; Collins, Luz; Wright, Ana Cecilia; Rybertt, Tomás; González, Agustín; Sirhan, Marisol; Solís, Nancy; Pizarro, Margarita; Arrese, Marco; Sarfatis, Alberto; Lustig, Nicole; Arab, Juan Pablo; Labarca, Jaime; Riquelme, Arnoldo

    2015-03-01

    Assessment for learning is a paradigm that is taking shape in the field of medical education. This approach aims to embed the assessment process within the educational and learning process. To evaluate the impact of curricular changes, from a focus of assessment of learning to one of assessment for learning, in the perception of undergraduate students of medicine and their final grades obtained in a theoretical course (TCG). In the year 2011 lectures were reduced and intermediate assessments followed by a feedback session were introduced. The activities of each program course, surveys about student perceptions of the course and the final grades of students (assessments with multiple choice questions) were compared between the periods prior and after curricular changes (2005-2010 and 2011-2013). As a consequence of curricular changes, time for lectures was reduced by 19.5%, time for summative assessments was increased by 8.5%, and feedback activity, occupying 7.3% of the course time was added. There were significant improvements in student is perceptions in all areas assessed by surveys, emphasizing feedback and assessments. The overall grade assigned to the course dictated after implementing the changes increased from 6.18 to 6.59 (p learning achieved the desired educational impact without increasing the assigned curricular time. Programmatic assessment is favorably perceived by students.

  7. The Future of e-Learning in Medical Education: Current Trend and Future Opportunity

    Directory of Open Access Journals (Sweden)

    Sara Kim

    2006-09-01

    Full Text Available A wide range of e-learning modalities are widely integrated in medical education. However, some of the key questions related to the role of e-learning remain unanswered, such as (1 what is an effective approach to integrating technology into pre-clinical vs. clinical training?; (2 what evidence exists regarding the type and format of e-learning technology suitable for medical specialties and clinical settings?; (3 which design features are known to be effective in designing on-line patient simulation cases, tutorials, or clinical exams?; and (4 what guidelines exist for determining an appropriate blend of instructional strategies, including online learning, face-to-face instruction, and performance-based skill practices? Based on the existing literature and a variety of e-learning examples of synchronous learning tools and simulation technology, this paper addresses the following three questions: (1 what is the current trend of e-learning in medical education?; (2 what do we know about the effective use of e-learning?; and (3 what is the role of e-learning in facilitating newly emerging competency-based training? As e-learning continues to be widely integrated in training future physicians, it is critical that our efforts in conducting evaluative studies should target specific e-learning features that can best mediate intended learning goals and objectives. Without an evolving knowledge base on how best to design e-learning applications, the gap between what we know about technology use and how we deploy e-learning in training settings will continue to widen.

  8. Medical students' experience in practical skills is far from stakeholders' expectations

    DEFF Research Database (Denmark)

    Ringsted, Charlotte; Schroeder, Torben V.; Henriksen, Jørgen;

    2001-01-01

    This study compares medical graduates' experience in practical skills with a range of stakeholders' expectations. A questionnaire listing 58 practical skills was sent out to a group of graduating medical students. The medical students were asked to indicate their experience in each skill during...... medical school. A similar questionnaire was sent out to five groups of stakeholders asking for their expectations regarding graduates' experience. The stakeholders were: faculty members; consultants at clinical departments with interns in training; general practitioners; nurses; recently graduated junior...... compared with faculty members and consultants. Differences between our results and reports in the literature from elsewhere emphasize the importance of performing local needs assessments, and in this process stakeholders apart from faculty members should be involved. Udgivelsesdato: 2001-Jul...

  9. The experience of linking Victorian emergency medical service trauma data

    Directory of Open Access Journals (Sweden)

    Boyle Malcolm J

    2008-11-01

    Full Text Available Abstract Background The linking of a large Emergency Medical Service (EMS dataset with the Victorian Department of Human Services (DHS hospital datasets and Victorian State Trauma Outcome Registry and Monitoring (VSTORM dataset to determine patient outcomes has not previously been undertaken in Victoria. The objective of this study was to identify the linkage rate of a large EMS trauma dataset with the Department of Human Services hospital datasets and VSTORM dataset. Methods The linking of an EMS trauma dataset to the hospital datasets utilised deterministic and probabilistic matching. The linking of three EMS trauma datasets to the VSTORM dataset utilised deterministic, probabilistic and manual matching. Results There were 66.7% of patients from the EMS dataset located in the VEMD. There were 96% of patients located in the VAED who were defined in the VEMD as being admitted to hospital. 3.7% of patients located in the VAED could not be found in the VEMD due to hospitals not reporting to the VEMD. For the EMS datasets, there was a 146% increase in successful links with the trauma profile dataset, a 221% increase in successful links with the mechanism of injury only dataset, and a 46% increase with sudden deterioration dataset, to VSTORM when using manual compared to deterministic matching. Conclusion This study has demonstrated that EMS data can be successfully linked to other health related datasets using deterministic and probabilistic matching with varying levels of success. The quality of EMS data needs to be improved to ensure better linkage success rates with other health related datasets.

  10. MATERNAL NEAR MISS: AN EXPERIENCE IN RURAL MEDICAL COLLEGE

    Directory of Open Access Journals (Sweden)

    Madhavi

    2014-10-01

    Full Text Available : INTRODUCTION: Maternal mortality is an important indicator of health care system. As the mortality rates are consistently decreasing the focus is shifted on maternal near miss which describes severe maternal morbidity which shares the common pathway as mortality. Maternal near miss indicators are relevant in developing world and low resource setting as it indicates the gaps in the health system. In 2009 WHO working group has standardized the criteria for selecting these cases. MATERIAL AND METHODS: This study is performed in rural medical college between October 2012 to september2014 and maternal near miss cases are identified according to WHO criteria. Variables related to age, parity, gestational age, intensive care unit admission, ventilator support, requirement of massive blood transfusion were analyzed. Further the events leading to maternal near miss were studied. Finally the indices like maternal near miss incidence ratio, maternal near miss: maternal mortality ratio and mortality index were calculated. RESULTS: during the study period 2409 deliveries were conducted of which 2385 were live births. Potentially life threatening conditions were identified to be 265 and maternal near miss cases were 22. Maternal near miss incidence ratio was 9.2per 1000 live births, maternal near miss to maternal mortality ratio was 11:1 and mortality index was 8.3%. The leading causes of maternal near miss were abruption and rupture uterus requiring emergency hysterectomy. The morbidity was high in unbooked cases. CONCLUSION: maternal near miss is good alternative indicator of health care system. Lacunae between grass root level and tertiary centers should be filled.

  11. The Moses Mabhida Medical Plan: medical care planning and execution at a FIFA2010 stadium; the Durban experience

    Directory of Open Access Journals (Sweden)

    Timothy C Hardcastle

    2010-12-01

    patients are treated and released in accordance with international literature, leading to low TTHR rates, while PPR was in line with international experience. Headache was the most common medical complaint. The blowing of Vuvuzelas® may have influenced the high headache rate.Keywords: spectator, soccer, world cup, emergency, Vuvuzela

  12. Medical radiation countermeasures for nuclear and radiological emergencies: Current status and future perspectives

    Directory of Open Access Journals (Sweden)

    Rajesh Arora

    2010-01-01

    Full Text Available Nuclear and radiological emergencies (NREs occurred globally and recent incidences in India are indicating toward the need for comprehensive medical preparedness required both at incident site and hospitals. The enhanced threat attributed toward insurgency is another causative factor of worry. The response capabilities and operational readiness of responders (both health and non-health service providers in contaminated environment need to be supported by advancement in R & D and technological efforts to develop prophylactics and radiation mitigators. It is essential to develop phase 1 alternatives of such drugs for unseen threats as a part of initial preparedness. At the incident site and hospital level, external decontamination procedures need to be standardized and supported by protective clothing and Shudika kits developed by INMAS. The medical management of exposure requires systematic approach to perform triage, resuscitation and curative care. The internal contamination requires decorporation agents to be administered based on procedural diagnostics. Various key issues pertaining to policy decisions, R & D promotion, community awareness, specialized infrastructure for NREs preparedness has been discussed. The present review is an attempt to provide vital information about the current status of various radiation countermeasures and future perspective(s ahead.

  13. Retention in care and medication adherence: current challenges to antiretroviral therapy success.

    Science.gov (United States)

    Holtzman, Carol W; Brady, Kathleen A; Yehia, Baligh R

    2015-04-01

    Health behaviors such as retention in HIV medical care and adherence to antiretroviral therapy (ART) pose major challenges to reducing new HIV infections, addressing health disparities, and improving health outcomes. Andersen's Behavioral Model of Health Service Use provides a conceptual framework for understanding how patient and environmental factors affect health behaviors and outcomes, which can inform the design of intervention strategies. Factors affecting retention and adherence among persons with HIV include patient predisposing factors (e.g., mental illness, substance abuse), patient-enabling factors (e.g., social support, reminder strategies, medication characteristics, transportation, housing, insurance), and healthcare environment factors (e.g., pharmacy services, clinic experiences, provider characteristics). Evidence-based recommendations for improving retention and adherence include (1) systematic monitoring of clinic attendance and ART adherence; (2) use of peer or paraprofessional navigators to re-engage patients in care and help them remain in care; (3) optimization of ART regimens and pharmaceutical supply chain management systems; (4) provision of reminder devices and tools; (5) general education and counseling; (6) engagement of peer, family, and community support groups; (7) case management; and (8) targeting patients with substance abuse and mental illness. Further research is needed on effective monitoring strategies and interventions that focus on improving retention and adherence, with specific attention to the healthcare environment.

  14. Current and potential cyber attacks on medical journals; guidelines for improving security.

    Science.gov (United States)

    Dadkhah, Mehdi; Seno, Seyed Amin Hosseini; Borchardt, Glenn

    2017-03-01

    At the moment, scholarly publishing is faced with much academic misconduct and threats such as predatory journals, hijacked journals, phishing, and other scams. In response, we have been discussing this misconduct and trying to increase the awareness of researchers, but it seems that there is a lack of research that presents guidelines for editors to help them protect themselves against these threats. It seems that information security is missing in some parts of scholarly publishing that particularly involves medical journals. In this paper, we explain different types of cyber-attacks that especially threaten editors and academic journals. We then explain the details involved in each type of attack. Finally, we present general guidelines for detection and prevention of the attacks. In some cases, we use small experiments to show that our claim is true. Finally, we conclude the paper with a prioritization of these attacks.

  15. Role of clinical skill centre in undergraduate medical education: Initial experience at Rehman Medical College Peshawar.

    Science.gov (United States)

    Shafiq, Zainab; Mufti, Tariq Saeed; Qayum, Iftikhar

    2017-01-01

    To assess the performance of students on clinical skill factors and to measure the satisfaction level of students related to the training. The descriptive study was conducted at Rehman Medical College, Peshawar, Pakistan, from August 1 to September 15, 2013, and comprised all third-year medical students who had undergone clinical skill training. Their performance was evaluated through end-of-module objective structured clinical examination. Students' feedback measuring satisfaction on a five-point Likert scale was obtained on a designed validated tool. Monitoring of the clinical skills centre training programme was done by the quality enhancement cell at the college. SPSS 16 was used for statistical analysis. Of the 98 students who took the examinations, 94(96%) cleared generic stations and 70(72%) to 96(98%) discipline-based stations. Overall, 94(96%) cleared the first objective structured clinical examination, ranging from 83(84.6%) for Persian language conversation training to 98(100%) for general physical examination. In the second examination, 90(92%) students passed; ranging from 72(73%) for Gynaecology to 97(98.7%) each for Surgery and Ear, Nose and Throat. There was no significant difference between mean results of the two exams (p>0.05). Clinical skills training achieved the desired objectives and outcomes. However, continuing studies need to be done to establish reliability of the programme.

  16. Laboratory experiments on current flow between stationary and moving electrodes in magnetoplasmas

    Science.gov (United States)

    Stenzel, Reiner L.; Urrutia, J. M.

    1990-01-01

    Laboratory experiments were performed in order to investigate the basic physics of current flow between tethered electrodes in magnetoplasmas. The major findings are summarized. The experiments are performed in an effectively very large laboratory plasma in which not only the nonlinear current collection is addressed but also the propagation and spread of currents, the formation of current wings by moving electrodes, the current closure, and radiation from transmission lines. The laboratory plasma consists of a pulsed dc discharge whose Maxwellian afterglow provides a quiescent, current-free uniform background plasma. Electrodes consisting of collectors and electron emitters are inserted into the plasma and a pulsed voltage is applied between two floating electrodes via insulated transmission lines. Besides the applied current in the wire, the total current density in the plasma is obtained from space and time resolved magnetic probe measurements via Maxwell's law. Langmuir probes yield the plasma parameters.

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

    NARCIS (Netherlands)

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

    2002-01-01

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

  18. Are Persons Reporting "Near-Death Experiences" Really Near Death? A Study of Medical Records.

    Science.gov (United States)

    Stevenson, Ian; And Others

    1990-01-01

    Examination of medical records from 40 patients who reported unusual experiences during an illness or injury revealed that only 18 patients were judged to have had serious, life-threatening conditions, while 33 believed they had been dead or near death. Findings suggest that an important precipitator of so-called near-death experience is belief…

  19. The Experiment of Modulated Toroidal Current on HT-7 and HT-6M Tokamak

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    The Experiments of Modulated Toroidal Current were done on the HT-6M tokamakand HT-7 superconducting tokamak. The toroidal current was modulated by programming theOhmic heating field. Modulation of the plasma current has been used successfully to suppressMHD activity in discharges near the density limit where large MHD m = 2 tearing modes weresuppressed by sufficiently large plasma current oscillations. The improved Ohmic confinementphase was observed during modulating toroidal current (MTC) on the Hefei Tokamak-6M (HT-6M) and Hefei superconducting Tokamak-7 (HT-7). A toroidal frequency-modulated current,induced by a modulated loop voltage, was added on the plasma equilibrium current. The ratio ofA.C. amplitude of plasma current to the main plasma current △Ip/Ip is about 12% ~ 30%. Thedifferent formats of the frequency-modulated toroidal current were compared.

  20. Medical educators working abroad: a pilot study of educators' experiences in the Middle East.

    Science.gov (United States)

    McLean, Michelle; McKimm, Judy; Major, Stella

    2014-09-01

    Medical education is now a global enterprise, with many medical educators working internationally, either for short or longer periods or even permanently. In parallel, many medical schools are now involved in collaborations and partnerships with schools in other countries. With this in mind, we set out to explore what motivates, supports and inhibits medical educators who wish to or might work outside their "home country". This article reports on the pilot stage (in specific organizational contexts in Middle East) of a longitudinal project aimed at canvassing medical educators on a broader global scale, using reflective accounts and a questionnaire survey. The findings from this pilot study raise interesting issues about the lived experience of medical educators who have chosen to work in a different culture from their own. Respondents identify many advantages around skills, personal and professional development. Three main issues emerged in terms of educators' experiences: the academic environment, medical practice in a different cultural context and personal matters. Adapting to the local culture, gender segregation and the impact on learning and teaching was an overarching factor. We introduce an explanatory framework to explain the development of international educator identity, a cyclical process in which, through experiences and reflection, individual world views and perspectives are continually modified and developed. This pilot study tested the methodologies and developed a new conceptual model that will be used in a wider study across different cultures.

  1. Experience, awareness, and perceptions about medical emergencies among dental interns of Chennai city, India

    Directory of Open Access Journals (Sweden)

    L Leelavathi

    2016-01-01

    Full Text Available Introduction: Every dental health professional should have the essential knowledge to identify, assess and manage a potentially life-threatening situation. Aim: To assess the experience, awareness, and perceptions about medical emergencies among dental interns in Chennai city, India. Materials and Methods: A cross-sectional study carried out in four randomly selected dental colleges of Chennai city. Data were collected using a self-administered, structured, closed-ended 20-item questionnaire. It consists of questions on experience of medical emergencies encountered by interns during their graduation, awareness of the essential drugs and equipment, the amount of medical emergencies training undertaken by participants, preparedness of interns in handling medical emergencies. Descriptive statistics, independent sample t-test, were used. Results: Out of 335 interns, 157 (47% said that syncope was the most common medical emergency event encountered by the interns. Regarding awareness about essential drugs, about 161 (48% study participants answered oxygen, epinephrine, nitroglycerin, antihistamine, salbutamol, and aspirin as emergency drugs. About half of the study participants, 187 (56% were aware that pressure should be given to the affected site, with or without suturing if the greater palatine artery is inadvertently cut. The majority of the interns (93% preferred to have a specified training on the handling of medical emergencies in dental practice. Conclusions: Syncope was the most common medical emergency event. Awareness about the essential drugs, equipment, and preparedness of dental interns in handling medical emergencies was low.

  2. Medical students' experience of and reaction to stress: the role of depression and anxiety.

    Science.gov (United States)

    Saravanan, Coumaravelou; Wilks, Ray

    2014-01-01

    Medical school is recognized as a stressful environment that often has a negative effect on students' academic performance, physical health, and psychosocial well-being. Previous studies have not identified differences between depressed and nondepressed and anxious and nonanxious medical students' experiences of stress or their reactions to stressors. The present study aimed to identify the prevalence of depression and anxiety among a sample of 358 medical students attending a private university in Malaysia and to examine differences according to participants' gender, year of study, and stage of training (preclinical and clinical). Additionally, this study examined the extent to which stress predicts depression and anxiety, differences between depressed and nondepressed medical students' experiences of and reactions to stressors, and differences between anxious and nonanxious medical students' experiences of and reactions to stressors. The Student Life Stress Inventory was used to measure stress and reaction to stressors and the Depression, Anxiety, and Stress Scale was used to measure depression and anxiety. The results showed that 44% (n = 158) of the students were anxious and 34.9% (n = 125) were depressed. More female students exhibited anxiety compared to male students. Stress is a predictor for depression and anxiety. A significant difference was found between depressed and nondepressed and anxious and nonanxious students' experience of stressors due to frustration, change, and their emotional reaction to stressors. Overall, depressed and anxious students were found to experience more stress and react differently to stressors compared to nondepressed and nonanxious students.

  3. Medical Students’ Experience of and Reaction to Stress: The Role of Depression and Anxiety

    Directory of Open Access Journals (Sweden)

    Coumaravelou Saravanan

    2014-01-01

    Full Text Available Background. Medical school is recognized as a stressful environment that often has a negative effect on students’ academic performance, physical health, and psychosocial well-being. Previous studies have not identified differences between depressed and nondepressed and anxious and nonanxious medical students’ experiences of stress or their reactions to stressors. The present study aimed to identify the prevalence of depression and anxiety among a sample of 358 medical students attending a private university in Malaysia and to examine differences according to participants’ gender, year of study, and stage of training (preclinical and clinical. Additionally, this study examined the extent to which stress predicts depression and anxiety, differences between depressed and nondepressed medical students’ experiences of and reactions to stressors, and differences between anxious and nonanxious medical students’ experiences of and reactions to stressors. Methods. The Student Life Stress Inventory was used to measure stress and reaction to stressors and the Depression, Anxiety, and Stress Scale was used to measure depression and anxiety. Results. The results showed that 44% (n=158 of the students were anxious and 34.9% (n=125 were depressed. More female students exhibited anxiety compared to male students. Stress is a predictor for depression and anxiety. A significant difference was found between depressed and nondepressed and anxious and nonanxious students’ experience of stressors due to frustration, change, and their emotional reaction to stressors. Conclusion. Overall, depressed and anxious students were found to experience more stress and react differently to stressors compared to nondepressed and nonanxious students.

  4. A discrete choice experiment studying students' preferences for scholarships to private medical schools in Japan.

    Science.gov (United States)

    Goto, Rei; Kakihara, Hiroaki

    2016-02-09

    The shortage of physicians in rural areas and in some specialties is a societal problem in Japan. Expensive tuition in private medical schools limits access to them particularly for students from middle- and low-income families. One way to reduce this barrier and lessen maldistribution is to offer conditional scholarships to private medical schools. A discrete choice experiment is carried out on a total of 374 students considering application to medical schools. The willingness to receive a conditional scholarship program to private medical schools is analyzed. The probability of attending private medical schools significantly decreased because of high tuition, a postgraduate obligation to provide a service in specific specialty areas, and the length of time of this obligation. An obligation to provide a service in rural regions had no significant effect on this probability. To motivate non-applicants to private medical schools to enroll in such schools, a decrease in tuition to around 1.2 million yen (US$ 12,000) or less, which is twice that of public schools, was found to be necessary. Further, it was found that non-applicants to private medical schools choose to apply to such schools even with restrictions if they have tuition support at the public school level. Conditional scholarships for private medical schools may widen access to medical education and simultaneously provide incentives to work in insufficiently served areas.

  5. Evaluation of a blended learning model in geriatric medicine: a successful learning experience for medical students.

    Science.gov (United States)

    Duque, Gustavo; Demontiero, Oddom; Whereat, Sarah; Gunawardene, Piumali; Leung, Oliver; Webster, Peter; Sardinha, Luis; Boersma, Derek; Sharma, Anita

    2013-06-01

    Despite the increasingly ageing population, teaching geriatric medicine at medical schools is a challenge due to the particularities of this subspecialty and the lack of student interest in this subject. We assessed a blended system that combines e-learning and person-to-person interaction. Our program offered the students a hands-on learning experience based on self-reflection, access to technology, interactive learning, frequent interaction with the multidisciplinary team, more exposure to patients, and regular feedback. Our results indicate that the students appreciate this system as a rich and effective learning experience demonstrated by their positive feedback and by their significant improvement in knowledge assessed at the end of their rotation. Implementing an interactive blended system is a beneficial approach to teaching geriatric medicine in medical schools and to motivating medical students' interest in this important medical subspecialty. © 2012 The Authors. Australasian Journal on Ageing © 2012 ACOTA.

  6. Medical and Psychology Student's Experiences in Learning Mindfulness: Benefits, Paradoxes, and Pitfalls.

    Science.gov (United States)

    Solhaug, Ida; Eriksen, Thor E; de Vibe, Michael; Haavind, Hanne; Friborg, Oddgeir; Sørlie, Tore; Rosenvinge, Jan H

    Mindfulness has attracted increased interest in the field of health professionals' education due to its proposed double benefit of providing self-help strategies to counter stress and burnout symptoms and cultivating attitudes central to the role of professional helpers. The current study explored the experiential aspects of learning mindfulness. Specifically, we explored how first-year medical and psychology students experienced and conceptualized mindfulness upon completion of a 7-week mindfulness-based stress reduction program. Twenty-two students participated in either two focus group interviews or ten in-depth interviews, and we performed an interpretive phenomenological analysis of the interview transcripts. All students reported increased attention and awareness of psychological and bodily phenomena. The majority also reported a shift in their attitudes towards their experiences in terms of decreased reactivity, increased curiosity, affect tolerance, patience and self-acceptance, and improved relational qualities. The experience of mindfulness was mediated by subjective intention and the interpretation of mindfulness training. The attentional elements of mindfulness were easier to grasp than the attitudinal ones, in particular with respect to the complex and inherently paradoxical elements of non-striving and radical acceptance. Some participants considered mindfulness as a means to more efficient instrumental task-oriented coping, whilst others reported increased sensitivity and tolerance towards their own state of mind. A broader range of program benefits appeared dependent upon embracing the paradoxes and integrating attitudinal elements in practising mindfulness. Ways in which culture and context may influence the experiences in learning mindfulness are discussed along with practical, conceptual, and research implications.

  7. Medication therapy management services in North Carolina community pharmacies: current practice patterns and projected demand.

    Science.gov (United States)

    Hansen, Richard A; Roth, Mary T; Brouwer, Emily S; Herndon, Susan; Christensen, Dale B

    2006-01-01

    To evaluate the types of cognitive services offered and the number of patients being served in community pharmacies, determine the number of pharmacies that plan to offer medication therapy management (MTM) services under the Medicare Part D prescription drug benefit, and assess whether current and expected practices will meet the potential needs of enrollees. Cross-sectional study. North Carolina in January 2005. 1,593 community pharmacy managers. Survey using a Web-based tool. Provision of cognitive services and number of patients for whom services are provided. A total of 262 (16%) pharmacy managers provided usable responses. Approximately 42% of respondents (n = 110) indicated that they provide some type of cognitive service. Comprehensive MTM services, or services consistent with the professionwide consensus definition, were provided by 31% of respondents (n = 81). Independent pharmacies were more likely to offer some type of service compared with chain pharmacies (58% versus 31%, respectively; P Pharmacy managers with a doctor of pharmacy degree were less likely than pharmacy managers with a bachelor's degree to offer services in their pharmacies (P = .02), and pharmacies with pharmacists on staff who had received certificate training were more likely to offer cognitive services (P = .03). Of all respondents, 28% (n = 73) indicated that they planned to offer MTM services under the Medicare Part D prescription drug benefit. Comparing these results with those of a 1999 survey of North Carolina pharmacists that used some of the same items, the percentage of community pharmacies that provide cognitive services has increased in the intervening years but remains low. Among the services being offered in 2005, most were focused on patient education and training, coordinating and integrating care, and medication regimen reviews. Implementation of MTM services under the Medicare Part D prescription drug benefit should hasten the development and offering of these

  8. Current Status of Home Medical Care Waste Collection by Nurses in Japan.

    Science.gov (United States)

    Ikeda, Yukihiro

    2017-02-01

    A questionnaire survey was conducted to determine the current status of home medical care (HMC) waste collection by nurses for individual items and whether the collection rate differs with city size. The questionnaire was mailed to 1,022 nursing offices, of which 645 offices provided valid responses. Offices were classified into three groups according to the local population size. Responses indicated that used syringes and needles, except for pen-type self-injection needles, were collected by >50% of HMC nurses. On the other hand, enteral nutrients, nutritional adjustment diet vessels, feeding tubes, portable injectors, ventilator masks, endotracheal suction catheters, tracheal cannulas, continuous ambulatory peritoneal dialysis (CAPD) bags, and urinary catheters and bags had a low collection rate in comparison with syringes or needles. The collection percentage of used syringes, needles, and infusion needles (p < 0.05) and that for infusion bags, tubes, and catheters (p < 0.001) differed among the three population groups. Although municipalities are responsible for collect all HMC waste, sharp or infectious items should be collected by HMC doctors or nurses. On the contrary, nonhazardous HMC waste should be collected by municipalities. This paper illustrates the status of waste collection of individual home medical care (HMC) items by HMC nurses. Infectious waste, such as needles and syringes, is collected by nurses. The collection rate of infectious waste by nurses in large cities was low compared with that in small cities. Although municipalities are responsible for collecting all HMC waste, sharp or infectious items should be collected by HMC doctors or nurses, whereas nonhazardous HMC waste should be collected by the municipalities.

  9. Mothers’ Experiences of Participating in the Medical Care of their Child with Cancer

    DEFF Research Database (Denmark)

    Korning Lund, Line; Bregnballe, Vibeke

    Background: Only a few research studies have addressed parents’ experiences of participating in the medical care and treatment of their child diagnosed with cancer. Objective: To explore how mothers of children diagnosed with cancer experienced participating in the medical care of their child both...... at hospital and at home. Design and methods: A qualitative study with a hermeneutical approach. The empirical data consisted of three semi-structured interviews with mothers of children diagnosed with cancer within the last three months. The interviews were analysed in accordance with Kvale and Brinkmann...... at home to prevent hospitalisation" and "Good training in the medical care is significant". Conclusion: In general, mothers experienced participating in the medical care as positive. However, in several aspects of the medical care, the mothers lacked support and guidance from the health professionals...

  10. Leadership and followership in the healthcare workplace: exploring medical trainees’ experiences through narrative inquiry

    OpenAIRE

    Gordon, Lisi J.; Rees, Charlotte E; Ker, Jean S.; Cleland, Jennifer

    2015-01-01

    This research was part of LJG’s PhD research which was generously funded by NHS Education for Scotland through SMERC. OBJECTIVES: To explore medical trainees' experiences of leadership and followership in the interprofessional healthcare workplace. DESIGN: A qualitative approach using narrative interviewing techniques in 11 group and 19 individual interviews with UK medical trainees. SETTING: Multisite study across four UK health boards. PARTICIPANTS: Through maximum variation sampling, 65...

  11. "Comments on Slavin": Through the Looking Glass--Experiments, Quasi-Experiments, and the Medical Model

    Science.gov (United States)

    Sloane, Finbarr

    2008-01-01

    Slavin (2008) has called for changing the criteria used for the inclusion of basic research in national research synthesis clearinghouses. The author of this article examines a number of the assumptions made by Slavin, provides critique with alternatives, and asks what it means to fully implement the medical model in educational settings.…

  12. Medical students volunteering in hospital: a novel method of exploring and recording the patient experience

    Directory of Open Access Journals (Sweden)

    Monica Lorraina Hytiris

    2017-05-01

    Full Text Available Background: Patient experience is increasingly recognised as an important feature of healthcare quality improvement. However, many of the methods implemented for its collection have significant limitations and reliability issues. This article describes how a UK healthcare organisation worked with medical student volunteers to build capacity for the collection of patient feedback in evidence-informed ways, and summarises student reflections on this process. Aims: To improve the quantity and quality of inpatient feedback, and in doing so provide new learning opportunities for medical students. Conclusions: Patient feedback gathered by volunteers is beneficial to the service and to medical student volunteers. As the feedback gathered is ward-specific, opportunities are created for practice improvements to be identified and acted on. It is feasible for medical students to be trained effectively as volunteers in gathering patient care experiences with adequate support mechanisms in place. Implications for practice: •\tHealthcare services should consider the use of personnel independent of the care team for the collection of patient feedback •\tPatient feedback needs to be shared with practitioners in a timely manner •\tMedical schools should consider this type of volunteering as a unique opportunity for medical students to improve understanding of patients’ experiences of healthcare, and of how care can be person-centred

  13. Medical students learning experiences of the labour ward: a qualitative research study.

    Science.gov (United States)

    Cotter, Danielle; Turner, Michael J; McAuliffe, Fionnuala M; Higgins, Mary F

    2016-11-01

    To study the educational value to medical students of a labour ward rotation. Qualitative research study was performed in two tertiary level obstetric hospitals attached to a large medical school in Dublin. Medical students attending a six-week rotation in Obstetrics and Gynaecology in University College Dublin were invited to participate. As part of this rotation, students spend one week as part of the clinical team working on the labour ward. Focus groups were held in order to identify common themes and experiences of medical students during this labour ward week. Grounded theory with thematic analysis was used. The main outcome measures were the educational experience and value of a labour ward rotation to medical students. Five distinct themes developed from the focus groups of 19 students. A high value was placed on patient centred bedside teaching. Midwives were identified as excellent teachers and facilitators of learning. There was a clear sense of teamwork and belonging by the students. However, students reported frustration with unclear learning objectives. Students identified extra pre-learning with pre-specified learning aims before the labour ward week as being important. Bedside teaching was highly valued as it advanced student's knowledge of obstetrics theory and improved communication skills. In general, medical students reported a positive experience from working in the labour word but there is scope for improvement. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Loss of international medical experiences: knowledge, attitudes and skills at risk

    Directory of Open Access Journals (Sweden)

    Legome Eric

    2007-11-01

    Full Text Available Background Despite the great influence International Medical Experiences (IMs can have on young physicians and their impact on patients and communities, they are not offered in all training programs and are at risk of being reduced in some due to stringent guidelines for funding of graduate medical education. Discussion IMs provide unique experiences in clinical, epidemiologic, cultural, and political arenas. From an educational perspective, they broaden a physician's differential diagnostic skills and introduce clinical entities rarely seen in the U.S. Time spent in developing countries emphasizes the importance of community health and increases cultural and linguistic competence. Experience working with the underserved during an IM has been shown to increase interest in volunteerism, humanitarian efforts, and work with underserved populations both in the US and abroad. IMs also afford physicians the opportunity to learn about the delivery of health care abroad and are associated with an increase in primary care specialty choice. Summary It is time for the leaders in graduate medical education to prioritize international health opportunities. Leaders in academic medicine can press for changes in reimbursement patterns at the national level or special funds for international electives. Hospitals can set up separate accounts to help finance resident salaries and benefits while abroad. Individual departments must be flexible with resident schedules to allow elective time. Medical students and housestaff can organize and lobby larger organizations such as the American Medical Association (AMA, the American Association of Medical Colleges (AAMC, and specialty groups to make IMs universally accessible.

  15. Factors influencing the current practice of self-medication consultations in Eastern Indonesian community pharmacies: a qualitative study.

    Science.gov (United States)

    Brata, Cecilia; Fisher, Colleen; Marjadi, Brahmaputra; Schneider, Carl R; Clifford, Rhonda M

    2016-05-13

    Research has shown that the current practice of pharmacy staff when providing self-medication consultations in Indonesia is suboptimal. To improve the performance of pharmacy staff when providing self-medication consultations in community pharmacies, the factors that influence current practice need to be understood. The aim of this study is to identify the factors that influence current practice of pharmacy staff when handling self-medication consultations in Eastern Indonesian community pharmacies. Fifteen in-depth interviews were conducted with pharmacists, pharmacy technicians, pharmacy owners, and counter attendants. Thematic analysis was used to generate findings. The current practice of pharmacy staff when handling self-medication consultations is directly influenced by the professionalism of pharmacy staff and patient responses to the consultations. These factors are in turn affected by the organisational context of the pharmacy and the external pharmacy environment. The organisational context of the pharmacy includes staffing, staff affordability, and the availability of time and facilities in which to provide consultations. The external pharmacy environment includes the number of trained pharmacy staff in the research setting, the relevance of pharmacy education to the needs of pharmacy practice, the support offered by the Indonesian Pharmacists Association, a competitive business environment, and the policy environment. Complex and inter-related factors influence the current practice of pharmacy staff when providing self-medication consultations in community pharmacies in this research setting. Multiple strategies will be required to improve consultation practices.

  16. Current Integration of Dissection in Medical Education in Australia and New Zealand: Challenges and Successes

    Science.gov (United States)

    Bouwer, Hope Ellen; Valter, Krisztina; Webb, Alexandra Louise

    2016-01-01

    The reduced use of dissection associated with the introduction of integrated systems problem-based learning curricula, graduate-entry programs and medical school expansion is a frequent topic of discussion and debate in modern medical training. The purpose of this study was to investigate the impact of these changes to the medical education…

  17. Evaluation of the current status of Rehabilitation, Physical Medicine and Naturopathy education 10 years after the reform of the Medical Licensure Act – a nationwide survey of German Medical Universities

    Science.gov (United States)

    Stock-Schröer, Beate; Huber, Roman; Joos, Stefanie; Klose, Petra

    2017-01-01

    Introduction: After the reform of the German Medical Licensure Act of 2003, Rehabilitation, Naturopathy and Physical Medicine were integrated into one discipline to be taught in Medical University. The aim of this survey is to determine the outcome of this change by evaluating the current status of education of these three disciplines based on the experience and satisfaction reported by lecturers responsible for teaching these subjects to medical students. Methods: A questionnaire-based survey. A paper version of the questionnaire for each discipline was posted to each Medical University in Germany. The first part asked about the current status of teaching; the second part asked about facilities and requirements; the third part asked respondents to give information on their career and teaching experience in this subject Results: The response rate was 51.5% for Rehabilitation, 48.5% for Physical Medicine and 60.6% for Naturopathy. A vast range of people and faculties were involved in the curricula. The percentage of each discipline taught was unevenly distributed: the major proportion being rehabilitation (38%), then naturopathy 34% lastly physical medicine with less than a third (28%). The main delivery of these disciplines was through lectures in plenary sessions. Modern teaching methods were not in evidence. Lecturers were generally pleased to be working with the combination of the three disciplines. Conclusion: Future medical education should improve upon teaching coordination and aim towards a common curriculum for these three disciplines. Expected future changes to medical curricula will provide opportunities to improve the implementation of Rehabilitation, Physical Medicine and Naturopathy in teaching and research. PMID:28293670

  18. Evaluation of the current status of Rehabilitation, Physical Medicine and Naturopathy education 10 years after the reform of the Medical Licensure Act - a nationwide survey of German Medical Universities.

    Science.gov (United States)

    Stock-Schröer, Beate; Huber, Roman; Joos, Stefanie; Klose, Petra

    2017-01-01

    Introduction: After the reform of the German Medical Licensure Act of 2003, Rehabilitation, Naturopathy and Physical Medicine were integrated into one discipline to be taught in Medical University. The aim of this survey is to determine the outcome of this change by evaluating the current status of education of these three disciplines based on the experience and satisfaction reported by lecturers responsible for teaching these subjects to medical students. Methods: A questionnaire-based survey. A paper version of the questionnaire for each discipline was posted to each Medical University in Germany. The first part asked about the current status of teaching; the second part asked about facilities and requirements; the third part asked respondents to give information on their career and teaching experience in this subject Results: The response rate was 51.5% for Rehabilitation, 48.5% for Physical Medicine and 60.6% for Naturopathy. A vast range of people and faculties were involved in the curricula. The percentage of each discipline taught was unevenly distributed: the major proportion being rehabilitation (38%), then naturopathy 34% lastly physical medicine with less than a third (28%). The main delivery of these disciplines was through lectures in plenary sessions. Modern teaching methods were not in evidence. Lecturers were generally pleased to be working with the combination of the three disciplines. Conclusion: Future medical education should improve upon teaching coordination and aim towards a common curriculum for these three disciplines. Expected future changes to medical curricula will provide opportunities to improve the implementation of Rehabilitation, Physical Medicine and Naturopathy in teaching and research.

  19. Evaluation of the current status of Rehabilitation, Physical Medicine and Naturopathy education 10 years after the reform of the Medical Licensure Act – a nationwide survey of German Medical Universities

    Directory of Open Access Journals (Sweden)

    Stock-Schröer, Beate

    2017-02-01

    Full Text Available Introduction: After the reform of the German Medical Licensure Act of 2003, Rehabilitation, Naturopathy and Physical Medicine were integrated into one discipline to be taught in Medical University. The aim of this survey is to determine the outcome of this change by evaluating the current status of education of these three disciplines based on the experience and satisfaction reported by lecturers responsible for teaching these subjects to medical students. Methods: A questionnaire-based survey. A paper version of the questionnaire for each discipline was posted to each Medical University in Germany. The first part asked about the current status of teaching; the second part asked about facilities and requirements; the third part asked respondents to give information on their career and teaching experience in this subjectResults: The response rate was 51.5% for Rehabilitation, 48.5% for Physical Medicine and 60.6% for Naturopathy. A vast range of people and faculties were involved in the curricula. The percentage of each discipline taught was unevenly distributed: the major proportion being rehabilitation (38%, then naturopathy 34% lastly physical medicine with less than a third (28%. The main delivery of these disciplines was through lectures in plenary sessions. Modern teaching methods were not in evidence. Lecturers were generally pleased to be working with the combination of the three disciplines. Conclusion: Future medical education should improve upon teaching coordination and aim towards a common curriculum for these three disciplines. Expected future changes to medical curricula will provide opportunities to improve the implementation of Rehabilitation, Physical Medicine and Naturopathy in teaching and research.

  20. A Measurement of Coherent Neutral Pion Production in Neutrino Neutral Current Interactions in NOMAD experiment

    CERN Document Server

    Kullenberg, C T

    2009-01-01

    We present a study of exclusive neutral pion production in neutrino-nucleus Neutral Current interactions using data from the NOMAD experiment at the CERN SPS. The data correspond to $1.44 \\times 10^6$ muon-neutrino Charged Current interactions in the energy range $2.5 \\leq E_{\

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

    Science.gov (United States)

    Morgen, Evelyn Breck

    2003-01-01

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

  2. Fast electron dynamics in lower hybrid current drive experiment on HT-7 tokamak

    Institute of Scientific and Technical Information of China (English)

    Shi Yue-Jiang; Kuang Gang-Li; Li Jian-Gang; HT-7 Team; Wan Bao-Nian; Chen Zhong-Yong; Hu Li-Qun; Lin Shi-Yao; Ruan Huai-Lin; Qian Jin-Ping; Zhen Xiang-Jun; Ding Bo-Jiang

    2005-01-01

    The dynamic behaviour of fast electron in lower hybrid current drive (LHCD) experiments is a crucial issue in the sense of enhancing plasma performance. A new hard x-ray diagnostic system on HT-7 allows the investigation of the lower hybrid wave dynamics. The behaviour of fast electron is studied in several kinds of LHCD experiments, including long pulse discharges, high performance discharges and counter-LHCD experiments.

  3. Tobacco counseling experience prior to starting medical school, tobacco treatment self-efficacy and knowledge among first-year medical students in the United States.

    Science.gov (United States)

    Xiao, Rui S; Hayes, Rashelle B; Waring, Molly E; Geller, Alan C; Churchill, Linda C; Okuyemi, Kolawole S; Adams, Michael; Huggett, Kathryn N; Ockene, Judith K

    2015-04-01

    To explore students' tobacco dependence counseling experiences prior to medical school and their associations with tobacco counseling self-efficacy, and familiarity with and perceived effectiveness of tobacco dependence treatment among first-year medical students in the United States. In 2010, 1266 first-year medical students from 10 US medical schools completed a survey reporting their clinical experiences with specific tobacco counseling skills (e.g., 5As) prior to medical school. The survey also included questions on tobacco counseling self-efficacy, perceived physician impact on smokers, and familiarity and effectiveness of tobacco-related treatments. Half (50.4%) reported some tobacco counseling experiences prior to medical school (i.e. at least one 5A). Students with prior counseling experiences were more likely to have higher tobacco counseling self-efficacy, and greater familiarity with medication treatment, nicotine replacement treatment, and behavioral counseling for smoking cessation, compared to those with no prior experiences. Perceived physician impact on patient smoking outcomes did not differ by prior tobacco counseling experiences. Many first-year medical students may already be primed to learn tobacco dependence counseling skills. Enhancing early exposure to learning these skills in medical school is likely to be beneficial to the skillset of our future physicians. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Avoiding student infection during a Middle East respiratory syndrome (MERS outbreak: a single medical school experience

    Directory of Open Access Journals (Sweden)

    Seung Won Park

    2016-06-01

    Full Text Available Purpose: In outbreaks of infectious disease, medical students are easily overlooked in the management of healthcare personnel protection although they serve in clinical clerkships in hospitals. In the early summer of 2015, Middle East respiratory syndrome (MERS struck South Korea, and students of Sungkyunkwan University School of Medicine (SKKUSOM were at risk of contracting the disease. The purpose of this report is to share SKKUSOM’s experience against the MERS outbreak and provide suggestions for medical schools to consider in the face of similar challenges. Methods: Through a process of reflection-on-action, we examined SKKUSOM’s efforts to avoid student infection during the MERS outbreak and derived a few practical guidelines that medical schools can adopt to ensure student safety in outbreaks of infectious disease. Results: The school leadership conducted ongoing risk assessment and developed contingency plans to balance student safety and continuity in medical education. They rearranged the clerkships to another hospital and offered distant lectures and tutorials. Five suggestions are extracted for medical schools to consider in infection outbreaks: instant cessation of clinical clerkships; rational decision making on a school closure; use of information technology; constant communication with hospitals; and open communication with faculty, staff, and students. Conclusion: Medical schools need to take the initiative and actively seek countermeasures against student infection. It is essential that medical schools keep constant communication with their index hospitals and the involved personnel. In order to assure student learning, medical schools may consider offering distant education with online technology.

  5. Impact of antipsychotic medication on transcranial direct current stimulation (tDCS) effects in schizophrenia patients.

    Science.gov (United States)

    Agarwal, Sri Mahavir; Bose, Anushree; Shivakumar, Venkataram; Narayanaswamy, Janardhanan C; Chhabra, Harleen; Kalmady, Sunil V; Varambally, Shivarama; Nitsche, Michael A; Venkatasubramanian, Ganesan; Gangadhar, Bangalore N

    2016-01-30

    Transcranial direct current stimulation (tDCS) has generated interest as a treatment modality for schizophrenia. Dopamine, a critical pathogenetic link in schizophrenia, is also known to influence tDCS effects. We evaluated the influence of antipsychotic drug type (as defined by dopamine D2 receptor affinity) on the impact of tDCS in schizophrenia. DSM-IV-TR-diagnosed schizophrenia patients [N=36] with persistent auditory hallucinations despite adequate antipsychotic treatment were administered add-on tDCS. Patients were divided into three groups based on the antipsychotic's affinity to D2 receptors. An auditory hallucinations score (AHS) was measured using the auditory hallucinations subscale of the Psychotic Symptom Rating Scales (PSYRATS). Add-on tDCS resulted in a significant reduction inAHS. Antipsychotic drug type had a significant effect on AHS reduction. Patients treated with high affinity antipsychotics showed significantly lesser improvement compared to patients on low affinity antipsychotics or a mixture of the two. Furthermore, a significant sex-by-group interaction occurred; type of medication had an impact on tDCS effects only in women. Improvement differences could be due to the larger availability of the dopamine receptor system in patients taking antipsychotics with low D2 affinity. Sex-specific differences suggest potential estrogen-mediated effects. This study reports a first-time observation on the clinical utility of antipsychotic drug type in predicting tDCS effects in schizophrenia.

  6. Initial experience in setting up a medical student first responder scheme in South Central England.

    Science.gov (United States)

    Seligman, William H; Ganatra, Sameer; England, David; Black, John J M

    2016-02-01

    Prehospital emergency medicine (PHEM) is a recently recognised subspecialty of emergency medicine, and anaesthetics, intensive care and acute medicine, in the UK, and yet it receives little to no mention in many undergraduate medical curricula. However, there is growing interest in PHEM among medical students and junior doctors. Several programmes are in existence across the UK that serve to provide teaching and exposure of prehospital care to medical students and junior doctors. However, relatively few students are able to gain significant first-hand experience of treating patients in the prehospital phase. In this short report, we discuss our experience of launching the student first responder (SFR) scheme across three counties in the Thames Valley. Medical students are trained by the regional ambulance service and respond to life-threatening medical emergencies in an ambulance response vehicle. The scheme is likely to benefit the ambulance service by providing a wider pool of trained volunteer first responders able to attend to emergency calls, to benefit patients by providing a quick response at their time of need, and to benefit medical students by providing first-hand experience of medical emergencies in the community. In its first 15 months of operation, SFRs were dispatched to 343 incidents. This scheme can serve as a training model for other ambulance services and medical schools across the UK. 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/

  7. Eight years' experience with a Medical Education Journal Club in Mexico: a quasi-experimental one-group study.

    Science.gov (United States)

    Sánchez-Mendiola, Melchor; Morales-Castillo, Daniel; Torruco-García, Uri; Varela-Ruiz, Margarita

    2015-12-14

    A time-honored strategy for keeping up to date in medicine and improving critical appraisal skills is the Journal Club (JC). There are several reports of its use in medicine and allied health sciences but almost no reports of JC focused on medical education. The purpose of the study is to describe and evaluate an eight years' experience with a medical education Journal Club (MEJC). We started a monthly medical education JC in 2006 at UNAM Faculty of Medicine in Mexico City. Its goal is to provide faculty with continuing professional development in medical education. A discussion guide and a published paper were sent 2 weeks before sessions. We reviewed the themes and publication types of the papers used in the sessions, and in June-July 2014 administered a retrospective post-then-pre evaluation questionnaire to current participants that had been regular attendees to the JC for more than 2 years. The retrospective post-then-pre comparisons were analyzed with Wilcoxon signed-rank test. Effect sizes were calculated for the pre-post comparisons with Cohen's r. There have been 94 MEJC sessions until July 2014. Average attendance is 20 persons, a mix of clinicians, educators, psychologists and a sociologist. The articles were published in 32 different journals, and covered several medical education themes (curriculum, faculty development, educational research methodology, learning methods, assessment, residency education). 22 Attendees answered the evaluation instrument. The MEJC had a positive evaluation from good to excellent, and there was an improvement in self-reported competencies in medical education literature critical appraisal and behaviors related to the use of evidence in educational practice, with a median effect size higher than 0.5. The evaluation instrument had a Cronbach's alpha of 0.96. A periodic Medical Education Journal Club can improve critical appraisal of the literature, and be maintained long-term using evidence-based strategies. This activity

  8. Medical Dosimetric Registry of Russian Atomic Industry Employees: Current Status and Perspectives

    Energy Technology Data Exchange (ETDEWEB)

    Ilyin, L. A.; Kiselev, M. F.; Panfilov, A. P.; Kochetkov, O. A.; Ivanov, A. A.; Grinev, M. P.; Soloviev, V. Y.; Semenov, V. G.; Tukov, A. R.; Koshuurnikova, N. A.; Takhauov, R. M.; Melnikov, G. Y.

    2004-07-01

    Epidemiological studies of nuclear industry personnel contain the significant abilities to assess the prolonged radiation exposure effects in the human health. The clarification of these assessments and following improvements of the scientific justification of radiation regulation require the expansion of factual basis of the research currently, Branch Medical Dosimetric Registry (BMDR) of atomic industry and nuclear power employees is under the development in Russian to compose a number of regional registries. This work is coordinated by the State Research Center- Institute of Biophysics (Moscow). The first phase of this project was devoted to the forming of the regional registry of Mayak PA employees (Ozersk, South Uranl region). the employee registries of Siberian Chemical Plant (SCP, Seversk, Tomsk region) and Mountain Chemical Plant (MCP, Zheleznogorsk, Krasnoyarsk region) are at the finalization. At later phases, BMDR will be added by the information on other enterprises and on operating NPP too. The paper describes the structure, general issues of the forming and current status of BMDR. The comparison of major BMDR features versus LSS registry (which is the one of basic components for international radiation protection recommendations and current radiation protection standards) demonstrates that BMDR information can be more preferable to assess the significance of the man made radiation at high and intermediate dose ranges. Particularly, the number of employees (20-40 year age range) exposed to doses specific to detectable radiation health effects (above 2000 mSv) is almost ten times more than that for LSS cohort. Besides, the health monitoring was elaborated since the employment start point (Whereas, since year 5 for LSS cohort). BMDR dose records were measured (against LSS reconstructed doses) and the employee exposure duration was equal to years and decade (alternatively to momentary exposure recorded in LSS). BMDR data quantity and quality correspond to

  9. Experiences of Psychological Distress and Sources of Stress and Support During Medical Training: a Survey of Medical Students.

    Science.gov (United States)

    Matheson, Katherine M; Barrett, Tessa; Landine, Jeff; McLuckie, Alan; Soh, Nerissa Li-Weh; Walter, Garry

    2016-02-01

    The authors examine the prevalence of psychological distress, the stressors experienced, and the supports used by medical students and residents during their medical training at a Canadian university. This study used an online survey that included a standardized instrument to evaluate psychological distress (Kessler-10) and Likert-based survey items that examined stress levels related to family relationships, living accommodations, commuting, finances, and program requirements. Depressive symptoms, substance use, and suicidal ideation were also measured, as were supports accessed (e.g., counseling) and students' perceptions of the overall supportiveness of the university. Non-parametric descriptive statistics were used to examine the prevalence of psychological distress, sources of stress, and supports accessed. Surveys were received from 381 students (37% response). Most students (60%) reported normal levels of psychological distress on the K10 (M = 19.5, SD = 6.25), and a subgroup reported high to very high levels of psychological distress. A small number also reported substance use, symptoms of depression, and/or suicidal ideation. These results indicate that students experience psychological distress from a number of stressors and suggest that medical schools should act as key partners in supporting student well-being by promoting self-care, educating students on the risks of burnout, and developing programs to support at-risk students.

  10. Comparing the Experience of Mature-Aged and Traditional Medical Students in the Clinical Setting: A Qualitative Approach

    OpenAIRE

    Jurjus, RA; Butera, G; ABDELNABI, M; Krapf, JM

    2017-01-01

    Background: Although the mean age of first year medical students is 24, an increasing number of “mature-aged” students, defined as over age 30, are entering medical school in the United States. Few studies have employed qualitative methodology to determine the experience of mature-aged medical students, especially in the clinical setting. Purpose: The purpose of this study was to employ a qualitative design to compare the experience of mature-aged and traditional medical students on clinic...

  11. Principal component analysis of Birkeland currents determined by the Active Magnetosphere and Planetary Electrodynamics Response Experiment

    Science.gov (United States)

    Milan, S. E.; Carter, J. A.; Korth, H.; Anderson, B. J.

    2015-12-01

    Principal component analysis is performed on Birkeland or field-aligned current (FAC) measurements from the Active Magnetosphere and Planetary Electrodynamics Response Experiment. Principal component analysis (PCA) identifies the patterns in the FACs that respond coherently to different aspects of geomagnetic activity. The regions 1 and 2 current system is shown to be the most reproducible feature of the currents, followed by cusp currents associated with magnetic tension forces on newly reconnected field lines. The cusp currents are strongly modulated by season, indicating that their strength is regulated by the ionospheric conductance at the foot of the field lines. PCA does not identify a pattern that is clearly characteristic of a substorm current wedge. Rather, a superposed epoch analysis of the currents associated with substorms demonstrates that there is not a single mode of response, but a complicated and subtle mixture of different patterns.

  12. Principle Component Analysis of Birkeland Currents Determined by the Active Magnetosphere and Planetary Electrodynamics Response Experiment

    Science.gov (United States)

    Milan, S. E.; Carter, J. A.; Korth, H.; Anderson, B. J.

    2015-12-01

    Principle Component Analysis is performed on northern and southern hemisphere Birkeland or field-aligned current (FAC) measurements from the Active Magnetosphere and Planetary Electrodynamics Response Experiment (AMPERE). PCA identifies the patterns in the FACs that respond coherently to different aspects of geomagnetic activity. The region 1 and 2 current system is shown to be the most reproducible feature of the currents, followed by cusp currents associated with magnetic tension forces on newly-reconnected field lines. The cusp currents are strongly modulated by season, indicating that their strength is regulated by the ionospheric conductance at the foot of the field lines. PCA does not identify a pattern that is clearly characteristic of a substorm current wedge. Rather, a superposed epoch analysis of the currents associated with substorms demonstrates that there is not a single mode of response, but a complicated and subtle mixture of different patterns. Other interhemispheric differences are discussed.

  13. Principal component analysis of Birkeland currents determined by the Active Magnetosphere and Planetary Electrodynamics Response Experiment

    CERN Document Server

    Milan, S E; Korth, H; Anderson, B J

    2016-01-01

    Principal component analysis is performed on Birkeland or field-aligned current (FAC) measurements from the Active Magnetosphere and Planetary Electrodynamics Response Experiment. Principal component analysis (PCA) identifies the patterns in the FACs that respond coherently to different aspects of geomagnetic activity. The regions 1 and 2 current system is shown to be the most reproducible feature of the currents, followed by cusp currents associated with magnetic tension forces on newly reconnected field lines. The cusp currents are strongly modulated by season, indicating that their strength is regulated by the ionospheric conductance at the foot of the field lines. PCA does not identify a pattern that is clearly characteristic of a substorm current wedge. Rather, a superposed epoch analysis of the currents associated with substorms demonstrates that there is not a single mode of response, but a complicated and subtle mixture of different patterns.

  14. Theory and experiments on RF plasma heating, current drive and profile control in TORE SUPRA

    Energy Technology Data Exchange (ETDEWEB)

    Moreau, D.

    1994-01-01

    This paper reviews the main experimental and theoretical achievements related to the study of RF heating and non-inductive current drive and particularly phenomena related to the current density profile control and the potentiality of producing stationary enhanced performance regimes: description of the Lower Hybrid (LH) and Ion Cyclotron Resonant Frequency (ICRF) systems; long pulse coupling performance of the RF systems; observation of the transition to the so-called ``stationary LHEP regime`` in which the (flat) central current density and (peaked) electron temperature profiles are fully decoupled; experiments on ICRF sawtooth stabilization with the combined effect of LHCD modifying the current density profile; diffusion of fast electrons generated by LH waves; ramp-up experiments in which the LH power provided a significant part of the resistive poloidal flux and flux consumption scaling; theory of spectral wave diffusion and multipass absorption; fast wave current drive modelling with the Alcyon full wave code; a reflector LH antenna concept. 18 figs., 48 refs.

  15. A TOOL FOR EMOTIONAL USER EXPERIENCE ASSESSMENT OF WEB-BASED MEDICAL SERVICES

    Directory of Open Access Journals (Sweden)

    Alexander Nikov

    2016-09-01

    Full Text Available Emotional User Experience Design (eUXD has become increasingly important for web-based services. The primary objective of this study is to enable users to use websites that are easy to understand and operate and pleasing to use. A checklist tool for an emotional user experience (eUX assessment that supports web-based medical services is proposed. This tool measures user moods while using medical services’ websites. The tool allocates emotive design-oriented problems and thus defines relevant website design recommendations. A case study was performed illustrating the proposed tool on a website offering medical services. Five variants of this website with different design element categories were created. These variants were assessed, analyzed, and proposed for further redesign in applying the tool. The results reveal the variant and website design elements that best influenced eUX. Significant improvement in eUX is expected with implementation of design recommendations of this study. The advantages of the tool are: (1 measuring emotional responses of medical website users, (2 allocating emotive problems, (3 defining of recommendations for eUX design of web-based medical services, and (4 creation of suitable practices for eUX design of web-based medical services.

  16. Understanding Medical Students' Experience with Stress and Its Related Constructs: A Focus Group Study from Singapore.

    Science.gov (United States)

    Farquhar, Julia; Lie, Desiree; Chan, Angelique; Ow, Mandy; Vidyarthi, Arpana

    2017-04-18

    In order to protect medical students from burnout and its untoward psychiatric effects, it is imperative to understand their stress, burnout, coping, and resilience experiences. This study aimed to derive collective definitions from the medical student perspective, to identify common themes of students' experiences, and to distinguish pre-clinical and clinical year students' experiences relating to these four constructs. The authors conducted focus groups of medical students in Singapore across 4 years using a semi-structured question guide. Participants shared their understanding, experiences, and the relationships between stress, burnout, coping, and resilience. Coders independently evaluated construct definitions and derived common themes through an iterative process, and compared transcripts of pre-clinical and clinical year students to determine differences in experience over time. Nine focus groups (54 students, 28 females, mean age 24.3) were conducted. Students identified common definitions for each construct. Nine themes emerged within three domains: (1) relating constructs to personal experience, (2) interrelating stress, burnout, coping, and resilience, and (3) understanding the necessity of stress. Compared to clinical students, pre-clinical students reported theory-based rather than reality-based experiences and exam-induced stress, defined constructs using present rather than future situations, and described constructs as independent rather than interrelated. This sample of medical students in Singapore shares a common understanding of stress, burnout, coping, and resilience, but experiences these uniquely. They perceive a positive role for stress. These findings build upon prior literature, suggesting an interrelationship between stress and its related constructs and adding the novel perspective of students from an Asian country.

  17. Polydispersed Gravity Currents Along a V-Shaped Valley: Experiments and Box Model.

    Science.gov (United States)

    Meriaux, C. A. M. D.; Besson, C. K.

    2014-12-01

    Turbidity currents, which occur at the continental margins and transport sediments along submarines canyons are particulate gravity currents made of poorly sorted particles. In such currents, the flow is to a large extent controlled by the grain size distribution of the particles at the source. Here we present the combined results of a box model and lock-exchange experiments of particulate gravity currents at small volumetric concentrations of particles (Tecnologia (FCT, Portugal) under Project Pest-OE/CTE /LA0019/2013-2014.

  18. MREIT experiments with 200μA injected currents: a feasibility study using two reconstruction algorithms, SMM and Harmonic BZ

    Science.gov (United States)

    Arpinar, V E; Hamamura, M J; Degirmenci, E; Muftuler, L T

    2012-01-01

    Magnetic resonance electrical impedance tomography (MREIT) is a technique that produces images of conductivity in tissues and phantoms. In this technique electrical currents are applied to an object and the resulting magnetic flux density is measured using magnetic resonance imaging (MRI) and the conductivity distribution is reconstructed using these MRI data. Currently the technique is used in research environments, primarily studying phantoms and animals. In order to translate MREIT to clinical applications, strict safety standards need to be established, especially for safe current limits. However, there are currently no standards for safe current limits specific to MREIT. Until such standards are established, human MREIT applications need to conform to existing electrical safety standards in medical instrumentation, such as the IEC601. This protocol limits patient auxiliary currents to 100μA for low frequencies. However, published MREIT studies have utilized currents 10 to 400 times larger than this limit, bringing into question whether the clinical applications of MREIT are attainable under current standards. In this study, we investigated the feasibility of MREIT to accurately reconstruct the relative conductivity of a simple agarose phantom using 200μA total injected current and we tested the performance of two MREIT reconstruction algorithms. These reconstruction algorithms used are the iterative sensitivity matrix method (SMM) by Ider and Birgul in 1998 with Tikhonov regularization and the Harmonic BZ proposed by Oh et al in 2003. The reconstruction techniques were tested at both 200μA and 5mA injected currents to investigate their noise sensitivity at low and high current conditions. It should be noted that 200μA total injected current into a cylindrical phantom generates only 14.7μA current in imaging slice. Similarly, 5mA total injected current results in 367μA in imaging slice. Total acquisition time for 200μA and 5mA experiments were about one

  19. Medication management policy, practice and research in Australian residential aged care: Current and future directions.

    Science.gov (United States)

    Sluggett, Janet K; Ilomäki, Jenni; Seaman, Karla L; Corlis, Megan; Bell, J Simon

    2017-02-01

    Eight percent of Australians aged 65 years and over receive residential aged care each year. Residents are increasingly older, frailer and have complex care needs on entry to residential aged care. Up to 63% of Australian residents of aged care facilities take nine or more medications regularly. Together, these factors place residents at high risk of adverse drug events. This paper reviews medication-related policies, practices and research in Australian residential aged care. Complex processes underpin prescribing, supply and administration of medications in aged care facilities. A broad range of policies and resources are available to assist health professionals, aged care facilities and residents to optimise medication management. These include national guiding principles, a standardised national medication chart, clinical medication reviews and facility accreditation standards. Recent Australian interventions have improved medication use in residential aged care facilities. Generating evidence for prescribing and deprescribing that is specific to residential aged care, health workforce reform, medication-related quality indicators and inter-professional education in aged care are important steps toward optimising medication use in this setting.

  20. Characteristics predicting laparoscopic skill in medical students: nine years' experience in a single center.

    Science.gov (United States)

    Nomura, Tsutomu; Matsutani, Takeshi; Hagiwara, Nobutoshi; Fujita, Itsuo; Nakamura, Yoshiharu; Kanazawa, Yoshikazu; Makino, Hiroshi; Mamada, Yasuhiro; Fujikura, Terumichi; Miyashita, Masao; Uchida, Eiji

    2017-06-21

    We introduced laparoscopic simulator training for medical students in 2007. This study was designed to identify factors that predict the laparoscopic skill of medical students, to identify intergenerational differences in abilities, and to estimate the variability of results in each training group. Our ultimate goal was to determine the optimal educational program for teaching laparoscopic surgery to medical students. Between 2007 and 2015, a total of 270 fifth-year medical students were enrolled in this observational study. Before training, the participants were asked questions about their interest in laparoscopic surgery, experience with playing video games, confidence about driving, and manual dexterity. After the training, aspects of their competence (execution time, instrument path length, and economy of instrument movement) were assessed. Multiple regression analysis identified significant effects of manual dexterity, gender, and confidence about driving on the results of the training. The training results have significantly improved over recent years. The variability among the results in each training group was relatively small. We identified the characteristics of medical students with excellent laparoscopic skills. We observed educational benefits from interactions between medical students within each training group. Our study suggests that selection and grouping are important to the success of modern programs designed to train medical students in laparoscopic surgery.

  1. Experiences and findings of a medical officer on Tristan da Cunha ...

    African Journals Online (AJOL)

    It is now 35 years since the volcanic eruption on Tristan da. Cunha in 1961 prompted Samuels' to report his experiences as medical officer there at the time_ The eruption in 1961 forced the ..... preViously been clinically suspected cases.

  2. Finding Medical Care for Colorectal Cancer Symptoms: Experiences among Those Facing Financial Barriers

    Science.gov (United States)

    Thomson, Maria D.; Siminoff, Laura A.

    2015-01-01

    Financial barriers can substantially delay medical care seeking. Using patient narratives provided by 252 colorectal cancer patients, we explored the experience of financial barriers to care seeking. Of the 252 patients interviewed, 84 identified financial barriers as a significant hurdle to obtaining health care for their colorectal cancer…

  3. Living with 'melanoma' … for a day: a phenomenological analysis of medical students' simulated experiences.

    Science.gov (United States)

    Corr, M; Roulston, G; King, N; Dornan, T; Blease, C; Gormley, G J

    2017-09-01

    Despite the rising incidence of melanoma, medical students have progressively fewer opportunities to encounter patients with this important condition. Curricula tend to attach the greatest value to intellectual forms of learning. However, compared with intellectual learning, experiential learning affords students deep insights about a condition. Doctors who experience ill health are more empathic towards patients. However, opportunities to learn about cancer experientially are limited. Temporary transfer tattoos can simulate the ill health associated with melanoma. We reasoned that if doctors who have been sick are more empathic temporarily 'having' melanoma might have a similar effect. To explore the impact of wearing a melanoma tattoo on medical students' understanding of patienthood and attitudes towards patients with melanoma. Ten fourth-year medical students were recruited to a simulation. They wore a melanoma tattoo for 24 h and listened to a patient's account of receiving their diagnosis. Data were captured using audio diaries and face-to-face interviews, transcribed and analysed phenomenologically using the template analysis method. There were four themes: (i) melanoma simulation: opening up new experiences; (ii) drawing upon past experiences; (iii) a transformative introduction to patienthood; (iv) doctors in the making: seeing cancer patients in a new light. By means of a novel simulation, medical students were introduced to lived experiences of having a melanoma. Such an inexpensive simulation can prompt students to reflect critically on the empathetic care of such patients in the future. © 2017 British Association of Dermatologists.

  4. Dependence of a rabbit's reaction on the frequency of repetition of an impulse and current exposition in experiment

    Directory of Open Access Journals (Sweden)

    Koklin А.Е.

    2013-12-01

    Full Text Available Now electroshock devices are used as a civilian weapon for self-defense and as a non-lethal weapon in the police. Therefore, medical-biological safety testing of electroshock devices should be carried out. Development of hygienic regulations is relevant as well. The aim of our work is the study of the biological effects of pulsed current depending on the pulse frequency, pulse amplitude and exposure. Material and methods. We compared the biological effects with varying frequency of the current pulse (50, 400, and 600 Hz with varying exposure (0.25, 0.5 and 1.0 s.. Average pulse power in all cases was equal, and the pulse energy was different. Experiments were performed on rabbits. Biological effects of stun device were evaluated by clinical lesions, as well as electrophysiological parameters: ECG and electro-pneumogram. Results. Response was observed only in the current period (0.25 s, 0.5 s or 1 s was disorientation, convulsing, dyspnea. The degree of severity of the reaction was determined by a combination of pulse repetition frequency and exposure. Immediately after switching off the current noted vocalization, decreased heart rate and breathing. Heart rate and respiration in 5 minutes back to the normal values. Conclusions. In the results of the research has got a comparative classification organism's response (based on a points system as well as the characteristic of the biological response of the individual systems of the body on the parameters of the current pulse.

  5. Experience of developing and implementing a motivation induction course for konyang university medical college freshmen.

    Science.gov (United States)

    Na, Beag Ju; Lee, Keumho; Kim, Kunil; Song, Daun; Hur, Yera

    2012-06-01

    This study aimed to develop a new course for Konyang University College of Medicine freshmen to motivate them with regard to their vision and medical professionalism and experience various learning methods of medical education. The course was developed by 4 faculty members through several intensive meetings throughout the winter of 2010. A 4-credit course was designed for 61 freshmen of Konyang University College of Medicine to provide structured guidance and an introduction to their medical education and increase their motivation with regard to their studies and school life. The course lasted for 4 weeks (February 28 to March 25), and every session of the program was evaluated by the students. The 'motivation induction course' consisted of the following sessions: university-wide: 'leadership camp' and 'special lectures for future vision;' college-wide: 'major immersion session,' 'Enneagram workshop,' 'STRONG workshop,' 'medical professionalism,' and 'team-based learning.' The group results were presented in a poster and by oral presentation and were awarded prizes for the best performance. Special features included: group discussion session on medical ethics, which used scenarios that were developed by a medical humanity course committee and visiting all departments and mentors of the medical college to fulfill their curiosity of their future major or workplace. Overall, the course was evaluated as satisfactory (M=4.22, SD=0.81). Although there was some dissatisfaction, the overall experience of the "motivation induction course" was a success. The course will continue to be valuable for freshmen in adapting to medical school and its culture and in defining one's view of a good doctor.

  6. How students experience and navigate transitions in undergraduate medical education: an application of Bourdieu's theoretical model.

    Science.gov (United States)

    Balmer, Dorene F; Richards, Boyd F; Varpio, Lara

    2015-10-01

    Using Bourdieu's theoretical model as a lens for analysis, we sought to understand how students experience the undergraduate medical education (UME) milieu, focusing on how they navigate transitions from the preclinical phase, to the major clinical year (MCY), and to the preparation for residency phase. Twenty-two medical students participated in this longitudinal case study. Students had similar preclinical and post-MCY experiences but different MCY experiences (rotational vs. longitudinal tracks). We interviewed students every 6 months in the preclinical phase, mid-way through MCY, and 7-8 months before graduation (101 total interviews). We inductively created codes, iteratively revised codes to best-fit the data, and thematically clustered codes into Bourdieu-informed categories: field (social structures), capital (resources) and habitus (dispositions). We found that students acclimated to shifts in the UME field as they moved through medical school: from medical school itself to the health system and back. To successfully navigate transitions, students learned to secure capital as medical knowledge and social connections in the preclinical and preparation for residency phases, and as reputable patient care and being noticed in the clinical phase. To obtain capital, and be well-positioned for the next phase of training, students consistently relied on dispositions of initiative and flexibility. In summary, students experience the complex context of medical school through a series of transitions. Efforts to improve UME would be well-served by greater awareness of the social structures (field) that students encounter, the resources to which they afford value (capital), and the dispositions which aid acquisition of these resources (habitus).

  7. Medical Advice on Smoking: A Current Need Consejo médico en tabaquismo: una necesidad

    Directory of Open Access Journals (Sweden)

    María Magdalena Caro Mantilla

    2012-07-01

    Full Text Available Tobacco dependence has currently become a health issue. Although it resembles other addictions in many aspects, it meets some specific features that hinder awareness and eradication by the very smoker. Motivating the patient to act in favor of a change in his lifestyle is essential in any medical intervention. In this paper we clarify motivational strategies for a more effective intervention based on knowledge of how people change their behavioral patterns according to their expectations, whether they are sufficiently encouraged and if the professional has the necessary therapeutic tools in the context of health care.La dependencia tabáquica es sin dudas un problema de salud en la actualidad y aunque se asemeja en muchos aspectos al resto de las adicciones, reúne algunas características específicas que dificultan la toma de conciencia y su erradicación por parte del fumador. Motivar al paciente para que actúe a favor de un cambio en su estilo de vida es esencial en cualquier intervención médica. En este trabajo se esclarecen estrategias motivacionales para hacer más efectiva esa intervención a partir del conocimiento de cómo las personas modifican sus patrones comportamentales en función de sus expectativas, si estas son suficientemente incentivadas y el profesional cuenta con las herramientas terapéuticas necesarias en el marco del proceso de atención médica.

  8. Non-medical prescribing by physiotherapists: issues reported in the current evidence.

    Science.gov (United States)

    Morris, Joanne H; Grimmer, Karen

    2014-02-01

    Physiotherapists should be proactive in preparing themselves to participate in innovative models of health care, which are emerging from the healthcare workforce reforms in Australia. One challenging outcome of workforce change is physiotherapy (non-medical) prescribing (NMP), which is part of the extension of scope of physiotherapy practice. This paper summarises the current evidence base for Australian physiotherapists seeking to obtain prescribing rights. A targeted literature review was undertaken through EBSCO Host, Cochrane, Medline, SportsDiscus, Cinahl, Healthsource and Google.com using broad search terms to identify peer-reviewed and grey literature pertaining to NMP by physiotherapists, nationally and internationally. No critical appraisal was undertaken however literature was structured into the NHMRC hierarchy of evidence. Themes raised in the included literature were reported descriptively. There were six relevant peer-reviewed articles, of hierarchy levels III_3 and IV. There was however, comprehensive and recent grey literature to inform Australian physiotherapy NMP initiatives. Themes included the need for standard National action in relation to legislative and regulatory/registration issues, appropriate education, credentialing and supervisory requirements for physiotherapy prescribing. Many lessons can be learnt from the literature, including the importance of planned, uniform National action (rather than piecemeal state-by-state initiatives). Essential elements include appropriate training and skills-based recognition within the discipline and the broader health team, and the need to overtly demonstrate effectiveness and safety. Regularly-evaluated service-delivery models which support NMP by physiotherapists are further required, to demonstrate efficiency, timeliness, patient centredness and equity. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  9. Radiology Physician Extenders: A Literature Review of the History and Current Roles of Physician Extenders in Medical Imaging.

    Science.gov (United States)

    Sanders, Vicki L; Flanagan, Jennifer

    2015-01-01

    The purpose of the literature review was to assess the origins of radiology physician extenders and examine the current roles found in the literature of advanced practice physician extenders within medical imaging. Twenty-six articles relating to physician assistants (PAs), nurse practitioners (NPs), radiologist assistants (RAs), and nuclear medicine advanced associates (NMAAs) were reviewed to discern similarities and differences in history, scope of practice, and roles in the medical imaging field. The literature showed PAs and NPs are working mostly in interventional radiology. PAs, NPs, and RAs perform similar tasks in radiology, including history and physicals, evaluation and management, preprocedure work-up, obtaining informed consent, initial observations/reports, and post-procedure follow-up. NPs and PAs perform a variety of procedures but most commonly vascular access, paracentesis, and thoracentesis. RAs perform gastrointestinal, genitourinary, nonvascular invasive fluoroscopy procedures, and vascular access procedures. The review revealed NMAAs are working in an advanced role, but no specific performances of procedures was found in the literature, only suggested tasks and clinical competencies. PAs, NPs, and RAs are currently the three main midlevel providers used in medical imaging. These midlevel providers are being used in a variety of ways to increase the efficiency of the radiologist and provide diagnostic and therapeutic radiologic procedures to patients. NMAAs are being used in medical imaging but little literature is available on current roles in clinical practice. More research is needed to assess the exact procedures and duties being performed by these medical imaging physician extenders.

  10. Women in medical education: views and experiences from the Kingdom of Saudi Arabia.

    Science.gov (United States)

    Alwazzan, Lulu; Rees, Charlotte E

    2016-08-01

    Although research from Western contexts suggests that considerable inequalities for female medical educators exist in the workplace, we do not yet know the views and experiences of women within non-Western contexts. By examining the influence of context, intersecting identities and language use, this study explores female medical educators' views and experiences of gender, career progression and leadership in academic medicine in the Kingdom of Saudi Arabia (KSA). We conducted individual interviews employing narrative interviewing techniques with 25 female medical educators from five schools in the KSA (June to December 2014). Data were analysed using framework analysis and drew on intersectionality theory. Participants expressed their views and experiences of career progression, leadership and gendered workplace cultures. Women's experiences of career progression and leadership in the KSA were influenced by their gender and varied according to their career stage, work environment and specialty. Participants discussed the gendered organisational cultures of academic medicine in the KSA in terms of gender inequalities (e.g. females being overlooked for leadership positions), gender stereotypes (e.g. women perceived as more likely to take part in shared leadership) and gendered specialties (e.g. surgery being male dominated). We revealed women's more tacit understandings about gender, career progression and leadership by examining how they talk (e.g. metaphoric, pronominal and emotional talk). Finally, participants constructed multiple intersecting personal (e.g. female, mother and young) and professional identities (e.g. doctor, teacher and leader) for themselves through their narratives. This study provides important new insights into female medical educators' experiences of career progression and leadership in a non-Western context. Investment in the future of women's careers in the KSA through faculty development initiatives and equality and diversity policies is

  11. Towards interprofessional networking in medication management of the aged: current challenges and potential solutions in Finland.

    Science.gov (United States)

    Kallio, Sonja; Kumpusalo-Vauhkonen, Anne; Järvensivu, Timo; Mäntylä, Antti; Pohjanoksa-Mäntylä, Marika; Airaksinen, Marja

    2016-12-01

    The Finnish Medicines Agency (Fimea) initiated a programme in 2012 for enhancing interprofessional networking in the medication management of the aged. The goal is to develop national guidelines for interprofessional collaboration with respect to medication management. This study aims to explore the challenges and potential solutions experienced by existing health care teams in managing medication of the aged: (1) at the individual and team level (micro level), (2) organisational level (meso level) and (3) structural level (macro level). Group discussions (n = 10), pair (n = 3) and individual interviews (n = 2). Abductive content analysis combining data and theory was applied. Networking was used as a theoretical framework. Meetings (n = 15) organised by Fimea in the formation phase of the interprofessional network in 2012. Health care professionals (n = 55). Challenges and solutions in the medication management of the aged at the micro, meso and macro levels. Challenges in interprofessional collaboration, problems with patient record systems, and the organisation of work and lack of resources were present at all the levels contributing to patients' medication problems. Participants suggested multiple potential solutions to improve interprofessional collaboration, sharing of tasks and responsibilities, better exploitation of pharmaceutical knowledge and developing tools as being the most commonly mentioned. Optimising medication use of the aged requires new systemic solutions within and between different system levels. The main challenges can be solved by clarifying responsibilities, enhancing communication and applying operational models that involve pharmacists and the use of information technology in medication management. KEY POINTS An interprofessional team approach has been suggested as a solution to promote rational medicine use among the aged. Fragmented health care system and lack of coordinated patient care are reasons for medication

  12. The effects of dissection-room experiences and related coping strategies among Hungarian medical students.

    Science.gov (United States)

    Sándor, Imola; Birkás, Emma; Győrffy, Zsuzsa

    2015-04-11

    Students get their first experiences of dissecting human cadavers in the practical classes of anatomy and pathology courses, core components of medical education. These experiences form an important part of the process of becoming a doctor, but bring with them a special set of problems. Quantitative, national survey (n = 733) among medical students, measured reactions to dissection experiences and used a new measuring instrument to determine the possible factors of coping. Fifty per cent of students stated that the dissection experience does not affect them. Negative effects were significantly more frequently reported by women and students in clinical training (years 3,4,5,6). The predominant factor in the various coping strategies for dissection practicals is cognitive coping (rationalisation, intellectualisation). Physical and emotional coping strategies followed, with similar mean scores. Marked gender differences also showed up in the application of coping strategies: there was a clear dominance of emotional-based coping among women. Among female students, there was a characteristic decrease in the physical repulsion factor in reactions to dissection in the later stages of study. The experience of dissection had an emotional impact on about half of the students. In general, students considered these experiences to be an important part of becoming a doctor. Our study found that students chiefly employed cognitive coping strategies to deal with their experiences. Dissection-room sessions are important for learning emotional as well as technical skills. Successful coping is achieved not by repressing emotions but by accepting and understanding the negative emotions caused by the experience and developing effective strategies to deal with them. Medical training could make better use of the learning potential of these experiences.

  13. Time-dependent ROC curve analysis in medical research: current methods and applications.

    Science.gov (United States)

    Kamarudin, Adina Najwa; Cox, Trevor; Kolamunnage-Dona, Ruwanthi

    2017-04-07

    ROC (receiver operating characteristic) curve analysis is well established for assessing how well a marker is capable of discriminating between individuals who experience disease onset and individuals who do not. The classical (standard) approach of ROC curve analysis considers event (disease) status and marker value for an individual as fixed over time, however in practice, both the disease status and marker value change over time. Individuals who are disease-free earlier may develop the disease later due to longer study follow-up, and also their marker value may change from baseline during follow-up. Thus, an ROC curve as a function of time is more appropriate. However, many researchers still use the standard ROC curve approach to determine the marker capability ignoring the time dependency of the disease status or the marker. We comprehensively review currently proposed methodologies of time-dependent ROC curves which use single or longitudinal marker measurements, aiming to provide clarity in each methodology, identify software tools to carry out such analysis in practice and illustrate several applications of the methodology. We have also extended some methods to incorporate a longitudinal marker and illustrated the methodologies using a sequential dataset from the Mayo Clinic trial in primary biliary cirrhosis (PBC) of the liver. From our methodological review, we have identified 18 estimation methods of time-dependent ROC curve analyses for censored event times and three other methods can only deal with non-censored event times. Despite the considerable numbers of estimation methods, applications of the methodology in clinical studies are still lacking. The value of time-dependent ROC curve methods has been re-established. We have illustrated the methods in practice using currently available software and made some recommendations for future research.

  14. Trajectories of Antidepressant Medication before and after the Onset of Unemployment by Subsequent Employment Experience.

    Science.gov (United States)

    Leinonen, Taina; Mäki, Netta; Martikainen, Pekka

    2017-01-01

    The unemployed more often suffer from depression than the employed. We examined whether mental health deterioration occurs already before unemployment implicating health selection, or whether it mostly occurs after becoming exposed to the experience rendering causal explanations more likely. We used nationally representative Finnish register data to examine changes in depressive morbidity as measured by antidepressant medication in 1995-2009 over four years before and since a new onset of unemployment (N = 28 000) at the age of 30-60 compared to the employed (N = 124 136). We examined separately those who became continuously long-term unemployed, intermittently unemployed and unemployed with eventual re-employment in the second, third or fourth year since the year of onset. Annual repeated measurements were analysed using generalised estimation equations. Among the employed antidepressant medication increased slowly but steadily over the study period and it was mainly at a lower level than among the unemployed. In the four years leading to unemployment there was excess increase in medication that was generally stronger among those with longer duration of the eventual unemployment experience. During unemployment medication decreased in all groups except among the intermittently unemployed. By the first year of re-employment antidepressant medication reached a level similar to that among the employed and afterwards followed no consistent trend. The associations of unemployment and re-employment with depressive morbidity appear to be largely driven by health selection. The question of potential causal associations remains unresolved for intermittent unemployment in particular.

  15. [Current situations and problems of quality control for medical imaging display systems].

    Science.gov (United States)

    Shibutani, Takayuki; Setojima, Tsuyoshi; Ueda, Katsumi; Takada, Katsumi; Okuno, Teiichi; Onoguchi, Masahisa; Nakajima, Tadashi; Fujisawa, Ichiro

    2015-04-01

    Diagnostic imaging has been shifted rapidly from film to monitor diagnostic. Consequently, Japan medical imaging and radiological systems industries association (JIRA) have recommended methods of quality control (QC) for medical imaging display systems. However, in spite of its need by majority of people, executing rate is low. The purpose of this study was to validate the problem including check items about QC for medical imaging display systems. We performed acceptance test of medical imaging display monitors based on Japanese engineering standards of radiological apparatus (JESRA) X-0093*A-2005 to 2009, and performed constancy test based on JESRA X-0093*A-2010 from 2010 to 2012. Furthermore, we investigated the cause of trouble and repaired number. Medical imaging display monitors had 23 inappropriate monitors about visual estimation, and all these monitors were not criteria of JESRA about luminance uniformity. Max luminance was significantly lower year-by-year about measurement estimation, and the 29 monitors did not meet the criteria of JESRA about luminance deviation. Repaired number of medical imaging display monitors had 25, and the cause was failure liquid crystal panel. We suggested the problems about medical imaging display systems.

  16. Reprioritizing current research trends in medical education: a reflection on research activities in Saudi Arabia.

    Science.gov (United States)

    Obeidat, Akef S; Alhaqwi, Ali Ibrahim; Abdulghani, Hamza Mohammad

    2015-04-01

    There are numerous national efforts to determine and develop research priorities of medical education in Saudi Arabia. These priorities were first proposed in 2010 by "Dr Al-Khuli's Chair for Developing Medical Education in Saudi Arabia". The proposed priority domains were: curriculum, students, faculty, and quality assurance and accreditation. To investigate publications in medical education at the national and international levels in areas relating to these proposed priorities. Electronic search within PubMed database for papers relating to each domain of priority was conducted at national and international levels in the last three years, using the same keywords as the priority domains, but only confined to undergraduate medical education. Out of 3145 articles retrieved when searching with keyword as broad as "undergraduate medical curriculum" only 81 articles worldwide and 3 articles from Saudi Arabia were dealing with curriculum related issues as a whole. Further search on the sub-domains "effective strategies to manage undergraduate curriculum" and "undergraduate medical education models", resulted in the retrieval of few articles worldwide and none from Saudi Arabia. At the national level, there were 63 publications from Saudi Arabia that were either course (topic)-specific or could not be classified under the four domains specified by Dr Al-Khuli's Chair. Research activities in medical education in Saudi Arabia in the last 3 years showed diversity and lack of focus in the research priorities. Efforts of academic and research centers should continue to monitor and encourage these activities toward achieving the recommended priorities.

  17. What students really learn: contrasting medical and nursing students' experiences of the clinical learning environment.

    Science.gov (United States)

    Liljedahl, Matilda; Boman, Lena Engqvist; Fält, Charlotte Porthén; Bolander Laksov, Klara

    2015-08-01

    This paper explores and contrasts undergraduate medical and nursing students' experiences of the clinical learning environment. Using a sociocultural perspective of learning and an interpretative approach, 15 in-depth interviews with medical and nursing students were analysed with content analysis. Students' experiences are described using a framework of 'before', 'during' and 'after' clinical placements. Three major themes emerged from the analysis, contrasting the medical and nursing students' experiences of the clinical learning environment: (1) expectations of the placement; (2) relationship with the supervisor; and (3) focus of learning. The findings offer an increased understanding of how medical and nursing students learn in the clinical setting; they also show that the clinical learning environment contributes to the socialisation process of students not only into their future profession, but also into their role as learners. Differences between the two professions should be taken into consideration when designing interprofessional learning activities. Also, the findings can be used as a tool for clinical supervisors in the reflection on how student learning in the clinical learning environment can be improved.

  18. Leadership and followership in the healthcare workplace: exploring medical trainees’ experiences through narrative inquiry

    Science.gov (United States)

    Gordon, Lisi J; Rees, Charlotte E; Ker, Jean S; Cleland, Jennifer

    2015-01-01

    Objectives To explore medical trainees’ experiences of leadership and followership in the interprofessional healthcare workplace. Design A qualitative approach using narrative interviewing techniques in 11 group and 19 individual interviews with UK medical trainees. Setting Multisite study across four UK health boards. Participants Through maximum variation sampling, 65 medical trainees were recruited from a range of specialties and at various stages of training. Participants shared stories about their experiences of leadership and followership in the healthcare workplace. Methods Data were analysed using thematic and narrative analysis. Results We identified 171 personal incident narratives about leadership and followership. Participants most often narrated experiences from the position of follower. Their narratives illustrated many factors that facilitate or inhibit developing leadership identities; that traditional medical and interprofessional hierarchies persist within the healthcare workplace; and that wider healthcare systems can act as barriers to distributed leadership practices. Conclusions This paper provides new understandings of the multiple ways in which leadership and followership is experienced in the healthcare workplace and sets out recommendations for future leadership educational practices and research. PMID:26628525

  19. Oral Health Education for Medical Students: Malaysian and Australian Students' Perceptions of Educational Experience and Needs.

    Science.gov (United States)

    Ahmad, Mas S; Abuzar, Menaka A; Razak, Ishak A; Rahman, Sabariah A; Borromeo, Gelsomina L

    2017-09-01

    Education in oral health is important to prepare future medical professionals for collaborative roles in maintaining patients' oral health, an important component of general health and well-being. The aims of this study were to determine the perceptions of medical students in Malaysia and Australia of the quality of their training in oral health care and their perceptions of their professional role in maintaining the oral health of their patients. A survey was administered in the classroom with final-year Malaysian (n=527; response rate=79.3%) and Australian (n=455; response rate: 60%) medical students at selected institutions in those countries. In the results, most of these medical students reported encountering patients with oral health conditions including ulcers, halitosis, and edentulism. A majority in both countries reported believing they should advise patients to obtain regular dental check-ups and eat a healthy diet, although they reported feeling less than comfortable in managing emergency dental cases. A high percentage reported they received a good education in smoking cessation but not in managing dental trauma, detecting cancerous lesions, or providing dietary advice in oral disease prevention. They expressed support for inclusion of oral health education in medical curricula. These students' experience with and perceptions of oral health care provide valuable information for medical curriculum development in these two countries as well as increasing understanding of this aspect of interprofessional education and practice now in development around the world.

  20. RADIATION ACCIDENTS: EXPERIENCE OF MEDICAL PROTECTION AND MODERN STRATEGY OF PHARMACOLOGICAL MAINTENANCE

    Directory of Open Access Journals (Sweden)

    A. N. Grebenyuk

    2012-01-01

    Full Text Available Experience of medical protection at radiation accidents is analyzed. It is shown, that medicines that have been in the arsenal of medical service during the liquidation of consequences of the Chernobyl nuclear power plant accident satisfied their predestination in a whole and were rather effective for radiation protection. The modern strategy of pharmacological maintenance based on use of means and methods, allowing to keeping a life, health and professional serviceability of people in conditions of amazing action of a complex of factors of radiation accidents, is submitted.

  1. Experiences of sickness absence, marginality and Medically Unexplained Physical Symptoms - A focus group study

    DEFF Research Database (Denmark)

    E.L., Werner; A, Aamland; Malterud, Kirsti

    2013-01-01

    with a purposive sample of 12 participants, six men and six women, aged 24-59 years. Their average duration of sickness absence was 10.5 months. Participants were invited to share stories about experiences from the process leading to the ongoing sickness absence, with a focus on the causes being medically......PURPOSE: Medically unexplained physical symptoms (MUPS) form a major cause of sickness absence. The purpose of this study was to explore factors which may influence further marginalization among patients with MUPS on long-term sickness absence. METHODS: Two focus-group discussions were conducted...

  2. SYMBIOmatics: Synergies in Medical Informatics and Bioinformatics - Exploring current scientific literature for emerging topics

    NARCIS (Netherlands)

    D. Rebholz-Schuhman (Dietrich); G. Cameron (Graham); D. Clark (Dominic); E.M. van Mulligen (Erik); J.-L. Coatrieux; E. del Hoyo Barbolla (Eva); F. Martin-Sanchez (Fernando); L. Milanesi (Luciano); I. Porro (Ivan); F. Beltrame (Francesco); I. Tollis (Ioannis); J. van der Lei (Johan)

    2007-01-01

    textabstractBackground: The SYMBIOmatics Specific Support Action (SSA) is "an information gathering and dissemination activity" that seeks "to identify synergies between the bioinformatics and the medical informatics" domain to improve collaborative progress between both domains (ref. to

  3. The charged current neutrino cross section for solar neutrinos, and background to \\BBz\\ experiments

    CERN Document Server

    Ejiri, H

    2013-01-01

    Solar neutrinos can interact with the source isotope in neutrinoless double beta decay experiments through charged current and neutral current interactions. The charged-current product nucleus will then beta decay with a Q-value larger than the double beta decay Q-value. As a result, this process can populate the region of interest and be a background to the double beta decay signal. In this paper we estimate the solar neutrino capture rates on three commonly used double beta decay isotopes, \

  4. Wave Scattering by Double Slotted Barriers in A Steady Current: Experiments

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    The adoption of slotted breakwaters can be an ideal option in the protection of very large near-shore floating structures that may extend offshore to a considerable water depth. In this paper, we experimently investigated the behaviour of wave transmission and reflection coefficients of double slotted barriers in the presence of a steady opposing current. The experimental results show that opposing currents have only minor effects on wave reflection, but can significantly reduce the wave transmission through double slotted barriers. The experimental results suggest that coastal currents should be taken into consideration for an economical design of slotted breakwaters.

  5. Types and severity of medication errors in Iran; a review of the current literature.

    Science.gov (United States)

    Mansouri, Ava; Ahmadvand, Alireza; Hadjibabaie, Molouk; Kargar, Mona; Javadi, Mohammadreza; Gholami, Kheirollah

    2013-06-20

    Medication error (ME) is the most common single preventable cause of adverse drug events which negatively affects patient safety. ME prevalence is a valuable safety indicator in healthcare system. Inadequate studies on ME, shortage of high-quality studies and wide variations in estimations from developing countries including Iran, decreases the reliability of ME evaluations. In order to clarify the status of MEs, we aimed to review current available literature on this subject from Iran. We searched Scopus, Web of Science, PubMed, CINAHL, EBSCOHOST and also Persian databases (IranMedex, and SID) up to October 2012 to find studies on adults and children about prescription, transcription, dispensing, and administration errors. Two authors independently selected and one of them reviewed and extracted data for types, definitions and severity of MEs. The results were classified based on different stages of drug delivery process. Eighteen articles (11 Persian and 7 English) were included in our review. All study designs were cross-sectional and conducted in hospital settings. Nursing staff and students were the most frequent populations under observation (12 studies; 66.7%). Most of studies did not report the overall frequency of MEs aside from ME types. Most of studies (15; 83.3%) reported prevalence of administration errors between 14.3%-70.0%. Prescribing error prevalence ranged from 29.8%-47.8%. The prevalence of dispensing and transcribing errors were from 11.3%-33.6% and 10.0%-51.8% respectively. We did not find any follow up or repeated studies. Only three studies reported findings on severity of MEs. The most reported types of and the highest percentages for any type of ME in Iran were administration errors. Studying ME in Iran is a new area considering the duration and number of publications. Wide ranges of estimations for MEs in different stages may be because of the poor quality of studies with diversity in definitions, methods, and populations. For gaining

  6. Types and Severity of Medication Errors in Iran; a Review of the Current Literature

    Directory of Open Access Journals (Sweden)

    Ava Mansouri

    2013-06-01

    Full Text Available Medication error (ME is the most common single preventable cause of adverse drug events which negatively affects patient safety. ME prevalence is a valuable safety indicator in healthcare system. Inadequate studies on ME, shortage of high-quality studies and wide variations in estimations from developing countries including Iran, decreases the reliability of ME evaluations. In order to clarify the status of MEs, we aimed to review current available literature on this subject from Iran. We searched Scopus, Web of Science, PubMed, CINAHL, EBSCOHOST and also Persian databases (IranMedex, and SID up to October 2012 to find studies on adults and children about prescription, transcription, dispensing, and administration errors. Two authors independently selected and one of them reviewed and extracted data for types, definitions and severity of MEs. The results were classified based on different stages of drug delivery process. Eighteen articles (11 Persian and 7 English were included in our review. All study designs were cross-sectional and conducted in hospital settings. Nursing staff and students were the most frequent populations under observation (12 studies; 66.7%. Most of studies did not report the overall frequency of MEs aside from ME types. Most of studies (15; 83.3% reported prevalence of administration errors between 14.3%-70.0%. Prescribing error prevalence ranged from 29.8%-47.8%. The prevalence of dispensing and transcribing errors were from 11.3%-33.6% and 10.0%-51.8% respectively. We did not find any follow up or repeated studies. Only three studies reported findings on severity of MEs. The most reported types of and the highest percentages for any type of ME in Iran were administration errors. Studying ME in Iran is a new area considering the duration and number of publications. Wide ranges of estimations for MEs in different stages may be because of the poor quality of studies with diversity in definitions, methods, and populations

  7. Current approaches to treatments for schizophrenia spectrum disorders, part I: an overview and medical treatments

    Directory of Open Access Journals (Sweden)

    Chien WT

    2013-09-01

    Full Text Available Wai Tong Chien, Annie LK Yip School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong Abstract: During the last three decades, an increasing understanding of the etiology, psychopathology, and clinical manifestations of schizophrenia spectrum disorders, in addition to the introduction of second-generation antipsychotics, has optimized the potential for recovery from the illness. Continued development of various models of psychosocial intervention promotes the goal of schizophrenia treatment from one of symptom control and social adaptation to an optimal restoration of functioning and/or recovery. However, it is still questionable whether these new treatment approaches can address the patients' needs for treatment and services and contribute to better patient outcomes. This article provides an overview of different treatment approaches currently used in schizophrenia spectrum disorders to address complex health problems and a wide range of abnormalities and impairments resulting from the illness. There are different treatment strategies and targets for patients at different stages of the illness, ranging from prophylactic antipsychotics and cognitive–behavioral therapy in the premorbid stage to various psychosocial interventions in addition to antipsychotics for relapse prevention and rehabilitation in the later stages of the illness. The use of antipsychotics alone as the main treatment modality may be limited not only in being unable to tackle the frequently occurring negative symptoms and cognitive impairments but also in producing a wide variety of adverse effects to the body or organ functioning. Because of varied pharmacokinetics and treatment responsiveness across agents, the medication regimen should be determined on an individual basis to ensure an optimal effect in its long-term use. This review also highlights that the recent practice guidelines and standards have

  8. Current status of obstetrics and gynecology resident medical-legal education: a survey of program directors.

    Science.gov (United States)

    Moreno-Hunt, Carey; Gilbert, William M

    2005-12-01

    To assess the level and type of medical-legal education offered to obstetrics and gynecology residents and medical students. All obstetrics and gynecology program directors (n = 252) were asked to complete a survey questioning the availability of, type of, and desire for medical-legal education within their programs. Seventy-eight percent of the program directors answered the survey with 86% reporting some degree of formal medical-legal education. The most common formats were didactic lectures (38%), grand rounds (30%), case conferences (19%), mock trials (9%), and other (4%). These sessions most commonly contained information on proper documentation (48%), testifying (25%), and giving a deposition (24%). The average number of sessions per year was 4.1 with a median of 3 sessions per year. Despite this high percentage of some formal education, 88% expressed an interest in pursuing other educational options on these topics. Most obstetrics and gynecology residency programs provide some form of medical-legal instruction to residents, but the small number of sessions suggests that this is inadequate. Residency programs may benefit from a larger and more formal resident education program on medical-legal issues.

  9. VISAR Unfold Analysis of Load Current in MagLIF Experiments

    Science.gov (United States)

    Hess, Mark; McBride, Ryan; Martin, Matthew

    2013-10-01

    An accurate prediction of the load current is essential in the performance of MagLIF experiments on the Z-Machine at Sandia. At present, the most accurate diagnostic for measuring load current on the Z-machine is the well-established VISAR technique. The VISAR diagnostic measures the velocity of a thin aluminum foil placed near the load, which is subject to the magnetic pressure produced by the load current, using a laser interferometer. The load current unfold analysis is highly nonlinear due to the equation of state/conductivity models, along with the MHD equations governing the foil. Nevertheless, an accurate load current unfold from the VISAR measurement is possible using an MHD code, in conjunction with an optimization algorithm. We will review the VISAR unfold analysis, and show recent current unfolds of MagLIF experiments in comparison to load current measurements using B-dot probes. Sandia National Laboratories is a multi-program laboratory managed and operated by Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-AC04-94AL85000.

  10. Prehospital electronic patient care report systems: early experiences from emergency medical services agency leaders.

    Directory of Open Access Journals (Sweden)

    Adam B Landman

    Full Text Available BACKGROUND: As the United States embraces electronic health records (EHRs, improved emergency medical services (EMS information systems are also a priority; however, little is known about the experiences of EMS agencies as they adopt and implement electronic patient care report (e-PCR systems. We sought to characterize motivations for adoption of e-PCR systems, challenges associated with adoption and implementation, and emerging implementation strategies. METHODS: We conducted a qualitative study using semi-structured in-depth interviews with EMS agency leaders. Participants were recruited through a web-based survey of National Association of EMS Physicians (NAEMSP members, a didactic session at the 2010 NAEMSP Annual Meeting, and snowball sampling. Interviews lasted approximately 30 minutes, were recorded and professionally transcribed. Analysis was conducted by a five-person team, employing the constant comparative method to identify recurrent themes. RESULTS: Twenty-three interviewees represented 20 EMS agencies from the United States and Canada; 14 EMS agencies were currently using e-PCR systems. The primary reason for adoption was the potential for e-PCR systems to support quality assurance efforts. Challenges to e-PCR system adoption included those common to any health information technology project, as well as challenges unique to the prehospital setting, including: fear of increased ambulance run times leading to decreased ambulance availability, difficulty integrating with existing hospital information systems, and unfunded mandates requiring adoption of e-PCR systems. Three recurring strategies emerged to improve e-PCR system adoption and implementation: 1 identify creative funding sources; 2 leverage regional health information organizations; and 3 build internal information technology capacity. CONCLUSION: EMS agencies are highly motivated to adopt e-PCR systems to support quality assurance efforts; however, adoption and

  11. Harmonic Analysis of Currents and Voltages Obtained in the Result of Computational Experiment

    Directory of Open Access Journals (Sweden)

    I. V. Novash

    2011-01-01

    Full Text Available The paper considers a methodology for execution of a harmonic analysis of current and voltage numerical values obtained in the result of a computational experiment and saved in an external data file. The harmonic analysis has been carried out in the Mathcad mathematical packet environment.

  12. Social media as an open-learning resource in medical education: current perspectives.

    Science.gov (United States)

    Sutherland, S; Jalali, A

    2017-01-01

    Numerous studies evaluate the use of social media as an open-learning resource in education, but there is a little published knowledge of empirical evidence that such open-learning resources produce educative outcomes, particularly with regard to student performance. This study undertook a systematic review of the published literature in medical education to determine the state of the evidence as to empirical studies that conduct an evaluation or research regarding social media and open-learning resources. The authors searched MEDLINE, ERIC, Embase, PubMed, Scopus, and Google Scholar from 2012 to 2017. This search included using keywords related to social media, medical education, research, and evaluation, while restricting the search to peer reviewed, English language articles only. To meet inclusion criteria, manuscripts had to employ evaluative methods and undertake empirical research. Empirical work designed to evaluate the impact of social media as an open-learning resource in medical education is limited as only 13 studies met inclusion criteria. The majority of these studies used undergraduate medical education as the backdrop to investigate open-learning resources, such as Facebook, Twitter, and YouTube. YouTube appears to have little educational value due to the unsupervised nature of content added on a daily basis. Overall, extant reviews have demonstrated that we know a considerable amount about social media use, although to date, its impacts remain unclear. There is a paucity of outcome-based, empirical studies assessing the impact of social media in medical education. The few empirical studies identified tend to focus on evaluating the affective outcomes of social media and medical education as opposed to understanding any linkages between social media and performance outcomes. Given the potential for social media use in medical education, more empirical evaluative studies are required to determine educational value.

  13. What is known about the patient's experience of medical tourism? A scoping review

    Directory of Open Access Journals (Sweden)

    Crooks Valorie A

    2010-09-01

    Full Text Available Abstract Background Medical tourism is understood as travel abroad with the intention of obtaining non-emergency medical services. This practice is the subject of increasing interest, but little is known about its scope. Methods A comprehensive scoping review of published academic articles, media sources, and grey literature reports was performed to answer the question: what is known about the patient's experience of medical tourism? The review was accomplished in three steps: (1 identifying the question and relevant literature; (2 selecting the literature; (3 charting, collating, and summarizing the information. Overall themes were identified from this process. Results 291 sources were identified for review from the databases searched, the majority of which were media pieces (n = 176. A further 57 sources were included for review after hand searching reference lists. Of the 348 sources that were gathered, 216 were ultimately included in this scoping review. Only a small minority of sources reported on empirical studies that involved the collection of primary data (n = 5. The four themes identified via the review were: (1 decision-making (e.g., push and pull factors that operate to shape patients' decisions; (2 motivations (e.g., procedure-, cost-, and travel-based factors motivating patients to seek care abroad; (3 risks (e.g., health and travel risks; and (4 first-hand accounts (e.g., patients' experiential accounts of having gone abroad for medical care. These themes represent the most discussed issues about the patient's experience of medical tourism in the English-language academic, media, and grey literatures. Conclusions This review demonstrates the need for additional research on numerous issues, including: (1 understanding how multiple information sources are consulted and evaluated by patients before deciding upon medical tourism; (2 examining how patients understand the risks of care abroad; (3 gathering patients' prospective and

  14. Latin American women’s experiences with medical abortion in settings where abortion is legally restricted

    Directory of Open Access Journals (Sweden)

    Zamberlin Nina

    2012-12-01

    Full Text Available Abstract Abortion is legally restricted in most of Latin America where 95% of the 4.4 million abortions performed annually are unsafe. Medical abortion (MA refers to the use of a drug or a combination of drugs to terminate pregnancy. Mifepristone followed by misoprostol is the most effective and recommended regime. In settings where mifepristone is not available, misoprostol alone is used. Medical abortion has radically changed abortion practices worldwide, and particularly in legally restricted contexts. In Latin America women have been using misoprostol for self-induced home abortions for over two decades. This article summarizes the findings of a literature review on women’s experiences with medical abortion in Latin American countries where voluntary abortion is illegal. Women’s personal experiences with medical abortion are diverse and vary according to context, age, reproductive history, social and educational level, knowledge about medical abortion, and the physical, emotional, and social circumstances linked to the pregnancy. But most importantly, experiences are determined by whether or not women have the chance to access: 1 a medically supervised abortion in a clandestine clinic or 2 complete and accurate information on medical abortion. Other key factors are access to economic resources and emotional support. Women value the safety and effectiveness of MA as well as the privacy that it allows and the possibility of having their partner, a friend or a person of their choice nearby during the process. Women perceive MA as less painful, easier, safer, more practical, less expensive, more natural and less traumatic than other abortion methods. The fact that it is self-induced and that it avoids surgery are also pointed out as advantages. Main disadvantages identified by women are that MA is painful and takes time to complete. Other negatively evaluated aspects have to do with side effects, prolonged bleeding, the possibility that it

  15. What is known about the patient's experience of medical tourism? A scoping review.

    Science.gov (United States)

    Crooks, Valorie A; Kingsbury, Paul; Snyder, Jeremy; Johnston, Rory

    2010-09-08

    Medical tourism is understood as travel abroad with the intention of obtaining non-emergency medical services. This practice is the subject of increasing interest, but little is known about its scope. A comprehensive scoping review of published academic articles, media sources, and grey literature reports was performed to answer the question: what is known about the patient's experience of medical tourism? The review was accomplished in three steps: (1) identifying the question and relevant literature; (2) selecting the literature; (3) charting, collating, and summarizing the information. Overall themes were identified from this process. 291 sources were identified for review from the databases searched, the majority of which were media pieces (n = 176). A further 57 sources were included for review after hand searching reference lists. Of the 348 sources that were gathered, 216 were ultimately included in this scoping review. Only a small minority of sources reported on empirical studies that involved the collection of primary data (n = 5). The four themes identified via the review were: (1) decision-making (e.g., push and pull factors that operate to shape patients' decisions); (2) motivations (e.g., procedure-, cost-, and travel-based factors motivating patients to seek care abroad); (3) risks (e.g., health and travel risks); and (4) first-hand accounts (e.g., patients' experiential accounts of having gone abroad for medical care). These themes represent the most discussed issues about the patient's experience of medical tourism in the English-language academic, media, and grey literatures. This review demonstrates the need for additional research on numerous issues, including: (1) understanding how multiple information sources are consulted and evaluated by patients before deciding upon medical tourism; (2) examining how patients understand the risks of care abroad; (3) gathering patients' prospective and retrospective accounts; and (4) the push and pull

  16. Gender differences and similarities in medical students' experiences of mistreatment by various groups of perpetrators.

    Science.gov (United States)

    Siller, Heidi; Tauber, Gloria; Komlenac, Nikola; Hochleitner, Margarethe

    2017-08-14

    Mistreatment of medical students during medical education is a widespread concern. Studies have shown that medical students report the most mistreatment compared to students of other study programs and that the prevalence of mistreatment peaks during clinical training. For this reason, a study was conducted to assess prevalence of mistreatment among medical students committed by various groups of people. The focus was to identify whether gender was associated with the experience of mistreatment. Additionally, students' perception of university climate for reporting sexual harassment was assessed. In the study 88 medical students (45 women, 43 men) participated. A modified version of the Questionnaire on Student Abuse was used to assess students' experience of various types of mistreatment and associated distress during medical education. To explore factors that could be associated with this experience the organizational climate for reporting sexual harassment was assessed with the Psychological Climate for Sexual Harassment. The most often cited perpetrators of mistreatment were strangers (79.5%), friends (75.0%) and university staff (68.2%). Strangers mostly committed psychological mistreatment and sexual harassment, whereas friends additionally engaged in physical mistreatment of medical students. The most common form of mistreatment conducted by university staff was humiliation of students. These kinds of psychological mistreatment were reported to be distressing (43%). Gender differences were found in the prevalence of mistreatment. Women experienced more sexual harassment and humiliation than did men. On the other hand, men experienced more physical mistreatment than did women. Women reported experiencing more distress from mistreatment experiences than did men and also more often reported being mistreated by university staff than did men. Women perceived a greater risk in reporting sexual harassment to the organization than did men. Mistreatment of female and

  17. Relationship between health promotion volunteer experience and medical costs: Hoken-hodouin activities in Suzaka, Nagano.

    Science.gov (United States)

    Imamura, Haruhiko; Murakami, Yoshitaka; Okamura, Tomonori; Nishiwaki, Yuji

    2017-01-01

    Objectives This study demonstrated the relationship between experience as a health promotion volunteer (Hoken-hodouin) and medical costs in Japan. The study area was Suzaka City (March 2016 population: 51,637) in Nagano Prefecture, Japan, where a total of about 300 women have been engaged and trained as health promotion volunteers since 1958.Methods A cross-sectional survey was conducted in 2014 using a self-administered questionnaire, which included items on experiences as a health promotion volunteer, age at engagement, leadership status, and satisfaction with the experience. Eligible study participants were all residents of Suzaka aged 65 years or over. Medical cost data from April 2013 to March 2014 were collected for women aged 65-74 years who were beneficiaries of the Japanese National Health Insurance (n=2,304). Medical consultation rates and costs for treatment at outpatient and inpatient clinics were analyzed as outcomes. Adjustments were made for age, marital status, educational level, cohabitation status, equivalent income, alcohol use, smoking status, awareness about a healthy diet, and walking time per day.Results Of the 2,304 study participants, 1,274 (55.3%) had experience as health promotion volunteers. Poisson regression analysis revealed that volunteers' experience was positively associated with outpatient care rates (adjusted relative risk [RR]=1.04; 95% confidence interval [CI]=1.02-1.07), and negatively associated with inpatient care rates (RR=0.74; 95% CI=0.56-0.98). Multivariate regression analysis revealed that the adjusted geometric means of outpatient and inpatient care costs were 7% and 23% lower, respectively, among participants with volunteer experience than that among those with no volunteer experience (140,588-151,465 JPY for outpatient costs; 418,457-539,971 JPY for inpatient costs). These associations were stronger among participants who began health promotion volunteer at age 60 years or more, those who had leadership roles

  18. Medical trainees' experiences and perceptions towards elective period; a cross sectional study.

    Science.gov (United States)

    Nyongesa, Henry; Mokua, Winstar; Adegu, Jacob

    2014-01-01

    Medical electives make significant contribution in the training of medical students on healthcare outside their affiliated academic institutions. During this period, learners get exposed to different healthcare systems, diagnostic, medical and surgical techniques as well as appreciate existing challenges. To assess experiences encountered by medical students during their electives. A cross sectional study was commissioned among level 5 medical students of University of Nairobi in July 2013. A random sample of 125 students was invited to fill in self structured questionnaires after obtaining informed consent. The questionnaire which had initially been pretested on 25 nursing students comprised bio data, place, duration, funding, experiences and challenges of electives. Data obtained was analyzed using SPSS 20 and computed in terms of frequencies and percentages. There were 76 (60.8% response rate) respondents with majority being males and staying in university hostel. Most of them had undertaken electives in Africa which were organized by themselves and funded mostly by their parents. There was overall positive attitude towards electives with majority (80.3%) claiming it to provide all rounded training. However, financial, transport and language barrier were identified as the main challenges (41.1%, 18.8% and 14.3%, respectively). There was a call by more than 80% of respondents for the university to collaborate with host institutions and provide stipend to cover living expenses mostly. The acquisition of practical skills involved in the treatment of patients forms the basis for high expectation of electives among medical trainees. It is evident that most of the participants would desire the scaling up of entire elective period through institutional collaborations and logistical support.

  19. [Current state of medical care of polytrauma and mass casualty incidents in Germany. Are we well-prepared?].

    Science.gov (United States)

    Brodauf, L; Heßing, K; Hoffmann, R; Friemert, B

    2015-10-01

    The white paper on the medical care of the severely injured published in 2006 is a collection of proposals and recommendations concerning structure, organization and equipment for the medical care of severely injured patients. Since its publication 50 networks ( http://www.dgu-traumanetzwerk.de/index ) have been established as part of the trauma network. This and the trauma register have helped to continuously improve the medical care of severely injured patients since 1993 [26]. Numerous studies have documented the progress made in measures required by the trauma network [4, 6]. For example, the mortality rate of severely injured patients has dropped from 25 % to approximately 10 % in the past 15 years. From the register and network data it is difficult to tell how each of these measures is implemented in the participating hospitals, who provides medical treatment to patients when, and how medical care is organized in detail. This is why a survey on medical care for polytrauma and in mass casualty situations was conducted among medical directors in German surgical hospitals who are members of the German Society for Trauma Surgery (DGU). Thanks to the 211 participants (most of whom specialize in orthopedic and trauma surgery) a detailed description of how medical treatment is currently organized and performed could be acquired. The survey showed that care of patients with polytrauma (i.e. medical treatment and management) is important irrespective of the level of training of physicians and of the level of patient treatment in hospitals. The central role of traumatologists was emphasized not only in terms of actual treatment but also as an administrator for organizational and management matters. Almost all hospitals have plans for a mass casualty situation; however, the levels of preparedness show considerable variation. A highly critical view is taken of the new surgical specialists with respect to interdisciplinary and comprehensive emergency medical treatment

  20. The current provision of community-based teaching in UK medical schools: an online survey and systematic review

    Science.gov (United States)

    Lee, Sandra W W; Clement, Naomi; Tang, Natalie; Atiomo, William

    2014-01-01

    Objective To evaluate the current provision and outcome of community-based education (CBE) in UK medical schools. Design and data sources An online survey of UK medical school websites and course prospectuses and a systematic review of articles from PubMed and Web of Science were conducted. Articles in the systematic review were assessed using Rossi, Lipsey and Freeman's approach to programme evaluation. Study selection Publications from November 1998 to 2013 containing information related to community teaching in undergraduate medical courses were included. Results Out of the 32 undergraduate UK medical schools, one was excluded due to the lack of course specifications available online. Analysis of the remaining 31 medical schools showed that a variety of CBE models are utilised in medical schools across the UK. Twenty-eight medical schools (90.3%) provide CBE in some form by the end of the first year of undergraduate training, and 29 medical schools (93.5%) by the end of the second year. From the 1378 references identified, 29 papers met the inclusion criteria for assessment. It was found that CBE mostly provided advantages to students as well as other participants, including GP tutors and patients. However, there were a few concerns regarding the lack of GP tutors’ knowledge in specialty areas, the negative impact that CBE may have on the delivery of health service in education settings and the cost of CBE. Conclusions Despite the wide variations in implementation, community teaching was found to be mostly beneficial. To ensure the relevance of CBE for ‘Tomorrow's Doctors’, a national framework should be established, and solutions sought to reduce the impact of the challenges within CBE. Strengths and limitations of this study This is the first study to review how community-based education is currently provided throughout Medical Schools in the UK. The use of Rossi, Lipsey and Freeman's method of programme evaluation means that the literature was analysed

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

    NARCIS (Netherlands)

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

    2008-01-01

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

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

    NARCIS (Netherlands)

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

    2008-01-01

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

  3. Correlation between Knowledge, Experience and Common Sense, with Critical Thinking Capability of Medical Faculty's Students at Indonesia Christian University

    Science.gov (United States)

    Nadeak, Bernadetha

    2015-01-01

    This research discusses correlation between knowledge, experience and common sense with critical thinking of Medical Faculty's Student. As to the objective of this research is to find the correlation between knowledge, experience and common sense with critical thinking of Medical Faculty's Students at Christian University of Indonesia. It is…

  4. A gaming approach to learning medical microbiology: students' experiences of flow.

    Science.gov (United States)

    Beylefeld, Adriana A; Struwig, Magdalena C

    2007-11-01

    There is a growing awareness in medical education of general skills(1) required for lifelong learning. Such skills are best achieved when students experience positive affective states while they are learning, as put forth by the Csikszentmihalyian theory of flow. This study describes how a quiz-type board game was used in the School of Medicine of the Faculty of Health Sciences at the University of the Free State to address students' negativity towards medical microbiology. The study population consisted of third-year medical students who had recently completed the Infections module of the undergraduate Learning Programme for Professional Medicine. Data gathered by means of two questionnaire surveys and direct observation showed that the game impacted positively on students' perceptions of and attitudes towards medical microbiology as a subject. A high perceived probability of the game contributing to the acquisition of general skills was recorded, since the experience of positive affect during the process of informal learning went hand-in-hand with heightened team effort and spontaneous communication. This article may be of value to health educators who wish to supplement formal teaching with informal learning so as to enhance not only the recall of factual knowledge, but also the advancement of general skills.

  5. Community-based medical education: is success a result of meaningful personal learning experiences?

    Science.gov (United States)

    Kelly, Len; Walters, Lucie; Rosenthal, David

    2014-01-01

    Community-based medical education (CBME) is the delivery of medical education in a specific social context. Learners become a part of social and medical communities where their learning occurs. Longitudinal integrated clerkships (LICs) are year-long community-based placements where the curriculum and clinical experience is typically delivered by primary care physicians. These programs have proven to be robust learning environments, where learners develop strong communication skills and excellent clinical reasoning. To date, no learning model has been offered to describe CBME. The characteristics of CBME are explored by the authors who suggest that the social and professional context provided in small communities enhances medical education. The authors postulate that meaningfulness is engendered by the authentic context, which develops over time. These relationships with preceptors, patients and the community provide meaningfulness, which in turn enhances learning. The authors develop a novel learning model. They propose that the context-rich environment of CBME allows for meaningful relationships and experiences for students and that such meaningfulness enhances learning.

  6. Medical and Psychology Student’s Experiences in Learning Mindfulness: Benefits, Paradoxes, and Pitfalls

    OpenAIRE

    Solhaug, Ida; Eriksen, Thor E.; de Vibe, Michael; Haavind, Hanne; Friborg, Oddgeir; Sørlie, Tore; Rosenvinge, Jan H.

    2016-01-01

    Mindfulness has attracted increased interest in the field of health professionals’ education due to its proposed double benefit of providing self-help strategies to counter stress and burnout symptoms and cultivating attitudes central to the role of professional helpers. The current study explored the experiential aspects of learning mindfulness. Specifically, we explored how first-year medical and psychology students experienced and conceptualized mindfulness upon completion of a 7-week mind...

  7. Improving medical student attitudes toward older patients through a "council of elders" and reflective writing experience.

    Science.gov (United States)

    Westmoreland, Glenda R; Counsell, Steven R; Sennour, Youcef; Schubert, Cathy C; Frank, Kathryn I; Wu, Jingwei; Frankel, Richard M; Litzelman, Debra K; Bogdewic, Stephen P; Inui, Thomas S

    2009-02-01

    In an effort to reduce "agism" which is prevalent among medical trainees, a new geriatrics educational experience for medical students aimed at improving attitudes toward older patients was developed. Each 90-minute Older Adult Session included four components: initial reflective writing exercise; introduction to the session; 75-minute dialogue with the "Council of Elders," a group of active, "well" older adults; and final reflective writing exercise. The new session was provided to 237 first- and second-year medical students during the 2006/07 academic year at Indiana University School of Medicine. Session evaluation included comparing scores on the 14-item Geriatrics Attitude Scale administered before and after the session, identifying attitude changes in the reflective writing exercises, and a student satisfaction survey. Student responses on the Geriatrics Attitude Scale after the session were significantly improved in seven of 14 items, demonstrating better attitudes toward being with and listening to older people and caring for older patients. Analysis of the reflective writings revealed changing of negative to positive or reinforced positive attitudes in 27% of medical students, with attitudes not discernable in the remaining 73% (except one student, in whom positive attitudes changed to negative). Learner satisfaction with the Older Adult Session was high, with 98% agreeing that the session had a positive effect on insight into the care of older adults. A Council of Elders coupled with a reflective writing exercise is a promising new approach to improving attitudes of medical students toward their geriatric patients.

  8. Improving the social responsiveness of medical schools: lessons from the Canadian experience.

    Science.gov (United States)

    Cappon, P; Watson, D

    1999-08-01

    The recent Canadian experience in promoting social accountability and social responsiveness of medical schools has been one of steady improvement in certain institutions, against a background lacking overall national policy direction. Canada has several distinct advantages in trying to devise means of enhancing social accountability of medical training and health services, including a strong national system of publicly supported and financed health care of high quality, a network of excellent academic medical centers, and well-established accreditation bodies. A review of the literature, complemented by a new survey of Canadian medical schools, confirms that some of the centers, conscious of the need to promote social responsiveness, are developing innovative programs to do so. Future progress toward the goal of social responsiveness of medical schools on a pan-Canadian basis will require a more cohesive approach involving systematic sharing of best practices among academic health centers, effective alliances with other health professionals to promote these objectives, and support by federal and provincial ministries of health. Canadian awareness of an international movement tending to similar objectives would support the efforts of Canadian health professionals engaged in practices of enhanced accountability.

  9. Social media as an open-learning resource in medical education: current perspectives

    Directory of Open Access Journals (Sweden)

    Sutherland S

    2017-06-01

    Full Text Available S Sutherland,1 A Jalali2 1Department of Critical Care, The Ottawa Hospital, ²Division of Clinical and Functional Anatomy, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada Purpose: Numerous studies evaluate the use of social media as an open-learning resource in education, but there is a little published knowledge of empirical evidence that such open-learning resources produce educative outcomes, particularly with regard to student performance. This study undertook a systematic review of the published literature in medical education to determine the state of the evidence as to empirical studies that conduct an evaluation or research regarding social media and open-learning resources.Methods: The authors searched MEDLINE, ERIC, Embase, PubMed, Scopus, and Google Scholar from 2012 to 2017. This search included using keywords related to social media, medical education, research, and evaluation, while restricting the search to peer reviewed, English language articles only. To meet inclusion criteria, manuscripts had to employ evaluative methods and undertake empirical research.Results: Empirical work designed to evaluate the impact of social media as an open-learning resource in medical education is limited as only 13 studies met inclusion criteria. The majority of these studies used undergraduate medical education as the backdrop to investigate open-learning resources, such as Facebook, Twitter, and YouTube. YouTube appears to have little educational value due to the unsupervised nature of content added on a daily basis. Overall, extant reviews have demonstrated that we know a considerable amount about social media use, although to date, its impacts remain unclear.Conclusion: There is a paucity of outcome-based, empirical studies assessing the impact of social media in medical education. The few empirical studies identified tend to focus on evaluating the affective outcomes of social media and medical education as opposed to

  10. Deriving welfare measures from discrete choice experiments: inconsistency between current methods and random utility and welfare theory.

    Science.gov (United States)

    Lancsar, Emily; Savage, Elizabeth

    2004-09-01

    Discrete choice experiments (DCEs) are being used increasingly in health economics to elicit preferences for products and programs. The results of such experiments have been used to calculate measures of welfare or more specifically, respondents' 'willingness to pay' (WTP) for products and programs and their 'marginal willingness to pay' (MWTP) for the attributes that make up such products and programs. In this note we show that the methods currently used to derive measures of welfare from DCEs in the health economics literature are not consistent with random utility theory (RUT), or with microeconomic welfare theory more generally. The inconsistency with welfare theory is an important limitation on the use of such WTP estimates in cost-benefit analyses. We describe an alternative method of deriving measures of welfare (compensating variation) from DCEs that is consistent with RUT and is derived using welfare theory. We demonstrate its use in an empirical application to derive the WTP for asthma medication and compare it to the results elicited from the method currently used in the health economics literature.

  11. What do UK medical students value most in their careers? A discrete choice experiment.

    Science.gov (United States)

    Cleland, Jennifer A; Johnston, Peter; Watson, Verity; Krucien, Nicolas; Skåtun, Diane

    2017-08-01

    Many individual- and job-related factors are known to influence medical careers decision making. Previous research has extensively studied medical trainees' (residents') and students' views of the factors that are important. However, how trainees and students trade off these factors at times of important careers-related decision making is under-researched. Information about trade-offs is crucial to the development of effective policies to enhance the recruitment and retention of junior doctors. Our aim was to investigate the strength of UK medical students' preferences for the characteristics of training posts in terms of monetary value. We distributed a paper questionnaire that included a discrete choice experiment (DCE) to final-year medical students in six diverse medical schools across the UK. The main outcome measure was the monetary value of training post characteristics, based on willingness to forgo and willingness to accept extra income for a change in each job characteristic calculated from regression coefficients. A total of 810 medical students answered the questionnaire. The presence of good working conditions was by far the most influential characteristic of a training position. Medical students consider that, as newly graduated doctors, they will require compensation of an additional 43.68% above average earnings to move from a post with excellent working conditions to one with poor working conditions. Female students value excellent working conditions more highly than male students, whereas older medical students value them less highly than younger students. Students on the point of completing medical school and starting postgraduate training value good working conditions significantly more than they value desirable geographical location, unit reputation, familiarity with the unit or opportunities for partners or spouses. This intelligence can be used to address the crisis in workforce staffing that has developed in the UK and opens up fruitful

  12. Formação médica, racionalidade e experiência Rationality and experience in medical education

    Directory of Open Access Journals (Sweden)

    Alícia Navarro de Souza

    2001-01-01

    Full Text Available Este trabalho decorre de experiência pedagógica e de investigação sobre o aprendizado da clínica por estudantes de medicina. Constitui-se de uma experiência intersubjetiva, que vai além da racionalidade anátomo-clínica e epidemiológica, a partir do processo de socialização destes estudantes, quando seus ideais do que seja ser médico confrontam-se com os valores instituídos de uma prática normalizada. Trabalha com a concepção de sujeito a partir da psicanálise, valoriza a escuta de conflitos experimentados por aprendizes da clínica ao vivenciarem a tensão doente/doença, busca sustentar esta tensão e manter a argumentação possível no contexto de uma experiência pedagógica. Tenta também preservar a complexidade da clínica. Realiza uma análise de discurso fundada no princípio dialógico de Bakhtin. Trabalha com a teoria da argumentação de Perelman. Chega a interpretações que, sem pretenderem ser únicas ou exclusivas, enriquecem a crítica e podem influenciar a formação dos médicos em uma prática extremamente complexa e difícil, não redutível à aplicação de um saber exclusivamente sobre a doença.This paper is the result of an experience in a discussion group, in which medical students discussed their first experiences in clinical practice. The research made in the analysis of the discourse of this discussion group isolated themes using the dialogical principle of Bakhtin and Perelman's theory of argumentation, and went beyond the anatomo-clinical and epidemiological rationality as it used the operational value of psychoanalytic concepts to the interpretation and deconstruction of the meanings produced in an intersubjective field. The resulting interpretations in our pedagogical experience - which cannot be said unique or exclusive - shows how this experience can contribute to a critical analysis in maintaining the tension and the production of knowledge between diseased and disease, and can furthermore

  13. Pre-clinical medical student experience in a pediatric pulmonary clinic

    Directory of Open Access Journals (Sweden)

    Thomas G. Saba

    2015-11-01

    Full Text Available Objective: Our objective was to evaluate the educational value of introducing pre-clinical medical students to pediatric patients and their families in a subspecialty clinic setting. Methods: First- and second-year medical students at the University of Michigan seeking clinical experience outside of the classroom attended an outpatient pediatric pulmonary clinic. Evaluation of the experience consisted of pre- and post-clinic student surveys and post-clinic parent surveys with statements employing a four-point Likert scale as well as open-ended questions. Results: Twenty-eight first-year students, 6 second-year students, and 33 parents participated in the study. Post-clinic statement scores significantly increased for statements addressing empathic attitudes, confidence communicating with children and families, comfort in the clinical environment, and social awareness. Scores did not change for statements addressing motivation, a sense of team membership, or confidence with career goals. Students achieved their goals of gaining experience interacting with patients, learning about pulmonary diseases, and observing clinic workflow. Parents felt that they contributed to student education and were not inconvenienced. Conclusions: Students identified several educational benefits of exposure to a single pediatric pulmonary clinic. Patients and families were not inconvenienced by the participation of a student. Additional studies are warranted to further investigate the value of this model of pre-clinical medical student exposure to subspecialty pediatrics.

  14. Perceptions of human cadaver dissection by medical students: a highly valued experience.

    Science.gov (United States)

    Hajj, Inaya; Dany, Mohammed; Forbes, William; Barremkala, Mallikarjuna; Thompson, Brent J; Jurjus, Abdo

    2015-01-01

    Cadaver dissection remains a cornerstone in the study of anatomical sciences by medical students. However, this activity can cause emotions that may affect learning outcomes. This study, which involved medical students of various cultural backgrounds, assessed their responses to dissection. Medicine I year students (n = 100) at Oakland University William Beaumont School of Medicine were invited to complete a questionnaire after the first week of dissection, and again at the end of the course. The questionnaire asked for demographics, and assessed the students' appraisal of their dissection experience, cultural influences, coping activities and learning outcomes. After the first week of dissection, most of the students found the experience challenging, stimulating, exciting and informative, rather than nauseating or unbearable. Still, some students found the experience anxiety-provoking, especially when they thought about human mortality. Cultural background influenced the students' emotional development as they worked through the course. Most of the participants agreed that dissection promotes teamwork, familiarity with the human body, and integration of the theoretical knowledge with practical application. At the end of the course, dissection was significantly less anxiety-provoking, and, interestingly, the study found that culture and religious beliefs became more important to the students. Most students agreed that dissection is important, relevant, and necessary, and has the potential to improve learning outcomes that are essential to the development of physicians. The study suggests that an introductory course in social, behavioral and ethical considerations be presented at the beginning of the medical curriculum.

  15. The utility of reflective writing after a palliative care experience: can we assess medical students' professionalism?

    Science.gov (United States)

    Braun, Ursula K; Gill, Anne C; Teal, Cayla R; Morrison, Laura J

    2013-11-01

    Medical education leaders have called for a curriculum that proactively teaches knowledge, skills, and attitudes required for professional practice and have identified professionalism as a competency domain for medical students. Exposure to palliative care (PC), an often deeply moving clinical experience, is an optimal trigger for rich student reflection, and students' reflective writings can be explored for professional attitudes. Our aim was to evaluate the merit of using student reflective writing about a PC clinical experience to teach and assess professionalism. After a PC patient visit, students wrote a brief reflective essay. We explored qualitatively if/how evidence of students' professionalism was reflected in their writing. Five essays were randomly chosen to develop a preliminary thematic structure, which then guided analysis of 30 additional, randomly chosen essays. Analysts coded transcripts independently, then collaboratively, developed thematic categories, and selected illustrative quotes for each theme and subtheme. Essays revealed content reflecting more rich information about students' progress toward achieving two professionalism competencies (demonstrating awareness of one's own perspectives and biases; demonstrating caring, compassion, empathy, and respect) than two others (displaying self-awareness of performance; recognizing and taking actions to correct deficiencies in one's own behavior, knowledge, and skill). Professional attitudes were evident in all essays. The essays had limited use for formal summative assessment of professionalism competencies. However, given the increasing presence of PC clinical experiences at medical schools nationwide, we believe this assessment strategy for professionalism has merit and deserves further investigation.

  16. Experiments on the magnetic coupling in a small scale counter rotating marine current turbine

    Science.gov (United States)

    Kim, I. C.; Lee, N. J.; Wata, J.; Hyun, B. S.; Lee, Y. H.

    2016-05-01

    Modern economies are dependent on energy consumption to ensure growth or sustainable development. Renewable energy sources provide a source of energy that can provide energy security and is renewable. Tidal energy is more predictable than other sources or renewable energy like the sun or wind. Horizontal axis marine current turbines are currently the most advanced and commercially feasible option for tidal current convertors. A dual rotor turbine is theoretically able to produce more power than a single rotor turbine at the same fluid velocity. Previous experiments for a counter rotating dual rotor horizontal axis marine current turbine used a mechanical oil seal coupling that caused mechanical losses when water entered through small gaps at the shaft. A new magnetic coupling assembly eliminates the need for a shaft to connect physically with the internal mechanisms and is water tight. This reduces mechanical losses in the system and the effect on the dual rotor performance is presented in this paper.

  17. Including Alternative Resources in State Renewable Portfolio Standards: Current Design and Implementation Experience

    Energy Technology Data Exchange (ETDEWEB)

    Heeter, J.; Bird, L.

    2012-11-01

    Currently, 29 states, the District of Columbia, and Puerto Rico have instituted a renewable portfolio standard (RPS). An RPS sets a minimum threshold for how much renewable energy must be generated in a given year. Each state policy is unique, varying in percentage targets, timetables, and eligible resources. This paper examines state experience with implementing renewable portfolio standards that include energy efficiency, thermal resources, and non-renewable energy and explores compliance experience, costs, and how states evaluate, measure, and verify energy efficiency and convert thermal energy. It aims to gain insights from the experience of states for possible federal clean energy policy as well as to share experience and lessons for state RPS implementation.

  18. The impact of open access on the medical literature: a review of current literature

    Directory of Open Access Journals (Sweden)

    Nana Turk

    2017-02-01

    Full Text Available Background: the aim of the article is to conduct an overview of the impact of OA on the medical articles based on 3-part categorization.Methods: Data were identified by a search strategy with eight combinations of keywords (open access, citation impact, citation advantage, citation count, article download, article usage, social media attention, altmetrics and searched in three different databases.Results: the analysis was conducted on 107 studies dealing with citations, downloads and social impact. Sixty-seven of them simply employed the counting citations to OA and non-OA articles; nineteen articles compared the downloads and citations counts; and twenty-one articles investigated the social impact of OA articles. Twenty-five articles investigated the citations, download counts, and social impact of medical articles.Conclusions: The studies investigating the citation impact mostly showed citation advantages. Those that employed citation and download counts of medical articles using randomized controlled trials showed that OA articles were downloaded significantly more frequently, but found no evidence of a citation advantage for open access articles. The citation advantage from open access might be caused by other factors. Results of the studies comparing the social media attention and citations/downloads of the medical articles are often diametrically opposed.

  19. The medical device industry and the biomedical engineer: current status and future trends.

    Science.gov (United States)

    Farley, B E

    1989-01-01

    The role of new and existing technology in the development of medical devices is examined. The impact of competition and economic and regulatory pressures is assessed. The identification of clinical needs is discussed. These include the needs to reduce liability, find less invasive alternatives to surgery, improve the quality of life, and prevent disease. Career opportunities are considered in some detail.

  20. Sexual Health Curricula in U.S. Medical Schools: Current Educational Objectives

    Science.gov (United States)

    Galletly, Carol; Lechuga, Julia; Layde, Joseph B.; Pinkerton, Steven

    2010-01-01

    Objective: The authors identify the explicit and implicit objectives that shape decisions about what medical schools teach regarding human sexuality. Methods: The authors reviewed relevant articles in journals, physician licensing examinations, and publications by professional organizations to identify learning objectives for human sexuality in…

  1. Director of Nursing Current Job Tenure and Past Experience and Quality of Care in Nursing Homes

    Science.gov (United States)

    Krause, Melanie R.

    2011-01-01

    Background Directors of nursing (DON) are central to quality of care in nursing homes (NH) because of their role in coordinating and overseeing nursing care. Research is needed to test the association between DON characteristics and quality using large, representative samples of NHs and global measures of quality. One such measure is the quality measure (QM) rating from the Centers for Medicare & Medicaid Services’ Five-Star Quality Rating, which aggregates 10 individual QMs into a single rating. Purpose This study examined whether DON current job tenure or past experience (1) differed across levels of the QM rating, (2) was associated with QM ratings, and (3) was associated with any of the individual 10 QM scores that comprise QM ratings. Methodology Data for a nationally representative sample of 1,174 NHs were obtained from the 2004 National Nursing Home Survey, publicly-reported QMs, and an Area Resource File. Wald tests were used to test differences in mean DON current job tenure and past experience across levels of the QM rating. Multinomial logistic and Poisson regression analyses were used to examine the association between DON current job tenure and past experience and QM ratings and QM scores, respectively, controlling for selected market and organizational characteristics. Findings NHs with longer DON current job tenure tended to have higher QM ratings. Longer DON current job tenure was associated with higher QM ratings and lower QM scores for several individual QMs, suggesting higher quality. DON past experience did not differ across levels of the QM rating and was neither associated with QM ratings or QM scores. Practice Implications This study highlights the need for owners and administrators to support DONs as they either transition into the role of the DON for the first time or learn to effectively fulfill their role in a new NH. PMID:21712721

  2. The barriers and facilitators people with diabetes from a nonEnglish speaking background experience when managing their medications: a qualitative study.

    Science.gov (United States)

    Claydon-Platt, Kate; Manias, Elizabeth; Dunning, Trisha

    2014-08-01

    To explore the barriers to and facilitators of effective medication management from the perspectives of people with diabetes from a nonEnglish speaking background, carers and health professionals. The barriers that people with diabetes experience managing their medications can adversely impact on health outcomes. People from nonEnglish speaking backgrounds are at risk of medication-related problems, although there is a paucity of research in this area. A qualitative research design using a purposive sampling approach. People with type 1 or type 2 diabetes from a nonEnglish speaking background, their carers, and health professionals who assisted these people and their carers to manage their medications were recruited from the diabetes outpatient clinic at an adult teaching public hospital in Melbourne, Australia. Participants were interviewed using a semi-structured interview guide. All interviews were audio-recorded, transcribed verbatim and analysed using a thematic framework method. Eleven people with diabetes, 10 carers and 10 health professionals were interviewed, and four key issues were identified: diabetes knowledge, diabetes impact, medication knowledge and medication management. The cost of medications, language barriers that hinder communication, forgetfulness, and poor knowledge and understanding emerged as barriers to effective medication management. Facilitators included the use of dose administration aids to manage medications, but current medication lists were not used. Findings revealed people with diabetes experienced a multitude of barriers when managing their medications, and, despite the problems people experienced, there appeared to be poor use of support aids to assist people to effectively manage their medications. The findings can be used to develop strategies aiming at improving how people from nonEnglish speaking backgrounds manage their medicines. © 2013 John Wiley & Sons Ltd.

  3. Sounding Rocket Experiments to Investigate Thermal Electron Heating in the Sq Current Focus

    Science.gov (United States)

    Abe, T.; Ishisaka, K.; Kumamoto, A.; Yoshikawa, A.; Takahashi, T.; Tanaka, M.

    2015-12-01

    Sounding rocket observations in the southern part of Japan suggest that the electron temperature profile occasionally exhibits the local increase by several hundred K at 100-110 km altitudes at 1100-1200 LT in winter. Detailed study of the temperature profiles indicates that such an increase is closely related to the existence of Sq current focus, because it becomes more significant when the measurement is made near the center of Sq focus. In order to understand a general feature of this unusual phenomena occurring in the Sq current focus, the sounding rocket experiment was conducted in Uchinoura of Japan. In this experiment, we launched "S-310-37" rocket equipped with a total of eight science instruments at 11:20 JST on January 16, 2007 after being convinced that the Sq current was approaching to the planned rocket trajectory. The geomagnetic activity had been successively quiet on that day so that we can estimate the position of Sq current focus. Our analysis of the obtained data indicates that the electron temperature was certainly increased by about 500-600 K at the altitude of 97-101 km with respect to the background. Strong electron density perturbation was also observed to exist above 97 km altitude, which corresponds to the lower boundary of the high electron temperatures. It is also noticeable that both the electric field and magnetic field data include unusual variation in the same altitude region as the temperature increase was observed, suggesting a possible connection between the thermal electron heating and variation of the electric and/or magnetic field. Thus, the first experiment in 2007 revealed a general feature of such unusual phenomena in the Sq current focus, and thereby our interest to the generation mechanism for increasing the electron temperature was more and more increased. We will conduct the second rocket experiment to investigate such unusual phenomena in the Sq current focus in January 2016. In this experiment, we will try to measure

  4. A Study of Strange Particles Produced in Neutrino Neutral Current Interactions in the NOMAD Experiment

    CERN Document Server

    Naumov, D V; Naumova, E; Popov, B; Astier, Pierre; Autiero, D; Baldisseri, Alberto; Baldo-Ceolin, Massimilla; Banner, M; Bassompierre, G; Benslama, K; Besson, N; Bird, I; Blumenfeld, B; Bobisut, F; Bouchez, J; Boyd, S; Bueno, A G; Bunyatov, S; Camilleri, L L; Cardini, A; Cattaneo, P W; Cavasinni, V; Cervera-Villanueva, A; Challis, R C; Collazuol, G; Conforto, G; Conta, C; Contalbrigo, M; Cousins, R; Daniels, D; Das, R; Degaudenzi, H M; Del Prete, T; De Santo, A; Dignan, T; Di Lella, L; do Couto e Silva, E; Dumarchez, J; Ellis, M; Feldman, G J; Ferrari, R; Ferrère, D; Flaminio, V; Fraternali, M; Gaillard, J M; Gangler, E; Geiser, A; Geppert, D; Gibin, D; Gninenko, S; Godley, A; Gómez-Cadenas, J J; Gosset, J; Gössling, C; Gouanère, M; Grant, A; Graziani, G; Guglielmi, A M; Hagner, C; Hernando, J; Hong, T M; Hubbard, D B; Hurst, P; Hyett, N; Iacopini, E; Joseph, C L; Juget, F R; Kent, N; Kirsanov, M; Klimov, O; Kokkonen, J; Kovzelev, A; Krasnoperov, A V; Lacaprara, S; Lachaud, C; Lakic, B; Lanza, A; La Rotonda, L; Laveder, M; Letessier-Selvon, A A; Lévy, J M; Linssen, Lucie; Ljubicic, A; Long, J; Lupi, A; Lyubushkin, V V; Marchionni, A; Martelli, F; Méchain, X; Mendiburu, J P; Meyer, J P; Mezzetto, Mauro; Mishra, S R; Moorhead, G F; Nédélec, P; Nefedov, Yu A; Nguyen-Mau, C; Orestano, D; Pastore, F; Peak, L S; Pennacchio, E; Pessard, H; Petti, R; Placci, A; Polesello, G; Pollmann, D; Polyarush, A Yu; Poulsen, C; Rebuffi, L; Rico, J; Roda, C; Rubbia, André; Salvatore, F; Schahmaneche, K; Schmidt, B; Schmidt, T; Sconza, A; Sevior, M E; Shih, D; Sillou, D; Soler, F J P; Sozzi, G; Steele, D; Stiegler, U; Stipcevic, M; Stolarczyk, T; Tareb-Reyes, M; Taylor, G N; Tereshchenko, V V; Toropin, A N; Touchard, A M; Tovey, Stuart N; Tran, M T; Tsesmelis, E; Ulrichs, J; Vacavant, L; Valdata-Nappi, M; Valuev, V Yu; Vannucci, François; Varvell, K E; Veltri, M; Vercesi, V; Vidal-Sitjes, G; Vieira, J M; Vinogradova, T G; Weber, F V; Weisse, T; Wilson, F F; Winton, L J; Yabsley, B D; Zaccone, Henri; Zuber, K; Zuccon, P

    2004-01-01

    Results of a detailed study of strange particle production in neutrino neutral current interactions are presented using the data from the NOMAD experiment. Integral yields of neutral strange particles (K0s, Lambda, Lambda-bar) have been measured. Decays of resonances and heavy hyperons with an identified K0s or Lambda in the final state have been analyzed. Clear signals corresponding to K* and Sigma(1385) have been observed. First results on the measurements of the Lambda polarization in neutral current interactions have been obtained.

  5. Study of D*+ production in νμ charged current interactions in the NOMAD experiment

    Science.gov (United States)

    NOMAD Collaboration; Astier, P.; Autiero, D.; Baldisseri, A.; Baldo-Ceolin, M.; Banner, M.; Bassompierre, G.; Benslama, K.; Besson, N.; Bird, I.; Blumenfeld, B.; Bobisut, F.; Bouchez, J.; Boyd, S.; Bueno, A.; Bunyatov, S.; Camilleri, L.; Cardini, A.; Cattaneo, P. W.; Cavasinni, V.; Cervera-Villanueva, A.; Challis, R.; Chukanov, A.; Collazuol, G.; Conforto, G.; Conta, C.; Contalbrigo, M.; Cousins, R.; Daniels, D.; Degaudenzi, H.; Del Prete, T.; De Santo, A.; Dignan, T.; Di Lella, L.; do Couto e Silva, E.; Dumarchez, J.; Ellis, M.; Fazio, T.; Feldman, G. J.; Ferrari, R.; Ferrère, D.; Flaminio, V.; Fraternali, M.; Gaillard, J.-M.; Gangler, E.; Geiser, A.; Geppert, D.; Gibin, D.; Gninenko, S.; Godley, A.; Gomez-Cadenas, J.-J.; Gosset, J.; Gößling, C.; Gouanère, M.; Grant, A.; Graziani, G.; Guglielmi, A.; Hagner, C.; Hernando, J.; Hubbard, D.; Hurst, P.; Hyett, N.; Iacopini, E.; Joseph, C.; Juget, F.; Kent, N.; Kirsanov, M.; Klimov, O.; Kokkonen, J.; Kovzelev, A.; Krasnoperov, A.; Kustov, D.; Kuznetsov, V.; Lacaprara, S.; Lachaud, C.; Lakić, B.; Lanza, A.; La Rotonda, L.; Laveder, M.; Letessier-Selvon, A.; Levy, J.-M.; Linssen, L.; Ljubičić, A.; Long, J.; Lupi, A.; Marchionni, A.; Martelli, F.; Méchain, X.; Mendiburu, J.-P.; Meyer, J.-P.; Mezzetto, M.; Mishra, S. R.; Moorhead, G. F.; Naumov, D.; Nédélec, P.; Nefedov, Yu.; Nguyen-Mau, C.; Orestano, D.; Pastore, F.; Peak, L. S.; Pennacchio, E.; Pessard, H.; Petti, R.; Placci, A.; Polesello, G.; Pollmann, D.; Polyarush, A.; Popov, B.; Poulsen, C.; Rico, J.; Riemann, P.; Roda, C.; Rubbia, A.; Salvatore, F.; Schahmaneche, K.; Schmidt, B.; Schmidt, T.; Sevior, M.; Sillou, D.; Soler, F. J. P.; Sozzi, G.; Steele, D.; Stiegler, U.; Stipčević, M.; Stolarczyk, Th.; Tareb-Reyes, M.; Taylor, G. N.; Tereshchenko, V.; Toropin, A.; Touchard, A.-M.; Tovey, S. N.; Tran, M.-T.; Tsesmelis, E.; Ulrichs, J.; Vacavant, L.; Valdata-Nappi, M.; Valuev, V.; Vannucci, F.; Varvell, K. E.; Veltri, M.; Vercesi, V.; Vidal-Sitjes, G.; Vieira, J.-M.; Vinogradova, T.; Weber, F. V.; Weisse, T.; Wilson, F. F.; Winton, L. J.; Yabsley, B. D.; Zaccone, H.; Zuber, K.; Zuccon, P.

    2002-02-01

    A search was made among νμ charged current events collected in the NOMAD experiment for the reaction: νμ+N-->μ- +D*++hadrons↪D0+π+↪K-+π+. A high purity D*+ sample composed of 35 events was extracted. The D*+ yield in νμ charged current interactions was measured to be /T=(0.79+/-0.17(stat.)+/-0.10(syst.))%. The mean fraction of the hadronic jet energy taken by the D*+ is /0.67+/-0.02(stat.)+/-0.02(syst.). The distributions of the fragmentation variables /z, PT2 and xF for D*+ are also presented.

  6. A study of strange particles produced in neutrino neutral current interactions in the NOMAD experiment

    Science.gov (United States)

    Naumov, D.; Chukanov, A.; Naumova, E.; Popov, B.; Astier, P.; Autiero, D.; Baldisseri, A.; Baldo-Ceolin, M.; Banner, M.; Bassompierre, G.; Benslama, K.; Besson, N.; Bird, I.; Blumenfeld, B.; Bobisut, F.; Bouchez, J.; Boyd, S.; Bueno, A.; Bunyatov, S.; Camilleri, L.; Cardini, A.; Cattaneo, P. W.; Cavasinni, V.; Cervera-Villanueva, A.; Challis, R.; Collazuol, G.; Conforto, G.; Conta, C.; Contalbrigo, M.; Cousins, R.; Daniels, D.; Das, R.; Degaudenzi, H.; Del Prete, T.; de Santo, A.; Dignan, T.; di Lella, L.; Do Couto E Silva, E.; Dumarchez, J.; Ellis, M.; Feldman, G. J.; Ferrari, R.; Ferrère, D.; Flaminio, V.; Fraternali, M.; Gaillard, J.-M.; Gangler, E.; Geiser, A.; Geppert, D.; Gibin, D.; Gninenko, S.; Godley, A.; Gomez-Cadenas, J.-J.; Gosset, J.; Gößling, C.; Gouanère, M.; Grant, A.; Graziani, G.; Guglielmi, A.; Hagner, C.; Hernando, J.; Hong, T. M.; Hubbard, D.; Hurst, P.; Hyett, N.; Iacopini, E.; Joseph, C.; Juget, F.; Kent, N.; Kirsanov, M.; Klimov, O.; Kokkonen, J.; Kovzelev, A.; Krasnoperov, A.; Lacaprara, S.; Lachaud, C.; Lakić, B.; Lanza, A.; La Rotonda, L.; Laveder, M.; Letessier-Selvon, A.; Levy, J.-M.; Linssen, L.; Ljubičić, A.; Long, J.; Lupi, A.; Lyubushkin, V.; Marchionni, A.; Martelli, F.; Méchain, X.; Mendiburu, J.-P.; Meyer, J.-P.; Mezzetto, M.; Mishra, S. R.; Moorhead, G. F.; Nédélec, P.; Nefedov, Yu.; Nguyen-Mau, C.; Orestano, D.; Pastore, F.; Peak, L. S.; Pennacchio, E.; Pessard, H.; Petti, R.; Placci, A.; Polesello, G.; Pollmann, D.; Polyarush, A.; Poulsen, C.; Rebuffi, L.; Rico, J.; Riemann, P.; Roda, C.; Rubbia, A.; Salvatore, F.; Schahmaneche, K.; Schmidt, B.; Schmidt, T.; Sconza, A.; Sevior, M.; Shih, D.; Sillou, D.; Soler, F. J. P.; Sozzi, G.; Steele, D.; Stiegler, U.; Stipčević, M.; Stolarczyk, Th.; Tareb-Reyes, M.; Taylor, G. N.; Tereshchenko, V.; Toropin, A.; Touchard, A.-M.; Tovey, S. N.; Tran, M.-T.; Tsesmelis, E.; Ulrichs, J.; Vacavant, L.; Valdata-Nappi, M.; Valuev, V.; Vannucci, F.; Varvell, K. E.; Veltri, M.; Vercesi, V.; Vidal-Sitjes, G.; Vieira, J.-M.; Vinogradova, T.; Weber, F. V.; Weisse, T.; Wilson, F. F.; Winton, L. J.; Yabsley, B. D.; Zaccone, H.; Zuber, K.; Zuccon, P.; NOMAD Collaboration

    2004-11-01

    Results of a detailed study of strange particle production in neutrino neutral current interactions are presented using the data from the NOMAD experiment. Integral yields of neutral strange particles ( Ks0, Λ, Λ¯) have been measured. Decays of resonances and heavy hyperons with an identified Ks0 or Λ in the final state have been analyzed. Clear signals corresponding to K and Σ(1385 have been observed. First results on the measurements of the Λ polarization in neutral current interactions have been obtained.

  7. Optimization of current waveform tailoring for magnetically driven isentropic compression experiments

    Science.gov (United States)

    Waisman, E. M.; Reisman, D. B.; Stoltzfus, B. S.; Stygar, W. A.; Cuneo, M. E.; Haill, T. A.; Davis, J.-P.; Brown, J. L.; Seagle, C. T.; Spielman, R. B.

    2016-06-01

    The Thor pulsed power generator is being developed at Sandia National Laboratories. The design consists of up to 288 decoupled and transit time isolated capacitor-switch units, called "bricks," that can be individually triggered to achieve a high degree of pulse tailoring for magnetically driven isentropic compression experiments (ICE) [D. B. Reisman et al., Phys. Rev. Spec. Top.-Accel. Beams 18, 090401 (2015)]. The connecting transmission lines are impedance matched to the bricks, allowing the capacitor energy to be efficiently delivered to an ICE strip-line load with peak pressures of over 100 GPa. Thor will drive experiments to explore equation of state, material strength, and phase transition properties of a wide variety of materials. We present an optimization process for producing tailored current pulses, a requirement for many material studies, on the Thor generator. This technique, which is unique to the novel "current-adder" architecture used by Thor, entirely avoids the iterative use of complex circuit models to converge to the desired electrical pulse. We begin with magnetohydrodynamic simulations for a given material to determine its time dependent pressure and thus the desired strip-line load current and voltage. Because the bricks are connected to a central power flow section through transit-time isolated coaxial cables of constant impedance, the brick forward-going pulses are independent of each other. We observe that the desired equivalent forward-going current driving the pulse must be equal to the sum of the individual brick forward-going currents. We find a set of optimal brick delay times by requiring that the L2 norm of the difference between the brick-sum current and the desired forward-going current be a minimum. We describe the optimization procedure for the Thor design and show results for various materials of interest.

  8. Dentists' leadership-related educational experiences, attitudes, and past and current behavior.

    Science.gov (United States)

    Taichman, L Susan; Taichman, Russell S; Inglehart, Marita R

    2014-06-01

    The purpose of this study was to assess practicing dentists' perceptions of their leadership-related educational experiences during predoctoral education and after graduation, to investigate if these perceptions differed as a function of the respondents' graduation year and gender, and to explore the relationships between educational experiences and the respondents' understanding/perceptions of leadership, leadership-related attitudes, self-perceived effectiveness, and past and current leadership- related behavior. Of the 3,000 general dentist members of the American Dental Association who were invited to participate, 593 returned the survey for a response rate of 20 percent. Between 37 and 65 percent of the respondents indicated that their predoctoral dental education had not prepared them well on a series of factors related to being leaders in their practice, community, state, or at the national level. However, 33 to 77 percent of these dentists responded that educational experiences after graduation prepared them well for different types of leadership activities. Overall, respondents rated their predoctoral experiences significantly less positively than their experiences after graduation for each content area. The more recently the respondents had graduated, the higher they rated their leadership-related educational experiences. The better their educational experiences, the more important the respondents evaluated leadership activities in their practice, organized dentistry, and research/teaching, the more important they assessed leadership to be, and the more effective they evaluated themselves to be as leaders. The perceived quality of the respondents' predoctoral education was not correlated with their past and current leadership activities. The results of this study may suggest that improving leadership training during predoctoral education could positively affect future dentists' attitudes about leadership and ratings of their own effectiveness as leaders.

  9. Ohmic Radio-Frequency Synergy Current Drive and Transformer Recharging Experiments in the HT-7 Tokamak

    Institute of Scientific and Technical Information of China (English)

    CHEN Zhong-Yong; WAN Bao-Nian; SHI Yue-Jiang; HU Li-Qun; XU Han-Dong

    2005-01-01

    @@ Lower hybrid current drive (LHCD) experiments for investigating the interaction between lower hybrid (LH) wave and residual dc electric field were performed in extensive plasma parameter ranges in the HT-7 superconducting tokamak. The experimental results are well fitted to the Karney-Fisch theory on the efficiency of LH waves energy converted to poloidal magnetic field energy. The fraction of absorbed LH power is about 0.75 for the HT-7 machine, and the upshift of the LH-wave parallel refraction index during LHCD experiments have been derived by the optimizing fitting parameters. The LH wave is also used for the transformer recharging when the plasma current is maintained unchanged. The highest efficiency about 7% has been achieved in HT-7 machine.

  10. 'E-learning' modalities in the current era of Medical Education in Pakistan.

    Science.gov (United States)

    Jawaid, Masood; Aly, Syed Moyn

    2014-09-01

    There are a number of e-Learning modalities, some or all of which may be used throughout a medical, dental, nursing or any other health related undergraduate curriculum. The purpose of this paper is to briefly describe what e-learning is along with some of the modalities, their common advantages and limitations. This publication ends with practical implications of these modalities for Pakistan.

  11. [Forensic-medical examination of the effect of current synthetic detergents on the exhibits].

    Science.gov (United States)

    Galitskiĭ, F A; Musabekova, S A

    2007-01-01

    A test for trace quantities of synthetic detergents on fabric is described in detail. Feasibility of detergents identification in the spots on the exhibits with thin-layer chromatography on silufol is shown and cases of such identification in biological material are given for illustration. Adequacy of the results is confirmed. Such investigation in forensic-medical practice will raise informative value of expert certification in cases when standard biological methods are unable to provide necessary precision.

  12. SPEAR-1: An experiment to measure current collection in the ionosphere by high voltage biased conductors

    Science.gov (United States)

    Raitt, W. John; Myers, Neil B.; Roberts, Jon A.; Thompson, D. C.

    1990-01-01

    An experiment is described in which a high electrical potential difference, up to 45 kV, was applied between deployed conducting spheres and a sounding rocket in the ionosphere. Measurements were made of the applied voltage and the resulting currents for each of 24 applications of different high potentials. In addition, diagnostic measurements of optical emissions in the vicinity of the spheres, energetic particle flow to the sounding rocket, dc electric field and wave data were made. The ambient plasma and neutral environments were measured by a Langmuir probe and a cold cathode neutral ionization gauge, respectively. The payload is described and examples of the measured current and voltage characteristics are presented. The characteristics of the measured currents are discussed in terms of the diagnostic measurements and the in-situ measurements of the vehicle environment. In general, it was found that the currents observed were at a level typical of magnetically limited currents from the ionospheric plasma for potentials less than 12 kV, and slightly higher for larger potentials. However, due to the failure to expose the plasma contactor, the vehicle sheath modified the sphere sheaths and made comparisons with the analytic models of Langmuir-Blodgett and Parker-Murphy less meaningful. Examples of localized enhancements of ambient gas density resulting from the operation of the attitude control system thrusters (cold nitrogen) were obtained. Current measurements and optical data indicated localized discharges due to enhanced gas density that reduced the vehicle-ionosphere impedance.

  13. Lower hybrid current drive experiments on Alcator C-Mod: Comparison with theory and simulationa)

    Science.gov (United States)

    Bonoli, P. T.; Ko, J.; Parker, R.; Schmidt, A. E.; Wallace, G.; Wright, J. C.; Fiore, C. L.; Hubbard, A. E.; Irby, J.; Marmar, E.; Porkolab, M.; Terry, D.; Wolfe, S. M.; Wukitch, S. J.; Alcator C-Mod Team; Wilson, J. R.; Scott, S.; Valeo, E.; Phillips, C. K.; Harvey, R. W.

    2008-05-01

    Lower hybrid (LH) current drive experiments have been carried out on the Alcator C-Mod tokamak [I. H. Hutchinson et al., Phys. Plasmas 1, 1511 (1994)] using a radio-frequency system at 4.6GHz. Up to 900kW of LH power has been coupled and driven LH currents have been inferred from magnetic measurements by extrapolating to zero loop voltage, yielding an efficiency of neILHR0/PLH≈2.5±0.2×1019(A/W/m2). We have simulated the LH current drive in these discharges using the combined ray tracing/three-dimensional (r,v⊥,v∥) Fokker-Planck code GENRAY-CQL3D (R. W. Harvey and M. McCoy, in Proceedings of the IAEA Technical Committee Meeting on Simulation and Modeling of Thermonuclear Plasmas, Montreal, Canada, 1992) and found similar current drive efficiencies. The simulated profiles of current density from CQL3D, including both ohmic plus LH drive have been found to be in good agreement with the measured current density from a motional Stark effect diagnostic. Measurements of nonthermal x-ray emission confirm the presence of a significant fast electron population and the three-dimensional (r,v⊥,v∥) electron distribution function from CQL3D has been used in a synthetic diagnostic code to simulate the measured hard x-ray data.

  14. Experiences of Swedish military medical personnel in combat zones: adapting to competing loyalties.

    Science.gov (United States)

    Lundberg, Kristina; Kjellström, Sofia; Jonsson, Anders; Sandman, Lars

    2014-08-01

    The aim of this qualitative study is to explore the Swedish military personnel's experience of what it means to perform a caring role in a combat zone. This study assesses the challenges faced by military medical personnel in the context of a combat zone. The design was descriptive with a qualitative inductive approach. Twenty military medical personnel (physicians, nurses, and combat lifesavers) were interviewed individually. They had been involved in international military operations between 2009 and 2012. This study was analyzed using qualitative content analysis. The analysis produced four categories: being in a primarily noncaring organization, caring in emotionally charged relationships, lacking an open dialog about expectations of killing and having to prioritize scarce resources. This study shows that medical personnel easily adapt to a military setting. They care but also perform other tasks when they are in a combat zone. The medical personnel want to give care to host nation but use drugs they can spare. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  15. The emotions of graduating medical students about prior patient care experiences.

    Science.gov (United States)

    Clay, Alison S; Ross, Elizabeth; Chudgar, Saumil M; Grochowski, Colleen O'Connor; Tulsky, James A; Shapiro, Dan

    2015-03-01

    To determine the emotional responses to patient care activities described by fourth year medical students. Qualitative content analysis for emerging themes in letters written by graduating medical students to patients during a Capstone Course. The patient need not be alive and the letter would never be sent. Six themes emerged from student letters: (1) Sorrow for the depths of patient suffering; (2) Gratitude towards patients and their families; (3) Personal responsibility for care provided to patients; (4) Regret for poor care provided by the student or student's team; (5) Shattered expectations about medicine and training; and (6) Anger towards patients. Students expressed sensitivity to vulnerable patients, including those who were alone, unable to communicate, or for whom care was biased. Students' expressed powerlessness (inability to cure, managing a work-life balance, and challenges with hierarchy) in some essays. At graduation, medical students describe strong emotions about previous patient care experiences, including difficulty witnessing suffering, disappointment with medicine, and gratitude to patients and their families Providing regular opportunities for writing throughout medical education would allow students to recognize their emotions, reflect upon them and promote wellness that would benefit students and their patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. Social Freezing in Medical Practice. Experiences and Attitudes of Gynecologists in Germany.

    Science.gov (United States)

    Schochow, Maximilian; Rubeis, Giovanni; Büchner-Mögling, Grit; Fries, Hansjakob; Steger, Florian

    2017-09-09

    Surveys of the German public have revealed a high acceptance of social freezing, i.e. oocyte conservation without medical indication. Up to now, there are no investigations available on the experiences and attitudes of health professionals towards social freezing. Between August 2015 and January 2016, we surveyed gynecologists Germany-wide on the topic social freezing. Five gynecologists specialized in reproductive medicine and five office-based gynecologists in standard care were chosen for the survey. The survey was conducted with an explorative, qualitative research design. The demand for social freezing in Germany is low. With regard to their fertility age, most women attend consultations too late, they have only little previous knowledge and false expectations. The gynecologists consider it the duty of society and politics to provide for the compatibility of family and work. They relate late parenthood to disadvantages primarily for the children. A majority of the gynecologists interviewed tend to advise natural reproduction. Social freezing is often mistaken as a kind of fertility insurance. Thus, it is necessary that physicians inform women early about the possibilities and limitations of social freezing. In the first place, social freezing is not a medical or medical-ethical topic. Women consider the method as a possibility to ensure the compatibility of family and work. This compatibility should be mostly perceived as a political topic. It cannot be a medical task to solve this issue. In fact, a debate in society as a whole is necessary that includes all relevant actors.

  17. Medical Support for Aircraft Disaster Search and Recovery Operations at Sea: the RSN Experience.

    Science.gov (United States)

    Teo, Kok Ann Colin; Chong, Tse Feng Gabriel; Liow, Min Han Lincoln; Tang, Kong Choong

    2016-06-01

    The maritime environment presents a unique set of challenges to search and recovery (SAR) operations. There is a paucity of information available to guide provision of medical support for SAR operations for aircraft disasters at sea. The Republic of Singapore Navy (RSN) took part in two such SAR operations in 2014 which showcased the value of a military organization in these operations. Key considerations in medical support for similar operations include the resultant casualty profile and challenges specific to the maritime environment, such as large distances of area of operations from land, variable sea states, and space limitations. Medical support planning can be approached using well-established disaster management life cycle phases of preparedness, mitigation, response, and recovery, which all are described in detail. This includes key areas of dedicated training and exercises, force protection, availability of air assets and chamber support, psychological care, and the forensic handling of human remains. Relevant lessons learned by RSN from the Air Asia QZ8501 search operation are also included in the description of these key areas. Teo KAC , Chong TFG , Liow MHL , Tang KC . Medical support for aircraft disaster search and recovery operations at sea: the RSN experience. Prehosp Disaster Med. 2016; 31(3):294-299.

  18. Women's participation in the medical profession: insights from experiences in Japan, Scandinavia, Russia, and Eastern Europe.

    Science.gov (United States)

    Ramakrishnan, Aditi; Sambuco, Dana; Jagsi, Reshma

    2014-11-01

    Although much literature has focused on the status of female physicians in the United States, limited English-language studies have examined the role of women in the medical profession elsewhere in the world. This article synthesizes evidence regarding the status of female physicians in three purposively selected regions outside the United States: Japan, Scandinavia, and Russia and Eastern Europe. These three regions markedly differ in the proportion of female physicians in the workforce, overall status of the medical profession, cultural views of gender roles, and workforce policies. Through a review of studies and articles published between 1992 and 2012 examining women's representation, status measures such as salary and leadership positions, and experiences of female physicians, the authors discuss potential relationships between the representation of female physicians, their status in medicine, and the overall status of the profession. The findings suggest that even when women constitute a high proportion of the physician workforce, they may continue to be underrepresented in positions of leadership and prestige. Evolving workforce policies, environments, and cultural views of gender roles appear to play a critical role in mediating the relationship between women's participation in the medical profession and their ability to rise to positions of influence within it. These insights are informative for the ongoing debates over the impact of the demographic shifts in the composition of the medical workforce in the United States.

  19. A ten-month program in curriculum development for medical educators: 16 years of experience.

    Science.gov (United States)

    Windish, Donna M; Gozu, Aysegul; Bass, Eric B; Thomas, Patricia A; Sisson, Stephen D; Howard, Donna M; Kern, David E

    2007-05-01

    Despite increased demand for new curricula in medical education, most academic medical centers have few faculty with training in curriculum development. To describe and evaluate a longitudinal mentored faculty development program in curriculum development. A 10-month curriculum development program operating one half-day per week of each academic year from 1987 through 2003. The program was designed to provide participants with the knowledge, attitudes, skills, and experience to design, implement, evaluate, and disseminate curricula in medical education using a 6-step model. One-hundred thirty-eight faculty and fellows from Johns Hopkins and other institutions and 63 matched nonparticipants. Pre- and post-surveys from participants and nonparticipants assessed skills in curriculum development, implementation, and evaluation, as well as enjoyment in curriculum development and evaluation. Participants rated program quality, educational methods, and facilitation in a post-program survey. Sixty-four curricula were produced addressing gaps in undergraduate, graduate, or postgraduate medical education. At least 54 curricula (84%) were implemented. Participant self-reported skills in curricular development, implementation, and evaluation improved from baseline (p higher than nonparticipants (all p sustainability and is associated with participant satisfaction, improvement in self-rated skills, and implementation of curricula on important topics.

  20. Eliciting preferences for medical devices in South Korea: A discrete choice experiment.

    Science.gov (United States)

    Lee, Hye-Jae; Bae, Eun-Young

    2017-03-01

    This study aims to identify the attributes that contribute to the value of medical devices and quantify the relative importance of them using a discrete choice experiment. Based on a literature review and expert consultation, seven attributes and their levels were identified-severity of disease (2), availability of substitutes (2), improvement in procedure (3), improvement in clinical outcomes (2), increase in survival (2), improvement in quality of life (3), and cost (4). Among 576 hypothetical profiles, optimal choice sets with 20 choices were developed and experts experienced in health technology assessment and reimbursement decision making in South Korea were surveyed. A total of 102 respondents participated in the survey. The results of the random-effect probit model showed that among the seven attributes, six, except for improvement in procedure, had a significant impact on respondents' choices on medical devices. Respondents were willing to pay the highest amount for devices that provided substantial improvements in quality of life, followed by increased survival, improved clinical outcome, treatment without substitutes, and technology for treating severe diseases. The findings of this experiment will inform decision-makers of the relative importance of the criteria and help them in reimbursement decision making of medical devices.

  1. Experiences of parenting a child with medical complexity in need of acute hospital care.

    Science.gov (United States)

    Hagvall, Monica; Ehnfors, Margareta; Anderzén-Carlsson, Agneta

    2016-03-01

    Parents of children with medical complexity have described being responsible for providing advanced care for the child. When the child is acutely ill, they must rely on the health-care services during short or long periods of hospitalization. The purpose of this study was to describe parental experiences of caring for their child with medical complexity during hospitalization for acute deterioration, specifically focussing on parental needs and their experiences of the attitudes of staff. Data were gathered through individual interviews and analyzed using qualitative content analysis. The care period can be interpreted as a balancing act between acting as a caregiver and being in need of care. The parents needed skilled staff who could relieve them of medical responsibility, but they wanted to be involved in the care and in the decisions taken. They needed support, including relief, in order to meet their own needs and to be able to take care of their children. It was important that the child was treated with respect in order for the parent to trust the staff. An approach where staff view parents and children as a single unit, as recipients of care, would probably make the situation easier for these parents and children.

  2. Adult Sexual Experiences as a Mediator Between Child Abuse and Current Secretory Immunoglobulin A Levels.

    Science.gov (United States)

    Waldron, Jonathan C; Scarpa, Angela; Kim-Spoon, Jungmeen; Coe, Christopher L

    2016-03-01

    The current study investigated whether a history of child abuse is a predictor of adult immune status, with unwanted adult sexual experiences as a proximal mediator. Participants included 89 young adult women (M(age) = 19.24) who were classified as having experienced no child abuse, child physical abuse, or child sexual abuse, based upon self-reported victimization history before 14 years of age. Participants also reported on unwanted sexual experiences in young adulthood and provided four saliva samples, which were collected over two consecutive days to determine secretory immunoglobulin A (sIgA). Age and negative life events were considered as covariates. The results indicated that adult sexual victimization partially mediated the relationship between child abuse (physical and sexual) and sIgA. Specifically, child abuse experiences predicted more adult sexual victimization experiences, which in turn predicted lower sIgA levels. These findings support long-term health effects of victimization, and suggest that the influence of child abuse on sIgA may be perpetuated through adult victimization. Prevention efforts should aim to empower child maltreatment survivors with skills to prevent adult re-victimization. By thwarting future unwanted sexual experiences in adulthood, individuals will be better protected from the health impairments associated with early abuse experiences. © The Author(s) 2014.

  3. Potential scour for marine current turbines based on experience of offshore wind turbine

    Science.gov (United States)

    Chen, L.; Lam, W. H.; Shamsuddin, A. H.

    2013-06-01

    The oceans have tremendous untapped natural resources. These sources are capable to make significant contribution to our future energy demands. Marine current energy offers sustainable and renewable alternative to conventional sources. Survival problems of Marine Current Turbines (MCTs) need to be addressed due to the harsh marine environment. The analogous researches in wind turbine have been conducted. Some of the results and knowledge are transferable to marine current energy industry. There still exist some gaps in the state of knowledge. Scour around marine structures have been well recognised as an engineering issue as scour is likely to cause structural instability. This paper aims to review different types of foundation of MCTs and potential scour and scour protection around these foundations based on the experience of offshore wind turbine farm.

  4. Evolution of Wave Energy Deposition Profile in HT-7 Lower Hybrid Current Drive Experiment

    Institute of Scientific and Technical Information of China (English)

    方瑜德; 石跃江; 匡光力; 刘岳修; 沈慰慈; 丁伯江

    2001-01-01

    Lower hybrid waves (LHWs) with a selected n‖ spectrum have been used to control the energy deposition profiles, and then the wave driven current profiles effectively in tokamak discharges. In our lower hybrid current drive experiment in the HT-7 tokamak, it was found that the set-up of the wave energy deposition profile is a graduation process. In the beginning phase of the wave injection duration, the waves (with different n‖ spectra)deposit almost all their energy in the central region of the plasma column, even if their n‖ are very different. Up to around one hundred milliseconds, the wave energy deposition profiles can only take their corresponding shapes according to the n‖ spectra of LHWs. It also shown that this evolution process is affected obviously by the LHW driven current profile, which has been formed early.

  5. Empirical compensation function for eddy current effects in pulsed field gradient nuclear magnetic resonance experiments.

    Science.gov (United States)

    Zhu, X X; Macdonald, P M

    1995-05-01

    An empirical compensation function for the correction of eddy current effects in the Stejskal-Tanner pulsed-gradient spin-echo (PGSE) nuclear magnetic resonance (NMR) experiments has been established. Eddy currents may arise as a result of the application of sharp and strong gradient pulses and may cause severe distortion of the NMR signals. In this method, the length of one gradient pulse is altered to compensate for the eddy current effects. The compensation is considered to be ideal when the position and the phase of the spin-echo maximum obtained from an aqueous solution of poly(ethylene glycol) (PEG) is the same in the presence and absence of a gradient pulse in the PGSE pulse sequence. We first characterized the functional dependence of the length of the required compensation on the three principal variables in the PGSE experiment: the gradient strength, the duration of the gradient pulse, and the interval between the two gradient pulses. Subsequently, we derived a model which successfully describes the general relationship between these variables and the size of the induced eddy current. The parameters extracted from fitting the model to the experimental compensation data may be used to predict the correct compensation for any combination of the three principal variables.

  6. The Heidelberg High Current Injector A Versatile Injector for Storage Ring Experiments

    CERN Document Server

    Von Hahn, R; Repnow, R; Schwalm, D; Welsch, C P

    2004-01-01

    The High Current Injector (HCI) was designed and built as a dedicated injector for the Test Storage Ring in Heidelberg to deliver mainly singly charged Li- and Be-ions. After start for routine operation in 1999 the HCI delivered stable beams during the following years for about 50 % of the experiments with very high reliability. Due to the requirements from the experiment the HCI changed during that period from a machine for singly charged positive ions to an injector for a large variety of molecules as well as positively or negatively charged light ions. After successful commissioning of the custom built 18 GHz high power ECR-source at its present test location various modifications and additions were made in preparation of a possible conversion into an injector for highly charged heavy ions as a second phase. This paper gives an overview of the experience gained in the passed 5 years and presents the status of the upgrade of the HCI.

  7. Effects of neutral gas release on current collection during the CHARGE-2 rocket experiment

    Science.gov (United States)

    Gilchrist, B. E.; Banks, P. M.; Neubert, T.; Williamson, P. R.; Myers, Neil B.; Raitt, W. John; Sasaki, S.

    1990-01-01

    Observations of current collection enhancements due to cold nitrogen gas control jet emissions from a highly charged rocket payload in the ionosphere are reported. These observations were made during the second cooperative high altitude rocket gun experiment (CHARGE-2) which was an electrically tethered mother/daughter payload system. The current collection enhancement was observed at the daughter payload located 100 to 400 m away from the mother which was firing an energetic electron beam. The authors interpret these results in terms of an electrical discharge forming in close proximity to the daughter during the short periods of gas emission. The results indicate that it is possible to enhance the electron current collection capability of positively charged vehicles by means of deliberate neutral gas releases into an otherwise undisturbed space plasma. These results can also be compared with recent laboratory observations of hollow cathode plasma contactors operating in the ignited mode. Experimental observations of current collection enhancements due to cold nitrogen gas control jet emissions from a highly charged, isolated daughter payload in the nighttime ionosphere were made. These observations were derived from the second cooperative high altitude rocket gun experiment (CHARGE-2) which was an electrically tethered mother-daughter payload system. The rocket flew from White Sands Missile Range (WSMR) in December, 1985. The rocket achieved an altitude of 261 km and carried a 1 keV electron beam emitting up to 48 mA of current (Myers, et al., 1989a). The mother payload, carried the electron beam source, while the daughter acted as a remote current collection and observation platform and reached a distance of 426 m away from the main payload. Gas emissions at the daughter were due to periodic thruster jet firings to maintain separation velocity between the two payloads.

  8. Medical ozone is now ready for a scientific challenge: current status and future perspectives

    Directory of Open Access Journals (Sweden)

    Gregorio Martinez-Sanchez

    2012-06-01

    Full Text Available The aim of the present review is to clarify some of the basic mechanisms underlying ozone therapy. Indeed, after its empiric use started at the beginning of the last century, science is now ready to give a chance to the more and more medical doctors working in this field. Unfortunately, the lack of a full recognition by the health authorities and some ostracism against it is, up to date, the major obstacle for its full medical acceptance. Anyway, in the last years and thanks to the contributions of several scientists, most of the mechanisms characterizing the bio-humoral activity of ozone have been scientifically outlined. The built up of randomized clinical studies is going on slowly despite the lack of funds and the difficulties bound mainly to the huge variability of the ozone action. The thousand and thousand medical doctors involved in the use of ozone as emerging therapy, must be fully educated about the properties of this gas in the aim to counteract scientifically the criticisms of colleagues devoted to other field of medicine and not expert of the ozone pharmacological properties. Is for this reason that we encourage all the professionals to deeply increase the knowledge related to the scientific data produced and published on the international literatures in the field of the ozone therapy. For the future we suggest the use of ozone not in alternative but as a complement of the most appropriate pharmacological treatments also in the aim to reduce some side effects derived from a chronic drug use. The lack of a well-defined binding site for the ozone molecule could suggest the introduction of virtual receptors for the supposed biological activity of ozone acting mostly throughout second messengers pathways. [J Exp Integr Med 2012; 2(3.000: 193-196

  9. How current are leading evidence-based medical textbooks? An analytic survey of four online textbooks.

    Science.gov (United States)

    Jeffery, Rebecca; Navarro, Tamara; Lokker, Cynthia; Haynes, R Brian; Wilczynski, Nancy L; Farjou, George

    2012-12-10

    The consistency of treatment recommendations of evidence-based medical textbooks with more recently published evidence has not been investigated to date. Inconsistencies could affect the quality of medical care. To determine the frequency with which topics in leading online evidence-based medical textbooks report treatment recommendations consistent with more recently published research evidence. Summarized treatment recommendations in 200 clinical topics (ie, disease states) covered in four evidence-based textbooks--UpToDate, Physicians' Information Education Resource (PIER), DynaMed, and Best Practice--were compared with articles identified in an evidence rating service (McMaster Premium Literature Service, PLUS) since the date of the most recent topic updates in each textbook. Textbook treatment recommendations were compared with article results to determine if the articles provided different, new conclusions. From these findings, the proportion of topics which potentially require updating in each textbook was calculated. 478 clinical topics were assessed for inclusion to find 200 topics that were addressed by all four textbooks. The proportion of topics for which there was 1 or more recently published articles found in PLUS with evidence that differed from the textbooks' treatment recommendations was 23% (95% CI 17-29%) for DynaMed, 52% (95% CI 45-59%) for UpToDate, 55% (95% CI 48-61%) for PIER, and 60% (95% CI 53-66%) for Best Practice (χ(2) (3)=65.3, P<.001). The time since the last update for each textbook averaged from 170 days (range 131-209) for DynaMed, to 488 days (range 423-554) for PIER (P<.001 across all textbooks). In online evidence-based textbooks, the proportion of topics with potentially outdated treatment recommendations varies substantially.

  10. Effects of Medicaid disease management programs on medical expenditures: Evidence from a natural experiment in Georgia.

    Science.gov (United States)

    Kranker, Keith

    2016-03-01

    In recent decades, most states' Medicaid programs have introduced disease management programs for chronically ill beneficiaries. Interventions assist beneficiaries and their health care providers to appropriately manage chronic health condition(s) according to established clinical guidelines. Cost containment has been a key justification for the creation of these programs despite mixed evidence they actually save money. This study evaluates the effects of a disease management program in Georgia by exploiting a natural experiment that delayed the introduction of high-intensity services for several thousand beneficiaries. Expenditures for medical claims decreased an average of $89 per person per month for the high- and moderate-risk groups, but those savings were not large enough to offset the total costs of the program. Impacts varied by the intensity of interventions, over time, and across disease groups. Heterogeneous treatment effect analysis indicates that decreases in medical expenditures were largest at the most expensive tail of the distribution.

  11. Tools based on experiences of a community pharmacy providing destruction services for unwanted medications.

    Science.gov (United States)

    Johnson, Michelle Grossman

    2010-01-01

    To describe the process used by a pharmacy in Minnesota to develop a drug disposal option for its patients and the surrounding community to safely dispose of unwanted medications and to describe the current barriers to continuing activities. Information on rules and regulations regarding hazardous waste management was gathered from pertinent state agencies. Resources used included online access to the statutes and information posted on Minnesota and federal agencies websites. Further information was gathered during personal communications with key employees within agencies. Not applicable. By the author. Although the information provided in the current work pertains to Minnesota, modeling collection activities to meet the strict Minnesota hazardous waste regulations would likely ensure collection events that meet both federal and state regulations in states with less stringent regulations. The current limiting factor to further collection events within a pharmacy setting consists of Drug Enforcement Administration (DEA) interpretation and enforcement of the law. A solution is discussed for pharmacy collaboration within communities that would meet DEA rules until federal regulations are clarified or altered. Educating and offering patients easy, immediate alternatives is necessary before patients will choose proper disposal methods instead of sewering unwanted or expired medications. Pharmacists are well positioned to educate patients about protecting their families and the water supply.

  12. The experiences of successful faculty members in medical school in teaching of basic sciences

    Directory of Open Access Journals (Sweden)

    M Avizhgan

    2016-03-01

    Full Text Available Introduction: Basic sciences are an important part of education in medical courses, which without it training the competent and efficient physicians is impossible. Given the complexities of teaching and in particular the teaching of basic sciences and its influence of various factors, comprehensive investigate this phenomenon was felt. This study was aimed to explore the underlying factors affecting the teaching based on experiences of successful faculty members of basic sciences in Isfahan medical school. Methods: This qualitative study was conducted using conventional content analysis. The data was collected using purposive sampling and semi-structured interviews with faculty members of basic sciences and group interviews with the students of basic sciences. Results: After analysis the data, the extracted data were divided into three main categories and seven sub- classes, including strengthen the construction of teaching infrastructures (lesson plans, useful and practical educational materials, and continuous curriculum reform, improving the teaching process (facilitating learning and appropriate transfering of content and completing the teaching process (appropriate evaluation tool and continuity assessment. Conclusion: Some positive experiences, such as reducing volume of materials, teaching useful and practical materials, attractive teaching, early clinical exsposure and provide the appropriate educational materials should be considered as a model and to eliminate negative experiences such as teaching of pure basic sciences, drowning in detail, the emphass on memorization, indulge in speech, the multiple choice tests systems and some faculty members were not ready for some of teaching methods should be taken account some items.

  13. Teaching by example: educating medical students through a weight management experience.

    Science.gov (United States)

    Schmidt, Susan; Rice, Austin; Kolasa, Kathryn

    2013-09-01

    Surgeons General, the Institute of Medicine, and others have called for physicians to be role models for meeting the obesity epidemic. There are few published reports describing undergraduate medical education obesity curriculum elements. Physician experiences, knowledge, and attitudes have been shown to affect patient counseling behavior of physicians. Required and extra credit obesity educational interventions were designed for third-year family medicine clerkship. For extra credit, students completed a personal weight management experience that spanned at least 4 weeks, included calculations of body mass index (BMI), waist circumference, caloric needs, description of eating and physical activity and monitoring plan, and a final report and reflection. During 2011--2012, 72% of the students completed this extra credit activity with almost all losing or maintaining their weight. Most reflected gratitude for this opportunity and their increased empathy for patients as they struggle with weight issues. Medical students completing a weight management experience during their third-year clerkship can see the effects on their own health while developing empathy for and understanding of the weight management struggles of their patients. Minimal faculty time commitment is required.

  14. Medical versus surgical management of penetrating Crohn's disease: the current situation and future perspectives.

    Science.gov (United States)

    Patil, Seema A; Cross, Raymond K

    2017-09-01

    The development of penetrating Crohn's disease (CD) occurs in up to 50% of patients over the course of their lifetime. While the presentation of these complications, including free perforation, intra-abdominal abscess, and enteric fistula, are usually obvious, the management can require a nuanced approach, with distinct short and long-term approaches. Areas covered: This review discusses medical and surgical methods of treating these complications, including the role of percutaneous drainage of abscesses, the implications of a stricture associated with a fistula, and the efficacy of postoperative anti-TNF therapy in preventing recurrence after surgical treatment. Expert commentary: An approach to the management of these complications that begins with control of sepsis, including broad-spectrum antibiotics, bowel rest, and nutritional support is proposed. The next appropriate step is a diagnostic evaluation to determine the utility of medical versus surgical therapy, considering the presence of a stricture and prior immunosuppressive therapy. Postoperative anti-TNF therapy, a highly effective method to prevent recurrence, should be considered in many cases.

  15. International medical graduates (IMGs needs assessment study: comparison between current IMG trainees and program directors

    Directory of Open Access Journals (Sweden)

    Baerlocher Mark

    2008-08-01

    Full Text Available Abstract Background International Medical Graduates (IMGs training within the Canadian medical education system face unique difficulties. The purpose of this study was to explore the challenges IMGs encounter from the perspective of trainees and their Program Directors. Methods Program Directors of residency programs and IMGs at the University of Toronto were anonymously surveyed and asked to rate (using a 5-point Likert scale; 1 = least important – 5 = most important the extent to which specific issues were challenging to IMGs and whether an orientation program (in the form of a horizontal curriculum should be implemented for incoming IMGs prior to starting their residency. Results Among the IMGs surveyed, Knowledge of the Canadian Healthcare System received the highest mean score (3.93, followed by Knowledge of Pharmaceuticals and Hospital formularies (3.69, and Knowledge of the Hospital System (3.69. In contrast, Program Directors felt that Communication with Patients (4.40 was a main challenge faced by IMGs, followed by Communication with Team Members (4.33 and Basic Clinical Skills (4.28. Conclusion IMGs and Program Directors differ in their perspectives as to what are considered challenges to foreign-trained physicians entering residency training. Both groups agree that an orientation program is necessary for incoming IMGs prior to starting their residency program.

  16. Meningitis and Meningoencephalitis among Israel Defense Force Soldiers: 20 Years Experience at the Hadassah Medical Centers.

    Science.gov (United States)

    Pikkel, Yoav Y; Ben-Hur, Tamir; Eliahou, Ruth; Honig, Asaf

    2015-11-01

    Meningitis and meningoencephalitis pose major risks of morbidity and mortality. To describe 20 years of experience treating infections of the central nervous system in Israel Defense Force (IDF) soldiers, including the common presentations, pathogens and sequelae, and to identify risk groups among soldiers. All soldiers who were admitted to the Hadassah University Medical Center (both campuses: Ein Kerem and Mt. Scopus) due to meningitis and meningoencephalitis from January 1993 to January 2014 were included in this retrospective study. Clinical, laboratory and radiologic data were reviewed from their hospital and army medical corps files. Attention was given to patients' military job description, i.e., combat vs. non-combat soldier, soldiers in training, and medical personnel. We identified 97 cases of suspected meningitis or meningoencephalitis. Six were mistakenly filed and these patients were found to have other disorders. Four soldiers were diagnosed with epidural abscess and five with meningitis due to non-infectious in flammatory diseases. Eighty-two soldiers in active and reserve duty had infectious meningitis or meningoencephalitis. Of these, 46 (56.1%) were combat soldiers and 31 (37.8%) non-combat; 20 (29.2%) were soldiers in training, 10 (12.2%) were training staff and 8 (9.8%) were medical staff. The main pathogens were enteroviruses, Epstein-Barr virus an d Neisseria meningitidis. In our series, soldiers in training, combat soldiers and medical personnel had meningitis and meningoencephalitis more than other soldiers. Enteroviruses are highly infectious pathogens and can cause outbreaks. N. meningitidis among IDF soldiers is still a concern. Early and aggressive treatment with steroids should be considered especially in robust meningoencephalitis cases.

  17. Characterization of the plasma current quench during disruptions in the National Spherical Torus Experiment

    Energy Technology Data Exchange (ETDEWEB)

    Gerhardt, S.P., Menard, J.E., and the NSTX Research Team

    2008-12-17

    A detailed analysis of the plasma current quench in the National Spherical Torus Experiment [M.Ono, et al Nuclear Fusion 40, 557 (2000)] is presented. The fastest current quenches are fit better by a linear waveform than an exponential one. Area-normalized current quench times down to .4 msec/m2 have been observed, compared to the minimum of 1.7 msec/m2 recommendation based on conventional aspect ratio tokamaks; as noted in previous ITPA studies, the difference can be explained by the reduced self-inductance at low aspect ratio and high-elongation. The maximum instantaneous dIp/dt is often many times larger than the mean quench rate, and the plasma current before the disruption is often substantially less than the flat-top value. The poloidal field time-derivative during the disruption, which is directly responsible for driving eddy currents, has been recorded at various locations around the vessel. The Ip quench rate, plasma motion, and magnetic geometry all play important roles in determining the rate of poloidal field change.

  18. Modeling, Simulation, and Experiment of Switched Reluctance Ocean Current Generator System

    Directory of Open Access Journals (Sweden)

    Hao Chen

    2013-01-01

    Full Text Available This paper presents nonlinear simulation model of switched reluctance (SR ocean current generator system on MATLAB/SIMULINK with describing the structure of generator system. The developed model is made up of main model, rotor position calculation module, controller module, gate module, power converter module, phase windings module, flux-linkage module, torque module, and power calculation module. The magnetization curves obtained by two-dimensional finite-element electromagnetic field calculation and the conjugated magnetic energy graphics obtained from the three-dimensional graphics of flux linkage are stored in the “Lookup Table” modules on MATLAB/SIMULINK. The hardware of the developed three-phase 12/8 structure SR ocean current generator system prototype with the experimental platform is presented. The simulation of the prototype is performed by the developed models, and the experiments have been carried out under the same condition with different output power, turn-off angle, and rotor speed. The simulated phase current waveforms agree well with the tested phase current waveforms experimentally. The simulated output voltage curves agree well with the tested output voltage curves experimentally. It is shown that the developed nonlinear simulation model of the three-phase 12/8 structure SR ocean current generator system is valid.

  19. Adrenal lesions encountered in current medical practice − a review of their radiological imaging

    Directory of Open Access Journals (Sweden)

    Vanesha Naidu

    2013-11-01

    Full Text Available Modern radiological technology has transformed the way that adrenal lesions are currently investigated. The contemporary radiologist has been catapulted to the forefront in the management of adrenal disease. With the increasing use of cross-sectional imaging, adrenal lesions are being serendipitously discovered in radiological studies undertaken for non-adrenal-related conditions – the so-called adrenal ‘incidentaloma’. This review discusses the imaging modalities available for characterising these lesions, highlighting current concepts and controversies in differentiating benign from malignant pathology. The article also provides a brief overview of the spectrum of adrenal pathology commonly encountered in the adult population.

  20. Medical students' unique experience of army leadership training: a qualitative study.

    Science.gov (United States)

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

    2017-02-13

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

  1. Evaluating validity of current criteria for judgment passing ER rotation among internee medical students

    Directory of Open Access Journals (Sweden)

    Hooman Hoseinnejad

    2017-08-01

    Conclusions: According to association between successfully completions of training in emergency medicine and self-assessment questionnaire, it seems current criteria for judgment passing emergency medicine rotation is valid as well as we recommended using self-assessment for evaluating validity of such testes.

  2. Current status of nursing medication error management%护士给药错误管理研究现状

    Institute of Scientific and Technical Information of China (English)

    万文洁; 田梅梅; 施雁

    2012-01-01

    医院不良事件中用药错误的发生率较高.从护理专业角度,对国内外给药错误的基本概念、后果、现状分析、量化管理、发生因素及预防措施进行综述,为护士给药错误的管理提供依据,以保障和促进病人安全.%Medication errors represented high incident rates of all hospital adverse events. We summarized the basic concepts, consequences, current status analysis, qualitative management, causes and preventive measures from nursing prospective to provide the references for medication error management and to protect and promote patient safety.

  3. Profile of currently employed European Food Scientists and Technologists: Education, experience and skills

    Directory of Open Access Journals (Sweden)

    Katherine Flynn

    2013-10-01

    Full Text Available The food & drink (F&D sector in Europe ranks low in innovation and the European F&D industry has been losing importance in the global market. The food professionals, i.e., food scientists and technologists (FSTs, may not be meeting the varied demands of the sector. Here, we identify education, experience and skills of current FSTs and compare  geographic regions and employment areas. Between 2009 and 2012, 287 questionnaires representing over 4000 FSTs were collected from employers in 16 countries. Analyses showed that more than 80% of FSTs have a university degree; but only in Industry in the Central European region are most degrees in food science/technology. More than half of FSTs, and almost 60% in the South, have less than 10 years’ experience. The most common FST job title is Quality Manager, but with several variations based on region and employment area. Among skills, the most common is Communicating; found in over 90% of FSTs in all regions and employment areas. Food Safety is the most common of the food sector-specific skills, present in more than 75% of FSTs, yet there are differences in food sector skills based on employment area. Overall, these data suggest similarities among currently employed food professionals throughout Europe; they are young and highly educated, but also differences, especially in their food sector-specific skills. An understanding of the current FST should contribute to the improvement of FST training and thus benefit the European food sector.

  4. Effort of lower hybrid current drive experiments toward to H-mode in EAST

    Science.gov (United States)

    Ding, B. J.; Li, M. H.; Liu, F. K.; Shan, J. F.; Li, Y. C.; Wang, M.; Liu, L.; Zhao, L. M.; Yang, Y.; Wu, Z. G.; Feng, J. Q.; Hu, H. C.; Jia, H.; Cheng, M.; Zang, Q.; Lyu, B.; Duan, Y. M.; Lin, S. Y.; Wu, J. H.; Hillairet, J.; Ekedahl, A.; Peysson, Y.; Goniche, M.; Tuccillo, A. A.; Cesario, R.; Amicucci, L.; Shen, B.; Gong, X. Z.; Xu, G. S.; Zhao, H. L.; Hu, L. Q.; Li, J. G.; Wan, B. N.; EAST Team

    2017-02-01

    Lower hybrid current drive (LHCD) is an effective tool to achieve high confinement (H-mode) plasma in EAST. To utilize LHCD for accessing H-mode plasma, efforts have been made to improve LHW (lower hybrid wave)-plasma coupling and current drive capability at high density. Improved LHW-plasma coupling by means of local gas puffing and gas puffing from the electron side is routinely used during EAST operation with LHCD. High density experiments suggest that low recycling and high LH frequency are preferred for LHCD experiments at high density, consistent with previous results in other machines. The effect of LHCD on the current profile in EAST demonstrates that it is possible to control the plasma profile by optimizing the LHW spectrum. Repeatable H-mode plasma was obtained by LHCD and the maximum density during H-mode with the combination of 2.45 GHz and 4.6 GHz LH waves was up to 4.5  ×  1019 m-3.

  5. Current and future perspectives on integrative traditional Chinese and Western medical management of gastroenterological diseases

    Directory of Open Access Journals (Sweden)

    WEI Beihai

    2013-04-01

    Full Text Available In recent years, significant progress has been made in the systematic investigation and application of integrative traditional Chinese and western medical management of digestive system diseases. Evidence-based modern investigations of the pathogenic processes and related etiologies are confirming the systemic nature of disease and the need for a comprehensive approach to clinical management. For example, the conditions of acute pancreatitis and hepatitis caused by pathogenic agents are intimately associated with inflammation signaling and circulatory function. In traditional Chinese medicine (TCM, the individual’s systemic condition is addressed, complementing the targeted approach of Western medicines and therapies. Here, we review the theoretical and biological aspects of the integrative treatment modality for the various pancreatic and hepatobilliarly diseases that have been reported. In particular, the outcomes and mechanisms of integrative management of chronic hepatitis, liver fibrosis and cirrhosis, severe acute pancreatitis, gallstones, and malignancies of the digestive system are discussed in the context of specific TCM herbs and decoctions.

  6. Chronic migraine and medication overuse headache: clarifying the current International Headache Society classification criteria.

    Science.gov (United States)

    Sun-Edelstein, C; Bigal, M E; Rapoport, A M

    2009-04-01

    Despite the recent advances in the understanding and classification of the chronic daily headaches, considerable controversy still exists regarding the classification of individual headaches, including chronic migraine (CM) and medication overuse headache (MOH). The original criteria, published in 2004, were difficult to apply to most patients with these disorders and were subsequently revised, resulting in broader clinical applicability. Nonetheless, they remain a topic of debate, and the revisions to the criteria have further added to the confusion. Even some prominent headache specialists are unsure which criteria to use. We aimed to explain the nature of the controversies surrounding the entities of CM and MOH. A clinical case will be used to illustrate some of the problems faced by clinicians in diagnosing patients with chronic daily headache.

  7. Near-infrared spectroscopy for medical applications: Current status and future perspectives.

    Science.gov (United States)

    Sakudo, Akikazu

    2016-04-01

    The near-infrared radiation (NIR) window, also known as the "optical window" or "therapeutic window", is the range of wavelengths that has the maximum depth of penetration in tissue. Indeed, because NIR is minimally absorbed by water and hemoglobin, spectra readings can be easily collected from the body surface. Recent reports have shown the potential of NIR spectroscopy in various medical applications, including functional analysis of the brain and other tissues, as well as an analytical tool for diagnosing diseases. The broad applicability of NIR spectroscopy facilitates the diagnosis and therapy of diseases as well as elucidating their pathophysiology. This review introduces recent advances and describes new studies in NIR to demonstrate potential clinical applications of NIR spectroscopy.

  8. Mobile health in cardiology: a review of currently available medical apps and equipment for remote monitoring.

    Science.gov (United States)

    Treskes, Roderick Willem; van der Velde, Enno Tjeerd; Barendse, Rogier; Bruining, Nico

    2016-09-01

    Recent developments in implantable cardioverter-defibrillators (ICDs) and smartphone technology have increased the possibilities for remote monitoring. It is the purpose of this review to give an overview of these new possibilities. Remote monitoring in ICD allows for early detection of lead fractures and remote follow-up of patients. Possible limitations are the lack of standardization and the possible unsafety of the data stored on the ICD. Secondly, remote monitoring of health parameters using smartphone compatible wearables and smartphone medical apps is addressed. Possible limitations include the fact that the majority of smartphone apps are unregulated by the regulatory authorities and privacy issues such as selling of app-generated data to third parties. Lastly, clinical studies with smartphone apps are discussed. Expert commentary: New technologies in ICDs and smartphones have the potential to be used for remote monitoring. However, unreliability of smartphone technology, inadequate legislation and lack of reimbursement impede implementation.

  9. Electron Neutrino Charged-Current Quasielastic Scattering in the MINERvA Experiment

    CERN Document Server

    Wolcott, J

    2016-01-01

    The electron-neutrino charged-current quasielastic (CCQE) cross section on nuclei is an important input parameter for electron neutrino appearance oscillation experiments. Current experiments typically begin with the muon neutrino cross section and apply theoretical corrections to obtain a prediction for the electron neutrino cross section. However, at present no experimental verification of the estimates for this channel at an energy scale appropriate to such experiments exists. We present the cross sections for a CCQE-like process determined using the MINERvA detector, which are the first measurements of any exclusive reaction in few-GeV electron neutrino interactions. The result is given as differential cross-sections vs. the electron energy, electron angle, and square of the four-momentum transferred to the nucleus, $Q^{2}$. We also compute the ratio to a muon neutrino cross-section in $Q^{2}$ from MINERvA. We find satisfactory agreement between these measurements and the predictions of the GENIE generato...

  10. Electron neutrino charged-current quasielastic scattering in the MINERvA experiment

    CERN Document Server

    Wolcott, Jeremy

    2015-01-01

    The electron-neutrino charged-current quasielastic (CCQE) cross section on nuclei is an important input parameter to appearance-type neutrino oscillation experiments. Current experiments typically work from the muon neutrino cross section and apply corrections from theoretical arguments to obtain a prediction for the electron neutrino cross section, but to date there has been no experimental verification of the estimates for this channel at an energy scale appropriate to such experiments. We present the first measurement of an exclusive reaction in few-GeV electron neutrino interactions, namely, the cross section for a CCQE-like process, made using the MINERvA detector. The result is given as differential cross-sections vs. the electron energy, electron angle, and square of the four-momentum transferred to the nucleus, $Q^2$. We also compute the ratio to a muon neutrino cross-section in $Q^2$ from MINERvA. We find satisfactory agreement between this measurement and the predictions of the GENIE generator.

  11. Electron Neutrino Charged-Current Quasielastic Scattering in the MINERvA Experiment

    Energy Technology Data Exchange (ETDEWEB)

    Wolcott, J. [Tufts U.

    2015-12-31

    The electron-neutrino charged-current quasielastic (CCQE) cross section on nuclei is an important input parameter for electron neutrino appearance oscillation experiments. Current experiments typically begin with the muon neutrino cross section and apply theoretical corrections to obtain a prediction for the electron neutrino cross section. However, at present no experimental verification of the estimates for this channel at an energy scale appropriate to such experiments exists. We present the cross sections for a CCQE-like process determined using the MINERvA detector, which are the first measurements of any exclusive reaction in few-GeV electron neutrino interactions. The result is given as differential cross-sections vs. the electron energy, electron angle, and square of the four-momentum transferred to the nucleus, $Q^{2}$. We also compute the ratio to a muon neutrino cross-section in $Q^{2}$ from MINERvA. We find satisfactory agreement between these measurements and the predictions of the GENIE generator. We furthermore report on a photon-like background unpredicted by the generator which we interpret as neutral-coherent diffractive scattering from hydrogen.

  12. Electron Neutrino Charged-Current Quasielastic Scattering in the MINERvA Experiment

    Energy Technology Data Exchange (ETDEWEB)

    Wolcott, Jeremy [Rochester U.

    2015-10-28

    The electron-neutrino charged-current quasielastic (CCQE) cross section on nuclei is an important input parameter to appearance-type neutrino oscillation experiments. Current experiments typically work from the muon neutrino cross section and apply corrections from theoretical arguments to obtain a prediction for the electron neutrino cross section, but to date there has been no experimental verification of the estimates for this channel at an energy scale appropriate to such experiments. We present the first measurement of an exclusive reaction in few-GeV electron neutrino interactions, namely, the cross section for a CCQE-like process, made using the MINERvA detector. The result is given as differential cross-sections vs. the electron energy, electron angle, and square of the four-momentum transferred to the nucleus, $Q^2$. We also compute the ratio to a muon neutrino cross-section in $Q^2$ from MINERvA. We find satisfactory agreement between this measurement and the predictions of the GENIE generator.

  13. Some medical and other risk factors for current cesarean section in a Jakarta hospital

    Directory of Open Access Journals (Sweden)

    Endang Poedjiningsih

    2001-12-01

    Full Text Available For the last year the prevalence of cesarean section (CS increased in several countries as well as in Indonesia. In Indonesia there was no comprehensive study on risk factors related to CS. This case-control study was conducted at Fatmawati Hospital in Jakarta from 1 July 200 until 31 January 2001. Data was extracted from available medical records. Ceserean section was defined as a delivery through laparotomy. The control group consisted of subjects having vaginal deliveries. For each cases were selected randomly a control based on the date before or after 18 October 2000. Subject who had fetal distress had 544-folds increased risk to be CS relative to those who did not have fetal distress [adjusted odds ratio (OR = 544.86; 95% confidence intervals (CI = 71.85- 4131.78]. Furthermore, relative those who did not have dystocia, those who had dystocia had 143 times increased risk to be CS (adjusted OR = 52.86; 95% CI = 52.86 - 391.17. In term of previous CS, subjects who ever had previous CS had 30 times increased risk to be CS compared with the subjects who never had CS (adjusted OR = 30.23; 95% CI = 12.06 - 75.57. In contrast, compared with those who non cash payment, those who paid in cash had a lowered risk of 80% (adjusted OR = 0.20; 95% CI = 0.11-0.34. In conclusion, previous CS, dystocia, pre eclampsia, other medical indications, fetal distress, and non cash hospitalization expences increased risk of CS. (Med J Indones 2001; 10: 230-4Keywords: cesarean section, risk factors

  14. Medication management of febrile children: a qualitative study on pharmacy employees' experiences.

    Science.gov (United States)

    Stakenborg, Jacqueline P G; de Bont, Eefje G P M; Peetoom, Kirsten K B; Nelissen-Vrancken, Marjorie H J M G; Cals, Jochen W L

    2016-10-01

    Background While fever is mostly self-limiting, antibiotic prescription rates for febrile children are high. Although every parent who receives a prescription visits a pharmacy, we have limited insight into pharmacy employees' experiences with these parents. Pharmacy employees do however exert an important role in ensuring children receive correct dosages and in advising parents on administration of antibiotics. Objective To describe pharmacists' and pharmacy assistants' experiences with parents contacting a pharmacy for their febrile child, and to identify ways of improving medication management of these children. Setting Community pharmacies in the Netherlands. Method A qualitative study including 24 Dutch pharmacy employees was conducted, performing four focus group discussions among pharmacy employees. Analysis was based on constant comparative technique using open and axial coding. Main outcome measure Pharmacy employees' experiences with parents contacting a pharmacy for their febrile child. Results Three categories were identified: (1) workload and general experience, (2) inconsistent information on antibiotic prescriptions, (3) improving communication and collaboration. Pharmacy employees experienced that dosing errors in antibiotic prescriptions occur frequently and doctors provide inconsistent information on prescriptions. Consequently, they have to contact doctors, resulting in a higher workload for both stakeholders. They believe this can be improved by providing the indication for antibiotics on prescriptions, especially when deviating from standard dosages. Conclusion Pharmacy employees experience a high amount of dosing errors in paediatric antibiotic prescriptions. Providing the indication for antibiotics in febrile children on prescriptions, especially when deviating from standard dosages, can potentially reduce dosage errors and miscommunication between doctors and pharmacy employees.

  15. Teaching Physiology in integrated basic medical sciences – sharing experiences from Nepal.

    Directory of Open Access Journals (Sweden)

    Pradhan AK

    2013-12-01

    Full Text Available Physiology is the basis of the medical profession [1]. Clear understanding of the mechanisms of the body functions always requires a high level of integration, apart from a descriptive approach [2, 3]. I worked as Professor in the Manipal College of Medical Sciences (MCOMS, Pokhara in the year 2009 -2010. Although my stay in Nepal was relatively short period, but the medical education system in Nepal influenced me. In Nepal, a traditional way of teaching pattern which is lecture-based, teacher-centered, discipline-based, examination-driven, and hospital-oriented is followed. Basic sciences and clinical sciences are the two main part of the medical curriculum in Nepal. The Bachelor of Medicine and Bachelor of Surgery degree is a four and half year's program, which is followed by one year internship. A large number of new medical colleges are coming up under Nepal Medical Council guidelines. There is a growing demand of Physicians in Nepal. Currently there are 18 medical colleges under Nepal Medical Council [4]. Manipal College of Medical Sciences is under Kathmandu University, one of the best and leading medical institutes in the country. This medical college is located in Pokhara. Students hailing from Nepal, India, Sri Lanka and other countries attend the four and a half year undergraduate medical (MBBS course. The MBBS course in Nepal is divided into nine semesters. Basic science subjects include Anatomy, Physiology, Biochemistry, Microbiology, Pathology, Pharmacology and Community Medicine which are taught in an integrated manner during the first four semesters (two years period. Community Medicine continues as a part of syllabus till the seventh semester and the clinical subjects like Medicine, Surgery, OBG, Ophthalmology, Orthopedics, Dermatology etc. are taught during the last five semesters of the MBBS course. At present Tribhuvan University (TU, Kathmandu University (KU, BP Koirala Institute of Health Sciences (BPKIHS and NAMS (National

  16. Developing eLearning Technologies to Implement Competency Based Medical Education: Experiences from Muhimbili University of Health and Allied Sciences

    Science.gov (United States)

    Nagunwa, Thomas; Lwoga, Edda

    2012-01-01

    This paper provides the practical experience of developing an eLearning technology as a tool to implement Competency-based Medical Education (CBME) in Tanzania medical universities, with a specific focus on Muhimbili University of Health and Allied Sciences. The paper provides a background to eLearning and the early attempt to adopt it in 2006 at…

  17. "It's All Connected!" Nursing Students' Experiences of a New Form of Case Seminar Integrating Medical and Nursing Science

    Science.gov (United States)

    Turunen Olsson, Pernilla; Weurlander, Maria; Mattiasson, Anne-Cathrine; Wärn Hede, Gunnel; Panagiotidis, Georgios; Broberger, Eva; Hult, Håkan; Wernerson, Annika

    2016-01-01

    Traditionally, nursing students learn medical subjects and nursing separately, which makes it difficult to develop an integrated understanding. This study aimed to explore nursing students' experiences of participating in a case seminar integrating medical and nursing sciences and if, and how, it contributed to their learning. A case seminar…

  18. [Results of a problem-based learning experience applied to first year medical students].

    Science.gov (United States)

    Fasce, E; Ramírez, L; Ibáñez, P

    1994-11-01

    The aim of this work was to study the feasibility of applying problem-based learning methodologies to first year medical students. During 1992, they participated in tutorial groups composed by ten students, that undertook the study of three clinical problems from a biological, psychological and social perspective. Cognitive tests that included multiple choice and developmental questions were used for assessment. An anonymous enquiry about the students opinion towards the educational experience was also applied. Students achieved 76% of the predetermined goals for each problem. Scoring was better for developmental than multiple choice questions. The experience had a great acceptance among students, that considered as positive features the learning motivation, the stimulus for active participation, the achievement of personal expectancies, the integration of knowledge areas and the encouragement of team work and information seeking.

  19. COMPUTER ASSISTED LEARNING: PERCEPTION AND ACCEPTABILITY OF UNDERGRADUATE MEDICAL STUDENTS IN PHARMACOLOGY EXPERIMENTS

    Directory of Open Access Journals (Sweden)

    Ravi Babu

    2015-12-01

    Full Text Available BACKGROUND According to Medical Council of India theory and practical curriculum is very essential for all medical subjects in the under-graduate medical course in India. Animal based experimental pharmacology is still being taught in many institutions in the country, though such a practice has been abandoned at many centers. However, the use of animals in research and experimentation has been debated, defended and protested by both individuals and organizations at various levels. In recent years undergraduate training in pharmacology has been revolutionized with adoptions of new methods of teaching that focus on supportive learning through novel teaching approaches like CAL (Computer Assisted Learning. OBJECTIVE To assess the student’s perception and acceptability of Computer Assisted Learning (CAL as a tool in demonstrating the drug effects in animals and to analyze feedback about advantages and disadvantages of CAL software. METHODS CAL software was used to demonstrate action of drugs in animals. Feedback was taken from students regarding their perception, acceptability, advantages and disadvantages of this tool. RESULTS More than 50% of the students opined that CAL is an effective method of teaching practical aspects of pharmacology; 88.88% of students expressed that lack of interaction with living tissues and animals is the main disadvantage. CONCLUSION Computer Assisted Learning (CAL is an excellent beneficial tool. It enhances the learning experience of the students and it is one of the alternative educational tools to demonstrate the drug effects in animals.

  20. Adverse Childhood Experiences among Veterinary Medical Students: A Multi-Site Study.

    Science.gov (United States)

    Strand, Elizabeth B; Brandt, Jennifer; Rogers, Kenita; Fonken, Laurie; Chun, Ruthanne; Conlon, Peter; Lord, Linda

    2017-03-27

    This research explores Adverse Childhood Experiences (ACEs) among veterinary medical students across six academic institutions of veterinary medicine, and their relationship with depression, stress, and desire to become a veterinarian. Between April 1, 2016 and May 23, 2016, 1,118 veterinary medical students in all 4 years of the curriculum (39% response rate) completed an anonymous web-based questionnaire about ACEs, depression using the Center for Epidemiological Studies Depression scale (CESD), stress using the Perceived Stress Scale (PSS), and the age at which they wanted to become a veterinarian. Sixty-one percent (677) of respondents reported having at least one ACE. The most prevalent ACE reported was living with a household member with a mental illness (31%). Students who had experienced four or more ACEs had an approximately threefold increase in signs of clinical depression and higher than average stress when compared to students who had experienced no ACEs. The number of ACEs showed an overall graded relationship to signs of clinical depression and higher than average stress. There was no statistically significant relationship between age at which a student wanted to become a veterinarian and exposure to ACEs. Veterinary students report being exposed to ACEs before age 18 at a rate similar to that of other population-based studies. These findings do not suggest that veterinary students enter the veterinary medical education system more at risk for poor mental health due to ACEs than the general population.

  1. Findings from the Harvard Medical School Cambridge Integrated Clerkship, a Year-Long Longitudinal Psychiatry Experience.

    Science.gov (United States)

    Cheng, Elisa; Hirsh, David; Gaufberg, Elizabeth; Griswold, Todd; Wesley Boyd, J

    2017-06-23

    The Harvard Medical School Cambridge Integrated Clerkship is a longitudinal integrated clerkship that has provided an alternative clinical model for medical education in psychiatry since its inception in 2004. This study was undertaken in an effort to better understand the student experience of the Cambridge Integrated Clerkship and how it may have impacted students' perceptions of and interest in psychiatry, as well as performance. Qualitative surveys were sent via e-mail to the first 11 student cohorts who had completed the Cambridge Integrated Clerkship (from 2004 to 2014) and for whom we had e-mail addresses (N = 100), and the free-text responses were coded thematically. All available standardized scoring data and residency match data for Cambridge Integrated Clerkship graduates were obtained. From 2006 to 2014, 12 out of 73 Cambridge Integrated Clerkship students who entered the match chose a psychiatry residency (16.4%), four times more than students in traditional clerkships at Harvard Medical School (3.8% of 1355 students) or the national average (4.1% of 146,066 US applicants). Thirty of the 100 surveyed Cambridge Integrated Clerkship graduates (30%) responded to the qualitative survey with free-text remarks on a number of themes. Cambridge Integrated Clerkship students compared positively to their classmates in terms of standardized test performance. Their fourfold higher match rate into psychiatry compared to other students raises intriguing questions as to what role a longitudinal clerkship might have played in developing interest in psychiatry as a career.

  2. Medical physics staffing for radiation oncology: a decade of experience in Ontario, Canada.

    Science.gov (United States)

    Battista, Jerry J; Clark, Brenda G; Patterson, Michael S; Beaulieu, Luc; Sharpe, Michael B; Schreiner, L John; MacPherson, Miller S; Van Dyk, Jacob

    2012-01-05

    The January 2010 articles in The New York Times generated intense focus on patient safety in radiation treatment, with physics staffing identified frequently as a critical factor for consistent quality assurance. The purpose of this work is to review our experience with medical physics staffing, and to propose a transparent and flexible staffing algorithm for general use. Guided by documented times required per routine procedure, we have developed a robust algorithm to estimate physics staffing needs according to center-specific workload for medical physicists and associated support staff, in a manner we believe is adaptable to an evolving radiotherapy practice. We calculate requirements for each staffing type based on caseload, equipment inventory, quality assurance, educational programs, and administration. Average per-case staffing ratios were also determined for larger-scale human resource planning and used to model staffing needs for Ontario, Canada over the next 10 years. The workload specific algorithm was tested through a survey of Canadian cancer centers. For center-specific human resource planning, we propose a grid of coefficients addressing specific workload factors for each staff group. For larger scale forecasting of human resource requirements, values of 260, 700, 300, 600, 1200, and 2000 treated cases per full-time equivalent (FTE) were determined for medical physicists, physics assistants, dosimetrists, electronics technologists, mechanical technologists, and information technology specialists, respectively.

  3. Analysis and experiment of eddy current loss in Homopolar magnetic bearings with laminated rotor cores

    Science.gov (United States)

    Jinji, Sun; Dong, Chen

    2013-08-01

    This paper analyses the eddy current loss in Homopolar magnetic bearings with laminated rotor cores produced by the high speed rotation in order to reduce the power loss for the aerospace applications. The analytical model of rotational power loss is proposed in Homopolar magnetic bearings with laminated rotor cores considering the magnetic circuit difference between Homopolar and Heteropolar magnetic bearings. Therefore, the eddy current power loss can be calculated accurately using the analytical model by magnetic field solutions according to the distribution of magnetic fields around the pole surface and boundary conditions at the surface of the rotor cores. The measurement method of rotational power loss in Homopolar magnetic bearing is proposed, and the results of the theoretical analysis are verified by experiments in the prototype MSCMG. The experimental results show the correctness of calculation results.

  4. How experiences become data: the process of eliciting adverse event, medical history and concomitant medication reports in antimalarial and antiretroviral interaction trials.

    Science.gov (United States)

    Allen, Elizabeth N; Mushi, Adiel K; Massawe, Isolide S; Vestergaard, Lasse S; Lemnge, Martha; Staedke, Sarah G; Mehta, Ushma; Barnes, Karen I; Chandler, Clare I R

    2013-11-14

    Accurately characterizing a drug's safety profile is essential. Trial harm and tolerability assessments rely, in part, on participants' reports of medical histories, adverse events (AEs), and concomitant medications. Optimal methods for questioning participants are unclear, but different methods giving different results can undermine meta-analyses. This study compared methods for eliciting such data and explored reasons for dissimilar participant responses. Participants from open-label antimalarial and antiretroviral interaction trials in two distinct sites (South Africa, n = 18 [all HIV positive]; Tanzania, n = 80 [86% HIV positive]) were asked about ill health and treatment use by sequential use of (1) general enquiries without reference to particular conditions, body systems or treatments, (2) checklists of potential health issues and treatments, (3) in-depth interviews. Participants' experiences of illness and treatment and their reporting behaviour were explored qualitatively, as were trial clinicians' experiences with obtaining participant reports. Outcomes were the number and nature of data by questioning method, themes from qualitative analyses and a theoretical interpretation of participants' experiences. There was an overall cumulative increase in the number of reports from general enquiry through checklists to in-depth interview; in South Africa, an additional 12 medical histories, 21 AEs and 27 medications; in Tanzania an additional 260 medical histories, 1 AE and 11 medications. Checklists and interviews facilitated recognition of health issues and treatments, and consideration of what to report. Information was sometimes not reported because participants forgot, it was considered irrelevant or insignificant, or they feared reporting. Some medicine names were not known and answers to questions were considered inferior to blood tests for detecting ill health. South African inpatient volunteers exhibited a "trial citizenship", working to achieve

  5. The current status of "Troitsk nu-mass" experiment in search for sterile neutrino

    CERN Document Server

    Abdurashitov, D N; Berlev, A I; Chernov, V G; Geraskin, E V; Golubev, A A; Koroteev, G A; Likhovid, N A; Lokhov, A A; Markin, A I; Nozik, A A; Pantuev, V S; Parfenov, V I; Skasyrskaya, A K; Titov, N A; Tkachev, I I; Tkachov, F V; Zadorozhny, S V

    2015-01-01

    We propose a new experiment to search for a sterile neutrino in a few keV mass range at the "Troitsk nu-mass" facility. The expected signature corresponds to a kink in the electron energy spectrum in tritium beta-decay. The new goal compared to our previous experiment will be precision spectrum measurements well below end point. The experimental installation consists of a windowless gaseous tritium source and a high resolution electromagnetic spectrometer. We estimate that the current bounds on the sterile neutrino mixing parameter can be improved by an order of magnitude in the mass range under 5 keV without major upgrade of the existing equipment. Upgrades of calibration, data acquisition and high voltage systems will allow to improve the bounds by another order of magnitude.

  6. Exploring reconnection, current sheets, and dissipation in a laboratory MHD turbulence experiment

    Science.gov (United States)

    Schaffner, D. A.

    2015-12-01

    The Swarthmore Spheromak Experiment (SSX) can serve as a testbed for studying MHD turbulence in a controllable laboratory setting, and in particular, explore the phenomena of reconnection, current sheets and dissipation in MHD turbulence. Plasma with turbulently fluctuating magnetic and velocity fields can be generated using a plasma gun source and launched into a flux-conserving cylindrical tunnel. No background magnetic field is applied so internal fields are allowed to evolve dynamically. Point measurements of magnetic and velocity fluctuations yield broadband power-law spectra with a steepening breakpoint indicative of the onset of a dissipation scale. The frequency range at which this steepening occurs can be correlated to the ion inertial scale of the plasma, a length which is characteristic of the size of current sheets in MHD plasmas and suggests a connection to dissipation. Observation of non-Gaussian intermittent jumps in magnetic field magnitude and angle along with measurements of ion temperature bursts suggests the presence of current sheets embedded within the turbulent plasma, and possibly even active reconnection sites. Additionally, structure function analysis coupled with appeals to fractal scaling models support the hypothesis that current sheets are associated with dissipation in this system.

  7. Charged-current quasielastic scattering of muon antineutrino and neutrino in the MINERvA experiment

    CERN Document Server

    Ankowski, Artur M

    2015-01-01

    One of the largest sources of systematic uncertainties in ongoing neutrino-oscillation measurements is the description of nuclear effects. Its considerable reduction is expected thanks to the dedicated studies of (anti)neutrino-nucleus interactions in the MINERvA experiment. In this article, the calculations within the spectral function approach are compared to the charged-current quasielastic cross sections reported from MINERvA. The obtained results show that the effect of final-state interactions on the (anti)muon kinematics plays pivotal role in reproducing the experimental data.

  8. Measurement of the /Λ polarization in νμ charged current interactions in the NOMAD experiment

    Science.gov (United States)

    Astier, P.; Autiero, D.; Baldisseri, A.; Baldo-Ceolin, M.; Banner, M.; Bassompierre, G.; Benslama, K.; Besson, N.; Bird, I.; Blumenfeld, B.; Bobisut, F.; Bouchez, J.; Boyd, S.; Bueno, A.; Bunyatov, S.; Camilleri, L.; Cardini, A.; Cattaneo, P. W.; Cavasinni, V.; Cervera-Villanueva, A.; Chukanov, A.; Collazuol, G.; Conforto, G.; Conta, C.; Contalbrigo, M.; Cousins, R.; Daniels, D.; Degaudenzi, H.; Del Prete, T.; de Santo, A.; Dignan, T.; di Lella, L.; Do Couto E Silva, E.; Dumarchez, J.; Ellis, M.; Fazio, T.; Feldman, G. J.; Ferrari, R.; Ferrère, D.; Flaminio, V.; Fraternali, M.; Gaillard, J.-M.; Gangler, E.; Geiser, A.; Geppert, D.; Gibin, D.; Gninenko, S.; Godley, A.; Gomez-Cadenas, J.-J.; Gosset, J.; Gößling, C.; Gouanère, M.; Grant, A.; Graziani, G.; Guglielmi, A.; Hagner, C.; Hernando, J.; Hubbard, D.; Hurst, P.; Hyett, N.; Iacopini, E.; Joseph, C.; Juget, F.; Kirsanov, M.; Klimov, O.; Kokkonen, J.; Kovzelev, A.; Krasnoperov, A.; Kustov, D.; Kuznetsov, V.; Lacaprara, S.; Lachaud, C.; Lakić, B.; Lanza, A.; La Rotonda, L.; Laveder, M.; Letessier-Selvon, A.; Levy, J.-M.; Linssen, L.; Ljubičić, A.; Long, J.; Lupi, A.; Marchionni, A.; Martelli, F.; Méchain, X.; Mendiburu, J.-P.; Meyer, J.-P.; Mezzetto, M.; Mishra, S. R.; Moorhead, G. F.; Naumov, D.; Nédélec, P.; Nefedov, Yu.; Nguyen-Mau, C.; Orestano, D.; Pastore, F.; Peak, L. S.; Pennacchio, E.; Pessard, H.; Petti, R.; Placci, A.; Polesello, G.; Pollmann, D.; Polyarush, A.; Popov, B.; Poulsen, C.; Rathouit, P.; Rico, J.; Riemann, P.; Roda, C.; Rubbia, A.; Salvatore, F.; Schahmaneche, K.; Schmidt, B.; Schmidt, T.; Sevior, M.; Sillou, D.; Soler, F. J. P.; Sozzi, G.; Steele, D.; Stiegler, U.; Stipčević, M.; Stolarczyk, Th.; Tareb-Reyes, M.; Taylor, G. N.; Tereshchenko, V.; Toropin, A.; Touchard, A.-M.; Tovey, S. N.; Tran, M.-T.; Tsesmelis, E.; Ulrichs, J.; Vacavant, L.; Valdata-Nappi, M.; Valuev, V.; Vannucci, F.; Varvell, K. E.; Veltri, M.; Vercesi, V.; Vieira, J.-M.; Vinogradova, T.; Weber, F. V.; Weisse, T.; Wilson, F. F.; Winton, L. J.; Yabsley, B. D.; Zaccone, H.; Zuber, K.; Zuccon, P.; NOMAD Collaboration

    2000-11-01

    The Λ polarization in ν μ charged current interactions has been measured in the NOMAD experiment. The event sample (8087 reconstructed Λ 's) is more than an order of magnitude larger than that of previous bubble chamber experiments, while the quality of event reconstruction is comparable. We observe negative polarization along the W -boson direction which is enhanced in the target fragmentation region: P x(x F0)=-0.09±0.06 (stat)±0.03 (sys) . These results provide a test of different models describing the nucleon spin composition and the spin transfer mechanisms. A significant transverse polarization (in the direction orthogonal to the Λ production plane) has been observed for the first time in a neutrino experiment: P y=-0.22±0.03 (stat)±0.01 (sys) . The dependence of the absolute value of P y on the Λ transverse momentum with respect to the hadronic jet direction is in qualitative agreement with the results from unpolarized hadron-hadron experiments.

  9. Primary Care Providers’ experiences with Pharmaceutical Care-based Medication Therapy Management Services

    Directory of Open Access Journals (Sweden)

    Heather L. Maracle, Pharm.D.

    2012-01-01

    Full Text Available This study explored primary care providers’ (PCPs experiences with the practice of pharmaceutical care-based medication therapy management (MTM. Qualitative, semi-structured interviews were conducted with six PCPs who have experiences working with MTM pharmacists for at least three years. The first author conducted the interviews that were audio-taped, transcribed, and coded independently. The codes were then harmonized via discussion and consensus with the other authors. Data were analyzed for themes using the hermeneutic-phenomenological method as proposed by Max van Manen. Three men and three women were interviewed. On average, the interviewees have worked with MTM pharmacists for seven years. The six (6 themes uncovered from the interviews included: (1 “MTM is just part of our team approach to the practice of medicine”: MTM as an integral part of PCPs’ practices; (2 “Frankly it’s education for the patient but it’s also education for me”: MTM services as a source of education; (3 “It’s not exactly just the pharmacist that passes out the medicines at the pharmacy”: The MTM practitioner is different from the dispensing pharmacist; (4 “So, less reactive, cleaning up the mess, and more proactive and catching things before they become so involved”: MTM services as preventative health care efforts; (5“I think that time is the big thing”: MTM pharmacists spend more time with patients; (6 “There’s an access piece, there’s an availability piece, there’s a finance piece”: MTM services are underutilized at the clinics. In conclusion, PCPs value having MTM pharmacists as part of their team in ambulatory clinics. MTM pharmacists are considered an important source of education to patients as well as to providers as they are seen as having a unique body of knowledge –medication expertise. All PCPs highly treasure the time and education provided by the MTM pharmacists, their ability to manage and adjust patients

  10. Medical emergencies on large passenger ships without doctors: the Oslo-Kiel-Oslo ferry experience.

    Science.gov (United States)

    Holt, Thor-Erik; Tveten, Agnar; Dahl, Eilif

    2017-01-01

    The Oslo-Kiel-Oslo route is currently the only direct ferry crossing between Norway and Germany, covered by 2 cruise-and-cars ferries carrying about 2,600 passengers each and sailing every day (20 h at sea, 4 h in port). Unlike most ocean going cruise vessels, they are not required to carry a physician but an on-board paramedic handles medical emergencies. The aim of the study was to provide data on medical emergencies leading to helicopter evacuations (helivacs) or other urgent transfers to facilities ashore from the two ferries during a 3-year period. Data about the ferries, passengers, crew, helivacs and other medical transfers were collected from official company statistics and the paramedics' transfer reports. A total of 169 persons, including 14 (8.3%) crewmembers, were transferred from the ferries to land-based facilities by ambulance while alongside (n = 80; 47.3%) or evacuated by helicopter (n = 85; 50.3%) and rescue boat (n = 4; 2.4%) during the 3-year period. Transfer destinations were Denmark (n = 53), Germany (n = 49), Norway (n = 48) and Sweden (n = 19). The passenger helivac rate was 2.4 per 100,000 passenger-days. One person was airlifted from a ferry every 2 weeks. Among helivacs, 40% were heart-related, and more cardiac cases were airlifted than transferred by ambulance in port. All helivac requests were made after discussion between the ferry's paramedic and telemedical doctors ashore and agreement that the medical challenge exceeded the ferry's capability. This close cooperation kept the threshold for arranging helivacs from the ferries low, enabling short transport times to land-based facilities for critically ill patients. Further studies, including feedback from the receiving hospitals, are needed to determine measures that can reduce possible helicopter overutilisation without compromising patient safety and outcome.

  11. Use of a geriatric home visit experience to teach medical students the functional status assessment.

    Science.gov (United States)

    Tung, Ericka E; Thomas, Matthew R

    2009-02-01

    Functional status measures strongly predict hospital outcomes and mortality, yet teaching of these measures is often missing from medical schools' curricula. To address this deficiency, we developed a Geriatric Home-based Assessment (GHA) module for third-year medical students. The module was composed of a workshop and two to three home visits. To determine whether the GHA module would improve students' knowledge and proficiency in the functional status assessment. Students completed a validated questionnaire and evaluated a standardized patient in an Observed Structured Clinical Examination (OSCE). Scores from students completing the GHA were compared to the scores of students without this experience. Thirty-one students participated in the GHA module, and 19 students were in the control group. The mean score on the written assessment was 87% among GHA students vs. 46% in the control group (p students' knowledge and proficiency in the functional status assessment. "Hands on" experiences like the GHA allow students to develop a solid foundation for assessing functional status and mobility.

  12. Physicians' responses to financial and social incentives: A medically framed real effort experiment.

    Science.gov (United States)

    Lagarde, Mylène; Blaauw, Duane

    2017-04-01

    Because compensation policies have critical implications for the provision of health care, and evidence of their effects is limited and difficult to study in the real world, laboratory experiments may be a valuable methodology to study the behavioural responses of health care providers. With this experiment undertaken in 2013, we add to this new literature by designing a new medically framed real effort task to test the effects of different remuneration schemes in a multi-tasking context. We assess the impact of different incentives on the quantity (productivity) and quality of outputs of 132 participants. We also test whether the existence of benefits to patients influences effort. The results show that salary yields the lowest quantity of output, and fee-for-service the highest. By contrast, we find that the highest quality is achieved when participants are paid by salary, followed by capitation. We also find a lot of heterogeneity in behaviour, with intrinsically motivated individuals hardly sensitive to financial incentives. Finally, we find that when work quality benefits patients directly, subjects improve the quality of their output, while maintaining the same levels of productivity. This paper adds to a nascent literature by providing a new approach to studying remuneration schemes and modelling the medical decision making environment in the lab.

  13. Current status of medical and veterinary entomology in France: endangered discipline or promising science?

    Science.gov (United States)

    Cuisance, Dominique; Antoine Rioux, Jean

    2004-09-01

    Following alarming statements (French Senate, Académie des Sciences) on the present situation concerning entomology and systematics in France, the Conseil Général Vétérinaire designated one of us (D.C.) to carry out a survey on the status of medical and veterinary entomology (MVE) with respect to research orientations and university curricula. Around 100 participants, including scientists, teachers and several directors of research and educational bodies, were interviewed and filled in questionnaires for this survey. On the basis of the results, it was concluded that the deterioration of MVE in France is associated with: (1) the hasty reorganisation of training and research in the life sciences, leading to the disappearance of several disciplines. Hence, the postgraduate DEA degree in entomology was eliminated, and even the name 'entomology' no longer appears in teaching programmes or on research contracts; (2) France's withdrawal from action research programmes in developing countries. Although these programmes were efficient in controlling outbreaks of major endemic diseases, integrated pest and vector management programmes have been replaced by basic health care ('Health for everyone in 2000') and vaccination programmes; (3) the general shift from field to laboratory research, focused mainly on molecular mechanisms. The survey results confirmed generally acknowledged trends concerning many points and highlighted several specific problems, such as the disappearance of systematics experts. Several potential solutions are proposed.

  14. First Contact: interprofessional education based on medical students' experiences from their nursing internship

    Directory of Open Access Journals (Sweden)

    Eich-Krohm, Astrid

    2016-04-01

    Full Text Available Goal: The aim of the course “interprofessional communication and nursing” is to reflect medical students’ experiences from the nursing internship. The content of the course focuses on barriers and support of interprofessional communication as a foundation for teamwork between nursing professionals and physicians. The nursing internship is for most medical students the first contact with nursing professionals and can lead to perceptions about the other group that might hinder interprofessional teamwork and consequently harm patients. To meet the demographic challenges ahead it is important to emphasize interprofessional education in the study of medicine and better prepare future physicians for interprofessional collaboration. Method: The design of the course includes an assessment of a change in the students’ perceptions about nursing and interprofessional communication. The first class meeting presents the starting point of the assessment and visualizes students’ perceptions of nursing and medicine. The content of the following class meetings serve to enhance the students’ knowledge about nursing as a profession with its own theories, science and scholarship. In addition, all students have to write a research paper that entails to interview one nursing professional and one physician about their ideas of interprofessional communication and to compare the interviews with their own experiences from the nursing internship. To access what students learned during the course a reflective discussion takes place at the last meeting combined with an analysis of the students’ research papers. Results: The assessment of the students’ perceptions about the nursing profession and the importance of successful interprofessional communication showed a new and deeper understanding of the topic. They were able to identify barriers and support measures of interprofessional communication and their own responsibilities as part of a team

  15. Experience of problem-based learning in nursing education at Kaohsiung Medical University.

    Science.gov (United States)

    Chou, Fan-Hao; Chin, Chi-Chun

    2009-05-01

    Nursing education must keep up with the rapidly changing medical landscape to support the competences of nurses in the areas of critical thinking, problem solving, and creativity. Problem-based learning (PBL) provides an appropriate strategy for nursing education innovation. Nursing curricula based on PBL remain in the growing stage in Taiwan. Kaohsiung Medical University introduced PBL into nursing education in 2002. The critical events in the process included: (1) nurturing key tutors; (2) using PBL teaching methods in an elective course--Oncology Nursing, and designing a new elective course--Symposiums Regarding Clinical Cases; (3) holding conferences inside and outside the school to promote PBL teaching methods; (4) linking e-learning and PBL teaching methods; (5) conducting PBL research; (6) establishing a committee of PBL, objective structured clinical examination, and teaching material review for the College of Nursing; and (7) setting up a required course--Nursing Ethics. We now have 12 key tutors in the College of Nursing. We have also completed two studies to evaluate the ability of students and to explore the experience of tutors. From our studies, we know that PBL can increase learner abilities in self-directed learning, critical thinking, and PBL performance. The approach helps students to cope with the changing medical landscape. Furthermore, tutors and teachers develop adequate PBL teaching skills. Based on the experience above, we believe that we are on the right path in terms of continuing tutor development, gradually increasing the number of PBL courses, and undertaking further research to promote PBL methods in Taiwan.

  16. Overview of the current attempts toward the medical treatment of cataract

    Energy Technology Data Exchange (ETDEWEB)

    Kador, P.F.

    1983-04-01

    A variety of agents are currently available that claim to either prevent, delay, or reverse cataracts associated with aging (senile cataracts), radiation, or diabetes and galactosemia (sugar cataracts). Senile cataract therapy includes formulation containing inorganic salts, nutritional supplements, natural product extracts, sulfhydryl, and sulfonic acid containing compounds and miscellaneous redox and nonsteroidal anti-inflammatory compounds. Agents associated with the treatment of radiation cataracts include antioxidants and free radial scavengers. Aldose reductase inhibitors have been effective in the prevention of sugar cataracts. A summary of these agents and their potential ocular effects are presented.

  17. Multi-exposure and clustering of adverse childhood experiences, socioeconomic differences and psychotropic medication in young adults.

    Directory of Open Access Journals (Sweden)

    Emma Björkenstam

    Full Text Available PURPOSE: Stressful childhood experiences have negative long-term health consequences. The present study examines the association between adverse childhood experiences, socioeconomic position, and risk of psychotropic medication in young adulthood. METHODS: This register-based cohort study comprises the birth cohorts between 1985 and 1988 in Sweden. We followed 362 663 individuals for use of psychotropic medication from January 2006 until December 2008. Adverse childhood experiences were severe criminality among parents, parental alcohol or drug abuse, social assistance recipiency, parental separation or single household, child welfare intervention before the age of 12, mentally ill or suicidal parents, familial death, and number of changes in place of residency. Estimates of risk of psychotropic medication were calculated as odds ratio (OR with 95% confidence intervals (CIs using logistic regression analysis. RESULTS: Adverse childhood experiences were associated with increased risks of psychotropic medication. The OR for more than three adverse childhood experiences and risk of psychotropic medication was for women 2.4 (95% CI 2.3-2.5 and for men 3.1 (95% CI 2.9-3.2. The risk of psychotropic medication increased with a higher rate of adverse childhood experiences, a relationship similar in all socioeconomic groups. CONCLUSIONS: Accumulation of adverse childhood experiences increases the risk of psychotropic medication in young adults. Parental educational level is of less importance when adjusting for adverse childhood experiences. The higher risk for future mental health problems among children from lower socioeconomic groups, compared to peers from more advantaged backgrounds, seems to be linked to a higher rate of exposure to adverse childhood experiences.

  18. A Review of the Multi-Authored Monograph “The Medical (Clinical Psychology Diagnosis: Current State and Prospects”

    Directory of Open Access Journals (Sweden)

    Vachkov I.V.

    2017-06-01

    Full Text Available The monograph presents a number of articles written by leading domestic clinical psychologists on various issues connected with psychological diagnosis. The multi-authored monograph was written for the international research-to-practice conference “The medical (clinical psychology diagnosis: tradition and prospects”. The conference took place in Moscow on November 29-30, 2016. The book consists of the following sections: "Research methodology in clinical psychology", “The development of endogenous mental pathology diagnosis current trends”, “The development of clinical psychology diagnostics current trends: age aspects”, “The main problems of clinical-psychological prevention and rehabilitation”. The materials of the monograph may be interesting and useful for scientists, psychology lecturers, students and post-graduate students, as well as for specialists working in the field of public health, education and social support for the population.

  19. Legal and regulatory challenges currently facing diabetes treatment providers and related durable medical equipment suppliers.

    Science.gov (United States)

    Liles, Robert

    2013-03-01

    It has been estimated that 24 million Americans have diabetes, many of whom are Medicare beneficiaries. These individuals carefully monitor their blood glucose levels primarily through the use of in-home blood glucose testing kits. Although the test is relatively simple, the cumulative expense of providing glucose test strips and lancets to patients is ever increasing, both to the Medicare program and to uninsured individuals who must pay out-of-pocket for these testing supplies. This article discusses the diabetes durable medical equipment (DME) coverage under Part B Medicare, the establishment and role of DME Medicare administrative contractors, and national and local coverage requirements for diabetes DME suppliers. This article also discusses the federal government's ongoing concerns regarding the improper billing of diabetes testing supplies. To protect the Medicare Trust Fund, the federal government has contracted with multiple private entities to conduct reviews and audits of questionable Medicare claims. These private sector contractors have conducted unannounced site visits of DME supplier offices, interviewed patients and their families, placed suppliers on prepayment review, and conducted extensive postpayment audits of prior paid Medicare claims. In more egregious administrative cases, Medicare contractors have recommended that problematic providers and/or DME suppliers have their Medicare numbers suspended or, in some instances, revoked. More serious infractions can lead to civil or criminal liability. In the final part of this article, we will examine the future of enforcement efforts by law enforcement and Medicare contractors and the importance of understanding and complying with federal laws when ordering and supplying diabetes testing strips and lancets.

  20. Educating Medical Laboratory Technologists: Revisiting Our Assumptions in the Current Economic and Health-Care Environment

    Directory of Open Access Journals (Sweden)

    Regina Linder

    2012-08-01

    Full Text Available Health care occupies a distinct niche in an economy struggling to recover from recession. Professions related to the care of patients are thought to be relatively resistant to downturns, and thus become attractive to students typically drawn to more lucrative pursuits. Currently, a higher profile for clinical laboratory technology among college students and those considering career change results in larger and better prepared applicant pools. However, after decades of contraction marked by closing of programs, prospective students encounter an educational system without the capacity or vigor to meet their needs. Here discussed are some principles and proposals to allow universities, partnering with health-care providers, government agencies, and other stakeholders to develop new programs, or reenergize existing ones to serve our students and patients. Principles include academic rigor in biomedical and clinical science, multiple points of entry for students, flexibility in format, cost effectiveness, career ladders and robust partnerships.

  1. [Exchange of medical imaging and data information in radiotherapy: needs, methods and current limits].

    Science.gov (United States)

    Manens, J P

    1997-01-01

    Extension of the image network within radiotherapy departments provides the technical infrastructure which is made necessary by the rapid evolution of techniques in the field of diagnosis and treatment in radiotherapy. The system is aimed at managing the whole set of data (textual data and images) that are needed for planning and control of treatments. The radiotherapy network addresses two objectives: managing both the information necessary for treatment planning (target volumes definition, planning dosimetry) and the control of all parameters involved during the patient's treatment under the treatment unit. The major challenge is to improve the quality of treatment. Multimodal imaging is a major advance as it allows the use of new dosimetry and simulation techniques. The need for standards to exchange medical imaging information is now recognized by all the institutions and a majority of users and manufacturers. It is widely accepted that the lack of standard has been one of the fundamental obstacles in the deployment of operational "Picture Archiving Communication Systems". The International Standard Organisation Open System Interconnection model is the standard reference mode used to describe network protocols. The network is based on the Ethernet and TCP/IP protocol that provides the means to interconnect imaging devices and workstations dedicated to specific image processing or machines used in radiotherapy. The network uses Ethernet cabled on twisted-pair (10 BaseT) or optical fibres in a star-shaped physical layout. Dicom V3.0 supports fundamental network interactions: transfer of images (computerized tomography magnetic resonance imaging query and retrieve of images), printing on network attached cameras, support of HIS/RIS related interfacing and image management. The supplement to the Dicom standard, Dicom RT, specifies five data objects known in Dicom as Information Object Definition for relevant radiotherapy. Dicom RT objects can provide a mean for

  2. CURRENT ECONOMIC AND MEDICAL REFORMS IN THE ROMANIAN HEALTH CARE SYSTEM

    Directory of Open Access Journals (Sweden)

    Dragoi Mihaela Cristina

    2011-12-01

    Full Text Available The issue of health has always been, both in social reality and in academia and research, a sensitive topic considering the relationship each individual has with his own health and the health care system as a public policy. At public opinion levels and not only, health care is the most important sector demanding the outmost attention, considering that individual health is the fundamental prerequisite for well-being, happiness and a satisfying life. The ever present research and practical question is on the optimal financing of the health care system. Any answer to this question is also a political decision, reflecting the social-economic value of health for a particular country. The size of the resource pool and the criteria and methods for resource allocation are the central economic problems for any health system. This paper takes into consideration the limited resources of the national health care system (the rationalization of health services, the common methods of health financing, the specificity of health services market (the health market being highly asymmetric, with health professionals knowing most if not all of the relevant information, such as diagnosis, treatment options and costs and consumers fully dependent on the information provided in each case and the performance of all hospitals in Romania, in order to assess the latest strategic decisions (introduction of co-payment and merging and reconversion of hospitals taken within the Romanian health care system and their social and economic implications. The main finding show that, even though the intention of reforming and transforming the Romanian health care system into a more efficient one is obvious, the lack of economic and demographic analysis may results into greater discrepancies nationwide. This paper is aimed to renew the necessity of joint collaboration between the economic and medical field, since the relationship between health and economic development runs both ways

  3. Broadband sidebands generated by parametric instability in lower hybrid current drive experiments on EAST

    Energy Technology Data Exchange (ETDEWEB)

    Amicucci, L., E-mail: luca.amicucci@enea.it; Castaldo, C.; Cesario, R.; Giovannozzi, E.; Tuccillo, A. A. [EUROfusion-ENEA, Centro Ricerche Frascati, Unità Fusione, Frascati (Italy); Ding, B. J.; Li, M. H. [Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031 (China)

    2015-12-10

    Modern research on nuclear fusion energy, based on the tokamak concept, has strong need of tools for actively driving non-inductive current especially at the periphery of plasma column, where tools available so far have poor efficiency. This is essential for solving one of the most critical problems for thermonuclear reactor, consisting in how to achieve the figure of fusion gain in the context of sufficient stability. The lower hybrid current drive (LHCD) effect has the potential capability of driving current at large radii of reactor plasma with high efficiency [1]. Experiments recently carried out on EAST showed that a strong activity of LH sideband waves (from the RF probe spectra), accompanied by weak core penetration of the coupled LH power, is present when operating at relatively high plasma densities. Previous theoretical results, confirmed by experiments on FTU, showed that the LH sideband phenomenon is produced by parametric instability (PI), which are mitigated by higher plasma edge temperatures. This condition is thus useful for enabling the LH power propagation when operating with profiles having high plasma densities even at the edge. In the present work, we show new PI modeling of EAST plasmas data, obtained in condition of higher plasma edge temperature due to chamber lithisation. The obtained trend of the PI frequencies and growth rates is consistent with data of RF probe spectra, available in different regimes of lithisated and not lithisated vessel. Moreover, these spectra are interpreted as PI effect occurring at the periphery of plasma column, however in the low field side where the LH power is coupled.

  4. Broadband sidebands generated by parametric instability in lower hybrid current drive experiments on EAST

    Science.gov (United States)

    Amicucci, L.; Ding, B. J.; Castaldo, C.; Cesario, R.; Giovannozzi, E.; Li, M. H.; Tuccillo, A. A.

    2015-12-01

    Modern research on nuclear fusion energy, based on the tokamak concept, has strong need of tools for actively driving non-inductive current especially at the periphery of plasma column, where tools available so far have poor efficiency. This is essential for solving one of the most critical problems for thermonuclear reactor, consisting in how to achieve the figure of fusion gain in the context of sufficient stability. The lower hybrid current drive (LHCD) effect has the potential capability of driving current at large radii of reactor plasma with high efficiency [1]. Experiments recently carried out on EAST showed that a strong activity of LH sideband waves (from the RF probe spectra), accompanied by weak core penet