WorldWideScience

Sample records for current medical practice

  1. 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

  2. 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.

  3. 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

  4. 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.

  5. 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.

  6. 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

  7. 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

  8. 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…

  9. 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…

  10. Which medical error to disclose to patients and by whom? Public preference and perceptions of norm and current practice.

    Science.gov (United States)

    Hammami, Muhammad M; Attalah, Sahar; Al Qadire, Mohammad

    2010-10-18

    Disclosure of near miss medical error (ME) and who should disclose ME to patients continue to be controversial. Further, available recommendations on disclosure of ME have emerged largely in Western culture; their suitability to Islamic/Arabic culture is not known. We surveyed 902 individuals attending the outpatient's clinics of a tertiary care hospital in Saudi Arabia. Personal preference and perceptions of norm and current practice regarding which ME to be disclosed (5 options: don't disclose; disclose if associated with major, moderate, or minor harm; disclose near miss) and by whom (6 options: any employee, any physician, at-fault-physician, manager of at-fault-physician, medical director, or chief executive director) were explored. Mean (SD) age of respondents was 33.9 (10) year, 47% were males, 90% Saudis, 37% patients, 49% employed, and 61% with college or higher education. The percentage (95% confidence interval) of respondents who preferred to be informed of harmful ME, of near miss ME, or by at-fault physician were 60.0% (56.8 to 63.2), 35.5% (32.4 to 38.6), and 59.7% (56.5 to 63.0), respectively. Respectively, 68.2% (65.2 to 71.2) and 17.3% (14.7 to 19.8) believed that as currently practiced, harmful ME and near miss ME are disclosed, and 34.0% (30.7 to 37.4) that ME are disclosed by at-fault-physician. Distributions of perception of norm and preference were similar but significantly different from the distribution of perception of current practice (P preference of disclosure of near miss ME, while younger age and male gender predicted preference of no-disclosure of ME. Female gender also predicted preferring disclosure by the at-fault-physician. We conclude that: 1) there is a considerable diversity in preferences and perceptions of norm and current practice among respondents regarding which ME to be disclosed and by whom, 2) Distributions of preference and perception of norm were similar but significantly different from the distribution of perception

  11. Which medical error to disclose to patients and by whom? Public preference and perceptions of norm and current practice

    Directory of Open Access Journals (Sweden)

    Al Qadire Mohammad

    2010-10-01

    Full Text Available Abstract Background Disclosure of near miss medical error (ME and who should disclose ME to patients continue to be controversial. Further, available recommendations on disclosure of ME have emerged largely in Western culture; their suitability to Islamic/Arabic culture is not known. Methods We surveyed 902 individuals attending the outpatient's clinics of a tertiary care hospital in Saudi Arabia. Personal preference and perceptions of norm and current practice regarding which ME to be disclosed (5 options: don't disclose; disclose if associated with major, moderate, or minor harm; disclose near miss and by whom (6 options: any employee, any physician, at-fault-physician, manager of at-fault-physician, medical director, or chief executive director were explored. Results Mean (SD age of respondents was 33.9 (10 year, 47% were males, 90% Saudis, 37% patients, 49% employed, and 61% with college or higher education. The percentage (95% confidence interval of respondents who preferred to be informed of harmful ME, of near miss ME, or by at-fault physician were 60.0% (56.8 to 63.2, 35.5% (32.4 to 38.6, and 59.7% (56.5 to 63.0, respectively. Respectively, 68.2% (65.2 to 71.2 and 17.3% (14.7 to 19.8 believed that as currently practiced, harmful ME and near miss ME are disclosed, and 34.0% (30.7 to 37.4 that ME are disclosed by at-fault-physician. Distributions of perception of norm and preference were similar but significantly different from the distribution of perception of current practice (P Conclusions We conclude that: 1 there is a considerable diversity in preferences and perceptions of norm and current practice among respondents regarding which ME to be disclosed and by whom, 2 Distributions of preference and perception of norm were similar but significantly different from the distribution of perception of current practice, 3 most respondents preferred to be informed of ME and by at-fault physician, and 4 one third of respondents preferred to be

  12. 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.

  13. Oral cancer--current knowledge, practices and implications for training among an Irish general medical practitioner cohort.

    LENUS (Irish Health Repository)

    Ni Riordain, Richeal

    2009-11-01

    This study investigated the current knowledge and practices of general medical practitioners (GMPs) in Ireland regarding the examination of the oral cavity and the detection of oral malignancy and the training they had received at both undergraduate and postgraduate level and since commencing in practice. A questionnaire survey of GMPs in Ireland was conducted. One hundred and fifty four (65.3%) of the practitioners reported regularly examining the oral mucosa of their patients. Almost half of these (n=68) further qualified this response by stating that they only examined the oral mucosa if the patient reported pain in this area or if the patient specifically requested an oral examination for some reason. Eighty one (34.3%) practitioners surveyed felt confident in their ability to detect oral malignancies with the remaining two thirds unsure of whether they would be able to detect oral cancer. There was a significant association between the undergraduate and postgraduate teaching on examination of the oral cavity and whether practitioners felt confident in their ability to detect oral cancer [chi(2)(1)=4.811, p<0.05]. A statistically significant association was also found between the undergraduate and postgraduate teaching on the diagnosis of oral malignant disease and whether practitioners felt confident in their ability to detect oral cancer [chi(2)(1)=6.194, p<0.05]. In conclusion the level of knowledge of Irish general medical practitioners needs to be addressed with appropriate initiatives both at undergraduate level and via CME.

  14. Historical Perspective of Traditional Indigenous Medical Practices: The Current Renaissance and Conservation of Herbal Resources

    Directory of Open Access Journals (Sweden)

    Si-Yuan Pan

    2014-01-01

    Full Text Available In recent years, increasing numbers of people have been choosing herbal medicines or products to improve their health conditions, either alone or in combination with others. Herbs are staging a comeback and herbal “renaissance” occurs all over the world. According to the World Health Organization, 75% of the world’s populations are using herbs for basic healthcare needs. Since the dawn of mankind, in fact, the use of herbs/plants has offered an effective medicine for the treatment of illnesses. Moreover, many conventional/pharmaceutical drugs are derived directly from both nature and traditional remedies distributed around the world. Up to now, the practice of herbal medicine entails the use of more than 53,000 species, and a number of these are facing the threat of extinction due to overexploitation. This paper aims to provide a review of the history and status quo of Chinese, Indian, and Arabic herbal medicines in terms of their significant contribution to the health promotion in present-day over-populated and aging societies. Attention will be focused on the depletion of plant resources on earth in meeting the increasing demand for herbs.

  15. Historical perspective of traditional indigenous medical practices: the current renaissance and conservation of herbal resources.

    Science.gov (United States)

    Pan, Si-Yuan; Litscher, Gerhard; Gao, Si-Hua; Zhou, Shu-Feng; Yu, Zhi-Ling; Chen, Hou-Qi; Zhang, Shuo-Feng; Tang, Min-Ke; Sun, Jian-Ning; Ko, Kam-Ming

    2014-01-01

    In recent years, increasing numbers of people have been choosing herbal medicines or products to improve their health conditions, either alone or in combination with others. Herbs are staging a comeback and herbal "renaissance" occurs all over the world. According to the World Health Organization, 75% of the world's populations are using herbs for basic healthcare needs. Since the dawn of mankind, in fact, the use of herbs/plants has offered an effective medicine for the treatment of illnesses. Moreover, many conventional/pharmaceutical drugs are derived directly from both nature and traditional remedies distributed around the world. Up to now, the practice of herbal medicine entails the use of more than 53,000 species, and a number of these are facing the threat of extinction due to overexploitation. This paper aims to provide a review of the history and status quo of Chinese, Indian, and Arabic herbal medicines in terms of their significant contribution to the health promotion in present-day over-populated and aging societies. Attention will be focused on the depletion of plant resources on earth in meeting the increasing demand for herbs.

  16. Endocannabinoid system: An overview of its potential in current medical practice.

    Science.gov (United States)

    Mouslech, Zadalla; Valla, Vasiliki

    2009-01-01

    The endocannabinoid system (ECS) is a lipid signalling system, comprising of the endogenous cannabis-like ligands (endocannabinoids) anandamide (AEA) and 2-arachidonoylglycerol (2-AG), which derive from arachidonic acid. These bind to a family of G-protein-coupled receptors, called CB1 and CB2. The cannabinoid receptor 1 (CB1R) is distributed in brain areas associated with motor control, emotional responses, motivated behaviour and energy homeostasis. In the periphery, the same receptor is expressed in the adipose tissue, pancreas, liver, GI tract, skeletal muscles, heart and the reproduction system. The CB2R is mainly expressed in the immune system regulating its functions. Endocannabinoids are synthesized and released upon demand in a receptor-dependent way. They act as retrograde signalling messengers in GABAergic and glutamatergic synapses and as modulators of postsynaptic transmission, interacting with other neurotransmitters. Endocannabinoids are transported into cells by a specific uptake system and degraded by the enzymes fatty acid amide hydrolase (FAAH) and monoacylglycerol lipase (MAGL). The ECS is involved in various pathophysiological conditions in central and peripheral tissues. It is implicated in the hormonal regulation of food intake, cardiovascular, gastrointestinal, immune, behavioral, antiproliferative and mammalian reproduction functions. Recent advances have correlated the ECS with drug addiction and alcoholism. The growing number of preclinical and clinical data on ECS modulators is bound to result in novel therapeutic approaches for a number of diseases currently treated inadequately. The ECS dysregulation has been correlated to obesity and metabolic syndrome pathogenesis. Rimonabant is the first CB1 blocker launched to treat cardiometabolic risk factors in obese and overweight patients. Phase III clinical trials showed the drug's ability to regulate intra-abdominal fat tissue levels, lipidemic, glycemic and inflammatory parameters. However

  17. THE CURRENT PRACTICES FOR TESTING FOR HYPERGLYCAEMIA IN PREGNANCY (HIP IN THE MEDICAL COLLEGE INSTITUTIONS IN INDIA

    Directory of Open Access Journals (Sweden)

    Hema Divakar

    2017-04-01

    Full Text Available BACKGROUND The aim of the study is to determine the current practices in the medical college institutions pan India for testing for Hyperglycaemia in Pregnancy (HIP to detect gestational diabetes and highlight areas that need additional attention in order to ensure adherence to current national guidelines. MATERIALS AND METHODS Questionnaires were used to obtain information regarding the testing strategy for hyperglycaemia in pregnancy. The questionnaires were filled out by the teaching faculty of the OB/GYN departments of 47 medical college institutions in India. The perceptions regarding the prevalence of diabetes in pregnancy in India and the needs for capacity building were assessed. RESULTS Forty seven respondents answered the questionnaires. The majority of respondents (95.83% reported that all pregnant women were offered (universal testing for hyperglycaemia in pregnancy and 37.5% reported that women were screened both in early and midtrimester of pregnancy. Most reported that testing for HIP took place once at booking, irrespective of the gestational age (39.58%. Thirty three (70.21% respondents reported using the single-step nonfasting method to diagnose hyperglycaemia. Furthermore, 21.28% of respondents reported using a glucometer to determine the concentration of blood glucose in plasma, while 68.08% reported using a lab analyser. The instructions for the testing were offered by consultants and postgraduates in a vast majority of cases (87.5%. The staff communicated with the women in a significantly less number of cases (12.5%. 65.96% of respondents felt that all women readily agreed to follow this advice. The majority of respondents (89.35% reported having noticed an increase in the number of women with hyperglycaemia. Furthermore, 91% of all the respondents felt there was a need to train medical personnel to test and manage hyperglycaemia. CONCLUSION Our study confirms the continued wide variability in testing for HIP in India with

  18. Branding your medical practice.

    Science.gov (United States)

    Maley, Catherine; Baum, Neil

    2010-01-01

    Branding is the process of differentiating your medical practice from all other practices in the industry. Branding takes into account the "look and feel" of your office, you and your staff your materials, and every other detail that gives your patients clues as to who you are and what you value. This article will review the strategies that go into building your own solid brand so your existing patients, as well as prospective ones, are attracted and loyal to you and your brand.

  19. Malaria prevention and treatment in pregnancy: survey of current practice among private medical practitioners in Lagos, Nigeria.

    Science.gov (United States)

    Rabiu, Kabiru Afolarin; Davies, Nosimot Omolola; Nzeribe-Abangwu, Ugochi O; Adewunmi, Adeniyi Abiodun; Akinlusi, Fatimat Motunrayo; Akinola, Oluwarotimi Ireti; Ogundele, Sunday O

    2015-01-01

    We studied the practice of malaria prevention and treatment in pregnancy of 394 private medical practitioners in Lagos State, Nigeria using a self-administered pre-tested structured questionnaire. Only 39 (9.9%) respondents had correct knowledge of the World Health Organization (WHO) strategies. Malaria prophylaxis in pregnancy was offered by 336 (85.3%), but only 98 (24.9%) had correct knowledge of recommended chemoprophylaxis. Of these, 68 (17.3%) had correct knowledge of first trimester treatment, while only 41 (10.4%) had knowledge of second and third trimester treatment. Only 64 (16.2%) of respondents routinely recommended use of insecticide-treated bed nets. The most common anti-malarial drug prescribed for chemoprophylaxis was pyrimethamine (43.7%); chloroquine was the most common anti-malarial prescribed for both first trimester treatment (81.5%) and second and third trimester treatment (55.3%). The study showed that private medical practitioners have poor knowledge of malaria prophylaxis and treatment in pregnancy, and the practice of most do not conform to recommended guidelines.

  20. Understanding medical practice team roles.

    Science.gov (United States)

    Hills, Laura

    2015-01-01

    Do you believe that the roles your employees play on your medical practice team are identical to their job titles or job descriptions? Do you believe that team roles are determined by personality type? This article suggests that a more effective way to build and manage your medical practice team is to define team roles through employee behaviors. It provides 10 rules of behavioral team roles that can help practice managers to select and build high-performing teams, build more productive team relationships, improve the employee recruitment process, build greater team trust and understanding; and increase their own effectiveness. This article describes in detail Belbin's highly regarded and widely used team role theory and summarizes four additional behavioral team role theories and systems. It offers lessons learned when applying team role theory to practice. Finally, this article offers an easy-to-implement method for assessing current team roles. It provides a simple four-question checklist that will help practice managers balance an imbalanced medical practice team.

  1. KNOWLEDGE, ATTITUDE AND PRACTICES REGARDING “THE R OLE OF SPIRITUALITY IN CURRENT MEDICAL PRACTICE AMONGST ME DICAL PROFESSIONALS” IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Jain

    2013-01-01

    Full Text Available BSTRACT: INTRODUCTION: Spirituality has been integral part of medicine and h ealth since ancient age. This has been accepted in various devel oped countries as evident by a plethora of published articles. However, the extent of spiritual component in medical practice in India is largely unknown. The present study is a questionnair e based study to assess the extent of knowledge (awareness, attitude and practices among medical professionals at a tertiary care Hospital regarding role of spirituality in management of health and diseases. METHODS: A pre- designed validated list of questionnaire was distri buted among 250 doctors of all specialties at the hospital along with brief introduction on purpos e and scope of the study. The questions were collected back personally after giving sufficie nt time to attempt them. Doctors were evaluated regarding their knowledge, attitude and pr actice about spirituality in medicine using multiple choice question format. RESULTS: The response rate from participants was 80% (200/250. More than 90% participants had a good deal of knowledge of spirituality but unable to distinguish between truly spiritual practices from traditionally followed religious rituals. More than 70% felt that there is relevance of spirit ual practices in health and diseases but pointed out lack of credible scientific data to inco rporate these in health management strategy. There was wide variation among participants regardi ng underlying mechanism/s responsible for spiritual healing. Most of them believed this to be Psychological (90%, Neuroendocrine (70% or Immunology (26% and only (4% attributed it to all these factors. Majority of the participants agreed that spirituality offers maximum h ealth benefits in chronic and incurable diseases. Participants vouched for introduction of spiritual m edicine in medical curriculum to be taught by medical professionals with expertise in spir ituality. They also opined that there is need to involve

  2. [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.

  3. Practitioner Review: Current Best Practice in the Management of Adverse Events during Treatment with ADHD Medications in Children and Adolescents

    Science.gov (United States)

    Cortese, Samuele; Holtmann, Martin; Banaschewski, Tobias; Buitelaar, Jan; Coghill, David; Danckaerts, Marina; Dittmann, Ralf W.; Graham, John; Taylor, Eric; Sergeant, Joseph

    2013-01-01

    Background: Medication is an important element of therapeutic strategies for ADHD. While medications for ADHD are generally well-tolerated, there are common, although less severe, as well as rare but severe adverse events AEs during treatment with ADHD drugs. The aim of this review is to provide

  4. Practitioner Review: Current Best Practice in the Management of Adverse Events during Treatment with ADHD Medications in Children and Adolescents

    Science.gov (United States)

    Cortese, Samuele; Holtmann, Martin; Banaschewski, Tobias; Buitelaar, Jan; Coghill, David; Danckaerts, Marina; Dittmann, Ralf W.; Graham, John; Taylor, Eric; Sergeant, Joseph

    2013-01-01

    Background: Medication is an important element of therapeutic strategies for ADHD. While medications for ADHD are generally well-tolerated, there are common, although less severe, as well as rare but severe adverse events AEs during treatment with ADHD drugs. The aim of this review is to provide

  5. Knowledge, Attitude and Practice on Hypertension among Antihypertensive Medication Users

    Directory of Open Access Journals (Sweden)

    Shakti Shrestha

    2016-12-01

    Conclusions: The current knowledge, attitude and practice among hypertensive patients using antihypertensive medication can be improved. Keywords: attitude; hypertension; knowledge; practice. | PubMed

  6. Current practice in Europe

    DEFF Research Database (Denmark)

    Proclemer, Alessandro; Dagres, Nikolaos; Marinskis, Germanas

    2013-01-01

    The purpose of the EP wire is to examine the clinical practice in the management of sustained ventricular tachycardia (VT), with special focus on diagnostic and therapeutic strategies. Forty-five European centres, all members of the EHRA-EP Research network completed the questions of the survey...

  7. Medical Simulation Practices 2010 Survey Results

    Science.gov (United States)

    McCrindle, Jeffrey J.

    2011-01-01

    Medical Simulation Centers are an essential component of our learning infrastructure to prepare doctors and nurses for their careers. Unlike the military and aerospace simulation industry, very little has been published regarding the best practices currently in use within medical simulation centers. This survey attempts to provide insight into the current simulation practices at medical schools, hospitals, university nursing programs and community college nursing programs. Students within the MBA program at Saint Joseph's University conducted a survey of medical simulation practices during the summer 2010 semester. A total of 115 institutions responded to the survey. The survey resus discuss overall effectiveness of current simulation centers as well as the tools and techniques used to conduct the simulation activity

  8. Current practice and clinicians' perception of medication non-adherence in patients with inflammatory bowel disease: A survey of 98 clinicians.

    Science.gov (United States)

    Soobraty, Anisah; Boughdady, Sarah; Selinger, Christian P

    2017-02-06

    The survey ascertains perceptions and describes current practice of clinicians regarding medication non-adherence in patients with Inflammatory Bowel Disease. Gastroenterologists, trainees and inflammatory bowel disease (IBD) specialist nurses from the United Kingdom were invited to a web based survey collecting data on clinician demographics, patient volume and level of interest in IBD. Respondents were asked to estimate non-adherence levels and report use of screening tools and interventions to improve adherence. Non-adherence was seen as an infrequent problem by 57% of 98 respondents. Levels of non-adherence were estimated lower than evidence suggests by 29% for mesalazine (5ASA), 26% for immunomodulators (IMM) and 21% for biologics (BIOL). Respondents reporting non-adherence as a frequent problem were more likely to report adherence levels in line with evidence (5ASA P non-adherence. Patient counselling on benefits and risks of medication was a commonly used intervention. Clinicians treating IBD patients frequently underestimate non-adherence and use of validated screening tools is infrequent. Most respondents identified the main factors associated with non-adherence in line with evidence and often counselled patients accordingly. Professional education should focus more on non-adherence practice to avoid adverse treatment outcomes associated with non-adherence.

  9. Medical emergencies in dental practice.

    LENUS (Irish Health Repository)

    Wilson, M H

    2009-06-01

    Serious medical emergencies are fortunately a rare occurrence in the dental practice environment; however, if an emergency situation is encountered a delay in treatment may result in potentially avoidable consequences. The risk of mortality or serious morbidity can be reduced by ensuring that basic emergency equipment and medications are in place, and that the dental team is appropriately trained in basic life support measures. This article aims to provide an overview of the basic emergency medications and equipment that should be present in dental practices, and to discuss specific responses to some of the more common adverse medical events that can present while providing dental treatment.

  10. An evaluation of the current patterns and practices of educational supervision in postgraduate medical education in the UK.

    Science.gov (United States)

    Patel, Priyank

    2016-08-01

    Globally, clinical supervision has been widely adopted and studied. But in the UK, another variant of supervision has developed in the form of educational supervision. The quality of supervision remains highly variable and inadequate time, investment and guidance hinders its ability to actually benefit trainees. Therefore, undertaking a detailed study of the patterns and practices in educational supervision to inform developments in supervisory practice would be extremely beneficial. In this mixed methods study, educational supervisors and trainees working within a large London Trust were surveyed online about their experiences of educational supervision. In addition, observations of supervision sessions with a small group of supervisor and trainee pairs followed-up by semi-structured interviews were conducted. The quantitative data were analyzed using statistical software via descriptive statistics. The qualitative data underwent thematic framework analysis. Both the qualitative and quantitative data revealed that whilst most junior doctors and supervisors value the ideal of educational supervision as a process for engaging in mentoring dialogues, it can become a tick box exercise, devaluing its usefulness and purpose. Trainees highlighted the need for more frequent formal meeting along with better preparation by supervisors. Supervisors would appreciate more support from trusts to help them enhance supervision for trainees. The effectiveness of educational supervision can be improved with trainees and supervisors engaging in meaningful preparation and proactive communication before meetings. During these formal meetings, improving the quality of feedback and ensuring that regular mentoring dialogues occurred would be highly valuable.

  11. Current practice and clinicians’ perception of medication non-adherence in patients with inflammatory bowel disease: A survey of 98 clinicians

    Science.gov (United States)

    Soobraty, Anisah; Boughdady, Sarah; Selinger, Christian P

    2017-01-01

    AIM The survey ascertains perceptions and describes current practice of clinicians regarding medication non-adherence in patients with Inflammatory Bowel Disease. METHODS Gastroenterologists, trainees and inflammatory bowel disease (IBD) specialist nurses from the United Kingdom were invited to a web based survey collecting data on clinician demographics, patient volume and level of interest in IBD. Respondents were asked to estimate non-adherence levels and report use of screening tools and interventions to improve adherence. RESULTS Non-adherence was seen as an infrequent problem by 57% of 98 respondents. Levels of non-adherence were estimated lower than evidence suggests by 29% for mesalazine (5ASA), 26% for immunomodulators (IMM) and 21% for biologics (BIOL). Respondents reporting non-adherence as a frequent problem were more likely to report adherence levels in line with evidence (5ASA P < 0.001; IMM P = 0.012; BIOL P = 0.015). While 80% regarded screening as important only 25% screen regularly (40% of these with validated assessment tools). Respondents stated forgetfulness, beliefs about necessity of medication and not immediately apparent benefits as the main reasons for non-adherence. Patient counselling on benefits and risks of medication was a commonly used intervention. CONCLUSION Clinicians treating IBD patients frequently underestimate non-adherence and use of validated screening tools is infrequent. Most respondents identified the main factors associated with non-adherence in line with evidence and often counselled patients accordingly. Professional education should focus more on non-adherence practice to avoid adverse treatment outcomes associated with non-adherence. PMID:28217376

  12. They see a rat, we seek a cure for diseases: the current status of animal experimentation in medical practice.

    Science.gov (United States)

    Kehinde, Elijah O

    2013-01-01

    The objective of this review article was to examine current and prospective developments in the scientific use of laboratory animals, and to find out whether or not there are still valid scientific benefits of and justification for animal experimentation. The PubMed and Web of Science databases were searched using the following key words: animal models, basic research, pharmaceutical research, toxicity testing, experimental surgery, surgical simulation, ethics, animal welfare, benign, malignant diseases. Important relevant reviews, original articles and references from 1970 to 2012 were reviewed for data on the use of experimental animals in the study of diseases. The use of laboratory animals in scientific research continues to generate intense public debate. Their use can be justified today in the following areas of research: basic scientific research, use of animals as models for human diseases, pharmaceutical research and development, toxicity testing and teaching of new surgical techniques. This is because there are inherent limitations in the use of alternatives such as in vitro studies, human clinical trials or computer simulation. However, there are problems of transferability of results obtained from animal research to humans. Efforts are on-going to find suitable alternatives to animal experimentation like cell and tissue culture and computer simulation. For the foreseeable future, it would appear that to enable scientists to have a more precise understanding of human disease, including its diagnosis, prognosis and therapeutic intervention, there will still be enough grounds to advocate animal experimentation. However, efforts must continue to minimize or eliminate the need for animal testing in scientific research as soon as possible. © 2013 S. Karger AG, Basel.

  13. [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.

  14. 21 CFR 226.1 - Current good manufacturing practice.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Current good manufacturing practice. 226.1 Section...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR TYPE A MEDICATED ARTICLES General Provisions § 226.1 Current good manufacturing practice. (a) The criteria in §§ 226.10 through 226.115,...

  15. 21 CFR 225.1 - Current good manufacturing practice.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Current good manufacturing practice. 225.1 Section...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR MEDICATED FEEDS General Provisions § 225.1 Current good manufacturing practice. (a) Section 501(a)(2)(B) of the Federal Food, Drug, and Cosmetic...

  16. 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 ...

  17. First on-line survey of an international multidisciplinary working group (MightyMedic) on current practice in diagnosis, therapy and follow-up of dyslipidemias.

    Science.gov (United States)

    Stefanutti, C; D'Alessandri, G; Petta, A; Harada-Shiba, M; Julius, U; Soran, H; Moriarty, P M; Romeo, S; Drogari, E; Jaeger, B R

    2015-05-01

    The MightyMedic (Multidisciplinary International Group for Hemapheresis TherapY and MEtabolic DIsturbances Contrast) Working Group has been founded in 2013. The leading idea was to establish an international network of interdisciplinary nature aimed at working to cross national borders research projects, clinical trials, educational initiatives (meetings, workshops, summer schools) in the field of metabolic diseases, namely hyperlipidemias, and diabetes, preventive cardiology, and atherosclerosis. Therapeutic apheresis, its indications and techniques, is a parallel field of investigation. The first on-line survey of the Group has been completed in the first half of 2014. The survey included # 24 Centers in Italy, Germany, Greece, UK, Sweden, Japan and USA. Relevant data have been collected on current practice in diagnosis, therapy and follow-up of dyslipidemias. 240 subjects with hyperlipidemia and treated with lipoprotein apheresis have been reported in the survey, but a large percentage of patients (35%) who could benefit from this therapeutic option are still treated by conventional drug approach. Genetic molecular diagnosis is performed in only 33% of patients while Lipoprotein(a) (Lp(a)) is included in cardiovascular disease risk assessment in 71% of participating Centers. New detailed investigations and prospective multicenter studies are needed to evaluate changes induced by the impact of updated indications and strategies, as well as new treatment options, targeting standardization of therapeutic and diagnostic approaches.

  18. Self-medication practice among undergraduate medical students of ...

    African Journals Online (AJOL)

    Results: Self-medication practice was highly prevalent among the medical students, with 87 % reporting that ... The increase in self-medication is due to a number of ..... resistant strains and increased cost and morbidity. ... Conflict of Interest.

  19. 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 ...

  20. Current practice for pulmonary hypertension

    Institute of Scientific and Technical Information of China (English)

    Toru Satoh

    2014-01-01

    Objective To investigate the current practice of pulmonary hypertension including current epidemiology,diagnosis and treatment.Data sources The review was based on data obtained from the published articles and guidelines.Study selection Articles with high level of evidence or current best evidence in each issue were selected to be reviewed.Results Overall prevalence of pulmonary hypertension was 0.3% to 6% with left heart disease occupying the most proportion,followed by pulmonary disease,pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension.In diagnosis,a flow diagram of diagnosis of pulmonary hypertension,differential diagnosis of pulmonary hypertension and how to determine the severity of pulmonary hypertension are explained including recent development of magnetic resonance imaging and gene abnormality study on bone morphogenetic protein receptor Ⅱ.In treatment,newlydeveloped pulmonary vasodilators and the way to use them are shown to treat pulmonary hypertension.Conclusion Safer and more effective treatment algorithm and basic researches and clinical trials are warranted to be explored.

  1. Practical trials in medical education

    DEFF Research Database (Denmark)

    Tolsgaard, Martin G; Kulasegaram, Kulamakan M; Ringsted, Charlotte

    2017-01-01

    , limitations and future directions for this kind of research. CURRENT STATE: Practical trials have the overall aim of informing decision makers. They are carried out in real-life settings and are characterised by (i) comparison of viable alternative education strategies, (ii) broad inclusion criteria regarding...... participants across several settings and (iii) multiple outcome measures with long-term follow-up to evaluate both benefits and risks. Questions posed by practical trials may be proactive in applying theory in the development of educational innovations or reactive to educational reforms and innovations. Non......CONTEXT: Concerns have been raised over the gap between education theory and practice and how research can contribute to inform decision makers on their choices and priorities. Little is known about how educational theories and research outcomes produced under optimal conditions in highly...

  2. Assessing and changing medical practice culture.

    Science.gov (United States)

    Hills, Laura

    2011-01-01

    Your medical practice has an existing culture that manifests itself daily in literally hundreds of ways. Some aspects of your culture likely support your practice's growth; others may be impeding your progress. This article describes the characteristics of medical practice culture and provides numerous examples of how culture influences behavior. It describes how culture is expressed in a medical practice through objects and artifacts, language, emotions, interactions, practice management systems, and daily work habits. It offers three techniques for assessing an existing medical practice culture and a checklist for conducting culture observations. This article also provides guidelines for identifying a desired medical practice culture and explores why changing culture is so difficult. It describes five reasons employees are likely to resist culture change and provides 12 fundamental changes that will enable a practice to improve its culture. Finally, this article explores how medical practice cultures are formed and perpetuated and provides more than a dozen questions to ask employees in a culture survey.

  3. Medical records in equine veterinary practice.

    Science.gov (United States)

    Werner, Susan H

    2009-12-01

    Quality medical records are the cornerstone of successful equine veterinary practice. The scope and integrity of the information contained in a practice's medical records influence the quality of patient care and client service and affect liability risk, practice productivity, and overall practice value.

  4. Emotional Intelligence in medical practice

    Directory of Open Access Journals (Sweden)

    Abu Hasan Sarkar

    2016-08-01

    Full Text Available Emotional Intelligence is the ability to perceive, express, understand and regulate one’s inner emotions and the emotions of others. It is considered to be a ‘must have’ competence in the workplace. Several scientific studies have proven that the application of emotional intelligence is effective in improving the teaching-learning process and that it leads to organizational growth; however, only limited work has been carried out to assess its effectiveness in the practice of medicine, especially in India. Various scales have been developed to measure emotional intelligence but they are not universally applicable because emotional intelligence depends upon culture and personal background among other factors. In recent years in India, conflicts between patients and doctors have had serious, sometimes fatal, consequences for the physician. Behavior, when faced with a potential conflict-like situation, depends to a great extent on the emotional intelligence of the physician. Emotional intelligence of medical students and medical professionals can be honed through exposure to the medical humanities which are known to promote patient-centered care. Building better physician-patient relationships might help in averting doctor-patient conflict.

  5. Medical devices regulations, standards and practices

    CERN Document Server

    Ramakrishna, Seeram; Wang, Charlene

    2015-01-01

    Medical Devices and Regulations: Standards and Practices will shed light on the importance of regulations and standards among all stakeholders, bioengineering designers, biomaterial scientists and researchers to enable development of future medical devices. Based on the authors' practical experience, this book provides a concise, practical guide on key issues and processes in developing new medical devices to meet international regulatory requirements and standards. Provides readers with a global perspective on medical device regulationsConcise and comprehensive information on how to desig

  6. 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.

  7. 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. .

  8. [Conscientious objection in medical practice].

    Science.gov (United States)

    Beca, Juan Pablo I; Astete, Carmen A

    2015-04-01

    Medical practice implies the controversial encounter of diverse circumstances in which eventual conflicts between physicians and patients values as well as between physicians values and legal or institutional rules arise. When dealing with these situations, physicians have the right to refuse acting against their moral conscience. This conscientious objection, accepted as a personal right and recognized by several legislations and medical ethics codes, is valid only if it has been reasonably justified and declared in advance. Conversely, it would be invalid if it is based upon convenience or understood as a collective refusal, which may be a form of civil disobedience. Conscientious objection in medicine is considered a limited right even though patients ought to be respected in their demands for legally accepted treatments or interventions. On the other hand, personal conscientious objection is different from the prerogative of institutions to establish their own regulations according to their institutional ideology or ethics codes. However, public hospitals have to offer all treatments or interventions legally allowed, since the state has the obligation to guarantee all citizens an appropriate access to them.

  9. Virtue in Medical Practice: An Exploratory Study.

    Science.gov (United States)

    Kotzee, Ben; Ignatowicz, Agnieszka; Thomas, Hywel

    2017-03-01

    Virtue ethics has long provided fruitful resources for the study of issues in medical ethics. In particular, study of the moral virtues of the good doctor-like kindness, fairness and good judgement-have provided insights into the nature of medical professionalism and the ethical demands on the medical practitioner as a moral person. Today, a substantial literature exists exploring the virtues in medical practice and many commentators advocate an emphasis on the inculcation of the virtues of good medical practice in medical education and throughout the medical career. However, until very recently, no empirical studies have attempted to investigate which virtues, in particular, medical doctors and medical students tend to have or not to have, nor how these virtues influence how they think about or practise medicine. The question of what virtuous medical practice is, is vast and, as we have written elsewhere, the question of how to study doctors' moral character is fraught with difficulty. In this paper, we report the results of a first-of-a-kind study that attempted to explore these issues at three medical schools (and associated practice regions) in the United Kingdom. We identify which character traits are important in the good doctor in the opinion of medical students and doctors and identify which virtues they say of themselves they possess and do not possess. Moreover, we identify how thinking about the virtues contributes to doctors' and medical students' thinking about common moral dilemmas in medicine. In ending, we remark on the implications for medical education.

  10. Medication Administration Practices of School Nurses.

    Science.gov (United States)

    McCarthy, Ann Marie; Kelly, Michael W.; Reed, David

    2000-01-01

    Assessed medication administration practices among school nurses, surveying members of the National Association of School Nurses. Respondents were extremely concerned about medication administration. Errors in administering medications were reported by 48.5 percent of respondents, with missed doses the most common error. Most nurses followed…

  11. Information overload in medical practice.

    Science.gov (United States)

    Zeldes, Nathan; Baum, Neil

    2011-01-01

    Most practices are inundated with an excess of information. This information overload, or "infoglut," results in distractions and a loss of productivity. This article will discuss the concept of infoglut and what every practice can do to manage the tsunami of information that threatens to consume our practices.

  12. [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.

  13. The valuation of a medical practice.

    Science.gov (United States)

    Reilly, R F

    1990-01-01

    The valuation of a medical practice is important to the practice owners, employees, bankers, and others for many reasons. These reasons include taxation, transaction pricing, financing, litigation, and management planning. This article presents the three most common approaches to practice valuation: discounted net cash flow, market data comparable, and asset accumulation. Comprehensive illustrative examples of all three approaches are presented.

  14. Massive transfusion protocols: current best practice

    Directory of Open Access Journals (Sweden)

    Hsu YM

    2016-03-01

    Full Text Available Yen-Michael S Hsu,1 Thorsten Haas,2 Melissa M Cushing1 1Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY, USA; 2Department of Anesthesia, University Children's Hospital Zurich, Zurich, Switzerland Abstract: Massive transfusion protocols (MTPs are established to provide rapid blood replacement in a setting of severe hemorrhage. Early optimal blood transfusion is essential to sustain organ perfusion and oxygenation. There are many variables to consider when establishing an MTP, and studies have prospectively evaluated different scenarios and patient populations to establish the best practices to attain improved patient outcomes. The establishment and utilization of an optimal MTP is challenging given the ever-changing patient status during resuscitation efforts. Much of the MTP literature comes from the trauma population, due to the fact that massive hemorrhage is the leading cause of preventable trauma-related death. As we come to further understand the positive and negative clinical impacts of transfusion-related factors, massive transfusion practice can be further refined. This article will first discuss specific MTPs targeting different patient populations and current relevant international guidelines. Then, we will examine a wide selection of therapeutic products to support MTPs, including newly available products and the most suitable of the traditional products. Lastly, we will discuss the best design for an MTP, including ratio-based MTPs and MTPs based on the use of point-of-care coagulation diagnostic tools. Keywords: hemorrhage, MTP, antifibrinolytics, coagulopathy, trauma, ratio, logistics, guidelines, hemostatic

  15. 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.

  16. Troubling Muddy Waters: Problematizing Reflective Practice in Global Medical Education.

    Science.gov (United States)

    Naidu, Thirusha; Kumagai, Arno K

    2016-03-01

    The idea of exporting the concept of reflective practice for a global medical education audience is growing. However, the uncritical export and adoption of Western concepts of reflection may be inappropriate in non-Western societies. The emphasis in Western medical education on the use of reflection for a specific end--that is, the improvement of individual clinical practice--tends to ignore the range of reflective practice, concentrating on reflection alone while overlooking critical reflection and reflexivity. This Perspective places the concept of reflective practice under a critical lens to explore a broader view for its application in medical education outside the West. The authors suggest that ideas about reflection in medicine and medical education may not be as easily transferable from Western to non-Western contexts as concepts from biomedical science are. The authors pose the question, When "exporting" Western medical education strategies and principles, how often do Western-trained educators authentically open up to the possibility that there are alternative ways of seeing and knowing that may be valuable in educating Western physicians? One answer lies in the assertion that educators should aspire to turn exportation of educational theory into a truly bidirectional, collaborative exchange in which culturally conscious views of reflective practice contribute to humanistic, equitable patient care. This discussion engages in troubling the already-muddy waters of reflective practice by exploring the global applicability of reflective practice as it is currently applied in medical education. The globalization of medical education demands critical reflection on reflection itself.

  17. [New challenges for humanism in medical practice].

    Science.gov (United States)

    Soberón-Acevedo, G; García-Viveros, M; Narro-Robles, J

    1994-01-01

    This work is a review of the philosophical analysis surrounding the concept of "humanism" and what it means to be a human being, in relationship to daily life, education and medicine. The authors establish a direct relationship between humanism and bioethics as they relate to the new trends acquired through the development of institutional medicine and the increasing application of technological innovations in the health field. Both of these conditions tend to depersonalize the practice of medicine, and transform an ill person into a clinical file. Reflections are made about current topics, such as the knowledge and manipulation of human genome, assisted reproduction, abortion, survival of premature infants, organ transplants, technological innovation, euthanasia and disthanasia. Concepts and ideas are reviewed in relation to medical institutions and the sick, the physician and the community, and the physician and the government.

  18. Communication in medical practice across ethnic boundaries.

    OpenAIRE

    Crisp, A. H.; Edwards, W. J.

    1989-01-01

    The communication skills basic to good medical practice are, for many of us, unnatural. The authors attempt to address aspects of the matter with particular reference to communication across ethnic boundaries.

  19. 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

  20. Overview of current chelation practices

    Directory of Open Access Journals (Sweden)

    Y. Aydinok

    2011-12-01

    , should provide long-term survival and quality of life for patients with iron loading anemias. The goal of this review is to summarize current concepts in iron chelation therapies based on the considerable amount of prospective data obtained by clinical studies. 去铁胺 (DFO)是自20世纪80年以来输血引起铁过载的参考标准疗法。 虽然它是一种高效的铁螯合剂,但是去铁胺皮下给药的遵从性问题依旧是主要问题。 口服螯合剂去铁酮(DFP)在北美没有销售许可证,但是,它在1994年获得印度许可,1999年欧洲联盟(EU)批准授予去铁酮销售许可证,特别是当去铁胺不足、无法忍受或无法接受时,去铁酮可用于重型地中海贫血患者。 还可获得关于在6岁至10岁之间的儿童身上使用去铁酮的有限数据,但是没有关于在6岁以下儿童身上使用去铁酮的数据。 随后美国食品和药品管理局(FDA)和欧洲药品管理局(EMA)分别在2005年和2006年批准口服螯合剂去铁酮作为第一疗法来治疗2岁以上输血引起铁过载的患者。 铁螯合的主要目的是将身体铁维持在安全水平,但一旦铁累积起来,铁螯合的目标是把组织铁降低到安全级别,这是一个缓慢的过程。 确定螯合剂的螯合方案、剂量和频率管理的主要依据是身体铁负担、心肌铁的状态和输血铁负载速率。 适当监控螯合对测量特殊方案的反应速率和提供计量调整来加强螯合效果和避免毒效尤其重要。 由于一些因素,诸如:螯合剂的吸收和代谢,螯合方案的效果可能呈现个别变化。 耐受性和遵从性也是影响螯合反应的个别变量。 了解螯合剂的优点和局限性,准确确定铁过载患者的螯合需求以及设计毒效更小但效果更优的个性化螯合方案,可以向铁过载贫血患者提供长期的生存和生活质量。 此次调研的目的是在临床研究获得的相当数

  1. Medical physics practice and training in Ghana.

    Science.gov (United States)

    Amuasi, John H; Kyere, Augustine K; Schandorf, Cyril; Fletcher, John J; Boadu, Mary; Addison, Eric K; Hasford, Francis; Sosu, Edem K; Sackey, Theophilus A; Tagoe, Samuel N A; Inkoom, Stephen; Serfor-Armah, Yaw

    2016-06-01

    Medical physics has been an indispensable and strategic stakeholder in the delivery of radiological services to the healthcare system of Ghana. The practice has immensely supported radiation oncology and medical imaging facilities over the years, while the locally established training programme continues to produce human resource to feed these facilities. The training programme has grown to receive students from other African countries in addition to local students. Ghana has been recognised by the International Atomic Energy Agency as Regional Designated Centre for Academic Training of Medical Physicists in Africa. The Ghana Society for Medical Physics collaborates with the School of Nuclear and Allied Sciences of the University of Ghana to ensure that training offered to medical physicists meet international standards, making them clinically qualified. The Society has also worked together with other bodies for the passage of the Health Profession's Regulatory Bodies Act, giving legal backing to the practice of medical physics and other allied health professions in Ghana. The country has participated in a number of International Atomic Energy Agency's projects on medical physics and has benefited from its training courses, fellowships and workshops, as well as those of other agencies such as International Organization for Medical Physics. This has placed Ghana's medical physicists in good position to practice competently and improve healthcare.

  2. ETHICAL CONSIDERATIONS IN MEDICAL PRACTICE AND RESEARCH

    Directory of Open Access Journals (Sweden)

    Rajeev

    2016-01-01

    Full Text Available Ethics is governed by moral principles that define human conduct for an individual, group or society. Role of ethics has become extremely important in medical practice and research. Medical practice or any scientific act related to human participation in research should be carefully calibrated safeguarding the ethical interest of the patient/participant. The philosophy of medical intervention should be to integrate a transparent health care system that focuses on consistent delivery of evidence based care at the right time in the right environment and in right manner. In futuristic healthcare sector, upcoming professionals should be adequately sensitized to protect and respect the ethical interest of the patients.

  3. Structuring group medical practices: tax planning aspects.

    Science.gov (United States)

    Gassman, A S; Conetta, T F

    1992-01-01

    This article is the first in a series addressing the structuring of group medical practice entities, shareholder relationships, and general representation factors. In this article, a general background in federal tax planning is provided, including strategies for minimization of income tax payment and the potential problems that may be encountered when a group practice is not carefully structured.

  4. Marketing the academic medical center group practice.

    Science.gov (United States)

    Eudes, J A; Divis, K L

    1992-01-01

    From a marketing perspective, there are many differences between private and academic medical center (AMC) group practices. Given the growing competition between the two, write John Eudes and Kathy Divis, it is important for the AMC group practice to understand and use these differences to develop a competitive market advantage.

  5. Emotional Intelligence in medical practice

    OpenAIRE

    Abu Hasan Sarkar; Janumoni Senapati

    2016-01-01

    Emotional Intelligence is the ability to perceive, express, understand and regulate one’s inner emotions and the emotions of others. It is considered to be a ‘must have’ competence in the workplace. Several scientific studies have proven that the application of emotional intelligence is effective in improving the teaching-learning process and that it leads to organizational growth; however, only limited work has been carried out to assess its effectiveness in the practice of medicine, espe...

  6. 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

  7. Medical imaging principles and practices

    CERN Document Server

    Bronzino, Joseph D; Peterson, Donald R

    2013-01-01

    This book offers a selective review of key imaging modalities focusing on modalities with established clinical utilization. It provides a detailed overview of x-ray imaging and computed tomography, fundamental concepts in signal acquisition and processes, followed by an overview of functional MRI (fMRI) and chemical shift imaging. It also covers topics in Magnetic Resonance Microcopy, the physics of instrumentation and signal collection, and their application in clinical practice. The selection of topics provides readers with an appreciation of the depth and breadth of the field and the challenges ahead of the technical and clinical community of researchers and practitioners.

  8. Current american practice in color measurement.

    Science.gov (United States)

    Billmeyer, F W

    1969-04-01

    Current Aimerienn practice in color measurement is reviewed from the standpoint of instrumentation practice, measurement concepts, and computational methods. Instrumentation practice is described for spectrophotometers, abridged spectrophotometers, and tristimulus colorimeters. Measurement variables discussed include photometric and wavelength scales, standards and standardization, illuminating and viewing geometry, and instrument sources simulating standard illuminants. Computation-methods practiced for obtaining color coordinates and color differences are discussed. Topics indirectly related to the measurement step, such as the basis of colorimetry, color mixing laws, and computer color matching, are specifically excluded from this paper.

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

    Directory of Open Access Journals (Sweden)

    Srivastav Shalini, Mahajan Harsh, Mathur B P

    2012-01-01

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

  10. Medical students' perception of dyad practice

    DEFF Research Database (Denmark)

    Tolsgaard, Martin G; Rasmussen, Maria Birkvad; Bjørck, Sebastian

    2014-01-01

    Training in pairs (dyad practice) has been shown to improve efficiency of clinical skills training compared with single practice but little is known about students' perception of dyad practice. The aim of this study was to explore the reactions and attitudes of medical students who were instructed....... The students felt dyad practice improved their self-efficacy through social interaction with peers, provided useful insight through observation, and contributed with shared memory of what to do, when they forgot essential steps of the physical examination of the patient. However, some students were concerned...

  11. Toward the new pattern of medical practice.

    Science.gov (United States)

    Freidson, E

    1993-01-01

    As this article is being written, in the fall of 1993, we are waiting for the details of the President's plan for extending health insurance coverage of some kind to all members of the population while also containing costs. All observers, including practicing members of the medical profession itself, believe that a sharp break with the past is developing, most particularly a break with the old pattern of practice that flourished during the golden years between the end of World War II and the end of the 1960s, when the federal government made its first effort to control costs. In this article, I will discusses changes in the conditions of American medical practice that most observers can agree on. Then, I will summarize the major conceptions of the future shape of medical practice. I will conclude with my own view of critical issues in the constitution of practice, issues whose resolution depends not only on broad public policy initiatives, but also on the activities of physician executives within the medical community.

  12. Medical practice branding using cable television.

    Science.gov (United States)

    Miaoulis, George; Kissinger, Mark; Sirko-Fiorilli, Mary Ann

    2005-01-01

    Genesis Medical Associates is an independent primary care practice in the suburbs of Pittsburgh. Given competitive pressures, a member of the physician leadership began thinking about the need for the practice to develop an "identity and awareness" program to set the practice apart from the competition. The idea for branding the campaign began when Dr. Rob Potter, Jr., was attending a Pittsburgh Pirates baseball game and a fan said to him, "You're that doctor I see on television" in the nursing home commercial. Triggered by this experience, Potter saw the opportunity to develop an awareness and identity campaign for Genesis. In this article we share the reasons for, the steps taken, and initial results in developing a medical practice branding strategy.

  13. Fever management: Evidence vs current practice.

    Science.gov (United States)

    El-Radhi, A Sahib Mehdi

    2012-12-08

    Fever is a very common complaint in children and is the single most common non-trauma-related reason for a visit to the emergency department. Parents are concerned about fever and it's potential complications. The biological value of fever (i.e., whether it is beneficial or harmful) is disputed and it is being vigorously treated with the belief of preventing complications such as brain injury and febrile seizures. The practice of alternating antipyretics has become widespread at home and on paediatric wards without supporting scientific evidence. There is still a significant contrast between the current concept and practice, and the scientific evidence. Why is that the case in such a common complaint like fever The article will discuss the significant contrast between the current concepts and practice of fever management on one hand, and the scientific evidence against such concepts and practice.

  14. Medical rosters and the Trade Practices Act.

    Science.gov (United States)

    Pengilley, Warren

    2003-04-07

    Medical rosters are not free of trade practices problems, notwithstanding assurances by the Australian Competition and Consumer Commission (ACCC). Neither the ACCC nor the recently convened Wilkinson Committee has applied rigorous legal principles in interpreting the Trade Practices Act 1974 (Cwlth) to reach its conclusions. The Australian law should be changed to bring it into line with that of the United States and New Zealand.

  15. Is your practice at risk for medical identity theft?

    Science.gov (United States)

    Weinstock, Donna

    2014-01-01

    Medical identity theft has become increasingly prevalent. Medical practices need to take action and have policies and procedures in place to prevent data breaches. This will protect both the patient and the practice from medical identity theft.

  16. Medical Ethics in Contemporary Clinical Practice

    Directory of Open Access Journals (Sweden)

    John R. Williams

    2005-11-01

    Full Text Available This review article describes and analyzes ethical issues in medical practice, particularly those issues encountered by physicians in their relationships with their patients. These relationships often involve ethical conflicts between 2 or more interests, which physicians need to recognize and resolve. The article deals with 4 topics in clinical practice in which ethical conflicts occur: physicians' duty of confidentiality in a digital environment, their responsibilities for dealing with abuses of the human rights of patients, their role in clinical research, and their relationships with commercial enterprises. The ethical policies of the World Medical Association provide the basis for determining appropriate physician conduct on these matters. The article concludes with reflections on the need for international standards of medical ethics.

  17. Practice guidelines, did they reduce medical practice variation?

    NARCIS (Netherlands)

    Jong, J.D. de; Westert, G.P.; Schellevis, F.

    2003-01-01

    Background: A persistent finding in health services research is that medical practice varies widely between small areas. When clinical variables and patient characteristics are taken into account, residual variation still remains. The existence of this variation is often interpreted as a sign of ove

  18. Applying adult learning practices in medical education.

    Science.gov (United States)

    Reed, Suzanne; Shell, Richard; Kassis, Karyn; Tartaglia, Kimberly; Wallihan, Rebecca; Smith, Keely; Hurtubise, Larry; Martin, Bryan; Ledford, Cynthia; Bradbury, Scott; Bernstein, Henry Hank; Mahan, John D

    2014-07-01

    The application of the best practices of teaching adults to the education of adults in medical education settings is important in the process of transforming learners to become and remain effective physicians. Medical education at all levels should be designed to equip physicians with the knowledge, clinical skills, and professionalism that are required to deliver quality patient care. The ultimate outcome is the health of the patient and the health status of the society. In the translational science of medical education, improved patient outcomes linked directly to educational events are the ultimate goal and are best defined by rigorous medical education research efforts. To best develop faculty, the same principles of adult education and teaching adults apply. In a systematic review of faculty development initiatives designed to improve teaching effectiveness in medical education, the use of experiential learning, feedback, effective relationships with peers, and diverse educational methods were found to be most important in the success of these programs. In this article, we present 5 examples of applying the best practices in teaching adults and utilizing the emerging understanding of the neurobiology of learning in teaching students, trainees, and practitioners. These include (1) use of standardized patients to develop communication skills, (2) use of online quizzes to assess knowledge and aid self-directed learning, (3) use of practice sessions and video clips to enhance significant learning of teaching skills, (4) use of case-based discussions to develop professionalism concepts and skills, and (5) use of the American Academy of Pediatrics PediaLink as a model for individualized learner-directed online learning. These examples highlight how experiential leaning, providing valuable feedback, opportunities for practice, and stimulation of self-directed learning can be utilized as medical education continues its dynamic transformation in the years ahead.

  19. Current Practices in Resident Assistant Training

    Science.gov (United States)

    Koch, Virginia Albaneso

    2016-01-01

    Developing resident assistant (RA) training is a challenge for most housing and residence life staff. Grounded in the author's doctoral research on the curricular design of RA training programs, this study summarizes current practices in three types of RA training programs--preservice training, in-service training, and academic courses--and…

  20. Teaching Math Online: Current Practices in Turkey

    Science.gov (United States)

    Akdemir, Omur

    2011-01-01

    Changing nature of student population, developments in technology, and insufficient number of traditional universities have made online courses popular around the globe. This study was designed to investigate the current practices of teaching mathematics online in Turkish Universities through a qualitative inquiry. The snowball sampling method was…

  1. Current Practices in Resident Assistant Training

    Science.gov (United States)

    Koch, Virginia Albaneso

    2016-01-01

    Developing resident assistant (RA) training is a challenge for most housing and residence life staff. Grounded in the author's doctoral research on the curricular design of RA training programs, this study summarizes current practices in three types of RA training programs--preservice training, in-service training, and academic courses--and…

  2. [Homeopathy: a humanistic approach to medical practice].

    Science.gov (United States)

    Teixeira, Marcus Zulian

    2007-01-01

    During the last decade, the traditional medical model has endeavoured to retrieve an improvement in the patient-physician relationship by means of propositions for humanization in the areas of education, medical care and policies. To enhance holistic characteristics of non-conventional practices in health, the incorporation of several aspects of humanities in understanding the process of the individual's illness, stressing that the physician's interest in aspects apparently not related to the impaired organ (history of the patients life, personality, interests, etc.) should be added to the technical and less humanized consultation. Since homeopathy embraces this wide semiological approach as inherent practice, using the totality of characteristic symptoms to evaluate organic unbalance and choose means of treatment, homeopathic clinical practice can significantly contribute to humanism in medicine.

  3. 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.

  4. Cooperative epistemic work in medical practice

    DEFF Research Database (Denmark)

    Bansler, Jørgen P.; Havn, Erling Carl; Schmidt, Kjeld;

    2016-01-01

    ’ clinical notes form the core of the medical record. They serve both as a ‘tool for thinking’ for the individual physician, enabling him or her to make sense of the patient’s past history and current condition, and as a coordinative artifact used by physicians, nurses, and other health care professionals......We examine an important part of the medical record that has not been studied extensively: physicians’ clinical notes. These notes constitute an explanatory medical narrative that documents the patient’s illness trajectory by combining each physician’s notes into a common text. Although several...... prior CSCW studies have addressed the role of the medical record in patient care, they have not dealt specifically with the role, structure, and content of these notes. In this article, we present a detailed analysis of a set of physicians’ clinical notes recording the acute hospitalization...

  5. Management by objectives in medical group practice.

    Science.gov (United States)

    Bozis, D E

    1986-01-01

    When the concept of management by objectives first emerged, it was heralded by many as the long-sought secret to employee motivation. The MBO technique, involving the three primary functions of objective setting, objective using, and employee involvement, is described here in terms of both theory and practice. Although it does have its pitfalls and is certainly not the "ultimate answer," MBO in medical group practice does have its merits when properly introduced. It is much more than a purely academic concept, and its major strength lies in its recognition of the importance of human resources in getting the job done.

  6. 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…

  7. 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,…

  8. 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,…

  9. Current practice in laboratory diagnostics of autoimmune diseases in Croatia. 
Survey of the Working group for laboratory diagnostics of autoimmune diseases of the Croatian Society of Medical Biochemistry and Laboratory Medicine

    Science.gov (United States)

    Kuna, Andrea Tešija; Đerek, Lovorka; Kozmar, Ana; Drvar, Vedrana

    2016-01-01

    Introduction With the trend of increasing incidence of autoimmune diseases, laboratories are faced with exponential growth of the requests for tests relating the diagnosis of these diseases. Unfortunately, the lack of laboratory personnel experienced in this specific discipline of laboratory diagnostic, as well as an unawareness of a method limitation often results in confusion for clinicians. The aim was to gain insight into number and type of Croatian laboratories that perform humoral diagnostics with the final goal to improve and harmonize laboratory diagnostics of autoimmune diseases in Croatia. Materials and methods In order to get insight into current laboratory practice two questionnaires, consisting of 42 questions in total, were created. Surveys were conducted using SurveyMonkey application and were sent to 88 medical biochemistry laboratories in Croatia for the first survey. Out of 33 laboratories that declared to perform diagnostic from the scope, 19 were selected for the second survey based on the tests they pleaded to perform. The survey comprised questions regarding autoantibody hallmarks of systemic autoimmune diseases while regarding organ-specific autoimmune diseases was limited to diseases of liver, gastrointestinal and nervous system. Results Response rate was high with 80 / 88 (91%) laboratories which answered the first questionnaire, and 19 / 19 (1.0) for the second questionnaire. Obtained results of surveys indicate high heterogeneity in the performance of autoantibody testing among laboratories in Croatia. Conclusions Results indicate the need of creating recommendations and algorithms in order to harmonize the approach to laboratory diagnostics of autoimmune diseases in Croatia.

  10. Cooperative epistemic work in medical practice

    DEFF Research Database (Denmark)

    Bansler, Jørgen P.; Havn, Erling Carl; Schmidt, Kjeld

    2016-01-01

    prior CSCW studies have addressed the role of the medical record in patient care, they have not dealt specifically with the role, structure, and content of these notes. In this article, we present a detailed analysis of a set of physicians’ clinical notes recording the acute hospitalization......’ clinical notes form the core of the medical record. They serve both as a ‘tool for thinking’ for the individual physician, enabling him or her to make sense of the patient’s past history and current condition, and as a coordinative artifact used by physicians, nurses, and other health care professionals...

  11. Medical Physics Practice Guidelines - the AAPM's minimum practice recommendations for medical physicists.

    Science.gov (United States)

    Mills, Michael D; Chan, Maria F; Prisciandaro, Joann I; Shepard, Jeff; Halvorsen, Per H

    2013-11-04

    The AAPM has long advocated a consistent level of medical physics practice, and has published many recommendations and position statements toward that goal, such as Science Council Task Group reports related to calibration and quality assurance, Education Council and Professional Council Task Group reports related to education, training, and peer review, and Board-approved Position Statements related to the Scope of Practice, physicist qualifications, and other aspects of medical physics practice. Despite these concerted and enduring efforts, the profession does not have clear and concise statements of the acceptable practice guidelines for routine clinical medical physics. As accreditation of clinical practices becomes more common, Medical Physics Practice Guidelines (MPPGs) will be crucial to ensuring a consistent benchmark for accreditation programs. To this end, the AAPM has recently endorsed the development of MPPGs, which may be generated in collaboration with other professional societies. The MPPGs are intended to be freely available to the general public. Accrediting organizations, regulatory agencies, and legislators will be encouraged to reference these MPPGs when defining their respective requirements. MPPGs are intended to provide the medical community with a clear description of the minimum level of medical physics support that the AAPM would consider prudent in clinical practice settings. Support includes, but is not limited to, staffing, equipment, machine access, and training. These MPPGs are not designed to replace extensive Task Group reports or review articles, but rather to describe the recommended minimum level of medical physics support for specific clinical services. This article has described the purpose, scope, and process for the development of MPPGs.

  12. 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.

  13. Asthma in children: gaps between current management and best practice.

    Science.gov (United States)

    Haby, M M; Powell, C V E; Oberklaid, F; Waters, E B; Robertson, C F

    2002-06-01

    To determine the extent to which steps three to six of the Australian six-step asthma management plan are being implemented in the community and to identify barriers to the adoption of best practice asthma management. A cross-sectional descriptive study was conducted at the Royal Children's Hospital and Sunshine Hospital, Melbourne. Two hundred and thirty-one 2-5-year old children who visited the emergency department for asthma were enrolled in the study. Main outcome measures were frequency of asthma management practices and barriers, as measured by parent-completed questionnaire. Gaps: 51% of parents do not feel they have enough information about asthma triggers, more than 60% of children with persistent or frequent episodic asthma are not using regular preventive medication, 48% do not have a written action plan, 39% have not had their asthma reviewed in the last 6 months, and 38% of parents do not feel that they have enough information about their child's asthma. Areas where current practice was close to best practice: 83% of doctors had talked to parents about what causes or 'triggers' their child's asthma, less than 1% of children are using puffers without a spacer, 83% of parents who had an action plan used it for the current visit to the emergency department. Large gaps still exist between current management and best practice in this group of emergency department attenders. Improvements in asthma management could be achieved if the child's asthma doctor requested review visits for asthma, provided an action plan and followed best practice in relation to asthma medications.

  14. Paying research participants: a study of current practices in Australia.

    Science.gov (United States)

    Fry, C L; Ritter, A; Baldwin, S; Bowen, K J; Gardiner, P; Holt, T; Jenkinson, R; Johnston, J

    2005-09-01

    To examine current research payment practices and to inform development of clearer guidelines for researchers and ethics committees. Exploratory email based questionnaire study of current research participant reimbursement practices. A diverse sample of organisations and individuals were targeted. Australia. Contacts in 84 key research organisations and select electronic listservers across Australia. A total of 100 completed questionnaires were received with representations from a variety of research areas (for example, market, alcohol and drug, medical, pharmaceutical and social research). Open-ended and fixed alternative questions about type of research agency; type of research; type of population under study; whether payment is standard; amounts and mechanisms of payment; factors taken into account when deciding on payment practices; and whether payment policies exist. Reimbursement practice is highly variable. Where it occurs (most commonly for drug dependent rather than health professional or general population samples) it is largely monetary and is for time and out-of-pocket expenses. Ethics committees were reported to be often involved in decision making around reimbursement. Research subject payment practices vary in Australia. Researchers who do provide payments to research participants generally do so without written policy and procedures. Ethics committees have an important role in developing guidelines in this area. Specific guidelines are needed considering existing local policies and procedures; payment models and their application in diverse settings; case study examples of types and levels of reimbursement; applied definitions of incentive and inducement; and the rationale for diverse payment practices in different settings.

  15. 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

  16. Translational ethics? The theory-practice gap in medical ethics.

    Science.gov (United States)

    Cribb, Alan

    2010-04-01

    Translational research is now a critically important current in academic medicine. Researchers in all health-related fields are being encouraged not only to demonstrate the potential benefits of their research but also to help identify the steps through which their research might be 'made practical'. This paper considers the prospects of a corresponding movement of 'translational ethics'. Some of the advantages and disadvantages of focusing upon the translation of ethical scholarship are reviewed. While emphasising the difficulties of crossing the gap between scholarship and practice, the paper concludes that a debate about the business of translation would be useful for medical ethics.

  17. 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

  18. Endocrinopathies: The current and changing perspectives in anesthesia practice

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2015-01-01

    Full Text Available The gateways to advancements in medical fields have always been accessed through the coalition between various specialties. It is almost impossible for any specialty to make rapid strides of its own. However, the understanding of deeper perspectives of each specialty or super specialty is essential to take initiatives for the progress of the other specialty. Endocrinology and anesthesiology are two such examples which have made rapid progress in the last three decades. Somehow the interaction and relationship among these medical streams have been only scarcely studied. Diabetes and thyroid pathophysiologies have been the most researched endocrine disorders so far in anesthesia practice but even their management strategies have undergone significant metamorphosis over the last three decades. As such, anesthesia practice has been influenced vastly by these advancements in endocrinology. However, a comprehensive understanding of the relationship between these two partially related specialties is considered to be an essential cornerstone for further progress in anesthesia and surgical sciences. The current review is an attempt to imbibe the current and the changing perspectives so as to make the understanding of the relationship between these two medical streams a little simple and clearer.

  19. Endocrinopathies: The current and changing perspectives in anesthesia practice

    Science.gov (United States)

    Bajwa, Sukhminder Jit Singh; Kaur, Gurpreet

    2015-01-01

    The gateways to advancements in medical fields have always been accessed through the coalition between various specialties. It is almost impossible for any specialty to make rapid strides of its own. However, the understanding of deeper perspectives of each specialty or super specialty is essential to take initiatives for the progress of the other specialty. Endocrinology and anesthesiology are two such examples which have made rapid progress in the last three decades. Somehow the interaction and relationship among these medical streams have been only scarcely studied. Diabetes and thyroid pathophysiologies have been the most researched endocrine disorders so far in anesthesia practice but even their management strategies have undergone significant metamorphosis over the last three decades. As such, anesthesia practice has been influenced vastly by these advancements in endocrinology. However, a comprehensive understanding of the relationship between these two partially related specialties is considered to be an essential cornerstone for further progress in anesthesia and surgical sciences. The current review is an attempt to imbibe the current and the changing perspectives so as to make the understanding of the relationship between these two medical streams a little simple and clearer. PMID:26180760

  20. Relevance of anatomy to medical education and clinical practice: perspectives of medical students, clinicians, and educators.

    Science.gov (United States)

    Sbayeh, Amgad; Qaedi Choo, Mohammad A; Quane, Kathleen A; Finucane, Paul; McGrath, Deirdre; O'Flynn, Siun; O'Mahony, Siobhain M; O'Tuathaigh, Colm M P

    2016-12-01

    Against a backdrop of ever-changing diagnostic and treatment modalities, stakeholder perceptions (medical students, clinicians, anatomy educators) are crucial for the design of an anatomy curriculum which fulfils the criteria required for safe medical practice. This study compared perceptions of students, practising clinicians, and anatomy educators with respect to the relevance of anatomy education to medicine. A quantitative survey was administered to undergraduate entry (n = 352) and graduate entry students (n = 219) at two Irish medical schools, recently graduated Irish clinicians (n = 146), and anatomy educators based in Irish and British medical schools (n = 30). Areas addressed included the association of anatomy with medical education and clinical practice, mode of instruction, and curriculum duration. Graduate-entry students were less likely to associate anatomy with the development of professionalism, teamwork skills, or improved awareness of ethics in medicine. Clinicians highlighted the challenge of tailoring anatomy education to increase student readiness to function effectively in a clinical role. Anatomy educators indicated dissatisfaction with the time available for anatomy within medical curricula, and were equivocal about whether curriculum content should be responsive to societal feedback. The group differences identified in the current study highlight areas and requirements which medical education curriculum developers should be sensitive to when designing anatomy courses.

  1. Hand Hygiene Practices among Medical Students

    Directory of Open Access Journals (Sweden)

    Azzam al Kadi

    2012-01-01

    Full Text Available Background. Hand hygiene is a cost-effective method in preventing infection transmission. Hand hygiene practices have been found to be faulty in most healthcare settings. We conducted a study to evaluate the awareness, and compliance of hand hygiene among undergraduate medical students during their clinical phase in Qassim College of Medicine, Saudi Arabia. Methods. A questionnaire based on World Health Organization’s concept of “Five Moments for Hand Hygiene” was used to evaluate the awareness of the indications for hand hygiene and compliance was observed during Objective Structured Clinical Examination (OSCE sessions. Sixty students including thirty-six males (60% and twenty-four females (40% participated voluntarily in the study. Results. The average awareness regarding the positive indications of hand hygiene was 56%. Rest of the 44% of students were either not sure or unaware of the indications of hygiene. Only 29% of students were able to identify all the five indications for hand hygiene in the questionnaire. Compliance as assessed during OSCE sessions was only 17% with no significant difference between the genders. Conclusion. It was concluded that serious efforts are needed to improve the hand hygiene practices among medical students.

  2. The misplace of litigation in medical practice.

    Science.gov (United States)

    Wood, C

    1998-11-01

    Medical decision-making is based upon mathematical probability in determining the significance of variables involved. Truth is often not absolute and medical decisions often require reconsideration of information, reanalysis and possible change. Litigation based upon error negates the ordinary practice of medicine. Error is intrinsic to all human behaviour and contributed to by uncertainty concerning precision in diagnosis and treatment of some diseases, mood change affecting ability to process cognitive and analytic function, and adverse work environment. Error is an important process in learning and providing it is recognized and fully admitted is a creative process providing opportunity for improving medical practice. Litigation is based on proof of negligence. Negligence is defined as carelessness, which is a rare cause of human and medical errors. The law confuses error with negligence; error should not be the basis for litigation. Litigation based on error is counter-productive to the best practice and improvement of clinical medicine. The assessment of errors and negligence is limited by the method of choice of medical experts, the adversarial system often ignoring the intermediate position in favour of a yes-no answer, the selection of experts to favour the desired result rather than the real situation, the method of questioning of witnesses which discourages explanation and creative solution of disagreement, and the hierarchical system which does not allow exploration of the issues and creative solutions. The basis for financial compensation for ill health is relevant when this assists the sufferer to cope with the ill health. The ethical basis for compensation when ill health results from error by health care workers is not more valid than ill health resulting from biological or environmental factors. Human error is common normal behaviour, while biological and environmental causes of ill health are common errors of human biology and the environment

  3. Urine drug testing: current recommendations and best practices.

    Science.gov (United States)

    Owen, Graves T; Burton, Allen W; Schade, Cristy M; Passik, Steve

    2012-07-01

    The precise role of urine drug testing (UDT) in the practice of pain medicine is currently being defined. Confusion exists as to best practices, and even to what constitutes standard of care. A member survey by our state pain society revealed variability in practice and a lack of consensus. The authors sought to further clarify the importance of routine UDT as an important part of an overall treatment plan that includes chronic opioid prescribing. Further, we wish to clarify best practices based on consensus and data where available. A 20-item membership survey was sent to Texas Pain Society members. A group of chronic pain experts from the Texas Pain Society undertook an effort to review the best practices in the literature. The rationale for current UDT practices is clarified, with risk management strategies outlined, and recommendations for UDT outlined in detail. A detailed insight into the limitations of point-of-care (enzyme-linked immunosorbent assay, test cups, test strips) versus the more sensitive and specific laboratory methods is provided. Our membership survey was of a limited sample size in one geographic area in the United States and may not represent national patterns. Finally, there is limited data as to the efficacy of UDT practices in improving compliance and curtailing overall medication misuse. UDT must be done routinely as part of an overall best practice program in order to prescribe chronic opioid therapy. This program may include risk stratification; baseline and periodic UDT; behavioral monitoring; and prescription monitoring programs as the best available tools to monitor chronic opioid compliance.

  4. Current trends in endodontic practice: emergency treatments and technological armamentarium.

    Science.gov (United States)

    Lee, Michelle; Winkler, Johnathon; Hartwell, Gary; Stewart, Jeffrey; Caine, Rufus

    2009-01-01

    The current clinical practice of endodontics includes the utilization of a variety of new technological advances and materials. The last comprehensive survey that compared treatment modalities used in endodontic practices was conducted in 1990. The purpose of the current survey was to determine the frequency with which these new endodontic technologies and materials are being used in endodontic practices today. An e-mail questionnaire was sent to the 636 active diplomates of the American Board of Endodontics with current e-mail addresses. Two hundred thirty-two diplomates responded for a response rate of 35%. Calcium hydroxide was found to be the most frequently used intracanal medicament for all cases diagnosed with necrotic pulps. Ibuprofen was the most frequently prescribed medication for pain, and penicillin was the most frequently prescribed antibiotic when an active infection was present. Eighty-two percent of the respondents are still incorporating hand files in some fashion during the cleansing and shaping phase of treatment. Lateral condensation and continuous wave were the most common methods used for obturation. Digital radiography was reported as being used by 72.5% of the respondents, whereas 45.3% reported using the microscope greater than 75% of the patient treatment. Ultrasonics was used by 97.8% of the respondents. It appears from the results that new endodontic technology is currently being used in the endodontic offices of those who responded to the survey.

  5. Current practice in transvenous lead extraction

    DEFF Research Database (Denmark)

    Bongiorni, Maria Grazia; Blomström-Lundqvist, Carina; Kennergren, Charles

    2012-01-01

    AIM: Current practice with regard to transvenous lead extraction among European implanting centres was analysed by this survey. METHODS AND RESULTS: Among all contacted centres, 164, from 30 countries, declared that they perform transvenous lead extraction and answered 58 questions...... with a compliance rate of 99.9%. Data from the survey show that there seems to be an overall increasing experience of managing various techniques of lead extraction and a widespread involvement of cardiac centres in this treatment. Results and complication rates seem comparable with those of main international...... registries. CONCLUSION: This survey gives an interesting snapshot of lead extraction in Europe today and gives some clues for future research and prospective European registries....

  6. 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.

  7. Telehealth: current practices and future directions

    Science.gov (United States)

    David, Yadin B.

    1996-02-01

    When we review the positive impact that the integration of ostensibly independent patient-care services have on the efficient management of quality care, education, and collaborative research, it is not surprising that telehealth deployment is on the rise. The forces that drive this phenomenon include: the need to manage the entire disease episode; the desire for wider geographically-distributed quality health care; the escalation of customer expectations; globalization of healthcare and its support services; an increase in patient and provider convenience; and the acceptance of the present technological community. At the Telehealth Center at the Texas Children's Hospital, current classifications of clinical applications are listed: (1) initial urgent evaluation of patients, (2) triage decisions and pretransfer arrangements, (3) medical and surgical follow-up and medication review, (4) consultation for primary care encounters, (5) real-time subspecialty care consultation and planning, (6) management of chronic diseases and conditions, (7) extended diagnostic work-ups, (8) review of diagnostic images, and (9) preventive medicine and patient education. The delivery of such services is associated with challenges and opportunities. As we move forward from limited data processing to an integrated communication system, from centralized main frame functions to personalized and location-independent workstations, and from hospitals to clinics and homecare, an increase in the minimum features provided by the equipment and the communication systems must accompany the widening variety of clinical applications. Future expansion of telehealth systems stands to revolutionize the delivery of services to the benefits of providers' networks, our economy, and patients through integration.

  8. Current practice of gastric cancer treatment

    Institute of Scientific and Technical Information of China (English)

    Yoon Young Choi; Ji Yeong An; Hyung-Il Kim; Jae-Ho Cheong; Woo Jin Hyung; Sung Hoon Noh

    2014-01-01

    Objective The aim of this review was to overview the current practice of gastric cancer treatment including surgery and other adjuvant modalities.Data sources The review was based on data obtained from the published articles and main guidelines in the East and West.Study selection Articles with high level of evidence or current best evidence in each issue were selected to be reviewed.Results Although varied adjuvant modalities have been proved to be benefit for treating gastric cancer,surgery is still the most important treatment strategy against gastric cancer.Actively adapting to new technology is important but it should be balanced with an effort to establish sound scientific rationale that adheres to oncologic principles.Conclusions Future treatment of gastric cancer will be focused on tailored,personalized therapy.For achieving it,collaboration across disciplines is essential.Also the philosophy of caring for the patients with gastric cancer should be rooted in the realization of true patient benefit regardless of who is providing the care.With these philosophies,we can shift the scientific and technological advances toward triumph over gastric cancer.

  9. Rotator cuff rehabilitation: current theories and practice.

    Science.gov (United States)

    Osborne, Jeffrey D; Gowda, Ashok L; Wiater, Brett; Wiater, J Michael

    2016-01-01

    A fully functioning, painless shoulder joint is essential to maintain a healthy, normal quality of life. Disease of the rotator cuff tendons (RCTs) is a common issue that affects the population, increasing with age, and can lead to significant disability and social and health costs. RCT injuries can affect younger, healthy patients and the elderly alike, and may be the result of trauma or occur as a result of chronic degeneration. They can be acutely painful, limited to certain activities or completely asymptomatic and incidental findings. A wide variety of treatment options exists ranging from conservative local and systemic pain modalities, to surgical fixation. Regardless of management ultimately chosen, physiotherapy of the RCT, rotator cuff muscles and surrounding shoulder girdle plays an essential role in proper treatment. Length of treatment, types of therapy and timing may vary if therapy is definitive care or part of a postoperative protocol. Allowing time for adequate RCT healing must always be considered when implementing ROM and strengthening after surgery. With current rehabilitation methods, patients with all spectrums of RCT pathology can improve their function, pain and quality of life. This manuscript reviews current theories and practice involving rehabilitation for RCT injuries.

  10. Spirituality and medical practice: a Christian perspective.

    Science.gov (United States)

    Igboin, Benson O

    2015-01-01

    Everyday experience shows that there is a commonality between spirituality and medical practice. A text message I received from a friend recently read, "Please pray for me. I've been getting a mysterious headache for some days now. I will be seeing the doctor today." This clearly speaks of a relationship: asking for prayer so as to be relieved of a "mysterious headache", yet going to see a doctor whose job is not to cure mysterious headaches. Even though both areas of human experience have their peculiar and largely unrelated methodologies, this paper argues that any extreme separation of the two is injurious to the teleology of both disciplines in relation to human well-being, which forms the core of spirituality and medicine.

  11. 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

  12. [Quality assurance and quality improvement in medical practice. Part 3: Clinical audit in medical practice].

    Science.gov (United States)

    Godény, Sándor

    2012-02-01

    The first two articles in the series were about the definition of quality in healthcare, the quality approach, the importance of quality assurance, the advantages of quality management systems and the basic concepts and necessity of evidence based medicine. In the third article the importance and basic steps of clinical audit are summarised. Clinical audit is an integral part of quality assurance and quality improvement in healthcare, that is the responsibility of any practitioner involved in medical practice. Clinical audit principally measures the clinical practice against clinical guidelines, protocols and other professional standards, and sometimes induces changes to ensure that all patients receive care according to principles of the best practice. The clinical audit can be defined also as a quality improvement process that seeks to identify areas for service improvement, develop and carry out plans and actions to improve medical activity and then by re-audit to ensure that these changes have an effect. Therefore, its aims are both to stimulate quality improvement interventions and to assess their impact in order to develop clinical effectiveness. At the end of the article key points of quality assurance and improvement in medical practice are summarised.

  13. 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.

  14. Module Technology: Current Practice and Issues (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Wohlgemuth, J.

    2010-10-05

    PV modules must provide mechanical support for the cells, protect the world from the voltages inside, protect the cells, diodes and interconnects from the weather outside, couple as much light as possible into the PV cells and minimize the temperature increase of the cells. The package must continue to serve these functions for at least 25 years as that is the typical module warranty period today. Furthermore the package must do all this for as low a cost as possible since the key to large scale PV growth is a reduction in cost while retaining excellent module reliability and durability. This paper will review current module construction practices for both crystalline silicon and thin film PV with emphasis on explaining why the present designs and materials have been selected. Possible long term issues with today's designs and materials will be discussed. Several proposed solutions to these issues will be presented, highlighting the research efforts that will be necessary in order to verify that they can cost effectively solve the identified issues.

  15. Correlation Research of Medical Security Management System Network Platform in Medical Practice

    Science.gov (United States)

    Jie, Wang; Fan, Zhang; Jian, Hao; Li-nong, Yu; Jun, Fei; Ping, Hao; Ya-wei, Shen; Yue-jin, Chang

    Objective-The related research of medical security management system network in medical practice. Methods-Establishing network platform of medical safety management system, medical security network host station, medical security management system(C/S), medical security management system of departments and sections, comprehensive query, medical security disposal and examination system. Results-In medical safety management, medical security management system can reflect the hospital medical security problem, and can achieve real-time detection and improve the medical security incident detection rate. Conclusion-The application of the research in the hospital management implementation, can find hospital medical security hidden danger and the problems of medical disputes, and can help in resolving medical disputes in time and achieve good work efficiency, which is worth applying in the hospital practice.

  16. Death, organ transplantation and medical practice

    Directory of Open Access Journals (Sweden)

    Bailey F Amos

    2008-02-01

    Full Text Available Abstract A series of papers in Philosophy, Ethics and Humanities in Medicine (PEHM have recently disputed whether non-heart beating organ donors are alive and whether non-heart beating organ donation (NHBD contravenes the dead donor rule. Several authors who argue that NHBD involves harvesting organs from live patients appeal to "strong irreversibility" (death beyond the reach of resuscitative efforts to restore life as a necessary criterion that patients must meet before physicians can declare them to be dead. Sam Shemie, who defends our current practice of NHBD, holds that in fact physicians consider patients to be dead or not according to physician intention to resuscitate or not. We suggest that criteria for a concept are not necessarily truth conditions for assertions involving the concept. Hence, non-heart beating donors may be declared dead without meeting the criterion of strong irreversibility even though strong irreversibility is implied by the concept of death. Our perception that a concept applies in a given case is determined not by the concept itself but by our necessary skill and judgment when using it. In the case of deciding that a patient is dead, such judgment is learned by physicians as they learn the practice of medicine and may vary according to circumstances. Current practice of NHBD can therefore be defended without abandoning death as an empirical concept, as Shemie appears to do. We conclude that the dead donor rule continues to be viable and ought to be retained so as to guarantee what the public most cares about as regards organ donation: that physicians can be trusted to make determinations of eligibility for organ donation in the interests of patients and not for other purposes such as increasing the availability of organs.

  17. Neuroimaging in refractory epilepsy. Current practice and evolving trends

    Energy Technology Data Exchange (ETDEWEB)

    Ramli, N. [Department of Biomedical Imaging, University Malaya Research Imaging Centre (Malaysia); Rahmat, K., E-mail: katt_xr2000@yahoo.com [Department of Biomedical Imaging, University Malaya Research Imaging Centre (Malaysia); Lim, K.S.; Tan, C.T. [Neurology Unit, Department of Medicine, University Malaya, Kuala Lumpur (Malaysia)

    2015-09-15

    Highlights: • Neuroimaging is imperative in diagnostic work up and therapeutic assessment of refractory epilepsy. • Identification of epileptogenic zone on EEG, MRI and functional imaging improves the success of surgery. • High performance MRI greatly enhanced metabolic information and elucidate brain functions. • Optimisation of epilepsy protocols in structural and functional MRI are presented in this article. - Abstract: Identification of the epileptogenic zone is of paramount importance in refractory epilepsy as the success of surgical treatment depends on complete resection of the epileptogenic zone. Imaging plays an important role in the locating and defining anatomic epileptogenic abnormalities in patients with medically refractory epilepsy. The aim of this article is to present an overview of the current MRI sequences used in epilepsy imaging with special emphasis of lesion seen in our practices. Optimisation of epilepsy imaging protocols are addressed and current trends in functional MRI sequences including MR spectroscopy, diffusion tensor imaging and fusion MR with PET and SPECT are discussed.

  18. 21 CFR 110.5 - Current good manufacturing practice.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 110.5 Section...) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PACKING, OR HOLDING HUMAN FOOD General Provisions § 110.5 Current good manufacturing practice. (a) The criteria...

  19. Using Rituals to Strengthen Your Medical Practice Team.

    Science.gov (United States)

    Hills, Laura

    2015-01-01

    Rituals can cement the identity of and strengthen the bonds between any people, including the members of the medical practice team. This article presents the idea that the medical practice manager is in the ideal position to create and use rituals for team building. It defines the term ritual, and explores how rituals differ from customs or traditions. As well, it describes six benefits of rituals and the hallmarks of the most effective team rituals; describes seven creative and interesting corporate rituals that medical practice managers can study for inspiration; suggests 20 excellent opportunities within the medical practice calendar year for medical practice team rituals; and identifies six kinds of rituals that are used in organizations. Finally, this article provides a four-step action plan for ritualizing your medical practice team's morning huddles.

  20. Knowledge, Attitudes, and Practice of Medical Students Regarding ...

    African Journals Online (AJOL)

    appropriate practice toward infectious, occupational risks of. HBV. ... Keywords: Attitudes, Hepatitis B, Knowledge, Medical students, Saudi Arabia ..... this is a relatively small scale study among medical students .... Conflict of Interest: None.

  1. 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".

  2. 'Whereof one cannot speak thereof one must be silent': medical discourse and medical practice.

    Science.gov (United States)

    Måseide, Per

    2011-01-01

    Significant parts of medical work are conducted as talk. In studies of medical work researchers have focused on the discursive production or mediation of medical facts. Several studies have highlighted the role of talk in many kinds of medical practice. While talk and discourse may generate medical problems and contribute essentially to medical problem solving, much of this talk is referential. It may also be used as representations in medical problem solving. In many kinds of medical practice talk deals with how to relate to clinical data, references or representations, it deals with talk itself and it deals with relations between those participating in medical work. The purpose of this paper is to show that diversity in medical discourse is grounded, not so much in the diversity of available language games but in the diversity of medical work and medical objects. Data for the article come from observations of medical team meetings in the thoracic ward of a Norwegian hospital.

  3. Growing a medical practice with social media marketing.

    Science.gov (United States)

    Laban, Jake

    2012-01-01

    Many medical practices are facing the lack of practice growth that their social media efforts are generating. This article provides concrete ideas that can be put in place by any medical practice to realize sustainable practice growth through social media marketing. In the article, the author demonstrates that social media marketing of the medical practice has become absolutely essential in today's evolving, competitive, and fast-paced environment. This demonstration is made through an exploration of the evolution of what "good" marketing has looked like for medical practices over time. In addition, attention is paid to the shift in the definition of good marketing that is required for the practice that is preparing a social media-marketing plan. Specifically, the article investigates the proven requirements for a balanced blend of unique and engaging promotional and nonpromotional community outreach, which is required on a daily basis to achieve the significant, lasting, and sustainable growth that the practice wishes to achieve.

  4. Bariatric Endocrinology: Principles of Medical Practice

    Directory of Open Access Journals (Sweden)

    J. Michael Gonzalez-Campoy

    2014-01-01

    Full Text Available Obesity, is a chronic, biological, preventable, and treatable disease. The accumulation of fat mass causes physical changes (adiposity, metabolic and hormonal changes due to adipose tissue dysfunction (adiposopathy, and psychological changes. Bariatric endocrinology was conceived from the need to address the neuro-endocrinological derangements that are associated with adiposopathy, and from the need to broaden the scope of the management of its complications. In addition to the well-established metabolic complications of overweight and obesity, adiposopathy leads to hyperinsulinemia, hyperleptinemia, hypoadiponectinemia, dysregulation of gut peptides including GLP-1 and ghrelin, the development of an inflammatory milieu, and the strong risk of vascular disease. Therapy for adiposopathy hinges on effectively lowering the ratio of orexigenic to anorexigenic signals reaching the the hypothalamus and other relevant brain regions, favoring a lower caloric intake. Adiposopathy, overweight and obesity should be treated indefinitely with the specific aims to reduce fat mass for the adiposity complications, and to normalize adipose tissue function for the adiposopathic complications. This paper defines the principles of medical practice in bariatric endocrinology—the treatment of overweight and obesity as means to treat adiposopathy and its accompanying metabolic and hormonal derangements.

  5. Psychology of medically unexplained symptoms: A practical review

    Directory of Open Access Journals (Sweden)

    Sirous Mobini

    2015-12-01

    Full Text Available Medically unexplained symptoms (MUS or functional neurological symptoms (FNS are commonly seen in the medical and rehabilitation settings. Clinicians often tend to describe patients with MUS as the “most difficult to help”. This practical review discusses epidemiology, clinical presentations, assessment and diagnosis of these psychiatric and neurological conditions, and summarises psychological models that have been linked to the development and maintenance of MUS. The final purpose of the present paper was to review the current literature in the treatment on the management and treatment of MUS. It concludes that future research should focus on a more integrated treatment approach which addresses various biological, psychological and social factors contributing to the onset and maintenance of these debilitating conditions.

  6. Medication review practices in European countries

    NARCIS (Netherlands)

    Bulajeva, A; Labberton, L; Leikola, S; Pohjanoksa-Mäntylä, M; Geurts, M M E; de Gier, J J; Airaksinen, M

    2014-01-01

    BACKGROUND: Medication review procedures have been developed in many countries to improve rational and safe medication use. The similarities, comprehensiveness, and effectiveness of these procedures has not been assessed, or compared. OBJECTIVE: The aim of this study was to explore medication review

  7. First-trimester medical abortion practices in Canada

    Science.gov (United States)

    Guilbert, Edith R.; Hayden, Althea S.; Jones, Heidi E.; White, Katharine O’Connell; Steven Lichtenberg, E.; Paul, Maureen; Norman, Wendy V.

    2016-01-01

    Abstract Objective To understand the current availability and practice of first-trimester medical abortion (MA) in Canada. Design Using public sources and professional networks, abortion facilities across Canada were identified for a cross-sectional survey on medical and surgical abortion. English and French surveys were distributed by surface or electronic mail between July and November 2013. Setting Canada. Participants A total of 94 abortion facilities were identified. Main outcome measures Descriptive statistics on MA practice and facility and provider characteristics, as well as comparisons of MA practice by facility and provider characteristics using χ2 and t tests. Results A total of 78 of 94 (83.0%) facilities responded. Medical abortion represented 3.8% of first-trimester abortions reported (2706 of 70 860) in 2012. Among the facilities offering MA, 45.0% performed fewer than 500 first-trimester abortions a year, while 35.0% performed more than 1000. More MAs were performed in private offices or ambulatory health centres than in hospitals. Sixty-two physicians from 28 of 78 facilities reported providing first-trimester MA; 87.1% also provided surgical abortion. More than three-quarters of MA physicians were female and 56.5% were family physicians. A preponderance (85.2%) of providers offered methotrexate with misoprostol. Nearly all physicians (90.3%) required patients to have an ultrasound before MA, and 72.6% assessed the completion of the abortion with ultrasonography. Most physicians (74.2%) offered MA through 49 days after the onset of the last menstrual period, and 21.0% offered MA through 50 to 56 days; 37.1% reported providing MA to patients who lived more than 2 hours away. Four physicians from 1 site provided MA via telemedicine. Conclusion In Canada, MA provision using methotrexate and misoprostol is consistent with best-practice guidelines, but MA is rare and its availability is unevenly distributed. PMID:28192275

  8. First-trimester medical abortion practices in Canada: National survey.

    Science.gov (United States)

    Guilbert, Edith R; Hayden, Althea S; Jones, Heidi E; White, Katharine O'Connell; Steven Lichtenberg, E; Paul, Maureen; Norman, Wendy V

    2016-04-01

    To understand the current availability and practice of first-trimester medical abortion (MA) in Canada. Using public sources and professional networks, abortion facilities across Canada were identified for a cross-sectional survey on medical and surgical abortion. English and French surveys were distributed by surface or electronic mail between July and November 2013. Canada. A total of 94 abortion facilities were identified. Descriptive statistics on MA practice and facility and provider characteristics, as well as comparisons of MA practice by facility and provider characteristics using χ(2) and t tests. A total of 78 of 94 (83.0%) facilities responded. Medical abortion represented 3.8% of first-trimester abortions reported (2706 of 70 860) in 2012. Among the facilities offering MA, 45.0% performed fewer than 500 first-trimester abortions a year, while 35.0% performed more than 1000. More MAs were performed in private offices or ambulatory health centres than in hospitals. Sixty-two physicians from 28 of 78 facilities reported providing first-trimester MA; 87.1% also provided surgical abortion. More than three-quarters of MA physicians were female and 56.5% were family physicians. A preponderance (85.2%) of providers offered methotrexate with misoprostol. Nearly all physicians (90.3%) required patients to have an ultrasound before MA, and 72.6% assessed the completion of the abortion with ultrasonography. Most physicians (74.2%) offered MA through 49 days after the onset of the last menstrual period, and 21.0% offered MA through 50 to 56 days; 37.1% reported providing MA to patients who lived more than 2 hours away. Four physicians from 1 site provided MA via telemedicine. In Canada, MA provision using methotrexate and misoprostol is consistent with best-practice guidelines, but MA is rare and its availability is unevenly distributed. Copyright© the College of Family Physicians of Canada.

  9. Provision of medical student teaching in UK general practices: a cross-sectional questionnaire study

    Science.gov (United States)

    Harding, Alex; Rosenthal, Joe; Al-Seaidy, Marwa; Gray, Denis Pereira; McKinley, Robert K

    2015-01-01

    Background Health care is increasingly provided in general practice. To meet this demand, the English Department of Health recommends that 50% of all medical students should train for general practice after qualification. Currently 19% of medical students express general practice as their first career choice. Undergraduate exposure to general practice positively influences future career choice. Appropriate undergraduate exposure to general practice is therefore highly relevant to workforce planning Aim This study seeks to quantify current exposure of medical students to general practice and compare it with past provision and also with postgraduate provision. Design and setting A cross-sectional questionnaire in the UK. Method A questionnaire regarding provision of undergraduate teaching was sent to the general practice teaching leads in all UK medical schools. Information was gathered on the amount of undergraduate teaching, how this was supported financially, and whether there was an integrated department of general practice. The data were then compared with results from previous studies of teaching provision. The provision of postgraduate teaching in general practice was also examined. Results General practice teaching for medical students increased from teaching in 1968 to 13.0% by 2008; since then, the percentage has plateaued. The total amount of general practice teaching per student has fallen by 2 weeks since 2002. Medical schools providing financial data delivered 14.6% of the clinical curriculum and received 7.1% of clinical teaching funding. The number of departments of general practice has halved since 2002. Provision of postgraduate teaching has tripled since 2000. Conclusion Current levels of undergraduate teaching in general practice are too low to fulfil future workforce requirements and may be falling. Financial support for current teaching is disproportionately low and the mechanism counterproductive. Central intervention may be required to solve

  10. 21 CFR 129.1 - Current good manufacturing practice.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 129.1 Section... Current good manufacturing practice. The applicable criteria in part 110 of this chapter, as well as the... manufacturing practice to assure that bottled drinking water is safe and that it has been processed,...

  11. Practical fulltext search in medical records

    Directory of Open Access Journals (Sweden)

    Vít Volšička

    2015-09-01

    Full Text Available Performing a search through previously existing documents, including medical reports, is an integral part of acquiring new information and educational processes. Unfortunately, finding relevant information is not always easy, since many documents are saved in free text formats, thereby making it difficult to search through them. A full-text search is a viable solution for searching through documents. The full-text search makes it possible to efficiently search through large numbers of documents and to find those that contain specific search phrases in a short time. All leading database systems currently offer full-text search, but some do not support the complex morphology of the Czech language. Apache Solr provides full support options and some full-text libraries. This programme provides the good support of the Czech language in the basic installation, and a wide range of settings and options for its deployment over any platform. The library had been satisfactorily tested using real data from the hospitals. Solr provided useful, fast, and accurate searches. However, there is still a need to make adjustments in order to receive effective search results, particularly by correcting typographical errors made not only in the text, but also when entering words in the search box and creating a list of frequently used abbreviations and synonyms for more accurate results.

  12. Playing doctor: Simulation in medical school as affective practice.

    Science.gov (United States)

    Underman, Kelly

    2015-07-01

    Simulated patient encounters, in which a trained layperson role-plays a patient, have become increasingly important in medical education. One such type is the gynecological teaching associate (GTA), who teaches medical students how to perform the pelvic examination using her own body. This paper considers the role that simulation like the GTA session plays in medical students' professional socialization. Drawn from interviews and archival sources gathered from medical students, medical faculty, and GTAs, this paper explores the tensions between artificiality and authenticity in order to understand how, through pedagogical practice, medical students come to embody medical culture through simulation. This paper uses the theoretical framework of the medical habitus to understand the role of emotion in medical student socialization. It argues that simulation is an example of affective practice: any rehearsal of techniques or styles of expressing, experiencing, or managing emotion that reshape the body's capacity to feel. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Figures in clinical trial reports: current practice & scope for improvement

    Directory of Open Access Journals (Sweden)

    Travison Thomas G

    2007-11-01

    Full Text Available Abstract Background Most clinical trial publications include figures, but there is little guidance on what results should be displayed as figures and how. Purpose To evaluate the current use of figures in Trial reports, and to make constructive suggestions for future practice. Methods We surveyed all 77 reports of randomised controlled trials in five general medical journals during November 2006 to January 2007. The numbers and types of figures were determined, and then each Figure was assessed for its style, content, clarity and suitability. As a consequence, guidelines are developed for presenting figures, both in general and for each specific common type of Figure. Results Most trial reports contained one to three figures, mean 2.3 per article. The four main types were flow diagram, Kaplan Meier plot, Forest plot (for subgroup analyses and repeated measures over time: these accounted for 92% of all figures published. For each type of figure there is a considerable diversity of practice in both style and content which we illustrate with selected examples of both good and bad practice. Some pointers on what to do, and what to avoid, are derived from our critical evaluation of these articles' use of figures. Conclusion There is considerable scope for authors to improve their use of figures in clinical trial reports, as regards which figures to choose, their style of presentation and labelling, and their specific content. Particular improvements are needed for the four main types of figures commonly used.

  14. 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.

  15. [Scientific and practical tasks of medical embryology in the prevention of perinatal pathology].

    Science.gov (United States)

    Brusilovskiĭ, A I

    1991-01-01

    The paper analyzes the clinical aspects of medical embryology, emphasizes the topical problems of progenesis, fertilization, cleavage, gastrulation, implantation, and histo-, organo-, and systemogenesis. The current status of the studies into the mother-fetus system is explored. The new organizational patterns of the connection between theory and practice, which enables medical embryology to substantially affect the health care system are also discussed.

  16. Cardiovascular pharmacogenomics; state of current knowledge and implementation in practice.

    Science.gov (United States)

    Shahabi, Payman; Dubé, Marie-Pierre

    2015-04-01

    Pharmacogenomics (PGx) is the science that examines how an individual's genetic make-up affects the safety and efficacy of therapeutic drugs. PGx of response to cardiovascular (CV) medications is of the most successfully translated branches of PGx into the clinical workout. However, the clinical implementation of PGx of CV drugs is yet far beyond the growth of our understanding of the role of genetics in drug therapy. A considerable amount of efforts have been devoted by the regulatory agents like the food and drug administration (FDA) as well as the expert-based networks such as the Clinical Pharmacogenetics Implementation Consortium (CPIC) to overcome the existing barriers. This has been done, at least in part, for some of the most widely prescribed CV drugs, including clopidogrel, warfarin and simvastatin for which the PGx knowledge have been satisfactorily robust to provoke the CPIC to issue the guidelines for these drugs and the FDA to update the drugs' labeling, both strongly recommended the use of genotype-guided dosing for these medications, provided that the genetic data are available. For other drugs, however, studies have produced contradictory results and further large and well-designed clinical trials are required to expand and confirm the clinical utility of their PGx data. This review paper presents the current state of knowledge in the field of PGx of CV medications and describes the facilities assisting to the translation of PGx data into the clinical practice. Afterward, the existing body of PGx literature of the most-commonly used CV medications is comprehensively discussed.

  17. Increasing Medical Practice Team Commitment: Twenty-Five Strategies.

    Science.gov (United States)

    Hills, Laura

    2016-01-01

    Employee commitment is one of the most important principles of practice man- agement. Yet commitment is delicate; it must be carefully earned, and it can easily deteriorate. This article explores practical strategies the medical practice manager can use to assess, foster, and increase employee commitment. It de- fines commitment and how commitment is manifested in employee attitudes and behavior. It provides a 10-question guide medical practice managers can use to assess employee commitment, and a four-part roadmap that will inspire commitment through leadership. This article also offers 25 hands-on strate- gies to increase employee commitment, and more than a dozen questions to guide difficult conversations with employees when their commitment level to the medical practice is low or unclear. Finally, this article suggest four drivers of employee commitment and a five-part strategy medical practice managers can use to model commitment through their own leadership.

  18. 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.

  19. 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

  20. Cytokine medicines in clinical practice: current issues.

    Science.gov (United States)

    Barnes, Theresa; Moots, Robert J; Goodacre, John

    2005-10-21

    Cytokine medicines have been licensed for the treatment of rheumatoid arthritis since 2000. The rheumatology community has accrued a large amount of experience in the use of these medications. This experience has led to the development of guidelines for their use that include ongoing vigilance for long term adverse events and efficacy using the Biologics Register. Delivery of these expensive therapies has prompted extensive system developments within rheumatology. The cytokine medicines have provided important tools to probe the pathogenesis of rheumatoid and other inflammatory diseases. Further cytokine medicines, in various stages of development, are on the horizon and continue to stimulate excitement within this fast expanding field.

  1. Performance appraisal: helpful hints for the busy medical practice manager.

    Science.gov (United States)

    Bolon, Douglas S

    2006-01-01

    This article describes the performance appraisal process in terms of its three fundamental steps. defining job performance, measuring actual job performance, and providing job performance feedback. Given that most practice managers wear many hats and do not have extensive experience or staff support in human resources, the purpose of this article is to provide these busy individuals with useful, practical suggestions that should enhance the effectiveness of the performance appraisal process for nonphysician employees within the medical practice setting. Performance appraisal should be a priority for all practice managers, as the performance of individual employees represents the key to long-term success for any medical practice.

  2. Medical Symbols in Practice: Myths vs Reality

    Science.gov (United States)

    Shetty, Shraddha; Dsouza, Oliver

    2014-01-01

    Background: The caduceus is the popular symbol of medicine. However, premier health organizations and regulatory bodies such as the World Health Organization and the Medical Council of India use a different symbol- the rod of Asclepius in their logo. There is an increasing awareness and recognition that the caduceus is a false symbol and has no historical substantiation as an emblem of medicine. Many academic and health institutions in the western hemisphere have changed their logo as a consequence. There are other symbols of medicine which are similarly misunderstood. Objectives: The purpose of the study is to assess the knowledge of common medical symbols among doctors and medical students. Materials and Methods: Three hundred doctors and medical students were assessed on their knowledge about the Rx symbol, the Red Cross emblem and the true representative emblem of medicine. Logos and emblems of elite medical colleges and medical associations were also studied. Results: Only 6% of doctors were aware that the Rod of Asclepius is the true symbol of healing. Knowledge of the significance of the Rx symbol and the origin of the Red Cross emblem was 55% and 39 %. Conclusion: There is very little awareness about the rod of Asclepius and most institutions have adopted a logo based on the caduceus. Awareness of the true origins and the symbolism of the emblems is lacking in the medical fraternity. PMID:25302242

  3. 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.

  4. Medical humanitarianism: anthropologists speak out on policy and practice.

    Science.gov (United States)

    Abramowitz, Sharon; Marten, Meredith; Panter-Brick, Catherine

    2015-03-01

    In recent years, anthropologists have become increasingly present in medical humanitarian situations as scholars, consultants, and humanitarian practitioners and have acquired insight into medical humanitarian policy and practice. In 2012, we implemented a poll on anthropology, health, and humanitarian practice in which 75 anthropologists discussed their experiences in medical humanitarianism. Our goal was to move beyond the existing anarchy of individual voices in anthropological writing and gain an aggregate view of the perspective of anthropologists working in medical humanitarian contexts. Responses lead to six inductively derived thematic priorities. The findings illustrate how anthropologists perceive medical humanitarian practice; which aspects of medical humanitarianism should be seen as priorities for anthropological research; and how anthropologists use ethnography in humanitarian contexts.

  5. Journal of Medical Investigation and Practice: Submissions

    African Journals Online (AJOL)

    Provisionally accepted papers containing minor technical errors will be returned to the ... Other letters of general medical interest on topical or controversial issues may be ... The top of each illustration should be marked with an arrow pointing ...

  6. Commissioning medical education: principles for best practice.

    Science.gov (United States)

    Walsh, Kieran

    2016-04-01

    We need to ensure that we get value for money for our investments in medical education. Commissioning is one method of ensuring that we get value. However, like any other tool, it needs to be used properly.

  7. AAPM Medical Physics Practice Guideline 3.a: Levels of supervision for medical physicists in clinical training.

    Science.gov (United States)

    Seibert, J Anthony; Clements, Jessica B; Halvorsen, Per H; Herman, Michael G; Martin, Melissa C; Palta, Jatinder; Pfeiffer, Douglas E; Pizzutiello, Robert J; Schueler, Beth A; Shepard, S Jeff; Fairobrent, Lynne A

    2015-05-08

    The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States.The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner.Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized.The following terms are used in the AAPM practice guidelines:Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline.Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances.

  8. Medical home implementation: a sensemaking taxonomy of hard and soft best practices.

    Science.gov (United States)

    Hoff, Timothy

    2013-12-01

    The patient-centered medical home (PCMH) model of care is currently a central focus of U.S. health system reform, but less is known about the model's implementation in the practice of everyday primary care. Understanding its implementation is key to ensuring the approach's continued support and success nationally. This article addresses this gap through a qualitative examination of the best practices associated with PCMH implementation for older adult patients in primary care. I used a multicase, comparative study design that relied on a sensemaking approach and fifty-one in-depth interviews with physicians, nurses, and clinic support staff working in six accredited medical homes located in various geographic areas. My emphasis was on gaining descriptive insights into the staff's experiences delivering medical home care to older adult patients in particular and then analyzing how these experiences shaped the staff's thinking, learning, and future actions in implementing medical home care. I found two distinct taxonomies of implementation best practices, which I labeled "hard" and "soft" because of their differing emphasis and content. Hard implementation practices are normative activities and structural interventions that align well with existing national standards for medical home care. Soft best practices are more relational in nature and derive from the existing practice social structure and everyday interactions between staff and patients. Currently, external stakeholders are less apt to recognize, encourage, or incentivize soft best practices. The results suggest that there may be no standardized, one-size-fits-all approach to making medical home implementation work, particularly for special patient populations such as the elderly. My study also raises the issue of broadening current PCMH assessments and reward systems to include implementation practices that contain heavy social and relational components of care, in addition to the emphasis now placed on

  9. Keeping the medical practice financially viable: a marketer's approach.

    Science.gov (United States)

    Patrick, Michelle L; Capraro, Anthony J; Credito, Candace M

    2002-01-01

    This paper explores a way that medical practices might develop a higher margin revenue source by offering a differentiated service that caters to patients who value more personalized service. Using SERVQUAL, German patients were surveyed to determine if there is a relationship between a desire for personalized service and a willingness to pay a premium for medical care. The results indicate that a greater desire for personalized care distinguishes those who pay a premium for medical care from those who do not. This suggests that medical practices can differentiate their service based on more personalized care and charge a higher fee for this service.

  10. 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.

  11. 21 CFR 113.5 - Current good manufacturing practice.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 113.5 Section 113.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... CONTAINERS General Provisions § 113.5 Current good manufacturing practice. The criteria in §§ 113.10,...

  12. 21 CFR 120.5 - Current good manufacturing practice.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 120.5 Section 120.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 120.5 Current good manufacturing practice. Part 110 of this chapter applies in...

  13. 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…

  14. 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…

  15. 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.

  16. Triage in medical practices: an unacceptable model?

    Science.gov (United States)

    Bell, Nora K

    1981-12-01

    Two basic presuppositions of triage are challenged: the utilitarian notion that it is morally preferable to save the greater number, and the extension of the salvageability concept as a model for macroallocation of scarce medical resources. The 'more is better' principle lacks the status of a universal moral obligation and leads to an impersonal view of the valuing of life. In the allocation of scarce resources, triage is suspect since life-saving decisions involve medical, social, economic, and political criteria. Triage thus perpetuates existing injustices.

  17. Adaptive Systems Engineering: A Medical Paradigm for Practicing Systems Engineering

    Energy Technology Data Exchange (ETDEWEB)

    R. Douglas Hamelin; Ron D. Klingler; Christopher Dieckmann

    2011-06-01

    From its inception in the defense and aerospace industries, SE has applied holistic, interdisciplinary tools and work-process to improve the design and management of 'large, complex engineering projects.' The traditional scope of engineering in general embraces the design, development, production, and operation of physical systems, and SE, as originally conceived, falls within that scope. While this 'traditional' view has expanded over the years to embrace wider, more holistic applications, much of the literature and training currently available is still directed almost entirely at addressing the large, complex, NASA and defense-sized systems wherein the 'ideal' practice of SE provides the cradle-to-grave foundation for system development and deployment. Under such scenarios, systems engineers are viewed as an integral part of the system and project life-cycle from conception to decommissioning. In far less 'ideal' applications, SE principles are equally applicable to a growing number of complex systems and projects that need to be 'rescued' from overwhelming challenges that threaten imminent failure. The medical profession provides a unique analogy for this latter concept and offers a useful paradigm for tailoring our 'practice' of SE to address the unexpected dynamics of applying SE in the real world. In short, we can be much more effective as systems engineers as we change some of the paradigms under which we teach and 'practice' SE.

  18. Best practices in philanthropy in medical schools.

    Science.gov (United States)

    Schiele, Michele

    2014-08-01

    This paper is for academic leaders and administrators who are interested in growing their philanthropic revenue stream. Growing the philanthropic revenue stream will be especially meaningful to leaders and administrators who have seen their other revenue streams decline or stagnate in the last few years. This paper focuses on four best practices for a high-performing development program and gives examples about how to execute on these best practices.

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

    Science.gov (United States)

    Hills, Laura Sachs

    2010-01-01

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

  20. The human genome project and the future of medical practice ...

    African Journals Online (AJOL)

    The human genome project and the future of medical practice. ... the planning stages of the human genome project, the technology and sequence data ... the quality of healthcare available in the resource-rich and the resource-poor countries.

  1. [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.

  2. Ethical Guidelines and Practices for US Military Medical Professionals

    Science.gov (United States)

    2015-03-03

    JS. Utilitarianism . Hackett Publishing Company; 1979. 143. Thomasma DC, Marshall PA. Clinical medical ethics : cases and reading. New York, NY: New...Defense Health Board Defense Health Board Ethical Guidelines and Practices for U.S. Military Medical Professionals March 3, 2015 [This page...22042-5101 DEFENSE HEALTH BOARD MEMORANDUM FOR ASSISTANT SECRETARY OF DEFENSE FOR HEALTH AFFAIRS SUBJECT: Ethical Guidelines and Practices for

  3. Measuring Changes in the Economics of Medical Practice.

    Science.gov (United States)

    Fleming, Christopher; Rich, Eugene; DesRoches, Catherine; Reschovsky, James; Kogan, Rachel

    2015-08-01

    For the latter third of the twentieth century, researchers have estimated production and cost functions for physician practices. Today, those attempting to measure the inputs and outputs of physician practice must account for many recent changes in models of care delivery. In this paper, we review practice inputs and outputs as typically described in research on the economics of medical practice, and consider the implications of the changing organization of medical practice and nature of physician work. This evolving environment has created conceptual challenges in what are the appropriate measures of output from physician work, as well as what inputs should be measured. Likewise, the increasing complexity of physician practice organizations has introduced challenges to finding the appropriate data sources for measuring these constructs. Both these conceptual and data challenges pose measurement issues that must be overcome to study the economics of modern medical practice. Despite these challenges, there are several promising initiatives involving data sharing at the organizational level that could provide a starting point for developing the needed new data sources and metrics for physician inputs and outputs. However, additional efforts will be required to establish data collection approaches and measurements applicable to smaller and single specialty practices. Overcoming these measurement and data challenges will be key to supporting policy-relevant research on the changing economics of medical practice.

  4. Principles and practice of hyperbaric medicine: a medical practitioner's primer, part I.

    Science.gov (United States)

    Perdrizet, George A

    2014-01-01

    The purpose of this monograph is to narrow the knowledge gap between current medical practice and hyperbaric oxygen therapy. Graduate medical education has not kept pace with the expanding science and practice of hyperbaric medicine. The number of hyperbaric chambers in the state of Connecticut has increased by >400% during the past five years. A brief overview of the science and practice of hyperbaric oxygen therapy is presented, with additional resources identified where more in-depth coverage can be found. The reader will find the basics of hyperbaric medical practice reviewed and be able to recognize diagnoses that are appropriate for referral to a hyperbaric medical center. The intended audience is practitioners who have had no formal exposure to hyperbaric medicine or chronic wound care.

  5. Self-Medication Practices among Parents in Italy

    Science.gov (United States)

    Garofalo, Luca; Di Giuseppe, Gabriella; Angelillo, Italo F.

    2015-01-01

    The aims of this cross-sectional survey were to document the prevalence, the determinants, and the reasons of oral medication use without the prescription of a physician among a random sample of 672 parents of students attending randomly selected public schools in Italy. A total of 69.2% practiced self-medication at least once. The odds of having performed a self-medication were higher in females, in younger population, and in those who have had a health problem in the preceding year and were lower in respondents with a middle or lower school level of education. Among those reporting experience of self-medication, 53.4% have practiced at least once in the last year and this was more likely for those who have had a health problem. Nonsteroidal anti-inflammatory drugs were more frequently used without a prescription in the last year. Two-thirds inappropriately self-medicated in the last year at least once. Of those who did not report a self-medication, 13.1% were willing to practice it. Females were more willing and those with a secondary school level of education less willing to practice self-medication. The frequency of oral self-medication was quite high and in most cases inappropriate with a potential impact on the health status and educative programs are needed. PMID:25688359

  6. Health Care Practices for Medical Textiles in Government Hospitals

    Science.gov (United States)

    Akubue, B. N.; Anikweze, G. U.

    2015-01-01

    The purpose of this study was to investigate the health care practices for medical textiles in government hospitals Enugu State, Nigeria. Specifically, the study determined the availability and maintenance of medical textiles in government hospitals in Enugu State, Nigeria. A sample of 1200 hospital personnel were studied. One thousand two hundred…

  7. 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.

  8. Self-medication practice in Ethiopia: a systematic review

    Directory of Open Access Journals (Sweden)

    Ayalew MB

    2017-03-01

    Full Text Available Mohammed Biset Ayalew Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia Background: Self-medication patterns vary among different populations, and are influenced by many factors. No review has been done that comprehensively expresses self-medication practice in Ethiopia. The aim of this study was to provide an overview of the literature on self-medication practice in Ethiopia.Materials and methods: Databases (PubMed, Google Scholar, ResearchGate, and Hinari were searched for published studies on the practice of self-medication in Ethiopia without restriction in the year of publication or methodology. Some studies were also identified through manual Google search. Primary search terms were “self medication”, “Ethiopia”, “self care”, “non-prescription”, “OTC drug use”, “drug utilization”, and “drug hoarding”. Studies that measured knowledge only or attitude only or beliefs only and did not determine the practice of self-medication were excluded.Results: The database search produced a total of 450 papers. After adjustment for duplicates and inclusion and exclusion criteria, 21 articles were found suitable for the review. All studies were cross-sectional in nature. The prevalence of self-medication varied from 12.8% to 77.1%, with an average of 36.8%. Fever/headache, gastrointestinal tract diseases, and respiratory diseases were the commonest illnesses/symptoms for which self-medication was taken. The major reasons for practicing self-medication were previous experience of treating a similar illness and feeling that the illness was mild. Analgesics/antipyretics, antimicrobials, gastrointestinal drugs, and respiratory drugs were the common drug classes used in self-medication. Mainly, these drugs were obtained from drug-retail outlets. The use of self-medication was commonly suggested by pharmacy professionals and friends

  9. Overview of current and alternative slaughter practices

    Directory of Open Access Journals (Sweden)

    Troeger K.

    2004-01-01

    Full Text Available The conventional cattle slaughtering process includes some critical stages where a dissemination of Specified Risk Material (SRM: brain, spinal cord within or onto the carcass and within the slaughterhouse environment can occur. These processes are captive bolt stunning, removal of the head and first of all carcass splitting (sawing the spine lengthways. Captive bolt (CB stunning results in massive brain tissue damage with bleeding, and in some cases brain tissue also emerges from the CB hole. As the heart is still functioning, there is a risk of brain tissue particles being transferred v i a the blood flow to heart and lungs or even in the whole carcass. This contamination risk is actually assessed to be low, but a continuing leakage of Central Nervous System (CNS material from the captive bolt aperture in the further slaughter process may lead to direct and indirect contamination of carcass, meat and equipment. Therefore alternative stunning methods like electrical stunning or concussion stunning are discussed. A further critical point is the treatment of the head. When the head is removed, the spinal cord is cut with a knife. There is a danger of cross contamination due to spinal protein that may adhere to the knife and because of liquid cerebralis, which leaks from the foramen occipitale magnum. Further head cleaning with hand-held hoses following skinning also includes the danger of cross contamination from cleaning water or aerosol. Therefore measures regarding the safe handling of head and harvesting of head meat are proposed. The most critical point in terms of contamination of the meat surface with SRM is the currently common practise of sawing the spine vertically in the middle with hand-guided belt-type saws. A m i x t u r e of sawing residues and rinsing water (“sawing sludge” collects in the housing of the saw, and if it contains infectious material this leads to contamination of the subsequent carcasses. The most promising

  10. Site investigation on medical waste management practices in northern Jordan.

    Science.gov (United States)

    Abdulla, Fayez; Abu Qdais, Hani; Rabi, Atallah

    2008-01-01

    This study investigated the medical waste management practices used by hospitals in northern Jordan. A comprehensive inspection survey was conducted for all 21 hospitals located in the study area. Field visits were conducted to provide information on the different medical waste management aspects. The results reported here focus on the level of medical waste segregation, treatment and disposal options practiced in the study area hospitals. The total number of beds in the hospitals was 2296, and the anticipated quantity of medical waste generated by these hospitals was about 1400 kg/day. The most frequently used treatment practice for solid medical waste was incineration. Of these hospitals, only 48% had incinerators, and none of these incinerators met the Ministry of Health (MoH) regulations. As for the liquid medical waste, the survey results indicated that 57% of surveyed hospitals were discharging it into the municipal sewer system, while the remaining hospitals were collecting their liquid waste in septic tanks. The results indicated that the medical waste generation rate ranges from approximately 0.5 to 2.2 kg/bed day, which is comprised of 90% of infectious waste and 10% sharps. The results also showed that segregation of various medical waste types in the hospitals has not been conducted properly. The study revealed the need for training and capacity building programs of all employees involved in the medical waste management.

  11. Medical Residents’ and Practicing Physicians’ e-Cigarette Knowledge and Patient Screening Activities

    Directory of Open Access Journals (Sweden)

    Karen W. Geletko

    2016-11-01

    Full Text Available Purpose: The purpose of this study was to compare medical residents and practicing physicians in primary care specialties regarding their knowledge and beliefs about electronic cigarettes (e-cigarettes. We wanted to ascertain whether years removed from medical school had an effect on screening practices, recommendations given to patients, and the types of informational sources utilized. Methods: A statewide sample of Florida primary care medical residents (n = 61 and practicing physicians (n = 53 completed either an online or paper survey, measuring patient screening and physician recommendations, beliefs, and knowledge related to e-cigarettes. χ2 tests of association and linear and logistic regression models were used to assess the differences within- and between-participant groups. Results: Practicing physicians were more likely than medical residents to believe e-cigarettes lower cancer risk in patients who use them as an alternative to cigarettes (P = .0003. Medical residents were more likely to receive information about e-cigarettes from colleagues (P = .0001. No statistically significant differences were observed related to e-cigarette knowledge or patient recommendations. Conclusions: Practicing primary care physicians are accepting both the benefits and costs associated with e-cigarettes, while medical residents in primary care are more reticent. Targeted education concerning the potential health risks and benefits associated with the use of e-cigarettes needs to be included in the current medical education curriculum and medical provider training to improve provider confidence in discussing issues surrounding the use of this product.

  12. Strategic planning: how medical practices can succeed in a post-healthcare-reform world.

    Science.gov (United States)

    Howrigon, Ron

    2013-01-01

    This article addresses the recent trend of physicians being pressured to sell to hospitals in order to stay in practice. The author utilizes his experience in the healthcare industry to identify causes of this trend and ways in which physician groups can avoid finding themselves in these situations. The author uses real data from an existing medical practice to support his ideas and demonstrate how implementing change now will be beneficial for the success of this medical practice in the future. Objective practice evaluation and the execution of an efficient strategic plan are cited as the most important factors contributing to the financial solvency of medical practices in the current and future healthcare environment.

  13. Self-medication practice in Ethiopia: a systematic review

    Science.gov (United States)

    Ayalew, Mohammed Biset

    2017-01-01

    Background Self-medication patterns vary among different populations, and are influenced by many factors. No review has been done that comprehensively expresses self-medication practice in Ethiopia. The aim of this study was to provide an overview of the literature on self-medication practice in Ethiopia. Materials and methods Databases (PubMed, Google Scholar, ResearchGate, and Hinari) were searched for published studies on the practice of self-medication in Ethiopia without restriction in the year of publication or methodology. Some studies were also identified through manual Google search. Primary search terms were “self medication”, “Ethiopia”, “self care”, “non-prescription”, “OTC drug use”, “drug utilization”, and “drug hoarding”. Studies that measured knowledge only or attitude only or beliefs only and did not determine the practice of self-medication were excluded. Results The database search produced a total of 450 papers. After adjustment for duplicates and inclusion and exclusion criteria, 21 articles were found suitable for the review. All studies were cross-sectional in nature. The prevalence of self-medication varied from 12.8% to 77.1%, with an average of 36.8%. Fever/headache, gastrointestinal tract diseases, and respiratory diseases were the commonest illnesses/symptoms for which self-medication was taken. The major reasons for practicing self-medication were previous experience of treating a similar illness and feeling that the illness was mild. Analgesics/antipyretics, antimicrobials, gastrointestinal drugs, and respiratory drugs were the common drug classes used in self-medication. Mainly, these drugs were obtained from drug-retail outlets. The use of self-medication was commonly suggested by pharmacy professionals and friends/relatives. Conclusion Self-medication practice is prevalent in Ethiopia and varies in different populations and regions of the country. Some of the self-medication practices are harmful and need

  14. An audit of basic practical skills acquisition of final year medical ...

    African Journals Online (AJOL)

    year medical students of a Nigerian medical school to basic practical skills. ... Keywords: Acquisition, basic practical skills, medical students .... structured learning and feedback. ... role of practical experience in undergraduate and general.

  15. Changing perspectives in medical practice: disruptive innovation.

    Science.gov (United States)

    Paterick, Zachary R; Pradhan, Sala R; Paterick, Timothy E; Waterhouse, Blake E

    2009-01-01

    Disruptive innovation represents a business model that identifies a market location and increases consumer options. Retail clinics may represent a disruptive healthcare innovation that identifies strategies to reduce the cost of healthcare at the primary care level. The future of healthcare demands disruptive innovation that will allow for the 50 million uninsured members of our society to receive medical care. Disruptive innovative solutions need to ensure access, quality, and reasonable cost. Retail clinics represent the tip of the iceberg in disruptive innovative thinking. The obstacles that retail clinics must solve will be lessons learned for those that identify future innovative techniques.

  16. Practical design control implementation for medical devices

    CERN Document Server

    Justiniano, Jose

    2003-01-01

    Bringing together the concepts of design control and reliability engineering, this book is a must for medical device manufacturers. It helps them meet the challenge of designing and developing products that meet or exceed customer expectations and also meet regulatory requirements. Part One covers motivation for design control and validation, design control requirements, process validation and design transfer, quality system for design control, and measuring design control program effectiveness. Part Two discusses risk analysis and FMEA, designing-in reliability, reliability and design verific

  17. Financing and cash flow management for the medical group practice.

    Science.gov (United States)

    Bert, Andrew J

    2008-01-01

    The expansion of a medical group practice and the addition of ancillary services require a substantial cash outlay. Obtaining proper financing to complete a successful expansion is a process that takes time, and there are critical steps that must be followed. The group's business objectives must be presented properly by developing a business plan detailing the practice and goals associated with the desired expansion. This article discusses some of the key elements that are essential in creating an overall effective business plan for the group medical practice.

  18. A systematic review of medical practice variation in OECD countries.

    Science.gov (United States)

    Corallo, Ashley N; Croxford, Ruth; Goodman, David C; Bryan, Elisabeth L; Srivastava, Divya; Stukel, Therese A

    2014-01-01

    Major variations in medical practice have been documented internationally. Variations raise questions about the quality, equity, and efficiency of resource allocation and use, and have important implications for health care and health policy. To perform a systematic review of the peer-reviewed literature on medical practice variations in OECD countries. We searched MEDLINE to find publications on medical practice variations in OECD countries published between 2000 and 2011. We present an overview of the characteristics of published studies as well as the magnitude of variations for select high impact conditions. A total of 836 studies were included. Consistent with the gray literature, there were large variations across regions, hospitals and physician practices for almost every condition and procedure studied. Many studies focused on high-impact conditions, but very few looked at the causes or outcomes of medical practice variations. While there were an overwhelming number of publications on medical practice variations the coverage was broad and not often based on a theoretical construct. Future studies should focus on conditions and procedures that are clinically important, policy relevant, resource intensive, and have high levels of public awareness. Further study of the causes and consequences of variations is important. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  19. Educating physicians in evidence based medicine: current practices and curricular strategies

    NARCIS (Netherlands)

    Maggio, L.A.

    2015-01-01

    Evidence based medicine (EBM) is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.” The practice of EBM is an expectation of professional healthcare and requisite component in many medical school curricula. Yet, despite

  20. Educating physicians in evidence based medicine: current practices and curricular strategies

    NARCIS (Netherlands)

    Maggio, L.A.

    2015-01-01

    Evidence based medicine (EBM) is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.” The practice of EBM is an expectation of professional healthcare and requisite component in many medical school curricula. Yet, despite

  1. Medical expansionism: some implications for psychiatric nursing practice.

    Science.gov (United States)

    Barker, P; Baldwin, S; Ulas, M

    1989-06-01

    The paper discusses how health care models in general have been influenced by the authors' concept of 'medical expansionism'. Emphasis is given to addressing the impact of medical theory and practice on models of psychiatric nursing. The initial section discusses the concepts of medicalisation and medical imperialism, offering general health definitions and examination of mental health problems in more detail. From this analysis a definition is presented of a medical model in psychiatry. The effects of this model of health care on the future development of nursing models in psychiatry is discussed.

  2. 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

  3. Crystallization screening: the influence of history on current practice.

    Science.gov (United States)

    Luft, Joseph R; Newman, Janet; Snell, Edward H

    2014-07-01

    While crystallization historically predates crystallography, it is a critical step for the crystallographic process. The rich history of crystallization and how that history influences current practices is described. The tremendous impact of crystallization screens on the field is discussed.

  4. Teacher's current practices of teaching reading and grade four ...

    African Journals Online (AJOL)

    Teacher's current practices of teaching reading and grade four students' reading ... of teaching reading strategies and assessment in Dona Berber Primary School. ... random sampling technique and an English teacher and a school supervisor ...

  5. Fish quarantine: current practices in public zoos and aquaria.

    Science.gov (United States)

    Hadfield, Catherine A; Clayton, Leigh A

    2011-12-01

    The primary goal of quarantine is to reduce the risk of introducing infectious diseases into established collections. Fish quarantine is inherently complex because of the variety of species, environmental requirements, and facilities. To examine current practices, questionnaires were submitted to 60 public zoos and aquaria, predominantly in North America. Questions reviewed system type (closed, flow-through), quarantine length, diagnostics, treatments, and cleaning and disinfection. Forty-two of the 60 institutions responded. Most institutions had separate quarantine protocols for freshwater teleosts, marine teleosts, and elasmobranchs. Ninety-five percent of institutions had a minimum quarantine period of 30 days or more. Sixty-four percent of institutions used isolated areas for some or all of their fish quarantine. Twenty-five percent had designated fish quarantine staff. All institutions used regular visual examinations to assess animal health. Fifty-four percent of the institutions carried out routine hands-on diagnostics on some fish; this was more common for elasmobranchs than teleosts. All institutions carried out necropsies on mortalities. Fifteen percent of institutions performed histopathology on almost all fresh mortalities; 54% percent performed histopathology on less than 10% of mortalities. Prophylactic treatments were common in closed systems, in particular, formalin immersion for teleosts, freshwater dips and copper sulfate immersion for marine teleosts, and praziquantel immersion for marine teleosts and elasmobranchs. Institutions using dips generally did so at the start or end of quarantine. Fenbendazole- and praziquantel-medicated foods were used commonly in teleosts, but dosages varied greatly. Cleaning and disinfection of systems and equipment increased in response to known pathogens. These results can be used to compare and discuss fish quarantine practices at display facilities in order to improve quarantine success.

  6. Linkage between Graduate Medical Education Training Practice Profiles in Psychiatry, Obstetrics/Gynecology, and Family Practice. Deliverable No. 5. Final Report.

    Science.gov (United States)

    Moynihan, Christy; And Others

    This study examined the relationship between graduate medical education (GME) and practice profiles in three specialties: family practice, psychiatry, and obstetrics/gynecology. Two analyses were performed, the first assessing the relationship between GME and current practice patterns and the second assessing the relationship between GME and…

  7. Evaluating clinical dermatology practice in medical undergraduates.

    Science.gov (United States)

    Casanova, J M; Sanmartín, V; Martí, R M; Morales, J L; Soler, J; Purroy, F; Pujol, R

    2014-06-01

    The acquisition of competences (the set of knowledge, skills and attitudes required to perform a job to a professional level) is considered a fundamental part of medical training. Dermatology competences should include, in addition to effective clinical interviewing and detailed descriptions of skin lesions, appropriate management (diagnosis, differentiation, and treatment) of common skin disorders and tumors. Such competences can only be acquired during hospital clerkships. As a way of certifying these competences, we propose evaluating the different components as follows: knowledge, via clinical examinations or critical incident discussions; communication and certain instrumental skills, via structured workplace observation and scoring using a set of indicators; and attitudes, via joint evaluation by staff familiar with the student. Copyright © 2012 Elsevier España, S.L. and AEDV. All rights reserved.

  8. Nanomedicine: application of nanobiotechnology in medical practice.

    Science.gov (United States)

    Jain, K K

    2008-01-01

    Nanomedicine is the application of nanobiotechnologies to medicine. This article starts with the basics of nanobiotechnology, followed by its applications in molecular diagnostics, nanodiagnostics, and improvements in the discovery, design and delivery of drugs, including nanopharmaceuticals. It will improve biological therapies such as vaccination, cell therapy and gene therapy. Nanobiotechnology forms the basis of many new devices being developed for medicine and surgery such as nanorobots. It has applications in practically every branch of medicine and examples are presented of those concerning cancer (nanooncology), neurological disorders (nanoneurology), cardiovascular disorders (nanocardiology), diseases of bones and joints (nanoorthopedics), diseases of the eye (nanoophthalmology), and infectious diseases. Safety issues of in vivo use of nanomaterials are also discussed. Nanobiotechnology will facilitate the integration of diagnostics with therapeutics and facilitate the development of personalized medicine, i.e. prescription of specific therapeutics best suited for an individual. Many of the developments have already started and within a decade a definite impact will be felt in the practice of medicine.

  9. Current Practices in the Delivery of Undergraduate Exercise Physiology Content

    Science.gov (United States)

    Fisher, Michele M.

    2013-01-01

    The purpose of this study was to identify current practices for the delivery of exercise physiology content at the undergraduate level. An anonymous 22-item survey was sent to instructors of exercise physiology to collect information concerning the structure of course offerings and instructional practices. One hundred ten instructors responded to…

  10. 21 CFR 123.5 - Current good manufacturing practice.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 123.5 Section 123.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... manufacturing practice. (a) Part 110 of this chapter applies in determining whether the facilities,...

  11. A summarized discussion of current good manufacturing practice regulations.

    Science.gov (United States)

    Allen, Loyd V

    2013-01-01

    In light of recent events and discussions of compounding pharmacy, it is important to discuss and understand the purpose of good manufacturing practices. This article provides a summary of the current Good Manufacturing Practice Regulations which were established by the U.S. Food and Drug Administration.

  12. Sustainable practices in medicinal chemistry: current state and future directions.

    Science.gov (United States)

    Bryan, Marian C; Dillon, Barry; Hamann, Lawrence G; Hughes, Gregory J; Kopach, Michael E; Peterson, Emily A; Pourashraf, Mehrnaz; Raheem, Izzat; Richardson, Paul; Richter, Daniel; Sneddon, Helen F

    2013-08-08

    The medicinal chemistry subgroup of the American Chemical Society's Green Chemistry Institute Pharmaceutical Roundtable (ACS GCI PR) offers a perspective on the current state of environmentally sustainable practices in medicinal chemistry with the aim of sharing best practices more widely and highlighting some potential future developments.

  13. Patients' view on medical students in dermatology practice

    Directory of Open Access Journals (Sweden)

    Seval Doğruk Kaçar

    2014-12-01

    Full Text Available Background and Design: Practical training of medical students, especially in specialties such as dermatology, is performed in outpatient clinics where mostly outpatients are encountered. The aim of this study was to compare patients’ perspectives on medical students in two university hospitals (X–Y situated in different regions of Turkey. Materials and Methods: A total of 250 patients, who visited outpatient clinics of X (group 1 and Y (group 2 university hospitals during practical training for fifth year medical students, were included in this study. A questionnaire composed of 16 items was filled by all patients. The first eight questions were about patients’ consent and preferences on the presence of medical students during their interview and the remaining eight questions inquired patients’ overall thoughts on medical students. Results: The patients in both groups were willing to be a part of the educational programme of medical students (39.8%, 53.5%, respectively. The patients were aware that they had the right to refuse the presence of medical students (61.0%, 62.3% and majority wanted to be informed on the presence of medical students during the interview (72.4%, 80.7%. While patients in group 1 evaluated being with medical students as pleasurable (43.1%, patients in group 2 did not agree (44.7%. In addition, both groups were not bothered to share personal information with medical students (50.4%, 44.7% and stated that they would recommend their friends and relatives to have a physical examination done by medical students (51.2%, 41.2%. Conclusion: The active role of medical students during dermatology training is positively viewed by patients in both western and eastern parts of our country. The patients’ request on being informed for the presence of medical students during clinical examination reveals the requirement of oral and written informed consent.

  14. The Impact of Baccalaureate Medical Humanities on Subsequent Medical Training and Practice: A Physician-Educator's Perspective.

    Science.gov (United States)

    Barron, Lauren

    2017-06-17

    This reflective essay is an attempt to organize trends in feedback I have observed during ten years of coursework, conversations, and correspondence with former students associated with the Medical Humanities Program at Baylor University. Over the years, recurrent themes arise when speaking with alumni about whether and how their medical humanities experience intersects with their current training. I have identified five particular domains in which baccalaureate medical humanities training affects students' subsequent healthcare professions training and practice: context and complementarity, clinical relevance, reflective practice, professional preparedness and vocational calling. I created an instrument of open-ended questions for each of these categories and posted it to social media with an invitation for alumni to respond. This informal survey was conceived as an exploratory exercise with the intent to help generate a foundation for more formal qualitative research in these five domains. In this essay, I offer my own reflections together with those of former students on the impact of baccalaureate-level medical humanities training in order to illustrate the benefits in each domain for subsequent healthcare training and practice. The need for qualitative research that explores the impact of baccalaureate medical humanities merits collaboration between multiple centers of investigation across many disciplines, and across the divide between premedical and medical educators.

  15. Individual radiation sensitivity: implications in medical practice

    Energy Technology Data Exchange (ETDEWEB)

    Gisone, P.; Dubner, D.; Perez, M.D.R.; Michelin, S.; Di Giogio, M. [Autoridad Regulatoria Nuclear, Buenos Aires (Argentina); Bourguignon, M. [Direction Generale de la Surete Nucleaire et de la Radioprotection, Paris (France)

    2006-07-01

    Important advances in radiotherapy and nuclear medicine towards better treatment modalities and safer applications have taken place in recent years. Progress in medical imaging, better tumour targeting and optimization of radiation delivery have allowed for dose escalation and improved patient outcome. However, the tolerance of normal tissues constitutes the limiting factor for dose escalation in therapeutical uses of ionizing radiation (IR). Patients vary considerably in their normal tissue response to IR even after similar treatments. As many as 5% of cancer patients develop severe effects to external radiation therapy in normal tissues within the treatment field: they may include acute effects such as erythema and desquamation of the exposed skin and mucosa that appear during or directly after radiotherapy, late effects developed months or years later, such as fibrosis and telangiectasia and cancer induction. Several patient and treatment related factors are known to influence the variability of side effects, however up to a 70% of the total variance of normal tissue radiation response remained unexplained. Thus, individual sensitivity to IR, i.e. hypersensitivity to carcinogenic risks (stochastic effects) and hypersensitivity to deterministic effects, is becoming an important issue in oncology and raises questions regarding the underlying mechanisms. The mechanisms of DNA repair, the signalling pathways involved in radiation sensitivity and non-targeted effects are key aspects, essential to understanding radiation effects at genetic level. Moreover, human genetic diseases that combine higher incidence of cancer and hypersensitivity to IR are associated with defects in cell response to DNA damage. Therefore, much interest has raised during the last years in the developing of predictive tests capable to detect in advance such hypersensitive conditions. The goal of this presentation is to review the possible mechanisms involved in genetic and epigenetic

  16. Information Governance: A Model for Security in Medical Practice

    Directory of Open Access Journals (Sweden)

    Patricia A.H. Williams

    2007-03-01

    Full Text Available Information governance is becoming an important aspect of organisational accountability. In consideration that information is an integral asset of most organisations, the protection of this asset will increasingly rely on organisational capabilities in security.  In the medical arena this information is primarily sensitive patient-based information. Previous research has shown that application of security measures is a low priority for primary care medical practice and that awareness of the risks are seriously underestimated. Consequently, information security governance will be a key issue for medical practice in the future. Information security governance is a relatively new term and there is little existing research into how to meet governance requirements. The limited research that exists describes information security governance frameworks at a strategic level. However, since medical practice is already lagging in the implementation of appropriate security, such definition may not be practical although it is obviously desirable. This paper describes an on-going action research project undertaken in the area of medical information security, and presents a tactical approach model aimed at addressing information security governance and the protection of medical data. 

  17. Steve Jobs provides lessons for any medical practice.

    Science.gov (United States)

    Ornstein, Hal; Baum, Neil

    2013-01-01

    Steve Jobs is inarguably the greatest inventor and creative genius since Thomas Edison. He provided technology that enhances communication on a global level. Jobs also provided ideas and suggestions that could work in any medical practice regardless of the size of the practice, the location of the practice, or the employment model. His advice can be transferred from a high-tech business that employs thousands to a high-touch medical practice that has only a few employees. This article will list a few of Jobs leadership characteristics and how they might apply to physicians, their teams, and their practices. Wouldn't you like to be the Steve Jobs of healthcare? If so, read on!

  18. 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 ...

  19. 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.

  20. Self-Medication Practice with Nonprescription Medication among University Students: a review of the literature

    Directory of Open Access Journals (Sweden)

    Dedy Almasdy

    2011-09-01

    Full Text Available Objective: To review the literature relating to self-medicationpractice with nonprescription medication among universitystudents.Methods: A narrative review of studies on self-medicationpractice with nonprescription medication among universitystudent was performed. An extensive literature search wasundertaken using indexing services available at UniversitiSains Malaysia (USM library. The following keywords wereused for the search: self-care, self-medication, over-thecountermedicine, nonprescription medicine, minor illnesses,minor ailment, university population and communitypharmacy. Electronic databases searched were Science Direct,Medline, ISI Web of Knowledge, Inside Web, JSTOR, SpringerLink, Proquest, Ebsco Host and Google Scholar. Theseelectronic databases were searched for full text paperspublished in English.Results: Eleven studies were identified. In general, the reviewhas shown that self-medication practice with nonprescriptionmedication highly prevalence among university students. Thereasons for self-medication are vary among this populationand the main symptoms leading to self-medication areheadache or minor pain; fever, flu, cough, or cold; anddiarrhoea.The common medication is analgesic, antipyreticproducts, cough and cold remedies, anti allergy andvitamins or minerals. The sources of the medicines arepharmacy, home medicine cabinet, supermarket/shopand other person such as family, friend, neighbours andclassmates. The sources of drug information are familymember, previous experience, pharmacy salesman,doctor or nurse, advertisement and others. The reviewalso has shown that the self-medication practice couldhave many problems.Conclusions: The review provides insights about theself-medication practices among the university students.These practices were highly prevalence among universitystudents. The symptoms leading to self-medication arevary, thus the medication used and the medicationsources. It needs an adequate drug information

  1. Attitudes of undergraduate medical students of Addis Ababa University towards medical practice and migration, Ethiopia

    OpenAIRE

    Deressa Wakgari; Azazh Aklilu

    2012-01-01

    Abstract Background The health care system of Ethiopia is facing a serious shortage of health workforce. While a number of strategies have been developed to improve the training and retention of medical doctors in the country, understanding the perceptions and attitudes of medical students towards their training, future practice and intent to migrate can contribute in addressing the problem. This study was carried out to assess the attitudes of Ethiopian medical students towards their trainin...

  2. 21 CFR 114.5 - Current good manufacturing practice.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 114.5 Section 114.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION ACIDIFIED FOODS General Provisions § 114.5 Current good...

  3. Consumerism: forcing medical practices toward patient-centered care.

    Science.gov (United States)

    Ozmon, Jeff

    2007-01-01

    Consumerism has been apart of many industries over the years; now consumerism may change the way many medical practices deliver healthcare. With the advent of consumer-driven healthcare, employers are shifting the decision-making power to their employees. Benefits strategies like health savings accounts and high-deductible insurance plans now allow the patients to control how and where they spend their money on medical care. Practices that seek to attract the more affluent and informed consumers are beginning to institute patient-centered systems designs that invite patients to actively participate in their healthcare. This article will outline the changes in the healthcare delivery system facing medical practices, the importance of patient-centered care, and six strategies to implement to change toward more patient-centered care.

  4. [Interculturality in the medical practice of Dr. Albert Schweitzer].

    Science.gov (United States)

    Campos-Navarro, Roberto; Ruiz-Llanos, Adriana

    2004-01-01

    Albert Schweitzer (1875-1965) was a young and promising German who at age 29 decided to undertake the profession of Medical Doctor at the University of Strassburg after finishing a career in musical studies in Paris (1899) and obtaining in Berlin a doctoral degree in Philosophy and Theology. Surprisingly, Albert Schweitzer, despite his comfortable life in Europe, decided in 1913 to practice his medical career in a remote and small Equatorial African country. He devoted nearly 50 years of his life caring for the Black population at Lamaberene, where he built a hospital. In this paper, we attempt to develop some theoretical aspects related with interculturality in the medical practice of Dr. Albert Schweitzer. We begin by considering certain sociocultural variables in hospitals that give care to patients with cultural characteristics that are substantially different from those of the health care personnel who organize, administer, and execute medical functions.

  5. Information Governance: A Model for Security in Medical Practice

    OpenAIRE

    Patricia A.H. Williams

    2007-01-01

    Information governance is becoming an important aspect of organisational accountability. In consideration that information is an integral asset of most organisations, the protection of this asset will increasingly rely on organisational capabilities in security.  In the medical arena this information is primarily sensitive patient-based information. Previous research has shown that application of security measures is a low priority for primary care medical practice and that awareness of the r...

  6. Determinants of first practice location: among Manitoba medical graduates.

    Science.gov (United States)

    Raghavan, Malathi; Fleisher, William; Downs, Allan; Martin, Bruce; Sandham, J Dean

    2012-11-01

    To help understand physician movement out of Manitoba by determining the factors that influence Manitoba medical graduates' choices about practice locations. Cross-sectional, within-stage, mixed-model survey. Manitoba. All University of Manitoba medical graduates from classes 1998 to 2009 for whom we had valid contact information (N = 912 of 943 graduates) were invited in August 2009 to participate in a survey. Demographic information; ratings, on a 5-point scale, of the importance when choosing first practice locations of 12 practice characteristics, 3 recruitment strategies, and 4 location characteristics listed in the survey; free-text narratives on unlisted factors; and estimates of likely practice location upon completion of training for recent graduates still in residency training. Completed surveys were received from 331 (35.1%) graduates of the surveyed classes, 162 (53.3%) of whom chose Manitoba for their first practice location. Multiple regression analyses indicated that graduates choosing Manitoba for their first practice location were significantly more likely to have done their residency training in Manitoba (P choice of Manitoba as their first practice location, regardless of graduates' rating of the importance of being near family or friends. Graduates' narratives provided insights into the complexities of choosing practice locations and enhanced the interpretive and theoretical validity of the study findings. More extensive studies involving all Canadian residents could further define the role residency location plays in physician practice location.

  7. Implications of translating research into practice: a medication management intervention.

    Science.gov (United States)

    Alkema, Gretchen E; Frey, Dennee

    2006-01-01

    Through programs such as the Administration on Aging's Evidence-Based Prevention Initiative, researchers and practitioners are developing translational research studies seeking to implement rigorously tested, evidence-based interventions in new practice settings and evaluate the continuing effectiveness of these interventions. One such translational study is the Community-Based Medications Management Intervention (CBM Intervention), a collaborative effort to implement a medication management screening and intervention protocol in community-based waiver care management programs. The overall goals of the CBM Intervention are to implement an evidence-based medication management intervention in a California Medicaid waiver care management program, and to evaluate the effect of client-, intervention-, and organizational-level characteristics on resolving identified medication problems. This article presents the need for improved medication management in a frail, community-dwelling, older adult population and describes the CBM Intervention as an example of translating an evidence-based practice beyond its original efficacy trial in a home healthcare program into a care management program. It discusses critical factors involved in translating research into practice using a translational research framework, Promoting Action on Research Implementation in Health Services (PARIHS). Our experience suggests that although implementing research into practice can positively impact client care, professional skill enhancement and organizational effectiveness, this is very challenging work requiring signification facilitation for successful outcomes.

  8. Establishing advanced practice for medical imaging in New Zealand

    Energy Technology Data Exchange (ETDEWEB)

    Yielder, Jill, E-mail: j.yielder@auckland.ac.nz [University of Auckland, Auckland (New Zealand); Young, Adrienne; Park, Shelley; Coleman, Karen [University of Otago, Wellington (New Zealand); University of Auckland, Auckland (New Zealand)

    2014-02-15

    Introduction: This article presents the outcome and recommendations following the second stage of a role development project conducted on behalf of the New Zealand Institute of Medical Radiation Technology (NZIMRT). The study sought to support the development of profiles and criteria that may be used to formulate Advanced Scopes of Practice for the profession. It commenced in 2011, following on from initial research that occurred between 2005 and 2008 investigating role development and a possible career structure for medical radiation technologists (MRTs) in New Zealand (NZ). Methods: The study sought to support the development of profiles and criteria that could be used to develop Advanced Scopes of Practice for the profession through inviting 12 specialist medical imaging groups in NZ to participate in a survey. Results: Findings showed strong agreement on potential profiles and on generic criteria within them; however, there was less agreement on specific skills criteria within specialist areas. Conclusions: The authors recommend that one Advanced Scope of Practice be developed for Medical Imaging, with the establishment of generic and specialist criteria. Systems for approval of the overall criteria package for any individual Advanced Practitioner (AP) profile, audit and continuing professional development requirements need to be established by the Medical Radiation Technologists Board (MRTB) to meet the local needs of clinical departments. It is further recommended that the NZIMRT and MRTB promote and support the need for an AP pathway for medical imaging in NZ.

  9. Establishing advanced practice for medical imaging in New Zealand.

    Science.gov (United States)

    Yielder, Jill; Young, Adrienne; Park, Shelley; Coleman, Karen

    2014-02-01

    IntroductionThis article presents the outcome and recommendations following the second stage of a role development project conducted on behalf of the New Zealand Institute of Medical Radiation Technology (NZIMRT). The study sought to support the development of profiles and criteria that may be used to formulate Advanced Scopes of Practice for the profession. It commenced in 2011, following on from initial research that occurred between 2005 and 2008 investigating role development and a possible career structure for medical radiation technologists (MRTs) in New Zealand (NZ). MethodsThe study sought to support the development of profiles and criteria that could be used to develop Advanced Scopes of Practice for the profession through inviting 12 specialist medical imaging groups in NZ to participate in a survey. ResultsFindings showed strong agreement on potential profiles and on generic criteria within them; however, there was less agreement on specific skills criteria within specialist areas. ConclusionsThe authors recommend that one Advanced Scope of Practice be developed for Medical Imaging, with the establishment of generic and specialist criteria. Systems for approval of the overall criteria package for any individual Advanced Practitioner (AP) profile, audit and continuing professional development requirements need to be established by the Medical Radiation Technologists Board (MRTB) to meet the local needs of clinical departments. It is further recommended that the NZIMRT and MRTB promote and support the need for an AP pathway for medical imaging in NZ.

  10. 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.

  11. Perceptions and practices of self-medication among medical students in coastal South India.

    Directory of Open Access Journals (Sweden)

    Nithin Kumar

    Full Text Available Self-medication is a common practice worldwide and the irrational use of drugs is a cause of concern. This study assessed the prevalence of self-medication among the medical students in South India. The data was analysed using SPSS version 11.5. A total of 440 students were included in the study. The prevalence of self-medication was 78.6%. A larger number of females were self-medicating (81.2% than males (75.3%. The majority of the students self-medicated because of the illness being too trivial for consultation (70.5%. Antipyretics were most commonly self-medicated by the participants (74.8%. Only 47% of the participants opined that self-medication was a part of self-care and it needs to be encouraged. 39.3% of the participants perceived that the supply of medicine without prescription by the pharmacist can prevent the growing trend of self-medication. Easy availability and accessibility to health care facilities remains the cornerstone for reducing the practice of self-medication.

  12. Saudi parent′s attitude and practice about self-medicating their children

    Directory of Open Access Journals (Sweden)

    Ahmed S Eldalo

    2013-01-01

    Conclusion: The current study revealed the fact that parental self-medication among public in Saudi Arabia is a routine practice. The researchers suggested introduction of parental educational interventions throughout the Saudi Arabia to ensure that children will receive best pharmaceutical care.

  13. The limits of empathy: problems in medical education and practice.

    Science.gov (United States)

    Smajdor, Anna; Stöckl, Andrea; Salter, Charlotte

    2011-06-01

    Empathy is commonly regarded as an essential attribute for doctors and there is a conviction that empathy must be taught to medical students. Yet it is not clear exactly what empathy is, from a philosophical or sociological point of view, or whether it can be taught. The meaning, role and relevance of empathy in medical education have tended to be unquestioningly assumed; there is a need to examine and contextualise these assumptions. This paper opens up that debate, arguing that 'empathy', as it is commonly understood, is neither necessary nor sufficient to guarantee good medical or ethical practice.

  14. 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.

  15. Learning the law: practical proposals for UK medical education.

    Science.gov (United States)

    Margetts, J K

    2016-02-01

    Ongoing serious breaches in medical professionalism might be avoided if UK doctors rethink their approach to law. UK medical education has a role in creating a climate of change by re-examining how law is taught to medical students. Adopting a more insightful approach in the UK to the impact of The Human Rights Act and learning to manipulate legal concepts, such as conflict of interest, need to be taught to medical students now if UK doctors are to manage complex decision-making in the NHS of the future. The literature is reviewed from a unique personal perspective of a doctor and lawyer, and practical proposals for developing medical education in law in the UK are suggested.

  16. Practice of Regulatory Science (Development of Medical Devices).

    Science.gov (United States)

    Niimi, Shingo

    2017-01-01

     Prototypes of medical devices are made in accordance with the needs of clinical practice, and for systems required during the initial process of medical device development for new surgical practices. Verification of whether these prototypes produce the intended performance specifications is conducted using basic tests such as mechanical and animal tests. The prototypes are then improved and modified until satisfactory results are obtained. After a prototype passes through a clinical trial process similar to that for new drugs, application for approval is made. In the approval application process, medical devices are divided into new, improved, and generic types. Reviewers judge the validity of intended use, indications, operation procedures, and precautions, and in addition evaluate the balance between risk and benefit in terms of efficacy and safety. Other characteristics of medical devices are the need for the user to attain proficiency in usage techniques to ensure efficacy and safety, and the existence of a variety of medical devices for which assessment strategies differ, including differences in impact on the body in cases in which a physical burden to the body or failure of a medical device develops. Regulatory science of medical devices involves prediction, judgment, and evaluation of efficacy, safety, and quality, from which data result which can become indices in the development stages from design to application for approval. A reduction in the number of animals used for testing, improvement in efficiency, reduction of the necessity for clinical trials, etc. are expected through rational setting of evaluation items.

  17. Current Status of Nuclear Medicine Practice in the Middle East.

    Science.gov (United States)

    Paez, Diana; Becic, Tarik; Bhonsle, Uday; Jalilian, Amir R; Nuñez-Miller, Rodolfo; Osso, Joao Alberto

    2016-07-01

    availability of (68)Ge-(68)Ga generators is increasing and studies involving prostate-specific membrane antigen or DOTA-chelated peptides or both are performed in at least seven countries. Although therapeutic radionuclide agents are mostly imported from outside the region, this does not limit the availability of therapies with (90)Y, (153)Sm, (177)Lu, (131)I, (188)Re, and (89)Sr. Nevertheless, therapies based on alpha particle emitters are still largely not available in the region and are currently only available in Israel and Turkey. Regarding human resources, according to the data provided there are 1157 NM physicians, 1953 technologists, 586 medical physicists, and 173 radiopharmacists or radiochemists in the region. Approximately half of all available human resources are accounted for by Turkey. The region has great potential for expanding the applications of NM; this becomes especially important in view of the high prevalence of non-communicable diseases. Further increasing awareness of the clinical applications of NM in healthcare and strengthening technical and human capacities including the establishment of training programs for all professionals and disciplines in the field are recognized as key components in advancing the practice of NM in the Middle East.

  18. BEME systematic review : Predictive values of measurements obtained in medical schools and future performance in medical practice

    NARCIS (Netherlands)

    Hamdy, H; Prasad, K; Anderson, MB

    2006-01-01

    Background: Effectiveness of medical education programs is most meaningfully measured as performance of its graduates. Objectives: To assess the value of measurements obtained in medical schools in predicting future performance in medical practice. Methods: Search strategy: The English literature fr

  19. 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

  20. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Truth telling in medical practice: students' opinions versus their observations of attending physicians' clinical practice.

    Science.gov (United States)

    Tang, Woung-Ru; Fang, Ji-Tseng; Fang, Chun-Kai; Fujimori, Maiko

    2013-07-01

    Truth telling or transmitting bad news is a problem that all doctors must frequently face. The purpose of this cross-sectional study was to investigate if medical students' opinions of truth telling differed from their observations of attending physicians' actual clinical practice. The subjects were 275 medical clerks/interns at a medical center in northern Taiwan. Data were collected on medical students' opinions of truth telling, their observations of physicians' clinical practice, students' level of satisfaction with truth telling practiced by attending physicians, and cancer patients' distress level when they were told the truth. Students' truth-telling awareness was significantly higher than the clinical truth-telling practice of attending physicians (ptruth telling of attending physicians (mean ± SD=7.33 ± 1.74). However, our data also show that when cancer patients were informed of bad news, they all experienced medium to above average distress (5.93 ± 2.19). To develop the ability to tell the truth well, one must receive regular training in communication skills, including experienced attending physicians. This study found a significant difference between medical students' opinions on truth telling and attending physicians' actual clinical practice. More research is needed to objectively assess physicians' truth telling in clinical practice and to study the factors affecting the method of truth telling used by attending physicians in clinical practice. Copyright © 2012 John Wiley & Sons, Ltd.

  3. Effective ways to handle medical practice workplace stress.

    Science.gov (United States)

    Hills, Laura Sachs

    2010-01-01

    It may seem to you that there is little or nothing that you can do about the stressors you face in your medical practice. There is always so much to do. Working with patients who are anxious or frightened, short-staffing, emergencies, a crowded appointment schedule-all of this can make for a stressful work environment. Fortunately, there is quite a bit that the medical practice employee can do to reduce and manage his or her own stress. This article defines workplace stress and explains the difference between a workplace stressor and a challenge. It identifies the most common sources of workplace stress and how employees who work in a medical practice can use journaling to pinpoint their own particular stressors and stress responses. It describes the relationship between stress and health, and lists common physical and emotional responses to stress. Finally, this article provides recent statistics about workplace stress and offers 25 specific techniques and strategies that medical practice personnel can use to reduce and manage their own workplace stress.

  4. Persistent presentation of medically unexplained symptoms in general practice.

    NARCIS (Netherlands)

    Verhaak, P.F.M.; Meijer, S.A.; Visser, A.P.; Wolters, G.

    2006-01-01

    OBJECTIVES: To estimate the prevalence of persistent presentation of medically unexplained physical symptoms (MUPS) in general practice. To assess socio-demographic characteristics, health status and use of health services of patients who frequently present MUPS, compared with reference groups. DESI

  5. Professional autonomy and the normative structure of medical practice

    NARCIS (Netherlands)

    Hoogland, Jan; Jochemsen, Henk

    2000-01-01

    Professional autonomy is often described as a claim of professionals that has to serve primarily their own interests. However, it can also be seen as an element of a professional ideal that can function as a standard for professional, i.e. medical practice. This normative understanding of the medica

  6. The Medical Literature as a Resource for Health Care Practice.

    Science.gov (United States)

    McKibbon, K. Ann; And Others

    1995-01-01

    Discussion of evidence-based medicine (EBM) focuses on information tools to facilitate the practice of EBM that were developed, evaluated, and made more accessible by the McMaster University (Canada) Faculty of Health Sciences. Highlights include users' guides to medical literature, strategies for improving MEDLINE searches, new journals, and…

  7. Narrative review of telemedicine consultation in medical practice

    Science.gov (United States)

    Di Cerbo, Alessandro; Morales-Medina, Julio Cesar; Palmieri, Beniamino; Iannitti, Tommaso

    2015-01-01

    Background The use of telemedicine has grown across several medical fields, due to the increasing number of “e-patients”. Objective This narrative review gives an overview of the growing use of telemedicine in different medical specialties, showing how its use can improve medical care. Methods A PubMed/Medline, Embase, Web of Science, and Scopus search was performed using the following keywords: telemedicine, teleconsultation, telehealth, e-health, and e-medicine. Selected papers from 1996 to 2014 were chosen on the basis of their content (quality and novelty). Results Telemedicine has already been applied to different areas of medical practice, and it is as effective as face-to-face medical care, at least for the diagnosis and treatment of some pathological conditions. Conclusion Telemedicine is time- and cost-effective for both patients and health care professionals, encouraging its use on a larger scale. Telemedicine provides specialist medical care to patients who have poor access to hospitals, and ensures continuity of care and optimal use of available health resources. The use of telemedicine opens new perspectives for patients seeking a medical second opinion for their pathology, since they can have remote access to medical resources that would otherwise require enormous costs and time. PMID:25609928

  8. [Drug utilization in renal transplant patients: medication practices and representations].

    Science.gov (United States)

    de Arruda, Guilherme Oliveira; Renovato, Rogério Dias

    2012-12-01

    Qualitative research approach, descriptive and exploratory with objective of to know the practices and representations of medication on the use of drugs by people transplanted kidney. 18 people participated in the Dourados (MS), through semistructured interview. The theoretical contributions of medication practices were Peter Conrad and representation of Stuart Hall. The definition of the categories of theoretical analysis was Michel Foucault. Respondents had a mean age of 53.5 years, 13 males and 5 females, with median time to transplant eight years. The medications predominantly used were immunosuppresssive. We developed three categories of analysis: the drug as part of everyday life, the central role of the drug and correlation with rejection, and medicine and the autonomy of the transplanted kidney. The drugs are part of everyday life and the representations of autonomy and quality enhance your daily use.

  9. Predicting medical practices using various risk attitude measures.

    Science.gov (United States)

    Massin, Sophie; Nebout, Antoine; Ventelou, Bruno

    2017-08-31

    This paper investigates the predictive power of several risk attitude measures on a series of medical practices. We elicit risk preferences on a sample of 1500 French general practitioners (GPs) using two different classes of tools: scales, which measure GPs' own perception of their willingness to take risks between 0 and 10; and lotteries, which require GPs to choose between a safe and a risky option in a series of hypothetical situations. In addition to a daily life risk scale that measures a general risk attitude, risk taking is measured in different domains for each tool: financial matters, GPs' own health, and patients' health. We take advantage of the rare opportunity to combine these multiple risk attitude measures with a series of self-reported or administratively recorded medical practices. We successively test the predictive power of our seven risk attitude measures on eleven medical practices affecting the GPs' own health or their patients' health. We find that domain-specific measures are far better predictors than the general risk attitude measure. Neither of the two classes of tools (scales or lotteries) seems to perform indisputably better than the other, except when we concentrate on the only non-declarative practice (prescription of biological tests), for which the classic money-lottery test works well. From a public health perspective, appropriate measures of willingness to take risks may be used to make a quick, but efficient, profiling of GPs and target them with personalized communications, or interventions, aimed at improving practices.

  10. Health Technology Assessment: managing the introduction and use of medical devices in clinical practice in Italy.

    Science.gov (United States)

    Migliore, Antonio; Ratti, Marco; Cerbo, Marina; Jefferson, Tom

    2009-05-01

    Technology assumes a key role in current clinical practice. A number of innovative or improved products are constantly being launched on the market and offered directly to the users (i.e., clinicians) or even to the patients. However, in most cases, the regulation for admission to commerce is slower than the innovation process and may be inadequate for assessing the real clinical effectiveness and safety of medical devices in the premarket phase. Health Technology Assessment (HTA) can be used as a tool for the evaluation of clinical effectiveness, cost-effectiveness and risk to patients of medical devices. HTA products (e.g., periodic reports) may aid healthcare payers to make informed choices regarding the appropriate use, coverage and reimbursement of medical devices. We present the strengths and limitations of the first three Italian HTA reports we coauthored and critically explore some of the aspects related to the introduction, adoption and use of medical technologies in clinical practice.

  11. Medical engagement and organizational characteristics in general practice

    DEFF Research Database (Denmark)

    Ahnfeldt-Mollerup, Peder; dePont Christensen, René; Halling, Anders;

    2016-01-01

    and this is determined by a complex interaction between both individual and organizational characteristics. Working in collaboration, having staff and being engaged in vocational training of junior doctors are all associated with enhanced levels of medical engagement among GPs.......BACKGROUND: Medical engagement is a mutual concept of the active and positive contribution of doctors to maintaining and enhancing the performance of their health care organization, which itself recognizes this commitment in supporting and encouraging high quality care. A Medical Engagement Scale...... results were analysed in conjunction with the GP register data. RESULTS: Statistically adjusted analyses revealed that the GPs' medical engagement varied substantially. GPs working in collaboration with colleagues were more engaged than GPs from single-handed practices, older GPs were less engaged than...

  12. 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.

  13. Meaningful Peer Review in Radiology: A Review of Current Practices and Potential Future Directions.

    Science.gov (United States)

    Moriarity, Andrew K; Hawkins, C Matthew; Geis, J Raymond; Dreyer, Keith J; Kamer, Aaron P; Khandheria, Paras; Morey, Jose; Whitfill, James; Wiggins, Richard H; Itri, Jason N

    2016-12-01

    The current practice of peer review within radiology is well developed and widely implemented compared with other medical specialties. However, there are many factors that limit current peer review practices from reducing diagnostic errors and improving patient care. The development of "meaningful peer review" requires a transition away from compliance toward quality improvement, whereby the information and insights gained facilitate education and drive systematic improvements that reduce the frequency and impact of diagnostic error. The next generation of peer review requires significant improvements in IT functionality and integration, enabling features such as anonymization, adjudication by multiple specialists, categorization and analysis of errors, tracking, feedback, and easy export into teaching files and other media that require strong partnerships with vendors. In this article, the authors assess various peer review practices, with focused discussion on current limitations and future needs for meaningful peer review in radiology.

  14. 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).

  15. Description of a practice model for pharmacist medication review in a general practice setting

    DEFF Research Database (Denmark)

    Brandt, Mette; Hallas, Jesper; Hansen, Trine Graabæk;

    2014-01-01

    BACKGROUND: Practical descriptions of procedures used for pharmacists' medication reviews are sparse. OBJECTIVE: To describe a model for medication review by pharmacists tailored to a general practice setting. METHODS: A stepwise model is described. The model is based on data from the medical chart...... and clinical or laboratory data. The medication review focuses on the diagnoses of the patient instead of the individual drugs. Patient interviews are not part of the model. The model was tested in a pilot study by conducting medical reviews on 50 polypharmacy patients (i.e. receiving 7 or more drugs...... concerned the reporting of interventions and the considerations of the GPs. 208 interventions were proposed among the 50 patients. The acceptance rate among the GPs was 82%. The most common interventions were lack of clinical or laboratory data (n=57, 27%) and drugs that should be discontinued as they had...

  16. Narrative, Poststructuralism, and Social Justice: Current Practices in Narrative Therapy

    Science.gov (United States)

    Combs, Gene; Freedman, Jill

    2012-01-01

    This paper is a review of current practice in narrative therapy with a focus on how it is attractive and useful for therapists who wish to work for social justice. The authors describe narrative therapy's roots in poststructuralist philosophy and social science. They illustrate its major theoretical constructs, including the "narrative metaphor,"…

  17. Cardioversion for atrial fibrillation in current European practice

    DEFF Research Database (Denmark)

    Hernández-Madrid, Antonio; Svendsen, Jesper Hastrup; Lip, Gregory Y.H.

    2013-01-01

    This survey was conducted to provide an insight into the current clinical practice regarding the use of cardioversion for atrial fibrillation (AF) in Europe. Responses were received from 57 centres across Europe, 71.9% of which were university hospitals. For electrical cardioversion, general anae...

  18. Autism Spectrum Disorders: Neurobiology and Current Assessment Practices

    Science.gov (United States)

    Allen, Ryan A.; Robins, Diana L.; Decker, Scott L.

    2008-01-01

    This study reviews recent research related to the neurobiology of Autism Spectrum Disorders (ASDs) an provides an empirical analysis of current assessment practices. Data were collected through a survey of 117 school psychologists. The Childhood Autism Rating Scale (CARS), Gilliam Autism Rating Scale (GARS), and Gilliam Asperger's Disorder Scale…

  19. Current Practice and Infrastructures for Campus Centers of Community Engagement

    Science.gov (United States)

    Welch, Marshall; Saltmarsh, John

    2013-01-01

    This article provides an overview of current practice and essential infrastructure of campus community engagement centers in their efforts to establish and advance community engagement as part of the college experience. The authors identified key characteristics and the prevalence of activities of community engagement centers at engaged campuses…

  20. Crystallization screening: the influence of history on current practice

    Science.gov (United States)

    Luft, Joseph R.; Newman, Janet; Snell, Edward H.

    2014-01-01

    While crystallization historically predates crystallography, it is a critical step for the crystallographic process. The rich history of crystallization and how that history influences current practices is described. The tremendous impact of crystallization screens on the field is discussed. PMID:25005076

  1. Curating research data a handbook of current practice

    CERN Document Server

    Johnston, Lisa R

    2017-01-01

    Curating Research Data, Volume Two: A Handbook of Current Practice guides you across the data lifecycle through the practical strategies and techniques for curating research data in a digital repository setting. The data curation steps for receiving, appraising, selecting, ingesting, transforming, describing, contextualizing, disseminating, and preserving digital research data are each explored, and then supplemented with detailed case studies written by more than forty international practitioners from national, disciplinary, and institutional data repositories. The steps in this volume detail the sequential actions that you might take to curate a data set from receiving the data (Step 1) to eventual reuse (Step 8). Data curators, archivists, research data management specialists, subject librarians, institutional repository managers, and digital library staff will benefit from these current and practical approaches to data curation.

  2. Smartphones and Medical Applications in the Emergency Department Daily Practice.

    Science.gov (United States)

    Jahanshir, Amirhosein; Karimialavijeh, Ehsan; Sheikh, Hojjat; Vahedi, Motahar; Momeni, Mehdi

    2017-01-01

    Medical applications help physicians to make more rapid and evidence based decisions that may provide better patient care. This study aimed to determine the extent to which smart phones and medical applications are integrated in the emergency department daily practice. In a cross sectional study, a modified standard questionnaire (Payne et al.) consisting of demographic data and information regarding quality and quantity of smartphone and medical app utilization was sent to emergency-medicine residents and interns twice (two weeks apart), in January 2015. The questionnaire was put online using open access "Web-form Module" and the address of the web page was e-mailed along with a cover letter explaining the survey. Finally, responses were analyzed using descriptive statistics and SPSS 22 software. 65 cases participated (response rate 86%). The mean age of interns and residents were 25.03 ± 1.13 and 30.27 ± 4.68 years, respectively (p UpToDate, respectively. 38 (61.3%) of the respondents were using their apps more than once a day and mostly for drug information. English (83.9%), Persian (12.9%), and other languages (3.2%) were preferred languages for designing a medical software among the participants, respectively. The findings of present study showed that smartphones are very popular among Iranian interns and residents in emergency department and a substantial number of them own a smartphone and are using medical apps regularly in their clinical practice.

  3. 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.

  4. [Description of current hypnosis practice in French university hospitals].

    Science.gov (United States)

    Chabridon, G; Nekrouf, N; Bioy, A

    2017-10-01

    Hypnosis is very fashionable as an entertainment through TV shows searching for new sensational experiences. What about its practice in the medical world? The aim of this article is to answer to this question. Therefore, we contacted every French University Hospital of each region to find out if hypnosis was practiced for the care of pain (hypnoanalgesia), for chirurgical procedures (hypnosedation) and in adult psychiatry care units (hypnotherapy). For this last practice, we also questioned the type of indications. All 30 of the French University Hospitals had replied by November 2015. Hypnoanalgesia is practiced by all and two-thirds offer hypnosedation. Hypnotherapy is practiced by 40 % of the University Hospitals, 91,7 % for anxiety disorders, 66,7 % for psychotraumatic care and 25 % for mood disorders. Therefore, hypnosis seems to have found its place in the care of pain and as an anesthetic to replace standard procedures. However, the use of hypnotherapy in psychiatry is less frequent, indications for its use being variable and not very consensual. Copyright © 2016 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  5. 医护人员性健康指导知信行状况及其影响因素%Investigation of current status of the knowledge, attitude and practice of medical staff on sexual health guidance and analysis of influence factors

    Institute of Scientific and Technical Information of China (English)

    何平; 张安琴; 张蒙

    2012-01-01

    Objective To investigate the current status of knowledge, attitude and practice (KAP) of medical staff among different clinic unit on sexual health guidance,and analyze the influence factors. Methods A self-devetoped KAP questionnaire for medical staff was used, and 460 medical personnel in Chengdu city were investigated. The data were statistically analyzed. Results The scores of KAP of sexual health guidance were tow. There was a significant difference in KAP among different clinic units ( F = l. 063 , 6.746,7.618 for knowledge,attitude and practice,respectively;all P<0. 001) with the best in the department of gynaecotogy. The primary influence factor for guidance behavior was that the patients lacked consulting knowledge. The secondary factor was that medical staff lacked sexual knowledge. Conclusion The most clinical medical staff lack knowledge of sexual health guidance and ignore patients' sexual health problems. The guidance behavior is also limited. Therefore,it will be a tong way for sexual health guidance.%目的 了解医护人员对患者性健康指导现状,分析性健康指导知信行的影响因素.方法 自行设计问卷调查表,调查460名临床医护人员的性健康指导知信情况,并对数据进行分析统计.结果 医护人员对患者性健康指导的知信行分值均偏低;不同科室医护人员在性健康指导知识、态度和行为方面存在差异(F值分别为7.063、6.746和7.618,均P<0.001),妇科在性健康指导方面做得最好(P<0.01);影响健康指导行为的首要因素是没有患者咨询性知识,其次为医护人员性知识缺乏.结论 临床科室医护人员普遍存在性健康指导知识缺乏、忽视患者性健康问题、健康行为受限的诸多问题.性健康教育任重道远.

  6. Narrative review of telemedicine consultation in medical practice

    Directory of Open Access Journals (Sweden)

    Di Cerbo A

    2015-01-01

    Full Text Available Alessandro Di Cerbo,1,2 Julio Cesar Morales-Medina,3 Beniamino Palmieri,1,2 Tommaso Iannitti4 1Poliambulatorio del Secondo Parere, 2Department of General Surgery and Surgical Specialties, Surgical Clinic, University of Modena and Reggio Emilia Medical School, Modena, Italy; 3Centro de Investigación en Reproducción Animal, CINVESTAV, Universidad Autónoma de Tlaxcala, Tlaxcala de Xicohténcatl, Mexico; 4Department of Neuroscience, Sheffield Institute for Translational Neuroscience (SITraN, University of Sheffield, Sheffield, UK Background: The use of telemedicine has grown across several medical fields, due to the increasing number of “e-patients”.Objective: This narrative review gives an overview of the growing use of telemedicine in different medical specialties, showing how its use can improve medical care.Methods: A PubMed/Medline, Embase, Web of Science, and Scopus search was performed using the following keywords: telemedicine, teleconsultation, telehealth, e-health, and e-­medicine. Selected papers from 1996 to 2014 were chosen on the basis of their content (quality and novelty.Results: Telemedicine has already been applied to different areas of medical practice, and it is as effective as face-to-face medical care, at least for the diagnosis and treatment of some pathological conditions.Conclusion: Telemedicine is time- and cost-effective for both patients and health care professionals, encouraging its use on a larger scale. Telemedicine provides specialist medical care to patients who have poor access to hospitals, and ensures continuity of care and optimal use of available health resources. The use of telemedicine opens new perspectives for patients seeking a medical second opinion for their pathology, since they can have remote access to medical resources that would otherwise require enormous costs and time. Keywords: telemedicine, health care, patient

  7. Digitally Controllable Current Amplifier and Current Conveyors in Practical Application of Controllable Frequency Filter

    Science.gov (United States)

    Polak, Josef; Jerabek, Jan; Langhammer, Lukas; Sotner, Roman; Dvorak, Jan; Panek, David

    2016-07-01

    This paper presents the simulations results in comparison with the measured results of the practical realization of the multifunctional second order frequency filter with a Digitally Adjustable Current Amplifier (DACA) and two Dual-Output Controllable Current Conveyors (CCCII +/-). This filter is designed for use in current mode. The filter was designed of the single input multiple outputs (SIMO) type, therefore it has only one input and three outputs with individual filtering functions. DACA element used in a newly proposed circuit is present in form of an integrated chip and the current conveyors are implemented using the Universal Current Conveyor (UCC) chip with designation UCC-N1B. Proposed frequency filter enables independent control of the pole frequency using parameters of two current conveyors and also independent control of the quality factor by change of a current gain of DACA.

  8. 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.

  9. Telephone techniques and etiquette: a medical practice staff training tool.

    Science.gov (United States)

    Hills, Laura Sachs

    2007-01-01

    The telephone is usually the first contact a prospective or new patient has with a medical practice. It is also the method that existing patients and others commonly use to ask questions or convey information. At the same time, a telephone that rings off the hook can be one of the biggest drains on staff time and a source of tremendous frustration. This article suggests practical techniques for managing the medical practice telephone. It provides seven never-fail strategies for saving time on the phone while remaining courteous and attentive to callers. It offers tips to help readers avoid getting caught in an endless game of telephone tag. The article highlights strategies that work particularly well when placing calls and when dealing with a busy signal or voicemail system problem in the practice. It also describes the fine points for taking accurate and complete telephone messages without turning off callers or misleading them. This article further explores practical strategies for using and not abusing the hold button and offers additional tips for telephone equipment and accessories readers may find helpful. Finally, this article suggests guidelines for using an answering machine or voicemail system and provides a 25-question quiz to help readers assess their own telephone technique.

  10. Documentation of Nursing Practice Using a Computerized Medical Information System

    Science.gov (United States)

    Romano, Carol

    1981-01-01

    This paper discusses a definition of the content of the computerized nursing data base developed by the Nursing Department for the Clinical Center Medical Information System at the National Institutes of Health in Bethesda, Maryland. The author describes the theoretical framework for the content and presents a model to describe the organization of the nursing data components in relation to the process of nursing care delivery. Nursing documentation requirements of Nurse Practice Acts, American Nurses Association Standards of Practice and the Joint Commission on Accreditation of Hospitals are also addressed as they relate to this data base. The advantages and disadvantages of such an approach to computerized documentation are discussed.

  11. The transition from idealism to pragmatism in medical practice.

    Science.gov (United States)

    Haus, M

    1986-07-19

    The principles and practice of medicine as taught at our medical schools today cannot find expressive fulfillment in the private sector, nor are they appropriate in adequately serving our Third-World population. This results in many of our primary care physicians leaving general practice because of frustration and lack of fulfillment. Urgent correction of the status quo is necessary, particularly by making better use of specially trained primary health care nursing sisters and by readjustment of the statutory tariff, making it cost-effective for the physician to utilize his resources for optimal patient benefit.

  12. Branding your medical practice with effective public relations.

    Science.gov (United States)

    Trent, Nancy

    2009-01-01

    Whether you think of it as your image, your standing in the community, or your reputation, your medical practice is also a brand. While many organizations, companies, products, and services are known for specific attributes that make them stand out from competitors, most use a combination of marketing disciplines to communicate who and what they are to their customers, consumers, and patients. Public relations is often considered the most powerful, cost-effective, and efficacious of the marketing disciplines, surpassing advertising, promotion, and direct mail in molding and developing brands. Your practice can benefit from a well-crafted branding public relations program.

  13. Losing a valued member of the medical practice team.

    Science.gov (United States)

    Hills, Laura

    2014-01-01

    Losing a valued member of your staff can be disruptive, painful, and costly to your medical practice. And despite your best intentions and impeccable employee management policies and skills, things will happen beyond your control, and people move on. Being prepared for that possibility will help you minimize and contain the damage and move your practice forward. This article suggests 15 strategies that you can use to mitigate the effects of losing a valued employee. These include strategies to protect your practice's interests and several that will smooth the transition for your remaining staff. This article also describes 10 ways that losing a valued employee can impact a practice. It offers 10 additional strategies to help you cope with the death of an employee, one of the most difficult challenges a practice manager may ever face. This article further suggests several easy-to-implement practice management techniques that will help you soften the blow of employee turnover. It offers a sample farewell letter to announce an employee's departure from your practice and suggests six knowledge transfer questions to ask before the employee leaves. Finally, this article provides a comprehensive list of more than 30 thoughtful, eye-opening, and revealing questions that you can ask in an employee exit interview or exit survey.

  14. Why employees resist change in medical group practice acquisitions.

    Science.gov (United States)

    Fabrizio, N

    1999-01-01

    Understanding employees' values and considerations is important in undergoing major organizational change. This research provides an insight of the business and financial aspects vs. the human relations aspects of acquiring a medical group practice. The five employees interviewed in this analysis provide insight as to the factors that employees consider in resisting change. Considering how employees feel through communicating will have a significant impact on efficiency, effectiveness and turnover.

  15. A Human-Centered Approach to Medical Informatics for Medical Students, Residents, and Practicing Clinicians.

    Science.gov (United States)

    Stahlhut, Richard W.; Gosbee, John W.; Gardner-Bonneau, Daryle J.

    1997-01-01

    Describes development of a curriculum in medical information science that focuses on practical problems in clinical medicine rather than details of information technology. Design was guided by identification of six key clinical challenges that must be addressed by practitioners in the near future and by examination of past failures of informatics…

  16. CORRUPTION IN MEDICAL PRACTICE: WHERE DO WE STAND?

    Science.gov (United States)

    Yousafzai, Abdul Wahab

    2015-01-01

    Corruption in health care sector affects all countries, including the United States, China and India. Pakistan is no exception. It is preventing people from having access to the quality medical care. Corruption in medical practice include ordering unnecessary investigations, and procedures for kickbacks and commissions; significant absenteeism, which adversely affects patient care; and the conflict of interest within the physician-pharmaceutical nexus, which exploits patients. To overcome corruption there is need to establish a framework for accountability, eliminating the physician-pharmaceutical nexus; and emphasizing medical ethics at the undergraduate and postgraduate levels. It is also important to open a dialogue amongst health care professionals and encourage the establishment of an ethical health care system in Pakistan.

  17. Knowledge, attitude, and practice of medical doctors towards periodontal disease.

    Science.gov (United States)

    Nagarakanti, Sreenivas; Epari, Venkatarao; Athuluru, Deepthi

    2013-01-01

    The study aimed to assess the knowledge of medical doctors on the association between periodontal disease and general health and their willingness to advise their patients to seek dental treatment. In a cross-sectional survey, randomly selected medical doctors (n = 267) practicing in Nellore District were interviewed through a questionnaire survey about their knowledge of periodontal diseases and the bidirectional relationship between general health and periodontal diseases. Data were analyzed through percentages. All the medical doctors (100%) were aware that there existed a relation between oral health and general health. But only 10% of respondents refer their patients to dentists without patients asking for referral. Very few respondents (21.3%) knew about different branches of dentistry. Screening and referral by healthcare professionals may benefit their patients by improving access to dental care. Therefore, there is a need to educate doctors about oral health and general health.

  18. ACOG Committee Opinion No. 359: commercial enterprises in medical practice.

    Science.gov (United States)

    2007-01-01

    Increasing numbers of physicians sell and promote both medical and nonmedical products as part of their practices. Physicians always have rendered advice and treatment for a fee, and this practice is appropriate. It is unethical under most circumstances, however, for physicians to sell or promote medical or nonmedical products or services for their financial benefit. The following activities are considered unethical: sale of prescription drugs to be used at home, sale or promotion of nonprescription medicine, sale or promotion of presumptively therapeutic agents that generally are not accepted as part of standard medical practice, sale or promotion of non-health-related items, recruitment of patients or other health care professionals into multilevel marketing arrangements, and sale or promotion of any product in whose sale the physician has a significant financial interest. It is ethical and appropriate, however, to sell products to patients as follows: sale of devices or drugs that require professional administration in the office setting; sale of therapeutic agents, when no other facilities can provide them at reasonable convenience and at reasonable cost; sale of products that clearly are external to the patient-physician relationship, when such a sale would be considered appropriate in an external relationship; and sale of low-cost products for the benefit of community organizations. A rationale is provided for both the prohibited activities and exceptions.

  19. Practical trials in medical education: linking theory, practice and decision making.

    Science.gov (United States)

    Tolsgaard, Martin G; Kulasegaram, Kulamakan M; Ringsted, Charlotte

    2017-01-01

    Concerns have been raised over the gap between education theory and practice and how research can contribute to inform decision makers on their choices and priorities. Little is known about how educational theories and research outcomes produced under optimal conditions in highly controlled settings generalise to the real-life education context. One way of bridging this gap is applying the concept of practical trials in medical education. In this paper we elaborate on characteristics of practical trials and based on examples from medical education we discuss the challenges, limitations and future directions for this kind of research. Practical trials have the overall aim of informing decision makers. They are carried out in real-life settings and are characterised by (i) comparison of viable alternative education strategies, (ii) broad inclusion criteria regarding participants across several settings and (iii) multiple outcome measures with long-term follow-up to evaluate both benefits and risks. Questions posed by practical trials may be proactive in applying theory in the development of educational innovations or reactive to educational reforms and innovations. Non-inferiority or equivalence designs are recommended when comparing viable alternatives and the use of crossover designs, cluster randomisation or stepped wedge trial designs are feasible when studying implementations across several settings. Outcome measures may include variables related to learners, teachers, educational administration, quality of care, patient outcomes and cost. Practical trials in medical education may contribute to bridge the gap between education theory and practice and aid decision makers in making evidence-based choices and priorities. Conducting practical trials is not without challenges and rigorous design and methods must be applied. Of concern is that the practical focus may lead to failure to include a sound theoretical basis in the research questions and the interventions

  20. Teaching communications skills to medical students: Introducing the fine art of medical practice.

    Science.gov (United States)

    Choudhary, Anjali; Gupta, Vineeta

    2015-08-01

    Like many other people based professions, communications skills are essential to medical practice also. Traditional medical teaching in India does not address communication skills which are most essential in dealing with patients. Communication skills can be taught to medical students to increase clinical competence. To teach basic communication and counseling skills to fourth-year undergraduate students to increase their clinical competence. A total of 48, fourth-year MBBS students participated in the study. They were given training in basic communication and counseling skills and taught the patient interview technique according to Calgary-Cambridge guide format. Improvement in communication was assessed by change in pre- and post-training multiple choice questions, clinical patient examination, and Standardized Patient Satisfaction Questionnaire (SPSQ) scores. About 88% of the students in the sample were convinced of the importance of learning communication skills for effective practice. Almost 90% students were communicating better after training, as tested by improved SPSQ. As judged by Communication Skill Attitude Scale, student's positive attitude toward learning communication skill indicated that there is a necessity of communication skill training during undergraduate years. The ability to communicate effectively is a core competency for medical practitioners. Inculcating habits of good communications skill during formative years will help the medical students and future practitioners. Regular courses on effective communication should be included in the medical school curriculum.

  1. Current practice for diagnosis and management of silent atrial fibrillation

    DEFF Research Database (Denmark)

    Dobreanu, Dan; Svendsen, Jesper Hastrup; Lewalter, Thorsten

    2013-01-01

    Although it is well known that silent atrial fibrillation (AF) is associated with morbidity and mortality rates similar to those of symptomatic AF, no specific strategy for screening and management of this form of AF has been advocated. The purpose of this survey was to identify current practices...... for the diagnosis and management of silent AF. This survey is based on an electronic questionnaire sent to the European Heart Rhythm Association Research Network partners. Responses were received from 33 centres in 16 countries. The preferred screening methods for silent AF in patients with rhythm control...... episode of silent AF was documented, without recommending further investigations. The results of this survey have confirmed that there is currently no consensus regarding the screening and management of patients with silent AF and that clinical practice is not always consistent with the few existing...

  2. Gender Perspective to Vedic Education: Current Practices in Nepal

    Directory of Open Access Journals (Sweden)

    Rajendra Raj Timilsina

    2016-10-01

    Full Text Available Vedic civilization has seen changes in its history- from Satya Yug to current Kali Yug. There were equal rights and duties of both men and women at the beginning. Interpretations of Veda, brought out of the Puranas and externalities made the status unequal. Sanatan Dharma, which is still mainstream of Hinduism, has been challenged by reformist Arya Samaj. As a result, there are interpretive differences as well as practices. Such differences can be seen in contemporary Nepal for the last 130 years. Continuing the differences, classicism has been reviving in the education. This revival also commenced with the same dualism. In this qualitative approach of exploration, two different gurukuls of girls have been observed and analyzed from the field for the purpose of exploring the recent practices. The observation was based on respective scriptures as well as experts' interviews. These data have analyzed the confronting practices on gender in Veda and rooted ideas in contemporary Nepal.

  3. Credentialing in radiology:Current practice and future challenges

    Institute of Scientific and Technical Information of China (English)

    Adam Youssef; Paul Mc Coubrie

    2016-01-01

    Radiology has changed significantly in recent years. The volume of work has increased dramatically as has its complexity. Future radiologists need an adequate training and expertise in conventional practice as well as new techniques. This comes at a time when other stakeholders outside of radiology are voicing their own concerns. The rightly justified increasing focus on patient safety has placed even more emphasis on the demonstration of competent practice by all health care professionals. Credentialing has been put forward as a way to ensure a doctor is competent in specific areas. Credentialing may be an alien concept to many radiology trainees but moves are afoot in the United Kingdom to bring it to the forefront of its postgraduate medical training. Credentialing began in 20 th century North America where it was linked to the process of privileging. It subsequently garnered a strong patient safety focus and has become a part of the international healthcare agenda. Not everyone agrees with credentialing, it has many criticisms including the risk of speciality "turf wars" and the stifling of medical excellence to name just a couple. Is credentialing in radiology here to stay or will it pass by quietly? This paper reviews the global credentialing movement and discusses how this may impact on future radiology training, using the United Kingdom as its case example.

  4. Circulation Policies in Academic Medical Libraries: A Comparative Study of Allocation Strategies, Demographic Analysis, Service Offerings, and Implications for Practice

    Science.gov (United States)

    Whitehead, Michele L.; Gutierrez, Laura; Miller, Melody

    2014-01-01

    The purpose of this study is to gain an understanding of current academic medical library circulation polices and examine methods libraries utilize to meet patron needs. Key informants were selected from five states. Statistics regarding financial practices, users, services, space access, and circulation practices were collected via survey…

  5. Kidney Failure and Liver Allocation: Current Practices and Potential Improvements.

    Science.gov (United States)

    Saxena, Varun; Lai, Jennifer C

    2015-09-01

    In February 2002, the United Network for Organ Sharing implemented a system for prioritizing candidates for liver transplantation that was based on the risk of 90-day mortality as determined by the Model for End-Stage Liver Disease (MELD) score. As the MELD score is driven in part by serum creatinine as a marker of kidney function, the prevalence of kidney dysfunction and failure in patients with end-stage liver disease at the time of listing and at transplantation has steadily risen. In this review, we discuss current practices in liver transplantation in patients with kidney dysfunction focusing briefly on the decision to perform simultaneous liver-kidney transplantation. We then discuss pitfalls to the current practices of liver transplantation in patients with kidney dysfunction. We conclude by discussing potential improvements to current practices including the use of the MELD-Na score, alternatives to creatinine and creatinine-based equation for estimating kidney function, and the use of intraoperative kidney replacement therapy during liver transplantation.

  6. 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.

  7. 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.

  8. DYNAMICALLY EVOLVING CLINICAL PRACTICES AND IMPLICATIONS FOR PREDICTING MEDICAL DECISIONS

    Science.gov (United States)

    CHEN, JONATHAN H; GOLDSTEIN, MARY K; ASCH, STEVEN M; ALTMAN, RUSS B

    2015-01-01

    Automatically data-mining clinical practice patterns from electronic health records (EHR) can enable prediction of future practices as a form of clinical decision support (CDS). Our objective is to determine the stability of learned clinical practice patterns over time and what implication this has when using varying longitudinal historical data sources towards predicting future decisions. We trained an association rule engine for clinical orders (e.g., labs, imaging, medications) using structured inpatient data from a tertiary academic hospital. Comparing top order associations per admission diagnosis from training data in 2009 vs. 2012, we find practice variability from unstable diagnoses with rank biased overlap (RBO)0.6. Predicting admission orders for future (2013) patients with associations trained on recent (2012) vs. older (2009) data improved accuracy evaluated by area under the receiver operating characteristic curve (ROC-AUC) 0.89 to 0.92, precision at ten (positive predictive value of the top ten predictions against actual orders) 30% to 37%, and weighted recall (sensitivity) at ten 2.4% to 13%, (P<10−10). Training with more longitudinal data (2009-2012) was no better than only using recent (2012) data. Secular trends in practice patterns likely explain why smaller but more recent training data is more accurate at predicting future practices. PMID:26776186

  9. 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.

  10. 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.

  11. [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.

  12. Teaching and Assessing Professionalism in Medical Learners and Practicing Physicians

    Directory of Open Access Journals (Sweden)

    Paul S. Mueller

    2015-04-01

    Full Text Available Professionalism is a core competency of physicians. Clinical knowledge and skills (and their maintenance and improvement, good communication skills, and sound understanding of ethics constitute the foundation of professionalism. Rising from this foundation are behaviors and attributes of professionalism: accountability, altruism, excellence, and humanism, the capstone of which is professionalism. Patients, medical societies, and accrediting organizations expect physicians to be professional. Furthermore, professionalism is associated with better clinical outcomes. Hence, medical learners and practicing physicians should be taught and assessed for professionalism. A number of methods can be used to teach professionalism (e.g. didactic lectures, web-based modules, role modeling, reflection, interactive methods, etc.. Because of the nature of professionalism, no single tool for assessing it among medical learners and practicing physicians exists. Instead, multiple assessment tools must be used (e.g. multi-source feedback using 360-degree reviews, patient feedback, critical incident reports, etc.. Data should be gathered continuously throughout an individual’s career. For the individual learner or practicing physician, data generated by these tools can be used to create a “professionalism portfolio,” the totality of which represents a picture of the individual’s professionalism. This portfolio in turn can be used for formative and summative feedback. Data from professionalism assessments can also be used for developing professionalism curricula and generating research hypotheses. Health care leaders should support teaching and assessing professionalism at all levels of learning and practice and promote learning environments and institutional cultures that are consistent with professionalism precepts.

  13. 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.

  14. 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.

  15. 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.

  16. The business side of healthcare practice: retooling graduate medical students through medical school curriculum enhancements.

    Science.gov (United States)

    Iezzoni, Mario A; El-Badri, Nagwa

    2012-01-01

    Practicing physicians often complain that medical schools failed to provide them with any substantive business training. And with the financial stress placed on today's medical practices, doctors feel unprepared for the rigors of managing a business and shortchanged when it comes to cashing-in on the fair value of their education. The University of South Florida piloted a three-credit course for nonbusiness-minded graduate students, aptly named "The Business Side of Medicine." The intent was to imprint aspiring, time-constrained graduate students, early in their biomedical education, with the need to develop a sound business acumen. Students, if made aware that the structure of healthcare practice is changing into a value-based and consumer-driven marketplace, will process in tandem with their graduate and medical schooling the notion that wellness and compensation are interdependent. The Business Side of Medicine addresses four core concepts that will logically germinate within the students' minds the desire to make practical, profitable career choices.

  17. Medical social work practice in child protection in China: A multiple case study in Shanghai hospitals.

    Science.gov (United States)

    Zhao, Fang; Hämäläinen, Juha; Chen, Yu-Ting

    2017-01-24

    With the rapid development of the child welfare system in China over recent years, medical social work has been increasingly involved in providing child protection services in several hospitals in Shanghai. Focusing on five cases in this paper, the exploratory study aims to present a critical overview of current practices and effects of medical social work for child protection, based on a critical analysis of the multidimensional role of social work practitioners engaged in the provision of child protection services as well as potential challenges. Implications and suggestions for future improvements of China's child protection system are also discussed.

  18. Toward a more professional and practical medical education: a novel Central European approach

    Directory of Open Access Journals (Sweden)

    Drexel H

    2015-06-01

    Full Text Available Heinz Drexel,1–4,* Alexander Vonbank,1–3,* Peter Fraunberger,3,5 Walter F Riesen,3 Christoph H Saely1–3 1Vorarlberg Institute for Vascular Investigation and Treatment, 2Department of Medicine and Cardiology, Academic Teaching Hospital Feldkirch, Feldkirch, Austria; 3Private University of the Principality of Liechtenstein, Triesen, Liechtenstein; 4Drexel University College of Medicine, Philadelphia, PA, USA; 5Medical Central Laboratories, Feldkirch, Austria  *These authors contributed equally to this work Abstract: We here present an innovative curriculum for a complete medical education that conforms to the current European Bologna system of academic training. The curriculum aims at raising doctors who are excellently prepared for clinical work over as short a time as 5 years; it provides a comprehensive, yet shorter than usual, education that strongly pronounces the importance of increasing the students’ practical clinical competences and rigorously excludes superfluous contents. The curriculum encompasses 52 modules, 32 at the bachelor’s and 20 at the master’s level. Already at the level of the bachelor degree, full employability is given; the students finish the master’s course as medical doctors optimally prepared to manage patients at the level of postgraduate medical education. The structure of the curriculum is modular; each modular component is essential for medical education and contains an average of five European Credit Transfer System credits, amounting to 150 hours of education. Depending on the subspecialty, the courses include lectures, seminars, practical laboratory training, and clinical training at varying quantities. In addition to attendance times, sufficient time slots are prepared for self-study in lectures, seminars, and practical work. With our curriculum, we provide an easily applicable backbone for a modern course of medicine that can be installed also at smaller academic institutions. Keywords: Bologna

  19. Accounting for graduate medical education funding in family practice training.

    Science.gov (United States)

    Chen, Frederick M; Phillips, Robert L; Schneeweiss, Ronald; Andrilla, C Holly A; Hart, L Gary; Fryer, George E; Casey, Susan; Rosenblatt, Roger A

    2002-10-01

    Medicare provides the majority of funding to support graduate medical education (GME). Following the flow of these funds from hospitals to training programs is an important step in accounting for GME funding. Using a national survey of 453 family practice residency programs and Medicare hospital cost reports, we assessed residency programs' knowledge of their federal GME funding and compared their responses with the actual amounts paid to the sponsoring hospitals by Medicare. A total of 328 (72%) programs responded; 168 programs (51%) reported that they did not know how much federal GME funding they received. Programs that were the only residency in the hospital (61% versus 36%) and those that were community hospital-based programs (53% versus 22%) were more likely to know their GME allocation. Programs in hospitals with other residencies received less of their designated direct medical education payment than programs that were the only residency in the sponsoring hospital (-45% versus +19%). More than half of family practice training programs do not know how much GME they receive. These findings call for improved accountability in the use of Medicare payments that are designated for medical education.

  20. Peer review of medical practices: missed opportunities to learn.

    Science.gov (United States)

    Kadar, Nicholas

    2014-12-01

    Appropriately conducted peer review of medical practices provides the greatest opportunity for health care professionals to learn from their mistakes and improve the quality and safety of health care. But in practice, peer review has not been an effective learning tool because it is subjective and irreproducible. Physicians reviewing the same cases disagree over the cause(s) of adverse outcomes and the quality and appropriateness of care, and agreement is not improved by training, use of objective review criteria, or having the reviewers discuss the cases. The underlying reason is a general lack of understanding and an oversimplified view of the causes of medical errors in complex, high-risk organization and a preoccupation with attributing medical errors to particular individuals. This approach leads to judgments, not understanding, and creates a culture of blame that stops learning and undermines the potential for improvement. For peer review to have an impact on the quality of care and patient safety, it must be standardized to remove cognitive biases and subjectivity from the process.

  1. A Study of the Prevalence of Self-Medication Practice among ...

    African Journals Online (AJOL)

    ... The prevalence of the practice of self-medication was high among the age group of ... Among undergraduates, self-medication increased as the students' class ... Postgraduate students exhibited low prevalence of selfmedication practices.

  2. Improving care transitions: current practice and future opportunities for pharmacists.

    Science.gov (United States)

    Hume, Anne L; Kirwin, Jennifer; Bieber, Heather L; Couchenour, Rachel L; Hall, Deanne L; Kennedy, Amy K; LaPointe, Nancy M Allen; Burkhardt, Crystal D O; Schilli, Kathleen; Seaton, Terry; Trujillo, Jennifer; Wiggins, Barbara

    2012-11-01

    During the past decade, patient safety issues during care transitions have gained greater attention at both the local and national level. Readmission rates to U.S. hospitals are high, often because of poor care transitions. Serious adverse drug events (ADEs) caused by an incomplete understanding of changes in complex drug regimens can be an important factor contributing to readmission rates. This paper describes the roles and responsibilities of pharmacists in ensuring optimal outcomes from drug therapy during care transitions. Barriers to effective care transitions, including inadequate communication, poor care coordination, and the lack of one clinician ultimately responsible for these transitions, are discussed. This paper also identifies specific patient populations at high risk of ADEs during care transitions. Several national initiatives and newer care transition models are discussed, including multi- and interdisciplinary programs with pharmacists as key members. Among their potential roles, pharmacists should participate on medical rounds where available, perform medication reconciliation and admission drug histories, apply their knowledge of drug therapy to anticipate and resolve problems during transitions, communicate changes in drug regimens between providers and care settings, assess the appropriateness and patient understanding of drug regimens, promote adherence, and assess health literacy. In addition, this paper identifies barriers and ongoing challenges limiting greater involvement of pharmacists from different practice settings during care transitions. Professional degree programs and residency training programs should increase their emphasis on pharmacists' roles, especially as part of interdisciplinary teams, in improving patient safety during care transitions in diverse practice settings. This paper also recommends that Accreditation Council for Pharmacy Education (ACPE) standards include specific language regarding the exposure of students to

  3. Attitudes of undergraduate medical students of Addis Ababa University towards medical practice and migration, Ethiopia

    Directory of Open Access Journals (Sweden)

    Deressa Wakgari

    2012-08-01

    Full Text Available Abstract Background The health care system of Ethiopia is facing a serious shortage of health workforce. While a number of strategies have been developed to improve the training and retention of medical doctors in the country, understanding the perceptions and attitudes of medical students towards their training, future practice and intent to migrate can contribute in addressing the problem. This study was carried out to assess the attitudes of Ethiopian medical students towards their training and future practice of medicine, and to identify factors associated with the intent to practice in rural or urban settings, or to migrate abroad. Methods A cross-sectional study was conducted in June 2009 among 600 medical students (Year I to Internship program of the Faculty of Medicine at Addis Ababa University in Ethiopia. A pre-tested self-administered structured questionnaire was used for data collection. Descriptive statistics were used for data summarization and presentation. Degree of association was measured by Chi Square test, with significance level set at p  Results Only 20% of the students felt ‘excellent’ about studying medicine; followed by ‘very good’ (19%, ‘good’ (30%, ‘fair’ (21% and ‘bad’ (11%. About 35% of respondents responded they felt the standard of medical education was below their expectation. Only 30% of the students said they would like to initially practice medicine in rural settings in Ethiopia. However, students with rural backgrounds were more likely than those with urban backgrounds to say they intended to practice medicine in rural areas (adjusted OR = 2.50, 95% CI = 1.18-5.26. Similarly, students in clinical training program preferred to practice medicine in rural areas compared to pre-clinical students (adjusted OR = 1.83, 95% CI = 1.12-2.99. About 53% of the students (57% males vs. 46% females, p = 0.017 indicated aspiration to emigrate following graduation, particularly to the

  4. Bimodal Programming: A Survey of Current Clinical Practice.

    Science.gov (United States)

    Siburt, Hannah W; Holmes, Alice E

    2015-06-01

    The purpose of this study was to determine the current clinical practice in approaches to bimodal programming in the United States. To be specific, if clinicians are recommending bimodal stimulation, who programs the hearing aid in the bimodal condition, and what method is used for programming the hearing aid? An 11-question online survey was created and sent via email to a comprehensive list of cochlear implant programming centers in the United States. The survey was sent to 360 recipients. Respondents in this study represented a diverse group of clinical settings (response rate: 26%). Results indicate little agreement about who programs the hearing aids, when they are programmed, and how they are programmed in the bimodal condition. Analysis of small versus large implant centers indicated small centers are less likely to add a device to the contralateral ear. Although a growing number of cochlear implant recipients choose to wear a hearing aid on the contralateral ear, there is inconsistency in the current clinical approach to bimodal programming. These survey results provide evidence of large variability in the current bimodal programming practices and indicate a need for more structured clinical recommendations and programming approaches.

  5. 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.

  6. How to shape positive relationships in medical practices and hospitals.

    Science.gov (United States)

    Sotile, W M; Sotile, M O

    1999-01-01

    Managing workplace conflict is one of the most important, stressful, and time-consuming tasks faced by today's medical leaders. Poorly managed workplace conflict can alienate patients, demoralize staff, increase turnover, damage relationships with valued referral sources and third party carriers concerned about patient satisfaction, and lead medical practices to costly "corporate divorces." Physician executives cannot solve the problems caused by disruptive doctors simply by bolstering their own conflict management skills or by policing offenders. The larger contexts within which inappropriate workplace behavior occurs must also be assessed and addressed. The true leadership challenge is to intervene in ways that help to foster a "culture" of appropriate interpersonal dynamics throughout your organization. This requires learning to think and to intervene systematically.

  7. Tower of power: the Drummond Medical Building and the interwar centralization of medical practice.

    Science.gov (United States)

    Theodore, David; Burke, Stacie D; Adams, Annmarie

    2009-01-01

    This paper focuses on Montreal's Drummond Medical Building (1929), designed by the well-known architectural firm of Nobbs & Hyde, as a case study of the new typology that emerged in urban Canada in the 1920s: a modern, purpose-built high-rise for healthcare professionals, with elevators, telephones, indoor parking, and retail shops, located in an upscale commercial district. What role did medical high-rises play in the practice of modern medicine? We speculate that these clinics marked the end of the house-office era across Canada, centralizing the practice of healthcare professionals. This CIHR-funded project illustrates complex social and physical networks among architects and doctors, drawing attention to the importance of studying architecture as a technology in the history of modern medicine.

  8. 75 FR 18514 - Developing Guidance on Naming, Labeling, and Packaging Practices to Reduce Medication Errors...

    Science.gov (United States)

    2010-04-12

    ... Practices to Reduce Medication Errors; Public Workshop; Request for Comments AGENCY: Food and Drug... Packaging Practices to Reduce Medication Errors.'' The purpose of the public workshop is to initiate... practices to develop proprietary names to reduce medication errors. The input from this workshop will...

  9. A systematic review of self-medication practices among adolescents.

    Science.gov (United States)

    Shehnaz, Syed Ilyas; Agarwal, Anoop Kumar; Khan, Nelofer

    2014-10-01

    The purpose was to systematically review the global trends and factors influencing self-medication (SM) among adolescents. Databases (Medline/Pubmed, Ingenta, Cochrane Library, EMBASE, CINAHL, Proquest, Scopus, and Google Scholar) were searched for peer-reviewed research published between January 2000 and December 2013 on SM among adolescents aged 13-18 years. Articles were scrutinized for country of origin, sample size, recall period, prevalence rates and associations, influencing factors, medicines used, self-medicated health complaints, sources of drug information, recommendation and procurement, knowledge about medicines, and adverse drug reactions. One hundred and sixty-three publications met the inclusion criteria. SM prevalence ranged from 2% to 92% in different countries. The most frequently self-medicated over-the-counter and prescription-only medicines were analgesics and antibiotics, respectively. Headache, allergies, and fever were the most common self-medicated health complaints reported. Misuse of both over-the-counter and prescription-only medicines reflected a risky trend. Female gender, older age, maternal education, and familial practices were associated with SM among adolescents. The primary sources of drug information, recommendation, and procurement included pharmacists, parents, and friends. High-risk practices such as diversion of prescription medicines and utilization of previous prescriptions were also reported. Most studies revealed gaps in drug knowledge, although adolescents self-rated it as satisfactory. However, few adverse drug reactions were reported, probably because of lack of awareness about the potential harmful effects of medicines. Recommendations for "responsible SM" have been made to minimize the adverse effects of SM. Understanding the links between various factors promoting SM can be helpful in deriving strategies aimed at reducing drug-related health risks among adolescents. Moreover, these will aid in creating awareness

  10. Task analysis of patients' medication-taking practice and the role of making sense: a grounded theory study.

    Science.gov (United States)

    Bajcar, Jana

    2006-03-01

    Patients on long-term medications have varied medication-taking practices and complex and often unmet medication information needs. The objective of this qualitative study was to describe from the patient's perspective the medication-taking tasks performed by patients currently receiving long-term medications and then to hypothesize how these tasks relate to patients' medication information needs. In-depth semistructured interviews were conducted with individuals between the ages of 18 and 65, who had a college or university education, and who were on at least one long-term medication. Grounded theory approach was used for data gathering and data analysis. Maximum variation and theoretical sampling were used and the sample size was determined when theoretical saturation was reached in the core category. Interpretive and theoretical validity were ensured through member checking, through the use of the constant comparative method, and by a review of the results by a panel of pharmacists and physicians. Ten participants aged between 41 and 64 years were included in the study sample. The participants had between one and 7 chronic illnesses, duration of these illnesses to date varied from 1 year to 40 years, and each participant was taking between one and 13 medications. A model was developed that consists of 4 thematic categories: (a) making sense of medication taking, (b) medication-taking acts, (c) mediation-taking self-assessment, and (d) context of medication taking. The main category was making sense of medication taking that consisted of 3 subcategories: (a) nonproblematic mode, (b) problematic mode, and (c) stunned mode. The model explains how and why a patients' need for medication-taking education may vary because their medication-taking practices changes. The model also connects each category to medication information that people may need. Findings contribute to our understanding of medication-taking practice of individuals on long-term medication and have

  11. General practice observed. A do-it-yourself medical centre.

    Science.gov (United States)

    Ganner, A N; Lockie, A C

    1979-11-17

    A group practice commissioned a local building company to build their own medical centre comprising 370 m2 (4000 ft2) of building with an adequate car park at a total cost of 60 000 pounds with design to completion in nine months. A bank loan for 10 years was assigned to the partnership and each partner made his own arrangements for repayment. The updated cost for June 1979 is 80 000-85 000 pounds. Building a centre in this way is professionally and financially rewarding.

  12. The psychiatric cultural formulation: translating medical anthropology into clinical practice.

    Science.gov (United States)

    Aggarwal, Neil Krishan

    2012-03-01

    This article reviews proposed revisions to the DSM-IV Outline for Cultural Formulation for clinical practice. The author begins by exploring the theoretical development of and assumptions involved in the Cultural Formulation. A case presentation is then used to demonstrate shortcomings in the current implementation of the Cultural Formulation based on older definitions of culture. Finally, the author recommends practical questions based on the growing anthropological literature concerning the interpersonal elements of culture and the social course of illness. A simple clear format that clinically translates social science concepts has the potential to increase use of the Cultural Formulation by all psychiatrists, not just those specializing in cultural psychiatry.

  13. Oral Hygiene Practices and Teeth Cleaning Techniques Among Medical Students.

    Science.gov (United States)

    Naseem, Sajida; Fatima, Syeda H; Ghazanfar, Haider; Haq, Sana; Khan, Najeeb A; Mehmood, Moeez; Ghazanfar, Ali

    2017-07-18

    Objectives Oral health is essential for general health and quality of life. It is a state of being free from mouth and facial pain, oral and throat cancer, oral infections and sores, periodontal disease, tooth decay, tooth loss, and other diseases and disorders that limit an individual's capacity to bite, chew, smile, and speak; it affects psychosocial well-being too. The objective of our study was to assess teeth cleaning techniques and oral hygiene practices among medical students. Methods The data of the study were collected in two stages. The first stage involved the administration of a self-constructed questionnaire among medical students. In the second step, the students were asked to demonstrate their teeth cleaning techniques on a model. A standard teeth cleaning checklist was used to evaluate the students. The students were then given the checklist and a video on teeth cleaning techniques was shown to them. The data obtained was analyzed on IBM's statistical package for the social sciences (SPSS) version 21.  Results Out of a total of 444 students, 256 (57.7 percent) were males while 188 (42.3 percent) were females. About 254 (57.2 percent) participants were preclinical medical students while 190 (42.8 percent) were clinical year medical students. A majority of medical students used medium consistency toothbrushes (177; 39.9 percent) and soft consistency toothbrushes (137; 30.9 percent). Most medical students (248; 55.9 percent) brushed two times a day while 163 (36.7 percent) brushed only one time. About 212 (47.7 percent) of the medical students used mouthwash along with a toothbrush while only 36 (8.1 percent) used floss along with a toothbrush. About 157 participants (35.4 percent) changed their toothbrush once in two months while 132 (26.7 percent) changed their toothbrush once in three months. The mean duration that participants brushed their teeth was 134.99 ± 69.01 seconds. Conclusion Medical students were found to have a faulty teeth

  14. Current assessment practice, personality measurement, and rorschach usage by psychologists.

    Science.gov (United States)

    Musewicz, John; Marczyk, Geoffrey; Knauss, Linda; York, David

    2009-09-01

    In this study, we investigated current personality assessment practice and attitudes toward Rorschach (Exner, 2003) usage by 215 psychologists. We administered an Internet survey to members of the Society for Personality Assessment (SPA) and the American Psychological Association. Results were similar to those of past surveys, but the importance of using tests with strong psychometric properties was greater in this study. The majority of respondents reported using the Rorschach and supporting efforts to standardize and psychometrically validate the test. However, SPA members agreed more strongly than non-SPA members that the Rorschach is an effective test. Implications and directions for future research are discussed.

  15. Individual Performance Management: A Review of Current Practices

    Directory of Open Access Journals (Sweden)

    Ian O’ Boyle

    2013-05-01

    Full Text Available This paper provides a review of current practice in relation to individual performance management systems and process within the traditional business environment. There is a consensus that the role of the individual is central to the overall performance of any organization and how individual performances are managed and evaluated can have significant impacts on overall organizational success. Many organizations employ the traditional performance appraisal in order to monitor and assess individual employee performances. However, new approaches, such as 360-degree feedback have also become commonplace within the business environment. An analysis of each approach including benefits and challenges associated with each process is presented within this paper.

  16. Current Practice of Thermoregulation During the Transport of Combat Wounded

    Science.gov (United States)

    2010-07-01

    ORIGINAL ARTICLE Current Practice of Thermoregulation During the Transport of Combat Wounded Michael Nesbitt , DSc, PA-C, Paul Allen, DSc, PA-C, Alec...reprints: Mike Nesbitt , PA-C, 4511 Star Grove, San Antonio, TX 78259; email: mike.nesbitt@us.army.mil. DOI: 10.1097/TA.0b013e3181e45b83 S162 The Journal...ELEMENT NUMBER 6. AUTHOR(S) Nesbitt M., Allen P., Beekley A., Butler F., Eastridge B., Blackbourne L. H., 5d. PROJECT NUMBER 5e. TASK NUMBER 5f

  17. 76 FR 47593 - Guidance for Small Business Entities on Current Good Manufacturing Practice for Positron Emission...

    Science.gov (United States)

    2011-08-05

    ... a guidance for small business entities entitled ``PET Drugs--Current Good Manufacturing Practice... entitled ``PET Drugs--Current Good Manufacturing Practice (CGMP); Small Entity Compliance Guide.'' This... Manufacturing Practice for Positron Emission Tomography Drugs; Availability AGENCY: Food and Drug...

  18. [Personality of medical students declaring surgical specialty choice in the context of prospective medical practice style].

    Science.gov (United States)

    Skrzypek, Michał; Turska, Dorota

    2015-01-01

    Specialty choice made by medical students takes into account the nature of future medical practice. Holland's congruence theory, according to which career choice is treated as an expression of personality characteristics common for all representatives of the same profession, has served as a theoretical background for own research on the subject matter. Spectacular exemplification of fit between mental resources--personality characteristics and working environment requirements, is the concept of distinct surgical personality (DSP), widely discussed in worldwide literature of the subject (although not in native one). The article offers an author's broadened perception of DSP conception encompassing not only personality characteristics, but also values preference. The research aims at verifying the hypothesis that a given personality constellation directs the choice of surgery as a prospective specialty made by medical students, as well as allows predicting the style of future vocational practice, characterized by dominant instrumental activities, with little emphasis on affective medical actions, typical for technique-oriented specialties. The study involved a total of 223 students of fourth year of medical studies at Medical University of Lublin. Students declaring their choice of surgical specialty constituted the criterion group (N = 93). The control group comprised of students who declared their choice of person-oriented specialties, aimed at work with patient approached holistically (N = 75), in accordance with dichotomous specialty division adopted for the research purposes. Polish adaptations of NEO Five-Factor Inventory (NEO-FFI) by Costa and McCrae and Schwartz Value Survey were applied. The use of multivariate logistic regression indicates three crucial predictions of surgical specialty choice: 'neuroticism' and 'agreeableness' (personality trials-negative predictors) and 'self-enhancement' (value meta-category - positive predictors), however the latter

  19. The Healing Effects of Belief in Medical Practices and Spirituality.

    Science.gov (United States)

    Alling, Frederic A

    2015-01-01

    Shamans and other healing practitioners have used placebos from earliest recorded history to treat those who were ill. As modern scientific theories of disease developed, the use of placebos was considered to be an ineffective and deceptive practice. Later, medical researchers used placebos primarily as an inactive treatment standard against which scientifically based ("real") medicines could be evaluated. However, placebos were discovered to have their own self-healing effects. Spirituality including transcendent experiences also promotes healing effects and recently has been shown to involve neural systems (brain networks) comparable (if not identical) to those engaged in placebo responses. Therapists can facilitate both of these self-healing processes in different ways, including finding meaningfulness in physically and mentally painful situations using Viktor Frankl׳s practice of "logotherapy."

  20. Practice of self-medication of mifepristone-misoprostol drug combination for medical abortion

    Directory of Open Access Journals (Sweden)

    Sushila Godara

    2014-06-01

    However, the use of mifepristone and ndash; misoprostol combination for medical abortion used as self-medication, is rising due to changing socio-cultural practices and increased awareness among women for the termination of early pregnancy up to 63 days. It is observed that many women indulge in the practice of self-medication for termination of pregnancy. They take medicines either from local pharmacists, nurses, on advice of relatives, friends, husband, neighbors, newspaper articles, radio, television, magazines or any other such unauthorized sources for termination of pregnancy which mostly leads to incomplete abortion or many complications. It is observed that only few number of women have complete abortion with self-medication from an unauthorized source and moreover they suffer from pain and heavy bleeding when compared to normal menstrual flow. It is noticed that now-a-days, these drugs are used irrationally and nonjudiciously. Women are thus advised to take proper regimen of mifepristone and misoprostol under the guidance of an authorized practitioner and if they still fail to abort, then they have to undergo surgical evacuation that is, vaccum aspiration for termination of pregnancy. [Int J Basic Clin Pharmacol 2014; 3(3.000: 572-573

  1. Autopsy in Islam and current practice in Arab Muslim countries.

    Science.gov (United States)

    Mohammed, Madadin; Kharoshah, Magdy A

    2014-03-01

    Autopsy, or post-mortem examination, is the dissection of a dead body. It is performed for many reasons. Attitudes toward dead bodies vary with religious beliefs and cultural and geographical backgrounds. We have carried out an extensive literature review to determine the Islamic view and current practice of Autopsy, in at least four Arab countries which published their experiences. Several research articles have studied the history of Islamic Autopsy as well as the current situation and legal debates about it. The overwhelming conclusion is that data is lacking. More must be published from Arabic Muslim countries and more research done to correct misconceptions. We also recommend more application of non-invasive Autopsy.

  2. Benchmarking medical group practices using claims data: methodological and practical problems.

    Science.gov (United States)

    Dove, H G; Greene, B R

    2000-10-01

    As claims data for physicians and groups of physicians has improved in quality and quantity, health information vendors have begun marketing information about medical groups' productivity, utilization, and quality. Based on interviews with product developers and our understanding of the evolution of their products, several methodological and practical issues remain. For now and the immediate future, health information vendors will continue to face the limitations of physicians' claims data. Vendors and purchasers should be aware of common data shortcomings such as inadequate monthly enrollment figures, possible physician upcoding to circumvent utilization management restrictions, and incorrect coding when a test is used to rule out a disease. In the longer term, several avenues seem likely to make medical groups' data better and richer because of computer-based medical records and efficiencies possible from the Internet. The field of benchmarking products for group practices is still an immature market. However, several trends suggest such products are highly desirable. Provider organizations which bear medical risk need benchmarking data to help improve their efficiency. There are many important nonprovider organizations that need good information on group practices' utilization patterns and outcomes to help them plan new products and negotiate with physicians.

  3. The future of practical skills in undergraduate medical education – an explorative Delphi-Study

    Science.gov (United States)

    Dannenberg, Katja Anne; Stroben, Fabian; Schröder, Therese; Thomas, Anke; Hautz, Wolf E.

    2016-01-01

    Background: 64% of young medical professionals in Germany do not feel adequately prepared for the practical requirements of the medical profession. The goal of “outcome-orientated training” is to structure medical curricula based on the skills needed when entering the workforce after completing undergraduate medical education, and thus to bridge the gap between the skills graduates have attained and those necessary for a career in the medical profession. Outcome frameworks (OFs) are used for this purpose. In preparation for developing the National Competence-Based Catalogue of Learning Objectives for Medicine (NKLM) – the German OF – the “Consensus Statement of Practical Skills in Undergraduate Medical Education” (which structures the teaching and acquisition of practical skills in Germany and which strongly influenced the “Clinical-Practical Skills” chapter of the NKLM) was published in 2011. It is not uncommon for at least a decade to elapse between the definition and implementation of an OF and the students’ graduation, which can further increase the gap between necessary and acquired skills. Thus, the purpose of this paper is to posit theses for future development in healthcare and to apply these theses to a current OF. Methodology: Partially structured interviews with experts were used to generate theses pertaining to general, future development in healthcare. These theses were assessed by physician experts based on the likelihood of implementation by the year 2025. The 288 learning goals of the consensus statement were assessed for their relevance for medical education in the interim. Results: 11 theses were generated for the development of medicine, and these theses were assessed and discussed by 738 experts. These theses include the increase in diseases associated with old age, the increasing significance of interprofessional cooperation, and the growing prevalence of telemedicine applications. Of the 288 learning goals of the consensus

  4. Do calculation errors by nurses cause medication errors in clinical practice? A literature review.

    Science.gov (United States)

    Wright, Kerri

    2010-01-01

    calculation skills. Of the 33 studies reviewed only five articles specifically recorded information relating to calculation errors and only two of these detected errors using the direct observational approach. The literature suggests that there are other more pressing aspects of nurses' preparation and administration of medications which are contributing to medication errors in practice that require more urgent attention and calls into question the current focus on calculation and numeracy skills of pre registration and qualified nurses (NMC 2008). However, more research is required into the calculation errors in practice. In particular there is a need for a direct observational study on paediatric nurses as there are presently none examining this area of practice.

  5. 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.

  6. [Quality assurance and quality improvement in medical practice. Part 1. Definition and importance of quality in medical practice].

    Science.gov (United States)

    Godény, Sándor

    2012-01-22

    In Hungary, financing of healthcare has decreased relative to the GDP, while the health status of the population is still ranks among the worst in the European Union. Since healthcare financing is not expected to increase, the number of practicing doctors per capita is continuously decreasing. In the coming years, it is an important question that in this situation what methods can be used to prevent further deterioration of the health status of the Hungarian population, and within this is the role of the quality approach, and different methods of quality management. In the present and the forthcoming two articles those standpoints will be summarized which support the need for the integration of quality assurance in the everyday medical practice. In the first part the importance of quality thinking, quality management, quality assurance, necessity of quality measurement and improvement, furthermore, advantages of the quality systems will be discussed.

  7. General Practice as a career choice among undergraduate medical students in Greece

    Directory of Open Access Journals (Sweden)

    Stefanadis Christodoulos

    2007-06-01

    Full Text Available Abstract Background Although General Practice (GP was recognized as a medical specialty in Greece in 1986, the number of GPs is insufficient to cover needs and only few medical graduates choose GP as a career option. In the present study we investigated the profile of medical students in terms of their decisions regarding specialization and the possible association of career choices different from GP with the status of undergraduate training regarding GP. Methods The sample consisted of final year students in the Medical School of the University of Athens, Greece. Students filled in a self-reported questionnaire focusing on medical specialization, and GP in particular. Results Response rate was 82.5% with 1021 questionnaires collected, out of 1237 eligible medical students. Only 44 out of the 1021 (4.3% respondents stated that GP is -or could be- among their choices for specialty. The most popular medical specialty was General Surgery (10.9%, followed by Cardiology (9.6%, Endocrinology (8.7% and Obstetrics-Gynaecology (8.3%. The most common criterion for choosing GP was the guaranteed employment on completion of the residency (54.6% while a 56.6% of total respondents were positive to the introduction of GP/FM as a curriculum course during University studies. Conclusion Despite the great needs, GP specialty is currently not a career option among undergraduate students of the greater Medical University in Greece and is still held in low esteem. A university department responsible for undergraduate teaching, promotion and research in GP (where not available is essential; the status of undergraduate training in general practice/family medicine seems to be one of the most important factors that influence physician career choices regarding primary care specialties.

  8. [Relevance of nutrition knowledge on clinical practice: medical opinion survey].

    Science.gov (United States)

    Alvares, Luísa; Moreira, Isabel; Oliveira, António

    2007-01-01

    Although previous studies show that physicians generally agree that nutrition knowledge is important for their daily clinical practice, several other studies report their poor knowledge of the subject. One of the strongest reasons given for this is the non-incorporation of Nutrition as a compulsory subject for the medical sciences degree. Dietary counselling and assessment of the patients' nutritional status don't seem to be systematic. The aim of this study is to asses how relevant physicians consider Nutrition to be in the successful running of a good practice. The study was undertaken at the general hospital of Vila Real/Peso da Régua (CHVR/PR) by distribution of a self- administered questionnaire to 153 of the physicians of the clinical body. Mean values were compared with the Student's t test and proportions with the Chi-square test. Of the 153 physicians, 108 replies were received (70,6%). Of these 108 replies, 53,3% consider nutrition knowledge important although 29,6% state their knowledge is poor. More than half say that Clinical Nutrition should be a compulsory subject of the Medical Sciences syllabus, and 99,1% deem it important to assess the patient's nutritional status. About 95% stated they provided written or verbal nutritional guidance, and most of the physicians had already sought the assistance of a nutritionist. This study shows that the clinical body of the CHVR/PR is aware of the importance nutrition knowledge has in their daily practice. It must be noted, though, that although almost one third of the physicians rate their nutrition knowledge poor, most of them provide nutritional guidance to their patients.

  9. Research Reproducibility in Geosciences: Current Landscape, Practices and Perspectives

    Science.gov (United States)

    Yan, An

    2016-04-01

    Reproducibility of research can gauge the validity of its findings. Yet currently we lack understanding of how much of a problem research reproducibility is in geosciences. We developed an online survey on faculty and graduate students in geosciences, and received 136 responses from research institutions and universities in Americas, Asia, Europe and other parts of the world. This survey examined (1) the current state of research reproducibility in geosciences by asking researchers' experiences with unsuccessful replication work, and what obstacles that lead to their replication failures; (2) the current reproducibility practices in community by asking what efforts researchers made to try to reproduce other's work and make their own work reproducible, and what the underlying factors that contribute to irreproducibility are; (3) the perspectives on reproducibility by collecting researcher's thoughts and opinions on this issue. The survey result indicated that nearly 80% of respondents who had ever reproduced a published study had failed at least one time in reproducing. Only one third of the respondents received helpful feedbacks when they contacted the authors of a published study for data, code, or other information. The primary factors that lead to unsuccessful replication attempts are insufficient details of instructions in published literature, and inaccessibility of data, code and tools needed in the study. Our findings suggest a remarkable lack of research reproducibility in geoscience. Changing the incentive mechanism in academia, as well as developing policies and tools that facilitate open data and code sharing are the promising ways for geosciences community to alleviate this reproducibility problem.

  10. Soil Quality Impacts of Current South American Agricultural Practices

    Directory of Open Access Journals (Sweden)

    Ana B. Wingeyer

    2015-02-01

    Full Text Available Increasing global demand for oil seeds and cereals during the past 50 years has caused an expansion in the cultivated areas and resulted in major soil management and crop production changes throughout Bolivia, Paraguay, Uruguay, Argentina and southern Brazil. Unprecedented adoption of no-tillage as well as improved soil fertility and plant genetics have increased yields, but the use of purchased inputs, monocropping i.e., continuous soybean (Glycine max (L. Merr., and marginal land cultivation have also increased. These changes have significantly altered the global food and feed supply role of these countries, but they have also resulted in various levels of soil degradation through wind and water erosion, soil compaction, soil organic matter (SOM depletion, and nutrient losses. Sustainability is dependent upon local interactions between soil, climate, landscape characteristics, and production systems. This review examines the region’s current soil and crop conditions and summarizes several research studies designed to reduce or prevent soil degradation. Although the region has both environmental and soil resources that can sustain current agricultural production levels, increasing population, greater urbanization, and more available income will continue to increase the pressure on South American croplands. A better understanding of regional soil differences and quantifying potential consequences of current production practices on various soil resources is needed to ensure that scientific, educational, and regulatory programs result in land management recommendations that support intensification of agriculture without additional soil degradation or other unintended environmental consequences.

  11. GEOGRAPHIC MEDICAL HISTORY: ADVANCES IN GEOSPATIAL TECHNOLOGY PRESENT NEW POTENTIALS IN MEDICAL PRACTICE

    Directory of Open Access Journals (Sweden)

    F. S. Faruque

    2016-06-01

    Full Text Available Genes, behaviour, and the environment are known to be the major risk factors for common diseases. When the patient visits a physician, typical questions include family history (genes and lifestyle of the patient (behaviour, but questions concerning environmental risk factors often remain unasked. It is ironic that 25 centuries ago Hippocrates, known as the father of medicine, noted the importance of environmental exposure in medical investigation as documented in his classic work, “Airs, Waters, Places”, yet the practice of routinely incorporating environmental risk factors is still not in place. Modern epigenetic studies have found that unhealthy lifestyle and environmental factors can cause changes to our genes that can increase disease risk factors. Therefore, attempting to solve the puzzle of diseases using heredity and lifestyle alone will be incomplete without accounting for the environmental exposures. The primary reason why environmental exposure has not yet been a routine part of the patient’s medical history is mostly due to our inability to provide clinicians useful measures of environmental exposures suitable for their clinical practices. This presentation will discuss advances in geospatial technology that show the potential to catalyse a paradigm shift in medical practice and health research by allowing environmental risk factors to be documented as the patient’s “Geographic Medical History”. In order to accomplish this we need information on: a relevant spatiotemporal environmental variables, and b location of the individual in that person’s dynamic environment. Common environmental agents that are known to interact with genetic make-up include air pollutants, mold spores, pesticides, etc. Until recently, the other component, location of an individual was limited to a static representation such as residential or workplace location. Now, with the development of mobile technology, changes in an individual’s location

  12. Geographic Medical History: Advances in Geospatial Technology Present New Potentials in Medical Practice

    Science.gov (United States)

    Faruque, F. S.; Finley, R. W.

    2016-06-01

    Genes, behaviour, and the environment are known to be the major risk factors for common diseases. When the patient visits a physician, typical questions include family history (genes) and lifestyle of the patient (behaviour), but questions concerning environmental risk factors often remain unasked. It is ironic that 25 centuries ago Hippocrates, known as the father of medicine, noted the importance of environmental exposure in medical investigation as documented in his classic work, "Airs, Waters, Places", yet the practice of routinely incorporating environmental risk factors is still not in place. Modern epigenetic studies have found that unhealthy lifestyle and environmental factors can cause changes to our genes that can increase disease risk factors. Therefore, attempting to solve the puzzle of diseases using heredity and lifestyle alone will be incomplete without accounting for the environmental exposures. The primary reason why environmental exposure has not yet been a routine part of the patient's medical history is mostly due to our inability to provide clinicians useful measures of environmental exposures suitable for their clinical practices. This presentation will discuss advances in geospatial technology that show the potential to catalyse a paradigm shift in medical practice and health research by allowing environmental risk factors to be documented as the patient's "Geographic Medical History". In order to accomplish this we need information on: a) relevant spatiotemporal environmental variables, and b) location of the individual in that person's dynamic environment. Common environmental agents that are known to interact with genetic make-up include air pollutants, mold spores, pesticides, etc. Until recently, the other component, location of an individual was limited to a static representation such as residential or workplace location. Now, with the development of mobile technology, changes in an individual's location can be tracked in real time if

  13. The peculiarities of medical discourse in medical practice of doctor-pathologist

    Directory of Open Access Journals (Sweden)

    Tatsenko N.V.

    2012-01-01

    Full Text Available The paper is devoted to the peculiarities of medical pathoanatomical discourseas coherent speech and as linguistic correlate of medical practice taking intoaccount the analysis of its strategies and tactics. The purpose of the paper is to provide a multifaceted analysis of the speech strategies and tactics of pathoanatomical discourse and ways of their implementation. The main strategies of the pathoanatomical variant of medical discourse are anticipating strategy, diagnosing strategy and explaining one. The supporting strategiesare pragmatic, interactive and rhetorical one. The pragmatic strategy is imple-mented through contact establishing tactics, the interactive one – with the help of control tactics, the rhetoric one – with the help of attention correction tactics. The above mentioned tactics and strategies are used in the distinguishing of major, closely interrelated strategies: "contact strategy" (to establish contact with patient’s relatives - phatic replicas of greeting and addressing and the "strategy of explanation"(used in the practice of pathologist for a detailed explanation of the reasons of patient's death. The ethic aspect of speech conduct of doctor-pathologist is analyzed.

  14. Integration of herbal medicine into modern medical practices: issues and prospects.

    Science.gov (United States)

    Fong, Harry H S

    2002-09-01

    The integration of herbal medicine into modern medical practices including cancer treatments must take into account the interrelated issues of quality, safety, and efficacy. Quality is the paramount issue because it can affect the efficacy and/or safety of the herbal products being used. Current product quality ranges from very high to very low due to intrinsic, extrinsic, and regulatory factors. Intrinsically, species differences, organ specificity, diurnal and seasonal variations can affect the qualitative and quantitative accumulation of active chemical constituents in the source medicinal plants. Extrinsically, environmental factors; field collection methods such as cultivation, harvest, post-harvest transport and storage; manufacturing practices; inadvertent contamination and substitution; and intentional adulteration are contributing factors to the quality of herbal medicinal products. Source plant materials that are contaminated with microbes, microbial toxins, environmental pollutants, or heavy metals; or finished products that are adulterated with foreign toxic plants or synthetic pharmaceutical agents can lead to adverse events. Substandard source materials or finished products will yield therapeutically less effective agents. Herbal medicine quality can also be attributed to regulatory practices. In a number of countries, herbal medicines are unregulated, which has led to product quality differences. Product quality improvement may be achieved by implementing control measures from the point of medicinal plant procurement under good agricultural practices (GAPs) and the manufacture of the finished botanical products under good manufacturing practices (GMPs), plus post-marketing quality assurance surveillance. The lack of pharmacological and clinical data on the majority of herbal medicinal products is a major impediment to the integration of herbal medicines into conventional medical practices. For valid integration, pharmacological and especially

  15. Assessing quality. As pressure mounts for clinics to deliver quality, medical practice blueprints and genograms serve as useful tools.

    Science.gov (United States)

    Rodie, A R; Pol, L G; Crabtree, B F; McIlvain, H E

    1999-01-01

    Increasingly, medical practices feel pressure to provide and communicate high quality patient care. Offering their insight on how a medical practice can improve quality, the authors describe the process of delivering medical care during patient encounters. Specifically, they present two methods that can be used to understand, evaluate, and improve interactions between patients and providers: medical practice blue prints and medical practice genograms.

  16. 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:…

  17. The emergence of thanatology and current practice in death education.

    Science.gov (United States)

    Fonseca, Luciana Mascarenhas; Testoni, Ines

    Thanatology is a recent field that contemplates death studies and employs an interdisciplinary approach to practice. This science emerged in a historical context marked by intense social, economic, and political changes that contributed to the concept of death being excluded from social life. This literature review aims to outline the history and evolution ofthanatology in Western society, delineating the contextual circumstances that led to its origin and drawing special attention to current works on death education. In our post-modern society, the call for studies in the field of thanatology appears to be increasing. However, although there have been significant contributions and promising research is underway, there are still many questions to be answered.

  18. Strength and conditioning in tennis: current research and practice.

    Science.gov (United States)

    Reid, Machar; Schneiker, Knut

    2008-06-01

    Virtually all professional tennis players are in continuous pursuit of enhanced performance. With the modern game becoming increasingly dynamic and tournament schedules no less demanding, the importance of physical fitness is well accepted. Indeed, most professional tennis players resource strength and conditioning specialists on a full- or part-time basis. As tennis play is characterised by intricate bio-energetics, planning specific strength and conditioning interventions represents a significant challenge for the specialist. Further, where game physiology and mechanics have been described extensively, critiques of the efficacy of different training initiatives are far less common. This review therefore considers the current scientific, tennis-specific fitness training evidence base in light of contemporary conditioning, and more particularly resistance training, practices.

  19. Typography and layout of technical reports - Survey of current practices

    Science.gov (United States)

    Pinelli, T. E.; Cordle, V. M.; Mccullough, R.

    1985-01-01

    As part of a review of the NASA Langley Research Center scientific and technical information program, 50 technical reports from industry, research institutions, and government agencies were systematically examined and analyzed to determine current usage and practice in regard to (1) typography, including composition method, type style, type size, and margin treatment; (2) graphic design, including layout and imposition of material on the page; and (3) physical media, including paper, ink, and binding methods. The results indicate that approximately 50 percent of the reports were typeset, 70 percent used Roman (serif) type, 80 percent used 10- or 11-point type for text, 60 percent used a ragged right-hand margin, slightly more than half used paragraph indentation, 75 percent used a single-column layout, 65 percent had one or more figures or tables placed perpendicular to (not aligned with) the text, and perfect binding was the most frequently used binding method.

  20. Preparation of intravenous cholesterol tracer using current good manufacturing practices.

    Science.gov (United States)

    Lin, Xiaobo; Ma, Lina; Racette, Susan B; Swaney, William P; Ostlund, Richard E

    2015-12-01

    Studies of human reverse cholesterol transport require intravenous infusion of cholesterol tracers. Because insoluble lipids may pose risk and because it is desirable to have consistent doses of defined composition available over many months, we investigated the manufacture of cholesterol tracer under current good manufacturing practice (CGMP) conditions appropriate for phase 1 investigation. Cholesterol tracer was prepared by sterile admixture of unlabeled cholesterol or cholesterol-d7 in ethanol with 20% Intralipid(®). The resulting material was filtered through a 1.2 micron particulate filter, stored at 4°C, and tested at time 0, 1.5, 3, 6, and 9 months for sterility, pyrogenicity, autoxidation, and particle size and aggregation. The limiting factor for stability was a rise in thiobarbituric acid-reacting substances of 9.6-fold over 9 months (P postproduction. CGMP manufacturing methods can be achieved in the academic setting and need to be considered for critical components of future metabolic studies.

  1. REVIEW OF CURRENT PRACTICE IN CHARACTERIZATION AND MONITORING

    Energy Technology Data Exchange (ETDEWEB)

    M.A.Ebadian, Ph.D.

    2001-01-01

    Characterization and monitoring are important parts of environmental remediation of contaminated sites by the Department of Energy--Office of Environmental Management (DOE-EM). The actual remediation process often cannot begin or even be planned until characterization is complete. Monitoring is essential to verify the progress of remediation and of the waste stream. However, some contaminated sites are difficult, costly, or have a high exposure risk to personnel to characterize or monitor using the baseline technology or current practice. Therefore, development of new characterization and monitoring technologies is time-critical to remediate these sites. The main task of the Characterization, Monitoring, and Sensor Technology Crosscutting Program (CMST-CP) is to develop and deploy innovative characterization and monitoring technologies that improve performance and reduce personnel exposure, cost, and detection limits. However, to evaluate different proposals for new technologies to decide which ones to develop or deploy, it is necessary to compare their cost and performance to the baseline technology. The goal of this project is to facilitate the direct comparison of new technologies to the baseline technology by documenting the current practices for site characterization and monitoring at DOE sites and by presenting the information in an easy-to-use, concise database. The database will assist the CMST-CP and others in evaluating or designing new technologies by identifying the baseline technologies and describing their performance and cost. The purpose of this document is to report on the completion of this project and to describe the database. Section 2.0 describes the data assessment methodology. Section 3.0 presents the database and serves as a user manual. Section 4.0 lists the references used for each baseline technology in the database. The full references can be found in the Appendix.

  2. Revisiting reflexology: Concept, evidence, current practice, and practitioner training.

    Science.gov (United States)

    Embong, Nurul Haswani; Soh, Yee Chang; Ming, Long Chiau; Wong, Tin Wui

    2015-10-01

    Reflexology is basically a study of how one part of the human body relates to another part of the body. Reflexology practitioners rely on the reflexes map of the feet and hands to all the internal organs and other human body parts. They believe that by applying the appropriate pressure and massage certain spots on the feet and hands, all other body parts could be energized and rejuvenated. This review aimed to revisit the concept of reflexology and examine its effectiveness, practices, and the training for reflexology practitioners. PubMed, SCOPUS, Google Scholar, and SpringerLink databases were utilized to search the following medical subject headings or keywords: foot massage, reflexology, foot reflexotherapy, reflexological treatment, and zone therapy. The articles published for the last 10 years were included. Previous systematic reviews failed to show concrete evidence for any specific effect of reflexology in any conditions. Due to its non-invasive, non-pharmacological complementary nature, reflexology is widely accepted and anecdotal evidence of positive effect reflexology in a variety of health conditions are available. Adequate training for practitioners is necessary to ensure the consistency of service provided.

  3. Revisiting reflexology: Concept, evidence, current practice, and practitioner training

    Directory of Open Access Journals (Sweden)

    Nurul Haswani Embong

    2015-10-01

    Full Text Available Reflexology is basically a study of how one part of the human body relates to another part of the body. Reflexology practitioners rely on the reflexes map of the feet and hands to all the internal organs and other human body parts. They believe that by applying the appropriate pressure and massage certain spots on the feet and hands, all other body parts could be energized and rejuvenated. This review aimed to revisit the concept of reflexology and examine its effectiveness, practices, and the training for reflexology practitioners. PubMed, SCOPUS, Google Scholar, and SpringerLink databases were utilized to search the following medical subject headings or keywords: foot massage, reflexology, foot reflexotherapy, reflexological treatment, and zone therapy. The articles published for the last 10 years were included. Previous systematic reviews failed to show concrete evidence for any specific effect of reflexology in any conditions. Due to its non-invasive, non-pharmacological complementary nature, reflexology is widely accepted and anecdotal evidence of positive effect reflexology in a variety of health conditions are available. Adequate training for practitioners is necessary to ensure the consistency of service provided.

  4. Current practices and improved recommendations for treating hereditary fructose intolerance.

    Science.gov (United States)

    Bell, L; Sherwood, W G

    1987-06-01

    A study of treatment practices of pediatric centers managing hereditary fructose intolerance and a review of recent literature on this subject were undertaken in an attempt to establish the degree of dietary liberalization allowable with age and the acceptability of foods containing trace amounts of fructose. The information was needed to plan optimal therapy and thus avoid the consequences of the disorder, namely intestinal dysfunction, metabolic imbalance, and hepatic and renal damage. Fifty responses to 113 letters to centers in Canada and the United States, as well as data from The Hospital for Sick Children, Toronto, Ontario, identified only 29 affected children and provided information on their care, including food lists and literature references. Major principles of treatment were similar, but the approach to allowing and quantifying dietary fructose differed. In response to the apparent need for standardization of treatment, the authors formulated improved recommendations for the control of dietary fructose (less than 1.5 gm/day). Only a few foods of vegetable origin are allowed, including a limited selection of vegetables and cereal products from grain endosperm. Repeated dietary counseling is advocated with regard to allowed foods, sweeteners, and medications to ensure long-term dietary compliance.

  5. 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.

  6. [Medical practices in the migration novels in Spain].

    Science.gov (United States)

    Rossini, Ilaria

    2013-01-01

    Starting from the analysis of three Spanish novels written by African authors emigrated in Spain, the article focuses on different medical practices adopted locally, in Africa and in Europe. El Metro, Más allá del mar de arena and Rebeldía give the different disease treatments imagine, showing, on the one hand, the official medicine, and on the other hand, the traditional medicine. In some cases, it is emphasized little contradictions, doubts, and anxieties often experienced by immigrants, even when they are faced with the type of treatment to be undertaken. One of the many mosaic pieces of the world is highlighted: in fact, habits and cultures are very different in a society where more and more people with different physical appearance, language, religion, and customs live understanding that what "belongs" to the other is not necessarily something "distant" and extraneous, but something that can enrich our cultural identity for our open-mindedness.

  7. 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

  8. Breast feeding practice among medical women in Nigeria

    Directory of Open Access Journals (Sweden)

    A E Sadoh

    2011-01-01

    Full Text Available Background : Health care workers are important in the promotion, protection and support of breast feeding. Their ability to do this may be influenced by their knowledge, personal experiences and work. Patients and Method: The breast feeding experience of 36 female medical doctors who had babies within the preceding two years and had resumed work was evaluated using a semi-structured self administered questionnaire. Result: All respondents knew that babies should be exclusively breast fed for the first six months of life but only 60% knew that breast feeding should continue until two years. The exclusive breast feeding rate for the studied doctors was 11.1%. Before their babies were six months old, about 75% of respondents had resumed work whilst over 50% had started taking calls. Most could not breast feed during working or call hours. Alternative feeds during working or call hours included expressed breast milk in 34.4% and infant formula in 21.9%. Feeding bottle was the major method (77.4% for feeding these alternatives. Work schedule was rearranged to allow breast feeding in only 27.3% of respondents. Conclusion: Failure to carry out exclusive breast feeding, the use of infant formula and feeding bottles (rather than cup feeding are practices that may be inimical to the practice of breast feeding in society in general. The suboptimal breast feeding experience in these doctors and the identified knowledge deficits may limit their effectiveness in promoting and supporting breast feeding among their patients and communities. Female medical personnel should be empowered to carry out optimal feeding of their own infants.

  9. SECOND LANGUAGE VOCABULARY ASSESSMENT: CURRENT PRACTICES AND NEW DIRECTIONS

    Directory of Open Access Journals (Sweden)

    John Read

    2007-12-01

    Full Text Available This paper surveys some current developments in second language vocabulary assessment, with particular attention to the ways in which computer corpora can provide better quality information about the frequency of words and how they are used in specific contexts. The relative merits of different word lists are discussed, including the Academic Word List and frequency lists derived from the British National Corpus. Word frequency data is needed for measures of vocabulary size, such as the Yes/No format, which is being developed and used for a variety of purposes. The paper also reviews work on testing depth of knowledge of vocabulary, where rather less progress has been made, both in defining depth as a construct and in developing tests for practical use. Another important perspective is the use of vocabulary within particular contexts of use or registers, and recent corpus research is extending our understanding of the lexical features of academic registers. This provides a basis for assessing learners’ ability to deploy their vocabulary knowledge effectively for functional communication in specific academic contexts. It is concluded that, while current tests of vocabulary knowledge are valuable for certain purposes, they need to be complemented by more contextualised measures of vocabulary use.

  10. [Medical practice in the thought of Thomas Aquinas].

    Science.gov (United States)

    Fagiolo, Enzo

    2007-01-01

    In the works of St. Thomas Aquinas there are many examples of medical practice, in the discussion of philosophical and theological questions. St. Thomas asserts that like the doctor causes the recovery of the patient, although it is the power of nature to perform, so does the teacher with his student; the teacher raises the knowledge in the student, even if it is the own reason to act. Like the patient can be recovered only by natural force or by this force with the help of the doctor, in the same way, knowledge can be achieved only through the natural reason of the student or with the help of the teacher. To define the relationship between the desired aim and the means to achieve it, St. Thomas suggests a fundamental principle of medical ethics. The doctor, which is minister of nature, if has no limit wishing the recovery of the patient, must have a measure in relation to the means used to obtain that goal. In fact, he must try to cure the patient in the best way he can, not using the "strongest" drug; in fact, the drug is not the aim but it is only one of the means to obtain health.

  11. 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.

  12. 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.

  13. Medical management of paediatric burn injuries: best practice.

    Science.gov (United States)

    Kim, Leo K P; Martin, Hugh C O; Holland, Andrew J A

    2012-04-01

    Burns commonly occur in children and their first aid remains inadequate despite burn prevention programmes. While scald injuries predominate, contact and flame burns remain common. Although typically less severe injuries overall than those in adults, hypertrophic scarring complicating both the burn wound and even donor sites occur more frequently in children. The heterogeneous nature of burn wounds, coupled with the difficulties associated with the early clinical assessment of burn depth, has stimulated the application of novel technologies to predict burn wound outcome. This review explores current best practice in the management of paediatric burns, with a focus on prevention, optimal first aid, resuscitation, burn wound prediction and wound management strategies.

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

    Science.gov (United States)

    Jones, Claire L

    2012-01-01

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

  15. Hand Washing Practices Among Emergency Medical Services Providers

    Directory of Open Access Journals (Sweden)

    Joshua Bucher

    2015-10-01

    Full Text Available Introduction: Hand hygiene is an important component of infection control efforts. Our primary and secondary goals were to determine the reported rates of hand washing and stethoscope cleaning in emergency medical services (EMS workers, respectively. Methods: We designed a survey about hand hygiene practices. The survey was distributed to various national EMS organizations through e-mail. Descriptive statistics were calculated for survey items (responses on a Likert scale and subpopulations of survey respondents to identify relationships between variables. We used analysis of variance to test differences in means between the subgroups. Results: There were 1,494 responses. Overall, reported hand hygiene practices were poor among pre-hospital providers in all clinical situations. Women reported that they washed their hands more frequently than men overall, although the differences were unlikely to be clinically significant. Hygiene after invasive procedures was reported to be poor. The presence of available hand sanitizer in the ambulance did not improve reported hygiene rates but improved reported rates of cleaning the stethoscope (absolute difference 0.4, p=0.0003. Providers who brought their own sanitizer were more likely to clean their hands. Conclusion: Reported hand hygiene is poor amongst pre-hospital providers. There is a need for future intervention to improve reported performance in pre-hospital provider hand washing.

  16. [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.

  17. The state of radiologic teaching practice in preclinical medical education: survey of American medical, osteopathic, and podiatric schools.

    Science.gov (United States)

    Rubin, Zachary; Blackham, Kristine

    2015-04-01

    This study describes the state of preclinical radiology curricula in North American allopathic, osteopathic, and podiatric medical schools. An online survey of teaching methods, radiology topics, and future plans was developed. The Associations of American Medical Colleges, Colleges of Osteopathic Medicine, and Colleges of Podiatric Medicine listing for all US, Canadian, and Puerto Rican schools was used for contact information for directors of anatomy and/or radiology courses. Letters were sent via e-mail to 198 schools, with a link to the anonymous survey. Of 198 schools, 98 completed the survey (48%). Radiology curricula were integrated with other topics (91%), and taught by anatomists (42%) and radiologists (43%). The majority of time was spent on the topic of anatomy correlation (35%). Time spent teaching general radiology topics in the curriculum, such as physics (3%), modality differences (6%), radiation safety (2%), and contrast use (2%) was limited. Most schools had plans to implement an innovative teaching method in the near future (62%). The major challenges included limits on: time in the curriculum (73%); resources (32%); and radiology faculty participation (30%). A total of 82% reported that their curriculum did not model the suggestions made by the Alliance of Medical Student Educators in Radiology. This survey describes the current state of preclinical radiology teaching: curricula were nonstandard, integrated into other courses, and predominantly used for anatomy correlation. Other important contextual principles of the practice of radiology were seldom taught. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  18. [A study of pharmacists' consciousness toward separation of medical practice from pharmaceutical dispensing].

    Science.gov (United States)

    Akaho, Eiichi; Uchinashi, Masako; Tsurusawa, Akiko; Tominaga, Junko; Hayashi, Shinichi

    2003-03-01

    Separation of medical practice from pharmaceutical dispensing had been a system with just the notation without the reality even after Showa era, although its concept was brought into Japan along with European medicine in Meiji era. Since 1970's, its concept has been prevailing gradually, and the so-called separation rate currently has reached to 47 percent. Increasingly keen attention has been paid recently by the public toward medicine in general. Taking into consideration these facts, a questionnaire survey was conducted for dispensing pharmacists in order to find out where pharmacists stand at present. Most of pharmacists (98.3%) answered that they practice patient counseling either by documents or by verbal communication, and that they take patient profiles. They said that patients could enjoy a proper medical treatment (32.9%) as well as a rational prescribing (14.3%). For a question asking what pharmacists should do to promote the separation of medical practice from pharmaceutical dispensing, 40.3% of them answered that they should make progress in their knowledge on drug therapy.

  19. Medizinbibliotheken: Innovativ denken, strategisch planen, praktisch umsetzen / Medical libraries: think innovative, plan strategically, implement in practice

    Directory of Open Access Journals (Sweden)

    Bauer, Bruno

    2011-12-01

    Full Text Available The focus of the current issue 3/2011 of GMS Medizin – Bibliothek – Information is the annual conference 2011 of the German Medical Libraries Association in Cologne. The motto of the conference was “Think innovative, plan strategically, implement in practice”. Focal points of the meeting were innovation management, marketing and new applications in medical libraries.The authors in this issue are Bruno Bauer, Daniel Formanek & Helmut Dollfuß (E-Books at medical libraries: They came to stay, Ursula Georgy (Systematic innovation management, Maurizio Grilli (New library portal at Province College for Health-Care Professions Claudiana, Bozen, Sabine Köhrer-Weisser (Marketing in One Person Libraries, Roland Mumenthaler (Innovation Management at ETH-Bibliothek, Markus Schmiel (Performance-related bonuses at Hannover Medical School: practical experience report of the library, Guus van den Brekel (Mobile Computing & Semantic Web in Health & Medicine, Iris Reimann & Sonja Fräntz (Think innovative, plan strategically, implement in practice – Annual Meeting 2011 of the German MLA, 19th to 21th September in Cologne and Eike Hentschel (Aus der AGMB.

  20. 75 FR 33629 - Developing Guidance on Naming, Labeling, and Packaging Practices to Reduce Medication Errors...

    Science.gov (United States)

    2010-06-14

    ... Practices to Reduce Medication Errors; Public Workshop; Change of Meeting Location AGENCY: Food and Drug... Practices to Reduce Medication Errors.'' A new address is given for those attending the workshop. DATES: The... on describing practices for naming, labeling, and packaging drugs and biologics to reduce...

  1. 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.

  2. Amyloid Imaging: Poised for Integration into Medical Practice.

    Science.gov (United States)

    Anand, Keshav; Sabbagh, Marwan

    2017-01-01

    Amyloid imaging represents a significant advance as an adjunct in the diagnosis of Alzheimer's disease (AD) because it is the first imaging modality that identifies in vivo changes known to be associated with the pathogenesis. Initially, (11)C-PIB was developed, which was the prototype for many (18)F compounds, including florbetapir, florbetaben, and flutemetamol, among others. Despite the high sensitivity and specificity of amyloid imaging, it is not commonly used in clinical practice, mainly because it is not reimbursed under current Center for Medicare and Medicaid Services guidelines in the USA. To guide the field in who would be most appropriate for the utility of amyloid positron emission tomography, current studies are underway [Imaging Dementia Evidence for Amyloid Scanning (IDEAS) Study] that will inform the field on the utilization of amyloid positron emission tomography in clinical practice. With the advent of monoclonal antibodies that specifically target amyloid antibody, there is an interest, possibly a mandate, to screen potential treatment recipients to ensure that they are suitable for treatment. In this review, we summarize progress in the field to date.

  3. The role of community pharmacy-based vaccination in the USA: current practice and future directions

    Directory of Open Access Journals (Sweden)

    Bach AT

    2015-07-01

    Full Text Available Albert T Bach, Jeffery A Goad School of Pharmacy, Chapman University, Irvine, California, USA Abstract: Community pharmacy-based provision of immunizations in the USA has become commonplace in the last few decades, with success in increasing rates of immunizations. Community pharmacy-based vaccination services are provided by pharmacists educated in the practice of immunization delivery and provide a convenient and accessible option for receiving immunizations. The pharmacist's role in immunization practice has been described as serving in the roles of educator, facilitator, and immunizer. With a majority of pharmacist-provided vaccinations occurring in the community pharmacy setting, there are many examples of community pharmacists serving in these immunization roles with successful outcomes. Different community pharmacies employ a number of different models and workflow practices that usually consist of a year-round in-house service staffed by their own immunizing pharmacist. Challenges that currently exist in this setting are variability in scopes of immunization practice for pharmacists across states, inconsistent reimbursement mechanisms, and barriers in technology. Many of these challenges can be alleviated by continual education; working with legislators, state boards of pharmacy, stakeholders, and payers to standardize laws; and reimbursement design. Other challenges that may need to be addressed are improvements in communication and continuity of care between community pharmacists and the patient centered medical home. Keywords: immunization, pharmacy practice, pharmacists, continuity of care 

  4. The Development of Perioperative Practices for Liver Transplantation: Advances and Current Trends

    Directory of Open Access Journals (Sweden)

    Merceds Susan Mandell

    2008-09-01

    Full Text Available Transplantation is a young medical specialty that has grown rapidly over the past 50 years. Anesthesiologists, surgeons and hepatologists are all essential partners in the process of determining patient outcome. Each specialty has made landmark improvements in patient outcome. However, there is still variability in practice patterns in each of the 3 major specialties. This review will use a historic perspective to explore the unique forces that shaped specific transplant practices and those that gave rise to differences in perioperative practices. Anesthesiologists and surgeons have made significant improvements in the management of blood loss, and coagulation monitoring and intervention. This has improved operative survival and early patient outcome. Perioperative survival has improved despite a worldwide shortage of donor organs and a trend to transplant sicker patients. A smaller pool of donor organs is required to meet the needs of an expanding waiting list. The innovations to reduce deaths on the transplant wait list are reviewed along with their impact on overall patient outcome. The evolving organ shortage is the pinnacle point in shaping future transplant practices. Currently, institutional-specific practices may be reinforced by the informal “tutorship” that is used to train physicians and by the resources available at each site of practice. However, there is evidence that specific intraoperative practices such as the use of a low central venous pressure, selection of vasopressors and certain surgical techniques can modify patient outcome. Further investigation is needed to determine whether the good or the bad associated with each practice prevails and in what unique circumstance.

  5. Is dosimetry still a necessity in current dental practice?

    Science.gov (United States)

    Reddy, S S; Rakesh, N; Chauhan, Pallavi; Clint, Joseph Ben; Sharma, Shivani

    2015-12-01

    Today, dentists have a wide range of imaging modalities to choose from, the film based techniques, digital techniques, and the recent introduction of 3D volumetric or cone beam computed tomography (CBCT). The inherent design features of the new generation dental x-ray equipment has significantly improved over the years with no evidence of substandard x-ray units in operation. In dental facilities radiological workload is comparatively low, newer radiation equipments and accessories follow safety guidelines and employ better radiation protection measures for the patient and the operator. Dentists' knowledge and expertise in radiation protection measures is good, enabling them to carry out riskfree radiation procedures in their practice. Therefore, the present study is aimed at assessing the need for dosimeters in current dental scenario. 'Is there currently a significant risk from dental radiography to merit the use of personal dosimetery in dental practice. 'Dental health professionals (Oral radiologists) and radiographic assistants of fourteen dental colleges in Karnataka state participated in this questionnaire study. The questionnaire consisted of the following questions--the make, type, year of manufacture of radiographic machines used in their setup, number of radiographs made per day in the institution, type of receptors used, number of personnel at risk for radiation exposure, radiation protection measures used, regular monitoring by personal dosimeters, equivalent dosage readings for the past 12 months and whether the reading of thermoluminescent dosimeters (TLD) for any personnel had exceeded the recommended exposure value in the last 3 years. Dosimetry records of the radiology staff in the last three years shows doses no more than 1.50 mSv per year. The various institutions' dose (person mSv) was in the range of 3.70 mSv-3.90 mSv. Personal monitoring for Dentists can be omitted in the dental colleges since the estimated dose of oral radiologists

  6. 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.

  7. 75 FR 78715 - Small Entity Compliance Guide: Current Good Manufacturing Practice in Manufacturing, Packaging...

    Science.gov (United States)

    2010-12-16

    ... HUMAN SERVICES Food and Drug Administration Small Entity Compliance Guide: Current Good Manufacturing Practice in Manufacturing, Packaging, Labeling, or Holding Operations for Dietary Supplements; Availability...) is announcing the availability of a guidance entitled ``Current Good Manufacturing Practice in...

  8. Cancer pain management in China: current status and practice implications based on the ACHEON survey.

    Science.gov (United States)

    Xia, Zhongjun

    2017-01-01

    Cancer pain can seriously impact the quality of life (QoL) of patients, and optimal management practices are therefore of paramount importance. The ACHEON survey queried physicians and patients from 10 Asian countries/regions to assess current clinical practices in cancer pain management in Asia. This study presents the data obtained for cancer pain management in mainland China, with an emphasis on practices related to opioid drugs. In several tertiary hospitals across China, 250 patients experiencing cancer pain and 100 physicians were surveyed on questions designed to assess current cancer pain management practices and cancer pain impact on QoL. The patient survey showed that 88% of patients reported moderate-to-severe cancer pain, with a median duration of 6 months. The physician survey showed that medical school/residency training with regard to cancer pain management was inadequate in ~80% of physicians. A total of 80% of physicians and 67.2% of patients reported that pain scale was used during pain assessment; 84% of physicians expressed that physician-perceived pain severity was not completely consistent with actual pain the patient experienced. Of the 147 patients who recalled the medication received, 83.7% were administered opioid prescriptions. Of the 240 patients who received treatment, 43.8% perceived the inadequacy of controlling pain. The primary barriers from physicians perceived to optimal pain management included patients' fear of side effects (58%), patients' fear of addiction (53%), patients' reluctance to report pain (43%), physicians' reluctance to prescribe (29%), physicians' inadequacy of pain assessment (27%) and excessive regulation of opioid analgesics (47%). Knowledge of cancer pain management should be strengthened among physicians. Quantitative pain assessment and principle-based pain management should be combined to achieve pain relief. Misconceptions about opioids in patients and physicians and poor report about pain should be

  9. Practical pathology perspectives for minimally invasive hyperthermic medical devices

    Science.gov (United States)

    Coad, James E.

    2011-03-01

    Currently, hyperthermic-based minimally invasive medical devices are available for the treatment of dysfunctional and neoplastic tissues in a variety of organ systems. These therapies employ a spectrum of modalities for delivering heat energy to the targeted tissue, including radiofrequency/microwave, high intensity focused ultrasound, conductive/convective sources and others. While differences in energy transfer and organ systems exist, hyperthermic treatment sites show a spectrum of changes that intimately correlate with the thermal history generated in the tissue (temperature-time dependence). As a result, these hyperthermic medical technologies can be viewed using a "gradient" approach. First, the thermal applications themselves can be globally categorized along a high-dose ablation to low-dose ablation to lowdose non-ablative rejuvenating slope. Second, the resultant tissue changes can be viewed along a decreasing thermal dose gradient from thermally/heat-fixed tissue necrosis to coagulative tissue necrosis to partial tissue necrosis (transition zone) to subtle non-necrotizing tissue changes. Finally, a gradient of cellular and structural protein denaturation is present, especially within the transition zone and adjacent viable tissue region. A hyperthermic treatment's location along these gradients depends more on the overall thermal history it generates than the amount of energy it deposits into the tissue. The features of these gradients are highlighted to provide a better understanding of hyperthermic device associated tissue changes and their associated healing responses.

  10. 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.

  11. [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.

  12. Ethics and the comprehensive application of epistemology in medical practice.

    Science.gov (United States)

    Phaosavasdi, Sukhit; Taneepanichskul, Surasak; Tannirandorn, Yuen; Uerpairojkit, Boonchai; Thamkhantho, Manopchai; Pruksapong, Chumsak; Kanjanapitak, Aurchart; Phupong, Vorapong

    2005-12-01

    Our simple definition of ethics is good thought, speak and action. Epistemology means the hypothesis of facts about thought, speech and action. Medical practice is all means of medicine. Medicine classifies people into normal and abnormal. The abnormal are the sick. They loose some organs or those normal looking organs are dysfunctional. They are social problems, some can be treated, and some do not get the appropriate care. The problems of society of normal people are overeating and obesity, abortion, drug abuse, promiscuity, torture, terrorism, disobeying rules and order, corruption, brain-washing and unethical advertisements, etc. On the other hand, the social problems of the abnormal are down, deafness, blindness, dumb, hypertension, hypercholesterolemia, diabetes mellitus and cancer, etc. An example of the social-doctor problem is the mal distribution of doctors in rural areas. It was reported by the ministry of public health that the ratio of doctor to population to be 1:800 in Bangkok and 1:5, 700 in some rural areas in the north eastern part of Thailand. The doctors, themselves, are at a high grade of worker and intelligent quotient. They know all the problem and, at the same time, create problems, both, faster than the general population can do. It affects good and bad in the society. In the past, present and the foreseeable future the medical students get their studies in the western style. Their medical schools are situated in big cities. These schools are old and famous. They learn their medical procedure in a big hospital of more than 400 beds in the inpatient department wards. Their instructors and professors are highly qualified, are middle class people and well accepted in the society. Their families are lovely and warm. Their children study in the first class schools in town. The medical students feel very happy and appreciate seeing their professors in television routinely at prime time. In conclusion, their professors are an example of role model

  13. How to improve the performance of a good medical practice team: twelve techniques.

    Science.gov (United States)

    Hills, Laura

    2013-01-01

    It is incredibly easy to ignore the medical practice team that is doing a good job. However, when we allow good performers to continue as they are, they probably won't improve. Their performance may even worsen. This is unfortunate because with a little bit of effort and support, good performers can often learn to excel. This article offers 12 techniques medical practice managers can use to bring their team members from good performance to excellent. It describes how to use goal-setting, work assignments, modeling, confidence building, team retreats, rewards, incentives, and reinforcement to ratchet up a good medical practice team's performance. This article also identifies the signs of medical employee mediocrity. It describes why setting higher expectations of your medical practice employees will ultimately improve their performance. Finally, this article suggests 10 practical and affordable strategies that medical practice managers can use to reinforce excellent performance in their good employees.

  14. Current Practices in Global/International Advanced Pharmacy Practice Experiences: Home/Host Country or Site/Institution Considerations

    National Research Council Canada - National Science Library

    Naser Z Alsharif; Adnan Dakkuri; Jeanine P Abrons; Dennis Williams; David N Ombengi; HaiAn Zheng; Sara Al-Dahir; Toyin Tofade; Suzanna Gim; Mary Beth O'Connell; Anna Ratka; Emily Dornblaser

    2016-01-01

      International outreach by schools and colleges of pharmacy is increasing. In this paper, we provide current practice guidelines to establish and maintain successful global/international advanced pharmacy practice experiences (G/I APPEs...

  15. Evaluation of self-medication practices in acute diseases among university students in Oman

    Directory of Open Access Journals (Sweden)

    Marwa Al Flaiti

    2014-01-01

    Conclusion: The prevalence of self-medication among university students was very high. There is a need for intensive education and comprehensive awareness campaign to advocate for reduction in the prevalence of self-medication practices among students.

  16. A prospective study on medication and total parenteral nutrition practices at a Neonatal Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Vijayakumar Arumugam

    2016-01-01

    Conclusion: TPN and medication practices at the NICU should be highly monitored for avoiding medication errors, drug interactions, and mortality rate in neonates. The most effective method can be achieved when a clinical pharmacist become a part of it.

  17. 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.

  18. Gender relations and health research: a review of current practices

    Directory of Open Access Journals (Sweden)

    Bottorff Joan L

    2011-12-01

    Full Text Available Abstract Introduction The importance of gender in understanding health practices and illness experiences is increasingly recognized, and key to this work is a better understanding of the application of gender relations. The influence of masculinities and femininities, and the interplay within and between them manifests within relations and interactions among couples, family members and peers to influence health behaviours and outcomes. Methods To explore how conceptualizations of gender relations have been integrated in health research a scoping review of the existing literature was conducted. The key terms gender relations, gender interactions, relations gender, partner communication, femininities and masculinities were used to search online databases. Results Through analysis of this literature we identified two main ways gender relations were integrated in health research: a as emergent findings; and b as a basis for research design. In the latter, gender relations are included in conceptual frameworks, guide data collection and are used to direct data analysis. Conclusions Current uses of gender relations are typically positioned within intimate heterosexual couples whereby single narratives (i.e., either men or women are used to explore the influence and/or impact of intimate partner gender relations on health and illness issues. Recommendations for advancing gender relations and health research are discussed. This research has the potential to reduce gender inequities in health.

  19. Current safety practices in nano-research laboratories in China.

    Science.gov (United States)

    Zhang, Can; Zhang, Jing; Wang, Guoyu

    2014-06-01

    China has become a key player in the global nanotechnology field, however, no surveys have specifically examined safety practices in the Chinese nano-laboratories in depth. This study reports results of a survey of 300 professionals who work in research laboratories that handle nanomaterials in China. We recruited participants at three major nano-research laboratories (which carry out research in diverse fields such as chemistry, material science, and biology) and the nano-chemistry session of the national meeting of the Chinese Chemical Society. Results show that almost all nano-research laboratories surveyed had general safety regulations, whereas less than one third of respondents reported having nanospecific safety rules. General safety measures were in place in most surveyed nano-research laboratories, while nanospecific protective measures existed or were implemented less frequently. Several factors reported from the scientific literature including nanotoxicology knowledge gaps, technical limitations on estimating nano-exposure, and the lack of nano-occupational safety legislation may contribute to the current state of affairs. With these factors in mind and embracing the precautionary principle, we suggest strengthening or providing nanosafety training (including raising risk awareness) and establishing nanosafety guidelines in China, to better protect personnel in the nano-workplace.

  20. Current Continuing Professional Education Practice among Malaysian Nurses

    Directory of Open Access Journals (Sweden)

    Mei Chan Chong

    2014-01-01

    Full Text Available Nurses need to participate in CPE to update their knowledge and increase their competencies. This research was carried out to explore their current practice and the future general needs for CPE. This cross-sectional descriptive study involved registered nurses from government hospitals and health clinics from Peninsular Malaysia. Multistage cluster sampling was used to recruit 1000 nurses from four states of Malaysia. Self-explanatory questionnaires were used to collect the data, which were analyzed using SPSS version 16. Seven hundred and ninety-two nurses participated in this survey. Only 80% (562 of the nurses had engaged in CPE activities during the past 12 months. All attendance for the various activities was below 50%. Workshops were the most popular CPE activity (345, 43.6% and tertiary education was the most unpopular activity (10, 1.3%. The respondents did perceive the importance of future CPE activities for career development. Mandatory continuing professional education (MCPE is a key measure to ensure that nurses upgrade their knowledge and skills; however, it is recommended that policy makers and nurse leaders in the continuing professional development unit of health service facilities plan CPE activities to meet registered nurses’ (RNs needs and not simply organizational requirements.

  1. Current UK practices in the management of subacromial impingement

    Science.gov (United States)

    Drury, Colin; Tait, Gavin R

    2015-01-01

    Background Controversy presently exists surrounding the management of patients with subacromial impingement. This study aims to highlight current UK practices in the management of these patients. Methods BESS members were invited to complete a questionnaire and responses were received from 157 consultant shoulder surgeons. Results Physiotherapy is an integral part of management for 93% of surgeons with a minimum period of 12 weeks being most popular prior to consideration of arthroscopic subacromial decompression. Subacromial steroid injection is used by 95% and 86% repeat this if the patient has failed to respond to a previous injection by the general practioner. From initial presentation, 77% felt there should be at least 3 months of conservative management before proceeding to surgery. Good but transient response to subacromial injection was considered the best predictor of good surgical outcome by 77%. The coracoacromial ligament is fully released by 78%, although there was greater variation in how aggressive surgeons were with acromioplasty. Most (59%) do not include the nontender acromioclavicular joint to any extent in routine acromioplasty. Hospital physiotherapy protocols are used by 63% for postoperative rehabilitation. Conclusions Variation exists in the management regimes offered to patients with subacromial impingement, but most employ a minimum period of 12 weeks of conservative management incorporating physiotherapy and at least 2 subacromial steriod injections. PMID:27582972

  2. Computational structures technology at Grumman: Current practice/future needs

    Science.gov (United States)

    Pifko, Allan B.; Eidinoff, Harvey

    1992-05-01

    The current practice for the design analysis of new airframe structural systems is to construct a master finite element model of the vehicle in order to develop internal load distributions. The inputs to this model include the geometry which is taken directly from CADAM and CATIA structural layout and aerodynamic loads and mass distribution computer models. This master model is sufficiently detailed to define major load paths and for the computation of dynamic mode shapes and structural frequencies, but not detailed enough to define local stress gradients and notch stresses. This master model is then used to perform structural optimization studies that will provide minimum weights for major structural members. The post-processed output from the master model, load, stress, and strain analysis is then used by structural analysts to perform detailed stress analysis of local regions in order to design local structure with all its required details. This local analysis consists of hand stress analysis and life prediction analysis with the assistance of manuals, design charts, computer stress and structural life analysis and sometimes finite element or boundary element analysis. The resulting design is verified by fatigue tests.

  3. Current Continuing Professional Education Practice among Malaysian Nurses.

    Science.gov (United States)

    Chong, Mei Chan; Francis, Karen; Cooper, Simon; Abdullah, Khatijah Lim

    2014-01-01

    Nurses need to participate in CPE to update their knowledge and increase their competencies. This research was carried out to explore their current practice and the future general needs for CPE. This cross-sectional descriptive study involved registered nurses from government hospitals and health clinics from Peninsular Malaysia. Multistage cluster sampling was used to recruit 1000 nurses from four states of Malaysia. Self-explanatory questionnaires were used to collect the data, which were analyzed using SPSS version 16. Seven hundred and ninety-two nurses participated in this survey. Only 80% (562) of the nurses had engaged in CPE activities during the past 12 months. All attendance for the various activities was below 50%. Workshops were the most popular CPE activity (345, 43.6%) and tertiary education was the most unpopular activity (10, 1.3%). The respondents did perceive the importance of future CPE activities for career development. Mandatory continuing professional education (MCPE) is a key measure to ensure that nurses upgrade their knowledge and skills; however, it is recommended that policy makers and nurse leaders in the continuing professional development unit of health service facilities plan CPE activities to meet registered nurses' (RNs) needs and not simply organizational requirements.

  4. Cytokine release assays: current practices and future directions.

    Science.gov (United States)

    Finco, D; Grimaldi, C; Fort, M; Walker, M; Kiessling, A; Wolf, B; Salcedo, T; Faggioni, R; Schneider, A; Ibraghimov, A; Scesney, S; Serna, D; Prell, R; Stebbings, R; Narayanan, P K

    2014-04-01

    As a result of the CD28 superagonist biotherapeutic monoclonal antibody (TGN 1412) "cytokine storm" incident, cytokine release assays (CRA) have become hazard identification and prospective risk assessment tools for screening novel biotherapeutics directed against targets having a potential risk for eliciting adverse pro-inflammatory clinical infusion reactions. Different laboratories may have different strategies, assay formats, and approaches to the reporting, interpretation, and use of data for either decision making or risk assessment. Additionally, many independent contract research organizations (CROs), academic and government laboratories are involved in some aspect of CRA work. As a result, while some pharmaceutical companies are providing CRA data as part of the regulatory submissions when necessary, technical and regulatory practices are still evolving to provide data predictive of cytokine release in humans and that are relevant to safety. This manuscript provides an overview of different approaches employed by the pharmaceutical industry and CROs, for the use and application of CRA based upon a survey and post survey follow up conducted by ILSI-Health and Environmental Sciences Institute (HESI) Immunotoxicology Committee CRA Working Group. Also discussed is ongoing research in the academic sector, the regulatory environment, current limitations of the assays, and future directions and recommendations for cytokine release assays.

  5. NanoSIMS for Biological Applications: Current Practices and Analyses

    Energy Technology Data Exchange (ETDEWEB)

    Dunn, Jamie R.; Renslow, Ryan S.; Cliff, John B.; Anderton, Christopher R.

    2017-09-27

    Secondary ion mass spectrometry (SIMS) has become an increasingly utilized tool in biologically-relevant studies. Of these, high lateral resolution methodologies using the NanoSIMS 50/50L have been especially powerful within many biological fields over the past decade. Here, we provide a review of this technology, sample preparation and analysis considerations, examples of recent biological studies, data analysis, and current outlooks. Specifically, we offer an overview of SIMS and development of the NanoSIMS. We describe the major experimental factors that should be considered prior to NanoSIMS analysis and then provide information on best practices for data analysis and image generation, which includes an in-depth discussion of appropriate colormaps. Additionally, we provide an open-source method for data representation that allows simultaneous visualization of secondary electron and ion information within a single image. Finally, we present a perspective on the future of this technology and where we think it will have the greatest impact in near future.

  6. Postoperative delirium in elderly citizens and current practice

    Directory of Open Access Journals (Sweden)

    Siddareddygari Velayudha Reddy

    2017-01-01

    Full Text Available Postoperative delirium (POD represents an acute brain dysfunction in the postsurgical period. Perioperative physicians caring for the older adults are familiar with the care of dysfunction of organs such as lungs, heart, liver, or kidney in the perioperative setting, but they are less familiar with management of brain dysfunction. As early detection and prompt treatment of inciting factors are utmost important to prevent or minimize the deleterious outcomes of delirium. The purpose of this review is to prepare perioperative physicians with a set of current clinical practice recommendations to provide optimal perioperative care of older adults, with a special focus on specific perioperative interventions that have been shown to prevent POD. On literature search in EMBASE, CINAHL, and PUBMED between January 2000 and September 2015 using search words delirium, POD, acute postoperative confusion, and brain dysfunction resulted in 9710 articles. Among them, 73 articles were chosen for review, in addition, National Institute for Health and Clinical Excellence guidelines, American Geriatric Society guidelines, hospital elderly life program-confusion assessment method training manual, New York geriatric nursing protocols, World Health Organization's International Classification of Diseases, 10th Revision classification of mental disorders, Food and Drug Administration requests boxed warnings on older class of antipsychotic drugs 2008 and delirium in Miller's text book of anesthesia were reviewed and relevant information presented in this article.

  7. Targeted temperature management: Current evidence and practices in critical care

    Directory of Open Access Journals (Sweden)

    Saurabh Saigal

    2015-01-01

    Full Text Available Targeted temperature management (TTM in today′s modern era, especially in intensive care units represents a promising multifaceted therapy for a variety of conditions. Though hypothermia is being used since Hippocratic era, the renewed interest of late has been since early 21 st century. There have been multiple advancements in this field and varieties of cooling devices are available at present. TTM requires careful titration of its depth, duration and rewarming as it is associated with side-effects. The purpose of this review is to find out the best evidence-based clinical practice criteria of therapeutic hypothermia in critical care settings. TTM is an unique therapeutic modality for salvaging neurological tissue viability in critically ill patients viz. Post-cardiac arrest, traumatic brain injury (TBI, meningitis, acute liver failure and stroke. TTM is standard of care in post-cardiac arrest situations; there has been a lot of controversy of late regarding temperature ranges to be used for the same. In patients with TBI, it reduces intracranial pressure, but has not shown any favorable neurologic outcome. Hypothermia is generally accepted treatment for hypoxic ischemic encephalopathy in newborns. The current available technology to induce and maintain hypothermia allows for precise temperature control. Future studies should focus on optimizing hypothermic treatment to full benefit of our patients and its application in other clinical scenarios.

  8. Current practice of therapeutic drug monitoring of biopharmaceuticals in spondyloarthritis.

    Science.gov (United States)

    Medina, Frédéric; Placensia, Chamaida; Goupille, Philippe; Paintaud, Gilles; Balsa, Alejandro; Mulleman, Denis

    2017-04-04

    Treatment of spondyloarthritis (SpA) has greatly improved in the biopharmaceutical era. These compounds, primarily tumor necrosis factor (TNF) inhibitors, are effective, but some patients may show poor response, sometimes due to the presence of anti-drug antibodies (ADAs). In some instances, clinicians may increase or taper the dose, depending on the clinical response. Besides the current clinical practice, a tailored strategy based on drug monitoring is emerging as a way to improve the use of these drugs. However, the relevance of this therapeutic drug monitoring (TDM) of biopharmaceuticals for SpA is still unknown. In this literature review, we examined the most relevant articles dealing with the concentration-response relation, ADA detection, and pharmacokinetics in SpA treated with biopharmaceuticals. ADAs were associated with low or undetectable concentration of monoclonal antibodies. The relation between drug concentration and clinical response in SpA is debated, some studies showing an association and others not. Therefore, TDM of biopharmaceuticals for SpA requires a better understanding of the association among the pharmacokinetics, pharmacodynamics, and immunogenicity of these drugs.

  9. Life cycle assessment part 2: current impact assessment practice.

    Science.gov (United States)

    Pennington, D W; Potting, J; Finnveden, G; Lindeijer, E; Jolliet, O; Rydberg, T; Rebitzer, G

    2004-07-01

    Providing our society with goods and services contributes to a wide range of environmental impacts. Waste generation, emissions and the consumption of resources occur at many stages in a product's life cycle-from raw material extraction, energy acquisition, production and manufacturing, use, reuse, recycling, through to ultimate disposal. These all contribute to impacts such as climate change, stratospheric ozone depletion, photooxidant formation (smog), eutrophication, acidification, toxicological stress on human health and ecosystems, the depletion of resources and noise-among others. The need exists to address these product-related contributions more holistically and in an integrated manner, providing complimentary insights to those of regulatory/process-oriented methodologies. A previous article (Part 1, Rebitzer et al., 2004) outlined how to define and model a product's life cycle in current practice, as well as the methods and tools that are available for compiling the associated waste, emissions and resource consumption data into a life cycle inventory. This article highlights how practitioners and researchers from many domains have come together to provide indicators for the different impacts attributable to products in the life cycle impact assessment (LCIA) phase of life cycle assessment (LCA).

  10. Personalised Medical Reference to General Practice Notebook (GPnotebook - an evolutionary tale

    Directory of Open Access Journals (Sweden)

    James McMorran

    2002-09-01

    What has happened to this resource now? This brief paper outlines how the developers of the reference resource have improved on the design and content of the medical database. Now the reference resource is an Internet-based resource called General Practice Notebook (www.gpnotebook.co.uk and is currently attracting 5000 to 9000 page views per day and containing over 30 000 index terms in a complex web structure of over 60 000 links. This paper describes the evolutionary process that has occurred over the last decade.

  11. Internal medicine rounding practices and the Accreditation Council for Graduate Medical Education core competencies.

    Science.gov (United States)

    Shoeb, Marwa; Khanna, Raman; Fang, Margaret; Sharpe, Brad; Finn, Kathleen; Ranji, Sumant; Monash, Brad

    2014-04-01

    The Accreditation Council for Graduate Medical Education (ACGME) has established the requirement for residency programs to assess trainees' competencies in 6 core domains (patient care, medical knowledge, practice-based learning, interpersonal skills, professionalism, and systems-based practice). As attending rounds serve as a primary means for educating trainees at academic medical centers, our study aimed to identify current rounding practices and attending physician perceived capacity of different rounding models to promote teaching within the ACGME core competencies. We disseminated a 24-question survey electronically using educational and hospital medicine leadership mailing lists. We assessed attending physician demographics and the frequency with which they used various rounding models, as defined by the location of the discussion of the patient and care plan: bedside rounds (BR), hallway rounds (HR), and card-flipping rounds (CFR). Using the ACGME framework, we assessed the perceived educational value of each model. We received 153 completed surveys from attending physicians representing 34 institutions. HR was used most frequently for both new and established patients (61% and 43%), followed by CFR for established patients (36%) and BR for new patients (22%). Most attending physicians indicated that BR and HR were superior to CFR in promoting the following ACGME competencies: patient care, systems-based practice, professionalism, and interpersonal skills. HR is the most commonly employed rounding model. BR and HR are perceived to be valuable for teaching patient care, systems-based practice, professionalism, and interpersonal skills. CFR remains prevalent despite its perceived inferiority in promoting teaching across most of the ACGME core competencies. © 2014 Society of Hospital Medicine.

  12. Linkage between Graduate Medical Education Training Practice Profiles in Psychiatry, Obstetrics/Gynecology, and Family Practice. Appendices.

    Science.gov (United States)

    SysteMetrics, Inc., Santa Barbara, CA.

    Provided are appendices for a study which examined the relationship between graduate medical education (GME) and practice profiles in three specialties: family practice, psychiatry, and obstetrics/gynecology. Appendix A includes materials related to methodology of the study. Appendices B-D include supplementary materials for family practice,…

  13. Linkage between Graduate Medical Education Training Practice Profiles in Psychiatry, Obstetrics/Gynecology, and Family Practice. Appendices.

    Science.gov (United States)

    SysteMetrics, Inc., Santa Barbara, CA.

    Provided are appendices for a study which examined the relationship between graduate medical education (GME) and practice profiles in three specialties: family practice, psychiatry, and obstetrics/gynecology. Appendix A includes materials related to methodology of the study. Appendices B-D include supplementary materials for family practice,…

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

    Science.gov (United States)

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

    2016-01-01

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

  15. Getting ready for identity theft rules: creating a prevention program for your medical practice.

    Science.gov (United States)

    Cascardo, Debra

    2009-01-01

    Identity theft worries have found their way into medical practices. By August 1, 2009, all "creditors" must have a written program to prevent, detect, and minimize damage from identity theft. Any medical practice that bills patients is considered a creditor. Like HIPAA, these new Red Flag guidelines will serve to protect your practice from lawsuits as well as protect your patients from identity theft of their financial, personal, and medical information.

  16. 21 CFR 212.2 - What is current good manufacturing practice for PET drugs?

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false What is current good manufacturing practice for... HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR POSITRON EMISSION TOMOGRAPHY DRUGS (Eff. 12-12-2011) General Provisions § 212.2 What is current good manufacturing practice...

  17. 21 CFR 210.1 - Status of current good manufacturing practice regulations.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Status of current good manufacturing practice... SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PROCESSING, PACKING, OR HOLDING OF DRUGS; GENERAL § 210.1 Status of current good manufacturing practice...

  18. Moral regulation and the presumption of guilt in Health Canada's medical cannabis policy and practice.

    Science.gov (United States)

    Lucas, Philippe

    2009-07-01

    This paper is a sociological examination of policies and practices in Health Canada's Marihuana Medical Access Division (MMAD) that presume the illicit intentions and inherent "guilt" of medical cannabis users, hampering safe access to a medicine to which many are legally entitled, and raising doubts about this federal programme's overall effectiveness and constitutional legitimacy. Beginning with a brief historical overview of Canada's federal medical cannabis programme, this paper examines the failure of the MMAD to meet the needs of many sick and suffering Canadians through Hunt's [Hunt, A. (1999). Governing morals: A social history of moral regulation. Cambridge, UK: Cambridge University Press] work on moral regulation and Wodak's [Wodak, A. (2007). Ethics and drug policy. Psychiatry, 6(2), 59-62] critique of "deontological" drug policy strategies. I then cite Tupper's [Tupper, K. W. (2007). The globalization of ayahuasca: Harm reduction or benefit maximization? International Journal of Drug Policy, doi:10.1016/j.drugpo.2006.11.001] argument that shifting to a generative metaphor that constructs certain entheogenic substances as potentially useful "tools" rather than regulating them through inherently moralistic prohibitionist policies would better serve public health, and incorporate Young's [Young, I. M. (1990). Justice and the politics of difference. Princeton, New Jersey: Princeton University Press] theories of domination and oppression to examine the rise of community-base medical cannabis dispensaries as "new social movements". First-hand accounts by medical cannabis patients, federally funded studies, and internal Health Canada communication and documents suggest that current federal policies and practices are blocking safe access to this herbal medicine. The community-based dispensary model of medical cannabis access is a patient-centered "new social movement" that mitigates the stigmatization and moral regulation of their member-clients by creating

  19. 1978 U.S. Medical School Graduates: Practice Setting Preferences, Hometowns, and Spouses' Hometowns.

    Science.gov (United States)

    Cuca, Janet Melei

    1980-01-01

    National information about 1978 graduating medical students is reported that confirms a substantial relationship between their preferred practice settings and their hometowns and those of their spouses. (JMD)

  20. An overview of medical abortion for clinical practice.

    Science.gov (United States)

    Bryant, Amy G; Regan, Elizabeth; Stuart, Gretchen

    2014-01-01

    Medical abortion is a safe, convenient, and effective method for terminating an early unintended pregnancy. Medical abortion can be performed up to 63 days from the last menstrual period and may even be used up to 70 days for women who prefer medical abortion over surgical abortion. Counseling on the adverse effects and expectations for medical abortion is critical to success. Medical abortion can be performed in a clinic without special equipment, and it is perceived as more "natural" than a surgical abortion by many women. Follow-up for medical abortion can be simplified to include only serum human chorionic gonadotropin measurements when necessary, although obtaining an ultrasound remains the criterion standard. Pain associated with medical abortion is best treated with nonsteroidal anti-inflammatory medications, possibly in combination with opioid analgesics. Medical abortion can contribute to continuity of care for women who wish to remain with their primary care providers for management of their abortion.

  1. [Future trend medical apps. From the apps store directly into medical practice?].

    Science.gov (United States)

    Gehring, H; Pramann, O; Imhoff, M; Albrecht, U-V

    2014-12-01

    In day to day medical care, patients, nursing staff and doctors currently face a bewildering and rapidly growing number of health-related apps running on various "smart" devices and there are also uncountable possibilities for the use of such technology. Concerning regulation, a risk-based approach is applied for development and use (including safety and security considerations) of medical and health-related apps. Considering safety-related issues as well as organizational matters, this is a sensible approach but requires honest self-assessment as well as a high degree of responsibility, networking and good quality management by all those involved. This cannot be taken for granted. Apart from regulatory aspects it is important to not only consider what is reasonable, helpful or profitable. Quality aspects, safety matters, data protection and privacy as well as liability issues must also be considered but are often not adequately respected. If software quality is compromised, this endangers patient safety as well as data protection, privacy and data integrity. This can for example result in unwanted advertising or unauthorized access to the stored data by third parties; therefore, local, regional and international regulatory measures need to be applied in order to ensure safe use of medical apps in all possible areas, including the operating room (OR) with its highly specialized demands. Lawmakers need to include impulses from all stakeholders in their considerations and this should include input from existing private initiatives that already deal with the use and evaluation of apps in a medical context. Of course, this process needs to respect pre-existing national, European as well as international (harmonized) standards.

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

    NARCIS (Netherlands)

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

    2012-01-01

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

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

    NARCIS (Netherlands)

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

    2012-01-01

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

  4. Medical Students’ View about the Effects of Practical Courses on Learning the General Theoretical Concepts of Basic Medical Sciences

    Directory of Open Access Journals (Sweden)

    Leila Roshangar

    2014-05-01

    Full Text Available Introduction: The basic medical sciences section requires 2.5 years in the medical education curriculum. Practical courses complement theoretical knowledge in this period to improve their appreciation. Despite spending lots of disbursement and time, this period’s efficacy is not clearly known. Methods: One hundred thirty-three General Practitioner (GP students have been included in this descriptive cross-sectional study and were asked by questionnaire about the positive impact of practical courses on learning theoretical knowledge. Data were analyzed by descriptive statistics. Result: The agreement in “Practical Head and Neck Anatomy” was 40.91% ± 29.45, in “Practical Trunk Anatomy” was 63.62% ± 2.32 and in “Practical Anatomy of Extremities” was 56.16% ± 2.57. In “Practical Histology”, agreement was 69.50%±2.19; “Practical Biophysics” was 45.97%±2.25, “Practical Physiology” 61.75%±2.17; “Practical Biochemistry” 36.28%±2.42; “Practical Pathology” 59.80%±2.53; “Practical Immunology” 56.25%±26.40; “Practical Microbiology and Virology” 60.39%±2.27 and “Practical Mycology and Parasitology” 68.2%± 2.16.Conclusion: GP students in Tabriz University of Medical Sciences are not optimistic about the applicability of practical courses of basic medical sciences lessons.

  5. Anaesthetic specialist registrars in Ireland: current teaching practices and perceptions of their role as undergraduate teachers.

    LENUS (Irish Health Repository)

    Walsh, K

    2012-02-03

    BACKGROUND AND OBJECTIVES: Teaching is an important responsibility of non-consultant hospital doctors. In Ireland, specialist registrars (SpRs) in anaesthesia are contractually obliged to teach medical students, other doctors and nurses. Both medical students and fellow non-consultant hospital doctors attribute between 30 and 40% of their knowledge gain to non-consultant hospital doctors. METHODS: We carried out a confidential telephone survey of anaesthetic SpRs in Ireland regarding their current teaching practices and the perceptions of their role as undergraduate teachers. All the SpRs currently working in clinical practice in Ireland were eligible. RESULTS: Fifty-five of the 79 (70%) SpRs responded to the questionnaire. Only 7 (12.7%) of the respondents said they had been well trained as a teacher. The majority of the respondents stated that they would attend a learning-to-teach course\\/workshop if one was available, and felt that such a course would improve their ability as a teacher. Only 8 (14.5%) agreed that adequate emphasis is placed on commitment to teaching in the assessment of SpRs, both by individual departments and by the College of Anaesthetists. Anaesthetic SpRs in Ireland spend a considerable amount of time each day teaching undergraduate medical students, the majority (68.9%) stated that they had inadequate time to prepare for teaching. CONCLUSION: The majority of the respondents stated that they enjoy teaching, feel that they play an important role in undergraduate teaching but have inadequate time to prepare for teaching. An adequate emphasis is not placed on their commitment to teaching.

  6. Optical Coherence Tomography: Clinical Applications in Medical Practice

    Directory of Open Access Journals (Sweden)

    Abdullah Al-Mujaini

    2013-03-01

    Full Text Available Optical Coherence Tomography (OCT is a success story of scientific and technological co-operation between a physicist and a clinician. The concept of cross-sectional imaging revolutionalized the applicability of OCT in the medical profession. OCT is a non-contact, topographic, biomicroscopic device that provides high resolution, cross-sectional digital images of live biological tissues in vivo and in real time. OCT is based on the property of tissues to reflect and backscatter light involving low-coherence interferometry. The spatial resolution of as little as 3 microns or even less has allowed us to study tissues almost at a cellular level. Overall, OCT is an invaluable adjunct in the diagnosis and follow up of many diseases of both anterior and posterior segments of the eye, primarily or secondary to systemic diseases. The digitalization and advanced software has made it possible to store and retrieve huge patient data for patient services, clinical applications and academic research. OCT has revolutionized the sensitivity and specificity of diagnosis, follow up and response to treatment in almost all fields of clinical practice involving primary ocular pathologies and secondary ocular manifestations in systemic diseases like diabetes mellitus, hypertension, vascular and neurological diseases, thus benefitting non-ophthalmologists as well. Systemically, OCT is proving to be a helpful tool in substantiating early diagnosis in diseases like multiple sclerosis and drug induced retinopathies by detecting early changes in morphology of the retinal nerve fiber layer.

  7. Kant, curves and medical learning practice: a reply to Le Morvan and Stock.

    Science.gov (United States)

    Ives, J

    2007-02-01

    In a recent paper published in the Journal of Medical Ethics, Le Morvan and Stock claim that the kantian ideal of treating people always as ends in themselves and never merely as a means is in direct and insurmountable conflict with the current medical practice of allowing practitioners at the bottom of their "learning curve" to "practise their skills" on patients. In this response, I take up the challenge they issue [corrected] and try to reconcile this conflict. The kantian ideal offered in the paper is an incomplete characterisation of Kant's moral philosophy, and the formula of humanity is considered in isolation without taking into account other salient kantian principles. I also suggest that their argument based on "necessary for the patient" assumes too narrow a reading of "necessary". This reply is intended as an extension to, rather than a criticism of, their work.

  8. Medication errors: types, causes and impact on nursing practice.

    Science.gov (United States)

    Esi Owusu Agyemang, Rebecca; While, Alison

    Medication safety is a worldwide concern and a health priority, particularly in the UK. Safe and accurate medicine administration depends on correct prescribing and dispensing. Medication administration in hospital is the final stage of the medication process; nurses should be able to recognize errors in this process and prevent these errors from reaching the patient. Focusing on the serious consequences for those nurses involved in medication errors not only results in low reporting rates, but can also hamper effective improvements in medication safety, and lead to failure to discover the underlying contributory factors. This article explores the personal and organizational factors that contribute to medication errors among nurses within hospital ward settings.

  9. Shifting currents: Progress, setbacks, and shifts in policy and practice

    Science.gov (United States)

    ,; Dunning, Charles; Robertson, Dale

    2016-01-01

    clean water future. More than a decade has passed since our first statewide WOW conversation and the report that captured recommendations from its participants: Waters of Wisconsin: The Future of Our Aquatic Ecosystems and Resources. Drawing from a diverse and growing set of stakeholders from across the state, the Wisconsin Academy initiated a new conversation in 2012 (known as WOW II) to assess progress in regard to our 2003 recommendations. We also sought to review the status of waters in Wisconsin today. The result of this renewed conversation is Shifting Currents: Progress, Setbacks, and Shifts in Policy and Practice. The new report assesses progress in brief, and explores in greater depth the continuing and emerging challenges to water quality, supply, and aquatic ecosystems in Wisconsin.In this report, we first review the context and frameworks for public decision-making about water and then examine some of the root causes—or “drivers”—and ecological stressors that underlie many of the symptoms we see in the form of pollution or ecosystem degradation in Wisconsin. This is followed by a summary of current water issues, many of which had been identified in the 2003 report and remain relevant today. We examine progress since 2003 but also setbacks, and discuss issues that we are likely to continue to face in the coming decades, including controlling agricultural runoff, mitigating climate change and grappling with its effects on the state’s waters, protecting groundwater from bacterial contamination and other pollutants, and preventing groundwater depletion. We also attempt to anticipate issues on the horizon. We offer a deeper look at some particular challenges, such as phosphorus pollution and groundwater contamination. We then consider the current decision-making framework and how it is shaping our capacity to respond to water challenges in Wisconsin. Finally, we offer recommendations and identify opportunities to safeguard Wisconsin’s waters in the

  10. 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.

  11. 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.

  12. [Attitude of medical students to the preventive and social aspects of medical education and practice].

    Science.gov (United States)

    González Carbajal, E; Gutiérrez Avila, J H; Aguilar De La Garza, J; García Medrano, J

    1982-01-01

    This paper reports on a study carried out in the Faculty of Medicine of the Autonomous National University of Mexico to discover the attitudes of a group of students toward the preventive and social aspects of medicine, and their own professional aspirations. It was found that these students were aware of the importance of these aspects, and that they inclined by preference to the practice of a clinical specialty. No correlation was found between the patterns of the students' professional aspirations and their attitudes. The authors feel this could mean that attitudes are determined by the overall influence of the society, but the aspirations by the structure of the labor market and the prevailing medical practice model. It is suggested that a similar survey be done of the same group of students at the completion of their studies to determine the possible effects of the educational process on their attitudes. Comments are made and recommendations put forward for solving methodological problems that arise in studies of this type.

  13. A Call for Innovation: Reflective Practices and Clinical Curricula of US Army Special Operations Forces Medics.

    Science.gov (United States)

    Rocklein, Kate

    2014-01-01

    Special Operations Forces (SOF) medics have written and published numerous practice reflections that intricately describe their practice environments, clinical dilemmas, and suggestions for teaching and practice. The lack of translation of SOF medics experiential evidence to their curriculum has created a gap in evidence-based curriculum development. This study analyzed SOF medics learning and practice patterns and compared it to the evidence in the interdisciplinary clinical literature. After framing the problem, the literature was reviewed to determine appropriate tools by which perceptions and attitudes toward reflection-centered curricula could be measured. A recognizable practice reflection was extracted from the published SOF clinical literature and presented in writing to self-identified SOF medics and medic instructors via a descriptive crossover design, to ensure possible biases were mitigated. To measure SOF medics perceptions of reflection-based curricula, the Dundee Ready Education Environment Measure survey instrument was used, as it has validated psychometric properties and is used worldwide. SOF medics averaged scores of perceptions of their medic education indicated positive but not completely statistically significant preferences toward reflection-based curricula over traditional curriculum. Special Operations, medics, reflective practice, curricula BACKGROUND Special Operations Forces (SOF) medics practice in environments that are violent, austere, clandestine, and far removed from definitive hospital facilities. What was true almost 20 years ago?". . . academic demands of [Special Forces medic training] are roughly equivalent to those of an upper-level undergraduate curriculum in science or perhaps to those of first year medical school"?is even more challenging today. During this study, medics, physicians, and educators within the SOF medical community publicly and privately (ergo, names were redacted) expressed the need for curricular changes to

  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. Medical Physics Practice Guideline 4.a: Development, implementation, use and maintenance of safety checklists.

    Science.gov (United States)

    Fong de Los Santos, Luis E; Evans, Suzanne; Ford, Eric C; Gaiser, James E; Hayden, Sandra E; Huffman, Kristina E; Johnson, Jennifer L; Mechalakos, James G; Stern, Robin L; Terezakis, Stephanie; Thomadsen, Bruce R; Pronovost, Peter J; Fairobent, Lynne A

    2015-05-08

    The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States.The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner.Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized.The following terms are used in the AAPM practice guidelines:Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline.Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances.

  17. Perspectives on the changing healthcare system: teaching systems-based practice to medical residents

    Directory of Open Access Journals (Sweden)

    Johanna Martinez

    2013-09-01

    Full Text Available Purpose: The Accreditation Council for Graduate Medical Education restructured its accreditation system to be based on educational outcomes in six core competencies. Systems-based practice is one of the six core competencies. The purpose of this report is to describe Weill Cornell Medical College's Internal Medicine Residency program curriculum for systems-based practice (SBP and its evaluation process. Methods: To examine potential outcomes of the POCHS curriculum, an evaluation was conducted, examining participants': (1 knowledge gain; (2 course ratings; and (3 qualitative feedback. Results: On average, there was a 19 percentage point increase in knowledge test scores for all three cohorts. The course was rated overall highly, receiving an average of 4.6 on a 1–5 scale. Lastly, the qualitative comments supported that the material is needed and valued. Conclusion: The course, entitled Perspectives on the Changing Healthcare System (POCHS and its evaluation process support that systems-based practice is crucial to residency education. The course is designed not only to educate residents about the current health care system but also to enable them to think critically about the risk and benefits of the changes. POCHS provides a framework for teaching and assessing this competency and can serve as a template for other residency programs looking to create or restructure their SBP curriculum.

  18. The medical practice of euthanasia in Belgium and The Netherlands: legal notification, control and evaluation procedures.

    Science.gov (United States)

    Smets, Tinne; Bilsen, Johan; Cohen, Joachim; Rurup, Mette L; De Keyser, Els; Deliens, Luc

    2009-05-01

    To describe and compare current legal procedures for notifying, controlling and evaluating (NCE-procedures) euthanasia in Belgium and the Netherlands, and to discuss the implications for a safe and controllable euthanasia practice. We systematically studied and compared official documents relating to the Belgian and the Dutch NCE-procedures for euthanasia. In both countries, physicians are required to notify their cases to a review Committee, stimulating them to safeguard the quality of their euthanasia practice and to make societal control over the practice of euthanasia possible. However, the procedures in both countries differ. The main differences are that the Dutch notification and control procedures are more elaborate and transparent than the Belgian, and that the Belgian procedures are primarily anonymous, whereas the Dutch are not. Societal evaluation is made in both countries through the Committees' summary reports to Parliament. Transparent procedures like the Dutch may better facilitate societal control. Informing physicians about the law and the due care requirements for euthanasia, and systematic feedback about their medical actions are both pivotal to achieving efficient societal control and engendering the level of care needed when performing such far-reaching medical acts.

  19. Intern pharmacists as change agents to improve the practice of nonprescription medication supply: provision of salbutamol to patients with asthma.

    Science.gov (United States)

    Schneider, Carl R; Everett, Alan W; Geelhoed, Elizabeth; Padgett, Cale; Ripley, Scott; Murray, Kevin; Kendall, Peter A; Clifford, Rhonda M

    2010-01-01

    Earlier work established an evidence practice gap during provision of nonprescription salbutamol (albuterol). Pharmacist interns are hypothesized to be in a position to improve professional practice in the community pharmacy setting. To explore the potential of intern pharmacists to improve the professional practice of community pharmacy staff in the provision of nonprescription salbutamol. Intern pharmacists (n = 157) delivered an asthma intervention in 136 pharmacies consisting of an educational activity to pharmacy staff and a health promotion campaign to consumers. Post-intervention, simulated patients presented to 100 intervention and 100 control community pharmacies with a request for salbutamol. The appropriate outcome was medical referral for poor asthma control and correction of poor inhaler technique. Incidence and quantity of patient assessment and counseling provided during the visit were also assessed. Logistic regression was used to determine the predictors of medical referral. A doubling in the rate of medical referral was seen in the intervention group (19% vs 40%; p = 0.001). Assessment of reliever use frequency was the main predictor of medical referral (OR = 22.7; 95% CI 9.06 to 56.9). Correction of poor inhaler technique did not improve; however, a reduction in salbutamol supplied without patient assessment (23% vs 8%; p = 0.009) or counseling (75% vs 48%; p intern pharmacists were able to improve the current practice of community pharmacies yet were unable to establish a new practice behavior. This study provides evidence that intern pharmacists can act as change agents to improve pharmacy practice.

  20. 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

  1. Survey of nursing perceptions of medication administration practices, perceived sources of errors and reporting behaviours.

    Science.gov (United States)

    Armutlu, Markirit; Foley, Mary-Lou; Surette, Judy; Belzile, Eric; McCusker, Jane

    2008-01-01

    In January 2003, St. Mary's Hospital Center in Montreal, Quebec, established an interdisciplinary Committee on the Systematic Approach to Medication Error Control to review the whole process of medication administration within the hospital and to develop a systematic approach to medication error control. A cross-sectional survey on medication administration practices, perceived sources of errors and medication error reporting of nurses, adapted from a nursing practice survey and medication variance report (Sim and Joyner 2002), was conducted over a two-week period in February 2004. The results were analyzed by years of experience (greater or less than five years) and patient care unit of practice. The perceived source of error most often cited was transcription (processing), and the second most frequently cited source was the legibility of handwritten medication orders (prescribing). The results demonstrate no significant difference in medication safety practices or in perceptions of errors by years of experience. Nurses appear to adapt to the safety culture of the unit rather quickly, certainly within their first five years on the unit. Good medication error reporting behaviour was noted, with no differences between all comparative groups within both years of experience and unit of practice. Quality improvement initiatives to improve the safety of medication administration practices have included the development of a nursing medication administration handbook, the revision of policies and procedures related to medication administration safety, the standardization of solutions and limited variety of high-risk medication dosages and the reduction of handwritten reorders. The need for ongoing education and information sessions on policies and procedures specific to safe medication practices for all nurses, regardless of years of experience, was identified.

  2. Medical abortion practices among private providers in Vietnam

    Directory of Open Access Journals (Sweden)

    Park MH

    2013-09-01

    Full Text Available Min Hae Park,1 Thang Huu Nguyen,2 Anh Thi Ngoc Dang,2 Thoai Dinh Ngo1 1Research, Monitoring and Evaluation Team, Health System Department, Marie Stopes International, London, UK; 2Research and Metrics Team, Marie Stopes International Vietnam, Ha Noi, Vietnam Objective: To describe medical abortion (MA practices among private providers in Vietnam. Methods: The study subjects were women (n = 258 undergoing early MA through 12 private providers in Hanoi during February-June 2012. The women were interviewed on the day of their procedure and were followed up by telephone 14 days after mifepristone administration. Results: Of the 258 women in the study, 97% used a regimen of mifepristone plus misoprostol; 80% were instructed to administer misoprostol at home. MA resulted in a complete termination in 90.8% of cases. All women were provided with information on potential complications and were instructed to return for a follow-up visit. We successfully followed up 77.5% (n = 200 of participants by telephone, while nearly two-thirds of women returned to the clinic for a follow-up visit. At follow up, 39.5% of women reported having used a Help line service, while 7% had sought help from a health provider. A high unmet need for postabortion family planning was identified. Conclusion: Follow up of women, postabortion care, and the provision of family planning have been identified as important areas to address for strengthening MA services in the private sector in Vietnam. Keywords: misoprostol, mifepristone, abortion, mhealth, Vietnam

  3. Medical negligence. An overview of legal theory and neurosurgical practice: duty of care.

    Science.gov (United States)

    Todd, Nicholas V

    2014-04-01

    A working knowledge of the legal principles of medical negligence is helpful to neurosurgeons. It helps them to act in a "reasonable, responsible and logical" manner, that is a practice that is consistent with the surgical practice of their peers. This article will review and explain the relevant medical law in relation to duty of care with illustrative neurosurgical cases.

  4. eMedOffice: a web-based collaborative serious game for teaching optimal design of a medical practice.

    Science.gov (United States)

    Hannig, Andreas; Kuth, Nicole; Özman, Monika; Jonas, Stephan; Spreckelsen, Cord

    2012-10-31

    Preparing medical students for the takeover or the start-up of a medical practice is an important challenge in Germany today. Therefore, this paper presents a computer-aided serious game (eMedOffice) developed and currently in use at the RWTH Aachen University Medical School. The game is part of the attempt to teach medical students the organizational and conceptual basics of the medical practice of a general practitioner in a problem-based learning environment. This paper introduces methods and concepts used to develop the serious game and describes the results of an evaluation of the game's application in curricular courses at the Medical School. Results of the conducted evaluation gave evidence of a positive learning effect of the serious game. Educational supervisors observed strong collaboration among the players inspired by the competitive gaming aspects. In addition, an increase in willingness to learn and the exploration of new self-invented ideas were observed and valuable proposals for further prospective enhancements were elicited. A statistical analysis of the results of an evaluation provided a clear indication of the positive learning effect of the game. A usability questionnaire survey revealed a very good overall score of 4.07 (5=best, 1=worst). We consider web-based, collaborative serious games to be a promising means of improving medical education. The insights gained by the implementation of eMedOffice will promote the future development of more effective serious games for integration into curricular courses of the RWTH Aachen University Medical School.

  5. Current Perspectives on Pronunciation. Practices Anchored in Theory.

    Science.gov (United States)

    Morley, Joan, Ed.

    A collection of essays on pronunciation instruction theory and practice includes: "Teaching Pronunciation as Communication" (Marianne Celce-Murcia); "Learner Variables and Prepronunciation Considerations in Teaching Pronunciation" (Rita Wong); "Pronunciation and Listening Comprehension" (Judy B. Gilbert); "Pronunciation Tutorials for Nonnative…

  6. Forensic Occupational Therapy in Canada: The Current State of Practice.

    Science.gov (United States)

    Chui, Adora L Y; Wong, Chantal Isabelle; Maraj, Sara A; Fry, Danielle; Jecker, Justine; Jung, Bonny

    2016-09-01

    Although occupational therapists have been practicing in forensic settings for many years, there is a paucity of literature regarding the nature of this practice in Canada. The purpose of this study was to describe the practices of Canadian occupational therapists in forensic mental health. An online survey was designed based on the Canadian Practice Process Framework. Following purposive and snowball sampling, responses were analysed with descriptive statistics and content analysis. Twenty-seven clinicians responded (56% response rate). Respondents indicated commonalities in workplaces, client caseloads and practice challenges. The outstanding need in Canada to demonstrate client outcomes through the use of evaluation instruments reflects those practice gaps identified internationally. Education, advocacy and research are critical areas for the development of Canadian forensic occupational therapy. Although findings heavily reflect one provincial context and may not be generalizable to nonhospital settings, a number of priority areas were identified. Future efforts should clarify the role of forensic occupational therapy to stakeholders, and validate their contributions through research that evaluates intervention efficacy and meaningful outcomes. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  7. The effects of capitation payment on the organizational structure of medical group practices.

    Science.gov (United States)

    Kralewski, J E; Wingert, T D; Knutson, D J; Johnson, C E; Veazie, P J

    1996-01-01

    This study explores the effects of capitation payment on the structural elements used by medical group practices to control physician-directed use of resources and the quality of patient care. Forty-five medical groups located in the highly competitive Minneapolis/St. Paul metropolitan area were studied. The range of capitation payment in these medical group practices is from 2% to 87%. Although the practices vary considerably in the extent to which they have developed these control mechanisms, it does not appear that capitation payment is a major factor influencing that pattern. It appears that many of these medical group practices either use less formal mechanisms than those included in this study to control resource use and the quality of care or use none at all. In either event, the data suggest that the effects of capitation payment on the structure of medical practices may be overestimated.

  8. Pharmacist Staffing, Technology Use, and Implementation of Medication Safety Practices in Rural Hospitals

    Science.gov (United States)

    Casey, Michelle M.; Moscovice, Ira S.; Davidson, Gestur

    2006-01-01

    Context: Medication safety is clearly an important quality issue for rural hospitals. However, rural hospitals face special challenges implementing medication safety practices in terms of their staffing and financial and technical resources. Purpose: This study assessed the capacity of small rural hospitals to implement medication safety…

  9. ADHD medication prescription: effects of child, sibling, parent and general practice characteristics.

    NARCIS (Netherlands)

    Heins, M.J.; Bruggers, I.; Dijk, L. van; Korevaar, J.C.

    2016-01-01

    Many children receive attention-deficit hyperactivity disorder (ADHD) medication, but factors that determine medication prescription are largely unknown. This study aimed to determine the relative impact of factors on the child, family and general practitioner (GP) practice level on ADHD medication

  10. Tips for medical practice success in the upcoming accountable care era.

    Science.gov (United States)

    Bobbitt, Julian D

    2012-01-01

    Due to the unsustainable cost of healthcare, the movement to accountable care will be inevitable. This author predicts that recent Medicare Accountable Care Organization (ACO) regulations will energize ACO development. There are specific practical strategies every medical practice leader should know in order to navigate this new healthcare environment successfully. There is a window of opportunity, which will not stay open long, to control a medical practice's destiny in molding a fair, sustainable, and successful ACO. Not being prepared and defaulting to the status quo through passivity is also a choice that promises more work for less compensation for medical practices. The choice is clear, and the blueprint for success is available.

  11. Implementing best practice in medication management in a nursing home

    OpenAIRE

    2012-01-01

    Medication management is one of the major roles of a nurse leader in any health care setting particularly in the nursing homes. Evidence suggests that errors do occur at any stage of the medication use process (prescribing, documenting/transcribing, dispensing, administering and monitoring) and these might pose significant risks to older people in nursing homes. Thus, this change project was carried out to reduce the incidence of medication errors, ensure resident’s safety and promote complia...

  12. [Medical practice and clinical research: keys to generate knowledge and improve care].

    Science.gov (United States)

    Martínez Castuera-Gómez, Carla; Talavera, Juan O

    2013-01-01

    The increased quality in medical care may be immediately accomplished if clinical research is integrated into daily clinical practice. In the generation of medical knowledge are four steps: an unanswered question awakened from clinical practice, the critical analysis of specialized literature, the development of a research protocol, and, finally, the publication of outcomes. Decision making and continuous training are becoming part of an effective strategy of medical attention improvement.

  13. Influences on final year medical students’ attitudes to general practice as a career

    Directory of Open Access Journals (Sweden)

    Parker JE

    2014-03-01

    Full Text Available INTRODUCTION: General practice is under-represented in student career choices. This study aimed to identify and explore factors that influence the attitudes of final year medical students to general practice as a career. METHODS: This qualitative study used semi-structured interviews of focus groups of final year undergraduate medical students at the University of Otago, Christchurch, New Zealand. Thematic analysis and grounded theory were used to interpret the data. FINDINGS: General practitioners (GPs play a key role in influencing medical students’ attitudes to general practice as a career. Students identified their general practice placement during medical school training and personal contact with their own GP as principal factors. The media portrayal of general practice and the attitudes of friends and family were also influential. Students were positively influenced when they were made to feel part of the team, involved with consultations, allowed to carry out practical procedures under supervision, and witnessed what they perceived as good medical practice during clinical placements. Positive experiences often occurred later in training, when students felt more confident of their clinical abilities. While students reported occasional negative comments about general practice by some hospital doctors, these had a lesser role in influencing their perceptions of general practice compared with their own experiences, both as students and patients. CONCLUSION: GPs have a strong influence, positively and negatively, on the attitudes of medical students to general practice as a career. Effective influences include being made to feel welcome, involved, valued, and given legitimate roles during clinical placements.

  14. 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.

  15. Preparedness for practice : A systematic cross-specialty evaluation of the alignment between postgraduate medical education and independent practice

    NARCIS (Netherlands)

    Dijkstra, Ids S.; Pols, Jan; Remmelts, Pine; Brand, Paul L. P.

    2015-01-01

    Background: Postgraduate medical education training programs strive to prepare their trainees optimally for independent practice. Several studies have shown, however, that new consultants feel inadequately prepared for practice, and that this increases the risk of stress and burnout. Aim: To analyze

  16. Hospital-owned medical practices gaining the benefits without the losses.

    Science.gov (United States)

    Halley, Marc D

    2014-04-01

    Hospitals can correct most of the causes of reduced performance in hospital-owned medical practices by setting appropriate performance expectations and implementing correct operating principles. Engaging employed physicians and executives as partners who provide principle-based direction and support to practice managers encourages performance improvement. A critical determinant of a hospital's ability to successfully own medical practices is understanding and implementing the principles for success in this unique ambulatory business.

  17. A culture of safety: a business strategy for medical practices.

    Science.gov (United States)

    Saxton, James W; Finkelstein, Maggie M; Marles, Adam F

    2012-01-01

    Physician practices can enhance their economics by taking patient safety to a new level within their practices. Patient safety has a lot to do with systems and processes that occur not only at the hospital but also within a physician's practice. Historically, patient safety measures have been hospital-focused and -driven, largely due to available resources; however, physician practices can impact patient safety, efficiently and effectively, with a methodical plan involving assessment, prioritization, and compliance. With the ever-increasing focus of reimbursement on quality and patient safety, physician practices that implement a true culture of safety now could see future economic benefits using this business strategy.

  18. Brief psychotherapy in medical practice. Keys to success.

    OpenAIRE

    1993-01-01

    For physicians faced with helping their patients cope with difficult medical problems, solution-oriented psychotherapeutic techniques provide brief, effective interventions. These approaches offer "skeleton keys" that can be used in a broad patient population. They include clarifying the meaning of the medical illness, therapeutic reframing, projection of the problem, role reversal, and face-saving techniques.

  19. Enhancing medical-surgical nursing practice: using practice tests and clinical examples to promote active learning and program evaluation.

    Science.gov (United States)

    DuHamel, Martha B; Hirnle, Constance; Karvonen, Colleen; Sayre, Cindy; Wyant, Sheryl; Colobong Smith, Nancy; Keener, Sheila; Barrett, Shannon; Whitney, Joanne D

    2011-10-01

    In a 14-week medical-surgical nursing review course, two teaching strategies are used to promote active learning and assess the transfer of knowledge to nursing practice. Practice tests and clinical examples provide opportunities for participants to engage in self-assessment and reflective learning and enhance their nursing knowledge, skills, and practice. These strategies also contribute to program evaluation and are adaptable to a variety of course formats, including traditional classroom, web conference, and online self-study.

  20. Cost of Transformation among Primary Care Practices Participating in a Medical Home Pilot.

    Science.gov (United States)

    Martsolf, Grant R; Kandrack, Ryan; Gabbay, Robert A; Friedberg, Mark W

    2016-07-01

    Medical home initiatives encourage primary care practices to invest in new structural capabilities such as patient registries and information technology, but little is known about the costs of these investments. To estimate costs of transformation incurred by primary care practices participating in a medical home pilot. We interviewed practice leaders in order to identify changes practices had undertaken due to medical home transformation. Based on the principles of activity-based costing, we estimated the costs of additional personnel and other investments associated with these changes. The Pennsylvania Chronic Care Initiative (PACCI), a statewide multi-payer medical home pilot. Twelve practices that participated in the PACCI. One-time and ongoing yearly costs attributed to medical home transformation. Practices incurred median one-time transformation-associated costs of $30,991 per practice (range, $7694 to $117,810), equivalent to $9814 per clinician ($1497 to $57,476) and $8 per patient ($1 to $30). Median ongoing yearly costs associated with transformation were $147,573 per practice (range, $83,829 to $346,603), equivalent to $64,768 per clinician ($18,585 to $93,856) and $30 per patient ($8 to $136). Care management activities accounted for over 60% of practices' transformation-associated costs. Per-clinician and per-patient transformation costs were greater for small and independent practices than for large and system-affiliated practices. Error in interviewee recall could affect estimates. Transformation costs in other medical home interventions may be different. The costs of medical home transformation vary widely, creating potential financial challenges for primary care practices-especially those that are small and independent. Tailored subsidies from payers may help practices make these investments. Agency for Healthcare Research and Quality.

  1. Linking nurse characteristics, team member effectiveness, practice environment, and medication error incidence.

    Science.gov (United States)

    Fasolino, Tracy; Snyder, Rita

    2012-01-01

    Clinical unit nurse characteristics, practice environment, and team member effectiveness are assumed to play a critical role in medication safety. This study used a multimethod approach to examine the association of these factors with medication errors. Findings suggested that older, more experienced registered nurses made less medication errors. Environment and team member effectiveness were not strongly associated with medication error incidence. Numerous system factors limited implementation and outcomes of this safety study and are discussed.

  2. Applying Current Theory and Research in Career Exploration to Practice.

    Science.gov (United States)

    Blustein, David L.

    1992-01-01

    Provides selected review of two lines of recent research on career exploration (identifying antecedents of exploratory activity and application of information processes biases to career exploration), with specific focus on applications for counseling practice. Describes relevant counseling interventions and concludes with summary of six goals to…

  3. Current Neonatal Resuscitation Practices among Paediatricians in Gujarat, India

    Directory of Open Access Journals (Sweden)

    Satvik C. Bansal

    2014-01-01

    Full Text Available Aim. We assessed neonatal resuscitation practices among paediatricians in Gujarat. Methods. Cross-sectional survey of 23 questions based on guidelines of Neonatal Resuscitation Program (NRP and Navjaat Shishu Suraksha Karyakram (NSSK was conducted using web-based tool. Questionnaire was developed and consensually validated by three neonatologists. Results. Total of 142 (21.2% of 669 paediatricians of Gujarat, India, whose e-mail addresses were available, attempted the survey and, from them, 126 were eligible. Of these, 74 (58.7% were trained in neonatal resuscitation. Neonatal Intensive Care Unit with mechanical ventilation facilities was available for 54% of respondents. Eighty-eight (69.8% reported correct knowledge and practice regarding effective bag and mask ventilation (BMV and chest compressions. Knowledge and practice about continuous positive airway pressure use in delivery room were reported in 18.3% and 30.2% reported use of room air for BMV during resuscitation. Suctioning oral cavity before delivery in meconium stained liquor was reported by 27.8% and 38.1% cut the cord after a minute of birth. Paediatricians with NRP training used appropriate method of tracheal suction in cases of nonvigorous newborns than those who were not trained. Conclusions. Contemporary knowledge about neonatal resuscitative practices in paediatricians is lacking and requires improvement. Web-based tools provided low response in this survey.

  4. Equity crowdfunding in China : Current practice and important legal issues

    NARCIS (Netherlands)

    Li, Jing

    2017-01-01

    By studying two leading Chinese equity crowdfunding portals, namely, Renrentou and Zhongou8, this paper provides the very first empirical evidence on the practice and regulation of equity crowdfunding in China. In the case of Renrentou, I examine a hand-collected sample consisting of the investment

  5. Behavioral Marital Therapy: Current Trends in Research, Assessment and Practice.

    Science.gov (United States)

    Jacobson, Neil S.

    1980-01-01

    Behavioral Marital Therapy (BMT) is clinically useful because it includes elaborating procedures, modifying the spouse's self-defeating cognitions, and moving toward early intervention and prevention. Each article in this issue of American Journal of Family Therapy focuses on innovations in BMT, either in research or practice. (Author/NRB)

  6. Equity crowdfunding in China : Current practice and important legal issues

    NARCIS (Netherlands)

    Li, Jing

    2017-01-01

    By studying two leading Chinese equity crowdfunding portals, namely, Renrentou and Zhongou8, this paper provides the very first empirical evidence on the practice and regulation of equity crowdfunding in China. In the case of Renrentou, I examine a hand-collected sample consisting of the investment

  7. Current Practice of Extensive Reading in Asia: Teachers' Perceptions

    Science.gov (United States)

    Chang, Anna C.-S.; Renandya, Willy A.

    2017-01-01

    This study investigated teachers' perceptions of the practice of extensive reading (ER) in the Asian context. One hundred and nineteen L2 teachers in Asia responded to an online questionnaire that probed into their reasons for implementing ER, the difficulties they encountered, and their perception about the effectiveness of different ways of…

  8. Family Counseling in Malaysia: Current Issues and Practices

    Science.gov (United States)

    Noor, Norhayati Mohd.

    2014-01-01

    The study is carried out to explore the issues and practices in family counselling among the family counsellors at few counseling centres in Malaysia. Qualitative approach of single case embedded units was used for the study. Data collection was done using in-depth interview, observation and document analysis with 12 family counsellors. The data…

  9. Current marketing practices in the nursing home sector.

    Science.gov (United States)

    Calhoun, Judith G; Banaszak-Holl, Jane; Hearld, Larry R

    2006-01-01

    Marketing is widely recognized as an essential business function across all industries, including healthcare. While many long-term care facilities adopted basic healthcare marketing practices and hired marketing staff by the early 1990s, a paucity of research on nursing home marketing exists in the literature. This study examines the extent to which nursing homes have developed more formulated marketing and related communication and promotional strategies as market competition has increased in this sector during the past two decades. In addition, we explored managers' perceptions of their control over marketing decision making, the impact of competition on the use of marketing practices, and areas for enhanced competitive positioning. Administrators from 230 nursing homes in 18 Southeastern Michigan counties were surveyed regarding (1) the adoption level of approximately 40 literature-based, best-practice marketing strategies; (2) the types of staff involved with the marketing function; and (3) their perception of their level of control over marketing functions and of local competition. Results from 101 (44 percent) survey participants revealed that although respondents viewed their markets as highly competitive, their marketing practices remained focused on traditional and relatively constrained practices. In relation to the importance of customer relationship management, the majority of the administrators reported intensive efforts being focused on residents and their families, referrers, and staff, with minimal efforts being extended to insurers and other types of payers. A significant positive relation was found between the intensity of marketing initiatives and the size of the facility (number of beds), whereas significant negative correlations were revealed in relation to occupancy and the perceived level of control over the function.

  10. Public health partnerships in medical toxicology education and practice.

    Science.gov (United States)

    Schier, Joshua G; Rubin, Carol; Schwartz, Michael D; Thomas, Jerry D; Geller, Robert J; Morgan, Brent W; McGeehin, Michael A; Frumkin, Howard

    2010-06-01

    In December 2002, the medical toxicology sub-board, which consists of representatives from emergency medicine, preventive medicine, and pediatrics, released revised core content for medical toxicology, aiming to better meet the academic challenges imposed by the continually expanding knowledge base of medical toxicology. These challenges included the addition of relatively new areas of interest in medical toxicology, including population health, while simultaneously ensuring that a structural framework existed to accommodate future areas of interest. There is no evidence readily available to assess how well the educational curricula of existing fellowship programs are meeting these needs. In an effort to address this, the authors describe a medical toxicology fellowship program that consists of a partnership among the Emory University School of Medicine, the Georgia Poison Control Center, and the CDC, as well as the results of a reorganization of its academic curriculum that occurred in 2006. To the best of the authors' knowledge, this is the first published report describing such a curriculum redesign. Suggestions and potential resources proposed as enhancements for the public health-associated education of medical toxicology fellows are discussed. The authors also seek to initiate a discussion among programs about how to optimally meet the new challenges developed by the medical toxicology sub-board.

  11. Protocol for audit of current Filipino practice in rehabilitation of stroke inpatients

    Directory of Open Access Journals (Sweden)

    Gonzalez-Suarez CB

    2015-03-01

    Full Text Available Consuelo B Gonzalez-Suarez,1–3 Janine Margarita R Dizon,2,3 Karen Grimmer,3 Myrna S Estrada,4 Lauren Anne S Liao,1 Anne-Rochelle D Malleta,5 Ma Elena R Tan,6 Vero Marfil,6 Cristina S Versales,1 Jimah L Suarez,5 Kleon C So,1 Edgardo D Uyehara6 1University of Santo Tomas Hospital, University of Santo Tomas, 2University of Santo Tomas, Manila, Philippines; 3International Centre for Allied Health Evidence, University of South Australia, City East Campus, North Terrace, Adelaide, SA, Australia; 4De La Salle University Hospital, Cavite, Dasmariñas, 5Philippine Orthopedic Center, 6Veterans’ Memorial Medical Center, Quezon City, Philippines Background: Stroke is one of the leading medical conditions in the Philippines. Over 500,000 Filipinos suffer from stroke annually. Provision of evidence-based medical and rehabilitation management for stroke patients has been a challenge due to existing environmental, social, and local health system issues. Thus, existing western guidelines on stroke rehabilitation were contextualized to draft recommendations relevant to the local Philippine setting. Prior to fully implementing the guidelines, an audit of current practice needs to be undertaken, thus the purpose of this audit protocol.Methods: A clinical audit of current practices in stroke rehabilitation in the Philippines will be undertaken. A consensus list of data items to be captured was identified by the audit team during a 2-day meeting in 2012. These items, including patient demographics, type of stroke, time to referral for rehabilitation management, length of hospital stay, and other relevant descriptors of stroke management were included as part of the audit. Hospitals in the Philippines will be recruited to take part in the audit activity. Recruitment will be via the registry of the Philippine Academy of Rehabilitation Medicine, where 90% of physiatrists (medical doctors specialized in rehabilitation medicine are active members and are affiliated

  12. [Practice guidelines for medical treatment from the perspective of health law].

    Science.gov (United States)

    Roscam Abbing, H D

    1998-11-07

    Clinical practice guidelines are directions for medical doctors on the action to be taken in a given situation, thus standardising medical performance as regards content. The implementation of clinical practice guidelines (CPGs) is stimulated by government and health care insurers. Court decisions frequently refer to these guidelines. From a medical and legal perspective, the implementation of CPGs in daily medical practice has advantages (e.g. they contribute to best medical practice as well as to the quality of information to be provided to the patients), but also disadvantages (they may replace professional responsibility and may put cost containment over professional autonomy). CPGs may contribute to quality of care provided they are applied flexibly and responsibly.

  13. Collaboration with pharmacy services in a family practice for the medically underserved

    Directory of Open Access Journals (Sweden)

    Campbell K

    2009-12-01

    Full Text Available Objectives: Pharmacist-managed collaborative services in a family practice setting are described, and diabetes and hypertension outcomes are assessed.Methods: Pharmacist-managed clinics, pharmacotherapy consultations, and drug information services are provided for a medically underserved, predominantly African American population. A pharmacy residency director, an ambulatory care pharmacy resident and three PharmD candidate student pharmacists work directly with physicians, nurse practitioners, nurses, and social workers to form an interdisciplinary health care team. Providers utilize pharmacy services through consultations and referrals. Collaboration outcomes were evaluated in twenty-two patients with diabetes and thirty hypertensive patients. Patients were retrospectively followed throughout their history with pharmacy service. Hemoglobin A1c (A1C was tracked before referral to pharmacy services, 3 to 6 months after, and as the most current measure after at least 6 months. Blood pressure (BP was observed before pharmacy involvement, 2 to 4 months later, and then currently for at least 4 months with the service. The mean of the most current markers was calculated, and the percent of patients at their goal marker was compared to national averages.Results: Fifty percent of pharmacy service patients met the American Diabetes Association hemoglobin A1c goal of less than 7% in our evaluation compared to the national mean of 49.8% overall and 44% in African Americans. Thirty percent of patients were at their BP goal while 33.1% of patients without diabetes and 33.2% of patients with diabetes nationally are at goal. Conclusion: The medically underserved patients under the care of pharmacy services achieved a higher percentage at their A1C goal than the national mean. The percentage of patients who achieved their BP goals was comparable to the national average. Increasing utilization of pharmacy services in the family practice setting allows for

  14. [Medical professionals on the subject of their core values: the importance of practice-based stories and intrinsic motivation].

    Science.gov (United States)

    Witman, Yolande; van den Kerkhof, Peter C M; Braat, Didi D M

    2013-01-01

    In the current system for guaranteeing quality of care, emphasis is placed firmly on external control of professionals. We looked for a way to appeal to the intrinsic motivation of medical professionals and to discover what they mean by 'good work'. This was achieved with the aid of reflective sessions using the toolkit 'Good Work': in four sessions three different groups of medical professionals (medical department chairs, residents and interns) from a Dutch university hospital reflected on the topics 'excellence', 'moral responsibility' and 'personal engagement'. The participants exchanged practice-based stories during the sessions. The most important theme was moral responsibility, with its accompanying dilemmas. The sessions gave rise to feelings of mutual acknowledgement, recognition, inspiration and motivation. Sharing meaningful practice-based stories can be considered as a 'moment of learning', strengthening professional identity and stimulating intrinsic motivation. More space for this form of reflection might restore the balance with external control systems.

  15. The influence of experiential learning on medical equipment adoption in general practices.

    Science.gov (United States)

    Bourke, Jane; Roper, Stephen

    2014-10-01

    The benefits of the availability and use of medical equipment for medical outcomes are understood by physicians and policymakers alike. However, there is limited understanding of the decision-making processes involved in adopting and using new technologies in health care organisations. Our study focuses on the adoption of medical equipment in Irish general practices which are marked by considerable autonomy in terms of commercial practice and the range of medical services they provide. We examine the adoption of six items of medical equipment taking into account commercial, informational and experiential stimuli. Our analysis is based on primary survey data collected from a sample of 601 general practices in Ireland on practice characteristics and medical equipment use. We use a multivariate Probit to identify commonalities in the determinants of the adoption. Many factors, such as GP and practice characteristics, influence medical equipment adoption. In addition, we find significant and consistent evidence of the influence of learning-by-using effects on the adoption of medical equipment in a general practice setting. Knowledge generated by experiential or applied learning can have commercial, organisational and health care provision benefits in small health care organisations. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. Employee Internet management: current business practices and outcomes.

    Science.gov (United States)

    Case, Carl J; Young, Kimberly S

    2002-08-01

    This paper empirically examines emergent business practices that attempt to reduce and control employee Internet misuse and abuse. Over a 6-month period, 52 web-administered surveys were collected. Respondents ranged from human resource managers to company presidents. Data were stored in a database management system and analyzed utilizing statistical measures. Monitoring efforts and policy development issues are examined against critical incidents of employee Internet abuse. The analysis also includes a rank ordering of the types of Internet applications that were perceived as most problematic or abused. Types of applications abused include electronic mail, adult web sites, online gaming, chat rooms, stock trading, and so on. Moreover, company size and years online are examined. Overall, this research will assist organizations in implementing effective corporate initiatives to improve employee Internet management practices.

  17. Human resource aspects of antiretroviral treatment delivery models: current practices and recommendations.

    Science.gov (United States)

    Assefa, Yibeltal; Van Damme, Wim; Hermann, Katharina

    2010-01-01

    PURPOSE OF VIEW: To illustrate and critically assess what is currently being published on the human resources for health dimension of antiretroviral therapy (ART) delivery models. The use of human resources for health can have an effect on two crucial aspects of successful ART programmes, namely the scale-up capacity and the long-term retention in care. Task shifting as the delegation of tasks from higher qualified to lower qualified cadres has become a widespread practice in ART delivery models in low-income countries in recent years. It is increasingly shown to effectively reduce the workload for scarce medical doctors without compromising the quality of care. At the same time, it becomes clear that task shifting can only be successful when accompanied by intensive training, supervision and support from existing health system structures. Although a number of recent publications have focussed on task shifting in ART delivery models, there is a lack of accessible information on the link between task shifting and patient outcomes. Current ART delivery models do not focus sufficiently on retention in care as arguably one of the most important issues for the long-term success of ART programmes. There is a need for context-specific re-designing of current ART delivery models in order to increase access to ART and improve long-term retention.

  18. Current Credit Risk Management Practices in Chinese Banking Industry

    OpenAIRE

    Zheng, Hao

    2008-01-01

    ABSTRACT Bank loans can be characterized as the engine of the Chinese economy as the economy is almost financed by bank loans. As a result, Credit risk management in Chinese banks is not only the issue to those banks, but it is also essential to the stability of the whole economy. Inadequate credit risk management practices can create an unforeseeable disaster to China in the future, especially with a significant increase in credit expansion. In the last decade, the government has tried ha...

  19. Current practice in out-of-hospital cardiac arrest management

    DEFF Research Database (Denmark)

    Proclemer, Alessandro; Dobreanu, Dan; Pison, Laurent

    2012-01-01

    AIMS: The purpose of this EP wire is to examine clinical practice in the field of out-of-hospital cardiac arrest (OHCA) management, with special focus on in-hospital diagnostic and therapeutic strategies. METHODS AND RESULTS: Fifty-three European centres, all members of the EHRA-EP Research network...... management strategy, including coronary angiography/PCI and implantable cardioverter defibrillator therapy, while therapeutic hypothermia appears to be underused....

  20. Evaluation of Self Medication Practices in Rural Area of Town ...

    African Journals Online (AJOL)

    Keywords: Community pharmacies, Herbal drugs, Northern India, Over the counter, Self‑medication. Original Article .... media (25% [150/600]) or from a pharmacist (22% [132/600]) ..... that the economic rationale and the symbiotic relations that.

  1. Hand Washing Practices Among Emergency Medical Services Providers

    National Research Council Canada - National Science Library

    Bucher, Joshua; Donovan, Colleen; Ohman-Strickland, Pamela; McCoy, Jonathan

    2015-01-01

    Hand hygiene is an important component of infection control efforts. Our primary and secondary goals were to determine the reported rates of hand washing and stethoscope cleaning in emergency medical services (EMS...

  2. Time management tips, tricks, and exercises for busy medical practice employees.

    Science.gov (United States)

    Hills, Laura

    2012-01-01

    Working in a busy medical practice requires excellent time management skills and an ability to handle those unanticipated emergencies, urgencies, and monkey-wrenches that can and often do throw a well-planned day out of whack. This article offers busy medical practice employees 50 time management tips to help them manage their time well. It focuses specifically on eliminating time wasters, working more efficiently, and developing personal goals and habits that can increase productivity, reduce stress, and make working in the practice more enjoyable. This article also offers several hands-on time management exercises, including a time management self-assessment quiz, a multitasking exercise, and a time drain exercise. These can be completed individually or collaboratively with other members of the medical practice team. Finally, this article explores 12 popular time management myths and how a medical practice employee can increase his or her productivity by identifying and harnessing his or her productivity "happy hour(s)".

  3. Sleep Hygiene Practices and Their Relation to Sleep Quality in Medical Students of Qazvin University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Zohreh Yazdi

    2016-01-01

    Full Text Available Introduction: Poor quality of sleep is a distressing and worrying condition that can disturb academic performance of medical students. Sleep hygiene practices are one of the important variables that affect sleep quality. The objective of this study was to assess association between sleep hygiene practices and sleep quality of medical students in Qazvin University of Medical Sciences. Methods: In this descriptive-correlational study, a total of 285 medical students completed a self-administered questionnaire. Demographic data, sleep-wake schedule in weekday and weekend, and sleep duration were collected. Students' sleep quality was assessed by Pittsburg Sleep Quality Index (PSQI. Data were analyzed by SPSS Ver 13. Results: Overall, 164 (57.5 of students had poor sleep quality. Mean global PSQI score and average score of four subscales were significantly higher in male than female. Regression analysis showed that male students (β=-0.85, P<0.05, students at senior level (β=-0.81, P<0.05, married students (β=-0.45, P<0.05, and those with improper sleep hygiene practices slept worse. Conclusion: The findings of this study showed that the prevalence of poor sleep quality in medical students is high. Improper sleep hygiene behaviors might be a reason for poor quality of sleep in medical students.

  4. Self-Assessment in Librarianship: Current Practices and Future Possibilities

    Directory of Open Access Journals (Sweden)

    Ania Dymarz

    2015-07-01

    Full Text Available The authors of this qualitative study set out to investigate self-assessment practices within the library profession. The researchers conducted semi-structured interviews with a purposeful sample of nine librarians coming from a range of library settings and possessing a diversity of library experience. Interviews were then transcribed and coded in NVIVO to identify emergent themes. This paper details some of the results of that study, highlighting motivations, limitations, and strategies with regard to self-assessment. The findings present a summary of a range of approaches to the practice of assessment as reported by the interviewees. One area of possible growth for our profession, as highlighted by the findings, is in the development of peer networks as a support for the individual practice of self-assessment. While the results of this small case study cannot be generalized, the authors hope these preliminary findings can open up the conversation around self-assessment both for individual librarians and for those librarians and managers working to shape their workplace culture.

  5. Personal trainer demographics, current practice trends and common trainee injuries

    Directory of Open Access Journals (Sweden)

    Gregory R. Waryasz

    2016-10-01

    Full Text Available Increasing emphasis on maintaining a healthy lifestyle has led many individuals to seek advice on exercise from personal trainers. There are few studies to date that evaluate personal trainer education, practice trends, and injuries they have seen while training clients. A survey was distributed to personal trainers using Survey Monkey® (Palo Alto, CA, USA with 605 personal trainers accessing the survey. An exercise related bachelor’s degree was held by 64.2% of survey participants and a certification in personal training by 89.0%. The most common personal trainer certifications were from American College of Sports Medicine (59.2% and National Strength and Conditioning Association (28.9%. Only 2.9% of all personal trainers surveyed had no exercise-related bachelor’s degree and no personal trainer certification. The most common injuries seen by personal trainers during sessions were lumbar muscle strain (10.7%, rotator cuff tear/tendonitis (8.9%, shin splints (8.1%, ankle sprain (7.5%, and cervical muscle strain (7.4%. There is variability in the practices between different personal trainers when analyzing differences in collegiate education, personal trainer certifications, and strength and conditioning certifications. The clinical implication of the differences in practices is unknown as to the impact on injuries or exercise prescription effectiveness.

  6. Personal Trainer Demographics, Current Practice Trends and Common Trainee Injuries

    Science.gov (United States)

    Waryasz, Gregory R.; Daniels, Alan H.; Gil, Joseph A.; Suric, Vladimir; Eberson, Craig P.

    2016-01-01

    Increasing emphasis on maintaining a healthy lifestyle has led many individuals to seek advice on exercise from personal trainers. There are few studies to date that evaluate personal trainer education, practice trends, and injuries they have seen while training clients. A survey was distributed to personal trainers using Survey Monkey® (Palo Alto, CA, USA) with 605 personal trainers accessing the survey. An exercise related bachelor’s degree was held by 64.2% of survey participants and a certification in personal training by 89.0%. The most common personal trainer certifications were from American College of Sports Medicine (59.2%) and National Strength and Conditioning Association (28.9%). Only 2.9% of all personal trainers surveyed had no exercise-related bachelor’s degree and no personal trainer certification. The most common injuries seen by personal trainers during sessions were lumbar muscle strain (10.7%), rotator cuff tear/tendonitis (8.9%), shin splints (8.1%), ankle sprain (7.5%), and cervical muscle strain (7.4%). There is variability in the practices between different personal trainers when analyzing differences in collegiate education, personal trainer certifications, and strength and conditioning certifications. The clinical implication of the differences in practices is unknown as to the impact on injuries or exercise prescription effectiveness. PMID:27761219

  7. Cybersecurity and medical devices: A practical guide for cardiac electrophysiologists.

    Science.gov (United States)

    Ransford, Benjamin; Kramer, Daniel B; Foo Kune, Denis; Auto de Medeiros, Julio; Yan, Chen; Xu, Wenyuan; Crawford, Thomas; Fu, Kevin

    2017-08-01

    Medical devices increasingly depend on software. While this expands the ability of devices to perform key therapeutic and diagnostic functions, reliance on software inevitably causes exposure to hazards of security vulnerabilities. This article uses a recent high-profile case example to outline a proactive approach to security awareness that incorporates a scientific, risk-based analysis of security concerns that supports ongoing discussions with patients about their medical devices. © 2017 The Authors. Pacing and Clinical Electrophysiology published by Wiley Periodicals, Inc.

  8. Debriefing after failed paediatric resuscitation: a survey of current UK practice.

    Science.gov (United States)

    Ireland, S; Gilchrist, J; Maconochie, I

    2008-06-01

    Debriefing is a form of psychological "first aid" with origins in the military. It moved into the spotlight in 1983, when Mitchell described the technique of critical incident stress debriefing. To date little work has been carried out relating to the effectiveness of debriefing hospital staff after critical incidents. The aim of this study was to survey current UK practice in order to develop some "best practice" guidelines. This study was a descriptive evaluation based on a structured questionnaire survey of 180 lead paediatric and emergency medicine consultants and nurses, selected from 50 UK trusts. Questions collected data about trust policy and events and also about individuals' personal experience of debrief. Free text comments were analyzed using the framework method described for qualitative data. Overall, the response rate was 80%. 62% said a debrief would occur most of the time. 85% reported that the main aim was to resolve both medical and psychological and emotional issues. Nearly all involve both doctors and nurses (88%); in over half (62%) other healthcare workers would be invited, eg, paramedics, students. Sessions are usually led by someone who was involved in the resuscitation attempt (76%). This was a doctor in 80%, but only 18% of responders said that a specifically trained person had led the session. Individuals' psychological issues would be discussed further on a one-to-one basis and the person directed to appropriate agencies. Any strategic working problems highlighted would be discussed with a senior member of staff and resolved via clinical governance pathways. Little is currently known about the benefits of debriefing hospital staff after critical incidents such as failed resuscitation. Debriefing is, however, widely practised and the results of this study have been used to formulate some best practice guidelines while awaiting evidence from further studies.

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

    Science.gov (United States)

    Hills, Laura

    2016-01-01

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

  10. Improving standards of radiation protection in medical practice

    Energy Technology Data Exchange (ETDEWEB)

    Ginjaume, M.; Ortega, X. [Institute of Energy Technology, Universitat Politecnica de Catalunya - UPC (Spain); Carinou, E. [Greek Atomic Energy Commission - GAEC (Greece); Vanhavere, F. [Belgian Nuclear Research Centre, SCK.CEN (Belgium); Clairand, I. [Institut de Radioprotection et de Surete Nucleaire - IRSN (France); Gualdrini, G. [Ente per le Nuove Tecnologie, l' Energia e l' Ambiente - ENEA (Italy); Sans-Merce, M. [University Hospital Center Vaudois - CHUV (Switzerland)

    2010-07-01

    The use of ionizing radiation has led to major improvements in the diagnosis and treatment of patients. However, new developments in medical technology and the increased complexity of medical radiation techniques can produce high doses to medical personnel. In particular, interventional radiology and cardiology and nuclear medicine have been identified as fields where medical staff can receive potentially high doses. Within this framework, the ORAMED project, a collaborative project funded by the EU FP7, proposes new methodologies to improve standards of protection for medical staff. The main studied topics presented in this paper include extremity and eye-lens protection in interventional radiology and cardiology, extremity dosimetry in nuclear medicine, especially in therapy and positron emission tomography, and the evaluation and the improvement of active personal dosemeters used in pulsed medical radiation fields. An extensive dose measurement campaign of doses received in extremities and eye-lenses in more than 60 hospitals from 9 European countries has been undertaken. The analysis of the results highlights the most critical procedures and the effectiveness of the protection measures. (authors)

  11. The effects of deliberate practice in undergraduate medical education

    NARCIS (Netherlands)

    Moulaert, Véronique; Verwijnen, Maarten GM; Rikers, Remy; Scherpbier, Albert JJA

    2004-01-01

    INTRODUCTION: Ericsson and colleagues introduced the term 'deliberate practice' to describe training activities that are especially designed to maximise improvement. They stressed that how much one practises is as important as how one practises. Essential aspects of deliberate practice are the prese

  12. The effects of deliberate practice in undergraduate medical education

    NARCIS (Netherlands)

    Moulaert, Véronique; Verwijnen, Maarten GM; Rikers, Remy; Scherpbier, Albert JJA

    2004-01-01

    INTRODUCTION: Ericsson and colleagues introduced the term 'deliberate practice' to describe training activities that are especially designed to maximise improvement. They stressed that how much one practises is as important as how one practises. Essential aspects of deliberate practice are the

  13. Current status of traditional mental health practice in Ilorin Emirate Council area, Kwara State, Nigeria.

    Science.gov (United States)

    Makanjuola, A B; Adelekan, M L; Morakinyo, O

    2000-01-01

    Twenty-seven traditional mental health practitioners (TMHPs) and 16 patients' relatives (PR) were studied with a view to gaining an understanding of the current status of traditional mental health practice in five local government areas in Ilorin Emirate Council Area, Kwara State, Nigeria. Data was collected using Practitioners' Questionnaire (PQ), Patients' Relatives' Questionnaire (PRQ), Focus Group Discussions (FGDs) and observation of TMHPs in their clinics. Factors which affect utilization of traditional mental health services were also reviewed. We found that TMHPs still enjoy considerable patronage from the populace, are more in numerical strength, and are more widely and evenly dispersed in the community than orthodox mental health practitioners (OMHPs). About 74% of TMHPs expressed interest in attending seminars aimed at improving their skills. Most of the patients' relatives expressed the belief that only traditional healers can understand the supernatural aetiological basis of mental disorders, and can therefore offer more effective care than OMHPs. Some of the negative practices observed were (i) infliction of corporal punishment and physical restraints on patients by some TMHPs resulting in wounds, which often become septic (ii) low level of hygiene at the clinics and (iii) lack of adequate follow-up care. In conclusion, since TMHPs still play a major role in the treatment of the mentally ill in this environment, OMHPs should assist them in improving on some of the negative practices identified. Thus, there is an urgent need to organize a training programme for TMHPs to expose them to the general rules of hygiene in medical care, basic principles of orthodox mental health practice, including human treatment of the mentally ill.

  14. Geropsychology Mentoring: A Survey of Current Practices and Perceived Needs

    Science.gov (United States)

    Fiske, Amy; Zimmerman, Jennifer A.; Scogin, Forrest

    2011-01-01

    The need for clinical geropsychologists currently exceeds their availability, and this imbalance is expected to worsen along with the impending growth in the older adult population. Effective geropsychology mentoring may be helpful in meeting this challenge. However, little is known about mentoring within clinical geropsychology. The present paper…

  15. A Preliminary Investigation of Current Practices in American Youth Theatres.

    Science.gov (United States)

    Regan, F. Scott

    1983-01-01

    Summarizes results of a survey of youth theatres on (1) theatre goals; (2) staff training and courses offered; (3) organization and funds; and (4) teachers' knowledge of actor training, child and adolescent psychology, playwriting trends in children's theatre, and current theoretical writings. (PD)

  16. Integrative Assessment: Reframing Assessment Practice for Current and Future Learning

    Science.gov (United States)

    Crisp, Geoffrey T.

    2012-01-01

    The requirement to provide timely formative tasks that are designed to facilitate student learning and autonomy has provoked a wider examination of the role of assessment in higher education and encouraged further investigation of the alignment of learning, teaching and assessment in curriculum design frameworks. Many current authors have proposed…

  17. An Examination of Current Assessment Practices in Northeastern School Districts

    Science.gov (United States)

    Madaus, Joseph; Rinaldi, Claudia; Bigaj, Stephen; Chafouleas, Sandra M.

    2009-01-01

    Despite the central role of assessment in special education, there is a paucity of current research on instruments and methods used in schools. Special education directors (N = 164) in five northeastern states responded to an electronic survey related to the use of assessment instruments and methods in their districts. Data are presented regarding…

  18. NUCLEAR CARDIOLOGY, CURRENT APPLICATIONS IN CLINICAL-PRACTICE

    NARCIS (Netherlands)

    NIEMEYER, MG; VANDERWALL, EE; KUIJPER, AFM; CLEOPHAS, AT; PAUWELS, EKJ

    1995-01-01

    The clinical applications of nuclear cardiology have rapidly expanded since the introduction of suitable imaging cameras and readily applicable isotopes. The currently available methods can provide useful data on estimates of ventricular function and detection of myocardial ischemia for adequate pat

  19. Current HRD trends in the Netherlands: Conceptualisation and practices

    NARCIS (Netherlands)

    Kwakman, C.H.E.; Streumer, Jan; van der Heijden, Beatrice; Wognum, Ida; van Zolingen, S.J.

    2002-01-01

    In this contribution, we first report on a literature study aimed at describing current HRD developments. The resulting literature report was presented to a group of experts in the field of HRD. The participants were asked to sketch their vision as to the relevance of the HRD developments for their

  20. Current HRD trends in the Netherlands : conceptualizing and practices

    NARCIS (Netherlands)

    Kwakman, C.H.E.; Streumer, J.N.; Heijden, B.I.J.M. van der; Wognum, A.A.M.; Zolingen, S.J. van

    2002-01-01

    In this contribution, we first report on a literature study aimed at describing current HRD developments. The resulting literature report was presented to a group of experts in the field of HRD. The participants were asked to sketch their vision as to the relevance of the HRD developments for their

  1. Impact of Medication Dose Tracking Technology on Nursing Practice.

    Science.gov (United States)

    Peek, Grayson; Campbell, Udobi; Kelm, Matthew

    2016-09-01

    Objective: The impact of providing nursing staff access to data collected through a medication dose tracking technology (MDTT) web portal was investigated. Methods: A quasi-experimental, nonrandomized, pre-post intervention study was conducted in the Cardiothoracic Intensive Care Unit (CTICU) at Duke University Hospital. The change in the number of medication requests per dispense routed to the pharmacy electronic health record (EHR) in-basket was analyzed pre and post web portal access. Other endpoints included the number of MDTT web portal queries per day by nursing staff, change in nursing satisfaction survey scores, and technician time associated with processing medication requests pre and post web portal access. The pre web portal access phase of the study occurred from June 1, 2014 to August 31, 2014. The post web portal access phase occurred from October 1, 2014 to December 31, 2014. Results: An 11.4% decrease in the number of medication requests per dispense was exhibited between the pre and post web portal access phases of the study (0.0579 vs 0.0513, respectively; p < .001). Pre and post surveys showed a significant improvement in nurses' satisfaction regarding access to information on the location of medications (p = .009). Additionally, CTICU nursing staff utilized the MDTT web portal for 3.21 queries per day from October 1, 2014 to December 31, 2014. Conclusion: Providing nurses access to data collected via an MDTT decreased the number of communications between nursing and pharmacy staff regarding medication availability and led to statistically significant improvements in nursing satisfaction for certain aspects of the medication distribution process.

  2. Parameters of training, academic involvement, and practice setting predictive of retention in combined medical-psychiatric practice.

    Science.gov (United States)

    Silberman, Edward; Summergrad, Paul; Price, Lori

    2014-08-01

    The authors contrasted physicians trained in both psychiatry and another specialty who continue to practice both specialties vs. those who practice only psychiatry, in terms of their training, academic profile, and practice setting. The authors analyzed survey responses from 132 doubly boarded physicians who vary in whether or not they continue to practice both specialties. Group results were compared using chi square, Fisher exact, and t tests. Of graduates of double-board programs, 79.2% continue in dual practice. Other factors associated with continued combined practice were training in neurology-psychiatry, greater academic involvement, high motivation, practice in a non-public hospital setting, and demonstrated leadership capacity. Double-board training programs have been successful in producing a group of clinicians committed to long-term combined medical-psychiatric practice, but this effect is stronger in psychiatry-neurology than in other types of combined practice. Future research should investigate other practice parameters that foster or impede integrated medical-psychiatric care.

  3. Revisiting reflexology: Concept, evidence, current practice, and practitioner training

    OpenAIRE

    Embong, Nurul Haswani; Soh, Yee Chang; Ming, Long Chiau; Wong, Tin Wui

    2015-01-01

    Reflexology is basically a study of how one part of the human body relates to another part of the body. Reflexology practitioners rely on the reflexes map of the feet and hands to all the internal organs and other human body parts. They believe that by applying the appropriate pressure and massage certain spots on the feet and hands, all other body parts could be energized and rejuvenated. This review aimed to revisit the concept of reflexology and examine its effectiveness, practices, and th...

  4. Current problems of foreign practice-related educational psychology

    Directory of Open Access Journals (Sweden)

    A.D. Andreeva

    2012-09-01

    Full Text Available The article regards the questions of scientific-methodological provision of psychologist’s activity in an educational settlement which are urgent for the activity of practical educational psychologist in Russia as well. The presented information concerns the psychologist’s particular strands of work which can be both developing (development of ABM and psycho-correcting (reasons and forms of school phobias, bullying displays, lying. The ethical problems of psychologist’s work with families namely in case of the parent-child conflicts is also reviewed in the article.

  5. Current electroconvulsive therapy practice and research in the geriatric population

    Science.gov (United States)

    Kerner, Nancy; Prudic, Joan

    2014-01-01

    SUMMARY Electroconvulsive therapy (ECT) is utilized worldwide for various severe and treatment-resistant psychiatric disorders. Research studies have shown that ECT is the most effective and rapid treatment available for elderly patients with depression, bipolar disorder and psychosis. For patients who suffer from intractable catatonia and neuroleptic malignant syndrome, ECT can be life saving. For elderly patients who cannot tolerate or respond poorly to medications and who are at a high risk for drug-induced toxicity or toxic drug interactions, ECT is the safest treatment option. Organic causes are frequently associated with late-life onset of neuropsychiatric conditions, such as parkinsonism, dementia and stroke. ECT has proven to be efficacious even when these conditions are present. During the next decade, research studies should focus on the use of ECT as a synergistic therapy, to enhance other biological and psychological treatments, and prevent symptom relapse and recurrence. PMID:24778709

  6. [Medicinal plants in cancer patients: current practices and evaluation data].

    Science.gov (United States)

    Huet, Matthieu

    2013-05-01

    Many complementary and alternatives medicines are offered to patients with cancer. Among them, herbal medicines have a substantial place. These plants are mainly used to reduce adverse effects of anticancer treatments and for specific anticancer properties. Our review shows that only few clinical data support medicinal plants effectiveness in cancer patients. Arguments rely mainly on usual indications and pharmacological data for minimization of treatments toxicity while for the anticancer properties, on epidemiological and preclinical data. To inform and counsel patients and people around, healthcare professionals need to evaluate benefit-risk balance on evidence-based information. Because the medical decision should be shared with the patient, his beliefs and preferences have to be considered. When no adverse effect or drug interaction is associated with herbal medicine, we state that their use is acceptable. This paper discuss of potential risk and benefit of the most used medicinal plants by cancer patients.

  7. 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

  8. Big data in pharmacy practice: current use, challenges, and the future

    Directory of Open Access Journals (Sweden)

    Ma C

    2015-08-01

    Full Text Available Carolyn Ma, Helen Wong Smith, Cherie Chu, Deborah T JuarezDepartment of Pharmacy Practice, The Daniel K Inouye College of Pharmacy, University of Hawai'i at Hilo, Hilo, HI, USAAbstract: Pharmacy informatics is defined as the use and integration of data, information, knowledge, technology, and automation in the medication-use process for the purpose of improving health outcomes. The term “big data” has been coined and is often defined in three V's: volume, velocity, and variety. This paper describes three major areas in which pharmacy utilizes big data, including: 1 informed decision making (clinical pathways and clinical practice guidelines; 2 improved care delivery in health care settings such as hospitals and community pharmacy practice settings; and 3 quality performance measurement for the Centers for Medicare and Medicaid and medication management activities such as tracking medication adherence and medication reconciliation.Keywords: clinical pharmacy data base, pharmacy informatics, patient outcomes

  9. Virtuous acts as practical medical ethics: an empirical study.

    Science.gov (United States)

    Little, Miles; Gordon, Jill; Markham, Pippa; Rychetnik, Lucie; Kerridge, Ian

    2011-10-01

    To examine the nature, scope and significance of virtues in the biographies of medical practitioners and to determine what kind of virtues are at play in their ethical behaviour and reflection. A case study involving 19 medical practitioners associated with the Sydney Medical School, using semi-structured narrative interviews. Narrative data were analysed using dialectical empiricism, constant comparison and iterative reformulation of research questions. Participants represented virtuous acts as centrally important in their moral assessments of both themselves and others. Acts appeared to be contextually virtuous, rather than expressions of stable character traits, and virtue was linked to acts that served to protect or enhance fundamental values attached to ontological security and human flourishing. Virtue ethics, in this sense, was the single most important ethical system for each of the participants. Virtue ethics, construed as the appraisal of acts in contexts of risk, danger or threat to foundational values, emerged as the 'natural' ethical approach for medical practitioners in this case study. Teaching medical ethics to students and graduates alike needs to accommodate the priority attached to virtuous acts. © 2011 Blackwell Publishing Ltd.

  10. Regulatory Science in Practice (Pharmaceuticals and Medical Devices Agency).

    Science.gov (United States)

    Hojo, Taisuke

    2017-01-01

     Review, safety, and relief services of the Pharmaceuticals and Medical Devices Agency are primarily focused on scientifically evaluating pharmaceuticals, medical devices, and cellular and tissue-based products referring to their quality, efficacy, and safety, which requires a variety of scientific knowledge and methods. Pharmaceutical regulation should be established based on the most advanced scientific expertise at all times. In order to evaluate products that use cutting-edge technology such as induced pluripotent stem cells and information and communication technology adequately, since fiscal year 2012 the Science Committee has been established as a platform to exchange opinions among members from top-ranking domestic and international academia and to enhance personnel exchanges through the Initiative to Facilitate Development of Innovative Drugs. In addition, the Regulatory Science Center will be established in 2018 to increase the integrity of our services for product reviews and safety measures. In particular, requiring electronic data submissions for clinical trial applications followed by an advanced approach to analysis should not only enhance the quality of reviews of individual products but should also support the development of pharmaceuticals and medical devices by providing pharmaceutical affairs consultations on research and development strategies with various guidelines based on new insights resulting from product-bridging data analysis. Moreover, a database including electronic health records with comprehensive medical information collected mainly from 10 cooperating medical institutions will be developed with the aim of developing safety measures in a more timely manner using methods of pharmacoepidemiological analysis.

  11. Prevalence and pattern of self-medication practices in an urban area of Delhi, India

    Directory of Open Access Journals (Sweden)

    Varun Kumar

    2015-01-01

    Full Text Available Background: Self-medication is one of the major health concerns worldwide and World Health Organization has laid emphasis on correctly investigating and controlling it. There is much public and professional concern regarding self-medication practices, which has dramatically increased in the last few decades, especially in the developing countries. Hence, this study was designed to study the prevalence and practice of self-medication practices in an urban area of Delhi, India. Materials and Methods: A cross-sectional study was conducted in March 2013 and data were collected by personal interviews using pretested questionnaires. An urban colony in the south district of Delhi was chosen and the eldest member of the family, present at the time of the visit was interviewed. Data were collected from 236 persons and analyzed using SPSS version 21. Results: The prevalence of self-medication was 92.8% (95 confidence interval: 66.5-79.4. 74.9% preferred allopathic medicines. Self-medication was found to be practiced more among younger persons than older age group persons (P = 0.000. Graduates and postgraduates practiced self-medication more than others (P = 0.002. Common cold (61.6% and fever (51.8% were the most common ailments for which self-medication were practiced. Paracetamol and cough syrups were the most commonly used class of drugs. Conclusion: The prevalence of self-medication in this study was high. Drugs especially antimicrobials were not taken for the proper length of time. Awareness regarding self-medication practices to help patients decide on the appropriateness of self-medication is required.

  12. 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.

  13. Voice rest after vocal fold surgery: current practice and evidence.

    Science.gov (United States)

    Coombs, A C; Carswell, A J; Tierney, P A

    2013-08-01

    Voice rest is commonly recommended after vocal fold surgery, but there is a lack of evidence base and no standard protocol. The aim of this study was to establish common practice regarding voice rest following vocal fold surgery. An online survey was circulated via e-mail invitation to members of the ENT UK Expert Panel between October and November 2011. The survey revealed that 86.5 per cent of respondents agreed that 'complete voice rest' means no sound production at all, but there was variability in how 'relative voice rest' was defined. There was no dominant type of voice rest routinely recommended after surgery for laryngeal papillomatosis or intermediate pathologies. There was considerable variability in the duration of voice rest recommended, with no statistically significant, most popular response (except for malignant lesions). Surgeons with less than 10 years of experience were more likely to recommend fewer days of voice rest. There is a lack of consistency in advice given to patients after vocal fold surgery, in terms of both type and length of voice rest. This may arise from an absence of robust evidence on which to base practice.

  14. Premedication for neonatal intubation: Current practice in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Rafat Mosalli

    2012-01-01

    Full Text Available Background: Despite strong evidence of the benefits of rapid sequence intubation in neonates, it is still infrequently utilized in neonatal intensive care units (NICU, contributing to avoidable pain and secondary procedure-related physiological disturbances. Objectives: The primary objective of this cross-sectional survey was to assess the practice of premedication and regimens commonly used before elective endotracheal intubation in NICUs in Saudi Arabia. The secondary aim was to explore neonatal physicians′ attitudes regarding this intervention in institutions across Saudi Arabia. Methods: A web-based, structured questionnaire was distributed by the Department of Pediatrics, Umm Al Qura University, Mecca, to neonatal physicians and consultants of 10 NICUs across the country by E-mail. Responses were tabulated and descriptive statistics were conducted on the variables extracted. Results: 85% responded to the survey. Although 70% believed it was essential to routinely use premedication for all elective intubations, only 41% implemented this strategy. 60% cited fear of potential side effects for avoiding premedication and 40% indicated that the procedure could be executed more rapidly without drug therapy. Treatment regimens varied widely among respondents. Conclusion: Rates of premedication use prior to non-emergent neonatal intubation are suboptimal. Flawed information and lack of unified unit policies hampered effective implementation. Evidence-based guidelines may influence country-wide adoption of this practice.

  15. Post-arthroscopy septic arthritis: Current data and practical recommendations.

    Science.gov (United States)

    Bauer, T; Boisrenoult, P; Jenny, J Y

    2015-12-01

    Septic arthritis develops after less than 1% of all arthroscopy procedures. The clinical symptoms may resemble those seen after uncomplicated arthroscopy, raising diagnostic challenges. The diagnosis rests on emergent joint aspiration with microscopic smear examination and prolonged culturing on specific media. Urgent therapeutic measures must be taken, including abundant arthroscopic lavage, synovectomy, and the concomitant administration of two effective antibiotics for at least 6 weeks. Preservation of implants or transplants is increasingly accepted, and repeated joint lavage is a component of the treatment strategy. After knee arthroscopy, infection is the most common complication; most cases occur after cruciate ligament reconstruction, and staphylococci are the predominant causative organisms. Emergent synovectomy with transplant preservation and appropriate antibiotic therapy ensures eradication of the infection in 85% of cases, with no adverse effect on final functional outcomes. After shoulder arthroscopy, infection is 10 times less common than neurological complications and occurs mainly after rotator cuff repair procedures; the diagnosis may be difficult and delayed if Propionibacterium acnes is the causative organism. The update presented here is based on both a literature review and a practice survey. The findings have been used to develop practical recommendations aimed at improving the management of post-arthroscopy infections, which are exceedingly rare but can induce devastating functional impairments.

  16. A critique of current practice: ten foundational guidelines for autoethnographers.

    Science.gov (United States)

    Tolich, Martin

    2010-12-01

    Any research is potentially compromised when researchers address ethical issues retrospectively rather than by anticipating these issues. In this regard, creative analytical practices (CAP) autoethnography has endemic problems. In Part 1 of this article, I detail a case study of an autoethnography in which journal reviewers insisted that an author gain retrospective informed consent from the 23 persons documented in an autoethnography. Yet the journal reviewers' insistence failed to go one step further-acknowledging that a conflict of interest develops when gaining consent retrospectively. In Part 2, I contrast three leading autoethnographers' justifications for not gaining informed consent with the Position Statement on Qualitative Research developed by successive Congresses of Qualitative Inquiry. In Part 3, I identify resources available for autoethnographers, including ethical issues present when researchers use autoethnography to heal themselves, violating the internal confidentiality of relational others. In Part 4, I question if autoethnography is research and, like journalism, exempt from formal ethics review. Throughout the article, 10 foundational ethical considerations for autoethnographers are developed, taking autoethnographers beyond procedural ethics and providing tools for their ethics in practice.

  17. What do we do? Practices and learning strategies of medical education leaders.

    Science.gov (United States)

    Lieff, Susan; Albert, Mathieu

    2012-01-01

    Continuous changes in undergraduate and postgraduate medical education require faculty to assume a variety of new leadership roles. While numerous faculty development programmes have been developed, there is little evidence about the specific practices of medical education leaders or their learning strategies to help inform their design. This study aimed to explore what medical education leaders' actually do, their learning strategies and recommendations for faculty development. A total of 16 medical education leaders from a variety of contexts within the faculty of medicine of a large North American medical school participated in semi-structured interviews to explore the nature of their work and the learning strategies they employ. Using thematic analysis, interview transcripts were coded inductively and then clustered into emergent themes. Findings clustered into four key themes of practice: (1) intrapersonal (e.g., self-awareness), (2) interpersonal (e.g., fostering informal networks), (3) organizational (e.g., creating a shared vision) and (4) systemic (e.g. strategic navigation). Learning strategies employed included learning from experience and example, reflective practice, strategic mentoring or advanced training. Our findings illuminate a four-domain framework for understanding medical education leader practices and their learning preferences. While some of these findings are not unknown in the general leadership literature, our understanding of their application in medical education is unique. These practices and preferences have a potential utility for conceptualizing a coherent and relevant approach to the design of faculty development strategies for medical education leadership.

  18. Self-medication practices among a sample of Latino migrant workers in South Florida

    Directory of Open Access Journals (Sweden)

    Jesus eSanchez

    2014-08-01

    Full Text Available Introduction: Although the literature on self-medication among Latino migrant workers (LMWs is sparse, a few existing studies indicate that this practice is common in this community. The purpose of this paper is to estimate health status, access to health care, and patterns of self-medication practices of a cohort of LMWs in South Florida.Methods: A stratified network-based sample was utilized to recruit 278 LMWs in the Homestead area. After screening for eligibility, participants were administered a structured questionnaire that collected data on their health status, access to health care services, and self-medication practices. A convenience sample of 24 Latino migrant workers who participated in the parent study were invited back to participate in 3 focus groups to look more in depth into self-medication practices in the Latino migrant worker community. Results: Study findings indicate that Latino migrant workers are affected by a vast array of health problems yet lack access to health care services. Participants already engaged in self-medication practices in the countries of origin and, upon their arrival in the US, these practices continue and, in many cases, increase. Conclusion: Long-held traditions and lack of access to the formal health care system in the US contribute to the high prevalence of self-medication among Latino migrant workers. Self-medication practices such as the use of prescription medications without a prescription and lay injection are high risk practices that can have harmful consequences. Prevention interventions that address self-medication in the Latino migrant worker community are likely to be most effective if they are culturally adapted to the community and facilitate access to health care services.

  19. [Cervical cancer screening in Switzerland - current practice and future challenges].

    Science.gov (United States)

    Untiet, Sarah; Schmidt, Nicole; Low, Nicola; Petignat, Patrick

    2013-04-01

    At the beginning of the 20th Century, cervical cancer was the leading cause of death from cancer in women. A marked decline in cervical cancer has been observed since the 1960s, in parallel with the introduction of the Papanicolau (Pap) test as a cytological screening method. Today, Pap smear screening is still the most widely used tool for cervical cancer prevention. Testing for human papillomavirus (HPV) in cervical specimens or a combination of Pap and HPV testing are also now available. In this article we compare current guidelines for cervical cancer screening in Switzerland with those in other European countries. In view of the opportunities offered by HPV testing and, since 2008, HPV vaccination, current guidelines for cervical cancer screening should be updated. Both the choice of screening tests and general organization of cervical cancer screening should be reviewed.

  20. Practical Application of Eddy Currents Generated by Wind

    Energy Technology Data Exchange (ETDEWEB)

    Dirba, I; Kleperis, J, E-mail: imants.dirba@gmail.com [Institute of Solid State Physics of University of Latvia, 8 Kengaraga Street, Riga, LV-1063 (Latvia)

    2011-06-23

    When a conductive material is subjected to time-varying magnetic fluxes, eddy (Foucault) currents are generated in it and magnetic field of opposite polarity as the applied one arises. Due to the internal resistance of the conductive material, the eddy currents will be dissipated into heat (Joule heating). Conventional domestic water heaters utilize gas burners or electric resistance heating elements to heat the water in the tank and substantial part of the energy to use for it is wasted. In this paper the origin of electromagnetic induction heat generated by wind turbine in special heat exchange camera connected to water boiler is discussed and material evaluation performed using mathematical modelling (comparing the 2D finite element model with analytical and numerical calculation results).

  1. Practical Application of Eddy Currents Generated by Wind

    Science.gov (United States)

    Dirba, I.; Kleperis, J.

    2011-06-01

    When a conductive material is subjected to time-varying magnetic fluxes, eddy (Foucault) currents are generated in it and magnetic field of opposite polarity as the applied one arises. Due to the internal resistance of the conductive material, the eddy currents will be dissipated into heat (Joule heating). Conventional domestic water heaters utilize gas burners or electric resistance heating elements to heat the water in the tank and substantial part of the energy to use for it is wasted. In this paper the origin of electromagnetic induction heat generated by wind turbine in special heat exchange camera connected to water boiler is discussed and material evaluation performed using mathematical modelling (comparing the 2D finite element model with analytical and numerical calculation results).

  2. Prevalence and Pattern of Self-medication Practices in Urban area of Southern Rajasthan

    Directory of Open Access Journals (Sweden)

    Manish Jain, Rahul Prakash, Dhriti Bapna, Rohit Jain

    2015-01-01

    Full Text Available Background: Self-medications is widely practiced in both developed and developing countries. Inappropriate self-medication results in increases resistance of pathogens, wastage of resources, and serious health hazards. Objectives: Present study was conducted to determine the prevalence, pattern and factors associated with self-medication among general population of an urban area of Sothern Rajasthan. Materials and Methods: A cross sectional community based study was conducted among general population in urban field practice area of Department of community medicine, RNT Medical College, Udaipur, Rajasthan from May 2015 to August 2015. Individuals aged 18 years and above were included as study participants using Simple random method of sampling. Results: Out of total 440 study participants, 324 (73.6% had used self-medication within last three months recall period. The practice of self-medication was more common among younger age groups, male gender and higher levels of education. Paracetamol (73.77% and other analgesics (41.98% were most commonly used drugs. Most common symptoms warranting self-medication were fever (75.31% and headache (62.04%. Conclusion: Rising prevalence of self-medication is a matter of serious concern. IEC activities should be strengthened among general population to minimize the practice of self-medication.

  3. 口腔门诊医护人员“标准预防”知信行的调查报告%Current Situation and Inlfuential Factors of Medical Staffs' Knowledge-attitude-practice about Standard Precaution in Shenzhen First-class Hospitals

    Institute of Scientific and Technical Information of China (English)

    周军; 王羽凡; 刘开蕾

    2015-01-01

    Objective The objectives were to know knowledge-attitude–practice level with Standard Precaution among medical staffs in Shenzhen first-class hospitals.Methods Totally 170 medical staffs were investigated with a self designed questionnaire using stratiifed random sampling.Results Totally 170 valid questionnaires (54 doctors and 116 nurses) were collected. There was statistical significance in profession, working years, professional title and degree about know knowledge-attitude–practice level with Standard Precaution (P<0.01). It is influenced by many factors. The signiifcant differences between doctors (18.52%) and nurses (58.62%) has been found in hand hygiene. Medical staff who always "masks" and "wear isolation gowns" is just 43.53% and 23.53%. The main reason is "time" (35.29%) and "protective equipment supply" (36.47%). 88.24% medical staffs have been injured by sharp instrument, but 78.89%medical staffs do not report. Because 55.17% think the procedure is complex.Conclusion It is necessary to strengthen medical staffs’ training, correct errors, and increase compliance with standard precaution.%目的:了解三甲医院口腔门诊医护人员标准预防认知现状,防治医院感染的发生。方法采用随机抽样的方法,自行设计问卷,对170名口腔门诊医护人员进行调查。结果共回收有效问卷170份,其中,医生54份,护士116份。职业,工龄,职称,学历对标准预防相关知识了解的差异具有统计学意义(P<0.01);标准预防依从性受多种因素的影响。其中手卫生的依从性护士为58.62%,医生仅有18.52%,医护人员间的差异具有统计学意义。而影响手卫生依从性的主要因素为“工作忙碌/无足够时间”及“需优先处理病人”(58.83%,36.47%)。总是“戴面罩”和“穿隔离衣”的医护人员仅43.53%,23.53%。其主要原因是“时间紧迫”与“防护设备供应不足”(35.29%,36.47%)。

  4. An Investigation of Current Endodontic Practice in Turkey

    Science.gov (United States)

    Kaptan, R. F.; Haznedaroglu, F.; Kayahan, M. B.; Basturk, F. B.

    2012-01-01

    Objectives. The aim of this study was to gather information about the quality and quantity of root canal treatments carried out by general dental practitioners in Turkey. Methods. Questionnaires were given to 1400 dentists who attended the 16th National Congress organized by the Turkish Dental Association. The participants were asked to answer 34 multiple-choice questions. The questions were subdivided into 3 main topics; general information; general approach to endodontic treatment; and cleaning, shaping, and obturation of root canals. The statistical analysis was carried out by an χ 2-test to compare the means at a significance level of P Endodontic procedures in general practice in Turkey have differences from widely acknowledged quality guidelines. Despite the introduction of new instruments and techniques, most of the general practitioners chose conventional methods. PMID:23251103

  5. 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.

  6. 77 FR 16158 - Current Good Manufacturing Practice in Manufacturing, Processing, Packing, or Holding of Drugs...

    Science.gov (United States)

    2012-03-20

    ... Manufacturing Practice in Manufacturing, Processing, Packing, or Holding of Drugs; Revision of Certain Labeling... Administration (FDA) is amending the packaging and labeling control provisions of the current good manufacturing..., 21 CFR part 211 is amended as follows: PART 211--CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED...

  7. DETERMINANTS OF CURRENT ACCOUNT DEFICIT AND ECONOMY POLICIES PRACTICES FOR CURRENT ACCOUNT DEFICIT IN TURKISH ECONOMY

    Directory of Open Access Journals (Sweden)

    Veysel Karagol

    2017-03-01

    Full Text Available In last years with the impact of rapid globalization and financiallisation current account deficit became a major problem for Turkish economy. Hence, many studies have been conducted foreseeing for policy recommendations and precautions against the current deficit. In this study, by considering determinants of current account deficit and implemented policies, it is intended to provide policy recommendations for closing the deficit. As part of this goal, the determinants of current account deficit and impacts of the determinantsa re discussed. Also, by mentioning monetary and fiscal policies during the period 2003-2015 overall assessment of the policies and a set of policiy recommendations for the next periods were presented. The most important result achieved by the study is applying discussed structural reforms in able to have quick progress in dealing with the current account deficit would have a great effect.

  8. Literary and Documentary Evidence for Lay Medical Practice in the Roman Republic and Empire.

    Science.gov (United States)

    Draycott, Jane

    2016-01-01

    The majority of surviving ancient medical literature was written by medical practitioners and produced for the purpose of ensuring the effective diagnosis and treatment of their patients, suggesting an audience of medical professionals ranging from instructors to students. This has led historians to concentrate on the professional medical practitioner and their theories, methods and practices, rather than on lay medical practitioners, or even patients themselves. This chapter seeks to redress this imbalance, and examine the ancient literary and documentary evidence for lay medical theories, methods and practices in the Roman Republic and Empire in an attempt to reconstruct the experiences of lay medical practitioners and their patients. The Roman agricultural treatises of Cato, Varro and Columella, papyri and ostraca from Egypt, and tablets from Britain are investigated, and it is established that the individual's personal acquisition of knowledge and expertise, not only from medical professionals and works of medical literature, but also from family members and friends, and through trial and error, was considered fundamental to domestic medical practice.

  9. ADHD medication prescription: Effects of child, sibling, parent and general practice characteristics.

    Science.gov (United States)

    Heins, Marianne J; Bruggers, Inge; van Dijk, Liset; Korevaar, Joke C

    2016-10-05

    Many children receive attention-deficit hyperactivity disorder (ADHD) medication, but factors that determine medication prescription are largely unknown. This study aimed to determine the relative impact of factors on the child, family and general practitioner (GP) practice level on ADHD medication prescription. We included 1259 Dutch children aged 6-18 years with a diagnostic code of ADHD or related behavioural problems (ICPC codes P20-P22) in NIVEL primary care database. Using multilevel analyses, we examined predictors of ADHD medication prescription. Children diagnosed as 'hyperactive' were 16 times more likely to be prescribed ADHD medication than those with 'behavioural concerns'. Children with a parent or sibling receiving ADHD medication were three to four times more likely to be prescribed ADHD medication themselves. Children from GP practices with a high percentage of children with ADHD were twice as likely to be prescribed ADHD medication. Concluding, factors on the individual, family and GP practice level determine ADHD medication prescription. Future research into the decision-making process for ADHD medication is warranted.

  10. Metafunctional Practices in Medical Research Articles: A Comparative Study

    Science.gov (United States)

    Assadi, Nader; Ghassemi, Mojtaba; Madadi, Alireza

    2014-01-01

    The purpose of this study is to explore any possible difference among the verb types chosen in articles written in English by the non-natives and natives. In so doing, Halliday's Systemic Functional Grammar (1994) was employed. 80 published articles from the medical sciences field of study were chosen from among which 40 were written by native…

  11. [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.

  12. Competency-based medical education : theory to practice

    NARCIS (Netherlands)

    Frank, Jason R.; Snell, Linda S.; Ten Cate, Olle; Holmboe, Eric S.; Carraccio, Carol; Swing, Susan R.; Harris, Peter; Glasgow, Nicholas J.; Campbell, Craig; Dath, Deepak; Harden, Ronald M.; Iobst, William; Long, Donlin M.; Mungroo, Rani; Richardson, Denyse L.; Sherbino, Jonathan; Silver, Ivan; Taber, Sarah; Talbot, Martin; Harris, Kenneth A.

    2010-01-01

    Although competency-based medical education (CBME) has attracted renewed interest in recent years among educators and policy-makers in the health care professions, there is little agreement on many aspects of this paradigm. We convened a unique partnership - the International CBME Collaborators - to

  13. Practice of Self-medication in Jimma Town

    African Journals Online (AJOL)

    survey on a sample of 352 households, which were selected systematically. Data was ... The relative lesser cost (35.7%) was the major reason for using se1f~ ... availability to consumers' (3,4). ... medication & inappropriate purchasing of drugs ... pharmaceuticals seems to be a field in which ..... Forum 1993;14:381-384. 2.

  14. Practical approaches to family-friendly medical studies.

    Science.gov (United States)

    Liebhardt, Hubert; Niehues, Johanna; Fegert, Jörg M

    2012-01-01

    Based on the pilot study carried out by the Office of the Dean of the Medical University of Ulm on the family-friendliness of the organisation of medical education in Ulm, this paper describes concrete measures that were designed at the university or have been partly implemented already. More flexibility and customization are essential characteristics and prerequisites of a family-friendly medical school as part of university education structures. Flexibility and customization can be achieved by designing lesson plans and study regulations so that both childcare is assured and that in emergencies, help can be quickly offered with a minimum of bureaucracy. More flexibility includes, amongst other things, adequate means for the individual to compensate for missed compulsory attendances and examination dates. The necessary shift in thinking and the willingness to cooperate on behalf of the management and teaching staff can be supported through the audit for family-friendliness "berufundfamilie" (job and family) or "familiengerechte hochschule" (family-friendly university), as well as strategic management tools of family-friendly corporate policies. Supporting mechanisms such as effectively networked advice services, course progression monitoring based on data, providing a parents' passport with a cross-semester training contract, creating more interaction between student-parents or other students through a parent community or by study pairings and finally, reliable information on and compliance with the maternity leave rules for pregnant and breastfeeding medical students can help safeguard successful studying with children.

  15. Part-time medical practice: where is it headed?

    NARCIS (Netherlands)

    McMurray, J.E.; Heiligers, P.J.M.; Shugerman, R.P.; Douglas, J.A.; Gangnon, R.E.; Voss, C.; Costa, S.T.; Linzer, M.

    2005-01-01

    One of the fundamental tenets of medicine has been the centrality of the profession as a life calling; physicians work long hours and routinely sacrifice personal interests for professional demands. In 1993, only 13% of clinical faculty and 6% of basic science faculty members of U.S. medical schools

  16. Modern and Traditional Medical Practices of Vietnam. Vietnamese Concepts of Illness and Treatment.

    Science.gov (United States)

    Rieu, Le Tai

    This paper discusses superstitious, folk, traditional, and modern medical practices of Vietnam. Concepts of illness, somatization, behavior labeling, diagnostic attempts, and attitudes toward treatment among Vietnamese are also reviewed. (APM)

  17. Knowledge, attitudes and practices of prevention for cervical cancer and breast cancer among medical students

    National Research Council Canada - National Science Library

    Pablo Rodriguez Feria; Luis Jorge Hernández-Florez; Daniela Rodriguez-Feria

    2016-01-01

      Objective To assess the knowledge, attitudes and practices of medical students for health promotion, primary prevention and early detection of breast neoplasm and uterine cervical neoplasm, as well...

  18. [Practice guideline 'Medically unexplained physical symptoms (MUPS) and somatoform disorders': a step in the right direction

    NARCIS (Netherlands)

    Lucassen, P.L.B.J.

    2011-01-01

    The Dutch multidisciplinary practice guideline 'Medically unexplained physical symptoms (MUPS) and somatoform disorders' provides information on non-specific somatoform complaints, hypochondriasis, conversion disorders and a limited number of specific functional syndromes. Much attention is given in

  19. Principles and practice of hyperbaric medicine: a medical practitioner's primer, part II.

    Science.gov (United States)

    Perdrizet, George A

    2014-08-01

    Advances in the treatment of chronic wounds* have steadily occurred over the past decade and include the specialized use of dynamic compression therapy, implementation of moist wound care techniques, chronic lymphedema therapy, negative pressure wound therapy, arterial compression therapy and application of off-loading devices. General medical practitioners should recognize when timely patient referral to a comprehensive wound care center is indicated. The clinical practice of HBOT and its scientific basis has also advanced significantly during this same time period. HBOT is a therapeutic tool with many qualities that are unique to medical care and enable difficult and otherwise untreatable conditions to be safely and effectively managed. Level 1 evidence exists for HBOT and the therapeutic indications are growing. It is the responsibility of all practitioners to become informed about the modern principles and practice of HBOT. Clinicians should take the advice of Mark Twain: "Supposing is good but finding out is better." It is the responsibility of educational institutions and medical societies to become informed and actively engaged in hyperbaric medical care, education and research. This will benefit our patients as well as our systems of medical care. There is now ample access to hyperbaric oxygen facilities and expertise with the state. There is a growing need for HBOT services due to the rising incidence of obesity and diabetes combined with an aging demographic. Appropriate networks and patterns of referral have lagged behind this demand due to a generalized lack of understanding of the true risks, benefits and indications for HBOT. This review will hopefully begin to address this problem. Hyperbaric medicine is in an early phase of development. The current and future demand for clinical services will drive development of research and educational programs. Only through continued efforts for perform high quality research and education will the full potential

  20. Labelling of electronic cigarettes: regulations and current practice

    Science.gov (United States)

    Buonocore, Federico; Marques Gomes, Ana C N; Nabhani-Gebara, Shereen; Barton, Stephen J; Calabrese, Gianpiero

    2017-01-01

    Background Over the past decade e-cigarettes have established themselves in the global market. E-cigarettes triggered much interest in relation to their content and efficacy as smoking cessation tools, but less attention has been paid to users and environmental safety warnings and guidance. Several regulations have been introduced to promote their safe handling and disposal. From May 2016, liquids and cartridges will be regulated by European Community Directives (ECDs) 2001/83/EC and 93/42/EEC, or 2014/40/EU if marketed as tobacco-related products. Currently, manufacturers and distributors must abide by the Chemical (Hazard Information and Packaging for Supply) Regulations 2009 (CHIP) or Classification, Labelling and Packaging Regulations (CLP), the latter replacing CHIP in June 2015. Objective In this work, the compliance of marketed e-liquids and e-cigarettes with current European Union and UK legislations is assessed. Results E-liquids and e-cigarettes (21 and 9 brands, respectively) were evaluated. Evidence of non-compliance was found in relation to the CHIP/CLP toxic (13%) and environmental (37%) pictograms, tactile warning (23%), nominal amount of solution (30%), supplier contact telephone number and address (40%). None of the evaluated e-cigarettes displayed information on the correct disposal/recycling of batteries in line with the ECD 2006/66/EC. Conclusions More stringent enforcement of regulations is needed to ensure not only the user's safety and awareness, but also the safeguarding of the environment. PMID:26790924