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Sample records for department automated medication

  1. [Impact of an automated dispensing system for medical devices in cardiac surgery department].

    Science.gov (United States)

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

    2018-01-01

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

  2. Use of emergency department electronic medical records for automated epidemiological surveillance of suicide attempts: a French pilot study.

    Science.gov (United States)

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

    2017-06-01

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

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

    Science.gov (United States)

    Fanning, Laura; Jones, Nick; Manias, Elizabeth

    2016-04-01

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

  4. Automated Medical Literature Retrieval

    Directory of Open Access Journals (Sweden)

    David Hawking

    2012-09-01

    Full Text Available Background The constantly growing publication rate of medical research articles puts increasing pressure on medical specialists who need to be aware of the recent developments in their field. The currently used literature retrieval systems allow researchers to find specific papers; however the search task is still repetitive and time-consuming. Aims In this paper we describe a system that retrieves medical publications by automatically generating queries based on data from an electronic patient record. This allows the doctor to focus on medical issues and provide an improved service to the patient, with higher confidence that it is underpinned by current research. Method Our research prototype automatically generates query terms based on the patient record and adds weight factors for each term. Currently the patient’s age is taken into account with a fuzzy logic derived weight, and terms describing blood-related anomalies are derived from recent blood test results. Conditionally selected homonyms are used for query expansion. The query retrieves matching records from a local index of PubMed publications and displays results in descending relevance for the given patient. Recent publications are clearly highlighted for instant recognition by the researcher. Results Nine medical specialists from the Royal Adelaide Hospital evaluated the system and submitted pre-trial and post-trial questionnaires. Throughout the study we received positive feedback as doctors felt the support provided by the prototype was useful, and which they would like to use in their daily routine. Conclusion By supporting the time-consuming task of query formulation and iterative modification as well as by presenting the search results in order of relevance for the specific patient, literature retrieval becomes part of the daily workflow of busy professionals.

  5. Automated medical image segmentation techniques

    Directory of Open Access Journals (Sweden)

    Sharma Neeraj

    2010-01-01

    Full Text Available Accurate segmentation of medical images is a key step in contouring during radiotherapy planning. Computed topography (CT and Magnetic resonance (MR imaging are the most widely used radiographic techniques in diagnosis, clinical studies and treatment planning. This review provides details of automated segmentation methods, specifically discussed in the context of CT and MR images. The motive is to discuss the problems encountered in segmentation of CT and MR images, and the relative merits and limitations of methods currently available for segmentation of medical images.

  6. Asthma Medication Ratio Predicts Emergency Depart...

    Data.gov (United States)

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

  7. Building an automated SOAP classifier for emergency department reports.

    Science.gov (United States)

    Mowery, Danielle; Wiebe, Janyce; Visweswaran, Shyam; Harkema, Henk; Chapman, Wendy W

    2012-02-01

    Information extraction applications that extract structured event and entity information from unstructured text can leverage knowledge of clinical report structure to improve performance. The Subjective, Objective, Assessment, Plan (SOAP) framework, used to structure progress notes to facilitate problem-specific, clinical decision making by physicians, is one example of a well-known, canonical structure in the medical domain. Although its applicability to structuring data is understood, its contribution to information extraction tasks has not yet been determined. The first step to evaluating the SOAP framework's usefulness for clinical information extraction is to apply the model to clinical narratives and develop an automated SOAP classifier that classifies sentences from clinical reports. In this quantitative study, we applied the SOAP framework to sentences from emergency department reports, and trained and evaluated SOAP classifiers built with various linguistic features. We found the SOAP framework can be applied manually to emergency department reports with high agreement (Cohen's kappa coefficients over 0.70). Using a variety of features, we found classifiers for each SOAP class can be created with moderate to outstanding performance with F(1) scores of 93.9 (subjective), 94.5 (objective), 75.7 (assessment), and 77.0 (plan). We look forward to expanding the framework and applying the SOAP classification to clinical information extraction tasks. Copyright © 2011. Published by Elsevier Inc.

  8. COMMUNICATION FROM THE MEDICAL DEPARTMENT

    CERN Multimedia

    Service Médical

    2000-01-01

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

  9. Automation of Personnel Certification Roadbuilding Departments and Enterprises

    Directory of Open Access Journals (Sweden)

    Andrey Vladimirovich Ostroukh

    2015-10-01

    Full Text Available The article suggests science-based solutions to improve the efficiency of personnel certification of road construction departments and enterprises by developing an integrated learning environment based on an automated system of distance learning with the open source software and methodological support, tailored to the professional standards. Personnel certification procedure of road construction departments and enterprises for optimization and automation is analyzed. Optimization solutions for all stages of the preparation and conduction conformance testing to create test tasks for batch import of test tasks in a database of test tasks and adaptive algorithm for bringing the subject of tests proposed and implemented. The developed technique of adaptive presentation may perform various functions, depending on the settings of the algorithm.

  10. Medical ADP Systems: Automated Medical Records Hold Promise to Improve Patient Care

    Science.gov (United States)

    1991-01-01

    automated medical records. The report discusses the potential benefits that automation could make to the quality of patient care and the factors that impede...information systems, but no organization has fully automated one of the most critical types of information, patient medical records. The patient medical record...its review of automated medical records. GAO’s objectives in this study were to identify the (1) benefits of automating patient records and (2) factors

  11. Robotic automation of medication-use management.

    Science.gov (United States)

    Enright, S M

    1993-11-01

    In the October 1993 issue of Physician Assistant, we published "Robots for Health Care," the first of two articles on the medical applications of robotics. That article discussed ways in which robots could help patients with manipulative disabilities to perform activities of daily living and hold paid employment; transfer patients from bed to chair and back again; add precision to the most exacting surgical procedures; and someday carry out diagnostic and therapeutic techniques from within the human body. This month, we are pleased to offer an article by Sharon Enright, an authority on pharmacy operations, who considers how an automated medication-management system that makes use of bar-code technology is capable of streamlining drug dispensing, controlling safety, increasing cost-effectiveness, and ensuring accurate and complete record-keeping.

  12. US Department of Energy Automated Transportation Management System

    International Nuclear Information System (INIS)

    Portsmouth, J.H.

    1994-01-01

    The U.S. Department of Energy (DOE) Transportation Management Division (TMD) is responsible for managing its various programs via a diverse combination of Government-Owned/Contractor-Operated facilities. TMD is seeking to update it automation capabilities in capturing and processing DOE transportation information. TMD's Transportation Information Network (TIN) is an attempt to bring together transportation management, shipment tracking, research activities and software products in various stages of development. The TMD's Automated Transportation Management System (ATMS) proposes to assist the DOE and its contractors in performing their daily transportation management activities and to assist the DOE Environmental Management Division in its waste management responsibilities throughout the DOE complex. The ATMS system will center about the storage, handling and documentation involved in the environmental clean-up of DOE sites. Waste shipments will be moved to approved Treatment, Storage and Disposal (TSD) facilities and/or nuclear material repositories. An additional investment in shipping samples to analytical laboratories also involves packaging and documentation according to all applicable U.S. Department of Transportation (DOT) or International Air Transport Association (IATA) regulations. The most immediate goal of effectively managing DOE transportation management functions during the 1990's is an increase in automation capabilities of the DOE and its contractors. Subject-matter experts from various DOE site locations will be brought together to develop and refine these capabilities through the maximum use of computer applications. A major part of this effort will be the identification of the most economical modes of transportation and enhanced management reporting capabilities for transportation analysis. The ATMS system will also provide for increased strategic and shipment analysis during the 1990's and beyond in support of the DOE environmental mission

  13. United States Department of Energy Automated Transportation Management System

    International Nuclear Information System (INIS)

    Portsmouth, J.H.

    1992-01-01

    At the US Department of Energy (DOE) 80 transportation facilities, each contractor's transportation management operation has different internal and site specific procedures, and reports to a DOE regional Field Office Traffic Manager (FOTM). The DOE Transportation Management Program (TMP) has the responsibility to manage a transportation program for safe, efficient, and economical transportation of DOE-owned materials. The TMP develops and administers transportation/traffic operations management policies and programs for materials; including radioactive materials, other hazardous materials, hazardous substances, and hazardous wastes, pursuant to applicable federal regulations, such as the Code of Federal Register, Sections 40 and 49. Transportation management has become an increasingly critical primarily because of transportation issues regarding the shipment of radioactive materials and hazardous wastes that are frequently the focus of public concerns. A large shipments and requiring millions of business transactions necessitates the establishment of automated systems, programs, procedures, and controls to ensure that the transportation management process in being handled in a safe, efficient, and economical manner. As the mission of many DOE facilities changes from production of special nuclear materials for defense purposes to environmental restoration and waste management, the role of transportation management will become even more important to the safe and efficient movement of waste materials to prescribed locations. In support of this role, the Automated Transportation Management System (ATMS) was conceived to assist the DOE and its contractors in the performance of their day-to-day transportation management activities. The ATMS utilizes the latest in technology and will supply state-of-the-art automated transportation management for current and future DOE transportation requirements

  14. Modelling Cooperative Work at a Medical Department

    DEFF Research Database (Denmark)

    Christensen, Lars Rune; Hildebrandt, Thomas

    2017-01-01

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

  15. Automating the Technical Library at Los Angeles' Department of Information Systems.

    Science.gov (United States)

    Gillette, Robert

    1992-01-01

    Description of the automation of the technical library of the City of Los Angeles Department of Information Services provides background information on the department and its library; lists the automation project goals and objectives; and describes the two software programs--ObjectVision and Paradox Engine--used as applications development tools…

  16. Medical records department and balanced scorecard approach.

    Science.gov (United States)

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

    2013-01-01

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

  17. Automated drug dispensing system reduces medication errors in an intensive care setting.

    Science.gov (United States)

    Chapuis, Claire; Roustit, Matthieu; Bal, Gaëlle; Schwebel, Carole; Pansu, Pascal; David-Tchouda, Sandra; Foroni, Luc; Calop, Jean; Timsit, Jean-François; Allenet, Benoît; Bosson, Jean-Luc; Bedouch, Pierrick

    2010-12-01

    We aimed to assess the impact of an automated dispensing system on the incidence of medication errors related to picking, preparation, and administration of drugs in a medical intensive care unit. We also evaluated the clinical significance of such errors and user satisfaction. Preintervention and postintervention study involving a control and an intervention medical intensive care unit. Two medical intensive care units in the same department of a 2,000-bed university hospital. Adult medical intensive care patients. After a 2-month observation period, we implemented an automated dispensing system in one of the units (study unit) chosen randomly, with the other unit being the control. The overall error rate was expressed as a percentage of total opportunities for error. The severity of errors was classified according to National Coordinating Council for Medication Error Reporting and Prevention categories by an expert committee. User satisfaction was assessed through self-administered questionnaires completed by nurses. A total of 1,476 medications for 115 patients were observed. After automated dispensing system implementation, we observed a reduced percentage of total opportunities for error in the study compared to the control unit (13.5% and 18.6%, respectively; perror (20.4% and 13.5%; perror showed a significant impact of the automated dispensing system in reducing preparation errors (perrors caused no harm (National Coordinating Council for Medication Error Reporting and Prevention category C). The automated dispensing system did not reduce errors causing harm. Finally, the mean for working conditions improved from 1.0±0.8 to 2.5±0.8 on the four-point Likert scale. The implementation of an automated dispensing system reduced overall medication errors related to picking, preparation, and administration of drugs in the intensive care unit. Furthermore, most nurses favored the new drug dispensation organization.

  18. PS-022 Complex automated medication systems reduce medication administration error rates in an acute medical ward

    DEFF Research Database (Denmark)

    Risør, Bettina Wulff; Lisby, Marianne; Sørensen, Jan

    2017-01-01

    Background Medication errors have received extensive attention in recent decades and are of significant concern to healthcare organisations globally. Medication errors occur frequently, and adverse events associated with medications are one of the largest causes of harm to hospitalised patients...... cabinet, automated dispensing and barcode medication administration; (2) non-patient specific automated dispensing and barcode medication administration. The occurrence of administration errors was observed in three 3 week periods. The error rates were calculated by dividing the number of doses with one...

  19. Introduction of an automated medical record at an HMO clinic.

    Science.gov (United States)

    Churgin, P G

    1994-01-01

    In May 1993, CIGNA Healthcare of Arizona implemented a comprehensive automated medical record system in a pilot project performed at a primary care clinic in Chandler, Arizona. The system, EpicCare, operates in a client-server environment and completely replaces the paper chart in all phases of medical care. After six months of use by 10 medical providers and a 50-member staff, the system has been approved by clinicians, staff, and patients.

  20. Psychology departments in medical schools: there's one in Canada, eh?

    Science.gov (United States)

    McIlwraith, Robert D

    2014-12-01

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

  1. INTEGRATION OF INFORMATIONAL COMPUTER TECHNOLOGIES SMK: AUTOMATION OF THE MAIN FUNCTIONS OF THE TECHNICAL CONTROL DEPARTMENT

    Directory of Open Access Journals (Sweden)

    S. A. Pavlenko

    2010-01-01

    Full Text Available It is shown that automation of some functions of control department allows to record defects, reclamations and failures of technology, to make the necessary reporting forms and quality certificates for production.

  2. Automated Quality Assurance of Medical Digital X-Ray Equipment

    International Nuclear Information System (INIS)

    Zelikman, Mikhail; Kruchinin, Sergey

    2013-06-01

    Quality assurance of the x-ray equipment includes a set of various tests among which are installation and periodic exams performed by qualified engineers as well as daily routine tests carried out by the medical staff of the Radiology Department. As a rule, the decision concerning the applicability of the x-ray equipment for using in clinical studies is made on the basis of the routine tests results. The presented method is based on the detector's output signals, Signal-to-Noise Ratio and Modulation Transfer Function evaluation in automated way using the simple test-object's digital image registered with given geometry and x-ray exposure parameters settings. Rectangular 20 mm thick aluminum plate with fixed 1 mm thick well-finished steel edge (for general x-ray radiography/fluoroscopy systems) or 2 mm thick aluminum plate with fixed 1 mm thick aluminum well-finished edge (for digital x-ray mammography systems) can be used as a test equipment. Relevant to the decision concerning the x-ray device operation status are the parameters: deviations from the reference levels of the tube voltage and mAs as well as internal detector's noise variance and detector's gain deviations. Everyday testing procedure includes the following steps. On the first step the roentgenographer places the test-object at the center of the detector's surface, makes an exposure with specified parameters setting and geometry and after this, test results are displayed on the work station monitor or console screen in automatic way. In order to provide an automated regime of the presenting algorithm, the software must be integrated with the program module intended for the x-ray device control. The use of the presented method in clinical practice provides the reliable daily monitoring of the x-ray equipment operation status prior to its utilizing for patient diagnostic process. As a rule, it will take not more than 3-5 minutes for the roentgenographer to complete the routine

  3. Physician Retention in the Army Medical Department

    Science.gov (United States)

    2009-03-16

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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

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

    National Research Council Canada - National Science Library

    Sadlon, Gary

    2000-01-01

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

  6. Medical record automation at the Los Alamos Scientific Laboratory

    International Nuclear Information System (INIS)

    Hogle, G.O.; Grier, R.S.

    1979-01-01

    With the increase in population at the Los Alamos Scientific Laboratory and the growing concern over employee health, especially concerning the effects of the work environment, the Occupational Medicine Group decided to automate its medical record keeping system to meet these growing demands. With this computer system came not only the ability for long-term study of the work environment verses employee health, but other benefits such as more comprehensive records, increased legibility, reduced physician time, and better records management

  7. US Department of Energy automated transportation management system

    International Nuclear Information System (INIS)

    Thomas, T.M.; Frost, D.M.; Lopez, C.A.

    1996-01-01

    The US Department of Energy (DOE) has approximately 80 facilities throughout the United States that specialize in either scientific research, engineering, technology, production, and/or waste management activities. These facilities can best be described as Government Owned, Contractor Operated (GOCO) sites, and vary in size from very small laboratories to large industrial plant type facilities. Each of these GOCO's have varying needs for transportation of materials into and/or out of their facility. Therefore, Traffic Management operations will differ from site to site due to size and the internal or site specific mission. The DOE Transportation Management Division (TMD) has the corporate responsibility to provide a well managed transportation management program for the safe, efficient, and economical transportation of all DOE-owned materials. To achieve this mission, TMD provides oversight, and when necessary, resources to assist in ensuring regulatory compliance in the packaging and shipment of DOE-owned materials. A large part of TMD's responsibility is to develop, administer, and provide policies and guidance concerning department-wide transportation and packaging operations. This responsibility includes overall Transportation Management policies and programs for the packaging and movement of all DOE materials, including radioactive materials, other hazardous materials/substances, and hazardous wastes. TMD formulates policies and guidance that assist the DOE Field Elements and GOCO's in meeting TMD's goal for safe, efficient and economical transportation. Considering there are at least 80 shipping and receiving sites, the challenge encountered by TMD has been the difficulty in managing such a diverse transportation community

  8. PROBLEMS OF IT DEPARTMENT IN A MEDICAL UNIVERSITY

    Directory of Open Access Journals (Sweden)

    V. Ya Gelman

    2017-01-01

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

  9. Bespoke automation of medical workforce rostering using Google’s free cloud applications

    Directory of Open Access Journals (Sweden)

    Peter Benjamin Michael Thomas

    2017-12-01

    Full Text Available Background: Providing safe and consistent care requires optimal deployment of medical staff. Ensuring this happens is a significant administrative burden due to complex working patterns. Objective: To describe a pilot feasibility study of the automation of medical duty rostering in a busy tertiary Ophthalmology department. Methods: A cloud based web application was created using Google’s free cloud services. Users access the system via a website which hosts live rosters, and use electronic forms to submit requests which are automatically handled by Google App Scripts. Results: Over a 2-year period (8/2014-6/2016, the system processed 563 leave requests and 300 on call swaps automatically. 3,300 emails and 1,000 forms were automatically generated. User satisfaction was 100% (n=24. Discussion: Many time consuming aspects of roster management were automated with significant time savings to all parties, allowing increased clinical time for doctors involved in administration. Planning for safe staffing levels was supported.

  10. Improving medical stores management through automation and effective communication.

    Science.gov (United States)

    Kumar, Ashok; Cariappa, M P; Marwaha, Vishal; Sharma, Mukti; Arora, Manu

    2016-01-01

    Medical stores management in hospitals is a tedious and time consuming chore with limited resources tasked for the purpose and poor penetration of Information Technology. The process of automation is slow paced due to various inherent factors and is being challenged by the increasing inventory loads and escalating budgets for procurement of drugs. We carried out an indepth case study at the Medical Stores of a tertiary care health care facility. An iterative six step Quality Improvement (QI) process was implemented based on the Plan-Do-Study-Act (PDSA) cycle. The QI process was modified as per requirement to fit the medical stores management model. The results were evaluated after six months. After the implementation of QI process, 55 drugs of the medical store inventory which had expired since 2009 onwards were replaced with fresh stock by the suppliers as a result of effective communication through upgraded database management. Various pending audit objections were dropped due to the streamlined documentation and processes. Inventory management improved drastically due to automation, with disposal orders being initiated four months prior to the expiry of drugs and correct demands being generated two months prior to depletion of stocks. The monthly expense summary of drugs was now being done within ten days of the closing month. Improving communication systems within the hospital with vendor database management and reaching out to clinicians is important. Automation of inventory management requires to be simple and user-friendly, utilizing existing hardware. Physical stores monitoring is indispensable, especially due to the scattered nature of stores. Staff training and standardized documentation protocols are the other keystones for optimal medical store management.

  11. Automated Detection of Sepsis Using Electronic Medical Record Data: A Systematic Review.

    Science.gov (United States)

    Despins, Laurel A

    Severe sepsis and septic shock are global issues with high mortality rates. Early recognition and intervention are essential to optimize patient outcomes. Automated detection using electronic medical record (EMR) data can assist this process. This review describes automated sepsis detection using EMR data. PubMed retrieved publications between January 1, 2005 and January 31, 2015. Thirteen studies met study criteria: described an automated detection approach with the potential to detect sepsis or sepsis-related deterioration in real or near-real time; focused on emergency department and hospitalized neonatal, pediatric, or adult patients; and provided performance measures or results indicating the impact of automated sepsis detection. Detection algorithms incorporated systemic inflammatory response and organ dysfunction criteria. Systems in nine studies generated study or care team alerts. Care team alerts did not consistently lead to earlier interventions. Earlier interventions did not consistently translate to improved patient outcomes. Performance measures were inconsistent. Automated sepsis detection is potentially a means to enable early sepsis-related therapy but current performance variability highlights the need for further research.

  12. Role for automated communication strategies in medication adherence management.

    Science.gov (United States)

    Ross, S Michael

    2008-11-01

    Lack of medication adherence is a prevalent problem that causes a broad range of health-and health-economics-related issues. Adherence management is therefore an important strategy, but it also presents its own set of challenges. Interventional communication from care support teams at managed care organizations and disease management and wellness programs has proved effective at modifying patients' medication adherence and reporting behaviors. However, these communications do not work well from an economic standpoint. It is not economically feasible to scale call centers and the numbers of clinical and professional staff to communicate with the increasing number of patients with chronic diseases who require ongoing medication use. Using communication automation to augment traditional call center outreach can help to mediate patient medication-taking behaviors. Specific design criteria for the automation of this interaction are discussed in this article, offering supporting data from a recent trial of 304 elderly patients with hypertension, and showing the benefits of using such a system for effective blood pressure monitoring, at reduced costs.

  13. Defining the management role of the department medical director.

    Science.gov (United States)

    Brady, T F; Carpenter, C R

    1986-01-01

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

  14. Medical identity theft in the emergency department: awareness is crucial.

    Science.gov (United States)

    Mancini, Michelino

    2014-11-01

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

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

    Science.gov (United States)

    Mancini, Michelino

    2014-01-01

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

  16. Automated medical follow-up and delayed industrial risks

    International Nuclear Information System (INIS)

    Smith, M.E.

    In response to increasing demand for human data to identify social, environmental, and occupational influences upon health, Statistics Canada has been organizing existing files of vital and health records to facilitate such studies on a national scale. In particular, the development of a Canadian Mortality Data Base file, the initiation of the National Cancer Incidence system, and the development of new computer techniques have helped reduce the cost and increase the scale and efficiency of automated medical follow-up to produce statistics of sickness or death attributable to environmental factors. Specific occupational studies now in progress serve to illustrate the methods, practical difficulties, potential size, and products from such investigations

  17. Enhanced versus automated urinalysis for screening of urinary tract infections in children in the emergency department.

    Science.gov (United States)

    Shah, Ami P; Cobb, Benjamin T; Lower, Darla R; Shaikh, Nader; Rasmussen, Jayne; Hoberman, Alejandro; Wald, Ellen R; Rosendorff, Adam; Hickey, Robert W

    2014-03-01

    Urinary tract infections (UTI) are the most common serious bacterial infection in febrile infants. Urinalysis (UA) is a screening test for preliminary diagnosis of UTI. UA can be performed manually or using automated techniques. We sought to compare manual versus automated UA for urine specimens obtained via catheterization in the pediatric emergency department. In this prospective study, we processed catheterized urine samples from infants with suspected UTI by both the manual method (enhanced UA) and the automated method. We defined a positive enhanced UA as ≥ 10 white blood cells per cubic millimeter and presence of any bacteria per 10 oil immersion fields on a Gram-stained smear. We defined a positive automated UA as ≥ 2 white blood cells per high-powered field and presence of any bacteria using the IRIS iQ200 ELITE. We defined a positive urine culture as growth of ≥ 50,000 colony-forming units per milliliter of a single uropathogen. We analyzed data using SPSS software. A total of 703 specimens were analyzed. Prevalence of UTI was 7%. For pyuria, the sensitivity and positive predictive value (PPV) of the enhanced UA in predicting positive urine culture were 83.6% and 52.5%, respectively; corresponding values for the automated UA were 79.5% and 37.5%, respectively. For bacteriuria, the sensitivity and PPV of a Gram-stained smear (enhanced UA) were 83.6% and 59.4%, respectively; corresponding values for the automated UA were 73.4%, and 26.2%, respectively. Using criteria of both pyuria and bacteriuria for the enhanced UA resulted in a sensitivity of 77.5% and a PPV of 84.4%; corresponding values for the automated UA were 63.2% and 51.6%, respectively. Combining automated pyuria (≥ 2 white blood cells/high-powered microscopic field) with a Gram-stained smear resulted in a sensitivity of 75.5% and a PPV of 84%. Automated UA is comparable with manual UA for detection of pyuria in young children with suspected UTI. Bacteriuria detected by automated UA is

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

    Directory of Open Access Journals (Sweden)

    Michelino Mancini

    2014-11-01

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

  19. A Pilot Project Demonstrating that Combat Medics Can Safely Administer Parenteral Medications in the Emergency Department.

    Science.gov (United States)

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

    2017-12-01

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

  20. University of California San Francisco automated radiology department system-without picture archival and communication system (PACS)

    Science.gov (United States)

    Quintin, June A.; Simborg, Donald W.

    1982-01-01

    A fully automated and comprehensive Radiology Department system was implemented in the Fall of 1980, which highly integrates the multiple functions of a large Radiology Department in a major medical center. The major components include patient registration, film tracking, management statistics, patient flow control, radiologist reporting, pathology coding and billing. The highly integrated design allows sharing of critical files to reduce redundancy and errors in communication and allows rapid dissemination of information throughout the department. As one node of an integrated distributed hospital system, information from central hospital functions such as patient identification are incorporated into the system and reports and other information are available to other hospital systems. The system is implemented on a Data General Eclipse S/250 using the MIIS operating system. The management of a radiology department has become sufficiently complex that the application of computer techniques to the smooth operation of the department has become almost a necessity. This system provides statistics on room utilization, technologist productivity, and radiologist activity. Room utilization graphs are a valuable aid for staffing and scheduling of technologists, as well as analyzing appropriateness of radiologic equipment in a department. Daily reports summarize by radiology section exams not dictated. File room reports indicate which film borrowers are delinquent in returning films for 24 hours, 48 hours and one week. Letters to the offenders are automatically generated on the high speed line printer. Although all radiology departments have similar needs, customization is likely to be required to meet specific priorities and needs at any individual department. It is important in choosing a system vendor that such flexibility be available. If appropriately designed, a system will provide considerable improvements in efficiency and effectiveness.

  1. Automated de-identification of free-text medical records

    Directory of Open Access Journals (Sweden)

    Long William J

    2008-07-01

    Full Text Available Abstract Background Text-based patient medical records are a vital resource in medical research. In order to preserve patient confidentiality, however, the U.S. Health Insurance Portability and Accountability Act (HIPAA requires that protected health information (PHI be removed from medical records before they can be disseminated. Manual de-identification of large medical record databases is prohibitively expensive, time-consuming and prone to error, necessitating automatic methods for large-scale, automated de-identification. Methods We describe an automated Perl-based de-identification software package that is generally usable on most free-text medical records, e.g., nursing notes, discharge summaries, X-ray reports, etc. The software uses lexical look-up tables, regular expressions, and simple heuristics to locate both HIPAA PHI, and an extended PHI set that includes doctors' names and years of dates. To develop the de-identification approach, we assembled a gold standard corpus of re-identified nursing notes with real PHI replaced by realistic surrogate information. This corpus consists of 2,434 nursing notes containing 334,000 words and a total of 1,779 instances of PHI taken from 163 randomly selected patient records. This gold standard corpus was used to refine the algorithm and measure its sensitivity. To test the algorithm on data not used in its development, we constructed a second test corpus of 1,836 nursing notes containing 296,400 words. The algorithm's false negative rate was evaluated using this test corpus. Results Performance evaluation of the de-identification software on the development corpus yielded an overall recall of 0.967, precision value of 0.749, and fallout value of approximately 0.002. On the test corpus, a total of 90 instances of false negatives were found, or 27 per 100,000 word count, with an estimated recall of 0.943. Only one full date and one age over 89 were missed. No patient names were missed in either

  2. The medical physicist in a nuclear medicine department

    International Nuclear Information System (INIS)

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

    2007-01-01

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

  3. [Medical manuscripts in the library of the Deontology Department of the Ankara University Medical School].

    Science.gov (United States)

    Arda, B

    1998-01-01

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

  4. Automated patient and medication payment method for clinical trials

    Directory of Open Access Journals (Sweden)

    Yawn BP

    2013-01-01

    Full Text Available Barbara P Yawn,1 Suzanne Madison,1 Susan Bertram,1 Wilson D Pace,2 Anne Fuhlbrigge,3 Elliot Israel,3 Dawn Littlefield,1 Margary Kurland,1 Michael E Wechsler41Olmsted Medical Center, Department of Research, Rochester, MN, 2UCDHSC, Department of Family Medicine, University of Colorado Health Science Centre, Aurora, CO, 3Brigham and Women's Hospital, Pulmonary and Critical Care Division, Boston, MA, 4National Jewish Medical Center, Division of Pulmonology, Denver, CO, USABackground: Published reports and studies related to patient compensation for clinical trials focus primarily on the ethical issues related to appropriate amounts to reimburse for patient's time and risk burden. Little has been published regarding the method of payment for patient participation. As clinical trials move into widely dispersed community practices and more complex designs, the method of payment also becomes more complex. Here we review the decision process and payment method selected for a primary care-based randomized clinical trial of asthma management in Black Americans.Methods: The method selected is a credit card system designed specifically for clinical trials that allows both fixed and variable real-time payments. We operationalized the study design by providing each patient with two cards, one for reimbursement for study visits and one for payment of medication costs directly to the pharmacies.Results: Of the 1015 patients enrolled, only two refused use of the ClinCard, requesting cash payments for visits and only rarely a weekend or fill-in pharmacist refused to use the card system for payment directly to the pharmacy. Overall, the system has been well accepted by patients and local study teams. The ClinCard administrative system facilitates the fiscal accounting and medication adherence record-keeping by the central teams. Monthly fees are modest, and all 12 study institutional review boards approved use of the system without concern for patient

  5. Improving the medical records department processes by lean management.

    Science.gov (United States)

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

    2015-01-01

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

  6. Medical audit on asthma in an emergency department.

    Science.gov (United States)

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

    2006-01-01

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

  7. Automation of a high risk medication regime algorithm in a home health care population.

    Science.gov (United States)

    Olson, Catherine H; Dierich, Mary; Westra, Bonnie L

    2014-10-01

    Create an automated algorithm for predicting elderly patients' medication-related risks for readmission and validate it by comparing results with a manual analysis of the same patient population. Outcome and Assessment Information Set (OASIS) and medication data were reused from a previous, manual study of 911 patients from 15 Medicare-certified home health care agencies. The medication data was converted into standardized drug codes using APIs managed by the National Library of Medicine (NLM), and then integrated in an automated algorithm that calculates patients' high risk medication regime scores (HRMRs). A comparison of the results between algorithm and manual process was conducted to determine how frequently the HRMR scores were derived which are predictive of readmission. HRMR scores are composed of polypharmacy (number of drugs), Potentially Inappropriate Medications (PIM) (drugs risky to the elderly), and Medication Regimen Complexity Index (MRCI) (complex dose forms, instructions or administration). The algorithm produced polypharmacy, PIM, and MRCI scores that matched with 99%, 87% and 99% of the scores, respectively, from the manual analysis. Imperfect match rates resulted from discrepancies in how drugs were classified and coded by the manual analysis vs. the automated algorithm. HRMR rules lack clarity, resulting in clinical judgments for manual coding that were difficult to replicate in the automated analysis. The high comparison rates for the three measures suggest that an automated clinical tool could use patients' medication records to predict their risks of avoidable readmissions. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Emergency department overcrowding: Quality improvement in a Taiwan Medical Center.

    Science.gov (United States)

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

    2018-04-14

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

  9. Medication Review and Patient Outcomes in an Orthopedic Department

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  10. Medical Certification System -

    Data.gov (United States)

    Department of Transportation — Provides automated risk-based decision making capability in support of medical certification and clearances processing associated fees and supporting surveillance of...

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

    Directory of Open Access Journals (Sweden)

    maryam ahmadi

    2010-04-01

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

  12. The United States Army Medical Department Journal, April - June 2008

    Science.gov (United States)

    2008-06-01

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

  13. The Mobile Modular Surgical Hospital: the Army Medical Department’s Future Unit of Action

    Science.gov (United States)

    2005-06-17

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

  14. Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)

    Data.gov (United States)

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

  15. Department of Neurosurgery, Madurai Medical College and the development of neurosurgery in South Tamil Nadu.

    Science.gov (United States)

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

    2018-01-01

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

  16. Measuring the efficiency of dental departments in medical centers: a nonparametric analysis approach.

    Science.gov (United States)

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

    2002-12-01

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

  17. Unified Medical Command and Control in the Department of Defense

    Science.gov (United States)

    2012-03-22

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

  18. Equal Opportunity Program Management for the Army Medical Department

    Science.gov (United States)

    2008-04-09

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

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

    African Journals Online (AJOL)

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

  20. Automating payroll, billing, and medical records. Using technology to do more with less.

    Science.gov (United States)

    Vetter, E

    1995-08-01

    As home care agencies grow, so does the need to streamline the paperwork involved in running an agency. One agency found a way to reduce its payroll, billing, and medical records paperwork by implementing an automated, image-based data collection system that saves time, money, and paper.

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

    Science.gov (United States)

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

    2007-01-01

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

  2. Medical prescription adherence among patient visiting gynecology department

    International Nuclear Information System (INIS)

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

    2017-01-01

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

  3. Towards automated assistance for operating home medical devices.

    Science.gov (United States)

    Gao, Zan; Detyniecki, Marcin; Chen, Ming-Yu; Wu, Wen; Hauptmann, Alexander G; Wactlar, Howard D

    2010-01-01

    To detect errors when subjects operate a home medical device, we observe them with multiple cameras. We then perform action recognition with a robust approach to recognize action information based on explicitly encoding motion information. This algorithm detects interest points and encodes not only their local appearance but also explicitly models local motion. Our goal is to recognize individual human actions in the operations of a home medical device to see if the patient has correctly performed the required actions in the prescribed sequence. Using a specific infusion pump as a test case, requiring 22 operation steps from 6 action classes, our best classifier selects high likelihood action estimates from 4 available cameras, to obtain an average class recognition rate of 69%.

  4. Automated Medical Supply Chain Management: A Remedy for Logistical Shortcomings

    Science.gov (United States)

    2016-08-01

    identification (RFID) tracking methods. RFID could be considered an evolutionary jump of the barcode. Both have significance in business. A barcode is an...Challenges and Potential Effects,” New England Journal of Medicine , no. 364, 10 March 2011, 891. 7 Jamie M. Morin, “Making Every Dollar Count,” Armed Forces...Health Care Challenges and Potential Effects." New England Journal of Medicine , March 2011: 891. "St. John’s Medical Center improves efficiency using

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

    Energy Technology Data Exchange (ETDEWEB)

    Haywood, J K

    1986-01-01

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

  6. A Semi-automated Approach to Improve the Efficiency of Medical Imaging Segmentation for Haptic Rendering.

    Science.gov (United States)

    Banerjee, Pat; Hu, Mengqi; Kannan, Rahul; Krishnaswamy, Srinivasan

    2017-08-01

    The Sensimmer platform represents our ongoing research on simultaneous haptics and graphics rendering of 3D models. For simulation of medical and surgical procedures using Sensimmer, 3D models must be obtained from medical imaging data, such as magnetic resonance imaging (MRI) or computed tomography (CT). Image segmentation techniques are used to determine the anatomies of interest from the images. 3D models are obtained from segmentation and their triangle reduction is required for graphics and haptics rendering. This paper focuses on creating 3D models by automating the segmentation of CT images based on the pixel contrast for integrating the interface between Sensimmer and medical imaging devices, using the volumetric approach, Hough transform method, and manual centering method. Hence, automating the process has reduced the segmentation time by 56.35% while maintaining the same accuracy of the output at ±2 voxels.

  7. Active learning: a step towards automating medical concept extraction.

    Science.gov (United States)

    Kholghi, Mahnoosh; Sitbon, Laurianne; Zuccon, Guido; Nguyen, Anthony

    2016-03-01

    This paper presents an automatic, active learning-based system for the extraction of medical concepts from clinical free-text reports. Specifically, (1) the contribution of active learning in reducing the annotation effort and (2) the robustness of incremental active learning framework across different selection criteria and data sets are determined. The comparative performance of an active learning framework and a fully supervised approach were investigated to study how active learning reduces the annotation effort while achieving the same effectiveness as a supervised approach. Conditional random fields as the supervised method, and least confidence and information density as 2 selection criteria for active learning framework were used. The effect of incremental learning vs standard learning on the robustness of the models within the active learning framework with different selection criteria was also investigated. The following 2 clinical data sets were used for evaluation: the Informatics for Integrating Biology and the Bedside/Veteran Affairs (i2b2/VA) 2010 natural language processing challenge and the Shared Annotated Resources/Conference and Labs of the Evaluation Forum (ShARe/CLEF) 2013 eHealth Evaluation Lab. The annotation effort saved by active learning to achieve the same effectiveness as supervised learning is up to 77%, 57%, and 46% of the total number of sequences, tokens, and concepts, respectively. Compared with the random sampling baseline, the saving is at least doubled. Incremental active learning is a promising approach for building effective and robust medical concept extraction models while significantly reducing the burden of manual annotation. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

    International Nuclear Information System (INIS)

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

    1997-01-01

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

  9. Automated endoscopic navigation and advisory system from medical image

    Science.gov (United States)

    Kwoh, Chee K.; Khan, Gul N.; Gillies, Duncan F.

    1999-05-01

    , which is developed to obtain the relative depth of the colon surface in the image by assuming a point light source very close to the camera. If we assume the colon has a shape similar to a tube, then a reasonable approximation of the position of the center of the colon (lumen) will be a function of the direction in which the majority of the normal vectors of shape are pointing. The second layer is the control layer and at this level, a decision model must be built for endoscope navigation and advisory system. The system that we built is the models of probabilistic networks that create a basic, artificial intelligence system for navigation in the colon. We have constructed the probabilistic networks from correlated objective data using the maximum weighted spanning tree algorithm. In the construction of a probabilistic network, it is always assumed that the variables starting from the same parent are conditionally independent. However, this may not hold and will give rise to incorrect inferences. In these cases, we proposed the creation of a hidden node to modify the network topology, which in effect models the dependency of correlated variables, to solve the problem. The conditional probability matrices linking the hidden node to its neighbors are determined using a gradient descent method which minimizing the objective cost function. The error gradients can be treated as updating messages and ca be propagated in any direction throughout any singly connected network to adjust the network parameters. With the above two- level approach, we have been able to build an automated endoscope navigation and advisory system successfully.

  10. [Department of Otorhinolaryngology of the I.P. Pavlov Saint-Peterburg First State Medical University].

    Science.gov (United States)

    Karpishchenko, S A

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

  11. [Analysis of foreign experience of usage of automation systems of medication distribution in prevention and treatment facilities].

    Science.gov (United States)

    Miroshnichenko, Iu V; Umarov, S Z

    2012-12-01

    One of the ways of increase of effectiveness and safety of patients medication supplement is the use of automated systems of distribution, through which substantially increases the efficiency and safety of patients' medication supplement, achieves significant economy of material and financial resources for medication assistance and possibility of systematical improvement of its accessibility and quality.

  12. Challenges and Opportunities: Building a Relationship Between a Department of Biomedical Engineering and a Medical School.

    Science.gov (United States)

    George, Steven C; Meyerand, M Elizabeth

    2017-03-01

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

  13. Implementing Protocols to Improve Patient Safety in the Medical Imaging Department.

    Science.gov (United States)

    Carrizales, Gwen; Clark, Kevin R

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Pagliaroli Véronique

    2011-07-01

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

  15. Automated essay scoring and the future of educational assessment in medical education.

    Science.gov (United States)

    Gierl, Mark J; Latifi, Syed; Lai, Hollis; Boulais, André-Philippe; De Champlain, André

    2014-10-01

    Constructed-response tasks, which range from short-answer tests to essay questions, are included in assessments of medical knowledge because they allow educators to measure students' ability to think, reason, solve complex problems, communicate and collaborate through their use of writing. However, constructed-response tasks are also costly to administer and challenging to score because they rely on human raters. One alternative to the manual scoring process is to integrate computer technology with writing assessment. The process of scoring written responses using computer programs is known as 'automated essay scoring' (AES). An AES system uses a computer program that builds a scoring model by extracting linguistic features from a constructed-response prompt that has been pre-scored by human raters and then, using machine learning algorithms, maps the linguistic features to the human scores so that the computer can be used to classify (i.e. score or grade) the responses of a new group of students. The accuracy of the score classification can be evaluated using different measures of agreement. Automated essay scoring provides a method for scoring constructed-response tests that complements the current use of selected-response testing in medical education. The method can serve medical educators by providing the summative scores required for high-stakes testing. It can also serve medical students by providing them with detailed feedback as part of a formative assessment process. Automated essay scoring systems yield scores that consistently agree with those of human raters at a level as high, if not higher, as the level of agreement among human raters themselves. The system offers medical educators many benefits for scoring constructed-response tasks, such as improving the consistency of scoring, reducing the time required for scoring and reporting, minimising the costs of scoring, and providing students with immediate feedback on constructed-response tasks. © 2014

  16. Department

    African Journals Online (AJOL)

    USER

    2016-09-20

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

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

    Directory of Open Access Journals (Sweden)

    Acílio Gala

    2017-04-01

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

  18. Patients' acceptance of medical photography in a French adult and paediatric dermatology department: a questionnaire survey.

    Science.gov (United States)

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

    2013-08-01

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

  19. Effects of a direct refill program for automated dispensing cabinets on medication-refill errors.

    Science.gov (United States)

    Helmons, Pieter J; Dalton, Ashley J; Daniels, Charles E

    2012-10-01

    The effects of a direct refill program for automated dispensing cabinets (ADCs) on medication-refill errors were studied. This study was conducted in designated acute care areas of a 386-bed academic medical center. A wholesaler-to-ADC direct refill program, consisting of prepackaged delivery of medications and bar-code-assisted ADC refilling, was implemented in the inpatient pharmacy of the medical center in September 2009. Medication-refill errors in 26 ADCs from the general medicine units, the infant special care unit, the surgical and burn intensive care units, and intermediate units were assessed before and after the implementation of this program. Medication-refill errors were defined as an ADC pocket containing the wrong drug, wrong strength, or wrong dosage form. ADC refill errors decreased by 77%, from 62 errors per 6829 refilled pockets (0.91%) to 8 errors per 3855 refilled pockets (0.21%) (p error type detected before the intervention was the incorrect medication (wrong drug, wrong strength, or wrong dosage form) in the ADC pocket. Of the 54 incorrect medications found before the intervention, 38 (70%) were loaded in a multiple-drug drawer. After the implementation of the new refill process, 3 of the 5 incorrect medications were loaded in a multiple-drug drawer. There were 3 instances of expired medications before and only 1 expired medication after implementation of the program. A redesign of the ADC refill process using a wholesaler-to-ADC direct refill program that included delivery of prepackaged medication and bar-code-assisted refill significantly decreased the occurrence of ADC refill errors.

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

    Directory of Open Access Journals (Sweden)

    Crook M

    2007-06-01

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

  1. Semantic enrichment of medical forms - semi-automated coding of ODM-elements via web services.

    Science.gov (United States)

    Breil, Bernhard; Watermann, Andreas; Haas, Peter; Dziuballe, Philipp; Dugas, Martin

    2012-01-01

    Semantic interoperability is an unsolved problem which occurs while working with medical forms from different information systems or institutions. Standards like ODM or CDA assure structural homogenization but in order to compare elements from different data models it is necessary to use semantic concepts and codes on an item level of those structures. We developed and implemented a web-based tool which enables a domain expert to perform semi-automated coding of ODM-files. For each item it is possible to inquire web services which result in unique concept codes without leaving the context of the document. Although it was not feasible to perform a totally automated coding we have implemented a dialog based method to perform an efficient coding of all data elements in the context of the whole document. The proportion of codable items was comparable to results from previous studies.

  2. Platform for Automated Real-Time High Performance Analytics on Medical Image Data.

    Science.gov (United States)

    Allen, William J; Gabr, Refaat E; Tefera, Getaneh B; Pednekar, Amol S; Vaughn, Matthew W; Narayana, Ponnada A

    2018-03-01

    Biomedical data are quickly growing in volume and in variety, providing clinicians an opportunity for better clinical decision support. Here, we demonstrate a robust platform that uses software automation and high performance computing (HPC) resources to achieve real-time analytics of clinical data, specifically magnetic resonance imaging (MRI) data. We used the Agave application programming interface to facilitate communication, data transfer, and job control between an MRI scanner and an off-site HPC resource. In this use case, Agave executed the graphical pipeline tool GRAphical Pipeline Environment (GRAPE) to perform automated, real-time, quantitative analysis of MRI scans. Same-session image processing will open the door for adaptive scanning and real-time quality control, potentially accelerating the discovery of pathologies and minimizing patient callbacks. We envision this platform can be adapted to other medical instruments, HPC resources, and analytics tools.

  3. An Automated Medical Information Management System (OpScan-MIMS) in a Clinical Setting

    Science.gov (United States)

    Margolis, S.; Baker, T.G.; Ritchey, M.G.; Alterescu, S.; Friedman, C.

    1981-01-01

    This paper describes an automated medical information management system within a clinic setting. The system includes an optically scanned data entry system (OpScan), a generalized, interactive retrieval and storage software system(Medical Information Management System, MIMS) and the use of time-sharing. The system has the advantages of minimal hardware purchase and maintenance, rapid data entry and retrieval, user-created programs, no need for user knowledge of computer language or technology and is cost effective. The OpScan-MIMS system has been operational for approximately 16 months in a sexually transmitted disease clinic. The system's application to medical audit, quality assurance, clinic management and clinical training are demonstrated.

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  5. A continuous quality improvement project to reduce medication error in the emergency department.

    Science.gov (United States)

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

    2013-01-01

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

  6. Use of automated medication adherence monitoring in bipolar disorder research: pitfalls, pragmatics, and possibilities.

    Science.gov (United States)

    Levin, Jennifer B; Sams, Johnny; Tatsuoka, Curtis; Cassidy, Kristin A; Sajatovic, Martha

    2015-04-01

    Medication nonadherence occurs in 20-60% of persons with bipolar disorder (BD) and is associated with serious negative outcomes, including relapse, hospitalization, incarceration, suicide and high healthcare costs. Various strategies have been developed to measure adherence in BD. This descriptive paper summarizes challenges and workable strategies using electronic medication monitoring in a randomized clinical trial (RCT) in patients with BD. Descriptive data from 57 nonadherent individuals with BD enrolled in a prospective RCT evaluating a novel customized adherence intervention versus control were analyzed. Analyses focused on whole group data and did not assess intervention effects. Adherence was assessed with the self-reported Tablets Routine Questionnaire and the Medication Event Monitoring System (MEMS). The majority of participants were women (74%), African American (69%), with type I BD (77%). Practical limitations of MEMS included misuse in conjunction with pill minders, polypharmacy, cost, failure to bring to research visits, losing the device, and the device impacting baseline measurement. The advantages were more precise measurement, less biased recall, and collecting data from past time periods for missed interim visits. Automated devices such as MEMS can assist investigators in evaluating adherence in patients with BD. Knowing the anticipated pitfalls allows study teams to implement preemptive procedures for successful implementation in BD adherence studies and can help pave the way for future refinements as automated adherence assessment technologies become more sophisticated and readily available.

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

    DEFF Research Database (Denmark)

    Arvidsen, Pernille; Pressel, Eckart

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

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

    OpenAIRE

    Rukhsana Parvin; Shekhar Bhattacharjee; Swapna Bhattacharjee

    2013-01-01

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

  9. Automating and estimating glomerular filtration rate for dosing medications and staging chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Trinkley KE

    2014-05-01

    Full Text Available Katy E Trinkley,1 S Michelle Nikels,2 Robert L Page II,1 Melanie S Joy11Skaggs School of Pharmacy and Pharmaceutical Sciences, 2School of Medicine, University of Colorado, Aurora, CO, USA Objective: The purpose of this paper is to serve as a review for primary care providers on the bedside methods for estimating glomerular filtration rate (GFR for dosing and chronic kidney disease (CKD staging and to discuss how automated health information technologies (HIT can enhance clinical documentation of staging and reduce medication errors in patients with CKD.Methods: A nonsystematic search of PubMed (through March 2013 was conducted to determine the optimal approach to estimate GFR for dosing and CKD staging and to identify examples of how automated HITs can improve health outcomes in patients with CKD. Papers known to the authors were included, as were scientific statements. Articles were chosen based on the judgment of the authors.Results: Drug-dosing decisions should be based on the method used in the published studies and package labeling that have been determined to be safe, which is most often the Cockcroft–Gault formula unadjusted for body weight. Although Modification of Diet in Renal Disease is more commonly used in practice for staging, the CKD–Epidemiology Collaboration (CKD–EPI equation is the most accurate formula for estimating the CKD staging, especially at higher GFR values. Automated HITs offer a solution to the complexity of determining which equation to use for a given clinical scenario. HITs can educate providers on which formula to use and how to apply the formula in a given clinical situation, ultimately improving appropriate medication and medical management in CKD patients.Conclusion: Appropriate estimation of GFR is key to optimal health outcomes. HITs assist clinicians in both choosing the most appropriate GFR estimation formula and in applying the results of the GFR estimation in practice. Key limitations of the

  10. Automation of PCXMC and ImPACT for NASA Astronaut Medical Imaging Dose and Risk Tracking

    Science.gov (United States)

    Bahadori, Amir; Picco, Charles; Flores-McLaughlin, John; Shavers, Mark; Semones, Edward

    2011-01-01

    To automate astronaut organ and effective dose calculations from occupational X-ray and computed tomography (CT) examinations incorporating PCXMC and ImPACT tools and to estimate the associated lifetime cancer risk per the National Council on Radiation Protection & Measurements (NCRP) using MATLAB(R). Methods: NASA follows guidance from the NCRP on its operational radiation safety program for astronauts. NCRP Report 142 recommends that astronauts be informed of the cancer risks from reported exposures to ionizing radiation from medical imaging. MATLAB(R) code was written to retrieve exam parameters for medical imaging procedures from a NASA database, calculate associated dose and risk, and return results to the database, using the Microsoft .NET Framework. This code interfaces with the PCXMC executable and emulates the ImPACT Excel spreadsheet to calculate organ doses from X-rays and CTs, respectively, eliminating the need to utilize the PCXMC graphical user interface (except for a few special cases) and the ImPACT spreadsheet. Results: Using MATLAB(R) code to interface with PCXMC and replicate ImPACT dose calculation allowed for rapid evaluation of multiple medical imaging exams. The user inputs the exam parameter data into the database and runs the code. Based on the imaging modality and input parameters, the organ doses are calculated. Output files are created for record, and organ doses, effective dose, and cancer risks associated with each exam are written to the database. Annual and post-flight exposure reports, which are used by the flight surgeon to brief the astronaut, are generated from the database. Conclusions: Automating PCXMC and ImPACT for evaluation of NASA astronaut medical imaging radiation procedures allowed for a traceable and rapid method for tracking projected cancer risks associated with over 12,000 exposures. This code will be used to evaluate future medical radiation exposures, and can easily be modified to accommodate changes to the risk

  11. Automated electronic reminders to prevent miscommunication among primary medical, surgical and anaesthesia providers: a root cause analysis.

    Science.gov (United States)

    Freundlich, Robert E; Grondin, Louise; Tremper, Kevin K; Saran, Kelly A; Kheterpal, Sachin

    2012-10-01

    In this case report, the authors present an adverse event possibly caused by miscommunication among three separate medical teams at their hospital. The authors then discuss the hospital's root cause analysis and its proposed solutions, focusing on the subsequent hospital-wide implementation of an automated electronic reminder for abnormal laboratory values that may have helped to prevent similar medical errors.

  12. A prospective, multicenter study of pharmacist activities resulting in medication error interception in the emergency department.

    Science.gov (United States)

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

    2012-05-01

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

  13. Establishment of the Department of Anaesthesia at Harvard Medical School-1969.

    Science.gov (United States)

    Mizrahi, Ilan; Desai, Sukumar P

    2016-02-01

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

  14. Product-line administration: a framework for redefining medical record department services.

    Science.gov (United States)

    Postal, S N

    1990-06-01

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

  15. [End-of-life in specialized medical pediatrics department: A French national survey].

    Science.gov (United States)

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

    2017-03-01

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

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

    International Nuclear Information System (INIS)

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

    1996-01-01

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

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  18. Cost-Effectiveness Analysis of an Automated Medication System Implemented in a Danish Hospital Setting

    DEFF Research Database (Denmark)

    Risoer, Bettina Wulff; Lisby, Marianne; Soerensen, Jan

    2017-01-01

    Objectives To evaluate the cost-effectiveness of an automated medication system (AMS) implemented in a Danish hospital setting. Methods An economic evaluation was performed alongside a controlled before-and-after effectiveness study with one control ward and one intervention ward. The primary...... outcome measure was the number of errors in the medication administration process observed prospectively before and after implementation. To determine the difference in proportion of errors after implementation of the AMS, logistic regression was applied with the presence of error(s) as the dependent...... variable. Time, group, and interaction between time and group were the independent variables. The cost analysis used the hospital perspective with a short-term incremental costing approach. The total 6-month costs with and without the AMS were calculated as well as the incremental costs. The number...

  19. Commentary: Interim leadership of academic departments at U.S. medical schools.

    Science.gov (United States)

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

    2009-10-01

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

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

    Directory of Open Access Journals (Sweden)

    West LM

    2012-12-01

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

  1. [Anniversary of the medical department of the Federal Office for Safe Storage and Destruction of Chemical Weapons].

    Science.gov (United States)

    Kuz'menko, I E

    2013-01-01

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

  2. A comparison of medical litigation filed against obstetrics and gynecology, internal medicine, and surgery departments.

    Science.gov (United States)

    Hamasaki, Tomoko; Hagihara, Akihito

    2015-10-24

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

  3. 21 CFR 864.5700 - Automated platelet aggregation system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Automated platelet aggregation system. 864.5700 Section 864.5700 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Automated and Semi-Automated Hematology Devices...

  4. 21 CFR 864.5240 - Automated blood cell diluting apparatus.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Automated blood cell diluting apparatus. 864.5240 Section 864.5240 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Automated and Semi-Automated Hematology Devices...

  5. 21 CFR 864.5620 - Automated hemoglobin system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Automated hemoglobin system. 864.5620 Section 864.5620 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Automated and Semi-Automated Hematology Devices § 864...

  6. 21 CFR 864.5220 - Automated differential cell counter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Automated differential cell counter. 864.5220 Section 864.5220 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Automated and Semi-Automated Hematology Devices...

  7. 21 CFR 864.5260 - Automated cell-locating device.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Automated cell-locating device. 864.5260 Section 864.5260 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Automated and Semi-Automated Hematology Devices...

  8. 21 CFR 864.5800 - Automated sedimentation rate device.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Automated sedimentation rate device. 864.5800 Section 864.5800 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Automated and Semi-Automated Hematology Devices...

  9. 21 CFR 864.5200 - Automated cell counter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Automated cell counter. 864.5200 Section 864.5200 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Automated and Semi-Automated Hematology Devices § 864...

  10. 21 CFR 864.5680 - Automated heparin analyzer.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Automated heparin analyzer. 864.5680 Section 864.5680 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Automated and Semi-Automated Hematology Devices § 864...

  11. 21 CFR 864.5850 - Automated slide spinner.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Automated slide spinner. 864.5850 Section 864.5850 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Automated and Semi-Automated Hematology Devices § 864...

  12. 21 CFR 864.5600 - Automated hematocrit instrument.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Automated hematocrit instrument. 864.5600 Section 864.5600 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Automated and Semi-Automated Hematology Devices...

  13. Adoption of medication alert systems in hospital outpatient departments in Taiwan.

    Science.gov (United States)

    Kuo, Yu-Chun; Cheng, Shou-Hsia

    2017-06-01

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

  14. The design of a corporate identity for a department of medical illustration: a case study.

    Science.gov (United States)

    Thompson, G

    2001-06-01

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

  15. Automated collection of medical images for research from heterogeneous systems: trials and tribulations

    Science.gov (United States)

    Patel, M. N.; Looney, P.; Young, K.; Halling-Brown, M. D.

    2014-03-01

    Radiological imaging is fundamental within the healthcare industry and has become routinely adopted for diagnosis, disease monitoring and treatment planning. Over the past two decades both diagnostic and therapeutic imaging have undergone a rapid growth, the ability to be able to harness this large influx of medical images can provide an essential resource for research and training. Traditionally, the systematic collection of medical images for research from heterogeneous sites has not been commonplace within the NHS and is fraught with challenges including; data acquisition, storage, secure transfer and correct anonymisation. Here, we describe a semi-automated system, which comprehensively oversees the collection of both unprocessed and processed medical images from acquisition to a centralised database. The provision of unprocessed images within our repository enables a multitude of potential research possibilities that utilise the images. Furthermore, we have developed systems and software to integrate these data with their associated clinical data and annotations providing a centralised dataset for research. Currently we regularly collect digital mammography images from two sites and partially collect from a further three, with efforts to expand into other modalities and sites currently ongoing. At present we have collected 34,014 2D images from 2623 individuals. In this paper we describe our medical image collection system for research and discuss the wide spectrum of challenges faced during the design and implementation of such systems.

  16. When the visit to the emergency department is medically nonurgent: provider ideologies and patient advice.

    Science.gov (United States)

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

    2001-03-01

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

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

    Science.gov (United States)

    Lebrun, T; Sailly, J C

    1982-01-01

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

  18. [Medical short stay unit for geriatric patients in the emergency department: clinical and healthcare benefits].

    Science.gov (United States)

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

    2009-01-01

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

  19. Autonomic nervous system activity as risk predictor in the medical emergency department: a prospective cohort study.

    Science.gov (United States)

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

    2015-05-01

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

  20. Medication Incidents Related to Automated Dose Dispensing in Community Pharmacies and Hospitals - A Reporting System Study

    Science.gov (United States)

    Cheung, Ka-Chun; van den Bemt, Patricia M. L. A.; Bouvy, Marcel L.; Wensing, Michel; De Smet, Peter A. G. M.

    2014-01-01

    Introduction Automated dose dispensing (ADD) is being introduced in several countries and the use of this technology is expected to increase as a growing number of elderly people need to manage their medication at home. ADD aims to improve medication safety and treatment adherence, but it may introduce new safety issues. This descriptive study provides insight into the nature and consequences of medication incidents related to ADD, as reported by healthcare professionals in community pharmacies and hospitals. Methods The medication incidents that were submitted to the Dutch Central Medication incidents Registration (CMR) reporting system were selected and characterized independently by two researchers. Main Outcome Measures Person discovering the incident, phase of the medication process in which the incident occurred, immediate cause of the incident, nature of incident from the healthcare provider's perspective, nature of incident from the patient's perspective, and consequent harm to the patient caused by the incident. Results From January 2012 to February 2013 the CMR received 15,113 incidents: 3,685 (24.4%) incidents from community pharmacies and 11,428 (75.6%) incidents from hospitals. Eventually 1 of 50 reported incidents (268/15,113 = 1.8%) were related to ADD; in community pharmacies more incidents (227/3,685 = 6.2%) were related to ADD than in hospitals (41/11,428 = 0.4%). The immediate cause of an incident was often a change in the patient's medicine regimen or relocation. Most reported incidents occurred in two phases: entering the prescription into the pharmacy information system and filling the ADD bag. Conclusion A proportion of incidents was related to ADD and is reported regularly, especially by community pharmacies. In two phases, entering the prescription into the pharmacy information system and filling the ADD bag, most incidents occurred. A change in the patient's medicine regimen or relocation was the immediate causes of an incident

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

    Directory of Open Access Journals (Sweden)

    Vazin A

    2014-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Grozdova T.U.

    2011-06-01

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

  3. Automated, non-linear registration between 3-dimensional brain map and medical head image

    International Nuclear Information System (INIS)

    Mizuta, Shinobu; Urayama, Shin-ichi; Zoroofi, R.A.; Uyama, Chikao

    1998-01-01

    In this paper, we propose an automated, non-linear registration method between 3-dimensional medical head image and brain map in order to efficiently extract the regions of interest. In our method, input 3-dimensional image is registered into a reference image extracted from a brain map. The problems to be solved are automated, non-linear image matching procedure, and cost function which represents the similarity between two images. Non-linear matching is carried out by dividing the input image into connected partial regions, transforming the partial regions preserving connectivity among the adjacent images, evaluating the image similarity between the transformed regions of the input image and the correspondent regions of the reference image, and iteratively searching the optimal transformation of the partial regions. In order to measure the voxelwise similarity of multi-modal images, a cost function is introduced, which is based on the mutual information. Some experiments using MR images presented the effectiveness of the proposed method. (author)

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

    OpenAIRE

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

    2016-01-01

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

  5. The United States Army Medical Department Journal. January-March 2013

    Science.gov (United States)

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Rafeea F

    2017-11-01

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

  7. Automated external defibrillators in the hospital: A case of medical reversal.

    Science.gov (United States)

    Stewart, John A

    2018-05-01

    Automated external defibrillators (AEDs) emerged in the 1980s as an important innovation in pre-hospital emergency cardiac care (ECC). In the years since, the American Heart Association (AHA) and the International Liaison Committee for Resuscitation (ILCOR) have promoted AED technology for use in hospitals as well, resulting in the widespread purchase and use of AED-capable defibrillators. In-hospital use of AEDs now appears to have decreased survival from cardiac arrests. This article will look at the use of AEDs in hospitals as a case of "medical reversal." Medical reversal occurs when an accepted, widely used treatment is found to be ineffective or even harmful. This article will discuss the issue of AEDs in the hospital using a conceptual framework provided by recent work on medical reversal. It will go on to consider the implications of the reversal for in-hospital resuscitation programs and emergency medicine more generally. Copyright © 2017 The Author. Published by Elsevier Inc. All rights reserved.

  8. Automated Video Analysis of Non-verbal Communication in a Medical Setting.

    Science.gov (United States)

    Hart, Yuval; Czerniak, Efrat; Karnieli-Miller, Orit; Mayo, Avraham E; Ziv, Amitai; Biegon, Anat; Citron, Atay; Alon, Uri

    2016-01-01

    Non-verbal communication plays a significant role in establishing good rapport between physicians and patients and may influence aspects of patient health outcomes. It is therefore important to analyze non-verbal communication in medical settings. Current approaches to measure non-verbal interactions in medicine employ coding by human raters. Such tools are labor intensive and hence limit the scale of possible studies. Here, we present an automated video analysis tool for non-verbal interactions in a medical setting. We test the tool using videos of subjects that interact with an actor portraying a doctor. The actor interviews the subjects performing one of two scripted scenarios of interviewing the subjects: in one scenario the actor showed minimal engagement with the subject. The second scenario included active listening by the doctor and attentiveness to the subject. We analyze the cross correlation in total kinetic energy of the two people in the dyad, and also characterize the frequency spectrum of their motion. We find large differences in interpersonal motion synchrony and entrainment between the two performance scenarios. The active listening scenario shows more synchrony and more symmetric followership than the other scenario. Moreover, the active listening scenario shows more high-frequency motion termed jitter that has been recently suggested to be a marker of followership. The present approach may be useful for analyzing physician-patient interactions in terms of synchrony and dominance in a range of medical settings.

  9. Errors detected in pediatric oral liquid medication doses prepared in an automated workflow management system.

    Science.gov (United States)

    Bledsoe, Sarah; Van Buskirk, Alex; Falconer, R James; Hollon, Andrew; Hoebing, Wendy; Jokic, Sladan

    2018-02-01

    The effectiveness of barcode-assisted medication preparation (BCMP) technology on detecting oral liquid dose preparation errors. From June 1, 2013, through May 31, 2014, a total of 178,344 oral doses were processed at Children's Mercy, a 301-bed pediatric hospital, through an automated workflow management system. Doses containing errors detected by the system's barcode scanning system or classified as rejected by the pharmacist were further reviewed. Errors intercepted by the barcode-scanning system were classified as (1) expired product, (2) incorrect drug, (3) incorrect concentration, and (4) technological error. Pharmacist-rejected doses were categorized into 6 categories based on the root cause of the preparation error: (1) expired product, (2) incorrect concentration, (3) incorrect drug, (4) incorrect volume, (5) preparation error, and (6) other. Of the 178,344 doses examined, 3,812 (2.1%) errors were detected by either the barcode-assisted scanning system (1.8%, n = 3,291) or a pharmacist (0.3%, n = 521). The 3,291 errors prevented by the barcode-assisted system were classified most commonly as technological error and incorrect drug, followed by incorrect concentration and expired product. Errors detected by pharmacists were also analyzed. These 521 errors were most often classified as incorrect volume, preparation error, expired product, other, incorrect drug, and incorrect concentration. BCMP technology detected errors in 1.8% of pediatric oral liquid medication doses prepared in an automated workflow management system, with errors being most commonly attributed to technological problems or incorrect drugs. Pharmacists rejected an additional 0.3% of studied doses. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  10. Designing and evaluating an automated system for real-time medication administration error detection in a neonatal intensive care unit.

    Science.gov (United States)

    Ni, Yizhao; Lingren, Todd; Hall, Eric S; Leonard, Matthew; Melton, Kristin; Kirkendall, Eric S

    2018-05-01

    Timely identification of medication administration errors (MAEs) promises great benefits for mitigating medication errors and associated harm. Despite previous efforts utilizing computerized methods to monitor medication errors, sustaining effective and accurate detection of MAEs remains challenging. In this study, we developed a real-time MAE detection system and evaluated its performance prior to system integration into institutional workflows. Our prospective observational study included automated MAE detection of 10 high-risk medications and fluids for patients admitted to the neonatal intensive care unit at Cincinnati Children's Hospital Medical Center during a 4-month period. The automated system extracted real-time medication use information from the institutional electronic health records and identified MAEs using logic-based rules and natural language processing techniques. The MAE summary was delivered via a real-time messaging platform to promote reduction of patient exposure to potential harm. System performance was validated using a physician-generated gold standard of MAE events, and results were compared with those of current practice (incident reporting and trigger tools). Physicians identified 116 MAEs from 10 104 medication administrations during the study period. Compared to current practice, the sensitivity with automated MAE detection was improved significantly from 4.3% to 85.3% (P = .009), with a positive predictive value of 78.0%. Furthermore, the system showed potential to reduce patient exposure to harm, from 256 min to 35 min (P patient exposure to potential harm following MAE events.

  11. Increasing Therapist Productivity: Using Lean Principles in the Rehabilitation Department of an Academic Medical Center.

    Science.gov (United States)

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

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

  12. Delegation of medical tasks in French radiation oncology departments: current situation and impact on residents' training.

    Science.gov (United States)

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

    2013-10-01

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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ephrem Abebe

    2018-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Behrad Pour- Mohammadi

    2011-10-01

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

  16. Automated Budget System -

    Data.gov (United States)

    Department of Transportation — The Automated Budget System (ABS) automates management and planning of the Mike Monroney Aeronautical Center (MMAC) budget by providing enhanced capability to plan,...

  17. Comparative Cost-Effectiveness Analysis of Three Different Automated Medication Systems Implemented in a Danish Hospital Setting.

    Science.gov (United States)

    Risør, Bettina Wulff; Lisby, Marianne; Sørensen, Jan

    2018-02-01

    Automated medication systems have been found to reduce errors in the medication process, but little is known about the cost-effectiveness of such systems. The objective of this study was to perform a model-based indirect cost-effectiveness comparison of three different, real-world automated medication systems compared with current standard practice. The considered automated medication systems were a patient-specific automated medication system (psAMS), a non-patient-specific automated medication system (npsAMS), and a complex automated medication system (cAMS). The economic evaluation used original effect and cost data from prospective, controlled, before-and-after studies of medication systems implemented at a Danish hematological ward and an acute medical unit. Effectiveness was described as the proportion of clinical and procedural error opportunities that were associated with one or more errors. An error was defined as a deviation from the electronic prescription, from standard hospital policy, or from written procedures. The cost assessment was based on 6-month standardization of observed cost data. The model-based comparative cost-effectiveness analyses were conducted with system-specific assumptions of the effect size and costs in scenarios with consumptions of 15,000, 30,000, and 45,000 doses per 6-month period. With 30,000 doses the cost-effectiveness model showed that the cost-effectiveness ratio expressed as the cost per avoided clinical error was €24 for the psAMS, €26 for the npsAMS, and €386 for the cAMS. Comparison of the cost-effectiveness of the three systems in relation to different valuations of an avoided error showed that the psAMS was the most cost-effective system regardless of error type or valuation. The model-based indirect comparison against the conventional practice showed that psAMS and npsAMS were more cost-effective than the cAMS alternative, and that psAMS was more cost-effective than npsAMS.

  18. Automated medical resident rotation and shift scheduling to ensure quality resident education and patient care.

    Science.gov (United States)

    Smalley, Hannah K; Keskinocak, Pinar

    2016-03-01

    At academic teaching hospitals around the country, the majority of clinical care is provided by resident physicians. During their training, medical residents often rotate through various hospitals and/or medical services to maximize their education. Depending on the size of the training program, manually constructing such a rotation schedule can be cumbersome and time consuming. Further, rules governing allowable duty hours for residents have grown more restrictive in recent years (ACGME 2011), making day-to-day shift scheduling of residents more difficult (Connors et al., J Thorac Cardiovasc Surg 137:710-713, 2009; McCoy et al., May Clin Proc 86(3):192, 2011; Willis et al., J Surg Edu 66(4):216-221, 2009). These rules limit lengths of duty periods, allowable duty hours in a week, and rest periods, to name a few. In this paper, we present two integer programming models (IPs) with the goals of (1) creating feasible assignments of residents to rotations over a one-year period, and (2) constructing night and weekend call-shift schedules for the individual rotations. These models capture various duty-hour rules and constraints, provide the ability to test multiple what-if scenarios, and largely automate the process of schedule generation, solving these scheduling problems more effectively and efficiently compared to manual methods. Applying our models on data from a surgical residency program, we highlight the infeasibilities created by increased duty-hour restrictions placed on residents in conjunction with current scheduling paradigms.

  19. Medical emergencies in the imaging department of a university hospital: event and imaging characteristics.

    Science.gov (United States)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Julia González

    2003-11-01

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

  1. National Institutes of Health Funding to Departments of Orthopaedic Surgery at U.S. Medical Schools.

    Science.gov (United States)

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

    2017-01-18

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

  2. Cost-Effectiveness Analysis of an Automated Medication System Implemented in a Danish Hospital Setting.

    Science.gov (United States)

    Risør, Bettina Wulff; Lisby, Marianne; Sørensen, Jan

    To evaluate the cost-effectiveness of an automated medication system (AMS) implemented in a Danish hospital setting. An economic evaluation was performed alongside a controlled before-and-after effectiveness study with one control ward and one intervention ward. The primary outcome measure was the number of errors in the medication administration process observed prospectively before and after implementation. To determine the difference in proportion of errors after implementation of the AMS, logistic regression was applied with the presence of error(s) as the dependent variable. Time, group, and interaction between time and group were the independent variables. The cost analysis used the hospital perspective with a short-term incremental costing approach. The total 6-month costs with and without the AMS were calculated as well as the incremental costs. The number of avoided administration errors was related to the incremental costs to obtain the cost-effectiveness ratio expressed as the cost per avoided administration error. The AMS resulted in a statistically significant reduction in the proportion of errors in the intervention ward compared with the control ward. The cost analysis showed that the AMS increased the ward's 6-month cost by €16,843. The cost-effectiveness ratio was estimated at €2.01 per avoided administration error, €2.91 per avoided procedural error, and €19.38 per avoided clinical error. The AMS was effective in reducing errors in the medication administration process at a higher overall cost. The cost-effectiveness analysis showed that the AMS was associated with affordable cost-effectiveness rates. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Bui, Quan M.

    2015-05-01

    Full Text Available We use a case report to describe the acute psychiatric and medical management of marijuana intoxication in the emergency setting. A 34-year-old woman presented with erratic, disruptive behavior and psychotic symptoms after recreational ingestion of edible cannabis. She was also found to have mild hypokalemia and QT interval prolongation. Psychiatric management of cannabis psychosis involves symptomatic treatment and maintenance of safety during detoxification. Acute medical complications of marijuana use are primarily cardiovascular and respiratory in nature; electrolyte and electrocardiogram monitoring is indicated. This patient’s psychosis, hypokalemia and prolonged QTc interval resolved over two days with supportive treatment and minimal intervention in the emergency department. Patients with cannabis psychosis are at risk for further psychotic sequelae. Emergency providers may reduce this risk through appropriate diagnosis, acute treatment, and referral for outpatient care. [West J Emerg Med. 2015;16(3:414–417.

  4. Pain Management for Sickle Cell Disease in the Pediatric Emergency Department: Medications and Hospitalization Trends.

    Science.gov (United States)

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

    2017-10-01

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

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

    International Nuclear Information System (INIS)

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

    2003-01-01

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

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

    International Nuclear Information System (INIS)

    Rybakova, M.N.

    1997-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Eshghyar N

    1999-12-01

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

  8. Assessment of medical radiation exposure to patients and ambient doses in several diagnostic radiology departments

    Science.gov (United States)

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

    2017-11-01

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

  9. Education in medical billing benefits both neurology trainees and academic departments.

    Science.gov (United States)

    Waugh, Jeff L

    2014-11-11

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

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

    National Research Council Canada - National Science Library

    2002-01-01

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

  11. Job characteristic perception and intrinsic motivation in medical record department staff.

    Science.gov (United States)

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

    2013-01-01

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

  12. The effect of patient death on medical students in the emergency department.

    Science.gov (United States)

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

    2017-07-10

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

  13. Selective automation and skill transfer in medical robotics: a demonstration on surgical knot-tying.

    Science.gov (United States)

    Knoll, Alois; Mayer, Hermann; Staub, Christoph; Bauernschmitt, Robert

    2012-12-01

    Transferring non-trivial human manipulation skills to robot systems is a challenging task. There have been a number of attempts to design research systems for skill transfer, but the level of the complexity of the actual skills transferable to the robot was rather limited, and delicate operations requiring a high dexterity and long action sequences with many sub-operations were impossible to transfer. A novel approach to human-machine skill transfer for multi-arm robot systems is presented. The methodology capitalizes on the metaphor of 'scaffolded learning', which has gained widespread acceptance in psychology. The main idea is to formalize the superior knowledge of a teacher in a certain way to generate support for a trainee. In our case, the scaffolding is constituted by abstract patterns, which facilitate the structuring and segmentation of information during 'learning by demonstration'. The actual skill generalization is then based on simulating fluid dynamics. The approach has been successfully evaluated in the medical domain for the delicate task of automated knot-tying for suturing with standard surgical instruments and a realistic minimally invasive robotic surgery system. Copyright © 2012 John Wiley & Sons, Ltd.

  14. Remote Minimally Invasive Surgery – Haptic Feedback and Selective Automation in Medical Robotics

    Directory of Open Access Journals (Sweden)

    Christoph Staub

    2011-01-01

    Full Text Available The automation of recurrent tasks and force feedback are complex problems in medical robotics. We present a novel approach that extends human-machine skill-transfer by a scaffolding framework. It assumes a consolidated working environment for both, the trainee and the trainer. The trainer provides hints and cues in a basic structure which is already understood by the learner. In this work, the scaffolding is constituted by abstract patterns, which facilitate the structuring and segmentation of information during “Learning by Demonstration” (LbD. With this concept, the concrete example of knot-tying for suturing is exemplified and evaluated. During the evaluation, most problems and failures arose due to intrinsic system imprecisions of the medical robot system. These inaccuracies were then improved by the visual guidance of the surgical instruments. While the benefits of force feedback in telesurgery has already been demonstrated and measured forces are also used during task learning, the transmission of signals between the operator console and the robot system over long-distances or across-network remote connections is still a challenge due to time-delay. Especially during incision processes with a scalpel into tissue, a delayed force feedback yields to an unpredictable force perception at the operator-side and can harm the tissue which the robot is interacting with. We propose a XFEM-based incision force prediction algorithm that simulates the incision contact-forces in real-time and compensates the delayed force sensor readings. A realistic 4-arm system for minimally invasive robotic heart surgery is used as a platform for the research.

  15. Manual versus automated coding of free-text self-reported medication data in the 45 and Up Study: a validation study.

    Science.gov (United States)

    Gnjidic, Danijela; Pearson, Sallie-Anne; Hilmer, Sarah N; Basilakis, Jim; Schaffer, Andrea L; Blyth, Fiona M; Banks, Emily

    2015-03-30

    Increasingly, automated methods are being used to code free-text medication data, but evidence on the validity of these methods is limited. To examine the accuracy of automated coding of previously keyed in free-text medication data compared with manual coding of original handwritten free-text responses (the 'gold standard'). A random sample of 500 participants (475 with and 25 without medication data in the free-text box) enrolled in the 45 and Up Study was selected. Manual coding involved medication experts keying in free-text responses and coding using Anatomical Therapeutic Chemical (ATC) codes (i.e. chemical substance 7-digit level; chemical subgroup 5-digit; pharmacological subgroup 4-digit; therapeutic subgroup 3-digit). Using keyed-in free-text responses entered by non-experts, the automated approach coded entries using the Australian Medicines Terminology database and assigned corresponding ATC codes. Based on manual coding, 1377 free-text entries were recorded and, of these, 1282 medications were coded to ATCs manually. The sensitivity of automated coding compared with manual coding was 79% (n = 1014) for entries coded at the exact ATC level, and 81.6% (n = 1046), 83.0% (n = 1064) and 83.8% (n = 1074) at the 5, 4 and 3-digit ATC levels, respectively. The sensitivity of automated coding for blank responses was 100% compared with manual coding. Sensitivity of automated coding was highest for prescription medications and lowest for vitamins and supplements, compared with the manual approach. Positive predictive values for automated coding were above 95% for 34 of the 38 individual prescription medications examined. Automated coding for free-text prescription medication data shows very high to excellent sensitivity and positive predictive values, indicating that automated methods can potentially be useful for large-scale, medication-related research.

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

    Directory of Open Access Journals (Sweden)

    Ali Imani

    2017-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Sehnaz Akın Paker

    2015-09-01

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

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Robert W. Derlet

    2014-03-01

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

  20. Medication Administration Errors in an Adult Emergency Department of a Tertiary Health Care Facility in Ghana.

    Science.gov (United States)

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

    2016-12-01

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

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

    LENUS (Irish Health Repository)

    McCullagh, M

    2015-02-01

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

  2. The 5Cs of Consultation: Training Medical Students to Communicate Effectively in the Emergency Department.

    Science.gov (United States)

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

    2015-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Michael W. Manning

    2017-12-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

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

    Science.gov (United States)

    Penn, Christopher

    2004-08-01

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

  6. The suitability of ISO 9001 as a quality system for a medical illustration department.

    Science.gov (United States)

    Fleming, C M; Armes, F M

    2001-12-01

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

  7. Evaluating the Effectiveness of Community and Hospital Medical Record Integration on Management of Behavioral Health in the Emergency Department.

    Science.gov (United States)

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

    2017-11-09

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

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

    International Nuclear Information System (INIS)

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

    2002-01-01

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

  9. Unusual clustering of coefficients of variation in published articles from a medical biochemistry department in India.

    Science.gov (United States)

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

    2009-03-01

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

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

    Science.gov (United States)

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

    2016-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Pauline Haroutunian

    2017-12-01

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

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

    International Nuclear Information System (INIS)

    Jonquet, M.E.

    1990-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Joaquín M. González-Cabrera

    2018-03-01

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

  14. [Prognostic factors in community acquired pneumonia. Prospective multicenter study in internal medical departments].

    Science.gov (United States)

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

    2007-10-01

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

  15. Financial incentives and accountability for integrated medical care in Department of Veterans Affairs mental health programs.

    Science.gov (United States)

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

    2010-01-01

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

  16. Assessment of diabetic teleretinal imaging program at the Portland Department of Veterans Affairs Medical Center.

    Science.gov (United States)

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

    2015-01-01

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

  17. Spreading a medical home redesign: effects on emergency department use and hospital admissions.

    Science.gov (United States)

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

    2013-01-01

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

  18. [Accuracy in the medication history and reconciliation errors in the emergency department].

    Science.gov (United States)

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

    2015-10-05

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

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

    Directory of Open Access Journals (Sweden)

    Rukhsana Parvin

    2013-01-01

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

  20. The effect of medical trainees on pediatric emergency department flow: a discrete event simulation modeling study.

    Science.gov (United States)

    Genuis, Emerson D; Doan, Quynh

    2013-11-01

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

  1. Electronic medication complete communication strategy for opioid prescriptions in the emergency department: Rationale and design for a three-arm provider randomized trial.

    Science.gov (United States)

    McCarthy, Danielle M; Courtney, D Mark; Lank, Patrick M; Cameron, Kenzie A; Russell, Andrea M; Curtis, Laura M; Kim, Kwang-Youn A; Walton, Surrey M; Montague, Enid; Lyden, Abbie L; Gravenor, Stephanie J; Wolf, Michael S

    2017-08-01

    Thousands of people die annually from prescription opioid overdoses; however there are few strategies to ensure patients receive medication risk information at the time of prescribing. To compare the effectiveness of the Emergency Department (ED) Electronic Medication Complete Communication (EMC 2 ) Opioid Strategy (with and without text messaging) to promote safe medication use and improved patient knowledge as compared to usual care. The ED EMC 2 Opioid Strategy consists of 5 automated components to promote safe medication use: 1) physician reminder to counsel, 2) inbox message sent on to the patient's primary care physician, 3) pharmacist message on the prescription to counsel, 4) MedSheet supporting prescription information, and 5) patient-centered Take-Wait-Stop wording of prescription instructions. This strategy will be assessed both with and without the addition of text messages via a three-arm randomized trial. The study will take place at an urban academic ED (annual volume>85,000) in Chicago, IL. Patients being discharged with a new prescription for hydrocodone-acetaminophen will be enrolled and randomized (based on their prescribing physician). The primary outcome of the study is medication safe use as measured by a demonstrated dosing task. Additionally actual safe use, patient knowledge and provider counseling will be measured. Implementation fidelity as well as costs will be reported. The ED EMC 2 Opioid Strategy embeds a risk communication strategy into the electronic health record and promotes medication counseling with minimal workflow disruption. This trial will evaluate the strategy's effectiveness and implementation fidelity as compared to usual care. This trial is registered on clinicaltrials.gov with identifier NCT02431793. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    James Robert Langabeer

    2016-11-01

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

  3. Towards more reliable automated multi-dose dispensing: retrospective follow-up study on medication dose errors and product defects.

    Science.gov (United States)

    Palttala, Iida; Heinämäki, Jyrki; Honkanen, Outi; Suominen, Risto; Antikainen, Osmo; Hirvonen, Jouni; Yliruusi, Jouko

    2013-03-01

    To date, little is known on applicability of different types of pharmaceutical dosage forms in an automated high-speed multi-dose dispensing process. The purpose of the present study was to identify and further investigate various process-induced and/or product-related limitations associated with multi-dose dispensing process. The rates of product defects and dose dispensing errors in automated multi-dose dispensing were retrospectively investigated during a 6-months follow-up period. The study was based on the analysis of process data of totally nine automated high-speed multi-dose dispensing systems. Special attention was paid to the dependence of multi-dose dispensing errors/product defects and pharmaceutical tablet properties (such as shape, dimensions, weight, scored lines, coatings, etc.) to profile the most suitable forms of tablets for automated dose dispensing systems. The relationship between the risk of errors in dose dispensing and tablet characteristics were visualized by creating a principal component analysis (PCA) model for the outcome of dispensed tablets. The two most common process-induced failures identified in the multi-dose dispensing are predisposal of tablet defects and unexpected product transitions in the medication cassette (dose dispensing error). The tablet defects are product-dependent failures, while the tablet transitions are dependent on automated multi-dose dispensing systems used. The occurrence of tablet defects is approximately twice as common as tablet transitions. Optimal tablet preparation for the high-speed multi-dose dispensing would be a round-shaped, relatively small/middle-sized, film-coated tablet without any scored line. Commercial tablet products can be profiled and classified based on their suitability to a high-speed multi-dose dispensing process.

  4. MO-FG-303-04: A Smartphone Application for Automated Mechanical Quality Assurance of Medical Accelerators

    International Nuclear Information System (INIS)

    Kim, H; Lee, H; Choi, K; Ye, S

    2015-01-01

    Purpose: The mechanical quality assurance (QA) of medical accelerators consists of a time consuming series of procedures. Since most of the procedures are done manually – e.g., checking gantry rotation angle with the naked eye using a level attached to the gantry –, it is considered to be a process with high potential for human errors. To remove the possibilities of human errors and reduce the procedure duration, we developed a smartphone application for automated mechanical QA. Methods: The preparation for the automated process was done by attaching a smartphone to the gantry facing upward. For the assessments of gantry and collimator angle indications, motion sensors (gyroscope, accelerator, and magnetic field sensor) embedded in the smartphone were used. For the assessments of jaw position indicator, cross-hair centering, and optical distance indicator (ODI), an optical-image processing module using a picture taken by the high-resolution camera embedded in the smartphone was implemented. The application was developed with the Android software development kit (SDK) and OpenCV library. Results: The system accuracies in terms of angle detection error and length detection error were < 0.1° and < 1 mm, respectively. The mean absolute error for gantry and collimator rotation angles were 0.03° and 0.041°, respectively. The mean absolute error for the measured light field size was 0.067 cm. Conclusion: The automated system we developed can be used for the mechanical QA of medical accelerators with proven accuracy. For more convenient use of this application, the wireless communication module is under development. This system has a strong potential for the automation of the other QA procedures such as light/radiation field coincidence and couch translation/rotations

  5. MO-FG-303-04: A Smartphone Application for Automated Mechanical Quality Assurance of Medical Accelerators

    Energy Technology Data Exchange (ETDEWEB)

    Kim, H [Interdisciplinary Program in Radiation applied Life Science, College of Medicine, Seoul National University, Seoul (Korea, Republic of); Lee, H; Choi, K [Program in Biomedical Radiation Sciences, Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Seoul (Korea, Republic of); Ye, S [Interdisciplinary Program in Radiation applied Life Science, College of Medicine, Seoul National University, Seoul (Korea, Republic of); Program in Biomedical Radiation Sciences, Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Seoul (Korea, Republic of); Department of Radiation Oncology, Seoul National University Hospital, Seoul (Korea, Republic of)

    2015-06-15

    Purpose: The mechanical quality assurance (QA) of medical accelerators consists of a time consuming series of procedures. Since most of the procedures are done manually – e.g., checking gantry rotation angle with the naked eye using a level attached to the gantry –, it is considered to be a process with high potential for human errors. To remove the possibilities of human errors and reduce the procedure duration, we developed a smartphone application for automated mechanical QA. Methods: The preparation for the automated process was done by attaching a smartphone to the gantry facing upward. For the assessments of gantry and collimator angle indications, motion sensors (gyroscope, accelerator, and magnetic field sensor) embedded in the smartphone were used. For the assessments of jaw position indicator, cross-hair centering, and optical distance indicator (ODI), an optical-image processing module using a picture taken by the high-resolution camera embedded in the smartphone was implemented. The application was developed with the Android software development kit (SDK) and OpenCV library. Results: The system accuracies in terms of angle detection error and length detection error were < 0.1° and < 1 mm, respectively. The mean absolute error for gantry and collimator rotation angles were 0.03° and 0.041°, respectively. The mean absolute error for the measured light field size was 0.067 cm. Conclusion: The automated system we developed can be used for the mechanical QA of medical accelerators with proven accuracy. For more convenient use of this application, the wireless communication module is under development. This system has a strong potential for the automation of the other QA procedures such as light/radiation field coincidence and couch translation/rotations.

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

    International Nuclear Information System (INIS)

    Babiker, Esameldeen Mohamed Tom

    2002-02-01

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

  7. THE EXPERIENCE OF THE AUTOMATION OF THE STATISTICAL REPORTING FORMATION ON WAGES IN MULTIDISCIPLINARY MEDICAL INSTITUTION

    Directory of Open Access Journals (Sweden)

    O. E. Karpov

    2018-01-01

    Full Text Available The article is dedicated to the description of the experience of automation of the processes of statistical reporting on salaries in Federal State Budgetary Institution «NationalPirogovMedicalSurgicalCenter» of Ministry of Health of theRussian Federationwith the use of information systems.According to the current legislation of theRussian Federation, within the framework of the successful implementation of the «Road Map» on a national scale, statistical information about salaries of employees of social institutions is collected in various sections of data reporting. It became necessary to develop a tool to promptly collect, process and analyze data on salaries to provide statistical information to social institutions.The purpose of this article is to familiarize oneself with the concept of multidimensional data representation and to structure information on multidimensional analytical reports within the framework of practical application for solving economic problems related to the formation of statistical reporting on salaries. The algorithm and the procedure for the formation of multidimensional analytical reports are described, both from the methodological and from the practical point of view. As a material for this study, the normative and legal acts of the Russian Federation, statistical and analytical materials of the section «Salaries of certain categories of workers in the social sphere and science» of the Federal State Statistics Service of the Russian Federation, scientific publications and articles of the periodical press, as well as the results of their own research were used.To facilitate the perception, special attention is given to the description of the basic concepts of multidimensional analytical reporting: measure, performance variables, value. The authors not only gave a definition of multidimensional analytical reporting, but also demonstrated a visual representation of the multidimensional information space of

  8. Automated data extraction from general practice records in an Australian setting: trends in influenza-like illness in sentinel general practices and emergency departments.

    Science.gov (United States)

    Liljeqvist, Gösta T H; Staff, Michael; Puech, Michele; Blom, Hans; Torvaldsen, Siranda

    2011-06-06

    Influenza intelligence in New South Wales (NSW), Australia is derived mainly from emergency department (ED) presentations and hospital and intensive care admissions, which represent only a portion of influenza-like illness (ILI) in the population. A substantial amount of the remaining data lies hidden in general practice (GP) records. Previous attempts in Australia to gather ILI data from GPs have given them extra work. We explored the possibility of applying automated data extraction from GP records in sentinel surveillance in an Australian setting.The two research questions asked in designing the study were: Can syndromic ILI data be extracted automatically from routine GP data? How do ILI trends in sentinel general practice compare with ILI trends in EDs? We adapted a software program already capable of automated data extraction to identify records of patients with ILI in routine electronic GP records in two of the most commonly used commercial programs. This tool was applied in sentinel sites to gather retrospective data for May-October 2007-2009 and in real-time for the same interval in 2010. The data were compared with that provided by the Public Health Real-time Emergency Department Surveillance System (PHREDSS) and with ED data for the same periods. The GP surveillance tool identified seasonal trends in ILI both retrospectively and in near real-time. The curve of seasonal ILI was more responsive and less volatile than that of PHREDSS on a local area level. The number of weekly ILI presentations ranged from 8 to 128 at GP sites and from 0 to 18 in EDs in non-pandemic years. Automated data extraction from routine GP records offers a means to gather data without introducing any additional work for the practitioner. Adding this method to current surveillance programs will enhance their ability to monitor ILI and to detect early warning signals of new ILI events.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1989-01-01

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

  10. Automated detection of extradural and subdural hematoma for contrast-enhanced CT images in emergency medical care

    Science.gov (United States)

    Hara, Takeshi; Matoba, Naoto; Zhou, Xiangrong; Yokoi, Shinya; Aizawa, Hiroaki; Fujita, Hiroshi; Sakashita, Keiji; Matsuoka, Tetsuya

    2007-03-01

    We have been developing the CAD scheme for head and abdominal injuries for emergency medical care. In this work, we have developed an automated method to detect typical head injuries, rupture or strokes of brain. Extradural and subdural hematoma region were detected by comparing technique after the brain areas were registered using warping. We employ 5 normal and 15 stroke cases to estimate the performance after creating the brain model with 50 normal cases. Some of the hematoma regions were detected correctly in all of the stroke cases with no false positive findings on normal cases.

  11. Investments for medical equipment in a mother and child health hospital: correlation with level of services/departments.

    Science.gov (United States)

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

    2011-02-01

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

  12. Implementation of a pharmacy automation system (robotics) to ensure medication safety at Norwalk hospital.

    Science.gov (United States)

    Bepko, Robert J; Moore, John R; Coleman, John R

    2009-01-01

    This article reports an intervention to improve the quality and safety of hospital patient care by introducing the use of pharmacy robotics into the medication distribution process. Medication safety is vitally important. The integration of pharmacy robotics with computerized practitioner order entry and bedside medication bar coding produces a significant reduction in medication errors. The creation of a safe medication-from initial ordering to bedside administration-provides enormous benefits to patients, to health care providers, and to the organization as well.

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

    Directory of Open Access Journals (Sweden)

    Benjamin P Geisler

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

  14. A Model of Process-Based Automation: Cost and Quality Implications in the Medication Management Process

    Science.gov (United States)

    Spaulding, Trent Joseph

    2011-01-01

    The objective of this research is to understand how a set of systems, as defined by the business process, creates value. The three studies contained in this work develop the model of process-based automation. The model states that complementarities among systems are specified by handoffs in the business process. The model also provides theory to…

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

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

    National Research Council Canada - National Science Library

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

    2005-01-01

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

  17. U.S. Army Medical Department Journal (April-June 2006)

    Science.gov (United States)

    2006-06-01

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

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

    Science.gov (United States)

    Ajami, Sima; Ketabi, Saeedeh

    2012-06-01

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

  19. [Medication errors in a hospital emergency department: study of the current situation and critical points for improving patient safety].

    Science.gov (United States)

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

    2017-01-01

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

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  1. Dedication increases productivity: an analysis of the implementation of a dedicated medical team in the emergency department.

    Science.gov (United States)

    Ramos, Pedro; Paiva, José Artur

    2017-12-01

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

  2. Impact of a computerized provider radiography order entry system without clinical decision support on emergency department medical imaging requests.

    Science.gov (United States)

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

    2016-06-01

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

  3. Pharmacy Automation in Navy Medicine: A Study of Naval Medical Center San Diego

    Science.gov (United States)

    2015-09-01

    Whittlesea, C. (2013). The impact of automation on workload and dispensing errors in a hospital pharmacy . International Journal of Pharmacy Practice , 21...Welsh NHS hospitals. International Journal of Pharmacy Practice , 16, 175–188. Lin, A. C., Huang, Y.-C., Punches, G., & Chen, Y. (2007). Effect of a...expectations of outpatient pharmacy services in a teaching hospital. International Journal of Pharmacy Medicine , 5(3), 128–132. 79 INITIAL

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

    Directory of Open Access Journals (Sweden)

    Stoneking LR

    2016-08-01

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

  5. Emergency department boarding and adverse hospitalization outcomes among patients admitted to a general medical service.

    Science.gov (United States)

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

    2018-03-20

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

  6. Drug abuse-related accidents leading to emergency department visits at two medical centers.

    Science.gov (United States)

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

    2012-05-01

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

  7. U.S. Army Medical Department Journal, April-June 2008

    Science.gov (United States)

    2008-06-01

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

  8. Toward better public health reporting using existing off the shelf approaches: The value of medical dictionaries in automated cancer detection using plaintext medical data.

    Science.gov (United States)

    Kasthurirathne, Suranga N; Dixon, Brian E; Gichoya, Judy; Xu, Huiping; Xia, Yuni; Mamlin, Burke; Grannis, Shaun J

    2017-05-01

    Existing approaches to derive decision models from plaintext clinical data frequently depend on medical dictionaries as the sources of potential features. Prior research suggests that decision models developed using non-dictionary based feature sourcing approaches and "off the shelf" tools could predict cancer with performance metrics between 80% and 90%. We sought to compare non-dictionary based models to models built using features derived from medical dictionaries. We evaluated the detection of cancer cases from free text pathology reports using decision models built with combinations of dictionary or non-dictionary based feature sourcing approaches, 4 feature subset sizes, and 5 classification algorithms. Each decision model was evaluated using the following performance metrics: sensitivity, specificity, accuracy, positive predictive value, and area under the receiver operating characteristics (ROC) curve. Decision models parameterized using dictionary and non-dictionary feature sourcing approaches produced performance metrics between 70 and 90%. The source of features and feature subset size had no impact on the performance of a decision model. Our study suggests there is little value in leveraging medical dictionaries for extracting features for decision model building. Decision models built using features extracted from the plaintext reports themselves achieve comparable results to those built using medical dictionaries. Overall, this suggests that existing "off the shelf" approaches can be leveraged to perform accurate cancer detection using less complex Named Entity Recognition (NER) based feature extraction, automated feature selection and modeling approaches. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    National Research Council Canada - National Science Library

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

    1998-01-01

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

  10. Configuration Management Automation (CMA) -

    Data.gov (United States)

    Department of Transportation — Configuration Management Automation (CMA) will provide an automated, integrated enterprise solution to support CM of FAA NAS and Non-NAS assets and investments. CMA...

  11. Occupational and Environmental Health Programs in a Medical School: Should They Be a Department?

    Science.gov (United States)

    Rom, William N.

    1981-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Chien-Cheng Huang

    2005-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Nin-Chieh Hsu

    2014-08-01

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

  14. The Impact of a Health IT Changeover on Medical Imaging Department Work Processes and Turnaround Times: A mixed method study.

    Science.gov (United States)

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

    2015-01-01

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

  15. Evaluating acute medical admissions through emergency departments in Hong Kong: can one adjust for case-mix variation?

    Science.gov (United States)

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

    2012-12-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-08-01

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

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

    National Research Council Canada - National Science Library

    Percy, Allison

    2003-01-01

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

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

    International Nuclear Information System (INIS)

    Legras, B.; Kohler, F.

    1984-01-01

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

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

    National Research Council Canada - National Science Library

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

    2005-01-01

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

  20. The impact of an automated dose-dispensing scheme on user compliance, medication understanding, and medication stockpiles

    DEFF Research Database (Denmark)

    Larsen, Anna Bira; Haugbølle, Lotte Stig

    2007-01-01

    the assumed user benefits. Neither Danish nor international studies dealt with users' perspective on ADD in general or with respect to the pinpointed benefits, and thus exploration was needed. OBJECTIVES: The objective of this article is to respond to the following research question: How does ADD affect users......' handling and consumption of medication in terms of compliance behavior, and how does the assumption of user benefits made by health professionals and legislators measure up to users' experiences with ADD? METHODS: The results built on a secondary analysis of 9 qualitative interviews with a varied selection...... understanding, nor does it automatically eliminate stockpiles of old medication in users' homes. The gap between the perspectives of users and health professionals makes a compelling case for considering users' voices in the development and implementation of future health technologies....

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

    Science.gov (United States)

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

    2010-09-21

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

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

    National Research Council Canada - National Science Library

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

    2005-01-01

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

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

    National Research Council Canada - National Science Library

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

    2003-01-01

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

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

    National Research Council Canada - National Science Library

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

    2000-01-01

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

  5. Automated personnel-assets-consumables-drug tracking in ambulance services for more effective and efficient medical emergency interventions.

    Science.gov (United States)

    Utku, Semih; Özcanhan, Mehmet Hilal; Unluturk, Mehmet Suleyman

    2016-04-01

    Patient delivery time is no longer considered as the only critical factor, in ambulatory services. Presently, five clinical performance indicators are used to decide patient satisfaction. Unfortunately, the emergency ambulance services in rapidly growing metropolitan areas do not meet current satisfaction expectations; because of human errors in the management of the objects onboard the ambulances. But, human involvement in the information management of emergency interventions can be reduced by electronic tracking of personnel, assets, consumables and drugs (PACD) carried in the ambulances. Electronic tracking needs the support of automation software, which should be integrated to the overall hospital information system. Our work presents a complete solution based on a centralized database supported by radio frequency identification (RFID) and bluetooth low energy (BLE) identification and tracking technologies. Each object in an ambulance is identified and tracked by the best suited technology. The automated identification and tracking reduces manual paper documentation and frees the personnel to better focus on medical activities. The presence and amounts of the PACD are automatically monitored, warning about their depletion, non-presence or maintenance dates. The computerized two way hospital-ambulance communication link provides information sharing and instantaneous feedback for better and faster diagnosis decisions. A fully implemented system is presented, with detailed hardware and software descriptions. The benefits and the clinical outcomes of the proposed system are discussed, which lead to improved personnel efficiency and more effective interventions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. Automating the segmentation of medical images for the production of voxel tomographic computational models

    International Nuclear Information System (INIS)

    Caon, M.

    2001-01-01

    Radiation dosimetry for the diagnostic medical imaging procedures performed on humans requires anatomically accurate, computational models. These may be constructed from medical images as voxel-based tomographic models. However, they are time consuming to produce and as a consequence, there are few available. This paper discusses the emergence of semi-automatic segmentation techniques and describes an application (iRAD) written in Microsoft Visual Basic that allows the bitmap of a medical image to be segmented interactively and semi-automatically while displayed in Microsoft Excel. iRAD will decrease the time required to construct voxel models. Copyright (2001) Australasian College of Physical Scientists and Engineers in Medicine

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

    Directory of Open Access Journals (Sweden)

    Shapovalenko T.V.

    2013-12-01

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

  8. Semi-automated extraction and characterization of Stromal Vascular Fraction using a new medical device.

    Science.gov (United States)

    Hanke, Alexander; Prantl, Lukas; Wenzel, Carina; Nerlich, Michael; Brockhoff, Gero; Loibl, Markus; Gehmert, Sebastian

    2016-01-01

    The stem cell rich Stromal Vascular Fraction (SVF) can be harvested by processing lipo-aspirate or fat tissue with an enzymatic digestion followed by centrifugation. To date neither a standardised extraction method for SVF nor a generally admitted protocol for cell application in patients exists. A novel commercially available semi-automated device for the extraction of SVF promises sterility, consistent results and usability in the clinical routine. The aim of this work was to compare the quantity and quality of the SVF between the new system and an established manual laboratory method. SVF was extracted from lipo-aspirate both by a prototype of the semi-automated UNiStation™ (NeoGenesis, Seoul, Korea) and by hand preparation with common laboratory equipment. Cell composition of the SVF was characterized by multi-parametric flow-cytometry (FACSCanto-II, BD Biosciences). The total cell number (quantity) of the SVF was determined as well the percentage of cells expressing the stem cell marker CD34, the leucocyte marker CD45 and the marker CD271 for highly proliferative stem cells (quality). Lipo-aspirate obtained from six patients was processed with both the novel device (d) and the hand preparation (h) which always resulted in a macroscopically visible SVF. However, there was a tendency of a fewer cell yield per gram of used lipo-aspirate with the device (d: 1.1×105±1.1×105 vs. h: 2.0×105±1.7×105; p = 0.06). Noteworthy, the percentage of CD34+ cells was significantly lower when using the device (d: 57.3% ±23.8% vs. h: 74.1% ±13.4%; p = 0.02) and CD45+ leukocyte counts tend to be higher when compared to the hand preparation (d: 20.7% ±15.8% vs. h: 9.8% ±7.1%; p = 0.07). The percentage of highly proliferative CD271+ cells was similar for both methods (d:12.9% ±9.6% vs. h: 13.4% ±11.6%; p = 0.74) and no differences were found for double positive cells of CD34+/CD45+ (d: 5.9% ±1.7% vs. h: 1.7% ±1.1%; p = 0.13), CD34+/CD271+ (d: 24

  9. Reflections from a chair: Leadership of a clinical department at an academic medical center.

    Science.gov (United States)

    Willett, Christopher G

    2015-11-01

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

  10. An automated, broad-based, near real-time public health surveillance system using presentations to hospital Emergency Departments in New South Wales, Australia

    Directory of Open Access Journals (Sweden)

    Chiu Clayton

    2005-12-01

    Full Text Available Abstract Background In a climate of concern over bioterrorism threats and emergent diseases, public health authorities are trialling more timely surveillance systems. The 2003 Rugby World Cup (RWC provided an opportunity to test the viability of a near real-time syndromic surveillance system in metropolitan Sydney, Australia. We describe the development and early results of this largely automated system that used data routinely collected in Emergency Departments (EDs. Methods Twelve of 49 EDs in the Sydney metropolitan area automatically transmitted surveillance data from their existing information systems to a central database in near real-time. Information captured for each ED visit included patient demographic details, presenting problem and nursing assessment entered as free-text at triage time, physician-assigned provisional diagnosis codes, and status at departure from the ED. Both diagnoses from the EDs and triage text were used to assign syndrome categories. The text information was automatically classified into one or more of 26 syndrome categories using automated "naïve Bayes" text categorisation techniques. Automated processes were used to analyse both diagnosis and free text-based syndrome data and to produce web-based statistical summaries for daily review. An adjusted cumulative sum (cusum was used to assess the statistical significance of trends. Results During the RWC the system did not identify any major public health threats associated with the tournament, mass gatherings or the influx of visitors. This was consistent with evidence from other sources, although two known outbreaks were already in progress before the tournament. Limited baseline in early monitoring prevented the system from automatically identifying these ongoing outbreaks. Data capture was invisible to clinical staff in EDs and did not add to their workload. Conclusion We have demonstrated the feasibility and potential utility of syndromic surveillance using

  11. Medical Department, United States Army. Surgery in World War II. Neurosurgery. Volume 1

    Science.gov (United States)

    1958-01-01

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

  12. Evaluating the quality of medical multiple-choice items created with automated processes.

    Science.gov (United States)

    Gierl, Mark J; Lai, Hollis

    2013-07-01

    Computerised assessment raises formidable challenges because it requires large numbers of test items. Automatic item generation (AIG) can help address this test development problem because it yields large numbers of new items both quickly and efficiently. To date, however, the quality of the items produced using a generative approach has not been evaluated. The purpose of this study was to determine whether automatic processes yield items that meet standards of quality that are appropriate for medical testing. Quality was evaluated firstly by subjecting items created using both AIG and traditional processes to rating by a four-member expert medical panel using indicators of multiple-choice item quality, and secondly by asking the panellists to identify which items were developed using AIG in a blind review. Fifteen items from the domain of therapeutics were created in three different experimental test development conditions. The first 15 items were created by content specialists using traditional test development methods (Group 1 Traditional). The second 15 items were created by the same content specialists using AIG methods (Group 1 AIG). The third 15 items were created by a new group of content specialists using traditional methods (Group 2 Traditional). These 45 items were then evaluated for quality by a four-member panel of medical experts and were subsequently categorised as either Traditional or AIG items. Three outcomes were reported: (i) the items produced using traditional and AIG processes were comparable on seven of eight indicators of multiple-choice item quality; (ii) AIG items can be differentiated from Traditional items by the quality of their distractors, and (iii) the overall predictive accuracy of the four expert medical panellists was 42%. Items generated by AIG methods are, for the most part, equivalent to traditionally developed items from the perspective of expert medical reviewers. While the AIG method produced comparatively fewer plausible

  13. The impact of evidence-based sepsis guidelines on emergency department clinical practice: a pre-post medical record audit.

    Science.gov (United States)

    Romero, Bernadine; Fry, Margaret; Roche, Michael

    2017-11-01

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

  14. Lessons from Google and Apple: creating an open workplace in an academic medical department to foster innovation and collaboration.

    Science.gov (United States)

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

    2014-09-01

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

  15. Semi-Automated Annotation of Biobank Data Using Standard Medical Terminologies in a Graph Database.

    Science.gov (United States)

    Hofer, Philipp; Neururer, Sabrina; Goebel, Georg

    2016-01-01

    Data describing biobank resources frequently contains unstructured free-text information or insufficient coding standards. (Bio-) medical ontologies like Orphanet Rare Diseases Ontology (ORDO) or the Human Disease Ontology (DOID) provide a high number of concepts, synonyms and entity relationship properties. Such standard terminologies increase quality and granularity of input data by adding comprehensive semantic background knowledge from validated entity relationships. Moreover, cross-references between terminology concepts facilitate data integration across databases using different coding standards. In order to encourage the use of standard terminologies, our aim is to identify and link relevant concepts with free-text diagnosis inputs within a biobank registry. Relevant concepts are selected automatically by lexical matching and SPARQL queries against a RDF triplestore. To ensure correctness of annotations, proposed concepts have to be confirmed by medical data administration experts before they are entered into the registry database. Relevant (bio-) medical terminologies describing diseases and phenotypes were identified and stored in a graph database which was tied to a local biobank registry. Concept recommendations during data input trigger a structured description of medical data and facilitate data linkage between heterogeneous systems.

  16. Automated Assessment of Medical Students' Clinical Exposures according to AAMC Geriatric Competencies.

    Science.gov (United States)

    Chen, Yukun; Wrenn, Jesse; Xu, Hua; Spickard, Anderson; Habermann, Ralf; Powers, James; Denny, Joshua C

    2014-01-01

    Competence is essential for health care professionals. Current methods to assess competency, however, do not efficiently capture medical students' experience. In this preliminary study, we used machine learning and natural language processing (NLP) to identify geriatric competency exposures from students' clinical notes. The system applied NLP to generate the concepts and related features from notes. We extracted a refined list of concepts associated with corresponding competencies. This system was evaluated through 10-fold cross validation for six geriatric competency domains: "medication management (MedMgmt)", "cognitive and behavioral disorders (CBD)", "falls, balance, gait disorders (Falls)", "self-care capacity (SCC)", "palliative care (PC)", "hospital care for elders (HCE)" - each an American Association of Medical Colleges competency for medical students. The systems could accurately assess MedMgmt, SCC, HCE, and Falls competencies with F-measures of 0.94, 0.86, 0.85, and 0.84, respectively, but did not attain good performance for PC and CBD (0.69 and 0.62 in F-measure, respectively).

  17. Examining Regionalization Efforts to Develop Lessons Learned and Consideration for Department of Defense Medical Facilities

    Science.gov (United States)

    2017-03-23

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

  18. Utilizing Integrative Medicine in the U.S. Army Medical Department

    Science.gov (United States)

    2012-05-15

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

  19. Madigan Army Medical Center Department of Clinical Investigation Annual Progress Report Fiscal Year 1999

    Science.gov (United States)

    1999-09-30

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

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

    Science.gov (United States)

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

    2018-01-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

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

    International Nuclear Information System (INIS)

    Cameron, J.R.

    1973-01-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

  4. FINAL REPORT FORMER RADIATION WORKER MEDICAL SURVEILLANCE PROGRAM AT ROCKY FLATS For Department of Energy Programs

    Energy Technology Data Exchange (ETDEWEB)

    Joe M. Aldrich

    2004-11-01

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

  5. FINAL REPORT. FORMER RADIATION WORKER MEDICAL SURVEILLANCE PROGRAM AT ROCKY FLATS For Department of Energy Programs

    International Nuclear Information System (INIS)

    Aldrich, Joe M.

    2004-01-01

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

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

    Science.gov (United States)

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

    2018-02-26

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

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

    Science.gov (United States)

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

    2016-07-01

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

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

    International Nuclear Information System (INIS)

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

    2014-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-07-01

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

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

    International Nuclear Information System (INIS)

    Graf, G.; Heidenreich, P.

    1984-01-01

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

  11. Benzodiazepine Use During Hospitalization: Automated Identification of Potential Medication Errors and Systematic Assessment of Preventable Adverse Events.

    Directory of Open Access Journals (Sweden)

    David Franklin Niedrig

    Full Text Available Benzodiazepines and "Z-drug" GABA-receptor modulators (BDZ are among the most frequently used drugs in hospitals. Adverse drug events (ADE associated with BDZ can be the result of preventable medication errors (ME related to dosing, drug interactions and comorbidities. The present study evaluated inpatient use of BDZ and related ME and ADE.We conducted an observational study within a pharmacoepidemiological database derived from the clinical information system of a tertiary care hospital. We developed algorithms that identified dosing errors and interacting comedication for all administered BDZ. Associated ADE and risk factors were validated in medical records.Among 53,081 patients contributing 495,813 patient-days BDZ were administered to 25,626 patients (48.3% on 115,150 patient-days (23.2%. We identified 3,372 patient-days (2.9% with comedication that inhibits BDZ metabolism, and 1,197 (1.0% with lorazepam administration in severe renal impairment. After validation we classified 134, 56, 12, and 3 cases involving lorazepam, zolpidem, midazolam and triazolam, respectively, as clinically relevant ME. Among those there were 23 cases with associated adverse drug events, including severe CNS-depression, falls with subsequent injuries and severe dyspnea. Causality for BDZ was formally assessed as 'possible' or 'probable' in 20 of those cases. Four cases with ME and associated severe ADE required administration of the BDZ antagonist flumazenil.BDZ use was remarkably high in the studied setting, frequently involved potential ME related to dosing, co-medication and comorbidities, and rarely cases with associated ADE. We propose the implementation of automated ME screening and validation for the prevention of BDZ-related ADE.

  12. Acute cardiac events and deployment of emergency medical teams and automated external defibrillators in large football stadiums in the Netherlands.

    Science.gov (United States)

    van de Sandt, Femke; Umans, Victor

    2009-10-01

    The incidence of acute cardiac events - including out-of-hospital cardiac arrest - may be increased in visitors of large sports stadiums when compared with the general population. This study sought to investigate the incidence of acute cardiac events inside large Dutch football stadiums, as well as the emergency response systems deployed in these stadiums and the success rate for in-stadium resuscitation. Retrospective cohort study using a questionnaire sent to the 20 Dutch stadiums that hosted professional matches during the 2006-2007 and 2007-2008 football seasons. Stadium capacity ranged from 3600 to 51 600 spectators. Nearly 13 million spectators attended 686 'Eredivisie' (Honorary Division) and European football matches. All stadiums distribute multiple emergency medical teams among the spectators. Eighty-five percent of the stadiums have an ambulance standby during matches, 95% of the stadiums were equipped with automated external defibrillators (AEDs) during the study period. On an average, one AED was available for every 7576 spectators (range 1800-29 600). Ninety-three cardiac events were reported (7.3 per 1 million spectators). An AED was used 22 times (1.7 per 1 million spectators). Resuscitation was successful in 18 cases (82%, 95% confidence interval: 61-93). The incidence of out-of-hospital cardiac arrest inside large football stadiums in the Netherlands, albeit increased when compared with the general population, is low. The success rate for in-stadium resuscitation by medical teams equipped with AEDs is high. Dutch stadiums appear vigilant in regard to acute cardiac events. This report highlights the importance of adequate emergency medical response systems (including AEDs) in large sports venues.

  13. Effects of two types of medical contrast media on routine chemistry results by three automated chemistry analyzers.

    Science.gov (United States)

    Park, Yu Jin; Rim, John Hoon; Yim, Jisook; Lee, Sang-Guk; Kim, Jeong-Ho

    2017-08-01

    The use of iodinated contrast media has grown in popularity in the past two decades, but relatively little attention has been paid to the possible interferential effects of contrast media on laboratory test results. Herein, we investigate medical contrast media interference with routine chemistry results obtained by three automated chemistry analyzers. Ten levels of pooled serum were used in the study. Two types of medical contrast media [Iopamiro (iopamidol) and Omnipaque (iohexol)] were evaluated. To evaluate the dose-dependent effects of the contrast media, iopamidol and iohexol were spiked separately into aliquots of serum for final concentrations of 1.8%, 3.6%, 5.5%, 7.3%, and 9.1%. The 28 analytes included in the routine chemistry panel were measured by using Hitachi 7600, AU5800, and Cobas c702 analyzers. We calculated the delta percentage difference (DPD) between the samples and the control, and examined dose-dependent trends. When the mean DPD values were compared with the reference cut-off criteria, the only uniformly interferential effect observed for all analyzers was in total protein with iopamidol. Two additional analytes that showed trends toward interferential effects only in few analyzers and exceeded the limits of the allowable error were the serum iron and the total CO 2 . The other combinations of analyzer and contrast showed no consistent dose-dependent propensity for change in any analyte level. Our study suggests that many of the analytes included in routine chemistry results, except total protein and serum iron, are not significantly affected by iopamidol and iohexol. These results suggest that it would be beneficial to apply a flexible medical evaluation process for patients requiring both laboratory tests and imaging studies, minimizing the need for strict regulations for sequential tests. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  14. Disability management: corporate medical department management of employee health and productivity.

    Science.gov (United States)

    Burton, W N; Conti, D J

    2000-10-01

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

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

  16. [Contribution to the establishment of quality assurance in five medical microbiology departments in Togo].

    Science.gov (United States)

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

    2011-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Kaspar Küng

    2013-01-01

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

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

    LENUS (Irish Health Repository)

    Deasy, C

    2012-02-03

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

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

    Directory of Open Access Journals (Sweden)

    Fernando Nobre

    2002-02-01

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

  20. Quantitative Analysis of Uncertainty in Medical Reporting: Part 3: Customizable Education, Decision Support, and Automated Alerts.

    Science.gov (United States)

    Reiner, Bruce I

    2017-12-18

    In order to better elucidate and understand the causative factors and clinical implications of uncertainty in medical reporting, one must first create a referenceable database which records a number of standardized metrics related to uncertainty language, clinical context, technology, and provider and patient data. The resulting analytics can in turn be used to create context and user-specific reporting guidelines, real-time decision support, educational resources, and quality assurance measures. If this technology can be directly integrated into reporting technology and workflow, the goal is to proactively improve clinical outcomes at the point of care.

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

    Directory of Open Access Journals (Sweden)

    Marami Baishya

    2016-01-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

  3. Automated Risk Control in Medical Imaging Equipment Management Using Cloud Application

    Directory of Open Access Journals (Sweden)

    Sally M. Ghanem

    2018-01-01

    Full Text Available Medical imaging equipment (MIE is the baseline of providing patient diagnosis in healthcare facilities. However, that type of equipment poses high risk for patients, operators, and environment in terms of technology and application. Considering risk management in MIE management is rarely covered in literature. The study proposes a methodology that controls risks associated with MIE management. The methodology is based on proposing a set of key performance indicators (KPIs that lead to identify a set of undesired events (UDEs, and through a risk matrix, a risk level is evaluated. By using cloud computing software, risks could be controlled to be manageable. The methodology was verified by using a data set of 204 pieces of MIE along 104 hospitals, which belong to Egyptian Ministry of Health. Results point to appropriateness of proposed KPIs and UDEs in risk evaluation and control. Thus, the study reveals that optimizing risks taking into account the costs has an impact on risk control of MIE management.

  4. An Automated and Intelligent Medical Decision Support System for Brain MRI Scans Classification.

    Directory of Open Access Journals (Sweden)

    Muhammad Faisal Siddiqui

    Full Text Available A wide interest has been observed in the medical health care applications that interpret neuroimaging scans by machine learning systems. This research proposes an intelligent, automatic, accurate, and robust classification technique to classify the human brain magnetic resonance image (MRI as normal or abnormal, to cater down the human error during identifying the diseases in brain MRIs. In this study, fast discrete wavelet transform (DWT, principal component analysis (PCA, and least squares support vector machine (LS-SVM are used as basic components. Firstly, fast DWT is employed to extract the salient features of brain MRI, followed by PCA, which reduces the dimensions of the features. These reduced feature vectors also shrink the memory storage consumption by 99.5%. At last, an advanced classification technique based on LS-SVM is applied to brain MR image classification using reduced features. For improving the efficiency, LS-SVM is used with non-linear radial basis function (RBF kernel. The proposed algorithm intelligently determines the optimized values of the hyper-parameters of the RBF kernel and also applied k-fold stratified cross validation to enhance the generalization of the system. The method was tested by 340 patients' benchmark datasets of T1-weighted and T2-weighted scans. From the analysis of experimental results and performance comparisons, it is observed that the proposed medical decision support system outperformed all other modern classifiers and achieves 100% accuracy rate (specificity/sensitivity 100%/100%. Furthermore, in terms of computation time, the proposed technique is significantly faster than the recent well-known methods, and it improves the efficiency by 71%, 3%, and 4% on feature extraction stage, feature reduction stage, and classification stage, respectively. These results indicate that the proposed well-trained machine learning system has the potential to make accurate predictions about brain abnormalities

  5. Determinants of Contraceptive Availability at Medical Facilities in the Department of Veterans Affairs

    Science.gov (United States)

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

    2006-01-01

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

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

    Directory of Open Access Journals (Sweden)

    H Datobar

    2016-04-01

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

  7. Text mining approach to predict hospital admissions using early medical records from the emergency department.

    Science.gov (United States)

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

    2017-04-01

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

  8. Legal, Social, Ethical, and Medical Perspectives on the Care of the Statutory Rape Adolescent in the Emergency Department.

    Science.gov (United States)

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

    2017-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Aldina Gardellini

    2013-04-01

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

  10. Automation and integration of components for generalized semantic markup of electronic medical texts.

    Science.gov (United States)

    Dugan, J M; Berrios, D C; Liu, X; Kim, D K; Kaizer, H; Fagan, L M

    1999-01-01

    Our group has built an information retrieval system based on a complex semantic markup of medical textbooks. We describe the construction of a set of web-based knowledge-acquisition tools that expedites the collection and maintenance of the concepts required for text markup and the search interface required for information retrieval from the marked text. In the text markup system, domain experts (DEs) identify sections of text that contain one or more elements from a finite set of concepts. End users can then query the text using a predefined set of questions, each of which identifies a subset of complementary concepts. The search process matches that subset of concepts to relevant points in the text. The current process requires that the DE invest significant time to generate the required concepts and questions. We propose a new system--called ACQUIRE (Acquisition of Concepts and Queries in an Integrated Retrieval Environment)--that assists a DE in two essential tasks in the text-markup process. First, it helps her to develop, edit, and maintain the concept model: the set of concepts with which she marks the text. Second, ACQUIRE helps her to develop a query model: the set of specific questions that end users can later use to search the marked text. The DE incorporates concepts from the concept model when she creates the questions in the query model. The major benefit of the ACQUIRE system is a reduction in the time and effort required for the text-markup process. We compared the process of concept- and query-model creation using ACQUIRE to the process used in previous work by rebuilding two existing models that we previously constructed manually. We observed a significant decrease in the time required to build and maintain the concept and query models.

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

    Directory of Open Access Journals (Sweden)

    Aleshkina O.Yu.

    2015-03-01

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

  12. Modeling nurses' attitude toward using automated unit-based medication storage and distribution systems: an extension of the technology acceptance model.

    Science.gov (United States)

    Escobar-Rodríguez, Tomás; Romero-Alonso, María Mercedes

    2013-05-01

    This article analyzes the attitude of nurses toward the use of automated unit-based medication storage and distribution systems and identifies influencing factors. Understanding these factors provides an opportunity to explore actions that might be taken to boost adoption by potential users. The theoretical grounding for this research is the Technology Acceptance Model. The Technology Acceptance Model specifies the causal relationships between perceived usefulness, perceived ease of use, attitude toward using, and actual usage behavior. The research model has six constructs, and nine hypotheses were generated from connections between these six constructs. These constructs include perceived risks, experience level, and training. The findings indicate that these three external variables are related to the perceived ease of use and perceived usefulness of automated unit-based medication storage and distribution systems, and therefore, they have a significant influence on attitude toward the use of these systems.

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

    Science.gov (United States)

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

    1999-04-01

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

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

    International Nuclear Information System (INIS)

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

    1999-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Weiland Tracey J

    2010-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Tilahune AB

    2016-10-01

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

  17. 21 CFR 866.2170 - Automated colony counter.

    Science.gov (United States)

    2010-04-01

    ...) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Microbiology Devices § 866.2170 Automated colony counter. (a) Identification. An automated colony counter is a mechanical device intended for medical...

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2009-04-01

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

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

    Science.gov (United States)

    Council on Graduate Medical Education.

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

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

    Directory of Open Access Journals (Sweden)

    Abu Baker

    2011-07-01

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

  2. MANAGEMENT OF SPECIALIZED AUDIOLOGIC MEDICAL CARE AND SIMULTANEOUS MEDICAL AND EDUCATIONAL FOLLOW-UP OF PREMATURE CHILDREN IN THE OUT-PATIENT DEPARTMENT OF A LARGE HOSPITAL

    Directory of Open Access Journals (Sweden)

    I. V. Rakhmanova

    2014-01-01

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

  3. Automated assessment of joint synovitis activity from medical ultrasound and power doppler examinations using image processing and machine learning methods

    Directory of Open Access Journals (Sweden)

    Rafal Cupek

    2016-11-01

    Full Text Available Objectives : Rheumatoid arthritis is the most common rheumatic disease with arthritis, and causes substantial functional disability in approximately 50% patients after 10 years. Accurate measurement of the disease activity is crucial to provide an adequate treatment and care to the patients. The aim of this study is focused on a computer aided diagnostic system that supports an assessment of synovitis severity. Material and methods : This paper focus on a computer aided diagnostic system that was developed within joint Polish–Norwegian research project related to the automated assessment of the severity of synovitis. Semiquantitative ultrasound with power Doppler is a reliable and widely used method of assessing synovitis. Synovitis is estimated by ultrasound examiner using the scoring system graded from 0 to 3. Activity score is estimated on the basis of the examiner’s experience or standardized ultrasound atlases. The method needs trained medical personnel and the result can be affected by a human error. Results : The porotype of a computer-aided diagnostic system and algorithms essential for an analysis of ultrasonic images of finger joints are main scientific output of the MEDUSA project. Medusa Evaluation System prototype uses bone, skin, joint and synovitis area detectors for mutual structural model based evaluation of synovitis. Finally, several algorithms that support the semi-automatic or automatic detection of the bone region were prepared as well as a system that uses the statistical data processing approach in order to automatically localize the regions of interest. Conclusions : Semiquantitative ultrasound with power Doppler is a reliable and widely used method of assessing synovitis. Activity score is estimated on the basis of the examiner’s experience and the result can be affected by a human error. In this paper we presented the MEDUSA project which is focused on a computer aided diagnostic system that supports an

  4. California emergency department visit rates for medical conditions increased while visit rates for injuries fell, 2005-11.

    Science.gov (United States)

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

    2015-04-01

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

  5. Graduate Medical Education Funding and Curriculum in Physical Medicine and Rehabilitation: A Survey of Physical Medicine and Rehabilitation Department Chairs.

    Science.gov (United States)

    Perret, Danielle; Knowlton, Tiffany; Worsowicz, Gregory

    2018-03-01

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

  6. The Quality of Medication Treatment for Mental Disorders in the Department of Veterans Affairs and in Private-Sector Plans.

    Science.gov (United States)

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

    2016-04-01

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

  7. Family presence during trauma activations and medical resuscitations in a pediatric emergency department: an evidence-based practice project.

    Science.gov (United States)

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

    2010-03-01

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

  8. Does providing prescription information or services improve medication adherence among patients discharged from the emergency department? A randomized controlled trial.

    Science.gov (United States)

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

    2013-09-01

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

  9. Prediction of body mass index status from voice signals based on machine learning for automated medical applications.

    Science.gov (United States)

    Lee, Bum Ju; Kim, Keun Ho; Ku, Boncho; Jang, Jun-Su; Kim, Jong Yeol

    2013-05-01

    tools for real-time monitoring; such tools are considered helpful in improving automated BMI status diagnosis in remote healthcare or telemedicine and are expected to have applications in forensic and medical science. Copyright © 2013 Elsevier B.V. All rights reserved.

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

    International Nuclear Information System (INIS)

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

    1999-01-01

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

  11. Analysis of Inappropriate Admissions of Residents of Medicalized Nursing Homes to Emergency Departments: A Prospective Multicenter Study in Burgundy.

    Science.gov (United States)

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

    2016-07-01

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

  12. THE TOMSK SCIENTIFIC SCHOOL OF NEUROLOGISTS. TO THE 120TH ANNIVERSARY OF THE DEPARTMENT OF NEUROLOGY AND NEUROSURGERY OF SIBERIAN STATE MEDICAL UNIVERSITY

    Directory of Open Access Journals (Sweden)

    V. M. Alifirova

    2013-01-01

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

  13. Prescribing pattern of antipsychotic drugs in the outpatient department of psychiatry in Silchar Medical College and Hospital, Assam

    Directory of Open Access Journals (Sweden)

    Pinaki Chakravarty

    2016-01-01

    Full Text Available Objective: To study the prescribing pattern of antipsychotic drugs in the outpatient department of psychiatry in Silchar Medical College and Hospital (SMCH of Assam. Methods: It is a prospective cross-sectional study which was carried out for three months from August to November 2015 in the outpatient department of psychiatry. All patients irrespective of their ages and sexes were included in this study. Inpatients, referred patients, patients not willing to give consent, patients of epilepsy as well as those cases where diagnoses were not certain were excluded from the study. The prescription patterns of antipsychotic drugs and the occurrences of various psychiatric diseases on both the sexes were studied after taking permission from the Institutional Ethical Committee (SMCH. Results: A total of 112 prescriptions were analysed. The most common disease was found to be schizophrenia. Total drugs prescribed were 265 and average number of drugs per prescription was 2.36. It was seen that out of the 112 prescriptions, monotherapy was practiced in 19.64% (22 compared to polytherapy in 80.35% (90. Out of 265 prescribed drugs atypical antipsychotics were 112 (42.26%, typical antipsychotics 12 (4.52%, antiepileptics 57 (21.50%, antidepressants 29 (10.94%, antiparkinsonian 29 (10.94%, and others 26 (9.81%. Antipsychotics given orally were 122 of which olanzapine was 54 (44.26%, risperidone 40 (32.78%, chlorpromazine ten (8.19%, quetiapine eight (6.55%, aripiprazole five (4.09%, amisulpiride five (4.09% were seen. Injectable antipsychotics were two, of which only haloperidol two (100%. Antipsychotics in combination prescription with same groups were 14 (12.5%, with antidepressants, antipileptics, antiparkinsonian were 88 (78.57% and other agents were ten (8.92%, which included pantoprazole, multivitamins, and benfotiamine. Conclusion: This study shows that atypical antipsychotics are the most common drugs prescribed in patients with psychotic illness and

  14. Analysis of causes of intraocular lens explantations in the material of Department of Ophthalmology, Medical University of Lodz.

    Science.gov (United States)

    Wilczyński, Michał; Wilczyńska, Olena; Omulecki, Wojciech

    2009-01-01

    Implantation of intraocular lenses (IOLS) has become a standard practice in cataract surgery, however, similar to any other type of surgery, using IOLs is not complication-free and sometimes explantation of intraocular lenses may be necessary. This study was to gather data and analyze causes of intraocular lens explantations, performed in the Department of Ophthalmology, Medical University of Łódź. The data were gathered from medical documentation of all patients who underwent intraocular lens removal from January 2003 to July 2006. The examined group consisted of 16 patients (16 eyes): 9 women (fraction 0.56), and 7 men (fraction 0.44), at the age from 21 to 82 years (mean age 62.4 years, SD +/- 15.5). In all patients IOL explantation was performed under local, peribulbar anaesthesia. Two groups of patients were distinguished: patients who had an anterior chamber lens explanted (3 patients, fraction 0.19) and patients who underwent posterior chamber lens explantation (13 patients, fraction 0.81). Causes of AC IOL explantations were: vaulting of the IOL (1 eye, fraction 0.06), luxation of the IOL to the vitreous cavity (1 eye, fraction 0.06), and painful eyeball after anterior chamber lens implantation (1 eye, fraction 0.06). Causes of PC IOL explantations were: subluxation of the IOL (6 eyes, fraction 0.38), luxation of the lens to the vitreous cavity (3 eyes, fraction 0.19), luxation of the lens to the anterior chamber (1 eye, fraction 0.06), endophthalmitis (2 eyes, fraction 0.13) and incorrect lens power (1 eye, fraction 0.06). In the majority of eyes (n = 13, fraction 0.81) the removed implant was replaced by another intraocular lens, but 3 eyes (fraction 0.19) were left aphakic. We did not observe serious intra- or early postoperative complications which might influence the final result of the operation.

  15. Keys to Achieving Target First Medical Contact to Balloon Times and Bypassing Emergency Department More Important Than Distance

    Directory of Open Access Journals (Sweden)

    Saad Ezad

    2018-01-01

    Full Text Available Background. Australian guidelines advocate primary percutaneous coronary intervention (PPCI as the reperfusion strategy of choice for ST elevation myocardial infarction (STEMI in patients in whom it can be performed within 90 minutes of first medical contact; otherwise, fibrinolytic therapy is preferred. In a large health district, the reperfusion strategy is often chosen in the prehospital setting. We sought to identify a distance from a PCI centre, which made it unlikely first medical contact to balloon time (FMCTB of less than 90 minutes could be achieved in the Hunter New England health district and to identify causes of delay in patients who were triaged to a PPCI strategy. Methods and Results. We studied 116 patients presenting via the ambulance service with STEMI from January 2016 to December 2016. In patients who were taken directly to the cardiac catheterisation lab, a maximum distance of 50 km from hospital resulted in 75% of patients receiving PCI within 90 minutes and approximately 95% of patients receiving PCI within 120 minutes. Patients who bypassed the emergency department (ED were significantly more likely to have FMCTB of less than 90 minutes (p<0.001 despite having a longer travel distance (28.5 km versus 17.4 km, p<0.001. Patients transiting via the ED were significantly more likely to present out of hours (60 versus 24.2% p<0.001. Conclusions. Patients who do not bypass the ED have a longer FMCTB across all spectrum of distances from the PCI centre; therefore, bypassing the ED is key to achieving target FMCTB times. Using a cutoff distance of 50 km may reduce human error in estimating travel time to our PCI centre and thereby identifying patients who should receive prehospital thrombolysis.

  16. 21 CFR 864.3800 - Automated slide stainer.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Automated slide stainer. 864.3800 Section 864.3800 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Pathology Instrumentation and Accessories § 864.3800...

  17. 21 CFR 864.3875 - Automated tissue processor.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Automated tissue processor. 864.3875 Section 864.3875 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Pathology Instrumentation and Accessories § 864.3875...

  18. 77 FR 48527 - National Customs Automation Program (NCAP) Test Concerning Automated Commercial Environment (ACE...

    Science.gov (United States)

    2012-08-14

    ... National Customs Automation Program (NCAP) test concerning the simplified entry functionality in the... DEPARTMENT OF HOMELAND SECURITY U.S. Customs and Border Protection National Customs Automation Program (NCAP) Test Concerning Automated Commercial Environment (ACE) Simplified Entry: Modification of...

  19. The effectiveness of holistic diabetic management between Siriraj Continuity of Care clinic and medical out-patient department.

    Science.gov (United States)

    Chalermsri, Chalobol; Paisansudhi, Supalerg; Kantachuvesiri, Pitchaporn; Pramyothin, Pornpoj; Washirasaksiri, Chaiwat; Srivanichakorn, Weerachai; Nopmaneejumruslers, Cherdchai; Chouriyagune, Charoen; Pandejpong, Denla; Phisalprapa, Pochamana

    2014-03-01

    Diabetes mellitus is one of the most common diseases in the Thai population, and it is well known that diabetic complications could be prevented with appropriate management. Despite published guidelines, most Thai patients with diabetes do not achieve treatment goals. Siriraj Continuity of Care clinic (CC clinic) was recently established in order to provide training for medical students and internal medicine residents. It is possible that the training component in the CC clinic may contribute to better overall outcomes in type 2 diabetes mellitus (type 2 DM) patients when compared with usual care at the medical out-patient department (OPD). To compare the effectiveness of diabetic management in type 2 diabetes mellitus patients who attended the CC clinic and the medical OPD. Retrospective chart review was performed in type 2 diabetes mellitus patients who were treated at either clinic at Siriraj Hospital in 2007-2011. Baseline demographics, treatment strategies and outcomes, and participation in an appropriate health maintenance program were assessed in both groups. Seven hundred and fifty seven medical records were reviewed, including 383 patients in the CC clinic group and 374 in the OPD group. Mean HbA1c was significantly lower in the CC clinic group compared with the OPD group (7.3 +/- 0.9% and 7.8 +/- 1.3%, respectively, < 0.001). The number of patients who achieved goal HbA1c of less than 7% in CC clinic group was 123 (32.1%) compared with 91 (24.3%) in the OPD group (p = 0.039). More patients were screened for diabetic complications in the CC clinic group compared with the OPD group, including screening for diabetic neuropathy (57.4% vs. 2.1%, p < 0.001), diabetic retinopathy (56.7% vs. 36.6%, p < 0.001), and diabetic nephropathy (80.9% vs. 36.9%, p < 0.001). Patients in the CC clinic group had a higher rate of age-appropriate cancer screening than those in the OPD group (54.2% vs. 13.3%, p < 0.001 for breast cancer; 24.0% vs. 0.9%, p < 0.001 for cervical

  20. How can hospitals better protect the privacy of electronic medical records? Perspectives from staff members of health information management departments.

    Science.gov (United States)

    Sher, Ming-Ling; Talley, Paul C; Cheng, Tain-Junn; Kuo, Kuang-Ming

    2017-05-01

    The adoption of electronic medical records (EMR) is expected to better improve overall healthcare quality and to offset the financial pressure of excessive administrative burden. However, safeguarding EMR against potentially hostile security breaches from both inside and outside healthcare facilities has created increased patients' privacy concerns from all sides. The aim of our study was to examine the influencing factors of privacy protection for EMR by healthcare professionals. We used survey methodology to collect questionnaire responses from staff members in health information management departments among nine Taiwanese hospitals active in EMR utilisation. A total of 209 valid responses were collected in 2014. We used partial least squares for analysing the collected data. Perceived benefits, perceived barriers, self-efficacy and cues to action were found to have a significant association with intention to protect EMR privacy, while perceived susceptibility and perceived severity were not. Based on the findings obtained, we suggest that hospitals should provide continuous ethics awareness training to relevant staff and design more effective strategies for improving the protection of EMR privacy in their charge. Further practical and research implications are also discussed.

  1. Positive predictive value of automated database records for diabetic ketoacidosis (DKA in children and youth exposed to antipsychotic drugs or control medications: a tennessee medicaid study

    Directory of Open Access Journals (Sweden)

    Bobo William V

    2011-11-01

    Full Text Available Abstract Background Diabetic ketoacidosis (DKA is a potentially life-threatening complication of treatment with some atypical antipsychotic drugs in children and youth. Because drug-associated DKA is rare, large automated health outcomes databases may be a valuable data source for conducting pharmacoepidemiologic studies of DKA associated with exposure to individual antipsychotic drugs. However, no validated computer case definition of DKA exists. We sought to assess the positive predictive value (PPV of a computer case definition to detect incident cases of DKA, using automated records of Tennessee Medicaid as the data source and medical record confirmation as a "gold standard." Methods The computer case definition of DKA was developed from a retrospective cohort study of antipsychotic-related type 2 diabetes mellitus (1996-2007 in Tennessee Medicaid enrollees, aged 6-24 years. Thirty potential cases with any DKA diagnosis (ICD-9 250.1, ICD-10 E1x.1 were identified from inpatient encounter claims. Medical records were reviewed to determine if they met the clinical definition of DKA. Results Of 30 potential cases, 27 (90% were successfully abstracted and adjudicated. Of these, 24 cases were confirmed by medical record review (PPV 88.9%, 95% CI 71.9 to 96.1%. Three non-confirmed cases presented acutely with severe hyperglycemia, but had no evidence of acidosis. Conclusions Diabetic ketoacidosis in children and youth can be identified in a computerized Medicaid database using our case definition, which could be useful for automated database studies in which drug-associated DKA is the outcome of interest.

  2. Synopsis of Diet in Dermatology: A one day CME conducted by the Department of Dermatology, Kasturba Medical College, Manipal, March 3, 2013

    Directory of Open Access Journals (Sweden)

    Smitha S Prabhu

    2013-01-01

    Full Text Available Food is intricately related to mind and body and is one of the elements sustaining life, in disease as well as in health. There are many myths and misgivings regarding partake of food and its medicinal properties. The Department of Dermatology, Kasturba Medical College (KMC, Manipal organized a continuing medical education (CME on Diet in Dermatology on 3rd March 2013 focusing on pertinent issues regarding diet and medicinal use of food.

  3. Hydrometeorological Automated Data System

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Office of Hydrologic Development of the National Weather Service operates HADS, the Hydrometeorological Automated Data System. This data set contains the last 48...

  4. I-94 Automation FAQs

    Data.gov (United States)

    Department of Homeland Security — In order to increase efficiency, reduce operating costs and streamline the admissions process, U.S. Customs and Border Protection has automated Form I-94 at air and...

  5. INVESTIGATION OF THE RISK FACTORS FOR CORONARY ARTERY DISEASES IN EMPLOYEES AND THEIR SPOUSES OF THE ELAZIG SECURITY DEPARTMENT WHO ADMITTED TO MEDICAL DEPARTMENT OF THIS HEADQUARTER

    Directory of Open Access Journals (Sweden)

    Suleyman Erhan DEVECI

    2006-08-01

    Full Text Available This study was carried out with the aim of identifying risk factors coronary artery disease (CAD in the employees of Elazig Security Department. Questionnaires were applied to members and/or spouses (313 individuals of Elazig Security Department admitting to the Health Office for any reason in November-December 2003. Measurements for fasting blood sugar, serum cholesterol levels and blood pressure values were carried out. Of the individuals participating in this study, 1.9% reported having diabetes, 2.9% heart disease and 5.4% hypertension. Mean blood pressure measurements were; systolic 114.1±15.9 and diastolic 74.6±10.3 mmHg, mean fasting blood glucose values were reported as 90.9±16.6 mg/dl. 8.9% had high systolic and 7.7% had high diastolic blood pressure measurements, 16.0% had elevated total cholesterol and 3.5% had elevated fasting blood sugar levels. 36.7% reported to be current smokers, 20.8% reported having regular physical activity. 65.5% reported skipping meals and 47.3% reported eating snacks between the meals. In the group that was analyzed, the rates of smoking, sedentary life style and irregular eating habits that are considered as risk factors for CAD were high. [TAF Prev Med Bull 2006; 5(4.000: 235-243

  6. Application of time series analysis in modelling and forecasting emergency department visits in a medical centre in Southern Taiwan.

    Science.gov (United States)

    Juang, Wang-Chuan; Huang, Sin-Jhih; Huang, Fong-Dee; Cheng, Pei-Wen; Wann, Shue-Ren

    2017-12-01

    Emergency department (ED) overcrowding is acknowledged as an increasingly important issue worldwide. Hospital managers are increasingly paying attention to ED crowding in order to provide higher quality medical services to patients. One of the crucial elements for a good management strategy is demand forecasting. Our study sought to construct an adequate model and to forecast monthly ED visits. We retrospectively gathered monthly ED visits from January 2009 to December 2016 to carry out a time series autoregressive integrated moving average (ARIMA) analysis. Initial development of the model was based on past ED visits from 2009 to 2016. A best-fit model was further employed to forecast the monthly data of ED visits for the next year (2016). Finally, we evaluated the predicted accuracy of the identified model with the mean absolute percentage error (MAPE). The software packages SAS/ETS V.9.4 and Office Excel 2016 were used for all statistical analyses. A series of statistical tests showed that six models, including ARIMA (0, 0, 1), ARIMA (1, 0, 0), ARIMA (1, 0, 1), ARIMA (2, 0, 1), ARIMA (3, 0, 1) and ARIMA (5, 0, 1), were candidate models. The model that gave the minimum Akaike information criterion and Schwartz Bayesian criterion and followed the assumptions of residual independence was selected as the adequate model. Finally, a suitable ARIMA (0, 0, 1) structure, yielding a MAPE of 8.91%, was identified and obtained as Visit t =7111.161+(a t +0.37462 a t -1). The ARIMA (0, 0, 1) model can be considered adequate for predicting future ED visits, and its forecast results can be used to aid decision-making processes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Three years audit of the emergency patients in the department of ENT of a rural medical college.

    Science.gov (United States)

    Barman, Debasis; Maridal, Satadal; Goswami, Saileswar; Hembram, Rabi

    2012-06-01

    Surgical audit is a systematic, critical analysis of the quality of surgical care provided, with the aims of improving quality of care, continuing education for surgeons, and guiding appropriate use of health resources. Emergency service is an integral part of any discipline of clinical medicine and it is considered as an indicator of quality of healthcare system. A three years record based, retrospective, cross-sectional study was carried out in the department of ear, nose and throat (ENT) of Midnapore Medical College, Paschim Medinipur,West Bengal to identify the total attendance of various emergency patients, diagnosis made thereafter, the mode of interference and outcome and the potential problems in the quality of care provided to the community. A total of 9051 patients had been admitted/attended in the ENT emergency from January 2008 to December 2010 who were included in this audit. Detailed statistical analysis of the data showed male: female (2.38:1) with the peak in the first decade of life. Majority of the patients were from Medinipur sadar (58.43%). The total otological cases were maximum (42.41%) in comparison to nose (28.98%) and throat (28.60%). The most common ear emergencies were earache due to impacted wax, acute suppurative otitis media, foreign body ear and the trauma/injury. Chronic suppurative otitis media with complications were the least. Amongst the sinonasal emergency, the most common aetiology was the epistaxis and foreign body nose in children. The different types of foreign body impaction in the throat and the inflammatory condition of throat or the inspiratory stridor due to upper airway obstruction were the main emergency situation recorded. Some cases were fatal. The overall mortality was 0.44%.

  8. Using System Inflammatory Response Syndrome as an Easy-to-Implement, Sustainable, and Automated Tool for All-Cause Deterioration Among Medical Inpatients.

    Science.gov (United States)

    Fogerty, Robert L; Sussman, L Scott; Kenyon, Kathleen; Li, Fangyong; Sukumar, Nitin; Kliger, Alan S; Acker, Kurt; Sankey, Christopher

    2018-01-23

    Clinical deterioration detection among adult inpatients is known to be suboptimal, and many electronic health record tools have been developed to help identify these patients. Many of these tools are focused on sepsis spectrum disorders, but the evolution of the definition of sepsis is moving toward increased specificity, which may make automated detection of clinical deterioration from nonsepsis-related conditions less likely. The objectives of this study were to develop and to examine the use of a low-cost, highly sustainable deterioration detection tool based on systemic inflammatory response syndrome (SIRS) criteria. Using existing resources, a SIRS-based electronic health record monitoring and intervention tool was developed with a focus on ease of implementation and high sustainability. This tool was used to monitor 15,739 adult inpatients in real time during their admission. The SIRS-based tool, created with focus on ease of implementation and high sustainability, identified patients with higher risk of clinical deterioration. The project was rapidly deployed for a 4-month period at a 900-bed campus of an academic medical center with minimal additional resources required. Whereas the definition of sepsis moves away from SIRS, SIRS-based criteria may still have clinical benefit as an easy-to-automate detection tool for all-cause clinical deterioration among medical inpatients.

  9. Phenotyping for patient safety: algorithm development for electronic health record based automated adverse event and medical error detection in neonatal intensive care.

    Science.gov (United States)

    Li, Qi; Melton, Kristin; Lingren, Todd; Kirkendall, Eric S; Hall, Eric; Zhai, Haijun; Ni, Yizhao; Kaiser, Megan; Stoutenborough, Laura; Solti, Imre

    2014-01-01

    Although electronic health records (EHRs) have the potential to provide a foundation for quality and safety algorithms, few studies have measured their impact on automated adverse event (AE) and medical error (ME) detection within the neonatal intensive care unit (NICU) environment. This paper presents two phenotyping AE and ME detection algorithms (ie, IV infiltrations, narcotic medication oversedation and dosing errors) and describes manual annotation of airway management and medication/fluid AEs from NICU EHRs. From 753 NICU patient EHRs from 2011, we developed two automatic AE/ME detection algorithms, and manually annotated 11 classes of AEs in 3263 clinical notes. Performance of the automatic AE/ME detection algorithms was compared to trigger tool and voluntary incident reporting results. AEs in clinical notes were double annotated and consensus achieved under neonatologist supervision. Sensitivity, positive predictive value (PPV), and specificity are reported. Twelve severe IV infiltrates were detected. The algorithm identified one more infiltrate than the trigger tool and eight more than incident reporting. One narcotic oversedation was detected demonstrating 100% agreement with the trigger tool. Additionally, 17 narcotic medication MEs were detected, an increase of 16 cases over voluntary incident reporting. Automated AE/ME detection algorithms provide higher sensitivity and PPV than currently used trigger tools or voluntary incident-reporting systems, including identification of potential dosing and frequency errors that current methods are unequipped to detect. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. A Web-Based Telehealth Training Platform Incorporating Automated Nonverbal Behavior Feedback for Teaching Communication Skills to Medical Students: A Randomized Crossover Study.

    Science.gov (United States)

    Liu, Chunfeng; Lim, Renee L; McCabe, Kathryn L; Taylor, Silas; Calvo, Rafael A

    2016-09-12

    In the interests of patient health outcomes, it is important for medical students to develop clinical communication skills. We previously proposed a telehealth communication skills training platform (EQClinic) with automated nonverbal behavior feedback for medical students, and it was able to improve medical students' awareness of their nonverbal communication. This study aimed to evaluate the effectiveness of EQClinic to improve clinical communication skills of medical students. We conducted a 2-group randomized crossover trial between February and June 2016. Participants were second-year medical students enrolled in a clinical communication skills course at an Australian university. Students were randomly allocated to complete online EQClinic training during weeks 1-5 (group A) or to complete EQClinic training during weeks 8-11 (group B). EQClinic delivered an automated visual presentation of students' nonverbal behavior coupled with human feedback from a standardized patient (SP). All students were offered two opportunities to complete face-to-face consultations with SPs. The two face-to-face consultations were conducted in weeks 6-7 and 12-13 for both groups, and were rated by tutors who were blinded to group allocation. Student-Patient Observed Communication Assessment (SOCA) was collected by blinded assessors (n=28) at 2 time points and also by an SP (n=83). Tutor-rated clinical communications skill in face-to-face consultations was the primary outcome and was assessed with the SOCA. We used t tests to examine the students' performance during face-to-face consultations pre- and postexposure to EQClinic. We randomly allocated 268 medical students to the 2 groups (group A: n=133; group B: n=135). SOCA communication skills measures (score range 4-16) from the first face-to-face consultation were significantly higher for students in group A who had completed EQClinic training and reviewed the nonverbal behavior feedback, compared with group B, who had completed

  11. A Web-Based Telehealth Training Platform Incorporating Automated Nonverbal Behavior Feedback for Teaching Communication Skills to Medical Students: A Randomized Crossover Study

    Science.gov (United States)

    2016-01-01

    Background In the interests of patient health outcomes, it is important for medical students to develop clinical communication skills. We previously proposed a telehealth communication skills training platform (EQClinic) with automated nonverbal behavior feedback for medical students, and it was able to improve medical students’ awareness of their nonverbal communication. Objective This study aimed to evaluate the effectiveness of EQClinic to improve clinical communication skills of medical students. Methods We conducted a 2-group randomized crossover trial between February and June 2016. Participants were second-year medical students enrolled in a clinical communication skills course at an Australian university. Students were randomly allocated to complete online EQClinic training during weeks 1–5 (group A) or to complete EQClinic training during weeks 8–11 (group B). EQClinic delivered an automated visual presentation of students’ nonverbal behavior coupled with human feedback from a standardized patient (SP). All students were offered two opportunities to complete face-to-face consultations with SPs. The two face-to-face consultations were conducted in weeks 6–7 and 12–13 for both groups, and were rated by tutors who were blinded to group allocation. Student-Patient Observed Communication Assessment (SOCA) was collected by blinded assessors (n=28) at 2 time points and also by an SP (n=83). Tutor-rated clinical communications skill in face-to-face consultations was the primary outcome and was assessed with the SOCA. We used t tests to examine the students’ performance during face-to-face consultations pre- and postexposure to EQClinic. Results We randomly allocated 268 medical students to the 2 groups (group A: n=133; group B: n=135). SOCA communication skills measures (score range 4–16) from the first face-to-face consultation were significantly higher for students in group A who had completed EQClinic training and reviewed the nonverbal behavior

  12. Traumatic injuries of the permanent maxillory incisors at dental department, pakistan institute of medical sciences islamabad: A retrospective study

    International Nuclear Information System (INIS)

    Khan, N.A.; Maxood, A.; Khan, M.A.

    2008-01-01

    The study aims to ascertain the prevalence of traumatic dental injures of the maxillary permanent incisors at Dental Department, Pakistan Institute of Medical Science Islamabad during the years 2003-2005. Information concerning age, sex, cause, type of tooth number of injured teeth and patterns of tooth injury were recorded retrospectively from 33 patients aged between 8-40 years, comprising 498 traumatized teeth. The dental record of all the patients presenting with dental trauma were examined for collection of data relating to age, sex, cause, number of injured teeth, type of tooth and type of tooth trauma. Type of tooth trauma was recorded according to the Andreason classification. The data was subsequently processed and analyzed using the SPSS statistical software programme. The statistical significance level was set at 5%. Of the 336 patients, 227 were males (67.6%) and 109 were female (32.4%). The gender difference was statistically significant (p<0.0001). The patients had a total of 498 traumatized teeth. A large number of dental trauma occurred in patients aged between 9-11 years. Most injuries involved one tooth in 227 patients (67.6%). However two teeth in 90 patients (26.7%), three teeth in 11 patients (3.2%) and only in 8 patients (2.3%) four teeth were involved. Fractures in enamel only occurred in 74 teeth (14.6%). Uncomplicated crown fractures in 208 teeth (41.9%) were the most commonly encountered dental trauma. 137 teeth (27.6%) suffered complicated crown fractures, 44 teeth (8.9%) uncomplicated crown-root fractures, 19 teeth (3.8%) complicated crown-root fractures and avulsion in 16 teeth (3.2%) only. The main causes were falls in 225 patients (66.9%), collision with objects in 40 patients (11.9%), road traffic accident in 31 patients (9.2%) violence in 31 patients (6.2%), and sports in 19 patients (5.6%). The maxillary central incisor was traumatized in 384 teeth showing a high percentage of 77%. Raising public dental awareness regarding the

  13. Emergency Department Chief Complaint and Diagnosis Data to Detect Influenza-Like Illness with an Electronic Medical Record

    Science.gov (United States)

    May, Larissa S.; Griffin, Beth Ann; Bauers, Nicole Maier; Jain, Arvind; Mitchum, Marsha; Sikka, Neal; Carim, Marianne; Stoto, Michael A.

    2010-01-01

    Background: The purpose of syndromic surveillance is early detection of a disease outbreak. Such systems rely on the earliest data, usually chief complaint. The growing use of electronic medical records (EMR) raises the possibility that other data, such as emergency department (ED) diagnosis, may provide more specific information without significant delay, and might be more effective in detecting outbreaks if mechanisms are in place to monitor and report these data. Objective: The purpose of this study is to characterize the added value of the primary ICD-9 diagnosis assigned at the time of ED disposition compared to the chief complaint for patients with influenza-like illness (ILI). Methods: The study was a retrospective analysis of the EMR of a single urban, academic ED with an annual census of over 60, 000 patients per year from June 2005 through May 2006. We evaluate the objective in two ways. First, we characterize the proportion of patients whose ED diagnosis is inconsistent with their chief complaint and the variation by complaint. Second, by comparing time series and applying syndromic detection algorithms, we determine which complaints and diagnoses are the best indicators for the start of the influenza season when compared to the Centers for Disease Control regional data for Influenza-Like Illness for the 2005 to 2006 influenza season using three syndromic surveillance algorithms: univariate cumulative sum (CUSUM), exponentially weighted CUSUM, and multivariate CUSUM. Results: In the first analysis, 29% of patients had a different diagnosis at the time of disposition than suggested by their chief complaint. In the second analysis, complaints and diagnoses consistent with pneumonia, viral illness and upper respiratory infection were together found to be good indicators of the start of the influenza season based on temporal comparison with regional data. In all examples, the diagnosis data outperformed the chief-complaint data. Conclusion: Both analyses

  14. Y2K medical disaster preparedness in New York City: confidence of emergency department directors in their ability to respond.

    Science.gov (United States)

    Silber, S H; Oster, N; Simmons, B; Garrett, C

    2001-01-01

    To study the preparedness New York City for large scale medical disasters using the Year 2000 (Y2K) New Years Eve weekend as a model. Surveys were sent to the directors of 51 of the 9-1-1-receiving hospitals in New York City before and after the Y2K weekend. Inquiries were made regarding hospital activities, contingencies, protocols, and confidence levels in the ability to manage critical incidents, including weapons of mass destruction (WMD) events. Additional information was collected from New York City governmental agencies regarding their coordination and preparedness. The pre-Y2K survey identified that 97.8% had contingencies for loss of essential services, 87.0% instituted their disaster plan in advance, 90.0% utilized an Incident Command System, and 73.9% had a live, mock Y2K drill. Potential terrorism influenced Y2K preparedness in 84.8%. The post-Y2K survey indicated that the threat of terrorism influenced future preparedness in 73.3%; 73.3% had specific protocols for chemical; 62.2% for biological events; 51.1% were not or only slightly confident in their ability to manage any potential WMD incidents; and 62.2% felt very or moderately confident in their ability to manage victims of a chemical event, but only 35.6% felt similarly about victims of a biological incident. Moreover, 80% felt there should be government standards for hospital preparedness for events involving WMD, and 84% felt there should be government standards for personal protective and DECON equipment. In addition, 82.2% would require a moderate to significant amount of funding to effect the standards. Citywide disaster management was coordinated through the Mayor's Office of Emergency Management. Although hospitals were on a heightened state of alert, emergency department directors were not confident in their ability to evaluate and manage victims of WMD incidents, especially biological exposures. The New York City experience is an example for the rest of the nation to underscore the need

  15. Validation of the Brief Confusion Assessment Method for Screening Delirium in Elderly Medical Patients in a German Emergency Department.

    Science.gov (United States)

    Baten, Verena; Busch, Hans-Jörg; Busche, Caroline; Schmid, Bonaventura; Heupel-Reuter, Miriam; Perlov, Evgeniy; Brich, Jochen; Klöppel, Stefan

    2018-05-08

    Delirium is frequent in elderly patients presenting in the emergency department (ED). Despite the severe prognosis, the majority of delirium cases remain undetected by emergency physicians (EPs). At the time of our study there was no valid delirium screening tool available for EDs in German-speaking regions. We aimed to evaluate the brief Confusion Assessment Method (bCAM) for a German ED during the daily work routine. We implemented the bCAM into practice in a German interdisciplinary high-volume ED and evaluated the bCAM's validity in a convenience sample of medical patients aged ≥ 70 years. The bCAM, which assesses four core features of delirium, was performed by EPs during their daily work routine and compared to a criterion standard based on the criteria for delirium as described in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Compared to the criterion standard, delirium was found to be present in 46 (16.0%) of the 288 nonsurgical patients enrolled. The bCAM showed 93.8% specificity (95% confidence interval [CI] = 90.0%-96.5%) and 65.2% sensitivity (95% CI = 49.8%-78.7%). Positive and negative likelihood ratios were 10.5 and 0.37, respectively, while the odds ratio was 28.4. Delirium was missed in 10 of 16 cases, since the bCAM did not indicate altered levels of consciousness and disorganized thinking. The level of agreement with the criterion standard increased for patients with low cognitive performance. This was the first study evaluating the bCAM for a German ED and when performed by EPs during routine work. The bCAM showed good specificity, but only moderate sensitivity. Nevertheless, application of the bCAM most likely improves the delirium detection rate in German EDs. However, it should only be applied by trained physicians to maximize diagnostic accuracy and hence improve the bCAM's sensitivity. Future studies should refine the bCAM. © 2018 by the Society for Academic Emergency Medicine.

  16. Frequency of Burnout, Sleepiness and Depression in Emergency Medicine Residents with Medical Errors in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Alireza Aala

    2014-07-01

    Full Text Available Aims: Medical error is a great concern of the patients and physicians. It usually occurs due to physicians’ exhaustion, distress and fatigue. In this study, we aimed to evaluate frequency of distress and fatigue among emergency medicine residents reporting a medical error. Materials and Methods: The study population consisted of emergency medicine residents who completed an emailed questionnaire including self-assessment of medical errors, the Epworth Sleepiness Scale (ESS score, the Maslach Burnout Inventory, and PRIME-MD validated depression screening tool.   Results: In this survey, 100 medical errors were reported including diagnostic errors in 53, therapeutic errors in 24 and following errors in 23 subjects. Most errors were reported by males and third year residents. Residents had no signs of depression, but all had some degrees of sleepiness and burnout. There were significant differences between errors subtypes and age, residency year, depression, sleepiness and burnout scores (p<0.0001.   Conclusion: In conclusion, residents committing a medical error usually experience burnout and have some grades of sleepiness that makes them less motivated increasing the probability of medical errors. However, as none of the residents had depression, it could be concluded that depression has no significant role in medical error occurrence and perhaps it is a possible consequence of medical error.    Keywords: Residents; Medical error; Burnout; Sleepiness; Depression

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

    Science.gov (United States)

    1993-01-01

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

  18. Patients Who Attend the Emergency Department Following Medication Overdose: Self-Reported Mental Health History and Intended Outcomes of Overdose

    Science.gov (United States)

    Buykx, Penny; Ritter, Alison; Loxley, Wendy; Dietze, Paul

    2012-01-01

    Medication overdose is a common method of non-fatal self-harm. Previous studies have established which mental health disorders are commonly associated with the behaviour (affective, substance use, anxiety and personality disorders) and which medications are most frequently implicated (benzodiazepines, antidepressants, antipsychotics and non-opioid…

  19. Twenty years of operation of the Radioisotope Department of the 3rd Medical Clinic, Faculty of General Medicine, Charles University in Prague

    International Nuclear Information System (INIS)

    Kapitola, J.

    1983-01-01

    Twenty years ago a radioisotope department was established in the old building of the 3rd Medical Clinic in Prague 2. The department is suitably placed and meets present requirements. It was set up as part of the 3rd Medical Clinic and of the Laboratory for endocrinology and Metabolism which gave it its main orientation and scope. Its present scope is much broader. In the twenty years since it was established 115,800 examinations were carried out, some 40 examination methods were introduced, 103 publications published, members of the department were co-authors of another 113 publications, they completed 11 research projects. The production of the department represents a substantial part of laboratory material especially in the diagnosis of endocrinopathy and metabolic disorders at the Clinic and is a significant part of the material of a number of research projects. The department has significantly contributed to the development of nuclear medicine in the Czechoslovak Socialist Republic in thyroid diagnosis, by the first introduction of radioimmunoassay methods, by the introduction of certain other special examination and laboratory methods and is currently taking part in the fulfilment of tasks given by the zoning of nuclear medicine in health care in Czechoslovakia in general and in Prague in particular. (author)

  20. [Physical medicine in hospital. Minimum standards in a physical medical department in acute inpatient areas in rheumatology].

    Science.gov (United States)

    Reißhauer, A; Liebl, M E

    2012-07-01

    Standards for what should be available in terms of equipment and services in a department of physical medicine caring for acute inpatients do not exist in Germany. The profile of a department determines the therapeutic services it focuses on and hence the technical facilities required. The German catalogue of operations and procedures defines minimum thresholds for treatment. In the opinion of the authors a department caring for inpatients with acute rheumatic diseases must, as a minimum, have the facilities and equipment necessary for offering thermotherapeutic treatment. Staff trained in physical therapeutic procedures and occupational therapy is also crucial. Moreover, it is desirable that the staff should be trained in manual therapy.

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

    National Research Council Canada - National Science Library

    Sizemore, Charles J

    2004-01-01

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

  2. Department of Neurosurgery, Seth Gordhandas Sunderdas Medical College and King Edward VII Memorial (K.E.M.) Hospital, Mumbai.

    Science.gov (United States)

    Pandya, Sunil; Goel, Atul

    2017-01-01

    Seth Gordhandas Sunderdas Medical College and King Edward VII Memorial (K.E.M.) Hospital, Mumbai were inaugurated in 1925. This article traces its illustrious history and of the eminent neurosurgeons who shaped its destiny.

  3. Organization of educational process at the department of human anatomy of Saratov State Medical University n.a. V. I. Razumovsky

    Directory of Open Access Journals (Sweden)

    Bugaeva I0

    2017-06-01

    Full Text Available Human anatomy is one of the basic disciplines in the system of medical education. Knowledge in this area is necessary for the development of related theoretical subjects and constitutes a basis for studying clinical disciplines. Therefore the priority task of department of human anatomy is qualitative training of students at the modern level using classical and innovative pedagogical and computer technologies, being based on competence-based approach to training. In the article the features of organization of educational process at department of Human Anatomy of Saratov State Medical University n.a. V. I. Razumovsky, within the Federal state educational standard of the 3rd generation which key differences are considered: acquisition by students of cultural and professional competences.

  4. Language-concordant automated telephone queries to assess medication adherence in a diverse population: a cross-sectional analysis of convergent validity with pharmacy claims.

    Science.gov (United States)

    Ratanawongsa, Neda; Quan, Judy; Handley, Margaret A; Sarkar, Urmimala; Schillinger, Dean

    2018-04-06

    Clinicians have difficulty accurately assessing medication non-adherence within chronic disease care settings. Health information technology (HIT) could offer novel tools to assess medication adherence in diverse populations outside of usual health care settings. In a multilingual urban safety net population, we examined the validity of assessing adherence using automated telephone self-management (ATSM) queries, when compared with non-adherence using continuous medication gap (CMG) on pharmacy claims. We hypothesized that patients reporting greater days of missed pills to ATSM queries would have higher rates of non-adherence as measured by CMG, and that ATSM adherence assessments would perform as well as structured interview assessments. As part of an ATSM-facilitated diabetes self-management program, low-income health plan members typed numeric responses to rotating weekly ATSM queries: "In the last 7 days, how many days did you MISS taking your …" diabetes, blood pressure, or cholesterol pill. Research assistants asked similar questions in computer-assisted structured telephone interviews. We measured continuous medication gap (CMG) by claims over 12 preceding months. To evaluate convergent validity, we compared rates of optimal adherence (CMG ≤ 20%) across respondents reporting 0, 1, and ≥ 2 missed pill days on ATSM and on structured interview. Among 210 participants, 46% had limited health literacy, 57% spoke Cantonese, and 19% Spanish. ATSM respondents reported ≥1 missed day for diabetes (33%), blood pressure (19%), and cholesterol (36%) pills. Interview respondents reported ≥1 missed day for diabetes (28%), blood pressure (21%), and cholesterol (26%) pills. Optimal adherence rates by CMG were lower among ATSM respondents reporting more missed days for blood pressure (p = 0.02) and cholesterol (p < 0.01); by interview, differences were significant for cholesterol (p = 0.01). Language-concordant ATSM demonstrated modest potential

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

    Science.gov (United States)

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

    2016-10-01

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

  6. Interactive and collaborative learning in the classroom at the medical school Automated response systems and team-based learning.

    Science.gov (United States)

    Nasr, Rihab; Antoun, Jumana; Sabra, Ramzi; Zgheib, Nathalie K

    2016-01-01

    There has been a pedagogic shift in higher education from the traditional teacher centered to the student centered approach in teaching, necessitating a change in the role of the teacher from a supplier of information to passive receptive students into a more facilitative role. Active learning activities are based on various learning theories such as self-directed learning, cooperative learning and adult learning. There exist many instructional activities that enhance active and collaborative learning. The aim of this manuscript is to describe two methods of interactive and collaborative learning in the classroom, automated response systems (ARS) and team-based learning (TBL), and to list some of their applications and advantages. The success of these innovative teaching and learning methods at a large scale depends on few elements, probably the most important of which is the support of the higher administration and leadership in addition to the availability of “champions” who are committed to lead the change.

  7. Assessing the Burden of Diabetes Mellitus in Emergency Departments in the United States: The National Hospital Ambulatory Medical Care Survey (NHAMCS)

    Science.gov (United States)

    Asao, Keiko; Kaminski, James; McEwen, Laura N.; Wu, Xiejian; Lee, Joyce M.; Herman, William H.

    2014-01-01

    Objective To evaluate the performance of three alternative methods to identify diabetes in patients visiting Emergency Departments (EDs), and to describe the characteristics of patients with diabetes who are not identified when the alternative methods are used. Research Design and Methods We used data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) 2009 and 2010. We assessed the sensitivity and specificity of using providers’ diagnoses and diabetes medications (both excluding and including biguanides) to identify diabetes compared to using the checkbox for diabetes as the gold standard. We examined the characteristics of patients whose diabetes was missed using multivariate Poisson regression models. Results The checkbox identified 5,567 ED visits by adult patients with diabetes. Compared to the checkbox, the sensitivity was 12.5% for providers’ diagnoses alone, 20.5% for providers’ diagnoses and diabetes medications excluding biguanides, and 21.5% for providers’ diagnoses and diabetes medications including biguanides. The specificity of all three of the alternative methods was >99%. Older patients were more likely to have diabetes not identified. Patients with self-payment, those who had glucose measured or received IV fluids in the ED, and those with more diagnosis codes and medications, were more likely to have diabetes identified. Conclusions NHAMCS's providers’ diagnosis codes and medication lists do not identify the majority of patients with diabetes visiting EDs. The newly introduced checkbox is helpful in measuring ED resource utilization by patients with diabetes. PMID:24680472

  8. Using automated medical records for rapid identification of illness syndromes (syndromic surveillance: the example of lower respiratory infection

    Directory of Open Access Journals (Sweden)

    Dashevsky Inna

    2001-10-01

    Full Text Available Abstract Background Gaps in disease surveillance capacity, particularly for emerging infections and bioterrorist attack, highlight a need for efficient, real time identification of diseases. Methods We studied automated records from 1996 through 1999 of approximately 250,000 health plan members in greater Boston. Results We identified 152,435 lower respiratory infection illness visits, comprising 106,670 episodes during 1,143,208 person-years. Three diagnoses, cough (ICD9CM 786.2, pneumonia not otherwise specified (ICD9CM 486 and acute bronchitis (ICD9CM 466.0 accounted for 91% of these visits, with expected age and sex distributions. Variation of weekly occurrences corresponded closely to national pneumonia and influenza mortality data. There was substantial variation in geographic location of the cases. Conclusion This information complements existing surveillance programs by assessing the large majority of episodes of illness for which no etiologic agents are identified. Additional advantages include: a sensitivity, uniformity and efficiency, since detection of events does not depend on clinicians' to actively report diagnoses, b timeliness, the data are available within a day of the clinical event; and c ease of integration into automated surveillance systems. These features facilitate early detection of conditions of public health importance, including regularly occurring events like seasonal respiratory illness, as well as unusual occurrences, such as a bioterrorist attack that first manifests as respiratory symptoms. These methods should also be applicable to other infectious and non-infectious conditions. Knowledge of disease patterns in real time may also help clinicians to manage patients, and assist health plan administrators in allocating resources efficiently.

  9. Screening for Suicidal Ideation and Attempts among Emergency Department Medical Patients: Instrument and Results from the Psychiatric Emergency Research Collaboration

    Science.gov (United States)

    Allen, Michael H.; Abar, Beau W.; McCormick, Mark; Barnes, Donna H.; Haukoos, Jason; Garmel, Gus M.; Boudreaux, Edwin D.

    2013-01-01

    Joint Commission National Patient Safety Goal 15 calls for organizations "to identify patients at risk for suicide." Overt suicidal behavior accounts for 0.6% of emergency department (ED) visits, but incidental suicidal ideation is found in 3%-11.6%. This is the first multicenter study of suicide screening in EDs. Of 2,243 patients in…

  10. Highway Electrification And Automation

    OpenAIRE

    Shladover, Steven E.

    1992-01-01

    This report addresses how the California Department of Transportation and the California PATH Program have made efforts to evaluate the feasibility and applicability of highway electrification and automation technologies. In addition to describing how the work was conducted, the report also describes the findings on highway electrification and highway automation, with experimental results, design study results, and a region-wide application impacts study for Los Angeles.

  11. 78 FR 59623 - Emergency Medical Equipment

    Science.gov (United States)

    2013-09-27

    ... accordance with the FAA master minimum equipment list does not adversely affect aviation safety. This action... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration 14 CFR Parts 121 and 135 [Docket No... inoperative Emergency Medical Kit (EMK) or automated external defibrillator (AED). A copy of Master Minimum...

  12. 75 FR 24754 - Cost of Hospital and Medical Care Treatment Furnished by the Department of Defense Military...

    Science.gov (United States)

    2010-05-05

    ... OFFICE OF MANAGEMENT AND BUDGET Cost of Hospital and Medical Care Treatment Furnished by the... Third Persons AGENCY: Office of Management and Budget, Executive Office of the President. ACTION: Notice.... 593; 42 U.S.C. 2652), and delegated to the Director of the Office of Management and Budget by the...

  13. 78 FR 21631 - Fiscal Year 2013 Cost of Hospital and Medical Care Treatment Furnished by the Department of...

    Science.gov (United States)

    2013-04-11

    ... OFFICE OF MANAGEMENT AND BUDGET Fiscal Year 2013 Cost of Hospital and Medical Care Treatment... Tortiously Liable Third Persons AGENCY: Office of Management and Budget, Executive Office of the President...-603 (76 Stat. 593; 42 U.S.C. 2652), and delegated to the Director of the Office of Management and...

  14. 76 FR 15349 - Fiscal Year 2011 Cost of Hospital and Medical Care Treatment Furnished by the Department of...

    Science.gov (United States)

    2011-03-21

    ... OFFICE OF MANAGEMENT AND BUDGET Fiscal Year 2011 Cost of Hospital and Medical Care Treatment... Tortiously Liable Third Persons AGENCY: Executive Office of the President, Office of Management and Budget... 87-693 (76 Stat. 593; 42 U.S.C. 2652), and delegated to the Director of the Office of Management and...

  15. 76 FR 53921 - Privacy Act of 1974; Department of Homeland Security ALL-034 Emergency Care Medical Records...

    Science.gov (United States)

    2011-08-30

    ... AGENCY: Privacy Office, DHS. ACTION: Notice of Privacy Act system of records. SUMMARY: In accordance with... Security Office of Health Affairs to collect and maintain records on individuals who receive emergency care... consistent, quality medical care. To support MQM, OHA operates the electronic Patient Care Record (ePCR), an...

  16. Ukraine - USA partnership for peace. AEMS project on development and improving of 'Defense' automated emergency management system of the Civil Defense Department of Ukraine

    International Nuclear Information System (INIS)

    1998-01-01

    AEMS project is destined for the development and improving of 'Defense' system of the Civil Defense Department of Ukraine. 'Defense' system is destined for prevention and operation prognosis of emergencies of technological and natural character on the territory of Ukraine as well as for the elaboration of the solutions on protection and rescue of the population and national economy resources. The data are processed at national, regional, district and town levels. By the results of task solutions possible losses of human and material resources as well as necessary forces and means for removal of these consequences are defined. (R.P.)

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

    Science.gov (United States)

    2011-04-01

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

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

    Science.gov (United States)

    1990-10-01

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

  19. Positive predictive value of a case definition for diabetes mellitus using automated administrative health data in children and youth exposed to antipsychotic drugs or control medications: a Tennessee Medicaid study

    Directory of Open Access Journals (Sweden)

    Bobo William V

    2012-08-01

    Full Text Available Abstract Background We developed and validated an automated database case definition for diabetes in children and youth to facilitate pharmacoepidemiologic investigations of medications and the risk of diabetes. Methods The present study was part of an in-progress retrospective cohort study of antipsychotics and diabetes in Tennessee Medicaid enrollees aged 6–24 years. Diabetes was identified from diabetes-related medical care encounters: hospitalizations, outpatient visits, and filled prescriptions. The definition required either a primary inpatient diagnosis or at least two other encounters of different types, most commonly an outpatient diagnosis with a prescription. Type 1 diabetes was defined by insulin prescriptions with at most one oral hypoglycemic prescription; other cases were considered type 2 diabetes. The definition was validated for cohort members in the 15 county region geographically proximate to the investigators. Medical records were reviewed and adjudicated for cases that met the automated database definition as well as for a sample of persons with other diabetes-related medical care encounters. Results The study included 64 cases that met the automated database definition. Records were adjudicated for 46 (71.9%, of which 41 (89.1% met clinical criteria for newly diagnosed diabetes. The positive predictive value for type 1 diabetes was 80.0%. For type 2 and unspecified diabetes combined, the positive predictive value was 83.9%. The estimated sensitivity of the definition, based on adjudication for a sample of 30 cases not meeting the automated database definition, was 64.8%. Conclusion These results suggest that the automated database case definition for diabetes may be useful for pharmacoepidemiologic studies of medications and diabetes.

  20. Positive predictive value of a case definition for diabetes mellitus using automated administrative health data in children and youth exposed to antipsychotic drugs or control medications: a Tennessee Medicaid study.

    Science.gov (United States)

    Bobo, William V; Cooper, William O; Stein, C Michael; Olfson, Mark; Mounsey, Jackie; Daugherty, James; Ray, Wayne A

    2012-08-24

    We developed and validated an automated database case definition for diabetes in children and youth to facilitate pharmacoepidemiologic investigations of medications and the risk of diabetes. The present study was part of an in-progress retrospective cohort study of antipsychotics and diabetes in Tennessee Medicaid enrollees aged 6-24 years. Diabetes was identified from diabetes-related medical care encounters: hospitalizations, outpatient visits, and filled prescriptions. The definition required either a primary inpatient diagnosis or at least two other encounters of different types, most commonly an outpatient diagnosis with a prescription. Type 1 diabetes was defined by insulin prescriptions with at most one oral hypoglycemic prescription; other cases were considered type 2 diabetes. The definition was validated for cohort members in the 15 county region geographically proximate to the investigators. Medical records were reviewed and adjudicated for cases that met the automated database definition as well as for a sample of persons with other diabetes-related medical care encounters. The study included 64 cases that met the automated database definition. Records were adjudicated for 46 (71.9%), of which 41 (89.1%) met clinical criteria for newly diagnosed diabetes. The positive predictive value for type 1 diabetes was 80.0%. For type 2 and unspecified diabetes combined, the positive predictive value was 83.9%. The estimated sensitivity of the definition, based on adjudication for a sample of 30 cases not meeting the automated database definition, was 64.8%. These results suggest that the automated database case definition for diabetes may be useful for pharmacoepidemiologic studies of medications and diabetes.

  1. Positive predictive value of a case definition for diabetes mellitus using automated administrative health data in children and youth exposed to antipsychotic drugs or control medications: a Tennessee Medicaid study

    Science.gov (United States)

    2012-01-01

    Background We developed and validated an automated database case definition for diabetes in children and youth to facilitate pharmacoepidemiologic investigations of medications and the risk of diabetes. Methods The present study was part of an in-progress retrospective cohort study of antipsychotics and diabetes in Tennessee Medicaid enrollees aged 6–24 years. Diabetes was identified from diabetes-related medical care encounters: hospitalizations, outpatient visits, and filled prescriptions. The definition required either a primary inpatient diagnosis or at least two other encounters of different types, most commonly an outpatient diagnosis with a prescription. Type 1 diabetes was defined by insulin prescriptions with at most one oral hypoglycemic prescription; other cases were considered type 2 diabetes. The definition was validated for cohort members in the 15 county region geographically proximate to the investigators. Medical records were reviewed and adjudicated for cases that met the automated database definition as well as for a sample of persons with other diabetes-related medical care encounters. Results The study included 64 cases that met the automated database definition. Records were adjudicated for 46 (71.9%), of which 41 (89.1%) met clinical criteria for newly diagnosed diabetes. The positive predictive value for type 1 diabetes was 80.0%. For type 2 and unspecified diabetes combined, the positive predictive value was 83.9%. The estimated sensitivity of the definition, based on adjudication for a sample of 30 cases not meeting the automated database definition, was 64.8%. Conclusion These results suggest that the automated database case definition for diabetes may be useful for pharmacoepidemiologic studies of medications and diabetes. PMID:22920280

  2. Need of Department of General Practice / Family Medicine at AIIMS (All India Institute of Medical Sciences): Why the apex medical institute in India should also contribute towards training and education of general practitioners and family physicians.

    Science.gov (United States)

    Pal, Ranabir; Kumar, Raman

    2017-01-01

    Family medicine or general practice is the practicing discipline of the majority doctors in India, however formal academic departments of general practice (or family medicine) do not exist in India, as it is not a mandatory requirement as prescribed by the Medical Council of India; the principal regulator of medical education. Currently India has capacity to produce more than 60,000 medical graduates per year, majority of whom are expected to become general practitoners or primary care doctors without under going any vocational training in general practice or family medicine. The 92 nd parliamentary standing committee report (on health and family welfare) of the Indian Parliament recommended that Government of India in coordination with State Governments should establish robust postgraduate programs in Family Medicine and facilitate introducing Family Medicine discipline in all medical colleges. This will not only minimize the need for frequent referrals to specialist and decrease the load on tertiary care but also provide continuous health care for the individuals and families. The authors concur with the parliament of India and strongly feel that "Family Medicine" (community-based comprehensive clinical practice) deserves dedicated and distinct department at all medical colleges in India in order to availability of qualified medical doctors in the community-based health system. AIIMS, New Delhi, along with other newly established AIIMS, should rise to their foundation mandate of supporting excellence in all disciplines of medical science and to this historic responsibility; and not just remain an ivory tower of tertiary care based fragmented (into sub specialties) hospital culture.

  3. SU-D-BRD-06: Creating a Safety Net for a Fully Automated, Script Driven Electronic Medical Record

    Energy Technology Data Exchange (ETDEWEB)

    Sheu, R; Ghafar, R; Powers, A; Green, S; Lo, Y [Mount Sinai Medical Center, New York, NY (United States)

    2015-06-15

    Purpose: Demonstrate the effectiveness of in-house software in ensuring EMR workflow efficiency and safety. Methods: A web-based dashboard system (WBDS) was developed to monitor clinical workflow in real time using web technology (WAMP) through ODBC (Open Database Connectivity). Within Mosaiq (Elekta Inc), operational workflow is driven and indicated by Quality Check Lists (QCLs), which is triggered by automation software IQ Scripts (Elekta Inc); QCLs rely on user completion to propagate. The WBDS retrieves data directly from the Mosaig SQL database and tracks clinical events in real time. For example, the necessity of a physics initial chart check can be determined by screening all patients on treatment who have received their first fraction and who have not yet had their first chart check. Monitoring similar “real” events with our in-house software creates a safety net as its propagation does not rely on individual users input. Results: The WBDS monitors the following: patient care workflow (initial consult to end of treatment), daily treatment consistency (scheduling, technique, charges), physics chart checks (initial, EOT, weekly), new starts, missing treatments (>3 warning/>5 fractions, action required), and machine overrides. The WBDS can be launched from any web browser which allows the end user complete transparency and timely information. Since the creation of the dashboards, workflow interruptions due to accidental deletion or completion of QCLs were eliminated. Additionally, all physics chart checks were completed timely. Prompt notifications of treatment record inconsistency and machine overrides have decreased the amount of time between occurrence and execution of corrective action. Conclusion: Our clinical workflow relies primarily on QCLs and IQ Scripts; however, this functionality is not the panacea of safety and efficiency. The WBDS creates a more thorough system of checks to provide a safer and near error-less working environment.

  4. SU-D-BRD-06: Creating a Safety Net for a Fully Automated, Script Driven Electronic Medical Record

    International Nuclear Information System (INIS)

    Sheu, R; Ghafar, R; Powers, A; Green, S; Lo, Y

    2015-01-01

    Purpose: Demonstrate the effectiveness of in-house software in ensuring EMR workflow efficiency and safety. Methods: A web-based dashboard system (WBDS) was developed to monitor clinical workflow in real time using web technology (WAMP) through ODBC (Open Database Connectivity). Within Mosaiq (Elekta Inc), operational workflow is driven and indicated by Quality Check Lists (QCLs), which is triggered by automation software IQ Scripts (Elekta Inc); QCLs rely on user completion to propagate. The WBDS retrieves data directly from the Mosaig SQL database and tracks clinical events in real time. For example, the necessity of a physics initial chart check can be determined by screening all patients on treatment who have received their first fraction and who have not yet had their first chart check. Monitoring similar “real” events with our in-house software creates a safety net as its propagation does not rely on individual users input. Results: The WBDS monitors the following: patient care workflow (initial consult to end of treatment), daily treatment consistency (scheduling, technique, charges), physics chart checks (initial, EOT, weekly), new starts, missing treatments (>3 warning/>5 fractions, action required), and machine overrides. The WBDS can be launched from any web browser which allows the end user complete transparency and timely information. Since the creation of the dashboards, workflow interruptions due to accidental deletion or completion of QCLs were eliminated. Additionally, all physics chart checks were completed timely. Prompt notifications of treatment record inconsistency and machine overrides have decreased the amount of time between occurrence and execution of corrective action. Conclusion: Our clinical workflow relies primarily on QCLs and IQ Scripts; however, this functionality is not the panacea of safety and efficiency. The WBDS creates a more thorough system of checks to provide a safer and near error-less working environment

  5. Evaluation of a Computerized Problem-Oriented Medical Record in a Hospital Department: Does it Support Daily Clinical Practice?

    DEFF Research Database (Denmark)

    Bossen, Claus

    2007-01-01

    led to more time spent documenting clinical work, fragmentation of patient situation into separate problems, and lack of overview.Conclusion: The problem-oriented method for structuring a computerized medical record may provide a description of how physicians think or ought to think, but does...... not adequately support complex clinical work. While the CPOMR can be used for patients with few, simple problems who are admitted for only a short time, the CPOMR is not useful for patients with a complex set of problems or for patients admitted for longer periods of time. This is in accordance with criticism...

  6. Medications

    Science.gov (United States)

    ... Red Dress ® , and Red Dress ® are registered trademarks of U.S. Department of Health and Human Services. National Wear Red Day ® is a registered trademark of the U.S. Department of Health and Human ...

  7. The impact of an integrated hospital-community medical information system on quality and service utilization in hospital departments.

    Science.gov (United States)

    Nirel, Nurit; Rosen, Bruce; Sharon, Assaf; Blondheim, Orna; Sherf, Michael; Samuel, Hadar; Cohen, Arnon D

    2010-09-01

    In 2005, an innovative system of hospital-community on-line medical records (OFEK) was implemented at Clalit Health Services (CHS). The goals of the study were to examine the extent of OFEK's use and its impact on quality indicators and medical-service utilization in Internal Medicine and General Surgery wards of CHS hospitals. Examining the frequency of OFEK's use with its own track-log data; comparing, "before" and "after", quality indicators and service utilization data in experimental (CHS patients) versus control groups (other patients). OFEK's use increased by tens of percentages each year, Internal Medicine wards showed a significant decrease in the number of laboratory tests and 3 CT tests performed compared with the control group. Wards using OFEK extensively showed a greater decrease in CT tests, in one imaging test, and in the average number of ambulatory hospitalizations. No similar changes were found in General Surgery wards. The study helps evaluate the extent to which OFEK's targets were achieved and contributes to the development of measures to examine the impact of such systems, which can be used to assess a broad range of Health Information Technology (HIT) systems. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  8. Recognition difference and improvement direction of the radiological technologists and patient against medical service in department radiology - Inchon area in the object

    International Nuclear Information System (INIS)

    An, Sung Min; Kim, Sung Chul

    2006-01-01

    Satisfaction of the patient against the medical service in department of radiology and it evaluated the different recognition of radiological technologist and patient, and investigates it's improvement direction. It sent the reply the above the which is a usual result in question result of the most that, the receipt process it was complicated in the portion which is insufficient. 'The receipt process is complication', 'waiting time is long' and ' don't radiation protection for patient and guardian'. Also these a facts was recognizing patients and radiological technologist all. And the effort of the radiological technologist is necessary with the method which reduces a recognition difference. The periodical medical service satisfaction investigates and must endeavor in reform measure preparation

  9. Prediction of Mobility Limitations after Hospitalization in Older Medical Patients by Simple Measures of Physical Performance Obtained at Admission to the Emergency Department

    DEFF Research Database (Denmark)

    Bodilsen, Ann Christine; Hedegaard Klausen, Henrik; Petersen, Janne

    2016-01-01

    Objective: Mobility limitations relate to dependency in older adults. Identification of older patients with mobility limitations after hospital discharge may help stratify treatment and could potentially counteract dependency seen in older adults after hospitalization. We investigated the ability...... of four physical performance measures administered at hospital admission to identify older medical patients who manifest mobility limitations 30 days after discharge. Design: Prospective cohort study of patients (≥65 years) admitted to the emergency department for acute medical illness. During the first...... included. Of those, 128 (40%) patients had mobility limitations at follow-up. Univariate analyzes showed that each of the physical performance measures was strongly associated with mobility limitations at follow-up (handgrip strength(women), OR 0.86 (0.81–0.91), handgrip strength(men), OR 0.90 (0...

  10. Energy and nutritional value of diets used in patients alimentation and their assessment by patients of selected clinical department in the Military Medical Institute in Warsaw.

    Science.gov (United States)

    Kłos, Krzysztof; Bertrandt, Jerzy; Jałocha, Lukasz; Matuszewski, Tomasz; Abramowicz, Michał

    2007-01-01

    The aim of the work was laboratory assessment of energy and nutritional value of general and light diets used in patients of selected clinical department in the Military Medical Institute in Warsaw alimentation. Using questionnaire method the assessment of diets was done by patients too. Meals given to patients in hospital not always fulfilled nutritional requirements. Additional consumption of supplementary products did not always meet the requirements of proper nutrition. Half of examined patients appraised nutrition variety as good but at the same time claimed the there was not enough fruits and vegetables.

  11. AVTA Federal Fleet PEV Readiness Data Logging and Characterization Study for Department of Veterans Affairs. James J. Peters VA Medical Center, Bronx, NY

    Energy Technology Data Exchange (ETDEWEB)

    Schey, Stephen [Intertek Testing Services, North America, Phoenix, AZ (United States); Francfort, Jim [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2014-10-01

    This report focuses on the Department of Veterans Affairs, James J. Peters VA Medical Center (VA - Bronx) fleet to identify daily operational characteristics of select vehicles and report findings on vehicle and mission characterizations to support the successful introduction of PEVs into the agencies’ fleets. Individual observations of these selected vehicles provide the basis for recommendations related to electric vehicle adoption and whether a battery electric vehicle or plug-in hybrid electric vehicle (collectively referred to as PEVs) can fulfill the mission requirements.

  12. Incidence and prevalence of hospital-acquired infections in a cohort of patients admitted to medical departments

    DEFF Research Database (Denmark)

    Petersen, Martin Haubro; Holm, Morten Olskjær; Pedersen, Svend Stenvang

    2010-01-01

    INTRODUCTION: Hospital-acquired infections (HAI) are a significant cause of morbidity and mortality. Only point prevalence analyses of HAI have been recorded in Denmark. The aim of this study was to investigate the incidence and prevalence of HAI in patients admitted to departments of internal.......7-10.6). Exposure to bladder catheter was associated with an increased risk of urinary tract infection, incidence rate ratio 4.9; (95% CI 1.8-11.5). For the initial 14 days of hospitalization, the incidence of HAI was independent, while the prevalence increased linearly with duration of admittance. CONCLUSION......: The incidence of HAI was relatively constant during the initial 14-day-period of hospitalization, suggesting that shortening the period will have no major impact on the incidence of HAI. The prevalence was 9.7%, which is in line with results from prior studies....

  13. U.S. Department Of Energy's nuclear engineering education research: highlights of recent and current research-II. 5. Automation of Nuclear Fuel Pellet Quality Control

    International Nuclear Information System (INIS)

    Keyvan, Shahla; Song, Xiaolong

    2001-01-01

    At the present time, nuclear fuel pellet inspection is performed by humans using the naked eye for judgment and decision making as to whether to accept or reject the pellet. Unnecessary re-fabrication of pellets will be costly, and having too many low-quality pellets in a fuel assembly is unacceptable. The current practice of pellet inspection by humans is tedious and subject to inconsistencies and error. In addition, manual inspection is cumbersome since the inspector must keep the pellet at arm's length and must wear glasses to protect the lenses of his or her eyes. The pellets are taken from a pellet sizing machine, dumped onto a rack, and shaken into rows; they are then viewed as a group. The entire group is rotated 90 deg four times to provide the inspector with a 360-deg view of each pellet. The pellets are examined for certain types of cracks, chips, and unusual markings, i.e., water stains and machine banding. These defects appear at any location on the pellet surface image with different intensity, size, shape, and background noise. Figure 1 shows typical defective fuel pellets with chip, banded, and end defects. The goal of this work is to automate the pellet inspection process. A prototype of such an inspection system is developed. The system examines photographic images of pellets using various artificial intelligence techniques for image analysis and defect classification. Figure 2 shows the user interface of this inspection system, which is built using Java programming language. A total of 252 pellets with various defects was available for this research. Each pellet was photographed four times at rotations of 90 deg. The resultant black-and-white negatives were scanned into the computer in 256 gray scale mode. The inspection of a fuel pellet by image analysis involves several steps, as described in Fig. 3 and as follows: Step 1-On-line image conversion: This process involves on-line digitization of the input image. Step 2-Reference model: The second

  14. Capillary refill time is a predictor of short-term mortality for adult patients admitted to a medical department

    DEFF Research Database (Denmark)

    Mrgan, Monija; Rytter, Dorte; Brabrand, Mikkel

    2014-01-01

    the relationship between CRT (using two existing definitions and as a continuous variable) and short-term mortality. METHODS: We included all acutely admitted adult patients to a medical admission unit. We measured CRT, blood pressure, pulse, temperature and peripheral oxygen saturation. We presented the data...... mortality with all definitions of CRT. Performing multivariable analysis, controlling for age, sex, mean blood pressure, pulse, temperature and peripheral oxygen saturation, we found increasing CRT as a continuous variable and according to the Schriger and Baraff definition to be associated with increased...... mortality. Both the Trauma score and Schriger and Baraff definitions had high negative predictive values. The calculations on the Schriger and Baraff defition were based on limited power. CONCLUSIONS: We found a significant association between CRT measured as a continuous variable and short-term mortality...

  15. Home Automation

    OpenAIRE

    Ahmed, Zeeshan

    2010-01-01

    In this paper I briefly discuss the importance of home automation system. Going in to the details I briefly present a real time designed and implemented software and hardware oriented house automation research project, capable of automating house's electricity and providing a security system to detect the presence of unexpected behavior.

  16. Automated Versus Manual Blood Pressure Measurement: A Randomized Crossover Trial in the Emergency Department of a Tertiary Care Hospital in Karachi, Pakistan: Are Third World Countries Ready for the Change?

    Science.gov (United States)

    Mansoor, Kanaan; Shahnawaz, Saba; Rasool, Mariam; Chaudhry, Huwad; Ahuja, Gul; Shahnawaz, Sara

    2016-09-15

    Hypertension has proven to be a strong liability with 13.5% of all mortality worldwide being attributed to elevated blood pressures in 2001. An accurate blood pressure measurement lies at the crux of an appropriate diagnosis. Despite the mercury sphygmomanometer being the gold standard, the ongoing deliberation as to whether mercury sphygmomanometers should be replaced with the automated oscillometric devices stems from the risk mercury poses to the environment. This study was performed to check the validity of automated oscillometric blood pressure measurements as compared to the manual blood pressure measurements in Karachi, Pakistan. Blood pressure was recorded in 200 individuals aged 15 and above using both, an automated oscillometric blood pressure device (Dinamap Procare 100) and a manual mercury sphygmomanometer concomitantly. Two nurses were assigned to each patient and the device, arm for taking the reading and nurses were randomly determined. SPSS version 20 was used for analysis. Mean and standard deviation of the systolic and diastolic measurements from each modality were compared to each other and P values of 0.05 or less were considered to be significant. Validation criteria of British Hypertension Society (BHS) and the US Association for the Advancement of Medical Instrumentation (AAMI) were used. Two hundred patients were included. The mean of the difference of systolic was 8.54 ± 9.38 while the mean of the difference of diastolic was 4.21 ± 7.88. Patients were further divided into three groups of different systolic blood pressure 120 to = 150 and > 150, their means were 6.27 ± 8.39 (p-value 0.175), 8.91 ± 8.96 (p-value 0.004) and 10.98 ± 10.49 (p-value 0.001) respectively. In our study 89 patients were previously diagnosed with hypertension; their difference of mean systolic was 9.43 ± 9.89 (p-value 0.000) and difference of mean diastolic was 4.26 ± 7.35 (p-value 0.000). Systolic readings from a previously validated device are not reliable

  17. Prevailing Status and Treatment Seeking Awareness Among Patients Attending in The Orthodontics Department of Bangabandhu Sheikh Mujib Medical University

    Directory of Open Access Journals (Sweden)

    Tanzila Rafique

    2011-09-01

    Full Text Available Background: Malocclusion is problem since antiquity. But people’s perception about the problem varies with their geographical location and cultural background. The problem seems to be more acute in developing countries like Bangladesh. Objectives: The present study was undertaken to assess the awareness about aesthetic problem of malocclusion and treatment seeking behavior among the patients attending in orthodontic department of BSMMU. Methods: The present cross-sectional study was carried out in the Department of Orthodontic, Faculty of Dentistry, BSMMU, over a period 24 months from January 2008 to December 2009. A total of 110 participants who were suffering from malocclusion and came for dental treatment were the study population. Results: The mean age of the patients was 21 years and the youngest and the oldest patients were 8 and 32 years old respectively with female to male ratio being roughly 3:2. Graduate or postgraduate level educated patients were predominant (53.6%. Over 70% of the respondents viewed malocclusion as an aesthetic problem, 50% as functional problem, 55.5% social problem and 69.1% oral problem. Two-third (67% told that malocclusion was a treatable condition. Approximately 43% of the patients identified trauma as a cause of malocclusion, 40% gingivitis or periodontitis and 35.5% dental caries. About one-third (32.7% of the respondents was of the opinion that certain habits should be avoided to prevent malocclusion, 15.5% told timely treatment of malocclusion, 30% told prevention of early loss of teeth due to caries, 12.7% were in favour of the use of a space maintainer in places of premature loss of a deciduous tooth. Over 90% of the respondents held the view that symptoms of malocclusion, its prevention and different treatment options should get the priority in educating the society about malocclusion. However, 80% of the respondents told that causative factors should discussed. Regarding ways of behaviour change

  18. SU-D-BRD-02: Auto Weekly - An Automated Online Weekly Chart Check System for Medical Physics

    International Nuclear Information System (INIS)

    Tan, J; Yan, Y; Hager, F; Gu, X; Jia, X; Pompos, A; Foster, R; Stojadinovic, S; Yang, M; Hrycushko, B; Folkerts, M; Zhao, B; Medin, P; Ding, C; Jiang, S

    2015-01-01

    Purpose: Radiation therapy has evolved to become not only more precise and potent, but also more complicated to monitor and deliver. More rigorous and comprehensive quality assurance is needed to safeguard ever advancing radiation therapy. ICRU standards dictate that an ever growing set of treatment parameters are manually checked weekly by medical physicists. This “weekly chart check” procedure is laborious and subject to human errors or other factors. A computer-assisted chart checking process will enable more complete and accurate human review of critical parameters, reduce the risk of medical errors, and improve the efficiency. Methods: We developed a web-based software system that enables a thorough weekly quality assurance checks. In the backend, the software retrieves all machine parameters from a Treatment Management System (TMS) and compares them against the corresponding ones from the treatment planning system. They are also checked for validity against preset rules. The results are displayed as a web page in the front-end for physicists to review. Then a summary report is generated and uploaded automatically to the TMS as a record for weekly chart checking. Results: The software system has been deployed on a web server in our department’s intranet, and has been tested thoroughly by our clinical physicists. A plan parameter would be highlighted when it is off the preset limit. The developed system has changed the way of checking charts with significantly improved accuracy, efficiency, and completeness. It has been shown to be robust, fast, and easy to use. Conclusion: A computer-assisted system has been developed for efficient, accurate, and comprehensive weekly chart checking. The system has been extensively validated and is being implemented for routine clinical use

  19. SU-D-BRD-02: Auto Weekly - An Automated Online Weekly Chart Check System for Medical Physics

    Energy Technology Data Exchange (ETDEWEB)

    Tan, J; Yan, Y; Hager, F; Gu, X; Jia, X; Pompos, A; Foster, R; Stojadinovic, S; Yang, M; Hrycushko, B; Folkerts, M; Zhao, B; Medin, P; Ding, C; Jiang, S [UT Southwestern Medical Center, Dallas, TX (United States)

    2015-06-15

    Purpose: Radiation therapy has evolved to become not only more precise and potent, but also more complicated to monitor and deliver. More rigorous and comprehensive quality assurance is needed to safeguard ever advancing radiation therapy. ICRU standards dictate that an ever growing set of treatment parameters are manually checked weekly by medical physicists. This “weekly chart check” procedure is laborious and subject to human errors or other factors. A computer-assisted chart checking process will enable more complete and accurate human review of critical parameters, reduce the risk of medical errors, and improve the efficiency. Methods: We developed a web-based software system that enables a thorough weekly quality assurance checks. In the backend, the software retrieves all machine parameters from a Treatment Management System (TMS) and compares them against the corresponding ones from the treatment planning system. They are also checked for validity against preset rules. The results are displayed as a web page in the front-end for physicists to review. Then a summary report is generated and uploaded automatically to the TMS as a record for weekly chart checking. Results: The software system has been deployed on a web server in our department’s intranet, and has been tested thoroughly by our clinical physicists. A plan parameter would be highlighted when it is off the preset limit. The developed system has changed the way of checking charts with significantly improved accuracy, efficiency, and completeness. It has been shown to be robust, fast, and easy to use. Conclusion: A computer-assisted system has been developed for efficient, accurate, and comprehensive weekly chart checking. The system has been extensively validated and is being implemented for routine clinical use.

  20. Paternity analysis based on NGM SElect system in the Medical and Forensic Genetics Laboratory, Department of Forensic Medicine, Medical University of Lodz

    Directory of Open Access Journals (Sweden)

    Beata Markiewicz-Knyziak

    2015-08-01

    Full Text Available The aim of the study was to evaluate the usefulness of the NGM SElect multiplex kit for paternity testing in the population of central Poland, and compare it with the IDENTIFILER system. The study material consisted of buccal swabs taken from individuals who reported to the Medical and Forensic Genetics Laboratory in Lodz. Samples from 450 trio cases of disputed paternity carried out in 2010–2014 were investigated. Genomic DNA was extracted from buccal swabs collected from 1,350 individuals using the Swab kit (A&A Biotechnology according to the manufacturer’s protocol. DNA amplification was performed using the AmpFℓSTR ® NGM Select TM PCR Amplification Kit (Life Technologies. PCR products were separated by capillary electrophoresis using HID 3500 Genetic Analyzer. In the analyzed cases with paternity confirmation in the NGM SElect system, the maximum value of PI was 3.9 × 10 12 , which corresponds to the probability of paternity W = 99.9999999999%. It was thus significantly higher than analogical parameters obtained in the IDENTIFILER system (PI = 6.0 × 10 10 , W = 99.99999999%. The NGM SElect kit was unable to resolve just one case out of 450, which represents only 0.2% of all analyzed disputed paternity cases. The study showed the SE33 (ACTBP2 locus to have the highest evidence value in paternity analysis out of all investigated autosomal STRs.

  1. Medical science in the light of the Holocaust: Departing from a post-war paper by Ludwik Fleck.

    Science.gov (United States)

    Hedfors, Eva

    2008-04-01

    In scholarly debates, Ludwik Fleck's post-war paper 'Problemy naukoznawstwa [Problems of the Science of Science]', published in 1946, has been taken unanimously to illustrate the epistemology expounded in his monograph Genesis and Development of a Scientific Fact. The paper has also been seen to support parts of the received view of Fleck, notably that he manufactured an anti-typhus vaccine while imprisoned in Buchenwald. However, a different narrative emerges when comparing Fleck's paper with other accounts, also published in 1946 and written by other prisoners alluded to by Fleck in his paper. The situation is further complicated by four papers, published in prestigious scientific journals between 1942 and 1945, by the German medical leader of the typhus studies accounted for by Fleck. In addition, a thus-far neglected paper by Fleck, published in 1946 and summarizing his observations on typhus, discloses his role in the Buchenwald studies. Despite the obvious difficulties with tracing the history behind these works, notably the one on Nazi science, the contention is that what was attempted in Buchenwald in the name of science amounted to pseudoscience. This conclusion is amply supported not only by the accounts given by Fleck's fellow prisoners, but also by his own post-war paper on typhus. Based on the above findings, it is suggested that the mythology about Fleck, established in the 1980s, has been accomplished by a selective reading of his papers and also that the role played by Fleck was more complex than has so far been contemplated.

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

    Science.gov (United States)

    Kragh, John F; Dubick, Michael A

    2016-01-01

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

  3. Doses to medical workers operating in a PET/CT department after the use of new dynamic techniques

    International Nuclear Information System (INIS)

    Dalianis, K; Kollias, G; Malamitsi, J; Euthimiadou, R; Andreou, J; Georgiou, E; Prassopoulos, V

    2015-01-01

    Since new radiopharmaceuticals are used like [18F]-fluoro-3'-deoxy-3'-L- fluorothymidine and 18F fluoromethylcholine, also new dynamic techniques of imaging are used, measurements concerning the doses to medical staff are needed. The aim of this study was to measure the effective whole body dose of the personnel and compare them with the oldest. Estimation of equivalent dose for all members of the staff was monitored with the use of TLDs badges and electronic dosimeters. The duration of the study was year 2011 (983 patients).Concerning the nurses, we measured 10% increase in the wholebody doses and that is due to the longer time they spent near the patient (dynamic protocol). For technologist we measure 15-21% increase for they come near the patient immediately after administration. We can observe that there is an increase of the doses for technologists and nurses the numbers are significantly lower than the recommended annual dose limit by Euratrom 97/43. (paper)

  4. Doses to medical workers operating in a PET/CT department after the use of new dynamic techniques.

    Science.gov (United States)

    Dalianis, K.; Kollias, G.; Malamitsi, J.; Euthimiadou, R.; Andreou, J.; Georgiou, E.; Prassopoulos, V.

    2015-09-01

    Since new radiopharmaceuticals are used like [18F]-fluoro-3'-deoxy-3'-L- fluorothymidine and 18F fluoromethylcholine, also new dynamic techniques of imaging are used, measurements concerning the doses to medical staff are needed. The aim of this study was to measure the effective whole body dose of the personnel and compare them with the oldest. Estimation of equivalent dose for all members of the staff was monitored with the use of TLDs badges and electronic dosimeters. The duration of the study was year 2011 (983 patients).Concerning the nurses, we measured 10% increase in the wholebody doses and that is due to the longer time they spent near the patient (dynamic protocol). For technologist we measure 15-21% increase for they come near the patient immediately after administration. We can observe that there is an increase of the doses for technologists and nurses the numbers are significantly lower than the recommended annual dose limit by Euratrom 97/43.

  5. The relationship between emotional intelligence and transformational-transactional leadership style among the heads of nursing education departments in Iranian medical universities, 2012

    Directory of Open Access Journals (Sweden)

    2014-01-01

    Full Text Available Background and objectives: Emotional intelligence contributes to the success in leadership, especially among nursing managers. This study sought to determine the relationship between the components of emotional intelligence and transformational-transactional leadership style among the heads of nursing education departments of Iranian medical universities.Methods: This cross-sectional study used convenience sampling to select the managers of 68 nursing education departments from the country’s universities of medical sciences. Data were collected using the Bar-On Emotional Quotient Inventory and Bass’s Multifactor Leadership Questionnaire. Data analysis was performed with Pearson’s correlation coefficient, analysis of variance, and Student’s test in SPSS version 16.0.Results: There was a direct, positive correlation between emotional intelligence and leadership style (P < 0.05 r = 0.36. The components of problem solving, happiness, independence, self-actualization, emotional self-awareness, interpersonal relationship, optimism, and accountability showed significant correlations with all leadership styles. However, impulse control was not significantly correlation with any of the leadership styles.Conclusion: Considering the significant positive correlation between the components of emotional intelligence and leadership styles, training about emotional intelligence and its components and reinforcing the components of emotional intelligence can be beneficial to presenting leadership styles and thus more successful management.

  6. In memory of professor Czesław Niżankowski, Head of the Department of Anatomy, Wroclaw Medical University.

    Science.gov (United States)

    Kacała, Ryszard R; Wronecki, Krzysztof; Kacała, Arkadiusz; Domagała, Zygmunt; Porwolik, Michał

    2018-03-20

    Professor Czesław Niżankowski was an academic teacher and researcher at several universities; head of the Department of Anatomy at Wroclaw Medical University (1966-1982); and head of the Department of Biological Sciences at the Wrocław School of Physical Education (since 1972 University School of Physical Education in Wrocław), as well as the chancellor there. He contributed greatly to the development of morphological sciences, supervising many doctoral and post-doctoral works. He dedicated considerable time to the preparation of anatomical specimens of lungs, hearts and organs of the gastrointestinal tract. At the Museum of Anatomy, there are over 100 specimens of lungs prepared using the forced air technique improved by Professor Niżankowski, along with specimens of the bronchial tree and vascular system prepared using a corrosive technique. Professor Niżankowski was an active member of scientific societies in Wrocław and in other cities in Poland. For his accomplishments, he received a number of ministerial and state awards, including the Knight's Cross of the Order of Polonia Restituta, and was granted an honorary doctorate by Wroclaw Medical University.

  7. [Laboratory medicine in the obligatory postgraduate clinical training system--common clinical training program in the department of laboratory medicine in our prefectural medical university hospital].

    Science.gov (United States)

    Okamoto, Yasuyuki

    2003-04-01

    I propose a postgraduate common clinical training program to be provided by the department of laboratory medicine in our prefectural medical university hospital. The program has three purposes: first, mastering basic laboratory tests; second, developing the skills necessary to accurately interpret laboratory data; third, learning specific techniques in the field of laboratory medicine. For the first purpose, it is important that medical trainees perform testing of their own patients at bedside or in the central clinical laboratory. When testing at the central clinical laboratory, instruction by expert laboratory technicians is helpful. The teaching doctors in the department of laboratory medicine are asked to advise the trainees on the interpretation of data. Consultation will be received via interview or e-mail. In addition, the trainees can participate in various conferences, seminars, and meetings held at the central clinical laboratory. Finally, in order to learn specific techniques in the field of laboratory medicine, several special courses lasting a few months will be prepared. I think this program should be closely linked to the training program in internal medicine.

  8. An Analytical Comparison of the Opinions of Physicians Working in Emergency and Trauma Surgery Departments at Tabriz and Vienna Medical Universities Regarding Family Presence during Resuscitation.

    Science.gov (United States)

    Soleimanpour, Hassan; Behringer, Wilhelm; Tabrizi, Jafar Sadegh; Sarahrudi, Kambiz; Golzari, Samad E J; Hajdu, Stefan; Rasouli, Maryam; Nikakhtar, Mehdi; Mehdizadeh Esfanjani, Robab

    2015-01-01

    The present study evaluated the opinions of physicians working in the emergency and trauma surgery departments of Vienna Medical University, in Austria, and Tabriz Medical University, in Iran, regarding the presence of patients' relatives during resuscitation. In a descriptive-analytical study, the data obtained from questionnaires that had been distributed randomly to 40 specialists and residents at each of the participating universities were analyzed. The questionnaire consisted of two sections aimed at capturing the participants' demographic data, the participants' opinions regarding their support for the family's presence during resuscitation, and the multiple potential factors affecting the participants' attitudes, including health beliefs, triggers that could facilitate the procedure, self-efficacy, intellectual norms, and perceived behavioral control. The questionnaire also included a direct question (Question 16) on whether the participants approved of family presence. Each question could be answered using a Likert-type scale. The results showed that the mean scores for Question 16 were 4.31 ± 0.64 and 3.57 ± 1.31 for participants at Vienna and Tabriz universities, respectively. Moreover, physicians at Vienna University disapproved of the presence of patients' families during resuscitation to a higher extent than did those at Tabriz University (P = 0.018). Of the studied prognostic factors affecting the perspectives of Vienna Medical University's physicians, health beliefs (P = 0.000; B = 1.146), triggers (P = 0.000; B = 1.050), and norms (P = 0.000; B = 0.714) were found to be significant. Moreover, of the studied prognostic factors affecting the perspectives of Tabriz Medical University's physicians, health beliefs (P = 0.000; B = 0.875), triggers (P = 0.000; B = 1.11), self-efficacy (P = 0.001; B = 0.5), and perceived behavioral control (P = 0.03; B = 0.713) were significant. Most physicians at Vienna and Tabriz Medical universities were not open

  9. The Set-Up and Implementation of Fully Virtualized Lessons with an Automated Workflow Utilizing VMC/Moodle at the Medical University of Graz

    Directory of Open Access Journals (Sweden)

    Herwig Erich Rehatschek

    2011-12-01

    Full Text Available With start of winter semester 2010/11 the Medical University of Graz (MUG successfully introduced a new primary learning management system (LMS Moodle. Moodle currently serves more than 4,300 students from three studies and holds more than 7,500 unique learning objects. With begin of the summer semester 2010 we decided to start a pilot with Moodle and 430 students. For the pilot we migrated the learning content of one module and two optional subjects to Moodle. The evaluation results were extremely promising – more than 92% of the students wanted immediately Moodle – also Moodle did meet our high expectations in terms of performance and scalability. Within this paper we describe how we defined and set-up a scalable and highly available platform for hosting Moodle and extended it by the functionality for fully automated virtual lessons. We state our experiences and give valuable clues for universities and institutions who want to introduce Moodle in the near future.

  10. National Automated Conformity Inspection Process -

    Data.gov (United States)

    Department of Transportation — The National Automated Conformity Inspection Process (NACIP) Application is intended to expedite the workflow process as it pertains to the FAA Form 81 0-10 Request...

  11. Why do patients seek primary medical care in emergency departments? An ethnographic exploration of access to general practice.

    Science.gov (United States)

    MacKichan, Fiona; Brangan, Emer; Wye, Lesley; Checkland, Kath; Lasserson, Daniel; Huntley, Alyson; Morris, Richard; Tammes, Peter; Salisbury, Chris; Purdy, Sarah

    2017-05-04

    To describe how processes of primary care access influence decisions to seek help at the emergency department (ED). Ethnographic case study combining non-participant observation, informal and formal interviewing. Six general practitioner (GP) practices located in three commissioning organisations in England. Reception areas at each practice were observed over the course of a working week (73 hours in total). Practice documents were collected and clinical and non-clinical staff were interviewed (n=19). Patients with recent ED use, or a carer if aged 16 and under, were interviewed (n=29). Past experience of accessing GP care recursively informed patient decisions about where to seek urgent care, and difficulties with access were implicit in patient accounts of ED use. GP practices had complicated, changeable systems for appointments. This made navigating appointment booking difficult for patients and reception staff, and engendered a mistrust of the system. Increasingly, the telephone was the instrument of demand management, but there were unintended consequences for access. Some patient groups, such as those with English as an additional language, were particularly disadvantaged, and the varying patient and staff semantic of words like 'urgent' and 'emergency' was exacerbated during telephone interactions. Poor integration between in-hours and out-of-hours care and patient perceptions of the quality of care accessible at their GP practice also informed ED use. This study provides important insight into the implicit role of primary care access on the use of ED. Discourses around 'inappropriate' patient demand neglect to recognise that decisions about where to seek urgent care are based on experiential knowledge. Simply speeding up access to primary care or increasing its volume is unlikely to alleviate rising ED use. Systems for accessing care need to be transparent, perceptibly fair and appropriate to the needs of diverse patient groups. © Article author(s) (or

  12. Automation and adaptation: Nurses’ problem-solving behavior following the implementation of bar coded medication administration technology

    Science.gov (United States)

    Holden, Richard J.; Rivera-Rodriguez, A. Joy; Faye, Héléne; Scanlon, Matthew C.; Karsh, Ben-Tzion

    2012-01-01

    The most common change facing nurses today is new technology, particularly bar coded medication administration technology (BCMA). However, there is a dearth of knowledge on how BCMA alters nursing work. This study investigated how BCMA technology affected nursing work, particularly nurses’ operational problem-solving behavior. Cognitive systems engineering observations and interviews were conducted after the implementation of BCMA in three nursing units of a freestanding pediatric hospital. Problem-solving behavior, associated problems, and goals, were specifically defined and extracted from observed episodes of care. Three broad themes regarding BCMA’s impact on problem solving were identified. First, BCMA allowed nurses to invent new problem-solving behavior to deal with pre-existing problems. Second, BCMA made it difficult or impossible to apply some problem-solving behaviors that were commonly used pre-BCMA, often requiring nurses to use potentially risky workarounds to achieve their goals. Third, BCMA created new problems that nurses were either able to solve using familiar or novel problem-solving behaviors, or unable to solve effectively. Results from this study shed light on hidden hazards and suggest three critical design needs: (1) ecologically valid design; (2) anticipatory control; and (3) basic usability. Principled studies of the actual nature of clinicians’ work, including problem solving, are necessary to uncover hidden hazards and to inform health information technology design and redesign. PMID:24443642

  13. RFID and medication care.

    Science.gov (United States)

    Lahtela, Antti; Saranto, Kaija

    2009-01-01

    Dynamic healthcare needs new IT innovations and applications to be able to treat the rapidly growing number of patients effectively and safely. The information technology has to support healthcare in developing practices and nursing patients without confronting any complications or errors. One critical and important part of healthcare is medication care, which is very vulnerable for different kind of errors, even on fatal errors. Thus, medication care needs new methods for avoiding errors in different situations during medication administration. This poster represents an RFID-based automated identification system for medication care in a hospital environment. This work is a part of the research project MaISSI (Managing IT Services and Service Implementation) at the University of Kuopio, Department of Computer Science, Finland.

  14. Student-selected component in the medical curriculum: investigations and psychiatric referral for paracetamol overdose in an accident and emergency department

    Directory of Open Access Journals (Sweden)

    Cowman JG

    2017-08-01

    Full Text Available James G Cowman, Manuel Bakheet Royal College of Surgeons in Ireland – Medical University of Bahrain, Manama, Bahrain Background: A student-selected component (SSC of the medical curriculum requires the student to be self-directed in locating and undertaking a placement in a clinical specialty of their choosing and completing a project. The clinical area for experience was an accident and emergency department, and our topic was a focused audit on the investigations and referral for paracetamol overdose. The purpose of this paper is twofold: to reflect on the education value to medical students of an SSC in a medical curriculum, and to highlight learning and understanding through completion of an audit.Materials and methods: An audit approach was applied. The aim of the project study was to investigate the level of compliance with best-practice guidelines for investigations and psychiatric referral in paracetamol overdose.Results: A total of 40 cases meeting the inclusion criteria were randomly selected. The sample had a mean age of 27 years, of whom 70.5% were female, and the ingested dose of paracetamol ranged from 0.864 to 80 g. Paracetamol abuse may present as intentional and unintentional overdose. In our study, 85% of cases were identified as intentional overdose and 76% had a history of psychiatric illness. Generally, medical management was compliant with guidelines, with some minor irregularities. The international normalized ratio was the most underperformed test.Conclusion: Our choice of topic, paracetamol overdose, contributed to our understanding of the breadth of factors to be considered in the emergency medical management of a patient. In this regard, we had the benefit of understanding how the diagnostic and therapeutic factors, when applied in accordance with best-practice guidelines, work very effectively. The SSC impacted positively on our cognitive, personal, and professional development. In facilitating the student with

  15. The simple query "Do you want more pain medication?" is not a reliable way to assess acute pain relief in patients in the emergency department.

    Science.gov (United States)

    Chauny, Jean-Marc; Marquis, Martin; Paquet, Jean; Lavigne, Gilles; Cournoyer, Alexis; Manzini, Christiane; Daoust, Raoul

    2018-01-01

    The management of acute pain constitutes an essential skill of emergency department (ED) physicians. However, the accurate assessment of pain intensity and relief represents a clinically challenging undertaking. Some studies have proposed to define effective pain relief as the patient's refusal for additional analgesic administration. The aim of this study was to verify whether such a refusal is effectively indicative of pain relief. This prospective cohort study included ED patients who received single or multiple doses of pain medication for an acute pain problem. Patients were evaluated for pain relief using one Likert scale and two dichotomous questions: Is your pain relieved? and Do you want more analgesics? Non-relieved patients were further analysed using a checklist as to the reasons behind their refusal for supplemental pain medication. We have recruited 378 adult patients with a mean age of 50.3 years (±19.1); 60% were women and had an initial mean pain level of 7.3 (±2.0) out of 10. We observed that 68 out of 244 patients who were adequately relieved from pain asked for more analgesics (28%), whereas 51 out of 134 patients who were not relieved from pain refused supplemental drugs (38%). Reasons for refusal included wanting to avoid side effects, feeling sufficiently relieved, and disliking the medication's effects. Over a third of ED patients in acute pain were not relieved but refused supplemental pain medication. Patients have reported legitimate reasons to decline further analgesics, and this refusal cannot be used as an indication of pain relief.

  16. [Value of angiography and embolisation in treatment of head and neck vascular malformations at Otolaryngology Department, Poznań University of Medical Sciences, Poland].

    Science.gov (United States)

    Wróbel, Maciej; Kopeć, Tomasz; Juszkat, Robert; Szyfterl, Witold; Borucki, Łukasz

    2008-01-01

    Angiography is an invasive, radiological investigation of vascular system. It plays an important role within variety of diagnostic tools in head and neck pathologies. In selected cases with well defined tumor supply vessels, angiography may be combined with intravascular obliteration. This possibility widen indications, which comprise diagnostic arteriographies - visualization of blood supply and extension of vascularization; therapeutic and diagnostic arteriographies - palliative or radical in character, dependent on pathology; and therapeutic angiographies as adjuvant therapy prior to surgical treatment. Authors present their experience with endovascular techniques application in head and neck pathologies. Material comprised 59 angiographies performed in patients treated at Otolaryngology Department at Poznań University of Medical Sciences between 2000-2007. In conclusion authors emphasize advantages and disadvantages, as well as, the role of the endovascular treatment in head and neck surgery.

  17. THE MUTIFACTORIAL PATTERN OF OSTEOPOROSIS: A REVIEW OF THE RESEARCHES OF THE DEPARTMENT OF THERAPY, INSTITUTE OF POSTGRADUATE EDUCATION, YAROSLAVL STATE MEDICAL UNIVERSITY

    Directory of Open Access Journals (Sweden)

    O. B. Ershova

    2016-01-01

    Full Text Available Osteoporosis (OP is one of the most common diseases and is characterized by serious clinical manifestations such as low-energy bone fractures that cause severe social consequences. In this connection, OP is now receiving much attention worldwide. In Yaroslavl, the Department of Therapy (Head, Professor N.I. Korshunov, MD, Institute of Postgraduate Education, Yaroslavl State Medical University (Chancellor, Prof. A.V. Pavlov, MD, has been intensively conducting researches into different aspects of OP for more than 20 years. The main areas of the investigations performed are the issues of the epidemiology and outcomes of osteoporotic fractures, the relationship of OP to different diseases (rheumatoid arthritis, cardiovascular diseases, as well as the specific features of the development of OP in fertile men and women and the problem of calcium and vitamin D deficiency in pregnant women. 

  18. [Professional dysphonia and its risk factors in the material of the outpatient clinic of the Department of Otolaryngology, Medical Academy of Białystok].

    Science.gov (United States)

    Kosztyła-Hojna, Bozena; Rogowski, Marek; Ruczaj, Jan; Pepiński, Witold

    2004-01-01

    Occurrence of professional dysphonia was analysed in a group of 309 patients treated in the Phoniatric Outpatient Clinic, Department of Otolaryngology, Medical Academy in Białystok through the period of 1999-2001. In a group of professional voice users female teachers of primary schools and lower secondary schools predominated. Obtained results were compared with those from a group of 65 persons of other occupations. In the both groups other harmful factors affecting the voice organ were excluded. The clinical assessment included subjective and objective laryngological examination using videolaryngostroboscopy. The clinical material was evaluated in a view of functional and organic disorders of the voice organ. Early occurrence and aggravation of functional changes in the larynx was recorded in non professional voice users in the course of their seniority. In professional patients organic changes were more common and occurred earlier than functional disorders. Severity of dysphonia was related to the larynx pathology, especially of a functional character.

  19. Automated Cancer Registry Notifications: Validation of a Medical Text Analytics System for Identifying Patients with Cancer from a State-Wide Pathology Repository.

    Science.gov (United States)

    Nguyen, Anthony N; Moore, Julie; O'Dwyer, John; Philpot, Shoni

    2016-01-01

    The paper assesses the utility of Medtex on automating Cancer Registry notifications from narrative histology and cytology reports from the Queensland state-wide pathology information system. A corpus of 45.3 million pathology HL7 messages (including 119,581 histology and cytology reports) from a Queensland pathology repository for the year of 2009 was analysed by Medtex for cancer notification. Reports analysed by Medtex were consolidated at a patient level and compared against patients with notifiable cancers from the Queensland Oncology Repository (QOR). A stratified random sample of 1,000 patients was manually reviewed by a cancer clinical coder to analyse agreements and discrepancies. Sensitivity of 96.5% (95% confidence interval: 94.5-97.8%), specificity of 96.5% (95.3-97.4%) and positive predictive value of 83.7% (79.6-86.8%) were achieved for identifying cancer notifiable patients. Medtex achieved high sensitivity and specificity across the breadth of cancers, report types, pathology laboratories and pathologists throughout the State of Queensland. The high sensitivity also resulted in the identification of cancer patients that were not found in the QOR. High sensitivity was at the expense of positive predictive value; however, these cases may be considered as lower priority to Cancer Registries as they can be quickly reviewed. Error analysis revealed that system errors tended to be tumour stream dependent. Medtex is proving to be a promising medical text analytic system. High value cancer information can be generated through intelligent data classification and extraction on large volumes of unstructured pathology reports.

  20. Comparison of cephalometric norms of pleasing faces with patients reported in the out patients department of orthodontic at liaquat university of medical and health sciences hyderabad/ jamshoro

    International Nuclear Information System (INIS)

    Nisa, Q.U.

    2013-01-01

    Objective: This was a cross sectional study aimed to analyze Cephalometric norms of patients reporting to outpatients department of Orthodontic Department Liaquat University of Medical and health sciences, Hyderabad / Jamshoro in comparison with the Caucasian norms. Methods: The study was carried out on true lateral cephalometric radiographs of 150 subjects (75 male, 75 female) between 18-28 years, with esthetically pleasing and harmonious faces, competent lips, class 1 molar relationship, with all permanent teeth present, no facial trauma and no history of previous orthodontic treatment. The mean, standard deviation and ranges of all measurements were compared with the norms established by Steiner. For all statistical evaluation was performed by SPSS 16.0 version software, the student t-test were performed to compare the sample with Steiner means. Results: several significant findings were notable in the result of the present study. The result of the present study sample showed retrusive mandible (p < 0.000), horizontal growth pattern, procline upper incisors (p < 0.000), decrease inter-incisal angle (p < 0.001) when compared with the Caucasian norms taken by Steiner. No significant findings were found between male and female in present study sample.Conclusion: There were no significant differences between the male and female Population cephalometric norms Even though, a careful analysis of cephalom norms of patients along with other diagnostic considerations before initiating orthodontic treatment for better stability. (author)

  1. Improvement of medical education using web-based lecture repetition and extension: e-learning experiences of the Department of Obstetrics and Gynecology, University of Tuebingen

    Directory of Open Access Journals (Sweden)

    Wallwiener, Markus

    2006-11-01

    Full Text Available In order to improve the education of its medical students, the Department of Obstetrics and Gynecology of the University of Tuebingen established e-learning in terms of web-based lecture repetition and extension. Subsequent to lectures, questions are provided online. The participation is voluntary, but requires registration. The results of the analysed period (winter term 2004/2005, summer term 2005 and winter term 2005/2006 including more than 380 e-learning users are encouraging. An average of 45% of the target group used the offered online questions. The students who completed at least 75% of all prepared question units achieved significantly better results than their traditional learning fellow students (p=0.002. Users got more frequent the marks "good" and "very good". Twice as much conventional learning students as e-learning users failed the examination. E-Learning and the technical implementation are repeatedly appreciated by the students. In the future, more medical courses will be supplemented with e-learning, according to the students request.

  2. Odontogenic keratocyst: a 31- year retrospective study in the oral and maxillofacial pathology department, Faculty of Dentistry, Tehran University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Eshghyar N.

    2005-05-01

    Full Text Available Statement of Problem: Odontogenic keratocyst is a developmental odontogenic cyst which arises from dental lamina. One of the important features of odontogenic keratocyst is strong tendency to recurrence. Purpose: The purpose of this study was the statistical evaluation of age and gender of patient as well as area of involvement in odontogenic keratocysts in the oral and maxillofacial pathology department of dental faculty of Tehran University of Medical Sciences from 1971-2002. Materials and Methods: This study was a cross sectional, descriptive one. Medical records were reviewed and variables such as age, gender and site of involvement were recorded. The data were analyzed with SPSS software. Results: The relative frequency of odontogenic keratocyst was 36%. 66% of cysts were in men and 34% in women. 68% of lesions affected the lower jaw and 32% the upper jaw. Regarding the site of involvement, 48% of lesions involved the molar region of mandible and 42%, the anterior part of maxilla. The occurrence of keratocysts was higher in this sites. Most of the cases were diagnosed in the third decade. Conclusion: Based on the findings of this study, odontogenic keratocyst was more prevalent in men, mandible and the third decade. The posterior part of mandible and anterior region of maxilla were involved most frequently.

  3. [Adequacy of antibiotic therapy for urinary tract infection in a Medical Department from the university hospital of Lille: A retrospective cohort study].

    Science.gov (United States)

    Deconinck, L; Maillard, H; Lemaitre, M; Barbottin, E; Bakhache, E; Galperine, T; Puisieux, F; Hatron, P-Y; Lambert, M

    2015-11-01

    The main objective of the study was to assess the adequacy of antibiotic therapy for urinary tract infections (UTI) in a French hospital medical department. The secondary objective was to identify factors associated with inadequacy of the antibiotic therapy. A retrospective single centre cohort study was performed in the Post-Emergency Medicine Department (PEMD) of the university hospital of Lille. All patients presenting with an UTI from May 2012 to April 2014 were included. Adequacy of antibiotic therapy was assessed with reference to local guidelines. Factors associated with inadequacy of antibiotic prescription were determined using a multivariate logistic regression model. Two hundred and twenty-eight patients were included. The antibiotic prescription was fully adequate in 173 patients (76%) with appropriate use of a single or a combination antibiotic therapy in 96%, appropriate drug in 80%, appropriate dosage in 89% and appropriate route of administration in 95%. The risk for antibiotic inadequacy was significantly higher in patients with cystitis than in those with pyelonephritis (OR 12.01; 95% CI 4.17-34.65), when antibiotics were prescribed in the Emergency Department (OR 6.84; 95% CI 2.29-20.47) or before hospital admission (OR 382.46; 95% CI 19.61≥999.99) compared to when antibiotics were first administered in the PEMD, and in patients with severe UTI (OR 19.55; 95% CI 2.79-137.01). Adequacy of antibiotic therapy for UTI is relatively high in our study, reflecting the effective dissemination of antibiotic guidelines. However, antibiotic therapy is still inappropriate in cystitis, severe UTI and in case of prescription before the admission in the PEMD. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  4. Bilastine in allergic rhinoconjunctivitis and urticaria: a practical approach to treatment decisions based on queries received by the medical information department

    Directory of Open Access Journals (Sweden)

    Amalia Leceta

    2017-02-01

    Full Text Available Background: Bilastine is a safe and effective commonly prescribed non-sedating H1-antihistamine approved for symptomatic treatment in patients with allergic disorders such as rhinoconjunctivitis and urticaria. It was evaluated in many patients throughout the clinical development required for its approval, but clinical trials generally exclude many patients who will benefit in everyday clinical practice (especially those with coexisting diseases and/or being treated with concomitant drugs. Following its introduction into clinical practice, the Medical Information Specialists at Faes Farma have received many practical queries regarding the optimal use of bilastine in different circumstances. Data sources and methods: Queries received by the Medical Information Department and the responses provided to senders of these queries. Results: The most frequent questions received by the Medical Information Department included the potential for drug-drug interactions with bilastine and commonly used agents such as anticoagulants (including the novel oral anticoagulants, antiretrovirals, antituberculosis regimens, corticosteroids, digoxin, oral contraceptives, and proton pump inhibitors. Most of these medicines are not usually allowed in clinical trials, and so advice needs to be based upon the pharmacological profiles of the drugs involved and expert opinion. The pharmacokinetic profile of bilastine appears favourable since it undergoes negligible metabolism and is almost exclusively eliminated via renal excretion, and it neither induces nor inhibits the activity of several isoenzymes from the CYP 450 system. Consequently, bilastine does not interact with cytochrome metabolic pathways. Other queries involved specific patient groups such as subjects with renal impairment, women who are breastfeeding or who are trying to become pregnant, and patients with other concomitant diseases. Interestingly, several questions related to topics that are well covered in

  5. Comparison of hospitalizations, emergency department visits, and costs in a historical cohort of Texas Medicaid patients with chronic obstructive pulmonary disease, by initial medication regimen.

    Science.gov (United States)

    Rascati, Karen L; Akazawa, Manabu; Johnsrud, Michael; Stanford, Richard H; Blanchette, Christopher M

    2007-06-01

    Limited information is available on the relative outcomes and treatment costs of various pharmacotherapies for chronic obstructive pulmonary disease (COPD) in a Medicaid population. This study compared the effects of initial medication regimens for COPD on COPD-related and all-cause events (hospitalizations and/or emergency department [ED] visits) and COPD-related and all-cause costs. The study population was a historical cohort of Texas Medicaid beneficiaries aged 40 to 64 years with COPD-related medical costs (International Classification of Diseases, Ninth Revision, Clinical Modification codes 491.xx, 492.xx, 496.xx), 24 months of continuous Medicaid enrollment (12 months before and after the index prescription), and at least 1 prescription claim (index) for a combination product containing fluticasone propionate + salmeterol, an inhaled corticosteroid, salmeterol, or ipratropium between April 1, 2001, and March 31, 2003. The analyses of events employed Cox proportional hazards regression, controlling for baseline factors and preindex events. The analyses of costs used a 2-part model with logistic regression and generalized linear model to adjust for baseline characteristics and preindex utilization and costs. The study population included 6793 patients (1211 combination therapy, 968 inhaled corticosteroid, 401 salmeterol, and 4213 ipratropium). Only combination therapy was associated with a significantly lower risk for any COPD-related event (hazard ratio [HR] = 0.733; 95% CI, 0.650-0.826) and any all-cause event (HR = 0.906; 95% CI, 0.844-0.972) compared with ipratropium. COPD-related prescription costs were higher in all cohorts compared with the ipratropium cohort, but COPD-related medical costs were lower, offsetting the increase in prescription costs. For all-cause costs, prescription costs were higher in the combination-therapy cohort (+$415; P costs in the combination-therapy cohort (-$1735; P costs. In this historical population of Texas Medicaid

  6. 22 CFR 120.30 - The Automated Export System (AES).

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false The Automated Export System (AES). 120.30... DEFINITIONS § 120.30 The Automated Export System (AES). The Automated Export System (AES) is the Department of... system for collection of export data for the Department of State. In accordance with this subchapter U.S...

  7. Process automation

    International Nuclear Information System (INIS)

    Moser, D.R.

    1986-01-01

    Process automation technology has been pursued in the chemical processing industries and to a very limited extent in nuclear fuel reprocessing. Its effective use has been restricted in the past by the lack of diverse and reliable process instrumentation and the unavailability of sophisticated software designed for process control. The Integrated Equipment Test (IET) facility was developed by the Consolidated Fuel Reprocessing Program (CFRP) in part to demonstrate new concepts for control of advanced nuclear fuel reprocessing plants. A demonstration of fuel reprocessing equipment automation using advanced instrumentation and a modern, microprocessor-based control system is nearing completion in the facility. This facility provides for the synergistic testing of all chemical process features of a prototypical fuel reprocessing plant that can be attained with unirradiated uranium-bearing feed materials. The unique equipment and mission of the IET facility make it an ideal test bed for automation studies. This effort will provide for the demonstration of the plant automation concept and for the development of techniques for similar applications in a full-scale plant. A set of preliminary recommendations for implementing process automation has been compiled. Some of these concepts are not generally recognized or accepted. The automation work now under way in the IET facility should be useful to others in helping avoid costly mistakes because of the underutilization or misapplication of process automation. 6 figs

  8. Survey determinant factors of telemedicine strategic planning from the managers and experts perspective in the health department, isfahan university of medical sciences.

    Science.gov (United States)

    Keshvari, Hamid; Haddadpoor, Asefeh; Taheri, Behjat; Nasri, Mehran; Aghdak, Pezhman

    2014-10-01

    Awareness of Outlook, objectives, benefits and impact of telemedicine technology that can promote services quality, reduce costs, increase access to Specialized and subspecialty services, and immediately guide the health system subconsciously to the introduction greater use of technology. Therefore, the aim of this study was to determine the strengths, weaknesses, opportunities and threats in the telemedicine strategic planning from the managers and experts perspective in the health department, Isfahan University of Medical Sciences, in order to take a step towards facilitating strategic planning and approaching the equity aim in health in the province. This is a descriptive-analytical study, that data collection was done cross-sectional. The study population was composed of all managers and certified experts at the health department in Isfahan university of Medical Sciences. The sample size was 60 patients according to inclusion criteria. Information was collected by interview method. Researcher attempted to use the structured and specific questionnaire Then were investigated the viewpoints of experts and managers about determinative factors (strengths, weaknesses, opportunities and threats) in the strategic planning telemedicine. Data were analyzed using descriptive statistics (frequency, mean) and software SPSS 19. Data analysis showed that change management (100%) and continuity of supply of credit (79/3%) were weakness point within the organization and strengths of the program were, identity and health telemedicine programs (100%), goals and aspirations of the current directors of the organization and its compliance with the goals of telemedicine (100%), human resources interested using computers in daily activities in peripheral levels (93/1%). Also organization in the field of IT professionals, had opportunities, and repayment specialist's rights by insurance organizations is a threat for it. According to the strengths, weaknesses, opportunities and threats

  9. Prescription of opioid and nonopioid analgesics for dental care in emergency departments: Findings from the National Hospital Ambulatory Medical Care Survey.

    Science.gov (United States)

    Okunseri, Christopher; Okunseri, Elaye; Xiang, Qun; Thorpe, Joshua M; Szabo, Aniko

    2014-01-01

    The aim of this study was to examine trends and associated factors in the prescription of opioid analgesics, nonopioid analgesics, opioid and nonopioid analgesic combinations, and no analgesics by emergency physicians for nontraumatic dental condition (NTDC)-related visits. Our secondary aim was to investigate whether race/ethnicity is a possible predictor of receiving a prescription for either type of medication for NTDC visits in emergency departments (EDs) after adjustment for potential covariates. We analyzed data from the National Hospital Ambulatory Medical Care Survey for 1997-2000 and 2003-2007, and used multinomial multivariate logistic regression to estimate the probability of receiving a prescription for opioid analgesics, nonopioid analgesics, or a combination of both, compared with receiving no analgesics for NTDC-related visits. During 1997-2000 and 2003-2007, prescription of opioid analgesics and combinations of opioid and nonopioid analgesics increased, and that of no analgesics decreased over time. The prescription rates for opioid analgesics, nonopioid analgesics, opioid and nonopioid analgesic combinations, and no analgesics for NTDC-related visits in EDs were 43 percent, 20 percent, 12 percent, and 25 percent, respectively. Majority of patients categorized as having severe pain received prescriptions for opioids for NTDC-related visits in EDs. After adjusting for covariates, patients with self-reported dental reasons for visit and severe pain had a significantly higher probability of receiving prescriptions for opioid analgesics and opioid and nonopioid analgesic combinations. Prescription of opioid analgesics increased over time. ED physicians were more likely to prescribe opioid analgesics and opioid and nonopioid analgesic combinations for NTDC-related visits with reported severe pain. © 2014 American Association of Public Health Dentistry.

  10. Factors influencing readiness to deploy in disaster response: findings from a cross-sectional survey of the Department of Veterans Affairs Disaster Emergency Medical Personnel System.

    Science.gov (United States)

    Zagelbaum, Nicole K; Heslin, Kevin C; Stein, Judith A; Ruzek, Josef; Smith, Robert E; Nyugen, Tam; Dobalian, Aram

    2014-07-19

    The Disaster Emergency Medical Personnel System (DEMPS) program provides a system of volunteers whereby active or retired Department of Veterans Affairs (VA) personnel can register to be deployed to support other VA facilities or the nation during national emergencies or disasters. Both early and ongoing volunteer training is required to participate. This study aims to identify factors that impact willingness to deploy in the event of an emergency. This analysis was based on responses from 2,385 survey respondents (response rate, 29%). Latent variable path models were developed and tested using the EQS structural equations modeling program. Background demographic variables of education, age, minority ethnicity, and female gender were used as predictors of intervening latent variables of DEMPS Volunteer Experience, Positive Attitude about Training, and Stress. The model had acceptable fit statistics, and all three intermediate latent variables significantly predicted the outcome latent variable Readiness to Deploy. DEMPS Volunteer Experience and a Positive Attitude about Training were associated with Readiness to Deploy. Stress was associated with decreased Readiness to Deploy. Female gender was negatively correlated with Readiness to Deploy; however, there was an indirect relationship between female gender and Readiness to Deploy through Positive Attitude about Training. These findings suggest that volunteer emergency management response programs such as DEMPS should consider how best to address the factors that may make women less ready to deploy than men in order to ensure adequate gender representation among emergency responders. The findings underscore the importance of training opportunities to ensure that gender-sensitive support is a strong component of emergency response, and may apply to other emergency response programs such as the Medical Reserve Corps and the American Red Cross.

  11. Improving patient safety and efficiency of medication reconciliation through the development and adoption of a computer-assisted tool with automated electronic integration of population-based community drug data: the RightRx project.

    Science.gov (United States)

    Tamblyn, Robyn; Winslade, Nancy; Lee, Todd C; Motulsky, Aude; Meguerditchian, Ari; Bustillo, Melissa; Elsayed, Sarah; Buckeridge, David L; Couture, Isabelle; Qian, Christina J; Moraga, Teresa; Huang, Allen

    2018-05-01

    Many countries require hospitals to implement medication reconciliation for accreditation, but the process is resource-intensive, thus adherence is poor. We report on the impact of prepopulating and aligning community and hospital drug lists with data from population-based and hospital-based drug information systems to reduce workload and enhance adoption and use of an e-medication reconciliation application, RightRx. The prototype e-medical reconciliation web-based software was developed for a cluster-randomized trial at the McGill University Health Centre. User-centered design and agile development processes were used to develop features intended to enhance adoption, safety, and efficiency. RightRx was implemented in medical and surgical wards, with support and training provided by unit champions and field staff. The time spent per professional using RightRx was measured, as well as the medication reconciliation completion rates in the intervention and control units during the first 20 months of the trial. Users identified required modifications to the application, including the need for dose-based prescribing, the role of the discharge physician in prescribing community-based medication, and access to the rationale for medication decisions made during hospitalization. In the intervention units, both physicians and pharmacists were involved in discharge reconciliation, for 96.1% and 71.9% of patients, respectively. Medication reconciliation was completed for 80.7% (surgery) to 96.0% (medicine) of patients in the intervention units, and 0.7% (surgery) to 82.7% of patients in the control units. The odds of completing medication reconciliation were 9 times greater in the intervention compared to control units (odds ratio: 9.0, 95% confidence interval, 7.4-10.9, P < .0001) after adjusting for differences in patient characteristics. High rates of medication reconciliation completion were achieved with automated prepopulation and alignment of community and hospital

  12. Distribution automation

    International Nuclear Information System (INIS)

    Gruenemeyer, D.

    1991-01-01

    This paper reports on a Distribution Automation (DA) System enhances the efficiency and productivity of a utility. It also provides intangible benefits such as improved public image and market advantages. A utility should evaluate the benefits and costs of such a system before committing funds. The expenditure for distribution automation is economical when justified by the deferral of a capacity increase, a decrease in peak power demand, or a reduction in O and M requirements

  13. Controls and automation in the SPIRAL project

    International Nuclear Information System (INIS)

    Bothner, U.; Boulot, A.; Maherault, J.; Martial, L.

    1999-01-01

    The control and automation team of the R and D of Accelerator-Exotic Beam Department has had in the framework of SPIRAL collaboration the following tasks: 1. automation of the resonator high frequency equipment of the CIME cyclotron; 2. automation of the vacuum equipment, i.e. the low energy line (TBE), the CIME cyclotron, the low energy line (BE); 3. automation of load safety for power supply; 4. for each of these tasks a circuitry file based on the SCHEMA software has been worked out. The programs required in the automation of load safety for power supply (STEP5, PROTOOL, DESIGNER 4.1) were developed and implemented for PC

  14. Decoupling of the minority PhD talent pool and assistant professor hiring in medical school basic science departments in the US

    Science.gov (United States)

    Gibbs, Kenneth D; Basson, Jacob; Xierali, Imam M; Broniatowski, David A

    2016-01-01

    Faculty diversity is a longstanding challenge in the US. However, we lack a quantitative and systemic understanding of how the career transitions into assistant professor positions of PhD scientists from underrepresented minority (URM) and well-represented (WR) racial/ethnic backgrounds compare. Between 1980 and 2013, the number of PhD graduates from URM backgrounds increased by a factor of 9.3, compared with a 2.6-fold increase in the number of PhD graduates from WR groups. However, the number of scientists from URM backgrounds hired as assistant professors in medical school basic science departments was not related to the number of potential candidates (R2=0.12, p>0.07), whereas there was a strong correlation between these two numbers for scientists from WR backgrounds (R2=0.48, pprofessors and posited no hiring discrimination. Simulations show that, given current transition rates of scientists from URM backgrounds to faculty positions, faculty diversity would not increase significantly through the year 2080 even in the context of an exponential growth in the population of PhD graduates from URM backgrounds, or significant increases in the number of faculty positions. Instead, the simulations showed that diversity increased as more postdoctoral candidates from URM backgrounds transitioned onto the market and were hired. DOI: http://dx.doi.org/10.7554/eLife.21393.001 PMID:27852433

  15. [The teaching of orthodontics in the opinion of students from Department of Dentistry of Pomeranian Medical University in the academic year of 2005/2006].

    Science.gov (United States)

    Syryńska, Maria; Post, Marcin; Tsynkel, Pavel; Durka, Magdalena

    2007-01-01

    The aim of the paper was to get to know, collect and present information provided by students about classes from orthodontic and their opinion regarding the conduction of clinical and theoretical exercises. The study group was comprised of 69 fifth year students from the Department of Orthodontics of the Pomeranian Medical University. The material was collected by the use of an anonymous questionnaire distributed after the final exam from orthodontics. The questionnaire was created for the study and contained 6 questions. Most of the students have admitted that knowledge gained during the 4th year was useful on the 5th year and that the information presented on orthodontic seminars during the 5th year was beneficial in regard to clinical exercises. Graduates have admitted that they felt well prepared in the field of orthodontic profilaxis and removable appliances but not enough prepared in the field of fixed appliances, retention and the repair of damaged appliances. The number of patients on clinical exercises in most answers was rated as "enough". Most of the students have answered that the way of the exercises have been conducted in their groups was acceptable and the time on exercises has been properly used. Laboratory exercises and seminars on the 4th and 5th year of studies have supplemented the knowledge of students and prepared them for clinical work in orthodontics. Students have proved to be good observers when indicating the weak points of didactics.

  16. Office of Coast Survey's Automated Wreck and Obstruction Information System

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Automated Wreck and Obstruction Information System (AWOIS) is an automated file that contains information on wrecks and obstructions, and other significant...

  17. Safeguards through secure automated fabrication

    International Nuclear Information System (INIS)

    DeMerschman, A.W.; Carlson, R.L.

    1982-01-01

    Westinghouse Hanford Company, a prime contractor for the U.S. Department of Energy, is constructing the Secure Automated Fabrication (SAF) line for fabrication of mixed oxide breeder fuel pins. Fuel processing by automation, which provides a separation of personnel from fuel handling, will provide a means whereby advanced safeguards concepts will be introduced. Remote operations and the inter-tie between the process computer and the safeguards computer are discussed

  18. Automated sample analysis and remediation

    International Nuclear Information System (INIS)

    Hollen, R.; Settle, F.

    1995-01-01

    The Contaminant Analysis Automation Project is developing an automated chemical analysis system to address the current needs of the US Department of Energy (DOE). These needs focus on the remediation of large amounts of radioactive and chemically hazardous wastes stored, buried and still being processed at numerous DOE sites. This paper outlines the advantages of the system under development, and details the hardware and software design. A prototype system for characterizing polychlorinated biphenyls in soils is also described

  19. Automated external defibrillators in National Collegiate Athletic Association Division I Athletics.

    Science.gov (United States)

    Coris, Eric E; Sahebzamani, Frances; Walz, Steve; Ramirez, Arnold M

    2004-01-01

    Sudden cardiac death is the leading cause of death in athletes. Evidence on current sudden cardiac death prevention through preparticipation history, physicals, and noninvasive cardiovascular diagnostics has demonstrated a low sensitivity for detection of athletes at high risk of sudden cardiac death. Data are lacking on automated external defibrillator programs specifically initiated to respond to rare dysrhythmia in younger, relatively low-risk populations. Surveys were mailed to the head athletic trainers of all National Collegiate Athletic Association Division I athletics programs listed in the National Athletic Trainers' Association directory. In all, 303 surveys were mailed; 186 departments (61%) responded. Seventy-two percent (133) of responding National Collegiate Athletic Association Division I athletics programs have access to automated external defibrillator units; 54% (101) own their units. Proven medical benefit (55%), concern for liability (51%), and affordability (29%) ranked highest in frequency of reasons for automated external defibrillator purchase. Unit cost (odds ratio = 1.01; 95% confidence interval, 1.01-1.0), donated units (odds ratio = 1.92; confidence interval, 3.66-1.01), institution size (odds ratio =.0001; confidence interval, 1.3 E-4 to 2.2E-05), and proven medical benefit of automated external defibrillators (odds ratio = 24; confidence interval, 72-8.1) were the most significant predictors of departmental defibrillator ownership. Emergency medical service response time and sudden cardiac death event history were not significantly predictive of departmental defibrillator ownership. The majority of automated external defibrillator interventions occurred on nonathletes. Many athletics medicine programs are obtaining automated external defibrillators without apparent criteria for determination of need. Usage and maintenance policies vary widely among departments with unit ownership or access. Programs need to approach the issue of unit

  20. Investigative report, science committee of Aggregate corporation Radiological technologist society of the Oita prefecture. Questionnaires research on security control of department of radiological technology of medical facilities in the Oita prefecture. The second report. Research on high risk incident measures

    International Nuclear Information System (INIS)

    Eto, Yoshihiro; Mano, Isao; Takagi, Ikuya; Murakami, Yasunori; Sueyoshi, Seiji; Yoshimoto, Asahi

    2007-01-01

    Oita association of radiological technologists carried out the questionnaires about the measures against high lisk incidental in department of radiological technology at the medical facilities in Oita. We distributed the questionnaire to 102 facilities, which are worked by the technologists (member), and got response from 91 facilities (89%). Research contents are Patient verification method'' ''Input and verification of patient attribute'' ''Infection in hospital'' ''Stumbles and falls of patient'' Contrast enhancement CT'' ''Something related to pacemaker'' ''MRI inspection and the magnetic substance'' ''Remedy mistake'' and ''Risk management''. The Result, Low level recognition contents of medical accident measures are ''Contrast enhancement CT'' ''Stumbles and falls of patient'' Risk management of department of radiological technology''. (author)

  1. Fire Department Emergency Response

    International Nuclear Information System (INIS)

    Blanchard, A.; Bell, K.; Kelly, J.; Hudson, J.

    1997-09-01

    In 1995 the SRS Fire Department published the initial Operations Basis Document (OBD). This document was one of the first of its kind in the DOE complex and was widely distributed and reviewed. This plan described a multi-mission Fire Department which provided fire, emergency medical, hazardous material spill, and technical rescue services

  2. Implementation of the patient-centered medical home in the Veterans Health Administration: associations with patient satisfaction, quality of care, staff burnout, and hospital and emergency department use.

    Science.gov (United States)

    Nelson, Karin M; Helfrich, Christian; Sun, Haili; Hebert, Paul L; Liu, Chuan-Fen; Dolan, Emily; Taylor, Leslie; Wong, Edwin; Maynard, Charles; Hernandez, Susan E; Sanders, William; Randall, Ian; Curtis, Idamay; Schectman, Gordon; Stark, Richard; Fihn, Stephan D

    2014-08-01

    In 2010, the Veterans Health Administration (VHA) began implementing the patient-centered medical home (PCMH) model. The Patient Aligned Care Team (PACT) initiative aims to improve health outcomes through team-based care, improved access, and care management. To track progress and evaluate outcomes at all VHA primary care clinics, we developed and validated a method to assess PCMH implementation. To create an index that measures the extent of PCMH implementation, describe variation in implementation, and examine the association between the implementation index and key outcomes. We conducted an observational study using data on more than 5.6 million veterans who received care at 913 VHA hospital-based and community-based primary care clinics and 5404 primary care staff from (1) VHA clinical and administrative databases, (2) a national patient survey administered to a weighted random sample of veterans who received outpatient care from June 1 to December 31, 2012, and (3) a survey of all VHA primary care staff in June 2012. Composite scores were constructed for 8 core domains of PACT: access, continuity, care coordination, comprehensiveness, self-management support, patient-centered care and communication, shared decision making, and team-based care. Patient satisfaction, rates of hospitalization and emergency department use, quality of care, and staff burnout. Fifty-three items were included in the PACT Implementation Progress Index (Pi2). Compared with the 87 clinics in the lowest decile of the Pi2, the 77 sites in the top decile exhibited significantly higher patient satisfaction (9.33 vs 7.53; P hospitalization rates for ambulatory care-sensitive conditions (4.42 vs 3.68 quarterly admissions for veterans 65 years or older per 1000 patients; P < .001), and lower emergency department use (188 vs 245 visits per 1000 patients; P < .001). The extent of PCMH implementation, as measured by the Pi2, was highly associated with important outcomes for both

  3. Automated delivery of codes for charge in radiotherapy

    International Nuclear Information System (INIS)

    Sauer, Michael; Volz, Steffen; Hall, Markus; Roehner, Fred; Frommhold, Hermann; Grosu, Anca-Ligia; Heinemann, Felix

    2010-01-01

    Background and purpose: for the medical billing of Radiotherapy every fraction has to be encoded, including date and time of all administered treatments. With fractions averaging 30 per patient and about 2,500 new patients every year the number of Radiotherapy codes reaches an amount of 70,000 and more. Therefore, an automated proceeding for transferring and processing therapy codes has been developed at the Department of Radiotherapy Freiburg, Germany. This is a joint project of the Department of Radiotherapy, the Administration Department, and the Central II Department of the University Hospital of Freiburg. Material and methods: the project consists of several modules whose collaboration makes the projected automated transfer of treatment codes possible. The first step is to extract the data from the department's Clinical Information System (MOSAIQ). These data are transmitted to the Central IT Department via an HL7 interface, where a check for corresponding hospitalization data is performed. In the further processing of the data, a matching table plays an important role allowing the transformation of a treatment code into a valid medical billing code. In a last step, the data are transferred to the medical billing system. Results and conclusion: after assembling and implementing the particular modules successfully, a first beta test was launched. In order to test the modules separately as well as the interaction of the components, extensive tests were performed during March 2006. Soon it became clear that the tested procedure worked efficiently and accurately. In April 2006, a pilot project with a few qualities of treatment (e.g., computed tomography, simulation) was put into practice. Since October 2006, nearly all Radiation Therapy codes (∝ 75,000) are being transferred to the comprehensive Hospital Information System (HIS) automatically in a daily routine. (orig.)

  4. Virtual automation.

    Science.gov (United States)

    Casis, E; Garrido, A; Uranga, B; Vives, A; Zufiaurre, C

    2001-01-01

    Total laboratory automation (TLA) can be substituted in mid-size laboratories by a computer sample workflow control (virtual automation). Such a solution has been implemented in our laboratory using PSM, software developed in cooperation with Roche Diagnostics (Barcelona, Spain), to this purpose. This software is connected to the online analyzers and to the laboratory information system and is able to control and direct the samples working as an intermediate station. The only difference with TLA is the replacement of transport belts by personnel of the laboratory. The implementation of this virtual automation system has allowed us the achievement of the main advantages of TLA: workload increase (64%) with reduction in the cost per test (43%), significant reduction in the number of biochemistry primary tubes (from 8 to 2), less aliquoting (from 600 to 100 samples/day), automation of functional testing, drastic reduction of preanalytical errors (from 11.7 to 0.4% of the tubes) and better total response time for both inpatients (from up to 48 hours to up to 4 hours) and outpatients (from up to 10 days to up to 48 hours). As an additional advantage, virtual automation could be implemented without hardware investment and significant headcount reduction (15% in our lab).

  5. Attitudes and opinions of nursing and medical staff regarding the supply and storage of medicinal products before and after the installation of a drawer-based automated stock-control system.

    Science.gov (United States)

    Ardern-Jones, Joanne; Hughes, Donald K; Rowe, Philip H; Mottram, David R; Green, Christopher F

    2009-04-01

    This study assessed the attitudes of Emergency Department (ED) staff regarding the introduction of an automated stock-control system. The objectives were to determine attitudes to stock control and replenishment, speed of access to the system, ease of use and the potential for future uses of the system. The study was carried out in the Countess of Chester Hospital NHS Foundation Trust (COCH) ED, which is attended by over 65,000 patients each year. All 68 ED staff were sent pre-piloted, semi-structured questionnaires and reminders, before and after automation of medicines stock control. Pre-implementation, 35 staff (66.1% of respondents) reported that problems occurred with access to medicine storage keys 'very frequently' or 'frequently'. Twenty-eight (52.8%) respondents 'agreed' or 'strongly agreed' that medicines were quickly accessed, which rose to 41 (77%) post-automation (P fluids and refrigerated items. Twenty-seven (51.9%) staff reported access to the system within 1 min and 17 (32.7%) staff reported access within 1-2 min. The majority of staff found the system 'easy' or 'very easy' to use and there was a non-significant relationship between previous use of information technology and acceptance of the system. From a staff satisfaction perspective, automation improved medicines storage, security and stock control, and addressed the problem of searching for keys to storage areas. Concerns over familiarity with computers, queuing, speed of access and an improved audit trail do not appear to have been issues, when compared with the previous manual storage of medicines.

  6. Cranioplasty as the return-to-work factor - 112 patients with cranial defects treated in the Department of Neurosurgery at the Medical University of Lodz.

    Science.gov (United States)

    Kasprzak, Piotr; Ormezowska, Elżbieta; Jaskólski, Dariusz

    2017-07-14

    The number of craniectomies and the consequent reconstructive procedures has grown during the past decades. Cranial defects and methods of their repair could have some influence on work capability of the patients and their employability. The authors analyzed a group of 112 patients with cranial defects treated in the Department of Neurosurgery at the Medical University of Lodz, Poland, in the course of the katamnestic period longer than 6 months after reconstructive operation, and observed them between February 2008 and February 2015. Their work capability and employment were compared, all the patients were interviewed concerning the reasons for not working according to the Social Insurance Institution predication procedure. Before the cranioplasty, all the patients were capable of working without limitations according to biological criteria and 89 of them were employed. Twenty-three not working people consisted of 6 pupils, 7 retired and 10 not working for other reasons. During the period between the craniectomy and the cranioplasty, 88 patients were capable of working and only 2 were employed. After the reconstruction, 93 were capable of working without limitations and 16 - with limitations. Forty-seven were employed during the period of the follow-up, the rest of patients consisted of 2 pupils, 13 retired and 50 not working for various reasons. Cranioplasty is a very important factor contributing to return to work. This outcome may be seen as having a great social value and be added to the functions of cranial repair as protective, esthetic and normalizing the intracranial pressure previously described in the literature. Int J Occup Med Environ Health 2017;30(5):803-809. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  7. Powder handling for automated fuel processing

    International Nuclear Information System (INIS)

    Frederickson, J.R.; Eschenbaum, R.C.; Goldmann, L.H.

    1989-01-01

    Installation of the Secure Automated Fabrication (SAF) line has been completed. It is located in the Fuel Cycle Plant (FCP) at the Department of Energy's (DOE) Hanford site near Richland, Washington. The SAF line was designed to fabricate advanced reactor fuel pellets and assemble fuel pins by automated, remote operation. This paper describes powder handling equipment and techniques utilized for automated powder processing and powder conditioning systems in this line. 9 figs

  8. Automating Finance

    Science.gov (United States)

    Moore, John

    2007-01-01

    In past years, higher education's financial management side has been riddled with manual processes and aging mainframe applications. This article discusses schools which had taken advantage of an array of technologies that automate billing, payment processing, and refund processing in the case of overpayment. The investments are well worth it:…

  9. Library Automation.

    Science.gov (United States)

    Husby, Ole

    1990-01-01

    The challenges and potential benefits of automating university libraries are reviewed, with special attention given to cooperative systems. Aspects discussed include database size, the role of the university computer center, storage modes, multi-institutional systems, resource sharing, cooperative system management, networking, and intelligent…

  10. Automated breeder fuel fabrication

    International Nuclear Information System (INIS)

    Goldmann, L.H.; Frederickson, J.R.

    1983-01-01

    The objective of the Secure Automated Fabrication (SAF) Project is to develop remotely operated equipment for the processing and manufacturing of breeder reactor fuel pins. The SAF line will be installed in the Fuels and Materials Examination Facility (FMEF). The FMEF is presently under construction at the Department of Energy's (DOE) Hanford site near Richland, Washington, and is operated by the Westinghouse Hanford Company (WHC). The fabrication and support systems of the SAF line are designed for computer-controlled operation from a centralized control room. Remote and automated fuel fabriction operations will result in: reduced radiation exposure to workers; enhanced safeguards; improved product quality; near real-time accountability, and increased productivity. The present schedule calls for installation of SAF line equipment in the FMEF beginning in 1984, with qualifying runs starting in 1986 and production commencing in 1987. 5 figures

  11. Results of the implementation of a new screening protocol for child maltreatment at the Emergency Department of the Academic Medical Center in Amsterdam.

    Science.gov (United States)

    Teeuw, Arianne H; Sieswerda-Hoogendoorn, Tessa; Sangers, Esmée J; Heymans, Hugo S A; van Rijn, Rick R

    2016-01-01

    This study examines the results of the implementation of a new screening protocol for child maltreatment (CM) at the Emergency Department (ED) of the Academic Medical Center in Amsterdam, The Netherlands. This protocol consists of adding a so called 'top-toe' inspection (TTI), an inspection of the fully undressed child, to the screening checklist for child maltreatment, the SPUTOVAMO. We collected data from all patients 0-18 years old directly after introduction (February 2010) and 9 months later. Outcome measures were: completion of the screening and reasons for non-adherence. Data were collected on age, gender, reason for visiting the ED (defined by International Classification of Disease, ICD), presence of a chronic illness, type of professional performing the TTI and admission during week or weekend days. In February 560 and in November 529 paediatric patients were admitted. In February the complete screening protocol was performed in 42% of all children, in November in 17%. A correlation between completion of the SPUTOVAMO and having a TTI performed was found. Older age and presence of a chronic illness influenced the chance of having both SPUTOVAMO and TTI performed negatively. The completion rate of SPUTOVAMO was influenced by ICD code. Completion of TTI was influenced by type of investigator. The best performing professional was the ED physician followed by the paediatrician followed by the ED nurse. The reasons for not performing a TTI were not documented. Refusal of the TTI by a patient or parent was reported three times. Implementation of this new screening protocol for CM was only mildly successful and declined in time. A negative correlation between older child age and having a chronic illness and completion of the screening was found. A practical recommendation resulting from this study could be that, if CM screening protocols prove to be effective in detecting CM, regular training sessions have to be held. Filling out the checklist is something that

  12. Automated Safety Incident Surveillance and Tracking System (ASISTS)

    Data.gov (United States)

    Department of Veterans Affairs — The Automated Safety Incident Surveillance and Tracking System (ASISTS) is a repository of Veterans Health Administration (VHA) employee accident data. Many types of...

  13. A Study to Develop the Optimal Military Inter-Institutional Patient Referral Systems Model for DoD (Department of Defense) Military Medical Region III

    Science.gov (United States)

    1988-05-01

    I rerr syttemn an do wlon t P ontimal military inter-instittiuonal patient referral systems model for DOD Military Medical Region III. A convenience...Dactin- on the Armed Services Medical Regulating Office and Patient Airlift "lc rcsusl.s of :his study indicated that the single largest breakdown...and the requirement to regulate to the closest medical facility with capability to care for the patient . L! / I Ii I i A STUDY TO DEVELOP THE OPTIMAL

  14. Evaluation of Automated Flagger Assistance Devices

    Science.gov (United States)

    2018-02-01

    Automated flagger assistance devices (AFADs) are designed to improve worker safety by replacing flaggers who are typically located near traffic approaching a work zone. In this study, a new AFAD developed by the Missouri Department of Transportation ...

  15. 32 CFR Appendix C to Part 57 - Procedures for the Provision of Related Services by the Military Medical Departments to DoDDS...

    Science.gov (United States)

    2010-07-01

    ... EDIS shall ensure that a qualified medical authority conducts or verifies a medical evaluation for use... to the questions posed in the original referral. The written report shall include: (i) Demographic... initial parental permission, EDIS must: (i) Obtain parental permission for the additional activities. (ii...

  16. An Analysis of Primary Care Provider Productivity in the Department of Family and Community Medicine at Carl R. Darnall Army Medical Center

    Science.gov (United States)

    2007-06-08

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

  17. Automated Extraction of Genomic DNA from Medically Important Yeast Species and Filamentous Fungi by Using the MagNA Pure LC System

    OpenAIRE

    Loeffler, Juergen; Schmidt, Kathrin; Hebart, Holger; Schumacher, Ulrike; Einsele, Hermann

    2002-01-01

    A fully automated assay was established for the extraction of DNA from clinically important fungi by using the MagNA Pure LC instrument. The test was evaluated by DNA isolation from 23 species of yeast and filamentous fungi and by extractions (n = 28) of serially diluted Aspergillus fumigatus conidia (105 to 0 CFU/ml). Additionally, DNA from 67 clinical specimens was extracted and compared to the manual protocol. The detection limit of the MagNA Pure LC assay of 10 CFU corresponded to the sen...

  18. A Review of Automated Decision Support System

    African Journals Online (AJOL)

    pc

    2018-03-05

    Mar 5, 2018 ... Intelligence AI that enable decision automation based on existing facts, knowledge ... The growing reliance on data impacts dynamic data extraction and retrieval of the ... entertainment, medical, and the web. III. DECISION ...

  19. Activity measurements using recessed ionization chambers (activity meters) as performed in the Department for Nuclear Medicine at the Hanover Medical School

    International Nuclear Information System (INIS)

    Meyer, G.J.; Matzke, K.H.; Kuehn, J.

    1992-01-01

    Recessed ionization chambers have an application in the production and dose determination of radiopharmaceuticals. The measuring instrumentation installed in the radiochemical department, service instructions, quality assurance measures and relevant practical experiences are described in brief. (DG) [de

  20. Automated extraction of genomic DNA from medically important yeast species and filamentous fungi by using the MagNA Pure LC system.

    Science.gov (United States)

    Loeffler, Juergen; Schmidt, Kathrin; Hebart, Holger; Schumacher, Ulrike; Einsele, Hermann

    2002-06-01

    A fully automated assay was established for the extraction of DNA from clinically important fungi by using the MagNA Pure LC instrument. The test was evaluated by DNA isolation from 23 species of yeast and filamentous fungi and by extractions (n = 28) of serially diluted Aspergillus fumigatus conidia (10(5) to 0 CFU/ml). Additionally, DNA from 67 clinical specimens was extracted and compared to the manual protocol. The detection limit of the MagNA Pure LC assay of 10 CFU corresponded to the sensitivity when DNA was extracted manually; in 9 of 28 runs, we could achieve a higher sensitivity of 1 CFU/ml blood, which was found to be significant (p DNA from all fungal species analyzed could be extracted and amplified by real-time PCR. Negative controls from all MagNA Pure isolations remained negative. Sixty-three clinical samples showed identical results by both methods, whereas in 4 of 67 samples, discordant results were obtained. Thus, the MagNA Pure LC technique offers a fast protocol for automated DNA isolation from numerous fungi, revealing high sensitivity and purity.

  1. Algorithm for the prophylaxis of septic complications in orthopedics and traumatology of locomotor system at the Department of Orthopedics at the Postgraduate Medical Education Center in Otwock.

    Science.gov (United States)

    Białecki, Jerzy; Brychcy, Adrian; Marczyński, Wojciech Józef

    2013-09-18

    Current state of knowledge in a matter of septic complications after procedures with orthopaedic device implantation with particular consideration of THA and TKA is presented in the paper. Implant biocompatibility phenomenon as well as systemic reaction to its presence is also discussed. Algorithm for prophylactics of septic complications followed in Orthopaedic Department of PMEC in Otwock is introduced. Article is based on clinical observations of Orthopaedic Department's PMEC team.  

  2. Metallurgy Department

    DEFF Research Database (Denmark)

    Risø National Laboratory, Roskilde

    The activities of the Metallurgy Department at Risø during 1981 are described. The work is presented in three chapters: General Materials Research, Technology and Materials Development, Fuel Elements. Furthermore, a survey is given of the department's participation in international collaboration...

  3. ٍEffective factors on the Incidence of medication errors from the nursing staff perspective in various department of Fasa Hospital

    Directory of Open Access Journals (Sweden)

    Mostafa Bizhani

    2013-06-01

    Full Text Available  Background and Objective: The incidence of medical errors is deemed one of the unavoidable cases of serious threats to the health and safety of patients. This study aimed to determine the factors influencing medication errors from the perspective of the nursing staff. Materials and Methods: This descriptive -analytic study recruited 80 nurses working in various wards in Fasa Hospital. The nurses were selected via the availability sampling method, and their perspective on factors affecting medication errors was gathered using a questionnaire designed for this study. The data were analyzed with SPSS-15 software.   Results: The most important causes of medication errors were work fatigue, low nurse-to-patient ratio, long working hours, high density of work in units, and doing other tasks. Other variables such as age and gender as well as factors effective on the incidence of medication errors are mentioned in the full text. Conclusion: From the nurses’ standpoint, workload and the patient-to-nurse ratio were the most significant factors leading to medication errors.

  4. Public Health Ministere stablish that all medical equipment records request who emit ionizing radiations providing health organizations, Public or privates, such as enterprise who trade medical products, have to be carry out between of the Public a Health Ministere Technology Department and DINATEN of the Industry energy and Mining Ministere

    International Nuclear Information System (INIS)

    2004-01-01

    The present decree stablish that the evaluation of all the applications of registration of medical teams that emit ionizing radiations, coming from the institutions of health, you publish or private, as well as companies that market medical products will be carried out among the Department of Technology it Prescribes of the Ministry of Health it Public and the DINATEN of the Ministry of Industry Energy and Mining

  5. Plant automation

    International Nuclear Information System (INIS)

    Christensen, L.J.; Sackett, J.I.; Dayal, Y.; Wagner, W.K.

    1989-01-01

    This paper describes work at EBR-II in the development and demonstration of new control equipment and methods and associated schemes for plant prognosis, diagnosis, and automation. The development work has attracted the interest of other national laboratories, universities, and commercial companies. New initiatives include use of new control strategies, expert systems, advanced diagnostics, and operator displays. The unique opportunity offered by EBR-II is as a test bed where a total integrated approach to automatic reactor control can be directly tested under real power plant conditions

  6. 2013 Chinese Intelligent Automation Conference

    CERN Document Server

    Deng, Zhidong

    2013-01-01

    Proceedings of the 2013 Chinese Intelligent Automation Conference presents selected research papers from the CIAC’13, held in Yangzhou, China. The topics include e.g. adaptive control, fuzzy control, neural network based control, knowledge based control, hybrid intelligent control, learning control, evolutionary mechanism based control, multi-sensor integration, failure diagnosis, and reconfigurable control. Engineers and researchers from academia, industry, and government can gain an inside view of new solutions combining ideas from multiple disciplines in the field of intelligent automation.   Zengqi Sun and Zhidong Deng are professors at the Department of Computer Science, Tsinghua University, China.

  7. 2013 Chinese Intelligent Automation Conference

    CERN Document Server

    Deng, Zhidong

    2013-01-01

    Proceedings of the 2013 Chinese Intelligent Automation Conference presents selected research papers from the CIAC’13, held in Yangzhou, China. The topics include e.g. adaptive control, fuzzy control, neural network based control, knowledge based control, hybrid intelligent control, learning control, evolutionary mechanism based control, multi-sensor integration, failure diagnosis, and reconfigurable control. Engineers and researchers from academia, industry, and government can gain an inside view of new solutions combining ideas from multiple disciplines in the field of intelligent automation. Zengqi Sun and Zhidong Deng are professors at the Department of Computer Science, Tsinghua University, China.

  8. 76 FR 69755 - National Customs Automation Program Test Concerning Automated Commercial Environment (ACE...

    Science.gov (United States)

    2011-11-09

    ... DEPARTMENT OF HOMELAND SECURITY U.S. Customs and Border Protection National Customs Automation... announces U.S. Customs and Border Protection's (CBP's) plan to conduct a National Customs Automation Program... conveyance transporting the cargo to the United States. This data will fulfill merchandise entry requirements...

  9. WIDAFELS flexible automation systems

    International Nuclear Information System (INIS)

    Shende, P.S.; Chander, K.P.; Ramadas, P.

    1990-01-01

    After discussing the various aspects of automation, some typical examples of various levels of automation are given. One of the examples is of automated production line for ceramic fuel pellets. (M.G.B.)

  10. An Automation Planning Primer.

    Science.gov (United States)

    Paynter, Marion

    1988-01-01

    This brief planning guide for library automation incorporates needs assessment and evaluation of options to meet those needs. A bibliography of materials on automation planning and software reviews, library software directories, and library automation journals is included. (CLB)

  11. 75 FR 22846 - Norgren Automation Solutions, Including Workers Whose Unemployment Insurance (UI) Wages Are Paid...

    Science.gov (United States)

    2010-04-30

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-72,524] Norgren Automation... Engineering and Automation Division, A Subsidiary of Norgren, Inc.: Clinton Township, MI; Amended... workers of Norgren Automation Solutions, Erie Engineering and Automation Division, a subsidiary of Norgren...

  12. Low cost automation

    International Nuclear Information System (INIS)

    1987-03-01

    This book indicates method of building of automation plan, design of automation facilities, automation and CHIP process like basics of cutting, NC processing machine and CHIP handling, automation unit, such as drilling unit, tapping unit, boring unit, milling unit and slide unit, application of oil pressure on characteristics and basic oil pressure circuit, application of pneumatic, automation kinds and application of process, assembly, transportation, automatic machine and factory automation.

  13. Automated processing of electronic medical records is a reliable method of determining aspirin use in populations at risk for cardiovascular events.

    Science.gov (United States)

    Pakhomov, Serguei Vs; Shah, Nilay D; Hanson, Penny; Balasubramaniam, Saranya C; Smith, Steven A

    2010-01-01

    Low-dose aspirin reduces cardiovascular risk; however, monitoring over-the-counter medication use relies on the time-consuming and costly manual review of medical records. Our objective is to validate natural language processing (NLP) of the electronic medical record (EMR) for extracting medication exposure and contraindication information. The text of EMRs for 499 patients with type 2 diabetes was searched using NLP for evidence of aspirin use and its contraindications. The results were compared to a standardised manual records review. Of the 499 patients, 351 (70%) were using aspirin and 148 (30%) were not, according to manual review. NLP correctly identified 346 of the 351 aspirin-positive and 134 of the 148 aspirin-negative patients, indicating a sensitivity of 99% (95% CI 97-100) and specificity of 91% (95% CI 88-97). Of the 148 aspirin-negative patients, 66 (45%) had contraindications and 82 (55%) did not, according to manual review. NLP search for contraindications correctly identified 61 of the 66 patients with contraindications and 58 of the 82 patients without, yielding a sensitivity of 92% (95% CI 84-97) and a specificity of 71% (95% CI 60-80). NLP of the EMR is accurate in ascertaining documented aspirin use and could potentially be used for epidemiological research as a source of cardiovascular risk factor information.

  14. Medical assistance in the management of nuclear power plant accidents. Guide for: medical personnel of emergency preparedness services, doctors of emergency departments, doctors for out-patient or in-patient treatment. 2. rev. ed.

    International Nuclear Information System (INIS)

    Gumprecht, D.; Haehnel, S.

    1995-01-01

    The guide explains the medical tasks and activities in the context of the emergency preparedness programmes and provisions established by the Laender. The medical expert for radiation injuries is a particularly important function in the radiologial accident management services. The provisions for medical care have been determined on the basis of knowledge drawn among other sources from the German Nuclear Power Plant Risk Study, Phase B. In addition, the guide's provisions are based on international knowledge about the consequences of enhanced radiation exposure, and the medical tasks and the required organisational infrastructure have been determined accordingly. A further source of reference for planning the activities are the data accumulated during emergency preparedness training activities in the various Laender. (orig./MG). 3 figs., 5 tabs [de

  15. The relationship between critical thinking and self-esteem of nurses in emergency departments of hospitals affiliated to kerman university of medical sciences in 1393

    OpenAIRE

    Sara sarmast; Batool Pouraboli; Sakineh Miri; batool Tirgari

    2016-01-01

    This is correlational descriptive study that the number of 121 nurses working in emergency affiliated with the University of Medical Sciences were studied by census method, the total of 108 completed questionnaires were returned. The instruments included demographic characteristics questionnaire, California critical thinking and the Rosenberg self-esteem. The collected data were entered into SPSS software with version 20, and using descriptive statistic methods, correlation analysis was perfo...

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

    Science.gov (United States)

    2008-06-01

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

  17. 77: Development, utilization and evolution of a computer system for treatment follow-up and medical management of a radiotherapy department

    International Nuclear Information System (INIS)

    Costa, A.; Leca, M.; Marcie, S.; Rameau, P.; Lagrange, J.L.; Chauvel, P.; Hery, M.; Lalanne, C.M.

    1987-01-01

    SISGRAD, a computer system developed in the Radiotherapy Dept. of the Centre A. Lacassagne, has been operational for 5 years. This network of microcomputers is connected to the computers used for dosimetry, and is integrated in the hospital's general computer system. SISGRAD was designed primarily to verify that prescribed irradiation treatments are given properly and to improve medical and administrative management of the Dept. SISGRAD is also utilized to provide information to data bases. 22 refs.; 2 figs.; 1 table

  18. Automation 2017

    CERN Document Server

    Zieliński, Cezary; Kaliczyńska, Małgorzata

    2017-01-01

    This book consists of papers presented at Automation 2017, an international conference held in Warsaw from March 15 to 17, 2017. It discusses research findings associated with the concepts behind INDUSTRY 4.0, with a focus on offering a better understanding of and promoting participation in the Fourth Industrial Revolution. Each chapter presents a detailed analysis of a specific technical problem, in most cases followed by a numerical analysis, simulation and description of the results of implementing the solution in a real-world context. The theoretical results, practical solutions and guidelines presented are valuable for both researchers working in the area of engineering sciences and practitioners looking for solutions to industrial problems. .

  19. Marketing automation

    Directory of Open Access Journals (Sweden)

    TODOR Raluca Dania

    2017-01-01

    Full Text Available The automation of the marketing process seems to be nowadays, the only solution to face the major changes brought by the fast evolution of technology and the continuous increase in supply and demand. In order to achieve the desired marketing results, businessis have to employ digital marketing and communication services. These services are efficient and measurable thanks to the marketing technology used to track, score and implement each campaign. Due to the technical progress, the marketing fragmentation, demand for customized products and services on one side and the need to achieve constructive dialogue with the customers, immediate and flexible response and the necessity to measure the investments and the results on the other side, the classical marketing approached had changed continue to improve substantially.

  20. Department o

    African Journals Online (AJOL)

    USER

    2016-10-31

    Oct 31, 2016 ... Department of Urban and Regional Planning, University of Ibadan, Oyo State, Nigeria. 2 ... Geospatial techniques were used for this study; data from primary and secondary source ... development, for instance, Nigeria cities .... (road network, road medians and water ..... Countries: A Case Study of Nigeria.

  1. Electronics department

    International Nuclear Information System (INIS)

    1979-01-01

    This report summarizes the activities in 1978 of some of the groups within the Electronics Department. The work covered includes plant protection and operator studies, reliability techniques, application of nuclear techniques to mineral exploration, applied laser physics, computing and, lastly, research instrumentation. (author)

  2. The Prevalence and Risk Factors of Fall of the Patients Applying to the Department of Neurology in Erciyes University Medical Faculty

    OpenAIRE

    Ferhan Soyuer; Demet Ünalan; Füsun Erdoğan

    2006-01-01

    OBJECTIVE: To study the prevalence of fall and risk factors of the patients with neurological illnesses who applied to the polyclinic of the Department of Neurology in Erciyes University. METHODS: We studied 198 cases diagnosed as having a neurological illness for more than a year, from the point of a story of falling and its occurence. The patients were questioned whether they fell once or more in the last 12 years. Each patient was given an assessment test of Mini-Mental Status In ventor...

  3. 'Oral health is not my department'. Perceptions of elderly patients' oral health by general medical practitioners in primary health care centres: a qualitative interview study.

    Science.gov (United States)

    Andersson, Kerstin; Furhoff, Anna-Karin; Nordenram, Gunilla; Wårdh, Inger

    2007-03-01

    The purpose of this study was to explore general medical practitioners' (GPs) perceptions of the oral health of their elderly patients. The design was a qualitative study based on individual in-depth interviews with GPs. The criterion for inclusion in the study was that the GP was a specialist in family medicine working in a primary health care centre (PHCC:s) in the county of Stockholm. The participants took part in the study after informed consent. Eleven GPs were interviewed. The interview started with semi-structured questions about the respondents' clinical presentation of their elderly patients', e.g. medication, medical treatment and socioeconomic status. The interview concluded with questions about the respondents' experiences of and perceptions of the oral health of their patients. This process started with the first interview and proceeded with successive interviews until no new relevant information was forthcoming. The initial semi-structured part of the interview guide was analysed for content with special reference to descriptive answers. The final open questions were analysed by a method inspired by grounded theory (GT) and comprised three stages: open coding, axial coding and selective coding. In the GT influenced analysis process, three categories, health perspective, working conditions and cultural differences, each in turn containing subcategories, were identified and labelled. The most significant category, cultural differences, was identified as the core category, explaining the central meaning of the respondents' perceptions of the oral health of their elderly patients. The GPs in this study showed little or no awareness of the oral health of their elderly patients. The interviews disclosed several contributing factors. Barriers to closer integration of oral and general health in the elderly were identified. There existed a cultural gap between the disciplines of dentistry and medicine, which does not enhance and may be detrimental to the

  4. [Integration of fundamental and applied medical and technical research made at the department of the biomedical systems, Moscow State Institute of Electronic Engineering].

    Science.gov (United States)

    Selishchev, S V

    2004-01-01

    The integration results of fundamental and applied medical-and-technical research made at the chair of biomedical systems, Moscow state institute of electronic engineering (technical university--MSIEE), are described in the paper. The chair is guided in its research activity by the traditions of higher education in Russia in the field of biomedical electronics and biomedical engineering. Its activities are based on the extrapolation of methods of electronic tools, computer technologies, physics, biology and medicine with due respect being paid to the requirements of practical medicine and to topical issues of research and design.

  5. Both Automation and Paper.

    Science.gov (United States)

    Purcell, Royal

    1988-01-01

    Discusses the concept of a paperless society and the current situation in library automation. Various applications of automation and telecommunications are addressed, and future library automation is considered. Automation at the Monroe County Public Library in Bloomington, Indiana, is described as an example. (MES)

  6. [Realization of the modern educational concept for the organization of the teaching and learning activities at the Department of Forensic Medicine of I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation].

    Science.gov (United States)

    Pigolkin, Yu I; Lomakin, Yu V; Leonova, E N

    The modern educational concept for the organization of the teaching and learning activities (continuous, free, and open education) implies the necessity for its implementation the development and introduction of the new approaches to the work with the students. This problem should be addressed based on the use of the up-to-date technologies for education of the adult subjects. Such technologies find the increasingly wider application at the Department of Forensic Medicine of the I.M. Sechenov First Moscow State Medical University. It markedly contributes to the improvement of the quality of education.

  7. Pediatrics Department of the Russian Medical Academy of Continuous Professional Education and Moscow Research Clinical Institute of Pediatry and Children Surgery – half century hand in hand

    Directory of Open Access Journals (Sweden)

    I. N. Zakharova

    2018-01-01

    Full Text Available The long-term cooperation of the two scientific institutions contributing to the professional development of pediatricians is based on the long-term scientific relations of the Department of Pediatrics of the Russian Medical Academy of Continuing Professional Education and the Moscow Research Institute of Pediatrics and Pediatric Surgery (now the Research Institute of Pediatrics named after Academician Yu.E.Veltischev. The role of remarkable pediatric scientists – G.N. Speransky, Yu.E. Veltstschev, M.S. Ignatova, N.A. Korovina in the development of these links and pediatric science in Russia. 

  8. DIDACTIC AUTOMATED STATION OF COMPLEX KINEMATICS

    Directory of Open Access Journals (Sweden)

    Mariusz Sosnowski

    2014-03-01

    Full Text Available The paper presents the design, control system and software that controls the automated station of complex kinematics. Control interface and software has been developed and manufactured in the West Pomeranian University of Technology in Szczecin in the Department of Automated Manufacturing Systems Engineering and Quality. Conducting classes designed to teach programming and design of structures and systems for monitoring the robot kinematic components with non-standard structures was the reason for installation of the control system and software.

  9. Automated digital magnetofluidics

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, J; Garcia, A A; Marquez, M [Harrington Department of Bioengineering Arizona State University, Tempe AZ 85287-9709 (United States)], E-mail: tony.garcia@asu.edu

    2008-08-15

    Drops can be moved in complex patterns on superhydrophobic surfaces using a reconfigured computer-controlled x-y metrology stage with a high degree of accuracy, flexibility, and reconfigurability. The stage employs a DMC-4030 controller which has a RISC-based, clock multiplying processor with DSP functions, accepting encoder inputs up to 22 MHz, provides servo update rates as high as 32 kHz, and processes commands at rates as fast as 40 milliseconds. A 6.35 mm diameter cylindrical NdFeB magnet is translated by the stage causing water drops to move by the action of induced magnetization of coated iron microspheres that remain in the drop and are attracted to the rare earth magnet through digital magnetofluidics. Water drops are easily moved in complex patterns in automated digital magnetofluidics at an average speed of 2.8 cm/s over a superhydrophobic polyethylene surface created by solvent casting. With additional components, some potential uses for this automated microfluidic system include characterization of superhydrophobic surfaces, water quality analysis, and medical diagnostics.

  10. Automated digital magnetofluidics

    Science.gov (United States)

    Schneider, J.; Garcia, A. A.; Marquez, M.

    2008-08-01

    Drops can be moved in complex patterns on superhydrophobic surfaces using a reconfigured computer-controlled x-y metrology stage with a high degree of accuracy, flexibility, and reconfigurability. The stage employs a DMC-4030 controller which has a RISC-based, clock multiplying processor with DSP functions, accepting encoder inputs up to 22 MHz, provides servo update rates as high as 32 kHz, and processes commands at rates as fast as 40 milliseconds. A 6.35 mm diameter cylindrical NdFeB magnet is translated by the stage causing water drops to move by the action of induced magnetization of coated iron microspheres that remain in the drop and are attracted to the rare earth magnet through digital magnetofluidics. Water drops are easily moved in complex patterns in automated digital magnetofluidics at an average speed of 2.8 cm/s over a superhydrophobic polyethylene surface created by solvent casting. With additional components, some potential uses for this automated microfluidic system include characterization of superhydrophobic surfaces, water quality analysis, and medical diagnostics.

  11. [Children's relative age in class and medication for attention-deficit/hyperactivity disorder. A population-based study in a health department in Spain].

    Science.gov (United States)

    Librero, Julián; Izquierdo-María, Roberto; García-Gil, María; Peiró, Salvador

    2015-12-07

    Previous studies in various countries have shown that the youngest school children in the same class-grade are more likely to be treated for attention-deficit/hyperactivity disorder (ADHD) than their older classmates. The aim of this study is to determine in the Spanish setting whether younger relative age children in each grade have a higher prevalence of treatment for ADHD. Population, observational, cross-sectional study in a health department, using prevalence data (November 2013) of treatment for ADHD in children aged 6-12 years. Data was obtained from the information systems of the Valencia Ministry of Health and multivariate models were used to estimate the prevalence ratio of treatment according to the month of birth of children in each grade. Twenty thousand two hundred and thirty-seven children were included of whom 1.73% were treated for ADHD (boys: 2.70%; girls: 0.71%) in October 2013. The prevalence of treatment increased with age, in males, and in youngest children (born in the last months of each year). In the multivariate analysis, the prevalence of treatment in the youngest children (born in the months of August to December) was 2.5 to 3 times higher than in their older classmates (born in January). The younger children relative to their classmates are more likely to be treated pharmacologically with methylphenidate and/or atomoxetine. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  12. Relationship between anticholinergic drug use and one-year outcome among elderly people hospitalised in medical wards via emergency department: the SAFES cohort study.

    Science.gov (United States)

    Narbey, D; Jolly, D; Mahmoudi, R; Trenque, T; Blanchard, F; Novella, J-L; Dramé, M

    2013-09-01

    To investigate the relationship between anticholinergic drug use and one-year outcome of elderly patients hospitalised via the emergency department. Prospective, multicentre, cohort study of patients aged 75 years and older. Comprehensive geriatric evaluation was performed. We included in this analysis all patients for whom data on drug use was available. Anticholinergic drugs were coded using the online database "Thesorimed". One-year mortality and nursing home admission were analysed using a Cox model, with matching on the propensity to use anticholinergic drugs. In total, 1176 subjects were included in this analysis, average age 85±6 years, 65% women. Overall, 144 (12%) were taking at least one anticholinergic drug. Mortality and nursing home admission at one year were respectively 29% and 30% in the anticholinergic group, and 34% and 33% respectively in subjects not taking anticholinergic drugs. No significant relationship was observed between anticholinergic drug use and the main endpoints. Although we did not observed any statistically significant relationship between use of anticholinergic drugs and one-year outcome in elderly patients, the long-term use of anticholinergic drugs can have deleterious effects on memory and functional capacity, and therefore requires prescriptions to be reviewed regularly.

  13. Quantification of the impact of multifaceted initiatives intended to improve operational efficiency and the safety culture: a case study from an academic medical center radiation oncology department.

    Science.gov (United States)

    Chera, Bhishamjit S; Mazur, Lukasz; Jackson, Marianne; Taylor, Kinely; Mosaly, Prithima; Chang, Sha; Deschesne, Kathy; LaChapelle, Dana; Hoyle, Lesley; Saponaro, Patricia; Rockwell, John; Adams, Robert; Marks, Lawrence B

    2014-01-01

    We have systematically been incorporating several operational efficiency and safety initiatives into our academic radiation oncology clinic. We herein quantify the impact of these initiatives on prospectively collected, clinically meaningful, metrics. The data from 5 quality improvement initiatives, each focused on a specific safety/process concern in our clinic, are presented. Data was collected prospectively: operational metrics recorded before and after implementation of the initiative were compared using statistical analysis. Results from the Agency for Health Care Research and Quality (AHRQ) patient safety culture surveys administered during and after many of these initiatives were similarly compared. (1) Workload levels for nurses assisting with brachytherapy were high (National Aeronautics and Space Administration Task Load Index (NASA-TLX) scores >55-60, suggesting, "overwork"). Changes in work flow and procedure room layout reduced workload to more acceptable levels (NASA-TLX 50% to <10%; P < .01). To assess the overall changes in "patient safety culture," we conducted a pre- and postanalysis using the AHRQ survey. Improvements in all measured dimensions were noted. Quality improvement initiatives can be successfully implemented in an academic radiation oncology department to yield measurable improvements in operations resulting in improvement in patient safety culture. Copyright © 2014 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  14. The Prevalence and Risk Factors of Fall of the Patients Applying to the Department of Neurology in Erciyes University Medical Faculty

    Directory of Open Access Journals (Sweden)

    Ferhan Soyuer

    2006-08-01

    Full Text Available OBJECTIVE: To study the prevalence of fall and risk factors of the patients with neurological illnesses who applied to the polyclinic of the Department of Neurology in Erciyes University. METHODS: We studied 198 cases diagnosed as having a neurological illness for more than a year, from the point of a story of falling and its occurence. The patients were questioned whether they fell once or more in the last 12 years. Each patient was given an assessment test of Mini-Mental Status In ventory, Beck Depression Assessment, Tinetti Balance and Walking Test and determined whether they used an auxillary tool for walking. RESULTS: 90 (45% of the patients fell down once or more in the last 12 months. 33% of those who fell used a tool for walking. Peripheral traumas depending on falls were 33%. While mini-mental test scoresbetween those who fell and who didn't were not different (p>0.05, there was a statistically significant difference between the groups in respect to the assessments of age, Tinetti test, auxillary tools for walking and depression (p<0.05. In neurological illnesses the group who fell the most was those who had stroke (25% and multiple sclerosis (20%. CONCLUSION: The falls in neurological illnesses are related to way of walking, faulty balance and not using a suitable auxillary tool for walking. It may be effective to add treatment programmes related to determined risk factors in neurological illnesses, especially in rehabilitation treatment

  15.  Evaluation of the reasons for the extraction among patients referred to the Oral Surgery Department,Faculty of Dentistry, Tehran University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Ramezanian M.

    2004-06-01

    Full Text Available Statement of Problem: Tooth extraction is always considered as the final treatment option in dentistry."nConsidering the numerous advances in dentistry, nowadays the preservation of the permanent teeth until old"nage is common. However, in most economically poor countries or those without security service insurance,"nthe high rate of extraction, particularly among restorable teeth, is regrettable."nPurpose: The aim of the present study was to determine the reasons for tooth extraction among patients"nreferred to the faculty of Dentistry, Tehran University of Medical Sciences in 2002."nMaterials and Methods: This descriptive and cross-sectional study was conducted on 320 patients. The"ninformation about patient's general knowledge, oral health status, tooth location and causes of extraction were"ncollected and recorded in a questionnaire. The data were submitted to statistical Chi-Square test."nResults: No statistically significant difference was found between two genders in their mentioned causes for"nextraction. The most prevalent reasons were as follows: Caries (50%, Periodontal diseases (16.6%. Absence"nof an acceptable occlusion, prosthetic problems, patient's request, etc... make up the remaining 33.4% of the"nreasons."nConclusion: According to this study, it is suggested to investigate extraction etiology at the society level and"nif similar results are obtained, necessary steps should be taken to prevent caries and periodontal problems as"nthe major mentioned causes for tooth extraction.

  16. The nutritional intake of elderly patients with dysphagia admitted to the internal medical department of the emergency hospital was analyzed. The Fujishima dysphagia scale after care and treatment by the Nutrition Support Team was assessed.

    Science.gov (United States)

    Niwano, Mototaka

    2016-01-01

    The Nutrition Support Team (NST) assessed the severity of dysphagia in elderly patients admitted to the internal medical department, and the appropriate nutritional treatment was determined. Patients were treated with either oral nutrition (enteral nutrition, EN) or artificial alimentation (parenteral nutrition, PN). The goal of this study was to analyze whether or not the route of nutrition affected the patient discharge rates. We divided 290 elderly inpatients with dysphagia into 2 groups, the pneumonia group (200 patients) and the non-pneumonia group (90 patients). The NST estimated the swallowing function using the Fujishima dysphagia scale. Monitoring was continued until the NST care and treatment had been finalized. We further divided the pneumonia patients into two subgroups: those with a Fujishima dysphagia scale score ≤3 or ≥4 at the beginning of NST intervention. The changes in the swallowing function were analyzed.The swallowing function in the patients with a score ≥4 was significantly improved compared with that in the patients with a score ≤3. This difference, however, was not observed in the non-pneumonia group. In both the pneumonia and non-pneumonia groups, the ratio of patients discharged on oral nutrition was one-third, and the ratio of death in hospital was one-quarter, the remaining patients required artificial alimentation. Among elderly patients admitted to the internal medical department of the emergency hospital with dysphagia, one-third left the hospital with oral nutritional intake, one-quarter died in hospital, and the remaining required artificial alimentation.

  17. Lexmeter: validation of an automated system for the assessment of lexical competence of medical students as a base for an adaptive e-learning system

    Directory of Open Access Journals (Sweden)

    Fabrizio eConsorti

    2015-02-01

    Full Text Available Distance learning is used in medical education, even if some recent meta-analyses indicated that it is no more effective than traditional methods. To exploit the technological capabilities, adaptive distance learning systems aim to bridge the gap between the educational offer and the learner’s need. A decrease of lexical competence has been noted in many western countries, so lexical competence could be a possible target for adaptation. The Adaptive message learning project (Am-learning is aimed at designing and implementing an adaptive e-learning system, driven by lexical competence. The goal of the project is to modulate texts according to the estimated skill of learners, to allow a better comprehension. Lexmeter is the first of the four modules of the Am-learning system. It outlines an initial profile of the learner’s lexical competence and can also produce cloze tests, a test based on a completion task.A validation test of Lexmeter was run on 443 medical students of the 1st, 3rd and 6th year at the University Sapienza of Rome. Six cloze tests were automatically produced, with ten gaps each. The tests were different for each year and with varying levels of difficulty. A last cloze test was manually created as a control. The difference of the mean score between the easy tests and the tests with a medium level of difficulty was statistically significant for the 3rd year students but not for 1st and 6th year. The score of the automatically generated tests showed a slight but significant correlation with the control test. The reliability (Cronbach alpha of the different tests fluctuated under and above .60, as an acceptable level. In fact, classical item analysis revealed that the tests were on the average too simple.Lexical competence is a relevant outcome and its assessment allows an early detection of students at risk. Cloze tests can also be used to assess specific knowledge of technical jargon and to train reasoning skill.

  18. Problems and Countermeasures of Hospital Infection Management of Medi-cal Staff in the Department of Stomatology%口腔科医护人员医院感染管理存在的问题及对策

    Institute of Scientific and Technical Information of China (English)

    李春梅; 王馨

    2016-01-01

    Objective To study the problems and countermeasures of hospital infection management of medical staff in the department of stomatology. Methods 218 cases of medical staff in the department of stomatology from January 2014 to March 2016 were selected as the research objects, and the self-made nursing survey table was adopted and the survey con-tent was the hospital infection management problems in the medical staff in the department of stomatology, and the nursing countermeasures were put forward pointedly. Results Apparatus cleaning and soaking, disinfectant replacement time, disin-fectant concentration, disinfectant soaking after washing hands, drying hands with antisepsis paper after washing, washing hands with sanitizer, nursing operation with latex gloves, nursing operation wearing protective clothing, wearing mask and hat, disinfection by the autoclaving method, treatment table with one-time preservative film protection, cleaning the desk with disinfectant solution containing chlorine and mopping the floor had problems of varying degrees. Conclusion Intensify-ing prevention awareness of hospital infection management of medical staff in the department of stomatology and enhancing major knowledge and quality monitoring train contribute to improving the hospital infection management quality of medical staff in the department of stomatology.%目的:探讨口腔科医护人员医院感染管理存在的问题及对策。方法选取2014年1月—2016年3月期间口腔科医护人员218名作为研究对象,采用自制护理调查内容为口腔科医护人员医院感染管理问题,并针对性提出护理对策。结果器械清洗与浸泡,消毒液更换时间正常,消毒液浓度达标,洗手后消毒液浸泡,洗手后消毒纸巾擦干,洗手用洗手液,护理操作戴乳胶手套,护理操作穿防护衣,戴口罩、帽子,消毒用高压灭菌法,治疗台有用一次性保鲜膜保护,采用含氯消毒液擦桌子、拖

  19. [Prevalence and features of pathogenic bacteria in the department of hematology without bone marrow transplantation in Peking Union Medical College Hospital from 2010 to 2012].

    Science.gov (United States)

    Wnag, Lu; Yang, Chen; Zhang, Qian; Han, Bing; Zhuang, Jun-jing; Chen, Miao; Zou, Nong; Li, Jian; Duan, Ming-hui; Zhang, Wei; Zhu, Tie-nan; Xu, Ying; Wang, Shu-jie; Zhou, Dao-bin; Zhao, Yong-qiang; Zhang, Hui; Wang, Peng; Xu, Ying-chun

    2014-08-01

    To investigate the incidence, pathogens, and clinical features of infection in consecutive cases from 2010 to 2012 in Peking Union Medical College Hospital. The incidence, pathogen, treatment, and outcomes of patients with hematological diseases who had positive findings of bacterium in their samples from 2010 to 2012 were retrospectively analyzed. There were 449 positive samples (5.8%) from 4 890 patients during this period, among which 388 were proved to be with pathogenic bacteria. Samples separated from patients with community-aquired infections accounted for 8.4% of all positive samples. Most community-aquired infections were caused by Gram-negative bacteria (75%), although no multidrug-resistant bacteria was observed. Samples separated from patients with nosocomial infections accounted for 91.6% of all positive samples. Respiratory tract (49.4%) and peripheral blood (32.6%) were the most common samples with positive results. Skin soft tissues (10.4%), and urine (3.7%) were less common samples. Most of the pathogenic bacteria of the nosocomial infections were Gram-negative (66.9%). The most common Gram-negative bacteria included Escherichia coli (13.8%), Pseudomonas aeruginosa (12.1%), and Klebsiella pneumonia (12.1%), while Staphylococcus aureus (10.4%), Enterococcus faecium (7.0%), and Staphylococcus epidermidis (5.1%) were the most common Gram-positive bacteria. Gram-negative bacteria consisted of most of sputum samples and peripheral blood samples. Samples from the surface of skin wound and anal swab were composed largely by Gram-positive bacteria (63.8%). The detection rates of extended-spectrum beta-lactamase-producing Klebsiella pneumonia/Klebsiella oxytoca, Escherichia coli, and Proteus mirabilis were 24.0%, 87.9% and 38.4%, respectively. The resistance to Acinetobacter baumannii was serious. Multidrug-resistant, extensive drug resistant and pan drug resistant A. baumannii acountted for 74% of all A. Baumannii infections. Stenotrophomonas maltophilia

  20. Infection control measures of the regenerated medical instrument In department of stomatology%口腔科再生医疗器械的感染控制对策

    Institute of Scientific and Technical Information of China (English)

    马淳; 王仁兰; 栗娜; 秦文静

    2012-01-01

    目的:了解口腔科发生医源性感染的关键点,探讨预防控制对策.方法:采用诊疗后再生医疗器械的清洗、消毒、灭菌、无菌物品的储存等控制点的管理,制定控制感染程序,并落实执行.结果:供给口腔医师质量可靠的无菌物品,清洗彻底是保证消毒灭菌成功的关键;正确包装,保证无菌物品建立无菌屏障的完整有效性;消毒灭菌合格,有效控制医院感染;正确的无菌物品储存,确保无菌物品使用前不被污染.结论:做好口腔科再生医疗器械感染控制要点,可保证口腔科的医疗安全,确保无医源性感染的发生.%Objective To understand the key point of occurrence of iatrogenic infection in Department of Stomatology and explore the prevention and control counter measures.Methods These control points are managed, including the cleaning, disinfection, sterilization, sterile storage of regenerated medical instrument after diagnosed. Infection control procedures are established and implemented. Results To provide oral physician with aseptic items of quality and reliable , thorough cleaning is crucial to the success of disinfection and sterilization; Ensure package correctly .which establish complete validity of sterile barrie; Disinfection and sterilization are qualified, which control effectively the hospital infection; Proper sterile storage of objects, which ensure sterile goods prior to use are not contaminated.Conclusion It is very important to control the key point of infection of recycled medical instruments in department of stomatology, which can ensure the department of stomatology medical safety and no iatrogenic infection.

  1. An automated swimming respirometer

    DEFF Research Database (Denmark)

    STEFFENSEN, JF; JOHANSEN, K; BUSHNELL, PG

    1984-01-01

    An automated respirometer is described that can be used for computerized respirometry of trout and sharks.......An automated respirometer is described that can be used for computerized respirometry of trout and sharks....

  2. Autonomy and Automation

    Science.gov (United States)

    Shively, Jay

    2017-01-01

    A significant level of debate and confusion has surrounded the meaning of the terms autonomy and automation. Automation is a multi-dimensional concept, and we propose that Remotely Piloted Aircraft Systems (RPAS) automation should be described with reference to the specific system and task that has been automated, the context in which the automation functions, and other relevant dimensions. In this paper, we present definitions of automation, pilot in the loop, pilot on the loop and pilot out of the loop. We further propose that in future, the International Civil Aviation Organization (ICAO) RPAS Panel avoids the use of the terms autonomy and autonomous when referring to automated systems on board RPA. Work Group 7 proposes to develop, in consultation with other workgroups, a taxonomy of Levels of Automation for RPAS.

  3. ON EXPERIENCE OF THE COLLABORATION AND PROJECT MANAGEMENT INFORMATION SYSTEM PODIO IMPLEMENTATION IN THE MEDICAL UNIVERSITY

    Directory of Open Access Journals (Sweden)

    Andrii V. Semenets

    2014-12-01

    Full Text Available The Information Technologies role in the medical university management is analyzed. The importance of the application of the electronic document management in the medical universities is shown. The implementation capabilities of the electronic document management system within a cloud services are shown. A Podio collaboration and project management cloud service features overview is presented. The methodology of the Podio capabilities usage to the medical university task management solving is developed. An approaches to the Podio Workspaces and Applications development for the faculties collaboration and project management in the departments of the medical universities are presented. The examples of the Podio features usage to the work-flow automation of the information-analytical and hardware and software support departments of the Ternopil State Medical University named after I. Ja. Horbachevsky are shown.

  4. Use of Automated External Defibrillators

    Energy Technology Data Exchange (ETDEWEB)

    Gregory K Christensen

    2009-02-01

    In an effort to improve survival from cardiac arrest, the American Heart Association (AHA) has promoted the Chain of Survival concept, describing a sequence of prehospital steps that result in improved survival after sudden cardiac arrest. These interventions include immediate deployment of emergency medical services, prompt cardiopulmonary resuscitation, early defibrillation when indicated, and early initiation of advanced medical care. Early defibrillation has emerged as the most important intervention with survival decreasing by 10% with each minute of delay in defibrillation. Ventricular Fibrillation (VF) is a condition in which there is uncoordinated contraction of the heart cardiac muscle of the ventricles in the heart, making them tremble rather than contract properly. VF is a medical emergency and if the arrhythmia continues for more than a few seconds, blood circulation will cease, and death can occur in a matter of minutes. During VF, contractions of the heart are not synchronized, blood flow ceases, organs begin to fail from oxygen deprivation and within 10 minutes, death will occur. When VF occurs, the victim must be defibrillated in order to establish the heart’s normal rhythm. On average, the wait for an ambulance in populated areas of the United States is about 11 minutes. In view of these facts, the EFCOG Electrical Safety Task Group initiated this review to evaluate the potential value of deployment and use of automated external defibrillators (AEDs) for treatment of SCA victims. This evaluation indicates the long term survival benefit to victims of SCA is high if treated with CPR plus defibrillation within the first 3-5 minutes after collapse. According to the American Heart Association (AHA), survival rates as high as 74% are possible if treatment and defibrillation is performed in the first 3 minutes. In contrast survival rates are only 5% where no AED programs have been established to provide prompt CPR and defibrillation. ["CPR statistics

  5. Automation in Clinical Microbiology

    Science.gov (United States)

    Ledeboer, Nathan A.

    2013-01-01

    Historically, the trend toward automation in clinical pathology laboratories has largely bypassed the clinical microbiology laboratory. In this article, we review the historical impediments to automation in the microbiology laboratory and offer insight into the reasons why we believe that we are on the cusp of a dramatic change that will sweep a wave of automation into clinical microbiology laboratories. We review the currently available specimen-processing instruments as well as the total laboratory automation solutions. Lastly, we outline the types of studies that will need to be performed to fully assess the benefits of automation in microbiology laboratories. PMID:23515547

  6. effects of corporate culture on the implementation of automation

    African Journals Online (AJOL)

    Department of Library and Information Science. Universities of ... Tiamiyu (2000) noted that library automation involves using the computer as productivity- ... library loan, electronic circulation functions and the opportunity to, communicate.

  7. Oceanographic measurements from the Texas Automated Buoy System (TABS)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Texas Automated Buoy System contains daily oceanographic measurements from seven buoys off the Texas coast from Brownsville to Sabine. The Texas General Land...

  8. [The significance of student competitions for the development of motivation for education and the acquisition of professional competences in the students the Department of Forensic Medical Expertise of the Sechenovsky University].

    Science.gov (United States)

    Pigolkin, Yu I; Lomakin, Yu V; Leonova, E N

    2018-01-01

    Russia joined the Bologna process in 2003 and since that time has become integrated into the unified European educational space. The key element of the new form of the higher education process is the self-guided unsupervised work of the students. Motivation is needed to promote the involvement of the students in the educational process which implies the necessity of the goal-oriented initiative for the acquisition of professional knowledge and practical experience in the field of forensic medicine. To achieve this goal, the Department of Forensic Medicine of I.M. Sechenov First Moscow State Medical University places special emphasis on the experience with carrying out student competitions. Each such competition consists of several contests focused on the solution of a specific problem, e.g. the inspection of the place of occurrence under investigation with a gunshot or punctured-and-incised wound, forensic medical autopsy, problem studies, and intelligence tests. All the contests and problem studies are held in the form of an interactive game. The experience gained in the course of the student competitions gives practical evidence that the interdepartmental intelligence contests contribute to raising the interest of students in forensic medicine. The open competition provides a highly efficient tool for the popularization of scientific knowledge and the promotion of interest in the participation in the forensic medical research activities. Moreover, the student competitions facilitate formation of the earlier professional skills indispensable for team working and the development of abilities for making decisions under the extreme conditions. In addition, the contests teach the participants the art of public appearance. They improve the quality of vocational training in forensic medicine and help to establish the first professional contacts at the interinstitutional (including international) level.

  9. Evaluation of automated vehicle technology for transit.

    Science.gov (United States)

    2015-01-01

    The purpose of this report is to provide an overview of the state of automated vehicle (AV) technology : in transit. The Florida Department of Transportation (FDOT) wishes to know what AV technology is : currently available that could be used in tran...

  10. Site overview of robotics and automation

    International Nuclear Information System (INIS)

    Byrd, J.S.

    1985-01-01

    This paper summarizes the robotics and automation activities at the Savannah River Laboratory and the Savannah River Plant. The purpose is to provide an overview to facilitate the exchange of technology between various sites involved in development and production work for the Department of Energy. Throughout the paper references are made to assigned project engineers so that they may be contacted directly

  11. 76 FR 81986 - Honeywell International, Inc., Automation and Control Solutions Division, Including On-Site...

    Science.gov (United States)

    2011-12-29

    ..., Inc., Automation and Control Solutions Division, Including On-Site Leased Workers From Manpower...., Automation and Control Solutions Division. The Department has determined that these workers were sufficiently...., Automation and Control Solutions Division, including on-site leased workers from Manpower, Spherion...

  12. 21 CFR 866.2850 - Automated zone reader.

    Science.gov (United States)

    2010-04-01

    ...) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Microbiology Devices § 866.2850 Automated zone reader... surface of certain culture media used in disc-agar diffusion antimicrobial susceptibility tests. The...

  13. Effectiveness of off-the-shelf footwear in reducing foot pain in Australian Department of Veterans’ Affairs recipients not eligible for medical grade footwear: study protocol for a randomized controlled trial

    Science.gov (United States)

    2013-01-01

    Background Foot pain is highly prevalent in older people, and in many cases is associated with wearing inadequate footwear. In Australia, the Department of Veterans’ Affairs (DVA) covers the costs of medical grade footwear for veterans who have severe foot deformity. However, there is a high demand for footwear by veterans with foot pain who do not meet this eligibility criterion. Therefore, this article describes the design of a randomized controlled trial to evaluate the effectiveness of low cost, off-the-shelf footwear in reducing foot pain in DVA recipients who are currently not eligible for medical grade footwear. Methods One hundred and twenty DVA clients with disabling foot pain residing in Melbourne, Australia, who are not eligible for medical grade footwear will be recruited from the DVA database, and will be randomly allocated to an intervention group or a ‘usual care’ control group. The intervention group will continue to receive their usual DVA-subsidized podiatry care in addition to being provided with low-cost, supportive footwear (Dr Comfort®, Vasyli Medical, Labrador, Queensland, Australia). The control group will also continue to receive DVA-subsidized podiatry care, but will not be provided with the footwear until the completion of the study. The primary outcome measure will be pain subscale on the Foot Health Status Questionnaire (FHSQ), measured at baseline and 4, 8, 12 and 16 weeks. Secondary outcome measures measured at baseline and 16 weeks will include the function subscale of the FHSQ, the Manchester Foot Pain and Disability Index, the number of DVA podiatry treatments required during the study period, general health-related quality of life (using the Short Form 12® Version 2.0), the number of falls experienced during the follow-up period, the Timed Up and Go test, the presence of hyperkeratotic lesions (corns and calluses), the number of participants using co-interventions to relieve foot pain, and participants’ perception of

  14. Effectiveness of off-the-shelf footwear in reducing foot pain in Australian Department of Veterans' Affairs recipients not eligible for medical grade footwear: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Menz, Hylton B; Frescos, Nicoletta; Munteanu, Shannon E

    2013-04-23

    Foot pain is highly prevalent in older people, and in many cases is associated with wearing inadequate footwear. In Australia, the Department of Veterans' Affairs (DVA) covers the costs of medical grade footwear for veterans who have severe foot deformity. However, there is a high demand for footwear by veterans with foot pain who do not meet this eligibility criterion. Therefore, this article describes the design of a randomized controlled trial to evaluate the effectiveness of low cost, off-the-shelf footwear in reducing foot pain in DVA recipients who are currently not eligible for medical grade footwear. One hundred and twenty DVA clients with disabling foot pain residing in Melbourne, Australia, who are not eligible for medical grade footwear will be recruited from the DVA database, and will be randomly allocated to an intervention group or a 'usual care' control group. The intervention group will continue to receive their usual DVA-subsidized podiatry care in addition to being provided with low-cost, supportive footwear (Dr Comfort®, Vasyli Medical, Labrador, Queensland, Australia). The control group will also continue to receive DVA-subsidized podiatry care, but will not be provided with the footwear until the completion of the study. The primary outcome measure will be pain subscale on the Foot Health Status Questionnaire (FHSQ), measured at baseline and 4, 8, 12 and 16 weeks. Secondary outcome measures measured at baseline and 16 weeks will include the function subscale of the FHSQ, the Manchester Foot Pain and Disability Index, the number of DVA podiatry treatments required during the study period, general health-related quality of life (using the Short Form 12® Version 2.0), the number of falls experienced during the follow-up period, the Timed Up and Go test, the presence of hyperkeratotic lesions (corns and calluses), the number of participants using co-interventions to relieve foot pain, and participants' perception of overall treatment effect. Data

  15. Automated image quality assessment for chest CT scans.

    Science.gov (United States)

    Reeves, Anthony P; Xie, Yiting; Liu, Shuang

    2018-02-01

    Medical image quality needs to be maintained at standards sufficient for effective clinical reading. Automated computer analytic methods may be applied to medical images for quality assessment. For chest CT scans in a lung cancer screening context, an automated quality assessment method is presented that characterizes image noise and image intensity calibration. This is achieved by image measurements in three automatically segmented homogeneous regions of the scan: external air, trachea lumen air, and descending aorta blood. Profiles of CT scanner behavior are also computed. The method has been evaluated on both phantom and real low-dose chest CT scans and results show that repeatable noise and calibration measures may be realized by automated computer algorithms. Noise and calibration profiles show relevant differences between different scanners and protocols. Automated image quality assessment may be useful for quality control for lung cancer screening and may enable performance improvements to automated computer analysis methods. © 2017 American Association of Physicists in Medicine.

  16. Automation systems for radioimmunoassay

    International Nuclear Information System (INIS)

    Yamasaki, Paul

    1974-01-01

    The application of automation systems for radioimmunoassay (RIA) was discussed. Automated systems could be useful in the second step, of the four basic processes in the course of RIA, i.e., preparation of sample for reaction. There were two types of instrumentation, a semi-automatic pipete, and a fully automated pipete station, both providing for fast and accurate dispensing of the reagent or for the diluting of sample with reagent. Illustrations of the instruments were shown. (Mukohata, S.)

  17. Effect of an interactive cardiopulmonary resuscitation assist device with an automated external defibrillator synchronised with a ventilator on the CPR performance of emergency medical service staff: a randomised simulation study.

    Science.gov (United States)

    Nitzschke, Rainer; Doehn, Christoph; Kersten, Jan F; Blanz, Julian; Kalwa, Tobias J; Scotti, Norman A; Kubitz, Jens C

    2017-04-04

    The present study evaluates whether the quality of advanced cardiac life support (ALS) is improved with an interactive prototype assist device. This device consists of an automated external defibrillator linked to a ventilator and provides synchronised visual and acoustic instructions for guidance through the ALS algorithm and assistance for face-mask ventilations. We compared the cardiopulmonary resuscitation (CPR) quality of emergency medical system (EMS) staff members using the study device or standard equipment in a mannequin simulation study with a prospective, controlled, randomised cross-over study design. Main outcome was the effect of the study device compared to the standard equipment and the effect of the number of prior ALS trainings of the EMS staff on the CPR quality. Data were analysed using analyses of covariance (ANCOVA) and binary logistic regression, accounting for the study design. In 106 simulations of 56 two-person rescuer teams, the mean hands-off time was 24.5% with study equipment and 23.5% with standard equipment (Difference 1.0% (95% CI: -0.4 to 2.5%); p = 0.156). With both types of equipment, the hands-off time decreased with an increasing cumulative number of previous CPR trainings (p = 0.042). The study equipment reduced the mean time until administration of adrenaline (epinephrine) by 23 s (p = 0.003) and that of amiodarone by 17 s (p = 0.016). It also increased the mean number of changes in the person doing chest compressions (0.6 per simulation; p < 0.001) and decreased the mean number of chest compressions (2.8 per minute; p = 0.022) and the mean number of ventilations (1.8 per minute; p < 0.001). The chance of administering amiodarone at the appropriate time was higher, with an odds ratio of 4.15, with the use of the study equipment CPR.com compared to the standard equipment (p = 0.004). With an increasing number of prior CPR trainings, the time intervals in the ALS algorithm until the

  18. Total laboratory automation: Do stat tests still matter?

    Science.gov (United States)

    Dolci, Alberto; Giavarina, Davide; Pasqualetti, Sara; Szőke, Dominika; Panteghini, Mauro

    2017-07-01

    During the past decades the healthcare systems have rapidly changed and today hospital care is primarily advocated for critical patients and acute treatments, for which laboratory test results are crucial and need to be always reported in predictably short turnaround time (TAT). Laboratories in the hospital setting can face this challenge by changing their organization from a compartmentalized laboratory department toward a decision making-based laboratory department. This requires the implementation of a core laboratory, that exploits total laboratory automation (TLA) using technological innovation in analytical platforms, track systems and information technology, including middleware, and a number of satellite specialized laboratory sections cooperating with care teams for specific medical conditions. In this laboratory department model, the short TAT for all first-line tests performed by TLA in the core laboratory represents the key paradigm, where no more stat testing is required because all samples are handled in real-time and (auto)validated results dispatched in a time that fulfills clinical needs. To optimally reach this goal, laboratories should be actively involved in managing all the steps covering the total examination process, speeding up also extra-laboratory phases, such sample delivery. Furthermore, to warrant effectiveness and not only efficiency, all the processes, e.g. specimen integrity check, should be managed by middleware through a predefined set of rules defined in light of the clinical governance. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  19. Laboratory Automation and Middleware.

    Science.gov (United States)

    Riben, Michael

    2015-06-01

    The practice of surgical pathology is under constant pressure to deliver the highest quality of service, reduce errors, increase throughput, and decrease turnaround time while at the same time dealing with an aging workforce, increasing financial constraints, and economic uncertainty. Although not able to implement total laboratory automation, great progress continues to be made in workstation automation in all areas of the pathology laboratory. This report highlights the benefits and challenges of pathology automation, reviews middleware and its use to facilitate automation, and reviews the progress so far in the anatomic pathology laboratory. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Automated cloning methods.; TOPICAL

    International Nuclear Information System (INIS)

    Collart, F.

    2001-01-01

    Argonne has developed a series of automated protocols to generate bacterial expression clones by using a robotic system designed to be used in procedures associated with molecular biology. The system provides plate storage, temperature control from 4 to 37 C at various locations, and Biomek and Multimek pipetting stations. The automated system consists of a robot that transports sources from the active station on the automation system. Protocols for the automated generation of bacterial expression clones can be grouped into three categories (Figure 1). Fragment generation protocols are initiated on day one of the expression cloning procedure and encompass those protocols involved in generating purified coding region (PCR)

  1. Complacency and Automation Bias in the Use of Imperfect Automation.

    Science.gov (United States)

    Wickens, Christopher D; Clegg, Benjamin A; Vieane, Alex Z; Sebok, Angelia L

    2015-08-01

    We examine the effects of two different kinds of decision-aiding automation errors on human-automation interaction (HAI), occurring at the first failure following repeated exposure to correctly functioning automation. The two errors are incorrect advice, triggering the automation bias, and missing advice, reflecting complacency. Contrasts between analogous automation errors in alerting systems, rather than decision aiding, have revealed that alerting false alarms are more problematic to HAI than alerting misses are. Prior research in decision aiding, although contrasting the two aiding errors (incorrect vs. missing), has confounded error expectancy. Participants performed an environmental process control simulation with and without decision aiding. For those with the aid, automation dependence was created through several trials of perfect aiding performance, and an unexpected automation error was then imposed in which automation was either gone (one group) or wrong (a second group). A control group received no automation support. The correct aid supported faster and more accurate diagnosis and lower workload. The aid failure degraded all three variables, but "automation wrong" had a much greater effect on accuracy, reflecting the automation bias, than did "automation gone," reflecting the impact of complacency. Some complacency was manifested for automation gone, by a longer latency and more modest reduction in accuracy. Automation wrong, creating the automation bias, appears to be a more problematic form of automation error than automation gone, reflecting complacency. Decision-aiding automation should indicate its lower degree of confidence in uncertain environments to avoid the automation bias. © 2015, Human Factors and Ergonomics Society.

  2. Automated remedial assessment methodology software system

    International Nuclear Information System (INIS)

    Whiting, M.; Wilkins, M.; Stiles, D.

    1994-11-01

    The Automated Remedial Analysis Methodology (ARAM) software system has been developed by the Pacific Northwest Laboratory to assist the U.S. Department of Energy (DOE) in evaluating cleanup options for over 10,000 contaminated sites across the DOE complex. The automated methodology comprises modules for decision logic diagrams, technology applicability and effectiveness rules, mass balance equations, cost and labor estimating factors and equations, and contaminant stream routing. ARAM is used to select technologies for meeting cleanup targets; determine the effectiveness of the technologies in destroying, removing, or immobilizing contaminants; decide the nature and amount of secondary waste requiring further treatment; and estimate the cost and labor involved when applying technologies

  3. Public Health Departments

    Data.gov (United States)

    Department of Homeland Security — State and Local Public Health Departments in the United States Governmental public health departments are responsible for creating and maintaining conditions that...

  4. Interagency partnership to deliver Veteran-Directed Home and Community-Based Services: Interviews with Aging and Disability Network agency personnel regarding their experience with partner Department of Veterans Affairs medical centers.

    Science.gov (United States)

    Thomas, Kali S; Allen, Susan M

    2016-01-01

    Veteran-Directed Home and Community-Based Services (VD-HCBS) is a consumer-directed program that began in 2009 and is jointly administered in a partnership between the Veterans Health Administration and the Administration for Community Living. The objective of this article is to describe the Aging and Disability Network agency (ADNA) personnel's perceptions of the implementation of the VD-HCBS program with partner Department of Veterans Affairs medical centers (VAMCs). Qualitative interviews with 26 ADNA VD-HCBS personnel across the country were transcribed, coded, and analyzed. Results suggest that the majority of ADNA personnel interviewed perceive the collaboration experience to be positive. Interviewees reported several key mechanisms for facilitating a successful partnership, including frequent communication, training in VAMC billing procedures, having a designated VAMC staff person for the program, and active involvement of the VAMC from the onset of VD-HCBS program development. Findings have implications for other interagency partnerships formed to deliver services to vulnerable Veterans.

  5. [Laboratory diagnosis of pandemic influenza at the Department of Medical Microbiology of the Regional Authority of Public Health based in Banská Bystrica in the season 2009-2010].

    Science.gov (United States)

    Kissová, R; Mad'arová, L; Klement, C

    2011-02-01

    The Department of Medical Microbiology of the Regional Authority of Public Health (RAPH) in Banská Bystrica serves as a catchment laboratory of virology for the Central Slovakia Region, and in the influenza season 2009/10, it also served as such for the East Slovakia Region. Specimens (nasopharyngeal swabs and post-mortem specimens) from patients with suspected influenza were obtained from both sentinel and non-sentinel physicians. The specimens were analyzed by a rapid test, followed by real-time PCR (RT-PCR) for influenza A or B diagnosis. RT-PCR subtyping for pandemic influenza A/H1N1 was performed. From May 2009 to June 2010, 2497 specimens were analyzed for the presence of influenza A and B viruses and in particular for the presence of pandemic influenza A/H1N1 virus. As many as 537 of 589 influenza A-positive specimens, i.e. 21.5% of all specimens analyzed and 91.2% of influenza A-positive specimens, were subtyped as pandemic influenza A/H1N1. In the influenza season 2009/10, the new pandemic influenza A/H1N1 clearly predominated in Central and Eastern Slovakia. PCR tests have played a key role in diagnosing patients with suspected pandemic influenza in the laboratory participating in the surveillance of influenza and influenza-like illness in the Slovak Republic.

  6. EAST AFRICAN MEDICAL JOURNAL

    African Journals Online (AJOL)

    2003-11-11

    Nov 11, 2003 ... East African Medical Journal Vol. ... Lecturer/Consultant Surgeon, Paediatric Surgery Unit, Department of Surgery, College of Medical Sciences, University of Calabar, .... mind and the results obtained were however satisfying.

  7. Automated System Marketplace 1994.

    Science.gov (United States)

    Griffiths, Jose-Marie; Kertis, Kimberly

    1994-01-01

    Reports results of the 1994 Automated System Marketplace survey based on responses from 60 vendors. Highlights include changes in the library automation marketplace; estimated library systems revenues; minicomputer and microcomputer-based systems; marketplace trends; global markets and mergers; research needs; new purchase processes; and profiles…

  8. Automation in Warehouse Development

    NARCIS (Netherlands)

    Hamberg, R.; Verriet, J.

    2012-01-01

    The warehouses of the future will come in a variety of forms, but with a few common ingredients. Firstly, human operational handling of items in warehouses is increasingly being replaced by automated item handling. Extended warehouse automation counteracts the scarcity of human operators and

  9. Order Division Automated System.

    Science.gov (United States)

    Kniemeyer, Justin M.; And Others

    This publication was prepared by the Order Division Automation Project staff to fulfill the Library of Congress' requirement to document all automation efforts. The report was originally intended for internal use only and not for distribution outside the Library. It is now felt that the library community at-large may have an interest in the…

  10. Automate functional testing

    Directory of Open Access Journals (Sweden)

    Ramesh Kalindri

    2014-06-01

    Full Text Available Currently, software engineers are increasingly turning to the option of automating functional tests, but not always have successful in this endeavor. Reasons range from low planning until over cost in the process. Some principles that can guide teams in automating these tests are described in this article.

  11. Automation and robotics

    Science.gov (United States)

    Montemerlo, Melvin

    1988-01-01

    The Autonomous Systems focus on the automation of control systems for the Space Station and mission operations. Telerobotics focuses on automation for in-space servicing, assembly, and repair. The Autonomous Systems and Telerobotics each have a planned sequence of integrated demonstrations showing the evolutionary advance of the state-of-the-art. Progress is briefly described for each area of concern.

  12. Automating the Small Library.

    Science.gov (United States)

    Skapura, Robert

    1987-01-01

    Discusses the use of microcomputers for automating school libraries, both for entire systems and for specific library tasks. Highlights include available library management software, newsletters that evaluate software, constructing an evaluation matrix, steps to consider in library automation, and a brief discussion of computerized card catalogs.…

  13. Automated model building

    CERN Document Server

    Caferra, Ricardo; Peltier, Nicholas

    2004-01-01

    This is the first book on automated model building, a discipline of automated deduction that is of growing importance Although models and their construction are important per se, automated model building has appeared as a natural enrichment of automated deduction, especially in the attempt to capture the human way of reasoning The book provides an historical overview of the field of automated deduction, and presents the foundations of different existing approaches to model construction, in particular those developed by the authors Finite and infinite model building techniques are presented The main emphasis is on calculi-based methods, and relevant practical results are provided The book is of interest to researchers and graduate students in computer science, computational logic and artificial intelligence It can also be used as a textbook in advanced undergraduate courses

  14. Automation in Immunohematology

    Directory of Open Access Journals (Sweden)

    Meenu Bajpai

    2012-01-01

    Full Text Available There have been rapid technological advances in blood banking in South Asian region over the past decade with an increasing emphasis on quality and safety of blood products. The conventional test tube technique has given way to newer techniques such as column agglutination technique, solid phase red cell adherence assay, and erythrocyte-magnetized technique. These new technologies are adaptable to automation and major manufacturers in this field have come up with semi and fully automated equipments for immunohematology tests in the blood bank. Automation improves the objectivity and reproducibility of tests. It reduces human errors in patient identification and transcription errors. Documentation and traceability of tests, reagents and processes and archiving of results is another major advantage of automation. Shifting from manual methods to automation is a major undertaking for any transfusion service to provide quality patient care with lesser turnaround time for their ever increasing workload. This article discusses the various issues involved in the process.

  15. Automation in Warehouse Development

    CERN Document Server

    Verriet, Jacques

    2012-01-01

    The warehouses of the future will come in a variety of forms, but with a few common ingredients. Firstly, human operational handling of items in warehouses is increasingly being replaced by automated item handling. Extended warehouse automation counteracts the scarcity of human operators and supports the quality of picking processes. Secondly, the development of models to simulate and analyse warehouse designs and their components facilitates the challenging task of developing warehouses that take into account each customer’s individual requirements and logistic processes. Automation in Warehouse Development addresses both types of automation from the innovative perspective of applied science. In particular, it describes the outcomes of the Falcon project, a joint endeavour by a consortium of industrial and academic partners. The results include a model-based approach to automate warehouse control design, analysis models for warehouse design, concepts for robotic item handling and computer vision, and auton...

  16. AUTOMATED ANALYSIS OF BREAKERS

    Directory of Open Access Journals (Sweden)

    E. M. Farhadzade

    2014-01-01

    Full Text Available Breakers relate to Electric Power Systems’ equipment, the reliability of which influence, to a great extend, on reliability of Power Plants. In particular, the breakers determine structural reliability of switchgear circuit of Power Stations and network substations. Failure in short-circuit switching off by breaker with further failure of reservation unit or system of long-distance protection lead quite often to system emergency.The problem of breakers’ reliability improvement and the reduction of maintenance expenses is becoming ever more urgent in conditions of systematic increasing of maintenance cost and repair expenses of oil circuit and air-break circuit breakers. The main direction of this problem solution is the improvement of diagnostic control methods and organization of on-condition maintenance. But this demands to use a great amount of statistic information about nameplate data of breakers and their operating conditions, about their failures, testing and repairing, advanced developments (software of computer technologies and specific automated information system (AIS.The new AIS with AISV logo was developed at the department: “Reliability of power equipment” of AzRDSI of Energy. The main features of AISV are:· to provide the security and data base accuracy;· to carry out systematic control of breakers conformity with operating conditions;· to make the estimation of individual  reliability’s value and characteristics of its changing for given combination of characteristics variety;· to provide personnel, who is responsible for technical maintenance of breakers, not only with information but also with methodological support, including recommendations for the given problem solving  and advanced methods for its realization.

  17. AUTOMATION OF CHAMPAGNE WINES PROCESS IN SPARKLING WINE PRESSURE TANK

    Directory of Open Access Journals (Sweden)

    E. V. Lukyanchuk

    2016-08-01

    Full Text Available The wine industry is now successfully solved the problem for the implementation of automation receiving points of grapes, crushing and pressing departments installation continuous fermentation work, blend tanks, production lines ordinary Madeira continuously working plants for ethyl alcohol installations champagne wine in continuous flow, etc. With the development of automation of technological progress productivity winemaking process develops in the following areas: organization of complex avtomatization sites grape processing with bulk transportation of the latter; improving the quality and durability of wines by the processing of a wide applying wine cold and heat, as well as technical and microbiological control most powerful automation equipment; the introduction of automated production processes of continuous technical champagne, sherry wine and cognac alcohol madery; the use of complex automation auxiliary production sites (boilers, air conditioners, refrigeration unitsand other.; complex avtomatization creation of enterprises, and sites manufactory bottling wines. In the wine industry developed more sophisticated schemes of automation and devices that enable the transition to integrated production automation, will create, are indicative automated enterprise serving for laboratories to study of the main problems of automation of production processes of winemaking.

  18. Systematic review automation technologies

    Science.gov (United States)

    2014-01-01

    Systematic reviews, a cornerstone of evidence-based medicine, are not produced quickly enough to support clinical practice. The cost of production, availability of the requisite expertise and timeliness are often quoted as major contributors for the delay. This detailed survey of the state of the art of information systems designed to support or automate individual tasks in the systematic review, and in particular systematic reviews of randomized controlled clinical trials, reveals trends that see the convergence of several parallel research projects. We surveyed literature describing informatics systems that support or automate the processes of systematic review or each of the tasks of the systematic review. Several projects focus on automating, simplifying and/or streamlining specific tasks of the systematic review. Some tasks are already fully automated while others are still largely manual. In this review, we describe each task and the effect that its automation would have on the entire systematic review process, summarize the existing information system support for each task, and highlight where further research is needed for realizing automation for the task. Integration of the systems that automate systematic review tasks may lead to a revised systematic review workflow. We envisage the optimized workflow will lead to system in which each systematic review is described as a computer program that automatically retrieves relevant trials, appraises them, extracts and synthesizes data, evaluates the risk of bias, performs meta-analysis calculations, and produces a report in real time. PMID:25005128

  19. Validity of the Greek version of the PHQ 15-item Somatic Symptom Severity Scale in patients with chronic medical conditions and correlations with emergency department use and illness perceptions.

    Science.gov (United States)

    Hyphantis, Thomas; Kroenke, Kurt; Papatheodorou, Eugenia; Paika, Vassiliki; Theocharopoulos, Nicholaos; Ninou, Aggeliki; Tomenson, Barbara; Carvalho, Andre F; Guthrie, Elspeth

    2014-11-01

    The PHQ-15 is a brief measure assessing the severity of somatic symptoms and is widely used in different health care settings. We aimed to assess the psychometric properties of its Greek version in patients with chronic physical illnesses seeking urgent or unscheduled care in the Accident and Emergency Department (AED). The PHQ-15 was translated into Greek using back-translation, and it was administered to 303 patients with diabetes, COPD and rheumatic diseases visiting our AED during a one-year period. Patients were interviewed with the MINI. Depressive (PHQ-9) and somatization symptoms (SCL-12), illness perceptions (B-IPQ) and health-related quality of life (WHOQOL-BREF) were also assessed to test criterion and concurrent validity. The Greek version of the PHQ-15 showed acceptable internal consistency. Convergent validity was established by the strong associations observed between PHQ-15 scores and functional status, depressive symptom severity and AED visits during the previous year. PHQ-15 scores were also associated with the patients' concerns about personal and treatment illness's control and their beliefs regarding the number of bodily symptoms attributed to their illness (illness identity). The highly acceptable convergent and discriminant validity of the five individual bodily symptoms assessed by both the PHQ-15 and SCL-12 is a further construct validity indicator. The present findings support the applicability of the Greek version of PHQ-15 in assessing common somatic symptoms either medically explained or unexplained in patients seeking care in the AED, further confirming that it can be considered suitable for use in a broad range of populations in clinical research. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Operational proof of automation

    International Nuclear Information System (INIS)

    Jaerschky, R.; Reifenhaeuser, R.; Schlicht, K.

    1976-01-01

    Automation of the power plant process may imply quite a number of problems. The automation of dynamic operations requires complicated programmes often interfering in several branched areas. This reduces clarity for the operating and maintenance staff, whilst increasing the possibilities of errors. The synthesis and the organization of standardized equipment have proved very successful. The possibilities offered by this kind of automation for improving the operation of power plants will only sufficiently and correctly be turned to profit, however, if the application of these technics of equipment is further improved and if its volume is tallied with a definite etc. (orig.) [de