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Sample records for factors medical history

  1. Conducting the Medical History

    Science.gov (United States)

    Finkel, Martin A.; Alexander, Randell A.

    2011-01-01

    A key portion of the medical evaluation of child sexual abuse is the medical history. This differs from interviews or histories obtained by other professionals in that it is focuses more on the health and well-being of the child. Careful questions should be asked about all aspects of the child's medical history by a skilled, compassionate,…

  2. Errors in medication history at hospital admission: prevalence and predicting factors.

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    Hellström, Lina M; Bondesson, Åsa; Höglund, Peter; Eriksson, Tommy

    2012-04-03

    An accurate medication list at hospital admission is essential for the evaluation and further treatment of patients. The objective of this study was to describe the frequency, type and predictors of errors in medication history, and to evaluate the extent to which standard care corrects these errors. A descriptive study was carried out in two medical wards in a Swedish hospital using Lund Integrated Medicines Management (LIMM)-based medication reconciliation. A clinical pharmacist identified each patient's most accurate pre-admission medication list by conducting a medication reconciliation process shortly after admission. This list was then compared with the patient's medication list in the hospital medical records. Addition or withdrawal of a drug or changes to the dose or dosage form in the hospital medication list were considered medication discrepancies. Medication discrepancies for which no clinical reason could be identified (unintentional changes) were considered medication history errors. The final study population comprised 670 of 818 eligible patients. At least one medication history error was identified by pharmacists conducting medication reconciliations for 313 of these patients (47%; 95% CI 43-51%). The most common medication error was an omitted drug, followed by a wrong dose. Multivariate logistic regression analysis showed that a higher number of drugs at admission (odds ratio [OR] per 1 drug increase = 1.10; 95% CI 1.06-1.14; p medication history errors at admission. The results further indicated that standard care by non-pharmacist ward staff had partly corrected the errors in affected patients by four days after admission, but a considerable proportion of the errors made in the initial medication history at admission remained undetected by standard care (OR for medication errors detected by pharmacists' medication reconciliation carried out on days 4-11 compared to days 0-1 = 0.52; 95% CI 0.30-0.91; p=0.021). Clinical pharmacists conducting

  3. Environmental, medical, and family history risk factors for Parkinson's disease: a New England-based case control study.

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    Taylor, C A; Saint-Hilaire, M H; Cupples, L A; Thomas, C A; Burchard, A E; Feldman, R G; Myers, R H

    1999-12-15

    Controversy persists about the etiology of Parkinson's disease (PD). Pesticides, herbicides, well-water consumption, head injury, and a family history of PD have been reported as risk factors for PD. The purpose of this study was to (1) investigate the impact of environmental factors on PD risk (2) estimate the chronology, frequency, and duration of those exposures associated with PD; and (3) investigate the effects of family history on PD risk. One-hundred and forty PD cases were recruited from Boston University Medical Center. The control group was composed of 147 friends and in-laws of PD patients. Environmental, medical, and family history data were obtained by structured interview from each participant for events recalled prior to PD onset for cases, or corresponding censoring age for controls (mean age = 56 years of age for each group). A traditional stratified analysis, adjusting for birth cohort and sex, was employed. Four factors were associated with increased risk for PD: (1) head injury (OR=6.23, confidence interval [CI]: 2.58-15.07); (2) family history of PD (OR=6.08, CI: 2.35-15. 58); (3) family history of tremor (OR=3.97, CI: 1.17-13.50); and (4) history of depression (OR=3.01, CI: 1.32-6.88). A mean latency of 36. 5 (SE=2.81) years passed between the age of first reported head injury and PD onset. A mean latency of 22 (SE=2.66) years passed between the onset of the first reported symptoms of depression and onset of PD. Years of education, smoking, and well-water intake were inversely associated with PD risk. PD was not associated with exposure to pesticides or herbicides. These findings support the role of both environmental and genetic factors in the etiology in PD. The results are consistent with a multifactorial model. Am. J. Med. Genet. (Neuropsychiatr. Genet.) 88:742-749, 1999.

  4. The effective and preventive factors of taking patients\\' history from the viewpoint of the students of Birjand Medical School in 2010-2011

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    Z. Khazaee

    2013-06-01

    Full Text Available Introduction: Taking patients' history and doing physical examinations help physicians to diagnose correctly and treat accordingly. There are several factors which may affect the quality of taking patients' history. This study aims to assess determinants of taking patients' history from the viewpoint of the students of Birjand Medical School. Methods: This descriptive study was carried out in 2010-2011 on all 137 medical trainees and interns studying at Birjand Medical School. To determine the students’ attitudes towards history taking and to evaluate their performance a questionnaire and a check-list were used, respectively. The data analyzed using SPSS software. Descriptive-deductive statistics (T-test were applied on the data. Results: The average score of the motivational factors was more than the preventive factors. Among the motivational factors, the statement “taking patient history is a basis of proper diagnosis and treatment” (3.58 and among the preventive factors the statement “taking patient history just to evade responsibility”(2.57had the highest scores. Moreover, there was a significant difference between the performance of trainees and interns in taking and recording patients’ history (P<0.005. Conclusion: Although the students held a positive attitude toward taking patients' history, they didn’t have satisfactory performance in recording disease symptoms, diagnosis and treatment plans this entails more attention. Observation of trainers on the process of history taking may help.

  5. History of Medical Physics.

    Science.gov (United States)

    Laughlin, John S.

    1983-01-01

    Traces the development of basic radiation physics that underlies much of today's medical physics and looks separately at the historical development of two major subfields of medical physics: radiation therapy and nuclear medicine. Indicates that radiation physics has made important contributions to solving biomedical problems in medical…

  6. Computer assisted medical history taking

    NARCIS (Netherlands)

    M.J. Quaak; A.P.M. Hasman (Arie)

    1988-01-01

    textabstractIn this thesis a study is described which was performed to explore the possibilities of computer-assisted history taking to support patient care. A system was developed by which the patient himself enters his medical data into a computer. The system enables an unexperienced user, i.e.

  7. Computer assisted medical history taking

    NARCIS (Netherlands)

    M.J. Quaak; A.P.M. Hasman (Arie)

    1988-01-01

    textabstractIn this thesis a study is described which was performed to explore the possibilities of computer-assisted history taking to support patient care. A system was developed by which the patient himself enters his medical data into a computer. The system enables an unexperienced user, i.e. a

  8. Medizinhistorische Literatur [Medical history literature

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    Bauer, Bruno

    2012-09-01

    Full Text Available [english] The focus of the current issue 1-2/2012 of GMS Medizin – Bibliothek – Information is on medical history literature. In six articles special collections and recent projects of medical history libraries in Berlin, Hamburg, Heidelberg, Leipzig, Vienna and Zurich are presented. The authors in this issue are Melanie Scholz & Vera Seehausen (From Augusta to Klingsor, from Luise to Benjamin – past, present and future of the library of the Institute of the History of Medicine in Berlin, Alexandra Veith (Library of the Institute for History of Medicine and Ethics of Medicine, Heidelberg, Melanie Kintzel, Meike Knittel & Tanja Krutky (Historic collections of the Medical Library of the University of the University Medical Center Hamburg-Eppendorf and their deacidification, Dagmar Geithner (Library of the Karl Sudhoff Institute for the History of Medicine and Science, Leipzig – a Historical Review, Harald Albrecht, Bruno Bauer & Walter Mentzel (The Josephinian Library and the medical-historic stock of the University Library of the Medical University of Vienna and Monika Huber & Ursula Reis (Library of the Institute and Museum of the History of Medicine Zurich.[german] Schwerpunktthema der aktuellen Ausgabe 1-2/2012von GMS Medizin – Bibliothek – Information ist medizinhistorische Literatur. In sechs Beiträgen werden Bestände und aktuelle Projekte medizinhistorischer Bibliotheken in Berlin, Hamburg, Heidelberg, Leipzig, Wien und Zürich vorgestellt. Verfasst wurden die Beiträge der Schwerpunktausgabe von Melanie Scholz & Vera Seehausen (Von August zu Klingsor, von Luise zu Benjamin – Vergangenheit, Gegenwart und Zukunft der Bibliothek des Instituts für Geschichte der Medizin in Berlin, Melanie Kintzel, Meike Knittel & Tanja Krutky (Medizinhistorische Buchbestände am Universitätsklinikum Hamburg-Eppendorf und ihre Entsäuerung, Ara Veith (Bibliothek des Instituts für Geschichte und Ethik der Medizin in Heidelberg, Dagmar Geithner

  9. History repeats itself: the family medication history and pharmacogenomics.

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    Smith, Thomas R; Kearney, Elizabeth; Hulick, Peter J; Kisor, David F

    2016-05-01

    Related to many drug gene-product interactions, application of pharmacogenomics can lead to improved medication efficacy while decreasing or avoiding adverse drug reactions. However, utilizing pharmacogenomics without other information does not allow for optimal medication therapy. Currently, there is a lack of documentation of family medication history, in other words, inefficacy and adverse reactions across family members throughout generations. The family medication history can serve as an impetus for pharmacogenomic testing to explain lack of medication efficacy or an adverse drug reaction and pre-emptive testing can drive recognition and documentation of medication response in family members. We propose combining the family medication history via pedigree construction with pharmacogenomics to further optimize medication therapy. We encourage clinicians to combine family medication history with pharmacogenomics.

  10. [Medical history of Martin Luther].

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    Takigami, Tadashi

    2011-12-01

    Martin Luther achieved great success in religious reformation, though he was said to have suffered from many kinds of diseases during his lifetime. Unfortunately, however, his medical history has never been reported in Japan. Since the second half of his thirties, he was suffering from severe constipation, causing hemorrhoids and anal prolapse. At the beginning of his forties he had vertigo, tinnitis and headaches, which were the signs of chronic purlent otitis media and ended in left otorrhea and pyorrhea of the left mastoiditis. Nearly at the same time, he started to suffer from anginal pain, colic and dysuria due to urinary uric acid stones, gout and left leg ulcer, which were all caused by metabolic syndromes. The last 1/3 of his life was affected by the shadow of diseases, and his religious activities were frequently disturbed. He died from myocardial infarction at the age 63, in February 1546.

  11. Medical History: Compiling Your Medical Family Tree

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    ... history. Or, you can compile your family's health history on your computer or in a paper file. If you encounter reluctance from your family, consider these strategies: Share your ... have a family history of certain diseases or health conditions. Offer to ...

  12. [European medical history museums: preserving our heritage].

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    Podgórska-Klawe, Z

    2001-01-01

    The article focuses on the Polish medical community's lack of interest in its own material medical legacy. In addition, it furnishes examples of museums, collections and exhibitions devoted to the history of medicine in the countries of Western Europe.

  13. Medical history, lifestyle, family history, and occupational risk factors for diffuse large B-cell lymphoma: the InterLymph Non-Hodgkin Lymphoma Subtypes Project.

    Science.gov (United States)

    Cerhan, James R; Kricker, Anne; Paltiel, Ora; Flowers, Christopher R; Wang, Sophia S; Monnereau, Alain; Blair, Aaron; Dal Maso, Luigino; Kane, Eleanor V; Nieters, Alexandra; Foran, James M; Miligi, Lucia; Clavel, Jacqueline; Bernstein, Leslie; Rothman, Nathaniel; Slager, Susan L; Sampson, Joshua N; Morton, Lindsay M; Skibola, Christine F

    2014-08-01

    Although risk factors for diffuse large B-cell lymphoma (DLBCL) have been suggested, their independent effects, modification by sex, and association with anatomical sites are largely unknown. In a pooled analysis of 4667 cases and 22639 controls from 19 studies, we used stepwise logistic regression to identify the most parsimonious multivariate models for DLBCL overall, by sex, and for selected anatomical sites. DLBCL was associated with B-cell activating autoimmune diseases (odds ratio [OR] = 2.36, 95% confidence interval [CI] = 1.80 to 3.09), hepatitis C virus seropositivity (OR = 2.02, 95% CI = 1.47 to 2.76), family history of non-Hodgkin lymphoma (OR = 1.95, 95% CI = 1.54 to 2.47), higher young adult body mass index (OR = 1.58, 95% CI = 1.12 to 2.23, for 35+ vs 18.5 to 22.4 kg/m(2)), higher recreational sun exposure (OR = 0.78, 95% CI = 0.69 to 0.89), any atopic disorder (OR = 0.82, 95% CI = 0.76 to 0.89), and higher socioeconomic status (OR = 0.86, 95% CI = 0.79 to 0.94). Additional risk factors for women were occupation as field crop/vegetable farm worker (OR = 1.78, 95% CI = 1.22 to 2.60), hairdresser (OR = 1.65, 95% CI = 1.12 to 2.41), and seamstress/embroider (OR = 1.49, 95% CI = 1.13 to 1.97), low adult body mass index (OR = 0.46, 95% CI = 0.29 to 0.74, for therapy started age at least 50 years (OR = 0.68, 95% CI = 0.52 to 0.88), and oral contraceptive use before 1970 (OR = 0.78, 95% CI = 0.62 to 1.00); and for men were occupation as material handling equipment operator (OR = 1.58, 95% CI = 1.02 to 2.44), lifetime alcohol consumption (OR = 0.57, 95% CI = 0.44 to 0.75, for >400 kg vs nondrinker), and previous blood transfusion (OR = 0.69, 95% CI = 0.57 to 0.83). Autoimmune disease, atopy, and family history of non-Hodgkin lymphoma showed similar associations across selected anatomical sites, whereas smoking was associated with central nervous system, testicular and cutaneous DLBCLs; inflammatory bowel disease was associated with gastrointestinal DLBCL; and

  14. The history of medical simulation.

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    Rosen, Kathleen R

    2008-06-01

    The historical roots of simulation might be described with the broadest definition of medical simulation: "an imitation of some real thing, state of affairs, or process" for the practice of skills, problem solving, and judgment. From the first "blue box" flight simulator to the military's impetus in the transfer of modeling and simulation technology to medicine, worldwide acceptance of simulation training is growing. Large collaborative simulation centers support the expectation of increases in multidisciplinary, interprofessional, and multimodal simulation training. Virtual worlds, both immersive and Web-based, are at the frontier of innovation in medical education.

  15. Why Is It Important to Know My Family Medical History?

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    ... to know my family medical history? Why is it important to know my family medical history? A ... certificates) can help complete a family medical history. It is important to keep this information up-to- ...

  16. Perspective: Should we amputate medical history?

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    Sokol, Daniel K

    2008-12-01

    This Perspective article, a cri de coeur, argues that a modicum of medical history should be incorporated into the compulsory medical curriculum. Many medical schools have no formal teaching in the subject, and students can thus graduate without the slightest knowledge of their profession's history. The author argues that, aside from holding intrinsic interest, a knowledge of the history of medicine can provide students with a sense of perspective and connectedness with the past, better judgment and reasoning, a healthy dose of humility, a deeper understanding of professionalism, greater emotional maturity, and a more critical approach to contemporary medicine. The author provides several concrete illustrations of the value of medical history to clinical practice. In answer to the rejoinder, "to replace what?" the author proposes "a little part of medical ethics," and points out that both disciplines share much in common and can be usefully combined. Finally, the author address the challenges of the proposal to incorporate medical history in the curriculum, in particular the difficulty of finding suitable teachers.

  17. Microhistory and Chinese Medical History: A Review.

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    Yu, Xinzhong; Wang, Yumeng

    2015-08-01

    With a reflection on the grand quantitative analysis in previous historical investigations, microhistory came into being in Italy in the 1960s and the 70s. Microhistory is, in principle, the intensive historical investigation of a relatively well defined smaller object. Notwithstanding, it still has the ambition to draw a larger picture of the history. Microhistory is also characterized by its preference to the exceptional individuals or phenomena, its "narrative" style and the delicate way it deals with historical sources. Essentially, microhistory endeavors to bring the individual's role, the concrete life as well as the diversity and complexity of history to the historical writing. At first, microhistory did not have intersection with the medical history. Nevertheless, the history of medicine echoes microhistory in bringing the concrete and vivid life beings to history. Mainly due to this similarity, historical surveys on medicine from the perspective of microhistory are increasing and gradually develop into a remarkable trend in the international historical academy from the 1980s onwards. As the microhistory is rising and its influence is expanding, the microhistorical approach has been practiced to a certain extent in the historical writings on medicine in China. Concentrating on an individual person, a single event, a particular drug or a specific concept, there already have some studies conduct intensive historical investigation on a small scale. A small part of these researches, for example, those of Chang Che-Chia, Li Shang-jen and etc. could be regarded as perfect examples of microhistory. However, no relevant research is carried out explicitly under the heading of microhistory, instead, they are the offspring of the "new history". Besides, most of these researches could not be regarded as real microhistories, strictly speaking. They do not practice microhistory consciously and they have a long way to go to improve the delicacy of the analysis, to

  18. [A study on medical history and historiography of medicine].

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    Wang, Zhen-Rui

    2011-09-01

    Medical history is the objective process of the development of medicine. Medicine historiography is the recording, interpretation and comments of this process. Historiography of medicine is often called medical history. By subject attribute, historiography of medicine belongs to history and could be divided into study on specific medical historiography (the objective ibeing medical history), historical materials on medicine (the objective is to offer reliable materials for specific medical historiography) and study on medical historiography (the objective being mthe historiography of medicine itself).

  19. Factors Affecting Medical Service Quality.

    OpenAIRE

    Ali Mohammad Mosadeghrad

    2014-01-01

    A better understanding of factors influencing quality of medical service can pinpoint better strategies for quality assurance in medical services. This study aimed to identify factors affecting the quality of medical services provided by Iranian physicians.Exploratory in-depth individual interviews were conducted with sixty-four physicians working in various medical institutions in Iran.Individual, organizational and environmental factors enhance or inhibit the quality of medical services. Qu...

  20. The medical history and death of Mozart.

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    Jenkins, J S

    1991-10-01

    The medical history and final illness of Mozart are reviewed in the light of information provided by the letters of the composer and his family. Early in his life there is no doubt that he suffered from a series of infective diseases which were common in 18th century Europe, and died of an acute epidemic illness. There is no clinical evidence for the widespread belief that his last years were dogged by chronic disease and that he died in renal failure.

  1. Factors Affecting Medical Service Quality

    OpenAIRE

    Mosadeghrad, Ali Mohammad

    2014-01-01

    Abstract Background A better understanding of factors influencing quality of medical service can pinpoint better strategies for quality assurance in medical services. This study aimed to identify factors affecting the quality of medical services provided by Iranian physicians. Methods Exploratory in-depth individual interviews were conducted with sixty-four physicians working in various medical institutions in Iran. Results Individual, organizational and environmental factors enhance or inhib...

  2. Medical history, diet and pancreatic cancer.

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    La Vecchia, C; Negri, E; D'Avanzo, B; Ferraroni, M; Gramenzi, A; Savoldelli, R; Boyle, P; Franceschi, S

    1990-01-01

    The relation between various aspects of medical history, selected indicator foods and the risk of pancreatic cancer was analyzed in a hospital-based case-control study conducted in Northern Italy on 247 patients with cancer of the pancreas, and 1,089 controls in hospitals for acute, nonneoplastic or digestive conditions. There was a significant association with history of pancreatitis (relative risk, RR 3.2, 95% confidence interval = 1.3-7.9), which was however reduced when the condition was first diagnosed at least 5 years previously. The point estimates were slightly, but not significantly, above unity for diabetes (RR = 1.5), gastrectomy (RR = 1.1) and cholelithiasis (RR = 1.3), and no association was found with liver disease or drug allergy. In relation to diet, there was some tendency for the risk to decrease with more frequent fruit consumption, but the results were largely inconsistent in relation to various indicators of meat, animal protein or fat intake. Although no important associations were found in this study with various aspects of medical history or diet indicators and pancreatic cancer risk, on account of the size of the dataset and the statistical power, this study contributes usefully to the debate on a common cancer whose causes are still largely undefined.

  3. [Medical history from SARS to pneumonia].

    Science.gov (United States)

    Zhen, Cheng

    2003-05-31

    SARS is a new kind of pneumonia. From the end of 2002 to the beginning of 2003, SARS broke in Guangdong province, Hong Kong and Beijing, and then gradually spread to the world. SARS is extremely contagious. The symptoms of SARS progress very quickly. SARS smashes the people's tranquil life and many people live in horror, worry and anxiety. But if we review the medical history of pneumonia, we would have a better understanding of SARS. This article focuses the history of people's understanding of pneumonia on the historical documents, diagnosis, etiology and treatment. Through the epidemic of SARS, the author hopes to express that contagion will live with us for a long time, but it is not a deadly disease. It is preventable and good care is essential for contagious patients. As Chinese people, we should have the best use of TCM in our combat with contagion.

  4. Disease history and medication use as risk factors for the clinical manifestation of type 1 diabetes in children and young adults: an explorative case control study.

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    Soulmaz Fazeli Farsani

    Full Text Available BACKGROUND: There is a highly variable asymptomatic period of beta cell destruction prior to the clinical presentation of type1 diabetes. It is not well known what triggers type 1 diabetes to become a clinically overt disease. This explorative study aimed to identify the association between disease history/medication use and the clinical manifestation of type 1 diabetes. METHODOLOGY/PRINCIPAL FINDINGS: An explorative case control study was conducted in the Dutch PHARMO Record Linkage System. Cases (n = 1,107 were younger than 25 years and had at least 2 insulin prescriptions between 1999 and 2009. For each case, up to 4 controls (without any prescription for the glucose lowering medications (n = 4,424 were matched by age and sex. Conditional logistic regression analysis was used to evaluate the association between disease history/medication use in the year prior to the diagnosis of type 1 diabetes and clinical manifestation of this disease. Type1 diabetes was significantly associated with a history of mental disorder (odds ratio (OR 8.0, 95% confidence interval (CI 1.5-43.7, anemia (OR 5.1, 95% CI 1.1-22.9, and disease of digestive system (OR 2.6, 95% CI 1.2-5.5. The following drug exposures were significantly associated with the clinical manifestation of type 1 diabetes: "systemic hormonal preparations" (OR 1.7, 95% CI 1.1-2.6, medications for "blood and blood forming organs" (OR 1.6, 95% CI 1.1-2.6, "alimentary tract and metabolism" (OR 1.3, 95% CI 1.1-1.6, and "anti-infectives for systemic use" (OR 1.2, 95% CI 1.01-1.4. CONCLUSIONS: Our explorative study demonstrated that in the year prior to the presentation of type 1 diabetes in children and young adults, hospitalization for a diverse group of diseases and drug exposures were significantly more prevalent compared with age- and sex-matched diabetes-free controls.

  5. The historiography of medical history: from great men to archaeology.

    Science.gov (United States)

    King, C R

    1991-01-01

    The history of medicine is always written from the basis of the historian. Contemporary historiography provides an understanding of the major methods of historical analysis and their influences on the writing of medical history. Medical history in the 20th century has emphasized the historiographic methods of the history of great men, historicism, social history, and intellectual history. Each methodology has inherent biases that influence the historian's analysis of the past. Understanding the historian's biases provides the reader important tools for the interpretation of medical history.

  6. The historiography of medical history: from great men to archaeology.

    Science.gov (United States)

    King, C. R.

    1991-01-01

    The history of medicine is always written from the basis of the historian. Contemporary historiography provides an understanding of the major methods of historical analysis and their influences on the writing of medical history. Medical history in the 20th century has emphasized the historiographic methods of the history of great men, historicism, social history, and intellectual history. Each methodology has inherent biases that influence the historian's analysis of the past. Understanding the historian's biases provides the reader important tools for the interpretation of medical history. PMID:1933068

  7. G-C heterozygosis in mutS homolog2 as a risk factor to hereditary nonpolyposis colon cancer in the absence of a family medical history

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    Jorge Alfonso Arvayo-Zatarain

    2011-01-01

    Full Text Available To detect the presence of point mutations in a small section of the mutS homolog2 (MSH2 gene in both healthy and affected persons treated at the General Hospital of the State of Sonora, a 353 base pair section of the MSH2 gene was amplified and sequenced from six persons affected by hereditary nonpolyposis colorectal cancer and from 19 healthy persons. The affected persons did not show the mutations reported in the scientific literature; however, six healthy persons were heterozygote and mutant-allele carriers. The heterozygote condition implies that carriers are candidates for the development of colorectal cancer. However, it is important to know the family medical history when investigating hereditary mutations.

  8. G-C heterozygosis in mutS homolog2 as a risk factor to hereditary nonpolyposis colon cancer in the absence of a family medical history.

    Science.gov (United States)

    Arvayo-Zatarain, Jorge Alfonso; Grijalva-Chon, José Manuel; Castro-Longoria, Reina; Varela-Romero, Alejandro

    2011-05-01

    To detect the presence of point mutations in a small section of the mutS homolog2 (MSH2) gene in both healthy and affected persons treated at the General Hospital of the State of Sonora, a 353 base pair section of the MSH2 gene was amplified and sequenced from six persons affected by hereditary nonpolyposis colorectal cancer and from 19 healthy persons. The affected persons did not show the mutations reported in the scientific literature; however, six healthy persons were heterozygote and mutant-allele carriers. The heterozygote condition implies that carriers are candidates for the development of colorectal cancer. However, it is important to know the family medical history when investigating hereditary mutations.

  9. G-C heterozygosis in mutS homolog2 as a risk factor to hereditary nonpolyposis colon cancer in the absence of a family medical history

    Science.gov (United States)

    Arvayo-Zatarain, Jorge Alfonso; Grijalva-Chon, José Manuel; Castro-Longoria, Reina; Varela-Romero, Alejandro

    2011-01-01

    To detect the presence of point mutations in a small section of the mutS homolog2 (MSH2) gene in both healthy and affected persons treated at the General Hospital of the State of Sonora, a 353 base pair section of the MSH2 gene was amplified and sequenced from six persons affected by hereditary nonpolyposis colorectal cancer and from 19 healthy persons. The affected persons did not show the mutations reported in the scientific literature; however, six healthy persons were heterozygote and mutant-allele carriers. The heterozygote condition implies that carriers are candidates for the development of colorectal cancer. However, it is important to know the family medical history when investigating hereditary mutations. PMID:22090720

  10. Department of medical education; A personal history

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    BAHMAN JOORABCHI

    2013-01-01

    Full Text Available This is a brief overview of the history of formal introduction of the art and science of education into the sphere of medical education in Shiraz. Before this introduction medical education was, and in the majority of other institutions world-wide still is, a simple transfer of knowledge from teacher to student. The students accepted their passive role because this was how they had been taught all their life. The teachers perpetuated this process because this was how they were taught themselves. After all, what was good enough for them was good enough for the students. All one needed to be a good teacher was to be an expert in ones field. What the Department of Medical Education attempted to do locally and the Regional Teacher Training Center internationally, was to promulgate problem-based, learner directed teaching using the principles of adult learning and using evaluation methods that were valid and reliable. This article describes the process used for this transformation and some of the results obtained.

  11. Pharmacy collected medication histories in an observation unit

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    Gabrielle L Procopio

    2015-08-01

    Full Text Available Background: Clear processes to facilitate medication reconciliation in a hospital setting are still undefined. The observation unit allows for a high patient turnover rate, where obtaining accurate medication histories is critical. Objectives: The objective of this study was to assess the ability of pharmacists and student pharmacists to identify discrepancies in medication histories obtained at triage in observation patients. Methods: Pharmacists and student pharmacists obtained a medication history for each patient placed in observation status. Patients were excluded if they were unable to provide a medication history and family, caregiver, or community pharmacy was also unable to provide the history. A comparison was made between triage and pharmacy collected medication histories to identify discrepancies. Results: A total of 501 medications histories were collected, accounting for 3213 medication records. There were 1176 (37% matched medication records and 1467 discrepancies identified, including 808 (55% omissions, 296 (20.2% wrong frequency, 278 (19% wrong dose, 51 (3.5% discontinued, and 34 (2.3% wrong medication. There was an average of 2.9 discrepancies per patient profile. In all, 76 (15% of the profiles were matched. The median time to obtain a medication history was 4 min (range: 1–48 min. Conclusion: Pharmacy collected medication histories in an observation unit identify discrepancies that can be reconciled by the interdisciplinary team.

  12. Prescription data improve the medication history in primary care

    DEFF Research Database (Denmark)

    Glintborg, Bente; Andersen, S K; Poulsen, H E

    2010-01-01

    Incomplete medication lists increase the risk of medication errors and adverse drug effects. In Denmark, dispensing data and pharmacy records are available directly online to treating physicians. We aimed (1) to describe if use of pharmacy records improved the medication history among patients...... consulting their general practitioner and (2) to characterise inconsistencies between the medication history reported by the patient and the general practitioner's recordings....

  13. ChMP: A collaborative medical history portal.

    Science.gov (United States)

    Zimmerman, Noah H; Zimmerman, Noah; Patel, Chirag; Chen, David P; Chen, David Pei-Ann

    2008-11-06

    Family medical histories play an invaluable role in disease prevention, diagnosis and treatment. Self reported medical histories frequently contain incorrect or incomplete information, severely diminishing the quality of care and clinical outcome of the patient. While tools for obtaining and analyzing medical histories are available to medical professionals, no system exists to allow families to actively participate in the collection and utilization of medical history data. We have developed a free web-based service (http://www.inherithealth.com) that allows a family to collaboratively capture and store medical history information relevant to breast cancer. The service is built on a custom framework that enables the integration of existing breast cancer risk assessment models with web-based software to communicate evidence-based risk assessment to consumers. Preliminary user evaluations indicate that consumers find the tool usable, and are interested in learning about their breast cancer risk.

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

    Science.gov (United States)

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

    2016-06-01

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

  15. On the history of New York Medical College.

    Science.gov (United States)

    Greenberg, S J

    1986-01-01

    The history of New York Medical College reflects three distinct trends in the development of medical education: the rise and fall of homeopathy, the input of civic leaders (in this case, William Cullen Bryant) and the uneasy relationship between medical schools and hospitals caused by the dramatic increase in the complexity and cost of hospital care.

  16. Unesco – to preserve Slovenian medical history

    Directory of Open Access Journals (Sweden)

    Darinka Soban

    2006-03-01

    Full Text Available Abstract: The beginnings of university studies of medicine in Ljubljana, and wartime interruptions. – One hundred years of anesthesia on the European continent as part of the surgeon’s work and responsibility. – The organization of health service (1942–1945 within the partisan resistance struggle. – Clandestine partisan hospitals. The wounded, the staff, the physicians. – Wartime anesthesia: an overview and perspectives. – SVPB Franja: a description. The efforts invested so far for the recognition of this war memorial as a UNESCO World Heritage Site. – From the 1982 International Symposium on the History of Modern Anesthesia to ISHA – the international society for the history of anesthesia.

  17. 77 FR 74168 - Information Collection: Youth Conservation Corps Application and Medical History

    Science.gov (United States)

    2012-12-13

    ... history including vaccination history, previous and current illnesses or conditions that may affect... Forest Service Information Collection: Youth Conservation Corps Application and Medical History AGENCY... information collection, OMB 0596- 0084, Youth Conservation Corps Application and Medical History....

  18. The History, Biology and Medical Aspects of Leprosy.

    Science.gov (United States)

    Eichman, Phillip

    1999-01-01

    Presents information about the history, biology, and medical aspects of leprosy, including its description in historical documents, its cause and effects, statistics on its prevalence, and various attempts at treatment. Notes that leprosy is one of the few infectious diseases that, although treatable with medication, remains incurable. Contains 30…

  19. The History, Biology and Medical Aspects of Leprosy.

    Science.gov (United States)

    Eichman, Phillip

    1999-01-01

    Presents information about the history, biology, and medical aspects of leprosy, including its description in historical documents, its cause and effects, statistics on its prevalence, and various attempts at treatment. Notes that leprosy is one of the few infectious diseases that, although treatable with medication, remains incurable. Contains 30…

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

    Directory of Open Access Journals (Sweden)

    F. S. Faruque

    2016-06-01

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

  1. [The medical history of Edgar Allan Poe].

    Science.gov (United States)

    Miranda C, Marcelo

    2007-09-01

    Edgar Allan Poe, one of the best American storytellers and poets, suffered an episodic behaviour disorder partially triggered by alcohol and opiate use. Much confusion still exists about the last days of his turbulent life and the cause of his death at an early age. Different etiologies have been proposed to explain his main medical problem, however, complex partial seizures triggered by alcohol, poorly recognized at the time when Poe lived, seems to be one of the most acceptable hypothesis, among others discussed.

  2. History of Manuscriptology: study of medical manuscripts.

    Science.gov (United States)

    Narayana, Ala

    2005-01-01

    Connoisseurs of different areas of learning are apt to hold their particular area higher above all else, as the 'Science of Sciences'. These sciences transmitted to a scholar or to a common man are known through the texts, which are either handwritten or printed. The marvel of accuracy with which the vast literature specially Vedic literature has been handed down or transmitted to us orally, from generation to generations in India carried from person to person through mouth and ear, is a matter of great admiration all early literature that is now available in printed form, originally hand written i. e. in the form of manuscripts is the basis for the learning of science and technology today. Hence, it is forced to grant a top place of honor to the science of Manuscriptology and can be considered as 'Science of Sciences'. The scripts; Writing tools; Languages; Conservation, Preservation, Maintenance of the manuscripts; the study of medical manuscripts and its constraints; the strategies to validate the old concepts, drugs, diseases, and methods of treatment hidden in the manuscripts and knowledge application in the medical science are discussed here under.

  3. The implication of integrated training program for medical history education

    Directory of Open Access Journals (Sweden)

    Shun-Sheng Chen

    2015-02-01

    Full Text Available Background: A full spectrum of medical education requires not only clinical skills but also humanistic qualities in the medical professionals, which can be facilitated by an integrated training program. An integrated project was created to improve one's medical intellectual and communication competence and to enable them to become docents who can perform well, as well as for development of their humanitarian nature. The aim of this study was to suggest an integrated program that provided approaches for creating positive effects in medical history education. Methods: Taiwan Medical Museum conducted a project on medical history lessons and docent training program; 51 participants (24 male and 27 female attended this plan. Targets took pre-tests before lectures, attended courses of medical history, and then took post-tests. Next, they received a series of lessons on presentation skills and practiced for guiding performance. After all the training processes, the attendees succeeded in all evaluations in order to guide exhibition visitors. Data were analyzed using paired t test. Results: Two types of assessments were followed, i.e., cognitive examination and guiding practice, and both were related to good performance. Reliability (Cronbach's α was 0.737 for the cognitive examination and 0.87 for the guiding evaluation. It indicated that the integrated program for docent training resulted in a significant difference (p ≦ 0.0001. Conclusion: The participants demonstrated better achievement and knowledge acquisition through the entire process, which led to great performance when approached by the visitors. The whole project helped to shape up a good docent and to accumulate positive learning experiences for medical professionals as well. Therefore, an integrated program is recommended to medical history education in the future.

  4. [The trend and prospect of studies of East Asian medical history in Korea].

    Science.gov (United States)

    Sihn, Kyuhwan

    2010-06-30

    Studies of East Asian medical history in Korea have progressively accumulated in the last twenty years. First, Korean scholars broadened the focus of research from China-centered research to East Asian research. Studies of Toyo medical history in Korea mainly concentrated on Chinese medical history. Toyo medical history originated from Japanese orientalism and imperialism. Today the studies of East Asian medical history in Korea include Korea, China and Japan, and attempt to deal with East Asia as a single conceptual category. Second, researchers in East Asian medical history are steadily increasing. They study Chinese medical history or Japanese medical history from universities. As they continue their research in academic positions, successive researchers emerge. Third, the number of Korean scholars remains relatively small, but they pursue original research. Their interests are in the discourse of East Asian medical history, colonial modernity, environmental history, oral history, and history of disease.

  5. Reconstructing medical history: historiographical features, approaches and challenges.

    Science.gov (United States)

    Conti, A A

    2011-01-01

    Medical historiography deals with the concepts, theories, and approaches adopted in the reconstruction and discussion of the history of medicine. The expression has changed through time and according to different scholars and contexts, and it largely depends on the general standpoint from which the medicine of the past is examined. From an Evidence Based History of Medicine perspective, an accurate and complete examination of all available sources must be carried out to draw a picture of the medical theme examined, and, to reach this aim, the issue of the reliability of sources is a preliminary point to take into account. Different historiographical models adopted in the twentieth century will be discussed in this paper. The current ample discussion on the characterising features, methods and challenges of medical historiography documents the wide extent of the debate on the ways available today for the reconstruction of medical history. It also testifies to the relevance, inter-disciplinarity and remarkable vitality of the topic in current academic, scientific and social contexts. Medical and health history is an essential part of current medicine, and the study of the development of medicine through time is an extremely formative experience, which should not be confined to historians and professionals, but which, in appropriate formats and in correct methodological terms, should have full right of citizenship in current health care initiatives.

  6. Has medical history importance for surgeons?

    Science.gov (United States)

    Wangensteen, O W

    1975-03-01

    . Solution of the biologic rejection phenomenon is awaited eagerly by all investigators, a discovery that will greatly enhance predictable success of transfer of skin as well as of organs. When will surgery experience another great catalytic forward thrust like that achieved through anesthesia, prophylactic antisepsis, and the antibiotics? No discipline in medicine can exist alone without privation. For its continuing advancement, surgery is dependent upon close and intimate relationships with many other medical disciplines. Apart from the enlightenment provided by a searching examination of the origins of our surgical discipline, the earnest and persistent pursuer will discover a lively pleasure and satisfaction that accrues as a special dividend.

  7. [Medical history and ethics. In memoriam Rolf Winau (1937-2006)].

    Science.gov (United States)

    Schott, Heinz

    2008-01-01

    The paper contributes to the discussion on the self-image of the institutionalized medical history at the medical schools in Germany. Influenced by the curriculum of the new licence to practice medicine (Approbationsordnung für Arzte) containing a so-called cross-section (Querschnittsbereich) "history, theory, ethics of medicine", the scientific community is to a certain extent rather prone to assume clear cut different disciplines--especially medical history versus medical ethics--than to consider overlapping and almost inseparable fields of work with corresponding implications. The author supports the latter approach and advocates the appreciation of the "subjective factor" in regard to teaching granting an ample scope for the individual teacher.

  8. [The 'feminine' in the history of medical didactics].

    Science.gov (United States)

    Melillo, Luigia

    2005-01-01

    Women are present in the 'long' history of medicine both as patients and as healers specialising in curing and caring. The nowadays existing attempt to define a female specific medical knowledge (discussing, for instance, the quality of a supposed 'female' cultural and professional training; the role of women in medical research as well as in discussing bioethical subjects; the relationship between women-physicians and other medical professionals; the female approach to important bioethical issues such as euthanasy, 'therapeutical fury' for the incurable sick, female genital mutilations) is here analyzed in a broader historical context.

  9. [History of medical ethics in Korea: focused on analysis of medical codes and covenants].

    Science.gov (United States)

    Shin, D W

    2000-12-01

    This article deals with the emergence of the codes of medical ethics and their change in Korean history. The modernized medical codes or covenants by the group of medical doctors has been made from the mid-twentieth century, although Korea has a long tradition of medical ethics, so called the Confucian medical ethics, Insul or Uido which were taken on very strong paternalistic characters. The history of the codes of medical ethics in contemporary Korea showed several revisions in 1961, 1965, 1979, and 1997 since the first establishment in 1955. Changes of political circumstances, the cultural level of the people, medical care system, and medical power leaded to the revisions. Throughout the revisions the codes or covenants of medical ethics in Korea has changed from simple translations of the codes by the World Medical Association and the American Medical Association to the reflexes of domestic medical situations; from the ones based on paternalistic doctor-patient relationship to more democratic ones; from the ones that only medical ethics were expressed to the ones that bioethics was expressed too.

  10. Medical education in a foreign language and history-taking in the native language in Lebanon - a nationwide survey.

    Science.gov (United States)

    Abi Raad, Vanda; Raad, Kareem; Daaboul, Yazan; Korjian, Serge; Asmar, Nadia; Jammal, Mouin; Aoun Bahous, Sola

    2016-11-22

    With the adoption of the English language in medical education, a gap in clinical communication may develop in countries where the native language is different from the language of medical education. This study investigates the association between medical education in a foreign language and students' confidence in their history-taking skills in their native language. This cross-sectional study consisted of a 17-question survey among medical students in clinical clerkships of Lebanese medical schools. The relationship between the language of medical education and confidence in conducting a medical history in Arabic (the native language) was evaluated (n = 457). The majority (88.5%) of students whose native language was Arabic were confident they could conduct a medical history in Arabic. Among participants enrolled in the first clinical year, high confidence in Arabic history-taking was independently associated with Arabic being the native language and with conducting medical history in Arabic either in the pre-clinical years or during extracurricular activities. Among students in their second clinical year, however, these factors were not associated with confidence levels. Despite having their medical education in a foreign language, the majority of students in Lebanese medical schools are confident in conducting a medical history in their native language.

  11. [Methodological approach to the history of medical hydrology].

    Science.gov (United States)

    Rodríguez-Sánchez, J A

    1993-01-01

    An historical study of medical hydrology allows us to outline a clear social history in Spain. The author identifies three groups of people living and working in and around thermal baths; he suggests studying relations between doctors and patients, therms economics, the social life in baths and the organization of people living around them. A correct use of handwritten and printed sources describing various aspects of thermal life can help us to understand an always interesting phenomenon.

  12. History of the Journal of Veterinary Medical Education.

    Science.gov (United States)

    Fletcher, Oscar J; Hooper, Billy E; Schoenfeld-Tacher, Regina

    2015-01-01

    The Journal of Veterinary Medical Education (JVME), with the leadership of seven editors and two interim editors, grew from 33 pages of mostly news and commentary to become the premier source for information exchange in veterinary medical education. The first national publication of the Association of American Veterinary Medical Colleges (AAVMC) was a 21-page newsletter published in December 1973. This one-time newsletter was followed by volume 1, issue 1 of JVME, published in spring 1974 and edited by William W. Armistead. Richard Talbot was the second and longest serving editor, and under his leadership, JVME grew in the number and quality of papers. Lester Crawford and John Hubbell served as interim editors, maintaining quality and keeping JVME on track until a new editor was in place. Robert Wilson, Billy Hooper, Donal Walsh, Henry Baker, and the current editor, Daryl Buss, are major contributors to the success of JVME. The early history of the journal is described by Billy Hooper and followed by a brief history of the periods of each of the editors. This history concludes with objective and subjective evaluations of the impacts of JVME.

  13. Childhood obesity : medical, cultural and psychological factors

    NARCIS (Netherlands)

    Radhakishun, N.N.E.

    2014-01-01

    The aim of this thesis was to examine medical, cultural and psychological factors of childhood obesity in a multi-ethnic cohort. Medical factors Several associations between weight measured and hormones were determined in obese children between 6 and 18 years. Thyroid stimulating hormone (TSH) was a

  14. Childhood obesity: medical, cultural and psychological factors

    NARCIS (Netherlands)

    Radhakishun, N.N.E.

    2014-01-01

    The aim of this thesis was to examine medical, cultural and psychological factors of childhood obesity in a multi-ethnic cohort. Medical factors Several associations between weight measured and hormones were determined in obese children between 6 and 18 years. Thyroid stimulating hormone (TSH) was

  15. An audit comparing the discrepancies between a verbal enquiry, a written history, and an electronic medical history questionnaire: a suggested medical history/social history form for clinical practice.

    LENUS (Irish Health Repository)

    Carey, Barbara

    2011-04-01

    In everyday practice, dentists are confronted with an increasing number of patients with complex medical problems. There is divergence of opinion among dentists regarding how to obtain a thorough medical\\/social history.

  16. A short history of medical informatics in bosnia and herzegovina.

    Science.gov (United States)

    Masic, Izet

    2014-02-01

    The health informatics profession in Bosnia and Herzegovina has relatively long history. Thirty five years from the introduction of the first automatic manipulation of data, thirty years from the establishment of Society for Medical Informatics BiH, twenty years from the establishment of the Scientific journal "Acta Informatica Medica (Acta Inform Med", indexed in PubMed, PubMed Central Scopus, Embase, etc.), twenty years on from the establishment of the first Cathedra for Medical Informatics on Biomedical Faculties in Bosnia and Herzegovina, ten years on from the introduction of the method of "Distance learning" in medical curriculum. The author of this article is eager to mark the importance of the above mentioned Anniversaries in the development of Health informatics in Bosnia and Herzegovina and have attempted, very briefly, to present the most significant events and persons with essential roles throughout this period.

  17. Asthma, diabetes and hypertension: diseases and medical histories.

    Science.gov (United States)

    Nkansah, P J

    1995-01-01

    Virtually all dental offices are asked to treat patients with underlying medical concerns. Because of their high prevalence in our society, we are obligated to have some familiarity with asthma, diabetes, and hypertension. Dental treatment can affect or be affected by these diseases. Our mandate as health care professionals to "do no harm" dictates that we must be prepared to properly assess all patients in determining how, and if, they may be treated safely. Good medical histories and physical examinations are the only ways to do this. When faced with a medically compromised patient, the following recommendations apply: Have a working knowledge of the disease. Prepare your facility for a crisis. Consider your reasonable prevention protocols and use them as appropriate. Avoid known triggers. Plan to lower stress.

  18. [Preliminary exploration on educational reform of general western medical history in medical colleges and universities under new situations and circumstances].

    Science.gov (United States)

    Fu, Deming; Wang, Hongqi; Yan, Juan; He, Peifeng

    2015-03-01

    With the appearance of the "biological-psychological-social" medical model, the purpose, value and significance of medicine are reviewed and reconsidered by the people, and the history of medicine becomes one of the core subjects in the medical humanist education, along with change of the teaching of general western medical history. Medical history is no longer the accumulation of the achievements of human knowledge and medical experience, the intellectual history of theorytransformation, and the history of reformation of medical technologies, but a concrete and colorful living situation, displayed by the scientists, physicians and normal peoplecommunity during the process of their consistent recognition and transformation on medicine. Therefore, the teaching of generalwestern medical history should adjust the compilation of teaching materials, update the educational concept, change the contents, methods of teaching and examination in order to lay stress on the cultural viewpoint and the function of humanity and quality of education.

  19. Transfer factors in medical therapy

    National Research Council Canada - National Science Library

    Sánchez-González, Dolores J; Sosa-Luna, Carlos A; Vásquez-Moctezuma, Ismael

    2011-01-01

    Transfer factor (TF) consists of messenger peptides produced by activated T lymphocytes as part of cellular immunity, and it acts in virgin lymphocytes through TF inducers, suppressors and specific antigens...

  20. Depressive symptoms in medical students: prevalence and related factors.

    Science.gov (United States)

    Kim, Bomi; Roh, Hyerin

    2014-03-01

    This study was designed to estimate the prevalence of depression and the factors that influence it in Korean medical students. We evaluated depression in 122 first- and second-year medical students in December 2011 using the Korean Beck Depression Inventory (K-BDI). Sixteen potential factors were considered: gender, class year, grade point average, breakfast habits, residence type, leisure activity, sleep satisfaction, relationship status, a close friend or a significant other, finances, present health status, history of mood disorders, family history of mood disorders, religion, and self-esteem. The average BDI score was 8.9. There were 80 (65.6%), 16 (13.1%), 15 (12.3%), and 11 (9.0%) students with minimal, mild, moderate, and severe depression, respectively. The group with depressive symptoms comprised males with a total BDI score > or =24 and females with total BDI > or =25 and constituted 9.0% of students. Students in the depressive symptom group had lower self-esteem and lower grade point averages and were more frequently ill, less likely to be in a relationship, and more likely to have a history of mood disorders (pself-esteem score was an independent factor. The BDI scores in our study were similar to those that have been reported in other countries but slightly higher than in other Korean medical and university students. Self-esteem, grade point average, health status, history of mood disorders, family history of mood disorders, and presence of a significant other correlated significantly with depression in medical students.

  1. Factors associated with stress among medical students.

    Science.gov (United States)

    Qamar, Khadija; Khan, Najamus Saqib; Bashir Kiani, Muhammad Rizwan

    2015-07-01

    To determine the probable factors responsible for stress among undergraduate medical students. The qualitative descriptive study was conducted at a public-sector medical college in Islamabad, Pakistan, from January to April 2014. Self-administered open-ended questionnaires were used to collect data from first year medical students in order to study the factors associated with the new environment. There were 115 students in the study with a mean age of 19±6.76 years. Overall, 35(30.4%) students had mild to moderate physical problems, 20(17.4%) had severe physical problems and 60(52.2%) did not have any physical problem. Average stress score was 19.6±6.76. Major elements responsible for stress identified were environmental factors, new college environment, student abuse, tough study routines and personal factors. Majority of undergraduate students experienced stress due to both academic and emotional factors.

  2. Family history of cancer, personal history of medical conditions and risk of oral cavity cancer in France: the ICARE study.

    OpenAIRE

    Radoï, Loredana; Paget-Bailly, Sophie; Guida, Florence; Cyr, Diane; Menvielle, Gwenn; Schmaus, Annie; Carton, Matthieu; Cénée, Sylvie; Sanchez, Marie; Guizard, Anne-Valérie; Trétarre, Brigitte; Stücker, Isabelle; Luce, Danièle

    2013-01-01

    International audience; BACKGROUND: The aim of this study was to evaluate the role of family history of cancer and personal history of other medical conditions in the aetiology of the oral cavity cancer in France. METHODS: We used data from 689 cases of oral cavity squamous cell carcinoma and 3481 controls included in a population-based case--control study, the ICARE study. Odds-ratios (ORs) associated with family history of cancer and personal medical conditions and their 95% confidence inte...

  3. Role of medical history and medication use in the aetiology of upper aerodigestive tract cancers in Europe: the ARCAGE study.

    LENUS (Irish Health Repository)

    Macfarlane, T V

    2012-04-01

    The study aimed to investigate the role of medical history (skin warts, Candida albicans, herpetic lesions, heartburn, regurgitation) and medication use (for heartburn; for regurgitation; aspirin) in the aetiology of upper aerodigestive tract (UADT) cancer.

  4. Erosion of Conserved Binding Sites in Personal Genomes Points to Medical Histories.

    Directory of Open Access Journals (Sweden)

    Harendra Guturu

    2016-02-01

    Full Text Available Although many human diseases have a genetic component involving many loci, the majority of studies are statistically underpowered to isolate the many contributing variants, raising the question of the existence of alternate processes to identify disease mutations. To address this question, we collect ancestral transcription factor binding sites disrupted by an individual's variants and then look for their most significant congregation next to a group of functionally related genes. Strikingly, when the method is applied to five different full human genomes, the top enriched function for each is invariably reflective of their very different medical histories. For example, our method implicates "abnormal cardiac output" for a patient with a longstanding family history of heart disease, "decreased circulating sodium level" for an individual with hypertension, and other biologically appealing links for medical histories spanning narcolepsy to axonal neuropathy. Our results suggest that erosion of gene regulation by mutation load significantly contributes to observed heritable phenotypes that manifest in the medical history. The test we developed exposes a hitherto hidden layer of personal variants that promise to shed new light on human disease penetrance, expressivity and the sensitivity with which we can detect them.

  5. Factors influencing medication label viewing in Malaysia.

    Science.gov (United States)

    Cheah, Yong Kang; Chong, Yen Wan

    2016-07-12

    The misuse of medicine is a serious public health issue worldwide. An important factor that contributes to the misuse of medicine is the lack of medication label viewing by consumers. The objective of the present study is to examine the socio-economic, demographic and lifestyle factors associated with medication label viewing among Malaysian adults. The empirical analysis is based on a nationally representative data set of 30,992 respondents. An ordered probit model is used to examine different types of medication label viewers. The results of this study suggest that socio-economic (i.e. age, income level, education level, location of residence), demographic (i.e. gender, ethnicity, marital status) and lifestyle factors (i.e. physical activity, smoking) have significant effects on medication label viewing. It is found that age, low-income and low-education level reduce the likelihood of viewing medication label. Based on these findings, several policy implications are suggested. The present study provides policy makers with baseline information regarding which cohorts of individuals to focus on in efforts to increase the frequency of medication label viewing.

  6. History of evolution of the concept of medical ethics.

    Science.gov (United States)

    Majumdar, Sisir K

    2003-01-01

    "Time present and time past are both perhaps present in time future and time future contained in time past".--Thomas Steams Eliot (1888-1965), Noble Literature Laureate, 1948. History and evolution of the concept of Medical Ethics is the classical example of this poetic expression. Virtually, every human society has some forces of myth to explain the origin of morality. Indian ethics was philosophical from its very birth. In the Vedas (1500 B.C.), ethics was an integral aspect of philosophical and religious speculation about the nature of reality. The Vedas says how people ought to live and is the oldest philosophical literature in the world. It was the first account of philosophical ethics in human history. The old Testament of (c. 200 B.C.) the Hebrew Bible (Greek--ta biblia--"the books") gives account of God giving the Ten Commandments--the oral and written Law engraved on tablets of Stone to Moses around 13th century B.C. on Mount Sinai (Arabic--Gebel Musa) the Mountain near the tip of the Sinai Peninsula in West Asia.

  7. The Oral History Program: II. Personal views of health sciences librarianship and the Medical Library Association.

    Science.gov (United States)

    McKenzie, D; Pifalo, V

    1998-07-01

    The Medical Library Association Oral History Program uses accepted oral history techniques to collect and preserve interviews with members. The original taped interviews and transcripts are kept in the Medical Library Association archives and made available for research purposes; edited copies of the interviews are distributed through the National Network of Libraries of Medicine, and members are encouraged to borrow and read the histories. Summaries of forty-three interviews provide personal views on health sciences librarianship and the Medical Library Association.

  8. Factors affecting medication adherence in elderly people

    Directory of Open Access Journals (Sweden)

    Jin HK

    2016-10-01

    Full Text Available Hyekyung Jin,1 Yeonhee Kim,2 Sandy Jeong Rhie1,3 1College of Pharmacy, 2Center for Excellence in Teaching & Learning, 3Division of Life and Pharmaceutical Sciences, Ewha Womans University, Seoul, Republic of Korea Background: Little is known about the functional health literacy (FHL associated with medication adherence in elderly patients. The aim of this study was to examine the FHL among older adults and identify influencing factors that can predict medication adherence. Methods: This was a cross-sectional survey. Participants (n=160 aged 65 years and older were selected from outpatient clinics of 3 tertiary care hospitals, 6 community pharmacies, and 2 senior centers between November 1 and 30, 2014. The participants’ FHL was measured using the Korean Functional Health Literacy Test, which consists of 15 items including 8 numeracy and 7 reading comprehension items. Medication adherence was measured by the Adherence to Refills and Medication Scale. Descriptive statistics, chi-square or Fisher’s exact test, and multiple regression analyses were used to analyze the data. Results: The mean score of the total FHL was 7.72±3.51 (range 0–15. The percentage of the total number of correct answers for the reading comprehension subtest and numeracy subtest were 48.1% and 54.4%, respectively. Among 160 participants, 52.5% showed low adherence to medication. The factors affecting medication adherence included the patient’s degree of satisfaction with the service (β=-0.215, P=0.022, sufficient explanation of medication counseling (β=-0.335, P=0.000, education level (β=-0.153, P=0.045, health-related problems (β=-0.239, P=0.004, and dosing frequency (β=0.189, P=0.018. Conclusion: In this study, we found medication adherence of elderly patients was associated with education level, health-related problems, dosing frequency, satisfaction with patient counseling, and explanation of medication, but no association was found with FHL. Pharmacists

  9. [The function of philosophy of science in the teaching of medical history].

    Science.gov (United States)

    Li, Yaming

    2014-05-01

    The philosophy of science yields 3 important functions in the teaching of medical history. Firstly, by analyzing the development of medicine from the perspective of philosophy, we can integrate medical history into the history of human thought and clearly show the close connection between the development of humanity and the development of medical science. Secondly, philosophical analysis on the general rules of scientific discoveries involved in medical history can help medical students to understand the methodology in the research of sciences in history. Thirdly, philosophy of science offers new dimensions for understanding the relationship between medicine and the society. By making use of the relevant theory in scientific philosophy to explore the relationship between medicine and the society, the nature of medicine and the social nature and function of science can be further understood by medical students so as to exert an active role in the research and clinical work in the future.

  10. Application of oral history to contemporary history of medicine in Korea: with a focus on medical scientists.

    Science.gov (United States)

    Kim, Ock-Joo

    2013-08-01

    The oral history helps researchers to fill the gap in historical documents in research on the contemporary history of medicine in Korea. More and more studies in history of contemporary medicine in Korea have come out using oral history of doctors and patients. Based upon the author's research on development of neurosurgery in late 20th century Korea, this paper discusses how to apply oral history to contemporary history of medicine, focusing on oral history of doctors in Korea. In this paper the author describes how to do and use oral history of key doctors and medical scientists in the contemporary history of medicine in Korea. The oral history can be a powerful tool to complement the written documents as following. First, from their interview, doctors and medical scientists often provide valuable information which historians cannot get from documents and written sources. As intelligent interviewees, they not only understand the purpose of research but also help actively the historianresearcher- interviewer. Second, the oral history facilitates further searches and often it leads to more findings of informants, and written and image material. More often than not, doctors and medical scientists do their own research on the topic and provide the historian with valuable historical source material from their laboratories, bedsides, family and friends. Third, interviews with medical scientists and oral material produced by doctors and medical scientists helped the researcher to understand and interpret the papers and written documents. Fourth, the subjective stories told by the medical scientists provide perspectives and historical source as narrative truth. Before a historian attempts to use the oral material as complementary historial evidence, he or she needs to cross-check the validity and of objectivity of the oral material. Oral material is produced through bidirectional intersubjective interaction between the interviewer and interviewee, and critical reflection

  11. Using Medical History Embedded in Biometrics Medical Card for User Identity Authentication: Data Representation by AVT Hierarchical Data Tree

    Directory of Open Access Journals (Sweden)

    Simon Fong

    2012-01-01

    Full Text Available User authentication has been widely used by biometric applications that work on unique bodily features, such as fingerprints, retina scan, and palm vessels recognition. This paper proposes a novel concept of biometric authentication by exploiting a user’s medical history. Although medical history may not be absolutely unique to every individual person, the chances of having two persons who share an exactly identical trail of medical and prognosis history are slim. Therefore, in addition to common biometric identification methods, medical history can be used as ingredients for generating Q&A challenges upon user authentication. This concept is motivated by a recent advancement on smart-card technology that future identity cards are able to carry patents’ medical history like a mobile database. Privacy, however, may be a concern when medical history is used for authentication. Therefore in this paper, a new method is proposed for abstracting the medical data by using attribute value taxonomies, into a hierarchical data tree (h-Data. Questions can be abstracted to various level of resolution (hence sensitivity of private data for use in the authentication process. The method is described and a case study is given in this paper.

  12. Using medical history embedded in biometrics medical card for user identity authentication: data representation by AVT hierarchical data tree.

    Science.gov (United States)

    Fong, Simon; Zhuang, Yan

    2012-01-01

    User authentication has been widely used by biometric applications that work on unique bodily features, such as fingerprints, retina scan, and palm vessels recognition. This paper proposes a novel concept of biometric authentication by exploiting a user's medical history. Although medical history may not be absolutely unique to every individual person, the chances of having two persons who share an exactly identical trail of medical and prognosis history are slim. Therefore, in addition to common biometric identification methods, medical history can be used as ingredients for generating Q&A challenges upon user authentication. This concept is motivated by a recent advancement on smart-card technology that future identity cards are able to carry patents' medical history like a mobile database. Privacy, however, may be a concern when medical history is used for authentication. Therefore in this paper, a new method is proposed for abstracting the medical data by using attribute value taxonomies, into a hierarchical data tree (h-Data). Questions can be abstracted to various level of resolution (hence sensitivity of private data) for use in the authentication process. The method is described and a case study is given in this paper.

  13. Medical risk factors amongst drivers in single-car accidents.

    Science.gov (United States)

    Gislason, T; Tómasson, K; Reynisdóttir, H; Björnsson, J K; Kristbjarnarson, H

    1997-03-01

    To estimate medical risk factors amongst drivers in single-car accidents with special reference to sleepiness and alcohol abuse. An epidemiological survey by means of multiple-choice questionnaires that were mailed to drivers and a random control group. Iceland. All drivers in single-car accidents (n = 471) during 1989-91 and a control group from the general population (n = 1000). Medical health profile and answers to questions concerning sleep disorders and alcohol abuse. Compared to the controls the drivers were younger and there were three times more males. The drivers abused alcohol more often. Chronic disorders such as epilepsy, diabetes mellitus, and cardiac disorders were not over-represented. Altogether, 15.4% claimed that sleepiness had caused their traffic accident, logistic regression analyses revealed that these 'sleepy' drivers more often had alcohol abuse and a history of 'almost falling a sleep whilst driving'. Compared to controls, drivers in single-car accidents are more likely to be young, male, have a history of sleepiness whilst driving, and also have a history suggestive of alcoholism. Chronic disorders like epilepsy and diabetes mellitus were not over-represented amongst the single-car accidents drivers. These results raise the question of how drivers with a high probability of causing an accident (sleepiness and alcoholism) can be identified in time and proper measures taken to prevent 'accidents waiting to happen'.

  14. Medication Desensitization: Characterization of Outcomes and Risk Factors for Reactions.

    Science.gov (United States)

    Murray, Taryn S; Rice, Todd W; Wheeler, Arthur P; Phillips, Elizabeth J; Dworski, Ryszard T; Stollings, Joanna L

    2016-03-01

    Although its mechanisms are poorly understood, desensitization has been used to induce a temporary state of immune unresponsiveness in patients who have IgE-, non-IgE-, or pharmacologically mediated reactions when a drug has no alternatives. The purpose of this study was to characterize the outcomes and identify risk factors for reactions during drug desensitization. A retrospective review of electronic medical records of adult patients undergoing drug desensitization from January 1, 2011, to December 31, 2013, was conducted in 2 intensive care units at a tertiary medical center. We used multivariate analysis to determine if specified risk factors were associated with reacting during the desensitization. Reactions were classified according to the pretest probability prior to desensitization, and then, reactions during desensitization were classified based on the occurrence of cutaneous reactions as follows: successful with no reaction, mild reaction, moderate reaction, or failed. Failure could result from any systemic allergic or cutaneous reaction resulting in procedure termination. The desensitizations were also assessed to determine if the patient required de-escalation secondary to a reaction. A total of 88 desensitizations were performed in 69 patients. Desensitization was completed with no cutaneous reaction in 85% of patients. No baseline characteristic, medication class (P = 0.46), or indication for desensitization (P = 0.59) was associated with having a reaction. Reported histories of urticaria (P desensitization. However, neither history of urticaria nor labored breathing was independently associated with having a reaction in multivariate analysis (OR = 0.979, 95% CI = 0.325-2.952, P = 0.970, and OR = 1.626, 95% CI = 0.536-4.931, P = 0.739, respectively). Drug desensitization is safe for patients who have no alternative for therapy. Reported allergy histories of urticaria and labored breathing are both associated with having a reaction during the

  15. Competing risks model in screening for preeclampsia by maternal characteristics and medical history.

    Science.gov (United States)

    Wright, David; Syngelaki, Argyro; Akolekar, Ranjit; Poon, Leona C; Nicolaides, Kypros H

    2015-07-01

    The purpose of this study was to develop a model for preeclampsia based on maternal demographic characteristics and medical history. This was a screening study of 120,492 singleton pregnancies at 11-13 weeks' gestation, including 2704 pregnancies (2.2%) that experienced preeclampsia. A survival-time model for the gestational age at delivery with preeclampsia was developed from variables of maternal characteristics and history. This approach assumes that, if the pregnancy was to continue indefinitely, all women would experience preeclampsia and that whether they do so or not before a specified gestational age depends on competition between delivery before or after development of preeclampsia. A 5-fold cross validation study was conducted to compare the performance of the new model with the National Institute for Health and Clinical Excellence (NICE) guidelines. In the new model, increased risk for preeclampsia, with a consequent shift in the Gaussian distribution of the gestational age at delivery with preeclampsia to the left, is provided by advancing maternal age, increasing weight, Afro-Caribbean and South Asian racial origin, medical history of chronic hypertension, diabetes mellitus and systemic lupus erythematosus or antiphospholipid syndrome, family history and personal history of preeclampsia, and conception by in vitro fertilization. The risk for preeclampsia decreases with increasing maternal height and in parous women with no previous preeclampsia; in the latter, the protective effect, which is related inversely to the interpregnancy interval, persists beyond 15 years. At a screen-positive rate of 11%, as defined by NICE, the new model predicted 40%, 48%, and 54% of cases of total preeclampsia and preeclampsia requiring delivery at preeclampsia. Such estimation of the a priori risk for preeclampsia is an essential first step in the use of Bayes theorem to combine maternal factors with biomarkers for the continuing development of more effective methods of

  16. 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.

  17. Maternal history of adoption or foster care placement in childhood: a risk factor for preterm birth.

    Science.gov (United States)

    Bublitz, Margaret H; Rodriguez, Daniel; Polly Gobin, Asi; Waldemore, Marissa; Magee, Susanna; Stroud, Laura R

    2014-10-01

    The objective of the study was to assess the impact of maternal history of adoption or foster care placement in childhood on the risk for preterm birth (PTB), controlling for other known risk factors for PTB. Participants were 302 pregnant women from a low-income, diverse sample drawn from 2 intensive prospective studies of maternal mood and behavior and fetal and infant development. Gestational age was determined by best obstetric estimate. Maternal history of adoption or foster care placement prior to age 18 years was determined by maternal report. Other maternal characteristics, including maternal medical conditions, psychosocial characteristics, and health behaviors, were measured during the second and third trimesters of pregnancy. The odds of delivering preterm (gestational age foster care placement compared with women who were never placed out of the home during childhood. This association remained significant after adjusting for other known risk factors for PTB including maternal medical conditions, psychosocial characteristics, and negative health behaviors in pregnancy. Findings suggest that a history of adoption/foster care placement is an important risk factor for PTB and may be comparable with other established risk factors for PTB including prior history of PTB, body mass index, African-American race, and advanced maternal age. More studies are needed to understand why women with placement histories may be at increased risk to deliver preterm. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Readmission to medical intensive care units: risk factors and prediction.

    Science.gov (United States)

    Jo, Yong Suk; Lee, Yeon Joo; Park, Jong Sun; Yoon, Ho Il; Lee, Jae Ho; Lee, Choon-Taek; Cho, Young-Jae

    2015-03-01

    The objectives of this study were to find factors related to medical intensive care unit (ICU) readmission and to develop a prediction index for determining patients who are likely to be readmitted to medical ICUs. We performed a retrospective cohort study of 343 consecutive patients who were admitted to the medical ICU of a single medical center from January 1, 2008 to December 31, 2012. We analyzed a broad range of patients' characteristics on the day of admission, extubation, and discharge from the ICU. Of the 343 patients discharged from the ICU alive, 33 (9.6%) were readmitted to the ICU unexpectedly. Using logistic regression analysis, the verified factors associated with increased risk of ICU readmission were male sex [odds ratio (OR) 3.17, 95% confidence interval (CI) 1.29-8.48], history of diabetes mellitus (OR 3.03, 95% CI 1.29-7.09), application of continuous renal replacement therapy during ICU stay (OR 2.78, 95% CI 0.85-9.09), white blood cell count on the day of extubation (OR 1.13, 95% CI 1.07-1.21), and heart rate just before ICU discharge (OR 1.03, 95% CI 1.01-1.06). We established a prediction index for ICU readmission using the five verified risk factors (area under the curve, 0.76, 95% CI 0.66-0.86). By using specific risk factors associated with increased readmission to the ICU, a numerical index could be established as an estimation tool to predict the risk of ICU readmission.

  19. Factors That Influence the Financing and Cost of Medical Education.

    Science.gov (United States)

    McPheeters, Harold L.

    Financing and cost factors in medical education and the effect of the many missions of a medical school on funding issues are discussed. The teaching mission of medical schools includes undergraduate medical education (preparation for the MD degree), graduate medical education (training of resident physicians), biomedical specialist education,…

  20. Medical oncology, history and its future in Iran.

    Science.gov (United States)

    Mirzania, Mehrzad; Ghavamzadeh, Ardeshir; Asvadi Kermani, Iraj; Ashrafi, Farzaneh; Allahyari, Abolghasem; Rostami, Nematollah; Razavi, Seyed Mohsen; Ramzi, Mani; Nemanipour, Gholamreza

    2015-11-01

    Systemic therapy is one of the cornerstones of cancer treatment. In 1972, following representations by American Society of Clinical Oncology (ASCO), the American Board of Internal Medicine (ABIM) recognized medical oncology as a new subspecialty of internal medicine. Subspecialty of Hematology and Medical Oncology was emerged in Iran in 1983. In the past, modern medical treatments and education were started in Dar Al-fonun school and then in Tehran University; now six universities in Iran are training in Subspecialty of Hematology and Medical Oncology. There are also ten active hematopoietic stem cell transplantation centers, thirty-one provincial medical schools use their specialized services. Future goals for Hematology and Medical Oncology in Iran include expansion and reinforcement of multidisciplinary teams across the country, early detection and prevention of cancer, providing educational program and conducting cancer researches. To achieve these goals, it is necessary to establish Cancer Hospitals in each province that link together through a network.

  1. Continuity of Care Document (CCD) Enables Delivery of Medication Histories to the Primary Care Clinician.

    Science.gov (United States)

    Simonaitis, Linas; Belsito, Anne; Cravens, Gary; Shen, Changyu; Overhage, J Marc

    2010-11-13

    The goal of the Enhanced Medication History (EMH) project is to provide medication histories to ambulatory primary care practices in the Indiana Network for Patient Care. Medications were aggregated from three different sources of pharmacy data (Medicaid, SureScripts, and the county health system of Indianapolis). Dispensing events were assembled into the Continuity of Care Document (CCD), and presented to clinicians as RxNorm Clinical Drugs. The EMH project completed 46 weeks of operation in a community health center in Indianapolis. Medication Histories were generated for 10498 office visits for 4449 distinct patients. Seven (of nine) attending physicians responded to a written survey and found the Medication Histories useful (3.9±0.4 on a scale of 1 to 5). Implementation of the EMH project demonstrated the successful use (as well as the challenging aspects) of the CCD and the RxNorm terminology in the outpatient clinical setting.

  2. The history of open access medical publishing: a comprehensive review.

    Science.gov (United States)

    Sukhov, Andrea; Burrall, Barbara; Maverakis, Emanual

    2016-09-15

    Dermatology Online Journal became the first medical open access journal in the early 1990's. Today, thousands of open access medical journals are available on the Internet. Despite criticisms surrounding open access, these journals have allowed research to be rapidly available to the public. In addition, open access journal policies allow public health research to reach developing countries where this research has the potential to make a substantial impact. In the future, open access medical journals will likely continue to evolve with technology, changing how medical research is accessed and presented.

  3. Charles E. Rosenberg and the multifaceted promise of medical history.

    Science.gov (United States)

    Stevens, Rosemary A

    2008-10-01

    Charles E. Rosenberg has had a major influence in defining the history of medicine as a field. However, critics who focus on his leadership or "school" in terms of defined scholarly perspectives, including those of social history and the framing of disease, offer inadequate descriptions of the messages, breadth, and scope of his scholarly work as a whole. Shoehorning the history of medicine into prescribed patterns in order to build a more unitary discipline would weaken rather than strengthen the field and is not in the Rosenberg tradition.

  4. [Life style, family history and personal pathology in relation to arterial hypertension in students of the Medical Faculty of UNAM].

    Science.gov (United States)

    Güemez Sandoval, J C; Moreno Altamirano, L; Kuri Morales, P; Argote Roumagnere, A; Alba Leonel, A; Méndez Vargas, R; Ramos Velázquez, E

    1990-01-01

    Arterial hypertension (HA) is a public health problem, 15 to 30% of adults in our country suffer it. There are different facts that influence its outcome. Among young people the main factors are: alcoholism, smoking tobacco, overweight, diabetes, family history, sedentarism and psychological aspects. The main object of this study, was to detect the risk factor for the development of HA in the students of the University. For this search 489 sophomore students class at the Medical School of the University of Mexico (UNAM), between 17 and 24 years old, were studied. Our results showed that positive family history was more prevalent among females. Among males life-style factors were more significant, the main factor was sedentarism, whereas lesser factor was overweight. The prevalence of HA was higher for diastolic hypertension than for systolic. We concluded there are many risk factors that influence the development of HA, which are distributed in a different way according to gender preventive measures are recommended.

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

    Science.gov (United States)

    Warner, John Harley

    2011-12-01

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

  6. Isolated cases? The history and historiography of Australian medical research.

    Science.gov (United States)

    Hobbins, Peter; Hillier, Kathryn

    2010-01-01

    For over two hundred years, Australia has been portrayed as a terminus rather than a hub for scientific exchange. Alongside narratives valorising the struggle for a distinct national identity, the motif of isolation abounds in the historiography of Australian medical research. Yet these orthodoxies are ripe for rescripting, as illustrated by a symposium held in Sydney in 2010: Isolated Cases? 100 Years of Australian Medical Research. Weaving together several historical themes from this conference with wider historiographic threads, this article questions many prevailing representations. In particular the authors argue that rather than isolation or dependency, Australian medical science has been characterised by a profound interdependence across two centuries of antipodean endeavour.

  7. [The history of the institutionalization of medical psychology in Austria].

    Science.gov (United States)

    Hirnsperger, Hans; Mundschütz, Reinhard; Sonneck, Gernot

    2011-01-01

    Beginning with Freudian psychoanalysis and the Zürich school of psychiatry, which in the early 20th century were the first to call for studies in medical psychology at universities, the article traces the path to the institutionalization of medical psychology in Austria especially in Vienna. Particular attention is devoted to the Academic Society for Medical Psychology (Akademischer Verein für Medizinische Psychologie) which held lectures and courses at the University of Vienna from 1926 to 1938. The Society can thus be viewed as a predecessor of the foundation of the institutes for medical psychology and psychotherapeutic clinics, starting in the late 1960s and continuing into the early 1980s.

  8. A history of the American College of Medical Quality.

    Science.gov (United States)

    Fetterolf, Donald; Brodie, Bridget

    2011-01-01

    The American College of Medical Quality is a national organization of health care professionals who are interested in the advancement of medical quality as a field. Composed primarily of doctorate-level individuals in medicine, dentistry, and podiatry, it also includes affiliate members in preprofessional training as well as nursing. Origins of the organization date to 1973, when it was first called the American College of Utilization Review Physicians. It is formally recognized by the American Medical Association and holds a seat in its House of Delegates. The College views the advancement of medical quality as a field of study within itself and offers multiple venues for self-education, testing, and professional networking for its members. Recently, rising national awareness of quality in health care as a field of endeavor has elevated enrollment levels and increased interest in the organization.

  9. History of standards, certification, and licensure in medical health physics.

    Science.gov (United States)

    Bushong, S C

    1995-11-01

    Immediately following the discovery of x rays they were applied to medical diagnosis and therapy. These early medical applications were soon shown to be accompanied by rather severe biologic responses and injuries. This resulted in the development of standards. Radiation standards were developed to properly control the application of x rays in medicine by controlling equipment and how it was used. Control of personnel occurred later with first certification and then licensure.

  10. [The role of chronic gastritis in past medical history with NSAID administration in patients with osteoarthrosis].

    Science.gov (United States)

    Zak, M Iu

    2014-11-01

    122 patients with osteoarthrosis, who have in the past medical history verified chronic gastritis (50 males and 72 females) at the age from 42 to 64 have been examined. Control group was comprised of 40 patients with osteoarthrosis without gastroduodenal zone pathology in the past medical history. For arthralgia relief patients were prescribed meloxicam (average dose--12.5 - 1.39 mg daily) or nimesulide (average dose--150 ± 14.91 mg daily). As a result of this research it was determined that administration of selective NSAID (meloxicam and nimesulide) in patients with chronic gastritis in the past medical history raised the risk of NSAID gastropathy/dyspepsia 2.9 times (P 0.05) of erosive gastropathy. Patients with chronic gastritis in the past medical history when taking NSAID with the purpose of gastropathy prevention are recommended to undergo gastroprotective therapy.

  11. Results of the Medications at Transitions and Clinical Handoffs (MATCH) study: an analysis of medication reconciliation errors and risk factors at hospital admission.

    Science.gov (United States)

    Gleason, Kristine M; McDaniel, Molly R; Feinglass, Joseph; Baker, David W; Lindquist, Lee; Liss, David; Noskin, Gary A

    2010-05-01

    This study was designed to determine risk factors and potential harm associated with medication errors at hospital admission. Study pharmacist and hospital-physician medication histories were compared with medication orders to identify unexplained history and order discrepancies in 651 adult medicine service inpatients with 5,701 prescription medications. Discrepancies resulting in order changes were considered errors. Logistic regression was used to analyze the association of patient demographic and clinical characteristics including patients' number of pre-admission prescription medications, pharmacies, prescribing physicians and medication changes; and presentation of medication bottles or lists. These factors were tested after controlling for patient demographics, admitting service and severity of illness. Over one-third of study patients (35.9%) experienced 309 order errors; 85% of patients had errors originate in medication histories, and almost half were omissions. Cardiovascular agents were commonly in error (29.1%). If undetected, 52.4% of order errors were rated as potentially requiring increased monitoring or intervention to preclude harm; 11.7% were rated as potentially harmful. In logistic regression analysis, patient's age > or = 65 [odds ratio (OR), 2.17; 95% confidence interval (CI), 1.09-4.30] and number of prescription medications (OR, 1.21; 95% CI, 1.14-1.29) were significantly associated with errors potentially requiring monitoring or causing harm. Presenting a medication list (OR, 0.35; 95% CI, 0.19-0.63) or bottles (OR, 0.55; 95% CI, 0.27-1.10) at admission was beneficial. Over one-third of the patients in our study had a medication error at admission, and of these patients, 85% had errors originate in their medication histories. Attempts to improve the accuracy of medication histories should focus on older patients with a large number of medications. Primary care physicians and other clinicians should help patients utilize and maintain

  12. Brief Sexual Histories and Routine HIV/STD Testing by Medical Providers

    Science.gov (United States)

    Lanier, Yzette; Castellanos, Ted; Barrow, Roxanne Y.; Jordan, Wilbert C.; Caine, Virginia

    2014-01-01

    Abstract Clinicians who routinely take patient sexual histories have the opportunity to assess patient risk for sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), and make appropriate recommendations for routine HIV/STD screenings. However, less than 40% of providers conduct sexual histories with patients, and many do not receive formal sexual history training in school. After partnering with a national professional organization of physicians, we trained 26 (US and US territory-based) practicing physicians (58% female; median age=48 years) regarding sexual history taking using both in-person and webinar methods. Trainings occurred during either a 6-h onsite or 2-h webinar session. We evaluated their post-training experiences integrating sexual histories during routine medical visits. We assessed use of sexual histories and routine HIV/STD screenings. All participating physicians reported improved sexual history taking and increases in documented sexual histories and routine HIV/STD screenings. Four themes emerged from the qualitative evaluations: (1) the need for more sexual history training; (2) the importance of providing a gender-neutral sexual history tool; (3) the existence of barriers to routine sexual histories/testing; and (4) unintended benefits for providers who were conducting routine sexual histories. These findings were used to develop a brief, gender-neutral sexual history tool for clinical use. This pilot evaluation demonstrates that providers were willing to utilize a sexual history tool in clinical practice in support of HIV/STD prevention efforts. PMID:24564387

  13. Rural Factors in the Developing History of Medicine and the Ideality Education for Medical Students at Basic Level%医学发展史中的农村因素与面向基层医学生的理想教育

    Institute of Scientific and Technical Information of China (English)

    张俊义

    2011-01-01

    在医学史中,农村因素在医学进步与名医成长中发挥了重要作用.在面向基层医学生的理想教育中引入这方面的历史资料,从价值与能力两个方面帮助他们确立人生理想,使他们深刻认识到:基层医疗卫生事业既是使命与责任,也是施展才华、实现人生理想的广阔天地.%In the developing history of medicine, rural factors had played a major role in medical advancement and the growth of famous doctors.Introduction of the role of rural factors into the ideality education for medical students who will practice at basic level health institutes will help them establish a decent life ideal from the aspects of value and ability, and deeply understand that the basic level health career is doctors'mission and duty, and also a vast world to display their talents and realize their life goals.

  14. History of Medical Parasitology and Parasitic Infections in Iran.

    Science.gov (United States)

    Edrissian, Gholamhossein; Rokni, Mohammad Bagher; Mohebali, Mehdi; Nateghpour, Mehdi; Mowlavi, Gholamreza; Bahadori, Moslem

    2016-08-01

    Parasites and parasitic diseases have been prevalent in Iran according to Iranian ancient scholars and physicians' inscriptions dating back to 865-1496. Some protozoan diseases such as malaria and cutaneous leishmaniasis have been introduced by clinical manifestations and helminthic infections by size and morphology of the worms. Scientific studies of Parasitology started in Iran from 1833, first by foreign physicians and continued from 1909 by Iranian researchers. The pioneer medical parasitologists of Iran were Dr N. Ansari and Dr. Sh. Mofidi who established the Department of Medical Parasitology in the School of Medicine, University of Tehran, 1939. Afterward, a considerable number of researchers and professors of parasitology have been active in training and research works in the fields of medical parasitology throughout the entire nation. At present, some significant parasitic diseases such as bilharsiasis and dracunculiasis are more or less eradicated and malaria is in the elimination phase. The prevalence of most helminthic infections has considerably decreased. Most of the departments of medical Parasitology in Iran are active in training MD, MSPH and PhD students. The Iranian Society of Parasitology established in 1994 is active with many eligible members and its creditable publication, the Iranian Journal of Parasitology, published seasonally since 2006. From 1833, when the scientific studies of Parasitology have started in Iran up to 2013, many researchers have been done on various fields of medical Parasitology and parasitic diseases in Iran and 2517 papers in English and 1890 papers in Persian have been published in national and international scientific journals. In addition, more than 420 books related in the field of medical parasitology field have been published in Persian language.

  15. [Forum: dermopigmentation or medical tattooing. History of tattooing].

    Science.gov (United States)

    Horn, G

    1992-08-01

    Tattooing has been performed all over the world since prehistoric times, as indicated by numerous ancient relics. The significance of tattoos has differed at times and in different civilisations (means of communication, social identification mark, religious origin). Today, it is performed by real artists who have inspired its medical applications. Medical dermopigmentation was initially used in the context of breast reconstruction (nipple areola complex) and, with subsequent refinements, its indications have been extended to the treatment of residual scars and to the permanent make-up.

  16. Medical history. TMA 50-year club members helped make it.

    Science.gov (United States)

    BeSaw, L

    1995-11-01

    They survived the Great Depression, won a world war, and touched millions of lives--from the downtrodden to heads of state--while helping to bring about the greatest advances in medicine the world has ever known. Now in retirement, the members of the Texas Medical Association's 50-Year Club look back and marvel at what they have witnessed.

  17. Factors associated with discharge against medical advice among ...

    African Journals Online (AJOL)

    There is no significant relationship between hospital environmental factors ... of the population area equal and independent opportunity to be selected for the study. ... The result of the analysis revealed that patients' factors, medical staff factors ...

  18. Risk factors for development of systemic lupus erythematosus: allergies, infections, and family history.

    Science.gov (United States)

    Cooper, Glinda S; Dooley, Mary Anne; Treadwell, Edward L; St Clair, E William; Gilkeson, Gary S

    2002-10-01

    We examined risk factors for systemic lupus erythematosus (SLE) in 265 recently diagnosed patients in North Carolina and South Carolina and 355 control subjects identified through driver's license records and frequency matched to patients by age, sex, and state. Analyses were limited to exposures before diagnosis (cases) or reference year (control subjects). SLE patients were more likely than control subjects to report a history of allergy to medications (odds ratio [OR] 3.1, 95% confidence interval [CI], 2.1-4.5), particularly to antibiotics. SLE risk increased with history of shingles (OR 2.5, 95% CI 1.1-5.9) and with frequent (more than once per year) cold sores in the 3 years before diagnosis (OR 2.8, 95% CI 1.4-5.4). There was little association with history of mononucleosis, a marker of late infection with Epstein-Barr virus, implanted medical devices, or hepatitis B vaccination. History of lupus in parents or siblings was associated with an increased risk (OR 3.3, 95% CI 1.2-8.6). Further research is needed to clarify whether medication allergies and specific infectious agents are involved in the etiology of SLE. Published by Elsevier Science Inc.

  19. History of medical informatics in europe - a short review by different approach.

    Science.gov (United States)

    Mihalas, George; Zvarova, Jana; Kulikowski, Casimir; Ball, Marion; van Bemmel, Jan; Hasman, Arie; Masic, Izet; Whitehouse, Diane; Barber, Barry

    2014-02-01

    The panel intended to collect data, opinions and views for a systematic and multiaxial approach for a comprehensive presentation of "History of Medical Informatics", treating both general (global) characteristics, but emphasizing the particular features for Europe. The topic was not only a subject of large interest but also of great importance in preparing a detailed material for celebration of forty years of medical informatics in Europe. The panel comprised a list of topics, trying to cover all major aspects to be discussed. Proposals of staging the major periods of medical informatics history were also discussed.

  20. The road to medical vibrational spectroscopy--a history.

    Science.gov (United States)

    Mantsch, Henry H

    2013-07-21

    The present Editorial chronicles the journey from classical infrared and Raman spectroscopy to medical vibrational spectroscopy, as experienced by a contemporary witness of the times. During the second half of the last century vibrational biospectroscopy became a topic of increasing global interest and has spawned a number of international conferences of which the most recent, SPEC 2012 - Shedding New Light on Disease, constitutes the basis of the present themed issue.

  1. [History of menstruation--an aspect of the medical history of the woman].

    Science.gov (United States)

    Backe, J

    1996-01-01

    The understanding of menstruation as well as the image of women have much changed in the course of history. This development, as reflected by the views of the Old Testament (Leviticus), of Hippocrates and Aristoteles, its characterization in the books of Hildegard of Bingen and of Paracelsus, its description in the Renaissance and the 18th century, is followed up to our modern times.

  2. The history and evolution of immigration medical screening for tuberculosis.

    Science.gov (United States)

    Dara, Masoud; Gushulak, Brian D; Posey, Drew L; Zellweger, Jean-Pierre; Migliori, Giovanni B

    2013-02-01

    Identifying and managing TB in immigrating populations has been an important aspect of immigration health for over a century, with the primary aim being protecting the host population by preventing the import of communicable diseases carried by the arriving migrants. This review describes the history and development of screening for TB and latent TB infection in the immigration context (describing both screening strategies and diagnostic tests used over the last century), outlining current practices and considering the future impact of new advances in screening. The recent focus of the WHO, regarding their elimination strategy, is further increasing the importance of diagnosing and treating latent TB infection. The last section of this review discusses the latest public health developments in the context of TB screening in immigrant populations.

  3. Exploring Factors Affecting Emergency Medical Services Staffs' Decision about Transporting Medical Patients to Medical Facilities.

    Science.gov (United States)

    Ebrahimian, Abbasali; Seyedin, Hesam; Jamshidi-Orak, Roohangiz; Masoumi, Gholamreza

    2014-01-01

    Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS) staffs. So this study was performed to explore affecting factors in EMS staffs' decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed using a content analysis approach. The data analysis revealed the following theme: "degree of perceived risk in EMS staffs and their patients." This theme consisted of two main categories: (1) patient's condition' and (2) the context of the EMS mission'. The patent's condition category emerged from "physical health statuses," "socioeconomic statuses," and "cultural background" subcategories. The context of the EMS mission also emerged from two subcategories of "characteristics of the mission" and EMS staffs characteristics'. EMS system managers can consider adequate technical, informational, financial, educational, and emotional supports to facilitate the decision making of their staffs. Also, development of an effective and user-friendly checklist and scoring system was recommended for quick and easy recognition of patients' needs for transportation in a prehospital situation.

  4. Exploring Factors Affecting Emergency Medical Services Staffs’ Decision about Transporting Medical Patients to Medical Facilities

    Directory of Open Access Journals (Sweden)

    Abbasali Ebrahimian

    2014-01-01

    Full Text Available Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS staffs. So this study was performed to explore affecting factors in EMS staffs’ decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed using a content analysis approach. The data analysis revealed the following theme: “degree of perceived risk in EMS staffs and their patients.” This theme consisted of two main categories: (1 patient’s condition’ and (2 the context of the EMS mission’. The patent’s condition category emerged from “physical health statuses,” “socioeconomic statuses,” and “cultural background” subcategories. The context of the EMS mission also emerged from two subcategories of “characteristics of the mission” and EMS staffs characteristics’. EMS system managers can consider adequate technical, informational, financial, educational, and emotional supports to facilitate the decision making of their staffs. Also, development of an effective and user-friendly checklist and scoring system was recommended for quick and easy recognition of patients’ needs for transportation in a prehospital situation.

  5. [The history and library the Goda family of medical doctors].

    Science.gov (United States)

    Machi, Senjuro; Kosoto, Hiroshi; Amano, Yosuke; Hanawa, Toshihiko

    2005-12-01

    The Goda family discussed in this paper is a family lineage that served as the official physicians to the Sakakibara family that ruled Takada han in Echigo province from the middle of the Edo period. Last year old medical materials and writings that had been transmitted by the family were transferred to the Oriental Medicine Research Center of the Kitasato Institute. The authors have had the opportunity to study the family genealogy and collate these archives. The Goda family has continued through eight generations. These are, respectively- (1) the founder Heizo; (2) Chuzo; (3) Shojun; (4) Yoan; (5) Yoshinobu; (6) Hitoshi; (7) Hiroshi; and (8) the present head, Takashi. We have identified two lines of physicians in collateral families (from Susumu and Akira, both sons of Yoshinobu). The archive as received is comprised of 138 separate items from a total of 450 volumes. Of these, medical works constitute 102 items in 283 volumes. The library provides valuable material which sheds light on the standard of medicine in the Takada area of Echigo from the late Edo through the Meiji periods.

  6. [History of Medical Mycology in the former German Democratic Republic].

    Science.gov (United States)

    Seebacher, C; Blaschke-Hellmessen, Renate; Kielstein, P

    2002-01-01

    After the Second World War the development of medical mycology in Germany had taken a very different course in the east and west parts depending on the political division. In this respect our contribution deals with the situation in the former German Democratic Republic. Efficient mycological centres were founded step by step almost in all medical universities on the basis of the mycological laboratories in dermatological hospitals competent for diagnostic work, but also for teaching and scientific research. In this context biologists were the main stay of mycology, they finally were integrated to the same degree in the universities like physicians. The effectiveness of the Gesellschaft für Medizinische Mykologie der DDR (GMM), its board of directors and its working groups as well as the topics of human and animal mycology during this period are described. Especially the merger of the GMM with the Deutschsprachige Mykologische Gesellschaft after the reunification of Germany without problems and the kind co-operation of Prof. Dr. Johannes Müller during this procedure are emphasized.

  7. An Analysis into Metacognition and Family History of Diabetes Mellitus among First Year Medical Students.

    Science.gov (United States)

    Priya, Ak Sunitha; Babu, Rose; Panchu, Pallavi; Bahuleyan, Biju

    2017-07-01

    Medical course requires immense effort by the students to deal with vast curriculum and hence, the need to adopt metacognitive skill to cope up. Diabetes mellitus has an impact on cognition. Metacognition, being a component of cognition, is likely to be affected by diabetes. Children of diabetic parents have demonstrated insulin resistance which may contribute to metacognitive dysfunction. Hence, it is important to focus into the link between family history of diabetes and metacognition. To evaluate the impact of family history (parents and grandparents) of diabetes mellitus on metacognition in medical students. The present study was a questionnaire based cross-sectional study. Hundred first year medical students were recruited and they filled the Metacognitive Awareness (MA) questionnaire along with the details of the family history of diabetes. The metacognitive awareness questionnaire evaluated MA, its components (metacognitive knowledge and regulation) and their subcomponents. Positive history of diabetes in parents and grandparents were taken into account. The participants were then divided into two groups: with family history of diabetes (n=73) and without family history of diabetes (n=27). The metacognitive awareness and its subcomponents between the two groups were analysed using Student t-test between the groups (with and without family history). Pearson correlation was done to analyse the association between metacognition and family history of diabetes. Metacognitive knowledge (global score) was significantly lower in group with family history of diabetes (10.25±3.01 vs 12.04±3.2, p-valuemetacognitive regulation global score (7.08±1.83 vs 7.99±1.36, p-valueMetacognitive knowledge showed a significant negative correlation with family history of diabetes (correlation coefficient = -0.263, p-valuemetacognitive awareness. The awareness that metacognitive dysfunction can occur in early age in individuals with family history of diabetes would help us to

  8. Social factors in occupational health: a history of hard hats.

    Science.gov (United States)

    Rosenberg, Beth; Levenstein, Charles

    2010-01-01

    Personal protective equipment (PPE) is the least desirable way to ensure workplace safety, and it is difficult to use consistently. Hard hats are different; they have cachet and are often worn even when they are not required. We investigated the history of this personal protective equipment to see if there were any lessons that could be applied to other forms of PPE. We learned that what makes hard hats special are social factors that are specific to a certain time and place. The importance of social factors illuminates the requirement that cultural and social norms of workers be included in any kind of worker safety and health training.

  9. The library of the Royal Society of Physicians in Budapest becomes today's Semmelweis Medical History Library.

    Science.gov (United States)

    Kaproncszay, Katalin; Magyar, László András; Putnam, Constance E

    2011-01-01

    The 170-year history of the library of the Royal Society of Medicine in Budapest illustrates both that political and cultural context matter and that "medical" libraries, if they survive, in due course become primarily "medical history" libraries. Two of the authors are on the staff of the Semmelweis Medical History Library; the third is a US scholar who makes frequent use of the library. Together, they avail themselves of archival and published materials-and personal experience with the collection-to establish the context that produced the original library, trace its evolution, and describe its present-day incarnation. A tale of transformation emerges that reflects how collections are likely to change. The authors present events and individuals in the life of the Royal Society's library and paint a picture of the value of today's Semmelweis Medical History Library. Unique treasures in the collection are described. The story told here is of how a particular nineteenth-century library became a twenty-first-century institution. The authors establish its peculiarly Hungarian context and potential value to librarians and historians from outside Hungary. The overall message is that general medical libraries everywhere are perforce likely to become medical historical libraries over time.

  10. Japan Society for Medical Education (JSME: Its history and activities for the last 45 years

    Directory of Open Access Journals (Sweden)

    Nobutaro Ban

    2013-12-01

    Full Text Available The Japan Society for Medical Education (JSME [1] was established in 1969 and we are celebrating the 45th anniversary this year. In this article I describe the history of JSME as well as current activities of our society. In addition I briefly describe major changes in medical education during the last decade and current topics we are facing regarding medical education in Japan. It would be my great pleasure if this article can encourages development of the Czech and Slovak Society for Medical Education.

  11. An early history of the Gestalt factors of organisation.

    Science.gov (United States)

    Vezzani, Stefano; Marino, Barbara F M; Giora, Enrico

    2012-01-01

    Wertheimer's (1923, Psychologische Forschung 4 301 - 350) idea that the perceptual world is articulated according to factors of organisation is widely acknowledged as one of the most original contributions of Gestalt psychology and stands as a milestone in the history of vision research. An inquiry focused on the forerunners of some of Wertheimer's factors of perceptual organisation is documented here. In fact, in 1900 Schumann described grouping by proximity and by vertical symmetry, and in 1903 G E Müller identified the factors of sameness/similarity and contour. Other authors contributed to the early description of these factors, such as Rubin, who in 1922 originally illustrated grouping by similarity. Even though Wertheimer himself granted these authors due recognition, later psychologists have paid little attention to their contributions. Some possible reasons for this negligence are briefly discussed.

  12. Factors Associated with Undertreatment of Medical Student Depression.

    Science.gov (United States)

    Tjia, Jennifer; Givens, Jane L.; Shea, Judy A.

    2005-01-01

    The authors measured factors associated with undertreatment of medical students' depression. They administered a cross-sectional Beck Depression Inventory and sociodemographic questionnaire to students at 1 medical school, defining their outcome measure as the use of counseling services or antidepressant medication. Of an estimated 450 available…

  13. How Important is Medical Ethics and History of Medicine Teaching in the Medical Curriculum? An Empirical Approach towards Students' Views

    Science.gov (United States)

    Schulz, Stefan; Woestmann, Barbara; Huenges, Bert; Schweikardt, Christoph; Schäfer, Thorsten

    2012-01-01

    Objectives: It was investigated how students judge the teaching of medical ethics and the history of medicine at the start and during their studies, and the influence which subject-specific teaching of the history, theory and ethics of medicine (GTE) - or the lack thereof - has on the judgement of these subjects. Methods: From a total of 533 students who were in their first and 5th semester of the Bochum Model curriculum (GTE teaching from the first semester onwards) or followed the traditional curriculum (GTE teaching in the 5th/6th semester), questionnaires were requested in the winter semester 2005/06 and in the summer semester 2006. They were asked both before and after the 1st and 5th (model curriculum) or 6th semester (traditional curriculum). We asked students to judge the importance of teaching medical ethics and the history of medicine, the significance of these subjects for physicians and about teachability and testability (Likert scale from -2 (do not agree at all) to +2 (agree completely)). Results: 331 questionnaire pairs were included in the study. There were no significant differences between the students of the two curricula at the start of the 1st semester. The views on medical ethics and the history of medicine, in contrast, were significantly different at the start of undergraduate studies: The importance of medical ethics for the individual and the physician was considered very high but their teachability and testability were rated considerably worse. For the history of medicine, the results were exactly opposite. GTE teaching led to a more positive assessment of items previously ranked less favourably in both curricula. A lack of teaching led to a drop in the assessment of both subjects which had previously been rated well. Conclusion: Consistent with the literature, our results support the hypothesis that the teaching of GTE has a positive impact on the views towards the history and ethics of medicine, with a lack of teaching having a negative

  14. [The cultural and medical significance of Xin an mingzuzhi(History of Famous Family in Xin'an)].

    Science.gov (United States)

    Hu, A H; Wan, S M

    2016-01-28

    History of Famous Family in Xin'an includes abundant information and important value of the medical cultural history, including the medical family, medical ethics and the number of the famous doctors and its distribution, the medical books and its outline the medical ethics, the diseases. As for the 115 famous doctors recorded in this book, Shexian county owns the most while Jixi county owns the least, and of the average number of famous doctors among the 10, 000 local people, Yixian county owns the most while Xiuning county owns the least. History of Famous Family in Xin'an includes 26 medical books, ranging from medical literature study, gynecological treatment, external medical treatment, diagnosis and treatment of pediatric diseases, ancient medical case records, medical education, acu-moxibustion and summary of other medical experiences. The book also demonstrates the noble morality of doctors, development of doctor' family, and records of paralytic stroke, epistaxis, tuberculous consumptive diseases, furunculosis, dystocia and some infectious diseases.

  15. A history of medical student debt: observations and implications for the future of medical education.

    Science.gov (United States)

    Greysen, S Ryan; Chen, Candice; Mullan, Fitzhugh

    2011-07-01

    Over the last 50 years, medical student debt has become a problem of national importance, and obtaining medical education in the United States has become a loan-dependent, individual investment. Although this phenomenon must be understood in the general context of U.S. higher education as well as economic and social trends in late-20th-century America, the historical problem of medical student debt requires specific attention for several reasons. First, current mechanisms for students' educational financing may not withstand debt levels above a certain ceiling which is rapidly approaching. Second, there are no standards for costs of medical school attendance, and these can vary dramatically between different schools even within a single city. Third, there is no consensus on the true cost of educating a medical student, which limits accountability to students and society for these costs. Fourth, policy efforts to improve physician workforce diversity and mitigate shortages in the primary care workforce are inhibited by rising levels of medical student indebtedness. Fortunately, the current effort to expand the U.S. physician workforce presents a unique opportunity to confront the unsustainable growth of medical student debt and explore new approaches to the financing of medical students' education.

  16. 42 CFR 412.322 - Indirect medical education adjustment factor.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Indirect medical education adjustment factor. 412.322 Section 412.322 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Capital-Related Costs § 412.322 Indirect medical education adjustment factor. (a) Basic data....

  17. What factors influence UK medical students' choice of foundation school?

    OpenAIRE

    Miah, S.; Pang, K.H.; Rebello, W.; Rubakumar, Z.; Fung, V; Venugopal, S.; Begum, H.

    2017-01-01

    Background: We aimed to identify the factors influencing UK medical student applicants’ choice of foundation school. We also explored the factors that doctors currently approaching the end of their 2-year program believe should be considered. Methods: A cross-sectional study was conducted during the 2013–2014 academic year. An online questionnaire was distributed to 2092 final-year medical students from nine UK medical schools and 84 foundation year-2 (FY2) doctors from eight foundation sc...

  18. [About Itching and scabies. Pruritus in medical history--from ancient world to the French revolution].

    Science.gov (United States)

    Weisshaar, E; König, A; Diepgen, T L; Eckart, W U

    2008-12-01

    Pruritus (itching) as a disease state and especially as a disease symptom has been object of medical and scientific descriptions and examinations in all epochs since the antiquity and in different cultural periods. Antiquity was dominated by observations and descriptions but during the course of medical history and particularly since the establishment of dermatology, more and more emphasis has been placed on classification and etiologic research.

  19. Family history in breast cancer is not a prognostic factor?

    Science.gov (United States)

    Jobsen, J J; Meerwaldt, J H; van der Palen, J

    2000-04-01

    The aim of this study is to determine if breast conservative treatment is justified for patients with a positive family history of breast cancer and to investigate whether they have a worse prognosis. We performed a prospective cohort study of breast cancer patients, treated with breast conservative treatment with radiotherapy at the Radiotherapy Department of the Medisch Spectrum Twente. Between 1984 and 1996, 1204 patients with T1 and T2 or =2 FDRs. The local recurrence rate was 4.1%, with similar rates for all groups. In young patients, or =2 FDRs. Patients with a positive FH had significantly more contralateral tumours. The 5-year corrected survival was 91.3%. Among patients with a positive FH, a 5-year corrected survival of 91% was observed and the survival 100% among patients with one and > or =2 FDR. Family history is not a contraindication for breast conservative treatment and is not associated with a worse prognosis. Family history is not a prognostic factor for local recurrence rate in patients older than 40 years.

  20. An introductory on medical ethics history in different era in Iran

    Directory of Open Access Journals (Sweden)

    Bagher Larijani

    2006-03-01

    Full Text Available Medical ethics has a long history worldwide, and the move towards a transcultural ethics must be based on an appreciation of the history that has produced the present relationships. It is often thought that medical ethics history has begun at the time of Hippocrates, however it is much older. It is clear that various cultures such as Babylonia, ancient Egypt, Greece, and the Persians have attempted to regulate medicine and to protect patients' rights in the known ancient world. One of the earliest written provisions in this field that comes back to about 1750 BC is the code of Hammurabi. In medieval, great Iranian physicians had paid special attention to ethics in their practices, teachings and manuscripts."nIn this paper we aimed to explore the roots of medical ethics in Persian history, particularly after adherence of Iranians to Islam. History of medicine in Iran has begun at about fourth century BC. There was a gap between the ancient civilizations and the Renaissance era in Europe, commonly called the dark ages. The immense strides have been made by the Persians in that long interval which is briefly reviewed.

  1. History of medical informatics in Europe-a short review by different approach

    NARCIS (Netherlands)

    G. Mihalas (George); J. Zvárová (Jana); C. Kulikowski; M. Ball (Marion); J.H. van Bemmel (Jan); A.P.M. Hasman (Arie); I. Masic (Izet); D. Whitehouse (Diane); B. Barber (Barry)

    2014-01-01

    textabstractThe panel intended to collect data, opinions and views for a systematic and multiaxial approach for a comprehensive presentation of "History of Medical Informatics", treating both general (global) characteristics, but emphasizing the particular features for Europe. The topic was not only

  2. Factors of interpersonal communication and behavioral health on medication self-efficacy and medication adherence.

    Science.gov (United States)

    Archiopoli, Ashley; Ginossar, Tamar; Wilcox, Bryan; Avila, Magdalena; Hill, Ricky; Oetzel, John

    2016-12-01

    Despite devastating effects on health outcomes and disease progression, many people living with HIV (PLWH) are non-adherent to their medications. Medication self-efficacy is a pivotal factor in medication adherence, yet its formation and relationship with other factors are understudied. This study examines a model that considers the role of three communicative factors (patient-provider communication, social support, and social undermining) and two behavioral health factors (depression and alcohol abuse) and medication self-efficacy impacting medication adherence. Methods included a cross-sectional design using a survey questionnaire of 344 PLWH. Findings indicated that 25% of variance in medication adherence can be explained by a mediation model where depression (B = -.18) and provider-patient communication (B = .21) affect medication self-efficacy, which in turn impacts medication adherence (B = .64). Other variables, including demographics, did not add any explanatory power. These findings demonstrate the complex nature of medication adherence and the formation of medication self-efficacy.

  3. The history of dermatology at the Woman’s Medical College of Pennsylvania

    Directory of Open Access Journals (Sweden)

    Erika E. Reid

    2015-06-01

    Full Text Available There is little written about the history of women in dermatology. In this paper, we summarize the information obtained from archival records from the Woman’s Medical College of Pennsylvania, one of the first medical schools for women, where several of the early prominent women in dermatology obtained their medical degrees and practiced. Among others, graduates include Rose Hirschler, MD, and Margaret Gray Wood, MD. The school and its graduates made important contributions to dermatology and to the advancement of women in the field. The history of women in dermatology is not well documented, and this historical research provides background in the biographies of pioneering women in an effort to preserve and honor their important work.

  4. Natural history, definitions, risk factors and burden of otitis media.

    Science.gov (United States)

    Kong, Kelvin; Coates, Harvey L C

    2009-11-02

    Otitis media remains a major health problem in Australia, with an unacceptably great dichotomy of incidence and severity of otitis media and its complications between Indigenous and non-Indigenous Australians. Among most children with acute otitis media, infection resolves rapidly with or without antibiotics, with ongoing middle ear effusion the only sequela. Overcrowding, poor living conditions, exposure to cigarette smoke, and lack of access to medical care are all major risk factors for otitis media. Estimates of the number of cases of otitis media in 2008 vary between 992,000 and 2,430,000 Australians, with a total estimated cost of $100 - $400 million.

  5. A brief history of medical education in Sub-Saharan Africa.

    Science.gov (United States)

    Monekosso, G L

    2014-08-01

    Developments in medical education in Sub-Saharan Africa over the past 100 years have been characterized by the continent's unique history. During the first half of the 20th century, the Europeans effectively installed medical education in their African colonies. The years 1950 to 1960 were distinguished by successful movements for independence, with new governments giving priority to medical education. By 1980, there were 51 medical schools in Sub-Saharan Africa. The period from 1975 to 1990 was problematic both politically and economically for Sub-Saharan Africa, and medical schools did not escape the general difficulties. War, corruption, mounting national debts, and political instability were characteristics of this period. In many countries, maintaining medical school assets--faculty members, buildings, laboratories, libraries--became difficult, and emigration became the goal of many health professionals. In contrast, the past 20 years have seen rapid growth in the number of medical schools in Sub-Saharan Africa. Economic growth and political stability in most Sub-Saharan African countries augur well for investment in health systems strengthening and in medical education. There are, nonetheless, major problem areas, including inadequate funding, challenges of sustainability, and the continuing brain drain. The 20th century was a time of colonialism and the struggle for independence during which medical education did not advance as quickly or broadly as it did in other regions of the world. The 21st century promises a different history, one of rapid growth in medical education, leading to better care and better health for the people of Africa.

  6. Is a history of cesarean section a risk factor for abnormal uterine bleeding in patients with uterine leiomyoma?

    OpenAIRE

    2016-01-01

    Objectives: To determine whether a history of cesarean section was a risk factor for abnormal uterine bleeding in patients with uterine leiomyomas, and to identify other risk factors for this symptom. Methods: We analyzed retrospectively, the medical records of patients who underwent hysterectomies due to the presence of uterine leiomyomas during a 6-year period (2009 and 2014) at Etlik Zubeyde Hanim Women’s Health Training and Research Hospital, Ankara, Turkey. Uterine leiomyoma was diagnose...

  7. Influencing factors of mental health of medical students in China.

    Science.gov (United States)

    Yang, Fan; Meng, Heng; Chen, Hui; Xu, Xin-hao; Liu, Zhuo; Luo, Ai; Feng, Zhan-chun

    2014-06-01

    This study investigated the mental health status of medical students in China, and analyzed the influencing factors in order to provide evidence for mental health education for medical students. A stratified cluster sampling method was used to recruit medical students from Huazhong University of Science and Technology, China. The questionnaire survey on general information and Symptom Checklist 90 (SCL-90) were used for investigation and analysis. The results showed among the 1137 valid questionnaires, 278 (24.45%) participants had SCL-90 score ≥ 160. The top three mental problems of medical students were obsessive-compulsive disorder, interpersonal sensitivity and depression in terms of the factor score ≥ 2.5 and the number of participants who reflected on the diseases. The third-year medical students had the worst mental health status, and fifth-year medical students had the best mental health status. Students from rural area had more psychological problems than those from urban area; furthermore, students with high professional satisfaction, those who were the single child of the family, non-poor students, and those whose parents had high education level had better mental health status. It was concluded that the mental health of medical students is not optimistic in China. Medical students have some mental health problems of different degrees. Factors that influence the mental health of medical students include academic pressure, professional satisfaction level and family environment.

  8. The end of medical confidentiality? Patients, physicians and the state in history.

    Science.gov (United States)

    Rieder, Philip; Louis-Courvoisier, Micheline; Huber, Philippe

    2016-09-01

    Medical confidentiality has come under attack in the public sphere. In recent disasters both journalists and politicians have questioned medical confidentiality and claimed that in specific contexts physicians should be compelled to communicate data on their patients' health. The murders of innocent individuals by a suicidal pilot and a Swiss convicted criminal have generated polemical debates on the topic. In this article, historical data on medical confidentiality is used to show that medical practices of secrecy were regularly attacked in the past, and that the nature of medical confidentiality evolved through time depending on physicians' values and judgements. Our demonstration is based on three moments in history. First, at the end of the 16th century, lay authorities put pressure on physicians to disclose the names of patients suffering from syphilis. Second, in the 18th century, physicians faced constant demands for information about patients' health from relatives and friends. Third, employers and insurance companies in the 20th century requested medical data on sick employees. In these three different situations, history reveals that the concept of medical confidentiality was plastic, modelled in the first instance to defend well-to-do patients, in the second instance it was adapted to accommodate the physician's social role and, finally, to defend universal values and public health. Medical secrecy was, and is today, a medical and societal norm that is shaped collectively. Any change in its definition and enforcement was and should be the result of negotiations with all social actors concerned. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. Evaluation of computer-based medical histories taken by patients at home

    Science.gov (United States)

    Kowaloff, Hollis B; Davis, Roger B; Delbanco, Tom; Locke, Steven E; Safran, Charles; Bleich, Howard L

    2012-01-01

    The authors developed a computer-based general medical history to be taken by patients in their homes over the internet before their first visit with their primary care doctor, and asked six doctors and their participating patients to assess this history and its effect on their subsequent visit. Forty patients began the history; 32 completed the history and post-history assessment questionnaire and were for the most part positive in their assessment; and 23 continued on to complete their post-visit assessment questionnaire and were for the most part positive about the helpfulness of the history and its summary at the time of their visit with the doctor. The doctors in turn strongly favored the immediate, routine use of two modules of the history—the family and social histories—for all their new patients. The doctors suggested further that the summaries of the other modules of the history be revised and shortened to make it easier for them to focus on clinical issues in the order of their preference. PMID:22237866

  10. Factors affecting career preferences of medical students at the ...

    African Journals Online (AJOL)

    Factors affecting career preferences of medical students at the College of ... students, respondents from rural areas and small towns, and whose parents were ... between doctors' career expectations and the country's healthcare needs.

  11. Sex in the Curriculum: The Effect of a Multi-Modal Sexual History-Taking Module on Medical Student Skills

    Science.gov (United States)

    Lindau, Stacy Tessler; Goodrich, Katie G.; Leitsch, Sara A.; Cook, Sandy

    2008-01-01

    Purpose: The objective of this study was to determine the effect of a multi-modal curricular intervention designed to teach sexual history-taking skills to medical students. The Association of Professors of Gynecology and Obstetrics, the National Board of Medical Examiners, and others, have identified sexual history-taking as a learning objective…

  12. Sex in the Curriculum: The Effect of a Multi-Modal Sexual History-Taking Module on Medical Student Skills

    Science.gov (United States)

    Lindau, Stacy Tessler; Goodrich, Katie G.; Leitsch, Sara A.; Cook, Sandy

    2008-01-01

    Purpose: The objective of this study was to determine the effect of a multi-modal curricular intervention designed to teach sexual history-taking skills to medical students. The Association of Professors of Gynecology and Obstetrics, the National Board of Medical Examiners, and others, have identified sexual history-taking as a learning objective…

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

    OpenAIRE

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

    2012-01-01

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

  14. Factors affecting attitudes towards medical abortion in Lithuania

    DEFF Research Database (Denmark)

    Lazarus, Jeff; Nielsen, Stine; Jakubcionyte, Rita

    2006-01-01

    Surgical abortion in Lithuania is governed by a 1994 ministerial decree that made it legal for any woman 16 or older. This article seeks to determine the key demographic factors in Lithuanian attitudes towards medical abortion, which is currently not legal.......Surgical abortion in Lithuania is governed by a 1994 ministerial decree that made it legal for any woman 16 or older. This article seeks to determine the key demographic factors in Lithuanian attitudes towards medical abortion, which is currently not legal....

  15. Podcasts from the journal Medical Education. Personality factors and medical training: a review of the literature

    OpenAIRE

    Doherty, Eva M; Eva, Kevin

    2011-01-01

    It has been acknowledged that certain personality characteristics influence both medical students’ and doctors’ performance. With regard to medical students, studies have been concerned with the role of personality, and performance indicators such as academic results and clinical competence. Eva Doherty (Director of human factors and patient safety, National Surgical Training Centre, The Royal College of Surgeons in Ireland, Dublin, Ireland) speaks to Kevin Eva, Editor in Chief of Medical Edu...

  16. Using medical history embedded in biometrics medical card for user identity authentication: privacy preserving authentication model by features matching.

    Science.gov (United States)

    Fong, Simon; Zhuang, Yan

    2012-01-01

    Many forms of biometrics have been proposed and studied for biometrics authentication. Recently researchers are looking into longitudinal pattern matching that based on more than just a singular biometrics; data from user's activities are used to characterise the identity of a user. In this paper we advocate a novel type of authentication by using a user's medical history which can be electronically stored in a biometric security card. This is a sequel paper from our previous work about defining abstract format of medical data to be queried and tested upon authentication. The challenge to overcome is preserving the user's privacy by choosing only the useful features from the medical data for use in authentication. The features should contain less sensitive elements and they are implicitly related to the target illness. Therefore exchanging questions and answers about a few carefully chosen features in an open channel would not easily or directly expose the illness, but yet it can verify by inference whether the user has a record of it stored in his smart card. The design of a privacy preserving model by backward inference is introduced in this paper. Some live medical data are used in experiments for validation and demonstration.

  17. Fats and factors: lipid profiles associate with personality factors and suicidal history in bipolar subjects.

    Directory of Open Access Journals (Sweden)

    Simon J Evans

    Full Text Available Polyunsaturated fatty acids (PUFA have shown efficacy in the treatment of bipolar disorder, however their specific role in treating the illness is unclear. Serum PUFA and dietary intakes of PUFA associate with suicidal behavior in epidemiological studies. The objective of this study was to assess serum n-3 and n-6 PUFA levels in bipolar subjects and determine possible associations with suicidal risk, including suicidal history and relevant personality factors that have been associated with suicidality. We studied 27 bipolar subjects using the NEO-PI to assess the big five personality factors, structured interviews to verify diagnosis and assess suicidal history, and lipomics to quantify n-3 and n-6 PUFA in serum. We found positive associations between personality factors and ratios of n-3 PUFA, suggesting that conversion of short chain to long chain n-3s and the activity of enzymes in this pathway may associate with measures of personality. Thus, ratios of docosahexaenoic acid (DHA to alpha linolenic acid (ALA and the activity of fatty acid desaturase 2 (FADS2 involved in the conversion of ALA to DHA were positively associated with openness factor scores. Ratios of eicosapentaenoic acid (EPA to ALA and ratios of EPA to DHA were positively associated with agreeableness factor scores. Finally, serum concentrations of the n-6, arachidonic acid (AA, were significantly lower in subjects with a history of suicide attempt compared to non-attempters. The data suggest that specific lipid profiles, which are controlled by an interaction between diet and genetics, correlate with suicidal history and personality factors related to suicidal risk. This study provides preliminary data for future studies to determine whether manipulation of PUFA profiles (through diet or supplementation can affect personality measures and disease outcome in bipolar subjects and supports the need for further investigations into individualized specific modulations of lipid

  18. A real-time assessment of factors influencing medication events.

    Science.gov (United States)

    Dollarhide, Adrian W; Rutledge, Thomas; Weinger, Matthew B; Fisher, Erin Stucky; Jain, Sonia; Wolfson, Tanya; Dresselhaus, Timothy R

    2014-01-01

    Reducing medical error is critical to improving the safety and quality of healthcare. Physician stress, fatigue, and excessive workload are performance-shaping factors (PSFs) that may influence medical events (actual administration errors and near misses), but direct relationships between these factors and patient safety have not been clearly defined. This study assessed the real-time influence of emotional stress, workload, and sleep deprivation on self-reported medication events by physicians in academic hospitals. During an 18-month study period, 185 physician participants working at four university-affiliated teaching hospitals reported medication events using a confidential reporting application on handheld computers. Emotional stress scores, perceived workload, patient case volume, clinical experience, total sleep, and demographic variables were also captured via the handheld computers. Medication event reports (n = 11) were then correlated with these demographic and PSFs. Medication events were associated with 36.1% higher perceived workload (p sleep (p = .10). These results confirm the effect of factors influencing medication events, and support attention to both provider and hospital environmental characteristics for improving patient safety.

  19. Medical error and related factors during internship and residency.

    Science.gov (United States)

    Ahmadipour, Habibeh; Nahid, Mortazavi

    2015-01-01

    It is difficult to determine the real incidence of medical errors due to the lack of a precise definition of errors, as well as the failure to report them under certain circumstances. We carried out a cross- sectional study in Kerman University of Medical Sciences, Iran in 2013. The participants were selected through the census method. The data were collected using a self-administered questionnaire, which consisted of questions on the participants' demographic data and questions on the medical errors committed. The data were analysed by SPSS 19. It was found that 270 participants had committed medical errors. There was no significant difference in the frequency of errors committed by interns and residents. In the case of residents, the most common error was misdiagnosis and in that of interns, errors related to history-taking and physical examination. Considering that medical errors are common in the clinical setting, the education system should train interns and residents to prevent the occurrence of errors. In addition, the system should develop a positive attitude among them so that they can deal better with medical errors.

  20. Psychostimulant drug abuse and personality factors in medical students.

    Science.gov (United States)

    Bucher, Joshua T; Vu, Duc M; Hojat, Mohammadreza

    2013-01-01

    Psychostimulants have a high abuse potential and are appealing to college students for enhancing their examination performance. This study was designed to examine the prevalence of psychostimulant drug abuse among medical students and to test the hypothesis that medical students who use psychostimulant drugs for non-medical reasons are characterized by a sensation seeking and aggressive-hostility personality and exhibit lower empathy. The Zuckerman-Kuhlman personality questionnaire and the Jefferson scale of empathy were completed anonymously on-line by 321 medical students in 2010-2011 academic year. A total of 45 students (14%) reported that they had abused psychostimulant medications either before or during medical school. RESULTS of multivariate analysis of variance provided support for one of our research hypothesis: students who reported using psychostimulant compared to the rest, obtained a significantly higher average score on the aggressive-hostility personality factor. No other significant differences were observed. Further research is needed to confirm the rate of psychostimulant drug abusers among medical students in other medical schools. In particular, it is desirable to examine if such psychostimulant drug abusers are likely to abuse other substances in medical school and later in their professional career.

  1. Rhazes, a genius physician in diagnosis and treatment of kidney calculi in medical history.

    Science.gov (United States)

    Changizi Ashtiyani, Saeed; Cyrus, Ali

    2010-04-01

    Abu Bakr Mohammad Ibn Zakariya Razi, known in the west as Rhazes (865 to 925 AD), was born in the ancient city of Rayy, near Tehran, Iran. He was a renowned physician in medical history and not only followed Hippocrates and Galen, but also greatly extended the analytical approach of his predecessors. Based on the existing documents, he was known as the most distinguished character in the world of medicine up to the 17th century. A great number of innovations and pioneering works in the medical science have been recorded in the name of Rhazes. His fundamental works in urology as part of his research in the realm of medicine have remained unknown. Pathophysiology of the urinary tract, venereal diseases, and kidney and bladder calculi are among his main interests in this field. He also purposed and developed methods for diagnosis and treatment of kidney calculi for the first time in medical history. He also presented a very exact and precise description of neuropathic bladder followed by vertebral fracture. He advanced urine analysis and studied function and diseases of the kidneys. Rhazes recommendations for the prevention of calculi are quite scientific and practical and in accordance with current recommendations to avoid hypercalciuria and increased saturation of urine. Rhazes was not only one of the most important Persian physician-philosophers of his era, but for centuries, his writings became fundamental teaching texts in European medical schools. Some important aspects of his contributions to medicine are reviewed.

  2. Evaluation of forensic medical history taking from the child in cases of child physical and sexual abuse and neglect.

    Science.gov (United States)

    Drummond, Rachel; Gall, John A M

    2017-02-01

    Suspected child physical abuse, sexual abuse and neglect are not uncommon presentations. As part of the assessment of these cases, a forensic medical history may be taken. This forensic history is used not only to determine the steps necessary to address the child's wellbeing but also to direct the forensic examination. Currently, there is no clear consensus on whether or not a forensic medical history should consistently be considered an integral element within the paediatric forensic evaluation. This study examines the value derived by the medical practitioner taking a forensic medical history rather than relying on hearsay evidence when a child presents for an assessment. A retrospective review of paediatric cases seen by the Victorian Forensic Paediatric Medical Service (VFPMS) between 2014 and 2015 was undertaken. 274 forensic case reports were reviewed and the data was entered into an Excel spread sheet and analysed using chi squared tests within STATA(®). With increasing age of the child, a forensic medical history is significantly more likely to be taken. Additional information is made available to the medical practitioner what would otherwise have been provided if the medical practitioner relied only on the interview conducted by the police. Discrepancies observed between the official third parties (police or child protection) report of what a child has said and what the child says to the medical practitioner decrease with age, as do discrepancies observed between the child's version of events and a third party's (eg. parents, caregivers, friends) version of events. The study showed that by taking a forensic medical history from the child additional information can be obtained. Further, that there is a value in the examining medical practitioner taking a forensic medical history from children in cases of child physical and sexual abuse and neglect. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  3. From history to myth: productive engagement with the Flexnerian metanarrative in medical education.

    Science.gov (United States)

    Schrewe, Brett

    2013-12-01

    More than 100 years following its publication, the Flexner Report endures as a principal text in contemporary medical education. While recent scholarship has questioned popular conceptions of the report and attends to marginalized passages, explanations as to why the Flexner story endures as myth in medical education remain absent in the literature. From a Bourdieusian perspective applied to an archive of both primary and secondary texts related to the history, production, and reception of the Flexner Report, this work examines the events that led to the production of a mythological "Flexner" and what significance this has for repeated yet insufficient efforts towards improving medical education. Specifically, this work links the values, beliefs, and assumptions embedded in the Flexner mythology to the unintentional obstruction of wholesale curricular reform and suggests it is in productively struggling with the legacy of this myth that we may be better positioned to reconcile ourselves to the Flexner legacy and its implication for future training.

  4. Metal matrix composites: History, status, factors and future

    Science.gov (United States)

    Cyriac, Ajith James

    The history, status, and future of metal matrix composites are presented by evaluating the progression of available literature through time. The trends that existed and issues that still prevail are discussed and a prediction of the future for MMCs is presented. The factors that govern the performance of metal matrix composites are also discussed. In many developed countries and in several developing countries there exists continued interest in MMCs. Researchers tried numerous combinations of matrices and reinforcements since work strictly on MMCs began in the 1950s. This led to developments for aerospace and defense applications, but resultant commercial applications were limited. The introduction of ceramic whiskers as reinforcement and the development of 'in-situ' eutectics in the 1960s aided high temperature applications in aircraft engines. In the late 1970s the automobile industries started to take MMCs seriously. In the last 20 years, MMCs evolved from laboratories to a class of materials with numerous applications and commercial markets. After the collapse of the Berlin Wall, prevailing order in the world changed drastically. This effect was evident in the progression of metal matrix composites. The internet connected the world like never before and tremendous information was available for researchers around the world. Globalization and the internet resulted in the transformation of the world to a more level playing field, and this effect is evident in the nature and source of research on metal matrix composites happening around the world.

  5. Cardiovascular risk factors encountered during medical examination in athletic children.

    Science.gov (United States)

    Cis Spoturno, Adela C; Paz-Sauquillo, María T; López-Zea, Matilde; Fernández-Rostello, Eduardo A

    2013-12-01

    Cardiovascular risk factors can predispose to cardiovascular disease in adults or lead to cardiovascular events while practicing sports. The objectives of this study were: 1) to estimate the distribution of individual cardiovascular risk factors; 2) to establish a relationship between cardiovascular risk factors in parents or grandparents and the children's clinical condition. This was a retrospective study to assess overweight, obesity and hypertension in 1021 child athletes. The family history of obesity, type 2 diabetes, ischemic heart disease, and stroke was studied. Out of the studied children, 22.1% (n= 226) were obese and 2.1% (n= 21) had hypertension. Obesity was the most common family risk factor (30%).

  6. Medical history for the masses: how American comic books celebrated heroes of medicine in the 1940s.

    Science.gov (United States)

    Hansen, Bert

    2004-01-01

    When comic books rose to mass popularity in the early 1940s, one segment of the industry specialized in "true adventures," with stories about real people from the past and the present--in contrast to competing books that offered fantasy, science fiction, superheroes, detectives and crime, funny people, or funny animals. This study examines the figures from both medical history and twentieth-century medicine who were portrayed as heroes and role models in these comic books: first, to call attention to this very popular, if unknown, genre of medical history, and second, to illustrate how medical history was used at that time to popularize scientific and medical ideas, to celebrate the achievements of medical research, to encourage medical science as a career choice, and to show medicine as a humane and noble enterprise. The study explains how these medical history stories were situated in American popular culture more generally, and how the graphic power of comic books successfully conveyed both values and information while also telling a good story. Attention to this colorful genre of popular medical history enriches our picture of the mid-twentieth-century public's enthusiasm for medical progress.

  7. Veterinary Homeopathy: The Implications of Its History for Unorthodox Veterinary Concepts and Veterinary Medical Education.

    Science.gov (United States)

    Coulter, Dwight B.

    1979-01-01

    The history of veterinary homeopathy, its future and implications are discussed. The need for investigation into the validity of both allopathic and homeopathic claims is stressed and it is suggested that maintenance of quality is the key factor in any approach. (BH)

  8. Psychosocial Factors Related to Underuse of Medical Services.

    Science.gov (United States)

    Zhang, Chenshu; Brook, Judith S; Leukefeld, Carl G; Brook, David W

    2016-08-01

    In this longitudinal study, we applied structural equation modeling (SEM) to examine the historical, predisposing, enabling/barrier, and need factors as related to the underuse of medical services during early midlife. We gathered longitudinal data on a prospective cohort of community-dwelling men and women (N = 548) followed from adolescence to early midlife. The findings supported a mediational model: A mutually affectionate parent-child relationship in early adolescence was inversely related to underuse of medical services in early midlife via the mediational roles played by later predisposing factors (i.e., depressive mood and cigarette smoking), need factor (i.e., physical health problems), barriers (i.e., financial difficulty), and enabling factors (i.e., social support for health services in early midlife). In addition, satisfaction with medical services in the neighborhood had an association with less underuse of medical services in early midlife. Family therapy focused on an increase in the affectionate relationship between the adolescents and his/her parents and cognitive-behavioral treatment of depressive mood may lead to a decrease in the underuse of medical services.

  9. Factors Associated with Korean Immigrants' Medical Tourism to the Homeland.

    Science.gov (United States)

    Jang, Sou Hyun

    2017-07-01

    This study examined factors associated with first-generation Korean immigrants' medical tours to the homeland, which has emerged as a field of study in immigrant medical transnationalism and immigrant healthcare behaviors. This paper reports survey data from 507 Korean immigrants and indepth interviews with 120 Korean immigrants in the New York-New Jersey area. About one-fourth of survey respondents have visited their home country for medical care since their migration to the US. Of those with relatives in Korea, 29% have experienced at least one medical tour, compared to only 9.2% of those without relatives in Korea. Having frequent contacts with relatives in the home country was positively associated with the number of medical tour visits. Except for social transnational ties, other types of transnational ties with the home country were marginally related to Korean immigrants' medical tourism. Surprisingly, their health insurance status itself, which is assumed to be important, was not statistically associated with medical tourism. Although this study has the limitation of analyzing a convenience sample, it contributes to the literature on immigrant transnationalism and immigrant healthcare behaviors by using a mixed-methods approach to focus on one ethnic group's medical transnationalism.

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

    LENUS (Irish Health Repository)

    Grimes, Tamasine C

    2011-03-01

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

  11. [Factors affecting the educational environment in undergraduate medical schools].

    Science.gov (United States)

    Olave P, Guisela; Pérez V, Cristhian; Fasce H, Eduardo; Ortiz M, Liliana; Bastías V, Nancy; Márquez U, Carolina; Parra P, Paula; Ibáñez G, Pilar

    2016-10-01

    Educational environment has an important effect on the quality of learning and student satisfaction in medicine. Most of previous studies have been conducted using questionnaires that assess the phenomenon considering overall dimensions, without paying attention to the specific manifestations of this topic, especially those aspects that are related to the protagonists of the learning process: teachers and students. To describe factors that affect the educational environment in the preclinical Medical formation, according to Medical teachers in Concepción, Chile. Qualitative study, using the Grounded theory method. Semi-structured interviews were performed to 10 medical teachers in Concepcion, Chile. They were selected by theoretical sampling. Data were analyzed using open coding. Four emerging categories about the factors that affect the learning environment were identified: Personal factors of students, academic factors of students, personal factors of teachers and academic factors of teachers. According to interviewed teachers, both personal factors in teachers and students that promote a positive learning environment are related with an attitude oriented towards others and communication skills. Academic factors are related with the responsible exercise of student and teacher roles and with the promotion of participation in the educational process.

  12. Historie

    DEFF Research Database (Denmark)

    Poulsen, Jens Aage

    Historie i serien handler om læreplaner og læremidler og deres brug i skolefaget historie. Bogen indeholder nyttige redskaber til at analysere og vurdere læremidler......Historie i serien handler om læreplaner og læremidler og deres brug i skolefaget historie. Bogen indeholder nyttige redskaber til at analysere og vurdere læremidler...

  13. Personality factors and medical training: a review of the literature.

    Science.gov (United States)

    Doherty, Eva M; Nugent, Emmeline

    2011-02-01

    it has been acknowledged that certain personality characteristics influence both medical students' and doctors' performance. With regard to medical students, studies have been concerned with the role of personality, and performance indicators such as academic results and clinical competence. In addition, the link between personality and vulnerability to stress, which has implications for performance, has been investigated at both undergraduate and postgraduate levels. Most of the studies cited in the literature were published before the year 2000. The authors therefore undertook a literature search to determine whether any prospective systematic studies have been published since 2000. a review of the literature for 2000-2009 was performed, using the databases MEDLINE, PsycINFO and CINAHL. The search terms used were 'personality', 'performance', 'stress' and 'medical student'. Specific inclusion criteria required studies to be cohort studies carried out over a minimum period of 2 years, which measured medical student scores on valid and reliable personality tests, and used objective measures of performance and stress. the authors identified seven suitable studies. Four of these looked at personality factors and academic success, one looked at personality factors and clinical competence, and two looked at personality factors and stress. The main personality characteristic repeatedly identified in the literature was conscientiousness. the personality trait known as conscientiousness has been found to be a significant predictor of performance in medical school. The relationship between personality and performance becomes increasingly significant as learners advance through medical training. Additional traits concerning sociability (i.e. extraversion, openness, self-esteem and neuroticism) have also been identified as relevant, particularly in the applied medical environment. A prospective national study with the collaboration of all medical schools would make it

  14. Parochialism or Self-Consciousness? Internationality in Medical History Journals 1997–2006

    Science.gov (United States)

    Steinke, Hubert; Lang, Yves

    2011-01-01

    Research councils, universities and funding agencies are increasingly asking for tools to measure the quality of research in the humanities. One of their preferred methods is a ranking of journals according to their supposed level of internationality. Our quantitative survey of seventeen major journals of medical history reveals the futility of such an approach. Most journals have a strong national character with a dominance of native language, authors and topics. The most common case is a paper written by a local author in his own language on a national subject regarding the nineteenth or twentieth century. American and British journals are taken notice of internationally but they only rarely mention articles from other history of medicine journals. Continental European journals show a more international review of literature, but are in their turn not noticed globally. Increasing specialisation and fragmentation has changed the role of general medical history journals. They run the risk of losing their function as international platforms of discourse on general and theoretical issues and major trends in historiography, to international collections of papers. Journal editors should therefore force their authors to write a more international report, and authors should be encouraged to submit papers of international interest and from a more general, transnational and methodological point of view. PMID:22028500

  15. Parochialism or self-consciousness? Internationality in medical history journals 1997-2006.

    Science.gov (United States)

    Steinke, Hubert; Lang, Yves

    2011-10-01

    Research councils, universities and funding agencies are increasingly asking for tools to measure the quality of research in the humanities. One of their preferred methods is a ranking of journals according to their supposed level of internationality. Our quantitative survey of seventeen major journals of medical history reveals the futility of such an approach. Most journals have a strong national character with a dominance of native language, authors and topics. The most common case is a paper written by a local author in his own language on a national subject regarding the nineteenth or twentieth century. American and British journals are taken notice of internationally but they only rarely mention articles from other history of medicine journals. Continental European journals show a more international review of literature, but are in their turn not noticed globally. Increasing specialisation and fragmentation has changed the role of general medical history journals. They run the risk of losing their function as international platforms of discourse on general and theoretical issues and major trends in historiography, to international collections of papers. Journal editors should therefore force their authors to write a more international report, and authors should be encouraged to submit papers of international interest and from a more general, transnational and methodological point of view.

  16. Prevalence of self-medication in Brazil and associated factors

    Science.gov (United States)

    Arrais, Paulo Sérgio Dourado; Fernandes, Maria Eneida Porto; Pizzol, Tatiane da Silva Dal; Ramos, Luiz Roberto; Mengue, Sotero Serrate; Luiza, Vera Lucia; Tavares, Noemia Urruth Leão; Farias, Mareni Rocha; Oliveira, Maria Auxiliadora; Bertoldi, Andréa Dâmaso

    2016-01-01

    ABSTRACT OBJECTIVE To analyze the prevalence and associated factors regarding the use of medicines by self-medication in Brazil. METHODS This cross-sectional population-based study was conducted using data from the PNAUM (National Survey on Access, Use and Promotion of Rational Use of Medicines), collected between September 2013 and February 2014 by interviews at the homes of the respondents. All people who reported using any medicines not prescribed by a doctor or dentist were classified as self-medication practitioners. Crude and adjusted prevalence ratios (Poisson regression) and their respective 95% confidence intervals were calculated in order to investigate the factors associated with the use of self-medication by medicines. The independent variables were: sociodemographic characteristics, health conditions and access to and use of health services. In addition, the most commonly consumed medicines by self-medication were individually identified. RESULTS The self-medication prevalence in Brazil was 16.1% (95%CI 15.0–17.5), with it being highest in the Northeast region (23.8%; 95%CI 21.6–26.2). Following the adjusted analysis, self-medication was observed to be associated with females, inhabitants from the North, Northeast and Midwest regions and individuals that have had one, or two or more chronic diseases. Analgesics and muscle relaxants were the therapeutic groups most used for self-medication, with dipyrone being the most consumed medicines. In general, most of the medicines used for self-medication were classified as non-prescriptive (65.5%). CONCLUSIONS Self-medication is common practice in Brazil and mainly involves the use of non-prescription medicines; therefore, the users of such should be made aware of the possible risks. PMID:27982373

  17. [Suicide Ideation Among Medical Students: Prevalence and Associated Factors].

    Science.gov (United States)

    Pinzón-Amado, Alexander; Guerrero, Sonia; Moreno, Katherine; Landínez, Carolina; Pinzón, Julie

    2013-01-01

    It is well documented that physicians have higher rates of suicide than the general population. This risk tends to increase even from the beginning of undergraduate training in medicine. There are few studies evaluating the frequency of suicidal behaviors in undergraduate medical students, particularly in Latin America. To determine the lifetime prevalence and the variables associated with suicidal ideation and suicide attempts in a sample of medical students from the city of Bucaramanga, Colombia. An analytical cross-sectional observational study was conducted to determine the lifetime prevalence of suicidal ideation and suicide attempts in a non-random sample of medical students enrolled in three medical schools in Bucaramanga. A self-administered questionnaire was voluntarily and anonymously answered by the participants. Validated versions of the CES-D and CAGE scales were used to assess the presence of depressive symptoms and problematic alcohol use, respectively. A multivariate logistic regression model was generated in order to adjust the estimates of variables associated with the outcome «suicidal ideation in life». The study sample consisted of 963 medical students, of which 57% (n=549) of the participants were women. The average age was 20.3 years (SD=2.3 years). Having had at least one episode of serious suicidal ideation in their lifetime was reported by 15.7% (n=149) of the students, with 5% (n=47) of the students reported having made at least one suicide attempt. Having taken antidepressants during their medical training was reported by 13.9% (n=131) of the students. The variables associated with the presence of suicidal ideation in the logistic regression model were: clinically significant depressive symptoms (OR: 6.9, 95% CI; 4.54-10.4), history of illicit psychoactive substance use (OR 2.8, 95% CI; 1.6-4.8), and perception of poor academic performance over the past year (OR: 2.2, 95% CI; 1.4-3.6). The logistic regression model correctly classified

  18. Medication reconciliation errors in a tertiary care hospital in Saudi Arabia: admission discrepancies and risk factors.

    Science.gov (United States)

    Mazhar, Faizan; Akram, Shahzad; Al-Osaimi, Yousif A; Haider, Nafis

    2017-01-01

    Medication reconciliation is a major component of safe patient care. One of the main problems in the implementation of a medication reconciliation process is the lack of human resources. With limited resources, it is better to target medication reconciliation resources to patients who will derive the most benefit from it. The primary objective of this study was to determine the frequency and types of medication reconciliation errors identified by pharmacists performing medication reconciliation at admission. Each medication error was rated for its potential to cause patient harm during hospitalization. A secondary objective was to determine risk factors associated with medication reconciliation errors. This was a prospective, single-center pilot study conducted in the internal medicine and surgical wards of a tertiary care teaching hospital in the Eastern province of Saudi Arabia. A clinical pharmacist took the best possible medication history of patients admitted to medical and surgical services and compared with the medication orders at hospital admission; any identified discrepancies were noted and analyzed for reconciliation errors. Multivariate logistic regression was performed to determine the risk factors related to reconciliation errors. A total of 328 patients (138 in surgical and 198 in medical) were included in the study. For the 1419 medications recorded, 1091 discrepancies were discovered out of which 491 (41.6%) were reconciliation errors. The errors affected 177 patients (54%). The incidence of reconciliation errors in the medical patient group was 25.1% and 32.0% in the surgical group (perror was the omission (43.5% and 51.2%). Lipid-lowering (12.4%) and antihypertensive agents were most commonly involved. If undetected, 43.6% of order errors were rated as potentially requiring increased monitoring or intervention to preclude harm; 17.7% were rated as potentially harmful. A multivariate logistic regression model showed that patients aged ≥65 years

  19. Medication reconciliation errors in a tertiary care hospital in Saudi Arabia: admission discrepancies and risk factors

    Directory of Open Access Journals (Sweden)

    Mazhar F

    2017-03-01

    Full Text Available Background: Medication reconciliation is a major component of safe patient care. One of the main problems in the implementation of a medication reconciliation process is the lack of human resources. With limited resources, it is better to target medication reconciliation resources to patients who will derive the most benefit from it. Objective: The primary objective of this study was to determine the frequency and types of medication reconciliation errors identified by pharmacists performing medication reconciliation at admission. Each medication error was rated for its potential to cause patient harm during hospitalization. A secondary objective was to determine risk factors associated with medication reconciliation errors. Methods: This was a prospective, single-center pilot study conducted in the internal medicine and surgical wards of a tertiary care teaching hospital in the Eastern province of Saudi Arabia. A clinical pharmacist took the best possible medication history of patients admitted to medical and surgical services and compared with the medication orders at hospital admission; any identified discrepancies were noted and analyzed for reconciliation errors. Multivariate logistic regression was performed to determine the risk factors related to reconciliation errors. Results: A total of 328 patients (138 in surgical and 198 in medical were included in the study. For the 1419 medications recorded, 1091 discrepancies were discovered out of which 491 (41.6% were reconciliation errors. The errors affected 177 patients (54%. The incidence of reconciliation errors in the medical patient group was 25.1% and 32.0% in the surgical group (p<0.001. In both groups, the most frequent reconciliation error was the omission (43.5% and 51.2%. Lipid-lowering (12.4% and antihypertensive agents were most commonly involved. If undetected, 43.6% of order errors were rated as potentially requiring increased monitoring or intervention to preclude harm; 17

  20. Clinical stories and medical histories recorded by Rhazes (865-925), the Iranian-Islamic physician in the medieval period.

    Science.gov (United States)

    Zohalinezhad, Mohammad E; Askari, Alireza; Farjam, Mojtaba

    2015-01-01

    Recording medical histories of patients is not a new issue in clinical medicine. However, the method practiced by the Iranian chemist physician, Rhazes, in the ninth century A.D is incredible. Rhazes has written several textbooks in clinical medicine, but a particular one, "Clinical Stories and Medical Histories" (Qesas va hekayat al-marazi), is a classical case book describing precise clinical courses of thirty three patients. Each chapter includes a title, the name and demographic data about a patient, his/her history of present illness, past medical and family history, findings of physical exam, impression and interventions by the physician, including pharmacological or surgical management. The reasons for each decision made by Rhazes as well as the outcomes are clearly discussed. This book review will shed light on the unknown medical practice methods in Islamic-Iranian golden era.

  1. A history of the INTERNIST-1 and Quick Medical Reference (QMR) computer-assisted diagnosis projects, with lessons learned.

    Science.gov (United States)

    Miller, R A

    2010-01-01

    The INTERNIST-1/Quick Medical Reference (QMR) diagnostic decision support project spans four decades, from 1971-onward. This paper describes the history of the project and details insights gained of relevance to the general clinical and informatics communities.

  2. [The life of medical historian Miki Sakae, and the "history of Korean medicine and of diseases in Korea"].

    Science.gov (United States)

    Kim, Ho

    2005-12-01

    maintained during his entire life regarding the Korean medicine, was that 'One can only talk about the medicine of China and Japan when he or she is well versed in the medicine of Korea'. And his lifetime achievement, "History of Korean Medicine and of Diseases in Korea" was authored upon the basis established by such conviction and philosophy. First, in this book the perspective of Cultural Transmission, which considers the flow of cultural qualities and assets to be ordinarily flowing from highly developed regions to less developed ones, was firmly maintained. He argued that the medicine of China had to pass through the Korean peninsula to reach Japan. Second, he suggested that studies of medicine and diseases could only be fully and thoroughly understood when it is approached not only from the perspective devised by medical historical studies but also from perspectives devised for general and total historical examination of human life events. And third, he argued that all historical studies should be based upon proofs and evidences, and the 'development' factor of a particular type of studies or practices should be measured by whether that study or practice has reached or accomplished the level of Western modern science. Demonstrating such conviction, out of Korean traditional medical practices he particularly examined the medical procedures of treating tumors or regulations and procedures developed for forensic medicine, which he considered superior to or at least at the same level with Western medicine. In his final years he was forced to battle cancer, but he refused to be hospitalized. Instead, he exhibited his firm belief that medicine and medical practices which believe in the ultimate power of human body and soul are what the practitioners should pursue in order to acquire the very core of medicine. He died in 1992, at home, surrounded by his family. He is known to have always uttered that one of the most celebrated Medical books of Korea, the "Dongeui Bogam

  3. Risk factors for medical complications of acute hemorrhagic stroke

    Institute of Scientific and Technical Information of China (English)

    Jangala Mohan Sidhartha; Aravinda Reddy Purma; Nagaswaram Krupa Sagar; Marri Prabhu Teja; Meda Venkata subbaiah; Muniswami Purushothaman

    2015-01-01

    Objective: To assess the risk factors leading to medical complications of hemorrhagic stroke. Methods: We conducted an observational study in neurology, emergency and general medicine wards at a tertiary care teaching hospital in Kadapa. We recruited hemorrhagic stroke patients, and excluded the patients have evidence of trauma or brain tumor as the cause of hemorrhage. We observed the subjects throughout their hospital stay to assess the risk factors and complications. Results: During period of 12 months, 288 subjects included in the study, 89% of them identified at least 1 prespecified risk factor for their admission in hospital and 75% of them experienced at least 1 prespecified complication during their stay in hospital. Around 47% of subjects deceased, among which 64% were females. Conclusions: Our study has assessed that hypertension followed by diabetes mellitus are the major risk factors for medical complications of hemorrhagic stroke. Female mortality rate was more when compared to males.

  4. Rehabilitation of a patient with an elusive medical history and loss of occlusal vertical dimension.

    Science.gov (United States)

    Wong, Angela T T; Nguyen, Caroline T

    2013-01-01

    In this clinical report, we describe the medical history, diagnosis and prosthodontic treatment of a 61-year-old man with a previous history of oral cancer. Loss of a full upper denture and severe erosion of his teeth prompted the patient to seek treatment at the dental clinic at the British Columbia Cancer Agency. Although he stated that he was being treated for a sleeping disorder, hospital records revealed multiple recent admissions for alcoholism and depression. The patient's limited finances prevented complex restoration of worn lower dentition; thus, definitive treatment consisted of extraction of teeth with a poor prognosis, removal of a glandular odontogenic cyst and fabrication of a full maxillary prosthesis and a removable mandibular cast-metal overlay.

  5. Significance of experts' overall ratings for medical student competence in relation to history-taking

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    Luiz Ernesto de Almeida Troncon

    Full Text Available CONTEXT AND OBJECTIVE: Overall ratings (ORs of competence, given by expert physicians, are increasingly used in clinical skills assessments. Nevertheless, the influence of specific components of competence on ORs is incompletely understood. The aim here was to investigate whether ORs for medical student history-taking competence are influenced by performance relating to communication skills, completeness of questioning and asking contentdriven key questions. DESIGN AND SETTING: Descriptive, quantitative study at Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. METHODS: Thirty-six medical students were examined in a 15-station high-stake objective structured clinical examination (OSCE. At four stations devoted to history-taking, examiners filled out checklists covering the components investigated and independently rated students’ overall performance using a five-point scale from 1 (poor to 5 (excellent. Physician ratings were aggregated for each student. Nonparametric correlations were made between ORs. RESULTS: ORs presented significant correlations with checklist scores (Spearman’s rs = 0.38; p = 0.02 and OSCE general results (rs = 0.52; p < 0.001. Scores for "communication skills" tended to correlate with ORs (rs = 0.31, but without reaching significance (p = 0.06. Neither the scores for "completeness" (rs = 0.26; p = 0.11 nor those for "asking key questions" (rs = 0.07; p = 0.60 correlated with ORs. CONCLUSIONS: Experts’ overall ratings for medical student competence regarding history-taking is likely to encompass a particular dimension, since ratings were only weakly influenced by specific components of performance.

  6. Frequency of pediatric medication administration errors and contributing factors.

    Science.gov (United States)

    Ozkan, Suzan; Kocaman, Gulseren; Ozturk, Candan; Seren, Seyda

    2011-01-01

    This study examined the frequency of pediatric medication administration errors and contributing factors. This research used the undisguised observation method and Critical Incident Technique. Errors and contributing factors were classified through the Organizational Accident Model. Errors were made in 36.5% of the 2344 doses that were observed. The most frequent errors were those associated with administration at the wrong time. According to the results of this study, errors arise from problems within the system.

  7. Factors influencing paediatric nurses' responses to medication administration

    NARCIS (Netherlands)

    Davis, Leigh; Ware, Robert S.; McCann, Damhnat; Keogh, Samantha; Watson, Karen

    2010-01-01

    Objective To evaluate the importance of contextual and policy factors on nurses' judgement about medication administration practice. Design A questionnaire survey of responses to a number of factorial vignettes in June 2004. These vignettes considered a combination of seven contextual and policy fac

  8. Characteristics of Prison Hospice Patients: Medical History, Hospice Care, and End-of-Life Symptom Prevalence.

    Science.gov (United States)

    Cloyes, Kristin G; Berry, Patricia H; Martz, Kim; Supiano, Katherine

    2015-07-01

    Increasing numbers of prisoners in the United States are dying from age-related and chronic illnesses while incarcerated. This study is among the first to document characteristics of a population of prison hospice patients. Retrospective review of medical records for all patients admitted to the Louisiana State Penitentiary prison hospice program between January 1, 2004, and May 31, 2012 (N = 79) examined demographics, medical history, hospice diagnosis, length of stay, and end-of-life symptom prevalence on admission and during final 72 hours before death. Resulting data were contrasted with community-based end-of-life care study data, demonstrating a unique clinical profile of this group. As prisons consider adopting programs to meet the growing need for inmate end-of-life care, more research concerning the particular characteristics and unique needs of prison hospice patients will inform these efforts.

  9. Integrating social factors into cross-cultural medical education.

    Science.gov (United States)

    Green, Alexander R; Betancourt, Joseph R; Carrillo, J Emilio

    2002-03-01

    The field of cross-cultural medical education has blossomed in an environment of increasing diversity and increasing awareness of the effect of race and ethnicity on health outcomes. However, there is still no standardized approach to teaching doctors in training how best to care for diverse patient populations. As standards are developed, it is crucial to realize that medical educators cannot teach about culture in a vacuum. Caring for patients of diverse cultural backgrounds is inextricably linked to caring for patients of diverse social backgrounds. In this article, the authors discuss the importance of social issues in caring for patients of all cultures, and propose a practical, patient-based approach to social analysis covering four major domains--(1) social stress and support networks, (2) change in environment, (3) life control, and (4) literacy. By emphasizing and expanding the role of the social history in cross-cultural medical education, faculty can better train medical students, residents, and other health care providers to care for socioculturally diverse patient populations.

  10. What factors influence UK medical students’ choice of foundation school?

    Directory of Open Access Journals (Sweden)

    Miah S

    2017-04-01

    Full Text Available Saiful Miah,1,2 Karl H Pang,3 Wayne Rebello,4 Zoe Rubakumar,4 Victoria Fung,5 Suresh Venugopal,6 Hena Begum4 1Division of Surgery and Interventional science, University College London, London, UK; 2Department of Urology, Charing Cross Hospital Imperial College Healthcare NHS Trust, London, UK; 3Academic Urology Unit, University of Sheffield, Sheffield, UK; 4Medical School, University of Sheffield, Sheffield, UK; 5Department of Plastic Surgery, Royal Hallamshire Hospital, Sheffield, UK; 6Department of Urology, Chesterfield Royal Infirmary, Chesterfield, UK Background: We aimed to identify the factors influencing UK medical student applicants’ choice of foundation school. We also explored the factors that doctors currently approaching the end of their 2-year program believe should be considered. Methods: A cross-sectional study was conducted during the 2013–2014 academic year. An online questionnaire was distributed to 2092 final-year medical students from nine UK medical schools and 84 foundation year-2 (FY2 doctors from eight foundation schools. Participants were asked to rank their top 3 from a list of 12 factors that could potentially influence choice of foundation school on a 5-point Likert scale. Collated categorical data from the two groups were compared using a chi-square test with Yates correction. Results: Geographic location was overwhelmingly the most important factor for medical students and FY2 doctors with 97.2% and 98.8% in agreement, respectively. Social relationships played a pivotal role for medical student applicants. Clinical specialties within the rotations were of less importance to medical students, in comparison to location and social relationships. In contrast, FY2 doctors placed a significantly greater importance on the specialties undertaken in their 2-year training program, when compared to medical students (chi-square; p=0.0001. Conclusion: UK medical schools should make their foundation program applicants aware

  11. [[History of Community Health in Africa. The Swiss Medical Missionaries' Endeavour in South Africa].

    Science.gov (United States)

    Mabika, Hines

    2015-01-01

    It was not Dutch settlers nor British colonizers who introduced public and community health practice in north-eastern South Africa but medical doctors of the Swiss mission in southern Africa. While the history of medical knowledge transfer into 19th-20th century Africa emphasises colonial powers, this paper shows how countries without colonies contributed to expand western medical cultures, including public health. The Swiss took advantage of the local authorities' negligence, and implemented their own model of medicalization of African societies, understood as the way of improving health standards. They moved from a tolerated hospital-centred medicine to the practice of community health, which was uncommon at the time. Elim hospital's physicians moved back boundaries of segregationist policies, and sometime gave the impression of being involved in the political struggle against Apartheid. Thus, Swiss public health activities could later be seen as sorts of seeds that were planted and would partly reappear in 1994 with the ANC-projected national health policy.

  12. The search for the elusive electronic medical record system--medical liability, the missing factor.

    Science.gov (United States)

    Grams, R R; Moyer, E H

    1997-02-01

    Over the past few years, the traditional paper-based medical record system has come under close scrutiny by every participant in the healthcare industry. Some groups, especially federal agencies such as Medicare and Medicaid, HMOs, and other third party payors, have begun to demand changes in medical record documentation, and have become very assertive as to what goals and objectives will be met. In contrast, the medical liability insurance industry has remained almost invisible during this period of transition. At a recent electronic medical records (EMR) conference participants attending a software development workshop were asked if they had their systems reviewed from a medicolegal standpoint by a malpractice insurance carrier. In response to this inquiry, not one software vendor raised their hand to indicate this had been accomplished, or was even contemplated. In the author's opinion, the key missing factor in the current quest for a paperless medical office system rests in the domain of those who represent the medical liability industry. All of these gate-keepers of medical loss and risk prevention will eventually be called upon, either by choice or necessity, to validate every working EMR system that is used in medical practices in the future. This article will explore the best information published from this currently silent sector of the industry, and proposes an active involvement by the medical liability industry in the current EMR design and development processes taking place. In addition, there are 10 minimum EMR design criteria contained in this article that are recommended for implementation based upon 16 years of medical malpractice experience and loss prevention input.

  13. Impact of cardiovascular risk factors on medical expenditure: evidence from epidemiological studies analysing data on health checkups and medical insurance.

    Science.gov (United States)

    Nakamura, Koshi

    2014-01-01

    Concerns have increasingly been raised about the medical economic burden in Japan, of which approximately 20% is attributable to cardiovascular disease, including coronary heart disease and stroke. Because the management of risk factors is essential for the prevention of cardiovascular disease, it is important to understand the relationship between cardiovascular risk factors and medical expenditure in the Japanese population. However, only a few Japanese epidemiological studies analysing data on health checkups and medical insurance have provided evidence on this topic. Patients with cardiovascular risk factors, including obesity, hypertension, and diabetes, may incur medical expenditures through treatment of the risk factors themselves and through procedures for associated diseases that usually require hospitalization and sometimes result in death. Untreated risk factors may cause medical expenditure surges, mainly due to long-term hospitalization, more often than risk factors preventively treated by medication. On an individual patient level, medical expenditures increase with the number of concomitant cardiovascular risk factors. For single risk factors, personal medical expenditure may increase with the severity of that factor. However, on a population level, the medical economic burden attributable to cardiovascular risk factors results largely from a single, particularly prevalent risk factor, especially from mildly-to-moderately abnormal levels of the factor. Therefore, cardiovascular risk factors require management on the basis of both a cost-effective strategy of treating high-risk patients and a population strategy for reducing both the ill health and medical economic burdens that result from cardiovascular disease.

  14. Medical equipment ordinance and lack of personnel: two contrary factors influencing anesthesia patient safety.

    Science.gov (United States)

    Peter, K; Dieterich, H J

    1991-01-01

    In January 1986, West German legislators enacted the Medical Equipment Ordinance (MedGV) to define specific regulations for both manufacturers and operators of medical equipment and to offer a measure of safety to patients. We describe the history of MedGV, its regulations, and the mechanisms developed to enforce those regulations. We also evaluate its impact on clinical practice in light of the current staff shortages in anesthesia practice and research in Germany. Finally, we focus our discussion on the distinction between improved equipment as a minor factor in critical-incidents and the inadequate manpower as a major factor in anesthesia mishaps. It is unclear what will develop after 1993, when the national states in Europe form a common market.

  15. Shisha smoking and associated factors among medical students in Malaysia.

    Science.gov (United States)

    Al-Naggar, Redhwan A; Bobryshev, Yuri V

    2012-01-01

    The aim of the study was to determine the prevalence of shisha smoking and associated factors among medical students in Malaysia. A cross-sectional study was conducted at the Management and Science University from December 2011 until March 2012. The questionnaire consisted of five sections including socio-demographic, social environment, knowledge about shisha, psychosocial factors, and personal shisha smoking behavior. Obtained data were analyzed using Statistical Package for the Social Sciences (SPSS 13). T-test was used to determine the relationships between shisha smoking and socio-demographic characteristic. A total number of 300 medical students participated in this study. Mean age was 22.5±2.5 years. The majority were female, Malay, single, from urban areas (67%, 54%, 97%, 73%; respectively). The prevalence of shisha smoking among medical students was found to be 20%. The study revealed that many students believed that shisha does not contains nicotine, carbon monoxide, does not lead to lung cancer, dental problems and does not lead to cardiovascular diseases (25%, 20.7%, 22.3%, 29%, 26.7%; respectively). Age and sex were found to be significantly associated with smoking shisha status among medical students (p=0.029, p<0.001; respectively). Furthermore, having parents, siblings and friends smokers of shisha were found to be significantly associated with shisha smoking status (p<0.001, p<0.001, p<0.001; respectively). Furthermore, family problems, problems with friends, financial problems and university life were found to significantly associated with shisha smoking status among medical students (p<0.001, p=0.002, p<0.001, p=0.002; respectively). There is a high prevalence of shisha smoking and a poor knowledge about its impact on health among medical students. More attention is needed to focus on medical education in this regard. The policies that are currently employed in order to reduce the cigarettes smoking should be applied to shisha smoking and shisha

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

    Directory of Open Access Journals (Sweden)

    Basheti IA

    2016-03-01

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

  17. Organizational factors and change strategies associated with medical home transformation.

    Science.gov (United States)

    Solberg, Leif I; Stuck, Logan H; Crain, A Lauren; Tillema, Juliana O; Flottemesch, Thom J; Whitebird, Robin R; Fontaine, Patricia L

    2015-01-01

    There is limited information about how to transform primary care practices into medical homes. The research team surveyed leaders of the first 132 primary care practices in Minnesota to achieve medical home certification. These surveys measured priority for transformation, the presence of medical home practice systems, and the presence of various organizational factors and change strategies. Survey response rates were 98% for the Change Process Capability Questionnaire survey and 92% for the Physician Practice Connections survey. They showed that 80% to 100% of these certified clinics had 15 of the 18 organizational factors important for improving care processes and that 60% to 90% had successfully used 16 improvement strategies. Higher priority for this change (P = .001) and use of more strategies (P = .05) were predictive of greater change in systems. Clinics contemplating medical home transformation should consider the factors and strategies identified here and should be sure that such a change is indeed a high priority for them. © The Author(s) 2014.

  18. OBJECTIVE AND SUBJECTIVE FACTORS OF MEDICAL DRUG CHOICE

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    E. B. Babanskaya

    2017-01-01

    Full Text Available Aim. To analyze the factors of medical choice in the prescription of medicinal drug (MD for the treatment of cardiovascular diseases. Material and methods. A questionnaire survey of 212 doctors (138 physicians and 42 general practitioners was performed in Irkutsk region and Republic of Buryatia. Questions were related to the physicians’ choice of the original or generic MD and the factors that influence this choice. Results. The majority of respondents prefer the foreign MD, while they prescribed both original and generic drugs (60.4%. The determining factor in the prescription of MD is its efficacy (91.5-95.3%. The main source of information of MD for physicians is the medical literature (78.3%. Only 23.6% of doctors choose the MD based on the results of clinical trials and information about it in specialized medical literature. A half of the respondents believe that their knowledge of cardiovascular MD is insufficient. Doctors need and are interested in information on the pharmacokinetics and pharmacodynamics of MD, side effects, drug interactions and results of clinical studies. Conclusion. It is necessary to focus on the clinical pharmacology of cardiovascular MD during the training of doctors in specialized courses of continuous medical education.

  19. Prevalence of Irritable Bowel Syndrome and its Associated Factors Among Medical Students

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    Muneer Almutairi

    2017-02-01

    Full Text Available Background and aim: Irritable bowel syndrome (IBS is a common functional gastrointestinal disorder and is the most commonly diagnosed one by gastroenterologists. In this study, we aim to explore the frequency of IBS among medical students in Qassim, and the factors associated with this disorder among them. Materials and methods: A cross sectional study was carried out among medical students of all academic levels in three local universities in Qassim region; Qassim University, Unizah as well as Alrajhi colleges of medicine. Data for the study were collected throughout the 1st semester of the academic year 2015-2016 using a validated, self-administered, and anonymous paper questionnaire. The questionnaire included three main sections: Demographics, Rome III criteria and hospital anxiety and depression scale (HADS. Results: Among 511 students completed the study and of those 70 (13.7% had IBS. Senior medical students are 3.61 times more likely to have IBS than juniors (p<0.001. Depression was significantly associated with IBS (p=0.042. Stepwise logistic regression showed that chronic health problems, more advanced academic level and personal history of IBS were significant predictors for IBS. Conclusion: The prevalence of IBS is 13.7% among medical students in Qassim region. Depression, age, living situation, advanced academic years, family or personal history, or an episode of travellers’ diarrhoea were the main predictors of IBS. Offering psychological and emotional support along with stress management courses in order to deal with stress is recommended.

  20. ASSESSMENT OF CARDIAC RISK FACTORS IN MEDICAL STUDENTS OF TEHRAN UNIVERSITY

    Directory of Open Access Journals (Sweden)

    "M. J. Mahmoudi

    2004-11-01

    Full Text Available Prevention of coronary heart disease, mainly by reducing the levels of known risk factors in the population, remains a priority in public health. This cross-sectional study on randomly selected medical students during their internship was conducted from July 2001 to April 2002 in order to determine the prevalence of major coronary artery disease (CAD risk factors. This survey was done by filling the questionnaire, measuring physical parameters, and taking a fasting blood sample. Two hundred and sixty four medical students were evaluated in this study (48 female, 216 male with the mean age of 26.5 ± 2.8 years. The main risk factors in descending order of frequency were physical inactivity (43.5%, low high-density lipoprotein cholesterol (26.2%, family history of premature CAD (15.9%, smoking (10.3%, abdominal obesity (10.2%, high triglyceride level (5.3%, high blood pressure (3.4%, and high low-density lipoprotein cholesterol (1.5%. Also, 25% of married females were using oral contraceptives regularly. The number of risk factors per person was 2.2 on average (1.1 in females and 2.5 in males. Prevalence of CAD risk factors in this medical students’ population was unacceptably high. Additional studies should be done to gather more information and determine the need for preventive, educational or curative interventions.

  1. Effective factors in expansion of medical tourism in Iran

    Science.gov (United States)

    Rezaee, Reza; Mohammadzadeh, Mehdi

    2016-01-01

    Background: Medical tourism (MT) refers to circumstances in which people travel for medical treatments. The present study focuses on determining factors affecting MT in Iran. Methods: The study uses a mixed method approach. Initially, through a qualitative study, 12 experts were interviewed deeply; then, 22 participants in three equal focus groups expressed their ideas about growth and development of MT in Iran. Based on the expressed ideas, 120 factors were identified and accordingly a structured questionnaire was developed. Some members from the focus groups confirmed the questionnaire’s face and content validity. The reliability of pertinent items was confirmed using Cronbach’s alpha=0.8. Afterwards, 61 eligible subjects filled out this questionnaire. Results: The findings showed that "healthcare quality" and "high level of expertise" are two most attractive factors in MT. However, other factors such as "healthcare costs", and "visa facilities" are among key factors as well. Also, the role of "the healthcare providers" was found to be more prominent than the roles of "the government" and "the general tourist services". Conclusion: Although some attractive MT factors are present currently, MT expansion to a desirable level in Iran requires a comprehensive plan of which its factors were discussed in this paper. PMID:27683650

  2. Effective factors in expansion of medical tourism in Iran.

    Science.gov (United States)

    Rezaee, Reza; Mohammadzadeh, Mehdi

    2016-01-01

    Medical tourism (MT) refers to circumstances in which people travel for medical treatments. The present study focuses on determining factors affecting MT in Iran. The study uses a mixed method approach. Initially, through a qualitative study, 12 experts were interviewed deeply; then, 22 participants in three equal focus groups expressed their ideas about growth and development of MT in Iran. Based on the expressed ideas, 120 factors were identified and accordingly a structured questionnaire was developed. Some members from the focus groups confirmed the questionnaire's face and content validity. The reliability of pertinent items was confirmed using Cronbach's alpha=0.8. Afterwards, 61 eligible subjects filled out this questionnaire. The findings showed that "healthcare quality" and "high level of expertise" are two most attractive factors in MT. However, other factors such as "healthcare costs", and "visa facilities" are among key factors as well. Also, the role of "the healthcare providers" was found to be more prominent than the roles of "the government" and "the general tourist services". Although some attractive MT factors are present currently, MT expansion to a desirable level in Iran requires a comprehensive plan of which its factors were discussed in this paper.

  3. History of the Public Health Institute of Semmelweis Medical University, Budapest.

    Science.gov (United States)

    Tahin, E; Morava, E

    2000-05-01

    The science of public health of the XVIIIth century named politia medica together with medicina forensis became an independent obligatory subject in 1793 at the Medical Faculty of the Hungarian Royal University of Science. The independent Public Health Institute of the Medical Faculty was established in 1874. The first professor of public health was József Fodor who attained international reputation during his professorship. He organized training for school physicians and health teachers first in Europe and he organized courses for medical officers and for military doctors. He held courses for law-, engineer- and architect-students. He promoted all fields of the public health. His research on the bactericide effect of serum places him among the founders of immunology. Fodor's successors at the Chair of Public Health were Leó Liebermann whose research activities included physico-chemistry, biochemistry, microbiology and social hygiene; Gusztáv Rigler who focused on the epidemiology of communicable diseases, on the health effects of spa treatment and mineral waters. The next famous professor was Gyula Darányi. His scientific field was public health bacteriology and public health chemistry. They were followed by József Melly and László Dabis (Scheff). After the Second World War fundamental changes took place in the life of the university. The Faculty of Medicine was separated from the University of Science on February 1, 1951 and became an independent university under the control of the Ministry of Health. In 1953 the Institute of Public Health was cut into two separate institutes: Institute of Public Health and Institute for the Organization of Health Service. The Institute of Public Health was transformed to Institute of Public Health and Epidemiology in 1973. The Institute for the Organization of Health Service was transformed into Institute of Social Medicine and History of Medicine in 1985 and later into Institute of History of Medicine and Social Medicine

  4. Family History, Diabetes, and Other Demographic and Risk Factors Among Participants of the National Health and Nutrition Examination Survey 1999–2002

    Directory of Open Access Journals (Sweden)

    Debra Duquette, MS, CGC

    2005-03-01

    Full Text Available Introduction Family history of diabetes has been recognized as an important risk factor of the disease. Family medical history represents valuable genomic information because it characterizes the combined interactions between environmental, behavioral, and genetic factors. This study examined the strength and effect of having a family history of diabetes on the prevalence of self-reported, previously diagnosed diabetes among adult participants of the National Health and Nutrition Examination Survey 1999–2002. Methods The study population included data from 10,283 participants aged 20 years and older. Gender, age, race/ethnicity, poverty income ratio, education level, body mass index, and family history of diabetes were examined in relation to diabetes status. Diabetes prevalence estimates and odds ratios of diabetes were calculated based on family history and other factors. Results The prevalence of diabetes among individuals who have a first-degree relative with diabetes (14.3% was significantly higher than that of individuals without a family history (3.2%, corresponding to a crude odds ratio of five. Both prevalence and odds ratio estimates significantly increased with the number of relatives affected with diabetes. Family history was also associated with several demographic and risk factors. Conclusion Family history of diabetes was shown to be a significant predictor of diabetes prevalence in the adult U.S. population. We advocate the inclusion of family history assessment in public health prevention and screening programs as an inexpensive and valuable source of genomic information and measure of diabetes risk.

  5. Teaching medical students how to take a sexual history and discuss sexual health issues.

    Science.gov (United States)

    Ng, C J; McCarthy, S A

    2002-12-01

    Taking a sexual history and discussing sexual health issues with patients form an important part of a medical consultation. These specific communication skills can be acquired through various teaching methods. This paper describes the communication skill workshops conducted for undergraduate medical students on how to talk to patients about sex. 198 medical students participated in a series of workshops conducted in the University of Malaya in 2001-2002. Pre- and post-workshop evaluations of the programme were carried out to find out the students' difficulties and to assess the usefulness of the workshop. The workshop consisted of a short lecture, role-plays and discussion. Only 34% of the participants had received some informal training during their clinical years. The main barriers encountered were gender and age differences, language and choice of words, patients and doctors feeling shy, and cultural differences. The workshop was felt to be useful (mean score 4.38, maximum 5.0), most students felt comfortable during the workshop (mean score 4.10, maximum 5.0) and there was significant improvement in the "comfort level" when talking to patients about sex after attending the workshop (P students. Communication workshop was felt to be a useful and comfortable method of learning these specific.

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

    Science.gov (United States)

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

    2016-01-01

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

  7. Writing women into medical history in the 1930s: Kate Campbell Hurd-Mead and "medical women" of the past and present.

    Science.gov (United States)

    Appel, Toby A

    2014-01-01

    Kate Campbell Hurd-Mead (1867–1941), a leader among second-generation women physicians in America, became a pioneer historian of women in medicine in the 1930s. The coalescence of events in her personal life, the declining status of women in medicine, and the growing significance of the new and relatively open field of history of medicine all contributed to this transformation in her career. While she endeavored to become part of the community of male physicians who wrote medical history, her primary identity remained that of a “medical woman.” For Hurd-Mead, the history of women in the past not only filled a vital gap in scholarship but served practical ends that she had earlier pursued by other means—those of inspiring and advancing the careers of women physicians of the present day, promoting organizations of women physicians, and advocating for equality of opportunity in the medical profession.

  8. Factors potentially influencing academic performance among medical students

    Directory of Open Access Journals (Sweden)

    Al Shawwa L

    2015-01-01

    Full Text Available Lana Al Shawwa,1 Ahmad A Abulaban,2 Abdulrhman A Abulaban,3 Anas Merdad,3 Sara Baghlaf,3 Ahmed Algethami,3 Joullanar Abu-shanab,3 Abdulrahman Balkhoyor3 1Department of Medical Education, College of Medicine, King Abdulaziz University, Jeddah, 2Department of Medicine-Neurology, King Fahad National Guard Hospital, King Abdulziz Medical City, Riyadh, 3Department of Medical Education, College of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia Background: Studies are needed to examine predictors of success in medical school. The aim of this work is to explore factors that potentially influence excellence of medical students. Methods: The study was conducted in the Medical Faculty of King Abdulaziz University during October 2012. A self-administered questionnaire was used. Medical students with a grade point average (GPA ≥4.5 (out of 5 were included and compared to randomly selected medical students with a GPA <4.5, who were available at the time of the study. Results: A total of 359 undergraduate students participated in the study. 50.4% of the sample was students with a GPA ≥4.5. No statistically significant difference regarding the time spent on outings and social events was found. However, 60.7% of high GPA students spend less than 2 hours on social networking per day as compared to 42.6% of the lower GPA students (P<0.01. In addition, 79% of high GPA students prefer to study alone (P=0.02, 68.0% required silence and no interruptions during studying time (P=0.013, and 47% revise their material at least once before an exam (P=0.02. Conclusion: Excellent medical students have many different characteristics. For example, they do not use social networking for prolonged periods of time, and they have strong motivation and study enjoyment. Further studies are needed to examine whether these differences have a real impact on GPA or not. Keyword: King Abdulaziz University KAU, medical school, study habits, exam habits 

  9. Factors Affecting Accuracy of Data Abstracted from Medical Records.

    Directory of Open Access Journals (Sweden)

    Meredith N Zozus

    Full Text Available Medical record abstraction (MRA is often cited as a significant source of error in research data, yet MRA methodology has rarely been the subject of investigation. Lack of a common framework has hindered application of the extant literature in practice, and, until now, there were no evidence-based guidelines for ensuring data quality in MRA. We aimed to identify the factors affecting the accuracy of data abstracted from medical records and to generate a framework for data quality assurance and control in MRA.Candidate factors were identified from published reports of MRA. Content validity of the top candidate factors was assessed via a four-round two-group Delphi process with expert abstractors with experience in clinical research, registries, and quality improvement. The resulting coded factors were categorized into a control theory-based framework of MRA. Coverage of the framework was evaluated using the recent published literature.Analysis of the identified articles yielded 292 unique factors that affect the accuracy of abstracted data. Delphi processes overall refuted three of the top factors identified from the literature based on importance and five based on reliability (six total factors refuted. Four new factors were identified by the Delphi. The generated framework demonstrated comprehensive coverage. Significant underreporting of MRA methodology in recent studies was discovered.The framework generated from this research provides a guide for planning data quality assurance and control for studies using MRA. The large number and variability of factors indicate that while prospective quality assurance likely increases the accuracy of abstracted data, monitoring the accuracy during the abstraction process is also required. Recent studies reporting research results based on MRA rarely reported data quality assurance or control measures, and even less frequently reported data quality metrics with research results. Given the demonstrated

  10. A prospective cohort study investigating factors associated with depression during medical internship.

    Science.gov (United States)

    Sen, Srijan; Kranzler, Henry R; Krystal, John H; Speller, Heather; Chan, Grace; Gelernter, Joel; Guille, Constance

    2010-06-01

    Although the prevalence of depression among medical interns substantially exceeds that of the general population, the specific factors responsible are not well understood. Recent reports of a moderating effect of a genetic polymorphism (5-HTTLPR) in the serotonin transporter protein gene on the likelihood that life stress will precipitate depression may help to understand the development of mood symptoms in medical interns. To identify psychological, demographic, and residency program factors that are associated with depression among interns and to use medical internship as a model to study the moderating effects of this polymorphism. A prospective cohort study. Thirteen US hospitals. Seven hundred forty interns entering participating residency programs. Subjects were assessed for depressive symptoms using the 9-item Patient Health Questionnaire (PHQ-9), a series of psychological traits, and the 5-HTTLPR genotype prior to internship and then assessed for depressive symptoms and potential stressors at 3-month intervals during internship. The PHQ-9 depression score increased from 2.4 prior to internship to a mean of 6.4 during internship (P internship to a mean of 25.7% during internship (P internship (female sex, US medical education, difficult early family environment, history of major depression, lower baseline depressive symptom score, and higher neuroticism) and during internship (increased work hours, perceived medical errors, and stressful life events) was associated with a greater increase in depressive symptoms during internship. In addition, subjects with at least 1 copy of a less-transcribed 5-HTTLPR allele reported a greater increase in depressive symptoms under the stress of internship (P = .002). There is a marked increase in depressive symptoms during medical internship. Specific individual, internship, and genetic factors are associated with the increase in depressive symptoms.

  11. A survey of factors influencing career preference in new-entrant and exiting medical students from four UK medical schools

    OpenAIRE

    Cleland, Jennifer A.; Johnston, Peter W; Anthony, Micheal; Khan, Nadir; Scott, Neil W

    2014-01-01

    Background Workforce planning is a central issue for service provision and has consequences for medical education. Much work has been examined the career intentions, career preferences and career destinations of UK medical graduates but there is little published about medical students career intentions. How soon do medical students formulate careers intentions? How much do these intentions and preferences change during medical school? If they do change, what are the determining factors? Our a...

  12. How experiences become data: the process of eliciting adverse event, medical history and concomitant medication reports in antimalarial and antiretroviral interaction trials.

    Science.gov (United States)

    Allen, Elizabeth N; Mushi, Adiel K; Massawe, Isolide S; Vestergaard, Lasse S; Lemnge, Martha; Staedke, Sarah G; Mehta, Ushma; Barnes, Karen I; Chandler, Clare I R

    2013-11-14

    Accurately characterizing a drug's safety profile is essential. Trial harm and tolerability assessments rely, in part, on participants' reports of medical histories, adverse events (AEs), and concomitant medications. Optimal methods for questioning participants are unclear, but different methods giving different results can undermine meta-analyses. This study compared methods for eliciting such data and explored reasons for dissimilar participant responses. Participants from open-label antimalarial and antiretroviral interaction trials in two distinct sites (South Africa, n = 18 [all HIV positive]; Tanzania, n = 80 [86% HIV positive]) were asked about ill health and treatment use by sequential use of (1) general enquiries without reference to particular conditions, body systems or treatments, (2) checklists of potential health issues and treatments, (3) in-depth interviews. Participants' experiences of illness and treatment and their reporting behaviour were explored qualitatively, as were trial clinicians' experiences with obtaining participant reports. Outcomes were the number and nature of data by questioning method, themes from qualitative analyses and a theoretical interpretation of participants' experiences. There was an overall cumulative increase in the number of reports from general enquiry through checklists to in-depth interview; in South Africa, an additional 12 medical histories, 21 AEs and 27 medications; in Tanzania an additional 260 medical histories, 1 AE and 11 medications. Checklists and interviews facilitated recognition of health issues and treatments, and consideration of what to report. Information was sometimes not reported because participants forgot, it was considered irrelevant or insignificant, or they feared reporting. Some medicine names were not known and answers to questions were considered inferior to blood tests for detecting ill health. South African inpatient volunteers exhibited a "trial citizenship", working to achieve

  13. Medical Specialty Choice and Related Factors of Brazilian Medical Students and Recent Doctors.

    Directory of Open Access Journals (Sweden)

    Ligia Correia Lima de Souza

    Full Text Available Choosing a medical specialty is an important, complex, and not fully understood process. The present study investigated the factors that are related to choosing and rejecting medical specialties in a group of students and recent medical doctors.A cross-sectional survey of 1,223 medical students and doctors was performed in Brazil in 2012. A standardized literature-based questionnaire was applied that gathered preferable or rejected specialties, and asked questions about extracurricular experiences and the influence of 14 factors on a Likert-type scale from 0 to 4. Specialties were grouped according to lifestyle categories: controllable and uncontrollable, which were subdivided into primary care, internal medicine, and surgical specialties. Notably, the time period of rejection was usually earlier than the time period of intended choice (p < 0.0001, χ(2 = 107.2. The choice mainly occurred during the internship period in medical school (n = 466; 38.7%. An overall large frequency of participation in extracurricular activities was observed (n = 1,184; 95.8%, which were highly associated with the respective medical area. Orthopedic surgery had the highest correlation with participation in specialty-specific organized groups (OR = 59.9, 95% CI = 21.6-166.3 and psychiatry was correlated with participation in research groups (OR = 18.0, 95% CI = 9.0-36.2. With regard to influential factors in controllable lifestyle specialties, "financial reason" (mean score ± standard deviation: 2.8 ± 1.0; median = 3 and "personal time" (3.1 ± 1.3; median = 4 were important factors. In primary care, these factors were less important (1.7 ± 1.3 and 1.7 ± 1.5, respectively; median = 2 for both, and higher scores were observed for "curricular internship" (3.2 ± 1.1, median = 4 and "social commitment" (2.6 ± 1.3, median = 3.The present findings provide important insights into developing strategies to stimulate interest in specialties based on the needs of the

  14. Governmental oversight of prescribing medications: history of the US Food and Drug Administration and prescriptive authority.

    Science.gov (United States)

    Plank, Linda S

    2011-01-01

    The evolution of drug regulation and awarding of prescriptive authority is a complex and sometimes convoluted process that can be confusing for health care providers. A review of the history of how drugs have been manufactured and dispensed helps explain why this process has been so laborious and complicated. Because the federal and state governments have the responsibility for protecting the public, most regulations have been passed with the intentions of ensuring consumer safety. The current system of laws and regulations is the result of many years of using the legal system to correct drug marketing that had adverse health consequences. Government oversight will continue as prescribing medications transitions to an electronic form and as health care professionals in addition to physicians seek to gain prescriptive authority.

  15. [Brief history of the main institutions in the China Academy of Chinese Medical Sciences].

    Science.gov (United States)

    Sun, Qingwei

    2015-11-01

    On 19 October, 1955, the Academy of Traditional Chinese Medicine affiliated with the Ministry of Health of the People's Republic of China was established formally. On 8 October, 1985, its name was changed to "China Academy of Traditional Chinese Medicine", which was renamed as "China Academy of Chinese Medical Sciences (CACMS)" on 15 November, 2005. During its six decades of history, the construction of the institutions in the CACMS were improved constantly. Nowadays, there are altogether 17 academic institutions, 6 clinical institutions, 1 educational institution and 6 industrial institutions in the CACMS, which has become a comprehensive research institution of traditional Chinese medicine (TCM), embodying scientific research, clinical service, education and industry as a whole, under the direct control of the State Administration of Traditional Chinese Medicine of the People's Republic of China.

  16. Family history of venous thromboembolism and identifying factor V Leiden carriers during pregnancy.

    Science.gov (United States)

    Horton, Amanda L; Momirova, Valerija; Dizon-Townson, Donna; Wenstrom, Katharine; Wendel, George; Samuels, Philip; Sibai, Baha; Spong, Catherine Y; Cotroneo, Margaret; Sorokin, Yoram; Miodovnik, Menachem; O'Sullivan, Mary J; Conway, Deborah; Wapner, Ronald J

    2010-03-01

    To estimate whether there is a correlation between family history of venous thromboembolism and factor V Leiden mutation carriage in gravid women without a personal history of venous thromboembolism. This is a secondary analysis of a prospective observational study of the frequency of pregnancy-related thromboembolic events among carriers of the factor V Leiden mutation. Family history of venous thromboembolism in either first- or second-degree relatives was self-reported. Sensitivity, specificity, and positive and negative predictive values of family history to predict factor V Leiden mutation carrier status were calculated. Women without a personal venous thromboembolism history and with available DNA were included (n=5,168). One hundred forty women (2.7% [95% confidence interval (CI) 2.3-3.2%]) were factor V Leiden mutation-positive. Four hundred twelve women (8.0% [95% CI 7.3-8.7%]) reported a family history of venous thromboembolism. Women with a positive family history were twofold more likely to be factor V Leiden mutation carriers than those with a negative family history (23 of 412 [5.6%] compared with 117 of 4,756 [2.5%], Pfactor V Leiden carriers were 16.4% (95% CI 10.7-23.6%), 92.3% (95% CI 91.5-93.0%), and 5.6% (95% CI 3.6-8.3%), respectively. Although a family history of venous thromboembolism is associated with factor V Leiden mutation in thrombosis-free gravid women, the sensitivity and positive predictive values are too low to recommend screening women for the factor V Leiden mutation based solely on a family history.

  17. Characteristics and risk factors of cerebrovascular accidents after percutaneous coronary interventions in patients with history of stroke

    Institute of Scientific and Technical Information of China (English)

    ZHANG Hua; FENG Li-qun; BI Qi; WANG Yu-ping

    2010-01-01

    Background Percutaneous coronary intervention (PCI) is a well-established method for managing coronary diseases.However, the increasing use of PCI has led to an increased incidence of acute cerebrovascular accidents (CVA) related to PCI. In this study, we investigated the characteristics and risk factors of CVA after PCI in patients with known stroke history.Methods Between January 1, 2005 and March 1, 2009, 621 patients with a history of stroke underwent a total of 665 PCI procedures and were included in this retrospective study. Demographic and clinical characteristics, previous medications, procedures, neurologic deficits, location of lesion and in-hospital clinical outcomes of patients who developed a CVA after the cardiac catheterization laboratory visit and before discharge were reviewed.Results Acute CVA was diagnosed in 53 (8.5%) patients during the operation or the perioperative pedod. Seventeen patients suffered from transient ischemic attack, thirty-four patients suffered from cerebral infarction and two patients suffered from cerebral hemorrhage. The risk factors for CVA after PCI in stroke patients were: admission with an acute coronary syndrome, use of an intra-aortic balloon pump, urgent or emergency procedures, diabetes mellitus, and poor left ventricular systolic function, arterial fibrillation, previous myocardial infarction, dyslipidemia, tobacco use, and no/irregular use of anti-platelet medications.Conclusions The incidence of CVA during and after PCI in patients with history of stroke is much higher than that in patients without history of stroke. Patients with atrial fibrillation, previous myocardial infarction, diabetes mellitus,dyslipidemia, tobacco use, and no or irregular use of anti-platelet medications were at higher risk for recurrent stroke.This study showed a strong association between acute coronary syndromes and in-hospital stroke after PCI.

  18. Characteristics and risk factors of cerebrovascular accidents after percutaneous coronary interventions in patients with history of stroke.

    Science.gov (United States)

    Zhang, Hua; Feng, Li-qun; Bi, Qi; Wang, Yu-ping

    2010-06-01

    Percutaneous coronary intervention (PCI) is a well-established method for managing coronary diseases. However, the increasing use of PCI has led to an increased incidence of acute cerebrovascular accidents (CVA) related to PCI. In this study, we investigated the characteristics and risk factors of CVA after PCI in patients with known stroke history. Between January 1, 2005 and March 1, 2009, 621 patients with a history of stroke underwent a total of 665 PCI procedures and were included in this retrospective study. Demographic and clinical characteristics, previous medications, procedures, neurologic deficits, location of lesion and in-hospital clinical outcomes of patients who developed a CVA after the cardiac catheterization laboratory visit and before discharge were reviewed. Acute CVA was diagnosed in 53 (8.5%) patients during the operation or the perioperative period. Seventeen patients suffered from transient ischemic attack, thirty-four patients suffered from cerebral infarction and two patients suffered from cerebral hemorrhage. The risk factors for CVA after PCI in stroke patients were: admission with an acute coronary syndrome, use of an intra-aortic balloon pump, urgent or emergency procedures, diabetes mellitus, and poor left ventricular systolic function, arterial fibrillation, previous myocardial infarction, dyslipidemia, tobacco use, and no/irregular use of anti-platelet medications. The incidence of CVA during and after PCI in patients with history of stroke is much higher than that in patients without history of stroke. Patients with atrial fibrillation, previous myocardial infarction, diabetes mellitus, dyslipidemia, tobacco use, and no or irregular use of anti-platelet medications were at higher risk for recurrent stroke. This study showed a strong association between acute coronary syndromes and in-hospital stroke after PCI.

  19. History and factors of survival of total hip arthroplasty.

    Science.gov (United States)

    Kolundžić, Robert; Trkulja, Vladimir; Orlić, Dubravko

    2012-02-01

    Since the 1960s total hip arthroplasty (THA) has represented one of the greatest accomplishments in orthopedic surgery. It improves the functionality, working ability and quality of life of patients with non-functional hip joint due to various reasons. This article reviews general and regional history of THA, current knowledge and concepts regarding the long-term outcomes of the procedure and emphasizes the need for establishing national (and international) THA registries as an essential way of gathering data critical for decision making in daily practice as well as in defining national healthcare policies in respect to arthroplasty procedures.

  20. Development and Use of a Medication History Service Associated with a Health Information Exchange: Architecture and Preliminary Findings

    Science.gov (United States)

    Frisse, Mark E.; Tang, Lianhong; Belsito, Anne; Overhage, J. Marc

    2010-01-01

    We describe our early experience with use in emergency department settings of a standards-based medication history service integrated into a health information exchange (HIE). The service sends queries from one Exchange’s emergency department interface both to a local ambulatory care system and to the medication hub services provided by a second HIE. This second HIE in turn sends requests to SureScripts and returns histories for incorporation into the first Exchange’s clinical interface. The service caches all requests to avoid costly duplicate query charges and maintains an account of queries, registered users, charges, and results obtained. Usage may be increasing as additional retail pharmacy data become available. Early results suggest that research and development emphasis requirements will of necessity shift from obtaining prescription medication history to finding new means to ensuring effective use. PMID:21346977

  1. [The history of medical physics and biophysics at the Humboldt University in Berlin].

    Science.gov (United States)

    Schneck, P

    2001-01-01

    The present Institute of Medical Physics and Biophysics (former Institute of Radiation Research) was established on September 1st in 1923 by Walter Friedrich (1883-1968). It was after the Institute in Frankfurt A.M. (founded by Friedrich Dessauer in 1921) - the second Institute of its kind in Germany. As a physicist who wrote his dissertation under Wilhelm Conrad Röntgen, he did research together with a Gynecologist in Friedburg on problems of radiation therapy and the prevention of radiation injuries. Thus Friedrich became one of the first German Biomedical Physicists and was appointed to a professorship at the university of Berlin and its faculty of medicine. The paper gives a survey of the history of the Institute of Radiation Research in the twenties, in the time of Nazi-rule, the period after the World War II and in the era of GDR until 1990 and up to the present time. The succession of directorship of the Institute and the main research subjects in medical physics and biophysics have been sketched.

  2. Details acquired from medical history and patients' experience of empathy--two sides of the same coin.

    Science.gov (United States)

    Ohm, Friedemann; Vogel, Daniela; Sehner, Susanne; Wijnen-Meijer, Marjo; Harendza, Sigrid

    2013-05-09

    History taking and empathetic communication are two important aspects in successful physician-patient interaction. Gathering important information from the patient's medical history is needed for effective clinical decision making while empathy is relevant for patient satisfaction. We wanted to investigate whether medical students near graduation are able to combine both skills as required in daily medical practice. Thirty near graduates from Hamburg Medical School participated in an assessment for clinical competences including a consultation hour with five standardized patients. Each patient interview was videotaped and standardized patients rated participants with the CARE questionnaire for consultation and relational empathy. All videotaped interviews were rated with a checklist based on the number of important medical aspects for each case. Data were analysed with the linear mixed model to correct for random effects. Regression analysis was performed to look for correlations between the number of questions asked by a participant and their respective empathy rating. Of the 123 aspects that could have been gathered in total, students only requested 56.4% (95% CI 53.5-59.3). While no difference between male and female participants was found, a significant difference (pcommunication are two completely separate sides of the coin of history taking. While both skills have to be acquired during medical school training with particular focus on their respective learning objectives, medical students need to be provided with additional learning and feedback opportunities where they can be observed exercising both skills combined as required in physicians' daily practice.

  3. Factors affecting the performance of undergraduate medical students: A perspective

    Directory of Open Access Journals (Sweden)

    Ananya Mandal

    2012-01-01

    Full Text Available Context: Performance of medical students in developing nations like India is perceived to have largely declined. Aims: We attempted to assess the reasons behind such trends. Settings and Design: Students in their third year of medical study were given a predesigned, pretested structured and validated questionnaire that they filled in anonymously. The key areas assessed were concentration, interest and understanding of the subject and other perceived causes of poor performance. Tests for descriptive statistics were applied for evaluation. Results and Conclusions: One hundred and fifty students participated in the study. Fifty-five (36.66% students performed poorly. Male gender, inability to clear the previous professional examination at the first attempt, difficulty in understanding medium of instruction, self-assessed depression, sleep disorders and perceived parental and peer pressure and dissatisfaction with career choice were significantly linked with poor performance (P<0.05 for each factor. Socioeconomic status and regularity in class were not linked to academic performance.

  4. Assessment of Medical Student and Resident/Fellow Knowledge, Comfort, and Training With Sexual History Taking in LGBTQ Patients.

    Science.gov (United States)

    Hayes, Victoria; Blondeau, Whitney; Bing-You, Robert G

    2015-05-01

    Sexual health is an important aspect of overall health. Barriers to taking an adequate patient sexual history exist. Few studies have explored medical learners' comfort, knowledge, and training surrounding taking sexual histories with lesbian, gay, bisexual, transgender, questioning/queer (LGBTQ) patients specifically. A 10-question survey was offered to medical students and resident/fellows at one US institution. Survey questions reflected participants' knowledge, comfort, and training related to sexual history taking with attention to LGBTQ care. A total of 159 surveys were returned (rate of 42%). A significantly lower level of comfort existed with taking sexual histories and managing sexual health issues in the LGBTQ segment of the patient population versus all patients, especially in the advanced training group. Participants recognized the importance of understanding their patients' overall sexual health, though medical students rated this as more important than the resident/fellow group did. A correlation existed between both comfort with taking sexual histories and discussing safe sexual practices and management of sexual issues, suggesting that further training would be helpful in this area. Twenty percent of the respondents reported receiving no training at all in eliciting sexual histories in LGBTQ patients. The most preferred format in this study for future training was interviewing standardized patients. Medical students and resident/fellows reported a significantly lower level of comfort with sexual history-taking and management of sexual issues in the LGBTQ population. A comprehensive training format that not only views sexual health as an integral part of overall patient health, but also integrates LGBTQ care, is needed in medical education.

  5. Systems of medicine and nationalist discourse in India: towards "new horizons" in medical anthropology and history.

    Science.gov (United States)

    Khan, Shamshad

    2006-06-01

    While accepting medical "pluralism" as a historical reality, as an intrinsic value inherent in any medical system, and as an ideal or desired goal that any multicultural society ought to achieve, this paper argues the need to go beyond the liberal pluralist tendencies that have dominated the debate so far. It holds that while documenting or dealing with the "co-existence" of varied medical traditions and practices, we must not ignore or underplay issues of power, domination and hegemony and must locate our work in a larger historical, social and political context. With this perspective, and based essentially on Assembly proceedings, private papers, official documents and archival materials from the first half of the 20th-century, this paper identifies three major streams in the nationalist discourse in India: conformity, defiance and the quest for an alternative. It shows that while the elements of conformity to biomedicine and its dominance remained more pronounced and emphatic, those of defiance were conversely weak and at times even apologetic. The quest for alternatives, on the other hand, although powerful and able to build trenchant civilizational and institutional critique of modern science and medicine, could never find adequate space in the national agenda for social change. The paper further holds that although the "cultural authority" and hegemony of biomedicine over indigenous science and knowledge were initiated by the colonial state, they were extended by the mainstream national leaderships and national governments with far more extensive and profound implications and less resistance. In light of the growing global networking of "traditional", "complementary" and "alternative" health systems on the one hand and the hegemonic and homogenizing role and presence of multilateral organizations (such as the World Bank and IMF) in shaping national health policies on the other, such insights from history become extraordinarily important.

  6. Breastfeeding in America: a history of influencing factors.

    Science.gov (United States)

    Thulier, Diane

    2009-02-01

    The author explores the history of breastfeeding in America. Popular belief is that medicine, science, and the formula industry have had the most impact on women's decisions to bottle versus breastfeed. What cannot be overlooked are other areas of influence. Cultural practices, including the beliefs of colonial Americans, the increased social value of children in the 20th century, and the emergence of a middle class, have influenced maternal decision making. The first and second waves of feminism affected women's choices. Politics and religion have had multiple and varied influences. It is this author's position that culture, gender, politics, and religion, as well as medicine, science, and industry, have combined to affect feeding choices. All of these influences, as well as others, both unforeseen and unpredictable, will continue to affect the future of breastfeeding in our society.

  7. Factor structure of the SOCRATES questionnaire in hospitalized medical patients.

    Science.gov (United States)

    Bertholet, Nicolas; Dukes, Kim; Horton, Nicholas J; Palfai, Tibor P; Pedley, Alison; Saitz, Richard

    2009-01-01

    The Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES), a 19-item instrument developed to assess readiness to change alcohol use among individuals presenting for specialized alcohol treatment, has been used in various populations and settings. Its factor structure and concurrent validity has been described for specialized alcohol treatment settings and primary care. The purpose of this study was to determine the factor structure and concurrent validity of the SOCRATES among medical inpatients with unhealthy alcohol use not seeking help for specialized alcohol treatment. The subjects were 337 medical inpatients with unhealthy alcohol use, identified during their hospital stay. Most of them had alcohol dependence (76%). We performed an Alpha Factor Analysis (AFA) and Principal Component Analysis (PCA) of the 19 SOCRATES items, and forced 3 factors and 2 components, in order to replicate findings from Miller and Tonigan (Miller, W. R., & Tonigan, J. S., (1996). Assessing drinkers' motivations for change: The Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES). Psychology of Addictive Behavior, 10, 81-89.) and Maisto et al. (Maisto, S. A., Conigliaro, J., McNeil, M., Kraemer, K., O'Connor, M., & Kelley, M. E., (1999). Factor structure of the SOCRATES in a sample of primary care patients. Addictive Behavior, 24(6), 879-892.). Our analysis supported the view that the 2 component solution proposed by Maisto et al. (Maisto, S.A., Conigliaro, J., McNeil, M., Kraemer, K., O'Connor, M., & Kelley, M.E., (1999). Factor structure of the SOCRATES in a sample of primary care patients. Addictive Behavior, 24(6), 879-892.) is more appropriate for our data than the 3 factor solution proposed by Miller and Tonigan (Miller, W. R., & Tonigan, J. S., (1996). Assessing drinkers' motivations for change: The Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES). Psychology of Addictive Behavior, 10, 81-89.). The first component measured

  8. Factors affecting the depth of burns occurring in medical institutions.

    Science.gov (United States)

    Cho, Young Soon; Choi, Young Hwan; Yoon, Cheonjae; You, Je Sung

    2015-05-01

    Most cases of burns occurring in medical institutions are associated with activities involving heat. It is very difficult to detect these burns. To date, there are few reports on burns occurring in medical institutions. The purpose of this paper was to analyze the etiology of burns occurring in medical institutions and to elucidate the factors affecting burn depth. We conducted a retrospective analysis of the medical records of patients who visited our center from April 2008 to February 2013. This study enrolled all patients with burns occurring in the medical institution during or related to treatment. We excluded burn patients whose burns were not related to treatment (for example, we excluded patients with scalding burns that occurred in the hospital cafeteria and pediatric patients with hot water burns from the water purifier). However, patients with burns that occurred in the recovery room after general anesthesia were included. A total of 115 patients were enrolled in this study. The average patient age was 41.5 years, with more women than men (M:F=31:84). There were 29 cases (25.3%) of superficial burns (first-degree and superficial second-degree) and 86 cases (74.7%) of deep burns (deep second-degree and third-degree). Hot packs were the most common cause of burns (27 cases, 23.5%), followed by laser therapy, heating pads, and grounding pads, accounting for 15 cases each. There were 89 cases (77.4%) of contact burns and 26 cases (22.6%) of non-contact burns. The most common site of burns was the lower extremities (41 cases, 35.7%). The burn site and contact burns were both factors affecting burn depth. The rate of deep burns was higher in patients with contact burns than in those with non-contact burns (odds ratio 4.26) and was associated with lower body burns (odds ratio 2.85). In burns occurring in medical institutions, there is a high probability of a deep burn if it is a contact burn or occurs in the lower body. Therefore, safety guidelines are needed

  9. Fish consumption and its motives in households with versus without self-reported medical history of CVD

    DEFF Research Database (Denmark)

    Pieniak, Zuzanna; Verbeke, Wim; Perez-Cueto, Federico;

    2008-01-01

    Background - The purpose of this study was to explore the cross-cultural differences in the frequency of fish intake and in motivations for fish consumption between people from households with (CVD+) or without (CVD-) medical history of cardiovascular disease, using data obtained in five European...... a number of differences between CVD- and CVD+ subjects with respect to their frequency of fish intake are uncovered, the findings suggest that fish consumption traditions and habits - rather than a medical history of CVD - account for large differences between the countries, particularly in fatty fish...

  10. Factors influencing choice of medical specialty of preresidency medical graduates in southeastern Nigeria.

    Science.gov (United States)

    Eze, Boniface Ikenna; Okoye, Onochie Ike; Maduka-Okafor, Ferdinand Chinedu; Aguwa, Emmanuel Nwabueze

    2011-09-01

    This study examined the determinants of specialty choice of preresidency medical graduates in southeastern Nigeria. We used a comparative cross-sectional survey of preresidency medical graduates who took the Basic Sciences Examination of the Postgraduate Medical College in Enugu, southeastern Nigeria, in March 2007. Data on participants' demographics and specialty selected, the timing of the decision, and factors in specialty selection were collected using a questionnaire. Data were examined using descriptive and analytical statistics. P choice was more frequently influenced by personal interest (66.6%), career prospects (9.1%), and appraisal of own skills/aptitudes (5.6%), and it was least affected by altruistic motives (1.7%) and influence of parents/relations (1.7%). The respondents selected specialties at different rates: obstetrics and gynecology (22.6%), surgery (19.6%), pediatrics (16.0%), anesthesiology (3.1%), psychiatry (0.3%), and dentistry (0.0%). Most (97.2%) participants had decided on specialty choice by the end of their fifth (of a total 16 years) postgraduate year. The participants significantly more frequently preferred surgery and pediatrics to other disciplines (P medical graduates in southeastern Nigeria were influenced by personal interest, career prospects, and personal skills/aptitude in deciding which specialty training to pursue. The most frequently chosen specialties were surgery and pediatrics. These findings have implications for Nigeria's education and health care policy makers.

  11. [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.

  12. Evaluation of major risk factors related to depression among medical students of NRS medical college.

    Directory of Open Access Journals (Sweden)

    Mukhopadhyay Prianka, Sain Sonali, Mandal Nirmal Kumar, Saha Tushar Kanti , Dey Indira, Chattopadhyay Amitava

    2014-11-01

    Full Text Available Background and objectives: Medical students experience depression, burnout, and mental illness at a higher rate than general population. A better understanding of related risk factors can help target appropriate support services for them. The aim of the study was to assess the occurrence of depression and identify its risk factors among undergraduate students in a medical College in Kolkata, India. Methodology: A descriptive, cross-sectional study using a two stage, stratified cluster sampling technique was used to select a sample of 289 students. Data were collected using a self-administered, anonymous questionnaire based on Becks Depression Inventory II. Results: The mean score of students on depression scale was 10.47±10.39. 22.5 % of students tested positive for some form of depression while 6.2% had severe to extreme depression. The risk factors of depressive symptoms identified were older age, lower family income, students who did not choose admission in MBBS course on their own, had addictions, felt negatively about results, faced difficulty with study course and had relationship issues. Students with relationship issues in their personal lives were 3.7 times more likely to exhibit depressive symptoms than without them. Students who faced difficulty coping with study course were 2.18 times more likely to exhibit depressive symptoms than without them. Conclusion: Academic performance alone doesn’t influence the mental health of students, rather factors like older age, socioeconomic status, role in choice of medical career, negative perception of academic performance, difficulty with study course and relationship issues are also important.

  13. Relative accuracy and availability of an Irish National Database of dispensed medication as a source of medication history information: observational study and retrospective record analysis.

    LENUS (Irish Health Repository)

    Grimes, T

    2013-01-27

    WHAT IS KNOWN AND OBJECTIVE: The medication reconciliation process begins by identifying which medicines a patient used before presentation to hospital. This is time-consuming, labour intensive and may involve interruption of clinicians. We sought to identify the availability and accuracy of data held in a national dispensing database, relative to other sources of medication history information. METHODS: For patients admitted to two acute hospitals in Ireland, a Gold Standard Pre-Admission Medication List (GSPAML) was identified and corroborated with the patient or carer. The GSPAML was compared for accuracy and availability to PAMLs from other sources, including the Health Service Executive Primary Care Reimbursement Scheme (HSE-PCRS) dispensing database. RESULTS: Some 1111 medication were assessed for 97 patients, who were median age 74 years (range 18-92 years), median four co-morbidities (range 1-9), used median 10 medications (range 3-25) and half (52%) were male. The HSE-PCRS PAML was the most accurate source compared to lists provided by the general practitioner, community pharmacist or cited in previous hospital documentation: the list agreed for 74% of the medications the patients actually used, representing complete agreement for all medications in 17% of patients. It was equally contemporaneous to other sources, but was less reliable for male than female patients, those using increasing numbers of medications and those using one or more item that was not reimbursable by the HSE. WHAT IS NEW AND CONCLUSION: The HSE-PCRS database is a relatively accurate, available and contemporaneous source of medication history information and could support acute hospital medication reconciliation.

  14. EYE DONATION: PERCEPTION AND PROMOTING FACTORS AMONG MEDICAL STUDENTS.

    Directory of Open Access Journals (Sweden)

    M Singh

    2012-10-01

    Full Text Available Introduction: There are 2 million corneal blind in India with a big gap between corneal demand and supply. The Govt. of Haryana by launching Nehru Drishti Yojna has taken a big step to eliminate corneal blindness from Haryana. Medical students are from a different educational background with a scientific base and thus have a pivotal role play in becoming as role models and mass educators. Objective: To assess the perception of medical students regarding eye donation. Methods: A cross sectional study was conducted among medical students of MMIMSR, Mullana, Ambala. A pretested, semi-structured questionnaire was used for collecting the necessary information after getting informed consent. The data was statistically analyzed using SPSS version 11.5 software. Results: 96% of the students knew about corneal donation though only 67% were willing for eye donation. Nobility was the major inspiring force for eye donation.13% reported, objection by family and 3.2% reported religious factors as restrictions for eye donation. There were many misconceptions regarding eye donation.27% thought that eye donation would result in delay in funeral arrangements. Conclusion: There is an imperative need to emphasize undergraduate teaching to evade myths concerning eye donation and promote eye donation.

  15. Lifestyle-related factors and access to medically assisted reproduction.

    Science.gov (United States)

    Dondorp, W; de Wert, G; Pennings, G; Shenfield, F; Devroey, P; Tarlatzis, B; Barri, P

    2010-03-01

    Lifestyle is increasingly recognized as an outcome-determining factor in assisted reproduction, not only with regard to the cost-effectiveness but also in view of the balance of benefits and risks, including risks related to the welfare of the future child. This document briefly summarizes the evidence concerning the impact of three lifestyle-related factors (obesity, tobacco smoking and alcohol consumption) on both natural and assisted reproduction (IVF) and discusses the implications of this for the practice of medically assisted reproduction in the light of relevant ethical principles. The central question is whether and to what extent fertility treatment of obese, smoking or drinking patients should be made conditional on prior lifestyle changes.

  16. Factors influencing the choice of specialty of Australian medical graduates.

    Science.gov (United States)

    Harris, Mary G; Gavel, Paul H; Young, Jeannette R

    2005-09-19

    To identify the relative importance of extrinsic determinants of doctors' choice of specialty. A self-administered postal questionnaire. Australian vocational training programs. 4259 Australian medical graduates registered in September 2002 with one of 16 Australian clinical colleges providing vocational training programs. Choice of specialist vocational training program; extrinsic factors influencing choice of program, and variation by sex, age, marital status and country of birth. In total, 79% of respondents rated "appraisal of own skills and aptitudes" as influential in their choice of specialty followed by "intellectual content of the specialty" (75%). Extrinsic factors rated as most influential were "work culture" (72%), "flexibility of working arrangements" (56%) and "hours of work" (54%). We observed variation across training programs in the importance ascribed to factors influencing choice of specialty, and by sex, age and marital status. Factors of particular importance to women, compared with men, were "appraisal of domestic circumstances" (odds ratio [OR], 1.9), "hours of work" (OR, 1.8) and "opportunity to work flexible hours" (OR, 2.6). Partnered doctors, compared with single doctors, rated "hours of work" and "opportunity to work flexible hours" as more important (OR, 1.3), while "domestic circumstances" was more important to doctors with children than those without children (OR, 1.7). In total, 80% of doctors had chosen their specialty by the end of the third year after graduation. Experience with discipline-based work cultures and working conditions occurs throughout medical school and the early postgraduate years, and most doctors choose their specialty during these years. It follows that interventions to influence doctors' choice of specialty need to target these critical years.

  17. Factors influencing physicians' knowledge sharing on web medical forums.

    Science.gov (United States)

    Lin, Tung Cheng; Lai, Ming Cheng; Yang, Shu Wen

    2016-09-01

    Web medical forums are relatively unique as knowledge-sharing platforms because physicians participate exclusively as knowledge contributors and not as knowledge recipients. Using the perspective of social exchange theory and considering both extrinsic and intrinsic motivations, this study aims to elicit the factors that significantly influence the willingness of physicians to share professional knowledge on web medical forums and develops a research model to explore the motivations that underlie physicians' knowledge-sharing attitudes. This model hypothesizes that constructs, including shared vision, reputation, altruism, and self-efficacy, positively influence these attitudes and, by extension, positively impact knowledge-sharing intention. A conventional sampling method and the direct recruitment of physicians at their outpatient clinic gathered valid data from a total of 164 physicians for analysis in the model. The empirical results support the validity of the proposed model and identified shared vision as the most significant factor of influence on knowledge-sharing attitudes, followed in descending order by knowledge-sharing self-efficacy, reputation, and altruism.

  18. Spinal epidural abscesses: risk factors, medical versus surgical management, a retrospective review of 128 cases.

    Science.gov (United States)

    Patel, Amit R; Alton, Timothy B; Bransford, Richard J; Lee, Michael J; Bellabarba, Carlo B; Chapman, Jens R

    2014-02-01

    Spinal epidural abscess (SEA) is a rare, serious and increasingly frequent diagnosis. Ideal management (medical vs. surgical) remains controversial. The purpose of this study is to assess the impact of risk factors, organisms, location and extent of SEA on neurologic outcome after medical management or surgery in combination with medical management. Retrospective electronic medical record (EMR) review. We included 128 consecutive, spontaneous SEA from a single tertiary medical center, from January 2005 to September 11. There were 79 male and 49 female with a mean age of 52.9 years (range, 22-83). Patient demographics, presenting complaints, radiographic features, pre/post-treatment neurologic status (ASIA motor score [MS] 0-100), treatment (medical vs. surgical) and clinical follow-up were recorded. Neurologic status was determined before treatment and at last available clinical encounter. Imaging studies reviewed location/extent of pathology. Inclusion criteria were a diagnosis of a bacterial SEA based on radiographs and/or intraoperative findings, age greater than 18 years, and adequate EMR. Exclusion criteria were postinterventional infections, Pott's disease, isolated discitis/osteomyelitis, treatment initiated at an outside facility, and imaging suggestive of a SEA but negative intraoperative findings/cultures. The mean follow-up was 241 days. The presenting chief complaint was site-specific pain (100%), subjective fevers (50%), and weakness (47%). In this cohort, 54.7% had lumbar, 39.1% thoracic, 35.9% cervical, and 23.4% sacral involvement spanning an average of 3.85 disc levels. There were 36% ventral, 41% dorsal, and 23% circumferential infections. Risk factors included a history of IV drug abuse (39.1%), diabetes mellitus (21.9%), and no risk factors (22.7%). Pathogens were methicillin-sensitive Staphylococcus aureus (40%) and methicillin-resistance S aureus (30%). Location, SEA extent, and pathogen did not impact MS recovery. Fifty-one patients were

  19. Risk factors for incident delirium in an acute general medical setting: a retrospective case-control study.

    Science.gov (United States)

    Tomlinson, Emily Jane; Phillips, Nicole M; Mohebbi, Mohammadreza; Hutchinson, Alison M

    2017-03-01

    To determine predisposing and precipitating risk factors for incident delirium in medical patients during an acute hospital admission. Incident delirium is the most common complication of hospital admission for older patients. Up to 30% of hospitalised medical patients experience incident delirium. Determining risk factors for delirium is important for identifying patients who are most susceptible to incident delirium. Retrospective case-control study with two controls per case. An audit tool was used to review medical records of patients admitted to acute medical units for data regarding potential risk factors for delirium. Data were collected between August 2013 and March 2014 at three hospital sites of a healthcare organisation in Melbourne, Australia. Cases were 161 patients admitted to an acute medical ward and diagnosed with incident delirium between 1 January 2012 and 31 December 2013. Controls were 321 patients sampled from the acute medical population admitted within the same time range, stratified for admission location and who did not develop incident delirium during hospitalisation. Identified using logistic regression modelling, predisposing risk factors for incident delirium were dementia, cognitive impairment, functional impairment, previous delirium and fracture on admission. Precipitating risk factors for incident delirium were use of an indwelling catheter, adding more than three medications during admission and having an abnormal sodium level during admission. Multiple risk factors for incident delirium exist; patients with a history of delirium, dementia and cognitive impairment are at greatest risk of developing delirium during hospitalisation. Nurses and other healthcare professionals should be aware of patients who have one or more risk factors for incident delirium. Knowledge of risk factors for delirium has the potential to increase the recognition and understanding of patients who are vulnerable to delirium. Early recognition and

  20. Examining influential factors in providers' chronic pain treatment decisions: a comparison of physicians and medical students.

    Science.gov (United States)

    Hollingshead, Nicole A; Meints, Samantha; Middleton, Stephanie K; Free, Charnelle A; Hirsh, Adam T

    2015-10-01

    Chronic pain treatment guidelines are unclear and conflicting, which contributes to inconsistent pain care. In order to improve pain care, it is important to understand the various factors that providers rely on to make treatment decisions. The purpose of this study was to examine factors that reportedly influence providers' chronic pain treatment decisions. A secondary aim was to examine differences across participant training level. Eighty-five participants (35 medical students, 50 physicians) made treatment decisions for 16 computer-simulated patients with chronic pain. Participants then selected from provided lists the information they used and the information they would have used (had it been available) to make their chronic pain treatment decisions for the patient vignettes. Frequency analyses indicated that most participants reported using patients' pain histories (97.6 %) and pain description (95.3 %) when making treatment decisions, and they would have used information about patients' previous treatments (97.6 %) and average and current pain ratings (96.5 %) had this information been available. Compared to physicians, medical students endorsed more frequently that they would have used patients' employment and/or disability status (p medical students wanted information on patients' use of illicit drugs and alcohol to make treatment decisions; while a greater proportion of physicians reported using personal experience to inform their decisions. This study found providers use patients' information and their own experiences and intuition to make chronic pain treatment decisions. Also, participants of different training levels report using different patient and personal factors to guide their treatment decisions. These results highlight the complexity of chronic pain care and suggest a need for more chronic pain education aimed at medical students and practicing providers.

  1. Why the history of nephrology?

    Science.gov (United States)

    Eknoyan, Garabed

    2016-01-01

    Nephrology is a relatively new discipline that emerged at a time when the writing of the history of medicine was changing drastically. While the merits of medical history were valued since antiquity, it was only in the 18th century that the actual historiography of medicine began. It was nurtured, matured and appreciated enough that by the late 19th and early 20th centuries, medical history was incorporated into the medical curriculum and presented at national meetings. Unfortunately, the merits of medical history and its inclusion in medical education have come under increasing scrutiny over the past few decades. Ironically, the erosion began at about the same time that scholarly work on the history of medicine was flourishing whilst that of scientific discovery and innovation in medicine was accelerating. The demands of rigorous research into the history of medicine gradually led to the emergence of medical history as an independent discipline within academic departments of history. Simultaneously, the exponential growth of new information generated by medical research led to an overflow of medical knowledge in which the inclusion of medical history was contested and dismissed. That is just about the time that nephrology emerged in the 1960s. Whereas initially the quest for origins led renal journals to publish historical articles, the more recent quest to increase impact factors has led to the exclusion of historical articles from consideration for publication. This manuscript examines the reasons that brought about the separation of nephrology from its history and proposes potential solutions to their rapprochement.

  2. Assessment of Medication Adherence in Elderly Patients With Cardiovascular Diseases Based on Demographic Factors in Bushehr City in the Year 2013

    Directory of Open Access Journals (Sweden)

    Jahanpour

    2015-07-01

    Full Text Available Background The growing global elderly population is in need of more prescription medications. Objectives The present study assessed medication adherence with respect to demographic factors among elderly patients with cardiovascular disease who were admitted to a teaching hospital as well as outpatients referred to treatment centers in Bushehr, Iran. Patients and Methods The present study was a descriptive-analytic cross-sectional study using a simple random sampling method that investigated 125 elderly patients with cardiovascular disease. Data were collected through the Medication Adherence Questionnaire. Data were analyzed by using descriptive statistics, and Pearson and Cramer’s V correlation analyses, using SPSS version 18. Results Among the patients, 57.6% and 42.4% were female and male, respectively. Moreover, 62.4% had high adherence to their prescribed medications. Frequency of medication use, history of previous hospitalization, and sex were significantly associated with adherence to medication (P < 0.05. Conclusions More than half of elderly patients with cardiovascular disease had high adherence to their medications. Demographic factors including the frequency of daily medication use, history of hospitalization, and female sex were associated with adherence to medication. By considering these factors, doctors and nurses increase medication adherence, especially for older adults.

  3. Female Adolescents with a History of Sexual Abuse: Risk Outcome and Protective Factors.

    Science.gov (United States)

    Chandy, Joseph M.; And Others

    1996-01-01

    Examined the school performance, suicidal involvement, disordered eating behaviors, pregnancy risk, and chemical use of female teenagers with a history of sexual abuse. Found that they reported higher rates of adverse outcomes than did teenagers without a background of abuse. Lists protective factors and risk factors that influenced outcomes. (RJM)

  4. Medical and sociodemographic factors predict persistent smoking after coronary events.

    Science.gov (United States)

    Sverre, Elise; Otterstad, Jan Erik; Gjertsen, Erik; Gullestad, Lars; Husebye, Einar; Dammen, Toril; Moum, Torbjørn; Munkhaugen, John

    2017-09-06

    Understanding the determinants of persistent smoking after a coronary event constitutes the basis of modelling interventions of smoking cessation in secondary prevention programs. We aim to identify the potentially modifiable medical, sociodemographic and psychosocial factors, comprising the study factors, associated with unfavourable risk factor control after CHD events. A cross-sectional explorative study used logistic regression analysis to investigate the association between study factors and smoking status in 1083 patients hospitalized with myocardial infarction and/or coronary revascularization. Hospital record data, a self-report questionnaire, clinical examination and blood samples were applied. At the index hospitalization, 390 patients were smoking and at follow-up after 2-36 months 167 (43%) of these had quit, while 230 reported persistent smoking. In adjusted analyses, unemployed or disability benefits (Odds ratio (OR) 4.1), low education (OR 3.5), longer smoking duration (OR 2.3) and not having ST-elevation myocardial infarction (STEMI) as index event (OR 2.3) were significantly associated with persistent smoking. Psychosocial factors at follow-up were not associated with persistent smoking. Smokers reported high motivation for cessation, with 68% wanting help to quit. Only 42% had been offered nicotine replacement therapy or other cessation aids. Smokers rated use of tobacco as the most important cause of their coronary disease (6.8 on a 1-10 Likert scale). Low socioeconomic status, prior duration of smoking, and not having STEMI as index event were associated with persisting smoking. Persistent smokers in this study seem to have an acceptable risk perception and were motivated to cease smoking, but needed assistance through cessation programs including prescription of pharmacological aids. Registered at ClinicalTrials.gov: NCT02309255 , registered retrospectively.

  5. Natural histroy of trisomy 18 and trisomy 13: I. Growth, physical assessment, medical histories, survival, and recurrence risk

    Energy Technology Data Exchange (ETDEWEB)

    Baty, B.J.; Blackburn, B.L.; Carey, J.C. [Univ. of Utah School of Medicine, Salt Lake City, UT (United States)

    1994-01-15

    The natural history of trisomy 18 and trisomy 13 was investigated using data derived from parent questionnaires and medical records from 98 families with an index case of trisomy 18 and 32 families with an index case of trisomy 13. Data are presented on pregnancy, delivery, survival, medical complications, immunizations, growth, cause of death, cytogenetics, and recurrence risk. Half of the trisomy 18 babies were delivered by C-section. Fetal distress was a factor in half, and the only reason in a third of C-section deliveries. One minute Apgar scores were significantly lower in C-section and breech deliveries. There were more small-for-gestational-age babies than in the general population, but most of the low-birth-weight newborns were small for gestational age, unlike the general population. Survival in this group of children was better than in other studies due to ascertainment bias. There were more girls than boys at all ages for both conditions, and the sex ratio decreased with time. Growth curves for length, weight, head circumference, and weight vs height are provided. Long-term survival did not appear to be due to mosaicism. There were no adverse reactions attributable to immunizations. At age 1 year there was an average of approximately 2 operations per living child. The authors report the second case of successful major cardiac surgery in a trisomy 18 child. Almost 70% of deaths were attributed to cardiopulmonary arrest. The sibling recurrence risk for trisomy 18 or trisomy 13 was 0.55%. 86 refs., 5 figs., 5 tabs.

  6. Healthcare Factors for Obtaining a Mammogram in Latinas With a Variable Mammography History

    Science.gov (United States)

    Scheel, John R.; Molina, Yamile; Coronado, Gloria D.; Bishop, Sonia; Doty, Sarah; Jimenez, Ricardo; Thompson, Beti; Lehman, Constance D.; Beresford, Shirley A.A.

    2017-01-01

    Purpose/Objectives To understand the relationship between mammography history and current thoughts about obtaining a mammogram among Latinas and examine the mediation effects of several healthcare factors. Design Cross-sectional survey. Setting Federally qualified health centers (Sea Mar Community Health Centers) in western Washington. Sample 641 Latinas nonadherent and adherent with screening mammography. Methods Baseline survey data from Latinas with a mammography history of never, not recent (more than two years), or recent (less than two years) were analyzed. Preacher and Hayes methods were used to estimate the mediation effect of healthcare factors. Main Research Variables The survey assessed mammography history, sociodemographic and healthcare factors, and current thoughts about obtaining a mammogram. Findings Latinas’ thoughts about obtaining a mammogram were associated with mammography history. Having had a clinical breast examination mediated 70% of differences between Latinas with a never and recent mammography history. Receipt of a provider recommendation mediated 54% of differences between Latinas with and without a recent mammography history. Conclusions These findings emphasize the importance of the patient–provider relationship during a clinic visit and help inform how nurses may be incorporated into subsequent screening mammography interventions tailored to Latinas. Implications for Nursing As providers, health educators, and researchers, nurses have critical roles in encouraging adherence to screening mammography guidelines among Latinas. PMID:27991613

  7. Observable phenomena that reveal medical students' clinical reasoning ability during expert assessment of their history taking: a qualitative study.

    Science.gov (United States)

    Haring, Catharina M; Cools, Bernadette M; van Gurp, Petra J M; van der Meer, Jos W M; Postma, Cornelis T

    2017-08-29

    During their clerkships, medical students are meant to expand their clinical reasoning skills during their patient encounters. Observation of these encounters could reveal important information on the students' clinical reasoning abilities, especially during history taking. A grounded theory approach was used to analyze what expert physicians apply as indicators in their assessment of medical students' diagnostic reasoning abilities during history taking. Twelve randomly selected clinical encounter recordings of students at the end of the internal medicine clerkships were observed by six expert assessors, who were prompted to formulate their assessment criteria in a think-aloud procedure. These formulations were then analyzed to identify the common denominators and leading principles. The main indicators of clinical reasoning ability were abstracted from students' observable acts during history taking in the encounter. These were: taking control, recognizing and responding to relevant information, specifying symptoms, asking specific questions that point to pathophysiological thinking, placing questions in a logical order, checking agreement with patients, summarizing and body language. In addition, patients' acts and the course, result and efficiency of the conversation were identified as indicators of clinical reasoning, whereas context, using self as a reference, and emotion/feelings were identified by the clinicians as variables in their assessment of clinical reasoning. In observing and assessing clinical reasoning during history taking by medical students, general and specific phenomena to be used as indicators for this process could be identified. These phenomena can be traced back to theories on the development and the process of clinical reasoning.

  8. Risk factors for severe dental anxiety among medical students.

    Science.gov (United States)

    Janković, Slobodan M; Aleksić, Dragana; Bahtijari, Zulfer; Jelić, Anica; Klacar, Jelena; Kovacević, Aleksandra; Mijailović, Natasa; Milovanović, Olivera; Petrović, Aleksandra; Radovanović, Ana; Sovrlić, Miroslav; Zecević, Dejana Ruzić

    2014-01-01

    Severe dental anxiety (SDA) is the most severe form of dental anxiety, thus the aim of this study was to determine the factors associated with SDA in students of health-related disciplines. In this case-control study the cases were students with severe dental anxiety. The study was conducted at the Faculty of Medical Sciences, University of Kragujevac, Serbia. The participants were undergraduate students attending lectures during spring semester 2010/2011 (n = 1,812). A random sample of 800 students was assessed for the association between various risk factors and the severe dental anxiety. The main outcome measures were the data on demographics, dental anxiety, habits concerning oral hygiene, nutrition, general anxiety and (co)morbidity which were collected from the study participants by semi-structured questionnaire. Less frequent visits to the dentist (OR adjusted = 7.02 [2.65; 18.60]) and visiting the dentist only when there is a dental problem (OR adjusted = 8.08 [1.28; 50.93]) were associated with severe dental anxiety. The same was true for improper oral hygiene (OR adjusted = 4.25 [1.16; 15.60]). Factors as changing toothbrush more frequently (OR adjusted = 0.33 [0.14; 0.76]) and having chronic disease (OR adjusted = 0.01 [0.00; 0.09]) were inversely associated with severe dental anxiety. The level of education of students was not associated with severe dental anxiety. Inappropriate oral hygiene, less frequent changes of a toothbrush and less frequent visits to the dentist are important risk factors for severe dental anxiety.

  9. Risk factors for severe dental anxiety among medical students

    Directory of Open Access Journals (Sweden)

    Janković Slobodan M.

    2014-01-01

    Full Text Available Background/Aim. Severe dental anxiety (SDA is the most severe form of dental anxiety, thus the aim of this study was to determine the factors associated with SDA in students of health-related disciplines. Methods. In this case-control study the cases were students with severe dental anxiety. The study was conducted at the Faculty of Medical Sciences, University of Kragujevac, Serbia. The participants were undergraduate students attending lectures during spring semester 2010/2011 (n = 1,812. A random sample of 800 students was assessed for the association between various risk factors and the severe dental anxiety. The main outcome measures were the data on demographics, dental anxiety, habits concerning oral hygiene, nutrition, general anxiety and (comorbidity which were collected from the study participants by semi-structured questionnaire. Results. Less frequent visits to the dentist (OR adjusted = 7.02 [2.65; 18.60] and visiting the dentist only when there is a dental problem (OR adjusted = 8.08 [1.28; 50.93] were associated with severe dental anxiety. The same was true for improper oral hygiene (OR adjusted = 4.25 [1.16; 15.60]. Factors as changing toothbrush more frequently (OR adjusted = 0.33 [0.14; 0.76] and having chronic disease (OR adjusted = 0.01 [0.00; 0.09] were inversely associated with severe dental anxiety. The level of education of students was not associated with severe dental anxiety. Conclusion. Inappropriate oral hygiene, less frequent changes of a toothbrush and less frequent visits to the dentist are important risk factors for severe dental anxiety. [Projekat Ministarstva nauke Republike Srbije, br. 175007

  10. Enhancing Student Empathetic Engagement, History-Taking, and Communication Skills During Electronic Medical Record Use in Patient Care.

    Science.gov (United States)

    LoSasso, Alisa Alfonsi; Lamberton, Courtney E; Sammon, Mary; Berg, Katherine T; Caruso, John W; Cass, Jonathan; Hojat, Mohammadreza

    2017-07-01

    To examine whether an intervention on proper use of electronic medical records (EMRs) in patient care could help improve medical students' empathic engagement, and to test the hypothesis that the training would reduce communication hurdles in clinical encounters. Seventy third-year medical students from the Sidney Kimmel Medical College at Thomas Jefferson University were randomly divided into intervention and control groups during their six-week pediatric clerkship in 2012-2013. The intervention group received a one-hour training session on EMR-specific communication skills, including discussion of EMR use, the SALTED mnemonic and technique (Set-up, Ask, Listen, Type, Exceptions, Documentation), and role-plays. Both groups completed the Jefferson Scale of Empathy (JSE) at the clerkship's start and end. At clerkship's end, faculty and standardized patients (SPs) rated students' empathic engagement in SP encounters, using the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), and their history-taking and communication skills. Faculty mean ratings on the JSPPPE, history-taking skills, and communication skills were significantly higher for the intervention group than the control group. SP mean ratings on history-taking skills were significantly higher for the intervention group than the control group. Both groups' JSE mean scores increased pretest to posttest, but the changes were not significant. The intervention group's posttest JSE mean score was higher than the control group's, but the difference was not significant. The findings suggest that a simple intervention providing specialized training in EMR-specific communication can improve medical students' empathic engagement in patient care, history-taking skills, and communication skills.

  11. The K-factor, Covitality, and personality : A Psychometric Test of Life History Theory.

    Science.gov (United States)

    Figueredo, Aurelio José; Vásquez, Geneva; Brumbach, Barbara Hagenah; Schneider, Stephanie M R

    2007-03-01

    We present a psychometric test of life history theory as applied to human individual differences using MIDUS survey data (Brim et al. 2000). Twenty scales measuring cognitive and behavioral dimensions theoretically related to life history strategy were constructed using items from the MIDUS survey. These scales were used to construct a single common factor, the K-factor, which accounted for 70% of the reliable variance. The scales used included measures of personal, familial, and social function. A second common factor, Covitality, was constructed from scales for physical and mental health. Finally, a single general factor, Personality, was constructed from scales for the "Big Five" factors of personality. The K-factor, covitality factor, and general personality factor correlated significantly with each other, supporting the prediction that high K predicts high somatic effort and also manifests in behavioral display. Thus, a single higher-order common factor, the Super-K factor, was constructed that consisted of the K-factor, covitality factor, and personality factor.

  12. Medical treatment of idiopathic oligozoospermia and male factor subfertility

    Institute of Scientific and Technical Information of China (English)

    DimitriosA.Adamopoulos

    2000-01-01

    Pharmaceutical treatment for the so-called idiopathic oligozoospermia ( I. O. ) is possible and effective in a fair proportion of patients with the syndrome provided that appropriate investigative procedures may identify the major disorder or its level of disruption, this abnormality is reversible and appropriate prognostic indices for the treatment's success are devised and validated. According to the evidence available, minimal evaluation and prognostic indices for treatment eligibility in normogonadotropic men with I.O. include a routine work-up but, mainly, microscopical assessment of spermatogenesis and appraisal of Sertoli cell's functional capacity. Published data indicate that men with hypospermatogenesis without maturational arrest, respond favorably to agents stimulating Sertoli cells and germinal epithelium with increased sperm production. Furthermore, Sertoli cell activity as judged by cell-specific indices such as inhibin B secretion, may provide additional discriminating power to the microscopical picture of the testis. In this context, precise identification of the causative factor(s), together with the establishment of prognostic indices are the most important criteria on which the decision, for or against medical treatment in I. 0., should be based. Obviously, further basic research and clinical trials are urgently needed in this particular field, and this should be a major task for clinical andrologists. (Asian J Androl 2000; 2: 25-32)

  13. Improving risk assessment in schizophrenia: epidemiological investigation of criminal history factors.

    Science.gov (United States)

    Witt, Katrina; Lichtenstein, Paul; Fazel, Seena

    2015-05-01

    Violence risk assessment in schizophrenia relies heavily on criminal history factors. To investigate which criminal history factors are most strongly associated with violent crime in schizophrenia. A total of 13 806 individuals (8891 men and 4915 women) with two or more hospital admissions for schizophrenia were followed up for violent convictions. Multivariate hazard ratios for 15 criminal history factors included in different risk assessment tools were calculated. The incremental predictive validity of these factors was estimated using tests of discrimination, calibration and reclassification. Over a mean follow-up of 12.0 years, 17.3% of men (n = 1535) and 5.7% of women (n = 281) were convicted of a violent offence. Criminal history factors most strongly associated with subsequent violence for both men and women were a previous conviction for a violent offence; for assault, illegal threats and/or intimidation; and imprisonment. However, only a previous conviction for a violent offence was associated with incremental predictive validity in both genders following adjustment for young age and comorbid substance use disorder. Clinical and actuarial approaches to assess violence risk can be improved if included risk factors are tested using multiple measures of performance. © The Royal College of Psychiatrists 2015.

  14. Several factors increased job dissatisfaction among medical doctors in Indonesia

    Directory of Open Access Journals (Sweden)

    Bastaman Basuki

    2013-07-01

    Full Text Available AbstrakLatar belakang: Beberapa faktor stresor kerja dapat meningkatkkan ketidakpusasan kerja. Tujuan penelitian ini untuk mengidentifikasi beberapa faktor dominan terkait dengan ketidakpusasan kerja.Metode: Studi potong lintgang dengan sampling purposif yang dilakukan pada bulan April-Juli 2011. Subyek terdiri dari mahasiswa pascasarjana dan dosen Fakultas Kedokteran Universitas Indonesia. Regresi linier digunakan untuk menganalisis data. Hasil: Peserta terdiri dari 306 subyek, berusia 23-47 tahun, mayoritas perempuan (61,4%, menikah, dan tidak pernah mengikuti pelatihan manajemen stres. Sedangkan pekerjaan saat ini/sebelumnya adalah dalam pelayanan kesehatan, atau pejabat pemerintah. Tingkat ketidakpuasan kerja berkaitan dengan tujuh faktor: yang tertinggi ialah kurangnya dukungan dari atasan, dan yang terendah ialah melakukan layanan di luar jam kerja. Satu poin kurang dukungan atasan akan meningkatkan ketidakpuasan kerja sebesar 1,26 [koefisien regresi (β = 1,26, P = 0,000; satu poin untuk menyediakan layanan di luar jam kerja akan meningkatkan 0,61 poin ketidakpuasan kerja (β= 0,6, P = 0,001. Kesimpulan: Kurangnya dukungan atasan dan interaksi dengan rekan kerja, peran organisasi ambiguitas, prosedur birokrasi, memberikan pelayanan di luar jam kerja, dan umpan balik yang tidak memadai dari pasien akan meningkatkan ketidakpuasan kerja. (Health Science Indones 2013;1:11-6Kata kunci:ketidakpuasan kerja, stresor kerja, dokterAbstractBackground:Several factors of work stressors may increase a person’s job dissatisfaction level. This study aimed to identify several dominant factors related to job dissatisfaction among medical doctors. Methods: A cross-sectional study with purposive sampling was conducted in April-July 2011. Subjects consisted of postgraduate students and faculty members of the Faculty of Medicine, Universitas Indonesia. Linear regression was used to analyze the data. Results: The participants consisted of 306 subjects, aged

  15. Medical risk factors for small-bowel adenocarcinoma with focus on Crohn's disease

    DEFF Research Database (Denmark)

    Kærlev, Linda; Teglbjaerg, P.S.; Sabroe, Svend

    2001-01-01

    case and no controls had had long-standing Crohn disease. Coeliac disease was associated with SBA (2 cases, 0 controls), but one of the cases was diagnosed at the same time as the SBA. Overall, people with a history of gallstones had no increased risk of SBA. The OR was exclusively increased during...... with SBA had an increased prevalence of anaemia; OR 15.3 (2.5-92.1). An association between low educational level and SBA was found; OR 1.75 (1.0-3.0). CONCLUSION: This study supports Crohn disease and coeliac disease being strong but rare risk factors for SBA. Previous gallstones were unrelated to SBA......BACKGROUND: Crohn disease and biliary diseases have been associated with small-bowel adenocarcinoma (SBA). We examined how medical conditions affect the risk of SBA. METHODS: A population-based European multicentre case-control study during the period 1995-97 including 95 histologically verified...

  16. Medical risk factors for small-bowel adenocarcinoma with focus on Crohn's disease

    DEFF Research Database (Denmark)

    Kærlev, Linda; Teglbjaerg, P.S.; Sabroe, Svend

    2001-01-01

    case and no controls had had long-standing Crohn disease. Coeliac disease was associated with SBA (2 cases, 0 controls), but one of the cases was diagnosed at the same time as the SBA. Overall, people with a history of gallstones had no increased risk of SBA. The OR was exclusively increased during...... the 3-year period preceding the SBA diagnosis. Previous gallstone surgery, which may be a sign of severe gallstone disease, was not associated with SBA. Liver cirrhosis, hepatitis or medical treatments with radioactive substances or corticosteroid tablets were not associated with this disease. Cases...... with SBA had an increased prevalence of anaemia; OR 15.3 (2.5-92.1). An association between low educational level and SBA was found; OR 1.75 (1.0-3.0). CONCLUSION: This study supports Crohn disease and coeliac disease being strong but rare risk factors for SBA. Previous gallstones were unrelated to SBA...

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

    Directory of Open Access Journals (Sweden)

    Antonio González-Pérez

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

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

    Directory of Open Access Journals (Sweden)

    Nusrat

    2015-02-01

    needed to avoid more healthcare problems and have a responsible pattern of self - medication. AIMS AND OBJECTIVES : To determine the prevalence and pattern of self - medication among medical students of Jammu. To assess and evaluate the reasons, factors and problems related to self - medications.

  19. FAKTOR PENYEBAB MEDICATION ERROR DI INSTALASI RAWAT DARURAT FACTORS AFFECTING MEDICATION ERRORS AT EMERGENCY UNIT

    OpenAIRE

    2014-01-01

    Background: Incident of medication errors is an importantindicator in patient safety and medication error is most commonmedical errors. However, most of medication errors can beprevented and efforts to reduce such errors are available.Due to high number of medications errors in the emergencyunit, understanding of the causes is important for designingsuccessful intervention. This research aims to identify typesand causes of medication errors.Method: Qualitative study was used and data were col...

  20. Prevalence and factors associated with 2009 to 2011 influenza vaccinations at a university medical center.

    Science.gov (United States)

    Crowley, Kathleen A; Myers, Ronnie; Magda, Lori A; Morse, Stephen S; Brandt-Rauf, Paul; Gershon, Robyn R M

    2013-09-01

    Information on the rates and factors associated with influenza vaccinations, although limited, is important because it can inform the development of effective vaccination campaigns in a university medical center setting. A study was conducted in 2011 to identify individual and organizational level barriers and facilitators to influenza vaccination among clinical and nonclinical personnel (N = 428) from a major university medical center. Seventy-one percent of clinical personnel (n = 170) reported pandemic H1N1 vaccination compared with 27% of nonclinical personnel (n = 258), even though vaccine was made widely available to all personnel at no cost. Similarly, disparate rates between clinical and nonclinical personnel were noted for the 2009/2010 seasonal influenza vaccine (82% vs 42%, respectively) and 2010/2011 combination (pandemic plus seasonal) influenza vaccine (73% vs 28%, respectively). Factors associated with pandemic vaccination in nonclinical personnel included the following: high level of influenza-related knowledge, concern regarding influenza contagion, history of previous influenza vaccinations or influenza illness, participation in vaccine-related training, and awareness of the institution's written pandemic plan. For clinicians, past history of seasonal influenza vaccination was associated with pandemic vaccination. For all participants, taking any 1 or more of the 3 influenza vaccines available in 2009 to 2011 was associated with intent to take a hypothetical future novel pandemic vaccine (odds ratio, 6.7; 95% confidence interval: 4.32-10.44; P vaccination uptake are amenable to organizational strategies. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

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

    Science.gov (United States)

    Sanders, Vicki L; Flanagan, Jennifer

    2015-01-01

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

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  3. [Pages from the history of the Department of Forensic Medicine, I.M. Sechenov First Moscow State Medical University].

    Science.gov (United States)

    Leonova, E N; Romanenko, G Kh; Sidorovich, Iu V

    2012-01-01

    The history of the Department of Forensic Medicine of I.M. Sechenov First Moscow State Medical University is highlighted based on the results of the studies of the relevant literature data and archival materials. The authors lay special emphasis on the organization of the teaching process and research at different stages of the development of the Department, scientific and forensic medical activities of its leading specialists, materials obtained in the course of research, and the contribution to the development of forensic medicine made by outstanding scientists.

  4. Visualizing reproduction: a cultural history of early-modern and modern medical illustrations.

    Science.gov (United States)

    Harvey, Karen

    2010-03-01

    Written as a response to a conference exhibition of medical illustrations of reproduction, this article considers the gains of an interdisciplinary study of medical illustration to both historians and medics. The article insists that we should not only be attuned to the cultural work that such representations perform but also that such illustrations are the product of material medical practices and the often humane impulses that drive them.

  5. 78 FR 50136 - Notice of Information Collection Under Emergency Review: Medical History and Examination for...

    Science.gov (United States)

    2013-08-16

    ... proposed collection instrument and supporting documents, to Susan B. Summers, Chief of Medical Clearances... automated collection techniques or other forms of information technology. Please note that comments...: August 6, 2013. Susan B. Summers, Chief Medical Clearance Section, Office of Medical Services,...

  6. factors influencing the pattern of self-medication in an adult nigerian ...

    African Journals Online (AJOL)

    Emmanuel Ameh

    Conclusion: Literacy and public health education were the major factors influencing the pattern of self- medication .... assessing major sociodemographic variables, how the medication was used ..... medicines in diabetes mellitus. Diabet Med.

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

    Directory of Open Access Journals (Sweden)

    Kocfa Chung-Delgado

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

  8. Factors Associated with Anti-Tuberculosis Medication Adverse Effects: A Case-Control Study in Lima, Peru

    Science.gov (United States)

    Chung-Delgado, Kocfa; Revilla-Montag, Alejandro; Guillen-Bravo, Sonia; Velez-Segovia, Eduardo; Soria-Montoya, Andrea; Nuñez-Garbin, Alexandra; Silva-Caso, Wilmer; Bernabe-Ortiz, Antonio

    2011-01-01

    Background Long-term exposure to anti-tuberculosis medication increases risk of adverse drug reactions and toxicity. The objective of this investigation was to determine factors associated with anti-tuberculosis adverse drug reactions in Lima, Peru, with special emphasis on MDR-TB medication, HIV infection, diabetes, age and tobacco use. Methodology and Results A case-control study was performed using information from Peruvian TB Programme. A case was defined as having reported an anti-TB adverse drug reaction during 2005–2010 with appropriate notification on clinical records. Controls were defined as not having reported a side effect, receiving anti-TB therapy during the same time that the case had appeared. Crude, and age- and sex-adjusted models were calculated using odds ratios (OR) and 95% confidence intervals (95%CI). A multivariable model was created to look for independent factors associated with side effect from anti-TB therapy. A total of 720 patients (144 cases and 576 controls) were analyzed. In our multivariable model, age, especially those over 40 years (OR = 3.93; 95%CI: 1.65–9.35), overweight/obesity (OR = 2.13; 95%CI: 1.17–3.89), anemia (OR = 2.10; IC95%: 1.13–3.92), MDR-TB medication (OR = 11.1; 95%CI: 6.29–19.6), and smoking (OR = 2.00; 95%CI: 1.03–3.87) were independently associated with adverse drug reactions. Conclusions Old age, anemia, MDR-TB medication, overweight/obesity status, and smoking history are independent risk factors associated with anti-tuberculosis adverse drug reactions. Patients with these risk factors should be monitored during the anti-TB therapy. A comprehensive clinical history and additional medical exams, including hematocrit and HIV-ELISA, might be useful to identify these patients. PMID:22110689

  9. Factors influencing teamwork and collaboration within a tertiary medical center

    Science.gov (United States)

    Chien, Shu Feng; Wan, Thomas TH; Chen, Yu-Chih

    2012-01-01

    AIM: To understand how work climate and related factors influence teamwork and collaboration in a large medical center. METHODS: A survey of 3462 employees was conducted to generate responses to Sexton’s Safety Attitudes Questionnaire (SAQ) to assess perceptions of work environment via a series of five-point, Likert-scaled questions. Path analysis was performed, using teamwork (TW) and collaboration (CO) as endogenous variables. The exogenous variables are effective communication (EC), safety culture (SC), job satisfaction (JS), work pressure (PR), and work climate (WC). The measurement instruments for the variables or summated subscales are presented. Reliability of each sub-scale are calculated. Alpha Cronbach coefficients are relatively strong: TW (0.81), CO (0.76), EC (0.70), SC (0.83), JS (0.91), WP (0.85), and WC (0.78). Confirmatory factor analysis was performed for each of these constructs. RESULTS: Path analysis enables to identify statistically significant predictors of two endogenous variables, teamwork and intra-organizational collaboration. Significant amounts of variance in perceived teamwork (R2 = 0.59) and in collaboration (R2 = 0.75) are accounted for by the predictor variables. In the initial model, safety culture is the most important predictor of perceived teamwork, with a β weight of 0.51, and work climate is the most significant predictor of collaboration, with a β weight of 0.84. After eliminating statistically insignificant causal paths and allowing correlated predictors1, the revised model shows that work climate is the only predictor positively influencing both teamwork (β = 0.26) and collaboration (β = 0.88). A relatively weak positive (β = 0.14) but statistically significant relationship exists between teamwork and collaboration when the effects of other predictors are simultaneously controlled. CONCLUSION: Hospital executives who are interested in improving collaboration should assess the work climate to ensure that employees are

  10. Factors influencing teamwork and collaboration within a tertiary medical center.

    Science.gov (United States)

    Chien, Shu Feng; Wan, Thomas Th; Chen, Yu-Chih

    2012-04-26

    To understand how work climate and related factors influence teamwork and collaboration in a large medical center. A survey of 3462 employees was conducted to generate responses to Sexton's Safety Attitudes Questionnaire (SAQ) to assess perceptions of work environment via a series of five-point, Likert-scaled questions. Path analysis was performed, using teamwork (TW) and collaboration (CO) as endogenous variables. The exogenous variables are effective communication (EC), safety culture (SC), job satisfaction (JS), work pressure (PR), and work climate (WC). The measurement instruments for the variables or summated subscales are presented. Reliability of each sub-scale are calculated. Alpha Cronbach coefficients are relatively strong: TW (0.81), CO (0.76), EC (0.70), SC (0.83), JS (0.91), WP (0.85), and WC (0.78). Confirmatory factor analysis was performed for each of these constructs. Path analysis enables to identify statistically significant predictors of two endogenous variables, teamwork and intra-organizational collaboration. Significant amounts of variance in perceived teamwork (R(2) = 0.59) and in collaboration (R(2) = 0.75) are accounted for by the predictor variables. In the initial model, safety culture is the most important predictor of perceived teamwork, with a β weight of 0.51, and work climate is the most significant predictor of collaboration, with a β weight of 0.84. After eliminating statistically insignificant causal paths and allowing correlated predictors1, the revised model shows that work climate is the only predictor positively influencing both teamwork (β = 0.26) and collaboration (β = 0.88). A relatively weak positive (β = 0.14) but statistically significant relationship exists between teamwork and collaboration when the effects of other predictors are simultaneously controlled. Hospital executives who are interested in improving collaboration should assess the work climate to ensure that employees are operating in a setting conducive

  11. 中世纪欧洲法医学溯源%Forensic Medical History in Medieval Europe.

    Institute of Scientific and Technical Information of China (English)

    杨天潼

    2012-01-01

    法医学是应用病理学、生物学、生物化学和其他医学科学理论和技能解决法律问题,为侦查和审判提供证据的科学。法医学学科属性是医学,其目的是解决法律问题,因而法医学同时具有自然科学和人文科学属性。现今,我们对于法医学的研究往往局限在自然科学领域,而对其人文学科属性却有所忽视。当代西方法医学起源自中世纪的欧洲大陆,当时罗马法和教会法占统治地位,它们没有设立陪审团制度,而且允许对嫌疑人进行刑讯逼供,而英美法系的司法审判程序设立了陪审团制度。在这两种司法体制下,法医医学证言、证词逐步形成了两种形式:英美法系控诉式诉讼体制下的言辞证据形式和罗马法诉讼中纠问体制下的书证形式。本文将对中世纪欧洲的法医学进行溯源研究,从欧洲法医学的起源和发展角度,完善法医学史研究内容,为世界法医学史比较研究提供借鉴。%Forensic medicine is a science used to solve legal problems and provide evidences for investiga- tions and trials by applying the scientific theories and technologies of pathology, physiology, biochemistry and other medicine subjects. The nature of forensic medicine is medicine and its aim is to solve legal issues, therefore, it has characteristics of both natural science and humane science. Nowadays, we always focus on medical theory or technique in forensic medicine research, but neglect its function to satisfy legal requirements. The origins of west- ern forensic medicine lie on the medieval European continent where the Roman and canon law remained domi- nant, which excluded the jury system and allowed the use of torture on suspects. To contrast, the Anglo-American trial practice allows the jury system. This article reviews the legal inheritance of common law and the jury' s im- portance. Under the two systems, the forensic testimony gradually took shape in two forms of

  12. Copper, borders and nation-building : the Katangese factor in Zambian political and economic history

    NARCIS (Netherlands)

    Guene, E.

    2017-01-01

    This book is based on Enid Guene Master's thesis 'Copper, Borders and Nation-building: The Katangese Factor in Zambian Economic and Political History', runner-up in the African Studies Centre, Leiden's 2014 African Thesis Award. This annual award for Master's students encourages student research and

  13. Factors associated with young adults' knowledge regarding family history of Stroke

    Directory of Open Access Journals (Sweden)

    Maria Jose Melo Ramos Lima

    Full Text Available ABSTRACT Objective: to analyze the factors associated with young adults' knowledge regarding family history of stroke. Method: an analytical transversal study, with 579 young adults from state schools, with collection of sociodemographic, clinical and risk factor-related variables, analyzed using logistic regression (backward elimination. Results: a statistical association was detected between age, civil status, and classification of arterial blood pressure and abdominal circumference with knowledge of family history of stroke. In the final logistic regression model, a statistical association was observed between knowledge regarding family history of stroke and the civil status of having a partner (ORa=1.61[1.07-2.42]; p=0.023, abdominal circumference (ORa=0.98[0.96-0.99]; p=0.012 and normal arterial blood pressure (ORa=2.56[1.19-5.52]; p=0.016. Conclusion: an association was observed between socioeconomic factors and risk factors for stroke and knowledge of family history of stroke, suggesting the need for health education or even educational programs on this topic for the clientele in question.

  14. Are new medical students' specialty preferences gendered? Related motivational factors at a Dutch medical school.

    NARCIS (Netherlands)

    Tongeren-Alers, M.L.G. van; Esch, M. van der; Verdonk, P.; Johansson, E.; Hamberg, K.; Lagro-Janssen, T.

    2011-01-01

    BACKGROUND: Female students currently outnumber male students in most medical schools. Some medical specialties are highly gender segregated. Therefore, it is interesting to know whether medical students have early specialization preferences based on their gender. Consequently, we like to know impor

  15. Factors potentially influencing academic performance among medical students

    OpenAIRE

    Al Shawwa L; Abulaban AA; Merdad A; Baghlaf S; Algethami A; Abu-shanab J; Balkhoyor A

    2015-01-01

    Lana Al Shawwa,1 Ahmad A Abulaban,2 Abdulrhman A Abulaban,3 Anas Merdad,3 Sara Baghlaf,3 Ahmed Algethami,3 Joullanar Abu-shanab,3 Abdulrahman Balkhoyor3 1Department of Medical Education, College of Medicine, King Abdulaziz University, Jeddah, 2Department of Medicine-Neurology, King Fahad National Guard Hospital, King Abdulziz Medical City, Riyadh, 3Department of Medical Education, College of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia Background: Studies are needed t...

  16. Rhazes, a genius physician in the diagnosis and treatment of nocturnal enuresis in medical history.

    Science.gov (United States)

    Changizi Ashtiyani, Saeed; Shamsi, Mohsen; Cyrus, Ali; Tabatabayei, Seyed Mohammad

    2013-08-01

    Nocturnal enuresis has undoubtedly occurred since man's earliest days and the first references are found in the Ebers papyri of 1550 BC. The purpose of this study is to review of Rhazes opinion about diagnosis and treatment of nocturnal enuresis and compare his belief and clinical methods with modern medical practice. In the review study we searched all available and reliable electronic and paper sources using appropriate keywords about the views of Rhazes, and compared them with recent medical evidence about diagnosis and treatment of nocturnal in medication. Our findings proved that Rhazes described the symptoms, signs, and the treatment of nocturnal enuresis in accordance with contemporary medicine. A review of opinion Rhazes and other ancient Islamic medical textbooks on nocturnal enuresis reveals that medical practice in those days was comparable to modern medicine yet avoiding the side effects that are commonly experienced with the modern medical approach.

  17. Medical History for Prognostic Risk Assessment and Diagnosis of Stable Patients with Suspected Coronary Artery Disease

    Science.gov (United States)

    Min, James K.; Dunning, Allison; Gransar, Heidi; Achenbach, Stephan; Lin, Fay Y.; Al-Mallah, Mouaz; Budoff, Matthew J.; Callister, Tracy Q.; Chang, Hyuk-Jae; Cademartiri, Filippo; Chinnaiyan, Kavitha; Chow, Benjamin J. W.; D’Agostino, Ralph; DeLago, Augustin; Friedman, John; Hadamitzky, Martin; Hausleiter, Joerg; Hayes, Sean; Kaufmann, Philipp; Raff, Gilbert L.; Shaw, Leslee J.; Thomson, Louise; Villines, Todd; Cury, Ricardo C.; Feuchtner, Gudrun; Kim, Yong-Jin; Leipsic, Jonathon; Berman, Daniel S.; Pencina, Michael

    2014-01-01

    Aims To develop a clinical cardiac risk algorithm for stable patients with suspected CAD based upon angina typicality and CAD risk factors. Methods and Results Between 2004 and 2011, 14,004 adults with suspected CAD referred for cardiac imaging were followed: 1) 9,093 patients for CCTA (CCTA-1) followed for 2.0 years; 2) 2,132 patients for CCTA (CCTA-2) followed for 1·6 years, and 3) 2,779 patients for exercise myocardial perfusion scintigraphy followed for 5.0 years. A best-fit model from CCTA-1 for prediction of death or myocardial infarction (MI) was developed, with integer values proportional to regression coefficients. Discrimination was assessed using C-statistic. The validated model was also tested for estimation of the likelihood of obstructive CAD, defined as ≥50% stenosis, as compared to method of Diamond and Forrester (D-F). Primary outcomes included all-cause mortality and non-fatal MI. Secondary outcomes included prevalence of angiographically obstructive CAD. In CCTA-1, best-fit model discriminated individuals at risk of death or MI (C-statistic 0·76). The integer model ranged from 3-13, and corresponded to 3-year death risk or MI of 0·25% to 53·8%. When applied to the CCTA-2 and MPS, the model demonstrated C-statistics of 0·71 and 0·77. Both best-fit (C=0·76, 95% CI 0·746-0·771) and integer model (C=0·71, 95% CI 0·693-0·719) performed better than D-F (C=0·64; 95% CI, 0·628-0·659) for estimating obstructive CAD. Conclusions For stable symptomatic patients with suspected CAD, we developed a history-based method for prediction of death and obstructive CAD. PMID:25865923

  18. Apoptosis: its origin, history, maintenance and the medical implications for cancer and aging

    Science.gov (United States)

    Kaczanowski, Szymon

    2016-06-01

    Programmed cell death is a basic cellular mechanism. Apoptotic-like programmed cell death (called apoptosis in animals) occurs in both unicellular and multicellular eukaryotes, and some apoptotic mechanisms are observed in bacteria. Endosymbiosis between mitochondria and eukaryotic cells took place early in the eukaryotic evolution, and some of the apoptotic-like mechanisms of mitochondria that were retained after this event now serve as parts of the eukaryotic apoptotic machinery. Apoptotic mechanisms have several functions in unicellular organisms: they include kin-selected altruistic suicide that controls population size, sharing common goods, and responding to viral infection. Apoptotic factors also have non-apoptotic functions. Apoptosis is involved in the cellular aging of eukaryotes, including humans. In addition, apoptosis is a key part of the innate tumor-suppression mechanism. Several anticancer drugs induce apoptosis, because apoptotic mechanisms are inactivated during oncogenesis. Because of the ancient history of apoptosis, I hypothesize that there is a deep relationship between mitochondrial metabolism, its role in aerobic versus anaerobic respiration, and the connection between apoptosis and cancer. Whereas normal cells rely primarily on oxidative mitochondrial respiration, most cancer cells use anaerobic metabolism. According to the Warburg hypothesis, the remodeling of the metabolism is one of the processes that leads to cancer. Recent studies indicate that anaerobic, non-mitochondrial respiration is particularly active in embryonic cells, stem cells, and aggressive stem-like cancer cells. Mitochondrial respiration is particularly active during the pathological aging of human cells in neurodegenerative diseases. According to the reversed Warburg hypothesis formulated by Demetrius, pathological aging is induced by mitochondrial respiration. Here, I advance the hypothesis that the stimulation of mitochondrial metabolism leads to pathological aging.

  19. Factores asociados al rendimiento académico en estudiantes de medicina Factors associated with academic performance in medical students

    Directory of Open Access Journals (Sweden)

    Alberto Vélez van Meerbeke

    2005-06-01

    performance, using a logistic regression model. Results: Eighty students, aged between 17 and 18, were analysed. The majority were women, from Bogotá, from mixed (i.e. not single-sex, private and monolingual schools. The group was homogeneous in terms of demographic, social and cultural factors, and of schooling and motivation. Features of interfamilial violence, alcohol and cigarette consumption (but not psychoactive drug use were detected. The results obtained in the differential and general learning aptitude tests (BADyGs were low. Factors associated with poor academic performance were: No interest in reading as a pastime; interfamilial violence; a history of smoking marijuana; mixed educational background; no history of premedical studies; economic dependence on one of the parents. Grades in biology and biochemistry and the quarterly average grades were the best predictors. The best predictor of poor academic performance when controlled by other factors included in the model was the quarterly average, and the best predictor of failing the academic semester was the biochemistry laboratory grade. Conclusions: Although prior factors may explain academic performance before admission to Medical school, it is important to evaluate the performance during the first semester to identify cases in which rapid intervention is required in order to avoid academic failure.

  20. Prevalence of Obesity in Medical students and its correlation with cardiovascular risk factors: Emergency Alarm for Today?

    Science.gov (United States)

    Purohit, G; Shah, T; Harsoda, J M

    2015-01-01

    Background It is predicted that the prevalence of overweight and obesity will rise significantly by 2015 in young population. Problem of overweight and obesity has been recognized as public health problem worldwide due to the fact that it increases the risk of chronic diseases such as Cardiovascular Diseases (CVD), stroke, diabetes, sleep apnoea, osteoarthritis etc. Objective To assess the body mass index in medical students and its association with various cardiovascular risk factors like blood pressure, dietary habits, and family history of cardiovascular diseases. Method A university based cross-sectional analytical study was conducted in Department of Physiology, Smt. B.K. Shah Medical Institute and Research Center, Vadodara, Gujarat. Data was collected through convenient sampling technique by using selfadministered questionnaire followed by anthropometric measurement. Body Mass Index (BMI) of 138 first year medical students was assessed. Systolic blood pressure, diastolic blood pressure, pulse pressure, mean blood pressure, pulse rate and arterial oxygen saturation were measured. Result Data was compiled in excel sheet, analyzed for percentage and proportion. Chi square and Pearson correlation test were also applied and alpha error was set at 5% level. In comparison to the students with normal BMI, students with BMI >25 kg/m2 (N=49) showed significantly high blood pressure indices. Dietary habits and family history of cardiovascular diseases were also noted. Highly significant association of high BMI was found with elevated blood pressure (X2=7.4042***, pfamily history of cardiovascular diseases X2=9.8625***, pstudents were overweight, high prevalence of cardiovascular risk factors like family history, elevated blood pressure and less SpO2.

  1. "Modern medical science and the divine providence of god": rethinking the place of religion in postwar U.S. medical history.

    Science.gov (United States)

    Golden, Janet; Abel, Emily K

    2014-10-01

    Drawing on a large cache of letters to John and Frances Gunther after the death of their son as well as memoirs and fiction by bereaved parents, this essay challenges the assumptions of secularization that infuse histories of twentieth-century American medicine. Many parents who experienced the death of children during the postwar period relied heavily on religion to help make sense of the tragedies medicine could not prevent. Parental accounts included expression of belief in divine intervention and the power of prayer, gratitude for God's role in minimizing suffering, confidence in the existence of an afterlife, and acceptance of the will of God. Historians seeking to understand how parents and families understood both the delivery of medical care and the cultural authority of medical science must integrate an understanding of religious experiences and faith into their work.

  2. Medication and Counseling Histories of Gifted Students in a Summer Residential Program.

    Science.gov (United States)

    Jarosevich, Tania; Stocking, Vicki B.

    2003-01-01

    A review of medical forms for 1,762 gifted secondary students participating in a 3-week residential academic program found low rates of psychological disorders, medication use, and counseling. Students who received counseling (n=143) were dealing with family issues (divorce, blended families, adopted siblings, or family counseling), depression,…

  3. The GROG: A Journal of Navy Medical History and Culture. Issue 38, 2013

    Science.gov (United States)

    2013-01-01

    Tunis by American merchants , and cancelled the right of the Tunisian government to comman- deer, for its commercial needs, Ameri- can merchant vessels...order and discipline into the entire medical system of supply, medical treatment, sanitation, soldier hygiene and diet, training of drivers and litter

  4. History of the medical licensing examination (uieop in Korea’s Goryeo Dynasty (918-1392

    Directory of Open Access Journals (Sweden)

    Kyung-Lock Lee

    2015-05-01

    Full Text Available This article aims to describe the training and medical licensing system (uieop for becoming a physician officer (uigwan during Korea’s Goryeo Dynasty (918-1392. In the Goryeo Dynasty, although no license was necessary to provide medical services to the common people, there was a licensing examination to become a physician officer. No other national licensing system for healthcare professionals existed in Korea at that time. The medical licensing examination was administered beginning in 958. Physician officers who passed the medical licensing examination worked in two main healthcare institutions: the Government Hospital (Taeuigam and Pharmacy for the King (Sangyakguk. The promotion and expansion of medical education differed depending on the historical period. Until the reign of King Munjong (1046-1083, medical education as a path to licensure was encouraged in order to increase the number of physician officers qualifying for licensure by examination; thus, the number of applicants sitting for the examination increased. However, in the late Goryeo Dynasty, after the officer class of the local authorities (hyangri showed a tendency to monopolize the examination, the Goryeo government limited the examination applications by this group. The medical licensing examination was divided into two parts: medicine and ‘feeling the pulse and acupuncture’ (jugeumeop. The Goryeo Dynasty followed the Chinese Dang Dynasty’s medical system while also taking a strong interest in the Chinese Song Dynasty’s ideas about medicine.

  5. From History to Myth: Productive Engagement with the Flexnerian Metanarrative in Medical Education

    Science.gov (United States)

    Schrewe, Brett

    2013-01-01

    More than 100 years following its publication, the Flexner Report endures as a principal text in contemporary medical education. While recent scholarship has questioned popular conceptions of the report and attends to marginalized passages, explanations as to why the Flexner story endures as myth in medical education remain absent in the…

  6. High-impact medical journals and peace: a history of involvement.

    Science.gov (United States)

    Bloom, Joshua D; Sambunjak, Dario; Sondorp, Egbert

    2007-01-01

    The aim of this study is to explore the positions of five leading general medical journals (The Lancet, British Medical Journal--BMJ, Journal of American Medical Association--JAMA, New England Journal of Medicine--NEJM, and Annals of Internal Medicine--AIM) toward the issues of collective violence. We calculated the proportion of war-related articles in the total number of articles published in these five high-impact journals, and in the total number of articles indexed in PubMed during the last 60 years. The results showed a continuous increase in the proportion of war-related articles. Our findings suggest that the leading general medical journals have taken an active editorial stance toward the issues of war and peace. We conclude that high-impact medical journals can make an important contribution to efforts aimed at reducing the risks and consequences of war and violence.

  7. Evidence of Second-Order Factor Structure in a Diagnostic Problem Space: Implications for Medical Education.

    Science.gov (United States)

    Papa, Frank J.; And Others

    1997-01-01

    Chest pain was identified as a specific medical problem space, and disease classes were modeled to define it. Results from a test taken by 628 medical residents indicate a second-order factor structure that suggests that chest pain is a multidimensional problem space. Implications for medical education are discussed. (SLD)

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  9. [Factors related to purchasing over-the-counter medications online].

    Science.gov (United States)

    Kishimoto, Keiko; Yoshida, Takeshi; Fukushima, Noriko

    2009-09-01

    We conducted a Web-based survey of approximately 40,000 Internet users on the purchase of over-the-counter (OTC) medications online in March 2009. The valid response rate was 97.8% and the number of responses was 39,208. The number of people who had purchased OTC medications online was 4,653 (11.9%), prescription medicines 792 (2.0%), and medical contact lenses 1,993 (5.1%). As a result of the multiple logistic regression analysis, independent variables with odds ratios (ORs) >1.5 were experience of purchasing prescription-only medicine online (OR=4.997, 95%CI=4.288-5.824), regular supplement use (OR=2.384, 95%CI=2.233-2.548), experience of purchasing colored contact lenses online (OR=2.206, 95%CI=1.632-2.983), no time to visit drugstores (OR=2.092, 95%CI=1.928-2.270), usage of Web sites of uncertain reliability (OR=1.992, 95%CI=1.857-2.137), and experience of purchasing therapeutic contact lenses online (OR=1.796, 95%CI=1.597-2.020). As some people have purchased prescription-only medicine or medical devices and had problems with drug information sources, the development of awareness of medical and pharmaceutical supplies and health and medical information literacy are key priorities to ensure safe OTC medication sales systems.

  10. Specialty choice preference of medical students according to personality traits by Five-Factor Model

    National Research Council Canada - National Science Library

    Oh Young Kwon; So Youn Park

    2016-01-01

    Purpose: The purpose of this study was to determine the relationship between personality traits, using the Five-Factor Model, and characteristics and motivational factors affecting specialty choice in Korean medical students. Methods...

  11. Prevalence and associated factors of cigarette smoking among medical students at King Fahad Medical City in Riyadh of Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Abdulaziz F Al-Kaabba

    2011-01-01

    Full Text Available Objective: To determine the prevalence of smoking among medical students at the medical college at King Fahad Medical City in Riyadh, and assess the association between smoking and socio-demographical factors, smoking contacts, reasons for smoking and attempts to quit. Materials and Methods: Cross-sectional survey in which anonymous, self-administered questionnaire was used to survey the cigarette smoking habits of the first- and second-year medical students in the Faculty of Medicine, King Fahad Medical City in June 2009. Results: Overall 39.8 % of the investigated students (153 had smoked before, and 17.6% were current smokers. The mean age of initiating smoking was 15.8 (΁3.3. There were significantly more males than females. The most important reasons for smoking were leisure, imitation of other people and a means of relieving psychological pressure. Reasons for not smoking were mostly health and religion-based. Smokers tended to have friends who smoked. Conclusion: Cigarettes smoking is highly prevalent among medical students in the Faculty of Medicine, King Fahad Medical City. Contact with smokers particularly friends are the major risk factors for the initiation of the habit. Health and religious considerations are important motives for not smoking, quitting or attempting to quit. These findings can be of help in designing future intervention strategies.

  12. Sexual orientation and medical history among Iranian people with Complete Androgen Insensitivity Syndrome and Congenital Adrenal Hyperplasia.

    Science.gov (United States)

    Khorashad, Behzad S; Roshan, Ghasem M; Reid, Alistair G; Aghili, Zahra; Hiradfar, Mehran; Afkhamizadeh, Mozhgan; Talaei, Ali; Aarabi, Azadeh; Ghaemi, Nosrat; Taghehchian, Negin; Saberi, Hedieh; Farahi, Nazanin; Abbaszadegan, Mohammad Reza

    2017-01-01

    To report sexual orientation, relationship status and medical history of Iranian people with Differences of Sex Development (DSD) who were raised female. Our participants consisted of nineteen 46,XY individuals with Complete Androgen Insensitivity Syndrome (CAIS) and eighteen 46,XX individuals with Congenital Adrenal Hyperplasia (CAH) who were raised as females and older than 13years. As well as their relationship status and detailed medical history, an expert psychiatrist assessed their sexual orientation by a semi-structured psychiatric interview with them and, where applicable, their parents. Five percent of CAH participants and 42% of CAIS participants were in a relationship, which was significantly different. All CAH individuals had been diagnosed at birth; 89% of CAIS had been diagnosed after puberty and due to primary amenorrhea and 11% were diagnosed in childhood due to inguinal hernia. Genital reconstructive surgery had been performed in 100% of CAH participants and 37% of CAIS. Regarding sexual contact experiences and sexual fantasies (androphilic, gynephilic or both), no significant differences were found. However, CAH females had significantly more gynephilic dreams (P=0.045). This study, notable as one of the rare from a non-western culture, described sexual, medical and socioeconomic status of 46,XX CAH and 46,XY CAIS individuals living in Iran. Although broadly in line with previous findings from Western cultures, Iranian CAH individuals had fewer romantic relationships, but in contrast to previous studies their sexual orientation was only different from CAIS in the contents of sexual dreams. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. FAMILY HISTORY OF DISEASE AS A RISK FACTOR OF ACUTE MYOCARDIAL INFARCTION

    Directory of Open Access Journals (Sweden)

    Zoran Velickovic

    2006-10-01

    Full Text Available Myocardial infarction (MI is a complex disease that begins with a lifelong interaction between genetics and environmental factors. The aim of the study was to identify family history as a risk factor of myocardial infarction in examined population in the Municipality of Nis.We used a case-control study with 100 patients with a first MI (in the period 1998-2000 and 100 controls, matched with respect to sex and age (± 2 years from the Municipality of Nis.Data was obtained from the epidemiological questionnaire. The Yates c2 test, odds ratio-OR and their 99% interval of confident were used as statistical procedures.The results showed that statistical significance for MI was present among all three degrees of relatives of subjects who have had an acute MI, and for hypertension, hypercholesterolemia and stroke among first and second - degree relatives. The subjects with family history of hypercholesterolemia had 12.43 times higher risk of disease (p = 0,000 and in the case of family history of MI before the age of 55, the risk was almost 10 times (p = 0,000 higher. Almost 4 times higher risk of disease was registered in subjects with family history of hypertension (p < 0,00001 and stroke (before 65 years of age - (p < 00005; a two-fold higher risk was registered in subjects with diagnoses of diabetes (p < 0,05 and other cardiovascular diseases (unless hypertension (p < 0,01 in the nearest relatives before the age of 55.We concluded that family history of diseases on the sample of the Municipality of Nis inhabitants was very important risk factor, mostly in the first-degree relatives. Genetic epidemiology is the future for all investigations between different population, and special attention should be paid to investigations and findings of different genes and loci which are very important for myocardial infarction occurrence, which would allow a new approach to preventive medicine.

  14. Life history factors, personality and the social clustering of sexual experience in adolescents

    Science.gov (United States)

    2016-01-01

    Adolescent sexual behaviour may show clustering in neighbourhoods, schools and friendship networks. This study aims to assess how experience with sexual intercourse clusters across the social world of adolescents and whether predictors implicated by life history theory or personality traits can account for its between-individual variation and social patterning. Using data on 2877 adolescents from the Avon Longitudinal Study of Parents and Children, we ran logistic multiple classification models to assess the clustering of sexual experience by approximately 17.5 years in schools, neighbourhoods and friendship networks. We examined how much clustering at particular levels could be accounted for by life history predictors and Big Five personality factors. Sexual experience exhibited substantial clustering in friendship networks, while clustering at the level of schools and neighbourhoods was minimal, suggesting a limited role for socio-ecological influences at those levels. While life history predictors did account for some variation in sexual experience, they did not explain clustering in friendship networks. Personality, especially extraversion, explained about a quarter of friends' similarity. After accounting for life history factors and personality, substantial unexplained similarity among friends remained, which may reflect a tendency to associate with similar individuals or the social transmission of behavioural norms. PMID:27853543

  15. The stroke offspring study: is parental stroke history of value in targeted risk factor screening?

    Science.gov (United States)

    Hart, Nigel D; Cupples, Margaret E; Wiggam, M Ivan; Patterson, Christopher C; Yarnell, John W G

    2011-01-01

    This study aimed to compare the prevalence of stroke risk factors among people with a parental history of stroke to those in a control group of individuals, of similar age, gender and social class, with no parental stroke history. Parental stroke increases an individual's risk of stroke, but little is known of the potential value of using this information in targeted screening for primary prevention in general practice. We sent questionnaires to 300 randomly selected individuals aged 40-65 years, in each of 11 different general practices in Northern Ireland. Among 1061 responses received within six weeks, 332 reported a parental history of stroke (31.3%). We matched respondents with (cases) and without (controls) a parental history of stroke on characteristics of age, gender and socioeconomic status. Matched pairs were invited to attend a consultation at which their diet and exercise habits were assessed using validated questionnaires and height, weight, blood pressure and serum lipids and glucose were measured. Matched data were available for 199 case-control pairs (398 individuals). Mean systolic and diastolic blood pressures were significantly higher in cases than in paired controls (systolic 146.3 versus 140.6 mmHg (P pressure has potential value in identifying people likely to benefit from primary prevention, but do not support the adoption of a targeted screening strategy for other commonly cited stroke risk factors.

  16. Population prevalence and control of cardiovascular risk factors: what electronic medical records tell us.

    Science.gov (United States)

    Catalán-Ramos, Arantxa; Verdú, Jose M; Grau, María; Iglesias-Rodal, Manuel; del Val García, José L; Consola, Alicia; Comin, Eva

    2014-01-01

    To analyze the prevalence, control, and management of hypertension, hypercholesterolemia, and diabetes mellitus type 2 (DM2). Cross-sectional analysis of all individuals attended in the Catalan primary care centers between 2006 and 2009. History of cardiovascular diseases, diagnosis and treatment of hypertension, hypercholesterolemia, DM2, lipid profile, glycemia and blood pressure data were extracted from electronic medical records. Age-standardized prevalence and levels of management and control were estimated. Individuals aged 35-74 years using primary care databases. A total of 2,174,515 individuals were included (mean age 52 years [SD 11], 47% men). Hypertension was the most prevalent cardiovascular risk factor (39% in women, 41% in men) followed by hypercholesterolemia (38% and 40%) and DM2 (12% and 16%), respectively. Diuretics and angiotensin-converting enzyme inhibitors were most often prescribed for hypertension control (<140/90mmHg, achieved in 68% of men and 60% of women treated). Hypercholesterolemia was controlled (low-density lipoprotein cholesterol <130mg/dl) in just 31% of men and 26% of women with no history of cardiovascular disease, despite lipid-lowering treatment, primarily (90%) with statins. The percentage of women and men with DM2 and with glycated hemoglobin <7% was 64.7% and 59.2%, respectively; treatment was predominantly with oral hypoglycemic agents alone (70%), or combined with insulin (15%). Hypertension was the most prevalent cardiovascular risk factor in the Catalan population attended at primary care centers. About two thirds of individuals with hypertension or DM2 were adequately controlled; hypercholesterolemia control was particularly low. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  17. Daniel Alcides Carrion (1857-1885) and a history of medical martyrdom.

    Science.gov (United States)

    Chatterjee, Pranab; Chandra, Shivika; Biswas, Tamoghna

    2015-11-01

    Daniel Carrion, a sixth-year medical student, died while investigating the effects of self-inoculation of the causative organism of Oroya Fever and Bartonellosis and thereby contributed to understanding of the disease before the organisms had been identified.

  18. Public Health History Corner Edmund Pellegrino: a modern day prophet for medical humanities in the US

    OpenAIRE

    Roberto Bucci

    2009-01-01

    Abraham Flexner lit the fire that freed American doctors from obsolete aspects of their training. Edmund Pellegrino was the prudent fireman who acknowledged the risk of too broad a fire and put in place safe guards to protect those aspects that needed to be saved. The prodigious leap forward in medicine due to the “laboratory centred” training introduced by Flexner’s proposals for medical training began to have negative effects in daily medical practice, particularly with regards to the incre...

  19. Public Health History Corner Edmund Pellegrino: a modern day prophet for medical humanities in the US

    OpenAIRE

    Bucci, Roberto

    2012-01-01

    Abraham Flexner lit the fire that freed American doctors from obsolete aspects of their training. Edmund Pellegrino was the prudent fireman who acknowledged the risk of too broad a fire and put in place safe guards to protect those aspects that needed to be saved. The prodigious leap forward in medicine due to the “laboratory centred” training introduced by Flexner’s proposals for medical training began to have negative effects in daily medical practice, particularly with regards to the incre...

  20. Medical and psychosocial factors associated with antibiotic prescribing in primary care: survey questionnaire and factor analysis.

    Science.gov (United States)

    Lee, Tau-Hong; Wong, Joshua Gx; Lye, David Cb; Chen, Mark Ic; Loh, Victor Wk; Leo, Yee-Sin; Lee, Linda K; Chow, Angela Lp

    2017-03-01

    Acute upper respiratory infections (AURI) are the leading causes of antibiotic prescribing in primary care although antibiotics are often not indicated. To gain an understanding of the knowledge, attitudes, and practices (KAP) of GPs in Singapore and the associated latent factors to guide the implementation of an effective programme to reduce antibiotic use in primary care. An anonymous survey on the KAP of antibiotic use in AURI of GPs in Singapore. KAP survey questionnaires were posted to all GPs from a database. To ascertain the latent factors affecting prescribing patterns, exploratory factor analysis was performed. Among 427 responses, 351 (82.2%) were from GPs working in private practice. It was found that 58.4% of GPs in the private versus 72.4% of those in the public sector recognised that >80% of AURIs were caused by viruses (P = 0.02). The majority of GPs (353/427; 82.7%) felt that antibiotics were overprescribed in primary care. Significant factors associated with low antibiotic prescribing were good medical knowledge and clinical competency (adjusted odds ratio [aOR] 3.2, 95% confidence interval [CI] = 2.4 to 4.3), good clinical practice (aOR 2.7 [95% CI = 2.0 to 3.6]), availability of diagnostic tests (aOR 1.4 [95% CI = 1.1 to 1.8]), and desire to improve clinical practice (aOR 1.5 [95% CI = 1.2 to 1.9]). The conservative practice of giving antibiotics 'to be on the safe side' is significantly less likely to be associated with low antibiotic prescribing (aOR 0.7 [95% CI = 0.5 to 0.9]). This is the first KAP survey on antibiotic prescribing for AURI among GPs in Singapore. With the latent factors identified, future interventions should be directed at addressing these factors to reduce inappropriate antibiotic prescribing. © British Journal of General Practice 2017.

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

    LENUS (Irish Health Repository)

    Grimes, Tamasine C

    2012-02-01

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

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

    Science.gov (United States)

    Grimes, Tamasine C; Duggan, Catherine A; Delaney, Tim P; Graham, Ian M; Conlon, Kevin C; Deasy, Evelyn; Jago-Byrne, Marie-Claire; O' Brien, Paul

    2011-01-01

    AIMS Movement into or out of hospital is a vulnerable period for medication safety. Reconciling the medication a patient is using before admission with the medication prescribed on discharge, and documenting any changes (medication reconciliation) is recommended to improve safety. The aims of the study were to investigate the factors contributing to medication reconciliation on discharge, and identify the prevalence of non-reconciliation. METHODS The study was a cross-sectional, observational survey using consecutive discharges from purposively selected services in two acute public hospitals in Ireland. Medication reconciliation, potential for harm and unplanned re-admission were investigated. RESULTS Medication non-reconciliation was identified in 50% of 1245 inpatient episodes, involving 16% of 9569 medications. The majority of non-reconciled episodes had potential to result in moderate (63%) or severe (2%) harm. Handwritten rather than computerized discharges (adjusted odds ratio (adjusted OR) 1.60, 95% CI 1.11, 2.99), increasing number of medications (adjusted OR 1.26, 95% CI 1.21, 1.31) or chronic illness (adjusted OR 2.08, 95% CI 1.33, 3.24) were associated with non-reconciliation. Omission of endocrine, central nervous system and nutrition and blood drugs was more likely on discharge, whilst omission on admission and throughout inpatient care, without documentation, was more likely for obstetric, gynaecology and urinary tract (OGU) or respiratory drugs. Documentation in the discharge communication that medication was intentionally stopped during inpatient care was less likely for cardiovascular, musculoskeletal and OGU drugs. Errors involving the dose were most likely for respiratory drugs. CONCLUSIONS The findings inform strategies to facilitate medication reconciliation on discharge from acute hospital care. PMID:21284705

  3. Lifetime growth in wild meerkats: incorporating life history and environmental factors into a standard growth model.

    Science.gov (United States)

    English, Sinéad; Bateman, Andrew W; Clutton-Brock, Tim H

    2012-05-01

    Lifetime records of changes in individual size or mass in wild animals are scarce and, as such, few studies have attempted to model variation in these traits across the lifespan or to assess the factors that affect them. However, quantifying lifetime growth is essential for understanding trade-offs between growth and other life history parameters, such as reproductive performance or survival. Here, we used model selection based on information theory to measure changes in body mass over the lifespan of wild meerkats, and compared the relative fits of several standard growth models (monomolecular, von Bertalanffy, Gompertz, logistic and Richards). We found that meerkats exhibit monomolecular growth, with the best model incorporating separate growth rates before and after nutritional independence, as well as effects of season and total rainfall in the previous nine months. Our study demonstrates how simple growth curves may be improved by considering life history and environmental factors, which may be particularly relevant when quantifying growth patterns in wild populations.

  4. State of Digital Education Options in the areas of Medical Terminology and the History, Theory and Ethics of Medicine

    Directory of Open Access Journals (Sweden)

    Schochow, Maximilian

    2015-05-01

    Full Text Available Background: Institutes of the history of medicine, the theory of medicine, and medical ethics at German institutions of higher learning have created various e-learning options that are based on different learning platforms and tailored to the specific curricular needs of individual teaching. Up to now no valid data has been available about the types of such e-learning options as well as possibilities of future developments thanks to coordinated cooperation among the different institutes.Methods: Of 31 German institutes of the history and theory of medicine and medical ethics that were asked to fill out a questionnaire, 30 answered, which equals a return rate of 97 per cent. The questionnaire was completed between July and August 2012 using a telephone survey.Results: Available to students online, digitally interactive teaching tools have boomed in the course of the last few years at German institutes of the history of medicine, the theory of medicine, and medical ethics. This trend is also reflected in a willingness of more than half of the respective departments (67 per cent to expand their e-learning options on the basis of previous experience. The offered e-learning systems are accepted very well by the students. 57 per cent of the institutes stated, that 90-100 per cent of the students use the offered systems regularly. E-learning courses for terminology are offered particularly often, this is also reflected in the intended extension of these courses by the majority of institutes which plan to expand their e-learning systems.Conclusions: This article discusses the results of a comprehensive empirical survey about e-learning. It illustrates ways in which individual German institutes plan to expand their e-learning options in the future. Finally, specific proposals for cooperation among institutions (not just online are introduced, the purpose of which is to produce synergy in e-learning.

  5. State of Digital Education Options in the areas of Medical Terminology and the History, Theory and Ethics of Medicine.

    Science.gov (United States)

    Schochow, Maximilian; Steger, Florian

    2015-01-01

    Institutes of the history of medicine, the theory of medicine, and medical ethics at German institutions of higher learning have created various e-learning options that are based on different learning platforms and tailored to the specific curricular needs of individual teaching. Up to now no valid data has been available about the types of such e-learning options as well as possibilities of future developments thanks to coordinated cooperation among the different institutes. Of 31 German institutes of the history and theory of medicine and medical ethics that were asked to fill out a questionnaire, 30 answered, which equals a return rate of 97 per cent. The questionnaire was completed between July and August 2012 using a telephone survey. Available to students online, digitally interactive teaching tools have boomed in the course of the last few years at German institutes of the history of medicine, the theory of medicine, and medical ethics. This trend is also reflected in a willingness of more than half of the respective departments (67 per cent) to expand their e-learning options on the basis of previous experience. The offered e-learning systems are accepted very well by the students. 57 per cent of the institutes stated, that 90-100 per cent of the students use the offered systems regularly. E-learning courses for terminology are offered particularly often, this is also reflected in the intended extension of these courses by the majority of institutes which plan to expand their e-learning systems. This article discusses the results of a comprehensive empirical survey about e-learning. It illustrates ways in which individual German institutes plan to expand their e-learning options in the future. Finally, specific proposals for cooperation among institutions (not just online) are introduced, the purpose of which is to produce synergy in e-learning.

  6. State of Digital Education Options in the areas of Medical Terminology and the History, Theory and Ethics of Medicine

    Science.gov (United States)

    Schochow, Maximilian; Steger, Florian

    2015-01-01

    Background: Institutes of the history of medicine, the theory of medicine, and medical ethics at German institutions of higher learning have created various e-learning options that are based on different learning platforms and tailored to the specific curricular needs of individual teaching. Up to now no valid data has been available about the types of such e-learning options as well as possibilities of future developments thanks to coordinated cooperation among the different institutes. Methods: Of 31 German institutes of the history and theory of medicine and medical ethics that were asked to fill out a questionnaire, 30 answered, which equals a return rate of 97 per cent. The questionnaire was completed between July and August 2012 using a telephone survey. Results: Available to students online, digitally interactive teaching tools have boomed in the course of the last few years at German institutes of the history of medicine, the theory of medicine, and medical ethics. This trend is also reflected in a willingness of more than half of the respective departments (67 per cent) to expand their e-learning options on the basis of previous experience. The offered e-learning systems are accepted very well by the students. 57 per cent of the institutes stated, that 90-100 per cent of the students use the offered systems regularly. E-learning courses for terminology are offered particularly often, this is also reflected in the intended extension of these courses by the majority of institutes which plan to expand their e-learning systems. Conclusions: This article discusses the results of a comprehensive empirical survey about e-learning. It illustrates ways in which individual German institutes plan to expand their e-learning options in the future. Finally, specific proposals for cooperation among institutions (not just online) are introduced, the purpose of which is to produce synergy in e-learning. PMID:26038682

  7. Risk factors for problematic behaviors among forensic outpatients under the Medical Treatment and Supervision Act in Japan

    Directory of Open Access Journals (Sweden)

    Kumiko Ando

    2016-08-01

    Full Text Available The Medical Treatment and Supervision Act (MTSA was enacted in 2005 in Japan to promote the reintegration of clinical offenders with mental disorders into society. Under the MTSA, individuals who committed serious crimes in a state of insanity or diminished responsibility are diverted from the criminal justice system to the mental health system. Based on court decisions about MTSA-based treatment, clinical offenders have an obligation to engage in rehabilitation within their local community under the guidance of mental health professionals. However, patients under MTSA-based clinical treatments have faced various problems in the course of treatment, because of psychiatric as well as other static or dynamic factors, and sometimes have committed problematic behaviors, such as violence and medical non-compliance. Hence, this study aimed to clarify factors related to patients' inclusion in MTSA-based outpatient treatment and additionally, their commitment of problematic behaviors, based on confidential data acquired during a four-year government survey period (National Center of Neurology and Psychiatry from MTSA enactment (July 15, 2005 to December 31, 2009. In total, we recruited 441 clinical offenders receiving MTSA-based outpatient treatment from 158 nationwide facilities. To evaluate related factors, we collected demographic, psychiatric, forensic, clinical treatment, and social service information. Statistical analyses demonstrated that predominant profiles of patients included male gender, younger age, low school history, psychiatric diagnoses (F1, F2, and F3, and no correctional or outpatient history before MTSA-based treatment. F1 or substance use diagnosis, in particular, was increasingly correlated with other factors, such as male gender, older age, and correctional history before MTSA treatment. Among the 441 patients, 189 (43% committed problematic behaviors in the course of the MTSA-based outpatient treatment. Risk factors for patients

  8. Risk Factors for Problematic Behaviors among Forensic Outpatients under the Medical Treatment and Supervision Act in Japan

    Science.gov (United States)

    Ando, Kumiko; Soshi, Takahiro; Nakazawa, Kanako; Noda, Takamasa; Okada, Takayuki

    2016-01-01

    The Medical Treatment and Supervision Act (MTSA) was enacted in 2005 in Japan to promote the reintegration of clinical offenders with mental disorders into society. Under the MTSA, individuals who committed serious crimes in a state of insanity or diminished responsibility are diverted from the criminal justice system to the mental health system. Based on court decisions about MTSA-based treatment, clinical offenders have an obligation to engage in rehabilitation within their local community under the guidance of mental health professionals. However, patients under MTSA-based clinical treatments have faced various problems in the course of treatment, because of psychiatric as well as other static or dynamic factors, and sometimes have committed problematic behaviors, such as violence and medical non-compliance. Hence, this study aimed to clarify factors related to patients’ inclusion in MTSA-based outpatient treatment and additionally, their commitment of problematic behaviors, based on confidential data acquired during a four-year government survey period (National Center of Neurology and Psychiatry) from MTSA enactment (July 15, 2005) to December 31, 2009. In total, we recruited 441 clinical offenders receiving MTSA-based outpatient treatment from 158 nationwide facilities. To evaluate related factors, we collected demographic, psychiatric, forensic, clinical treatment, and social service information. Statistical analyses demonstrated that predominant profiles of patients included male gender, younger age, low school history, psychiatric diagnoses (F1, F2, and F3), and no correctional or outpatient history before MTSA-based treatment. F1 or substance use diagnosis, in particular, was increasingly correlated with other factors, such as male gender, older age, and correctional history before MTSA treatment. Among the 441 patients, 189 (43%) committed problematic behaviors in the course of the MTSA-based outpatient treatment. Risk factors for patients

  9. Correction: Washington and Geneva arrive in Buenos Aires: notes on the history of the habit of smoking and its medicalization.

    Science.gov (United States)

    2015-12-01

    [This corrects the article DOI: 10.1590/S0104-59702015000100017.]. Upon request of the author, the article "Washington and Geneva come to Buenos Aires: notes on the history of smoking and its medicalization" by Diego Armus, publicado em História, Ciências, Saúde - Manguinhos, v.22, n.1 , Jan.-Mar. 2015:on page 301, second paragraph, sixth line, where it says " It was only in 2012 when Argentina ratified the agreement and the National Congress approved a new national law" it should read "It was only in 2012, without having ratified the convention, when the National Congress approved a new national law. "

  10. [Experience from the teaching of the history of medicine syllabus in the Military Medical Academy].

    Science.gov (United States)

    Jeśman, C; Kielek, P; Jezierski, Z

    2000-01-01

    This paper presents in which the history of medicine syllabus has evolved over the past 30 years. It presents the aspects that are preferred today, the bibliography the students use and the way the course is conducted. The paper also includes the conclusions from many years experience.

  11. History of neurosciences at the School of Medical Sciences, Universiti Sains Malaysia.

    Science.gov (United States)

    Idris, Badrisyah; Sayuti, Sani; Abdullah, Jafri Malin

    2007-02-01

    Universiti Sains Malaysia is the only institution in Malaysia which incorporates all fields of the neurosciences under one roof. The integration of basic and clinical neurosciences has made it possible for this institution to become an excellent academic and research centre. This article describes the history, academic contributions and scientific progress of neurosciences at Universiti Sains Malaysia.

  12. Can family risk-factors moderate the link between psychopathy and life-history strategy?

    Directory of Open Access Journals (Sweden)

    Međedović Janko

    2016-01-01

    Full Text Available Life History Theory is an explanatory evolutionary framework which explains differences in fitness-relevant outcomes using the characteristics of the environment and individual organisms. Basically, individuals can be positioned somewhere on the r/K continuum of the Life History Strategy (LHS: a K or slow strategy represents later maturity and reproduction, a smaller number of offspring with higher investment in them, while the r (or fast strategy follows the opposite pattern. Previous research offered evidence that psychopathy can represent a trait associated with fast LHS. In the present research we examined the relations between the family risk-factors, a four-factor model of psychopathy and the LHS in a sample of male convicts (N=181. The results have shown that a manipulative and deceitful interpersonal style is associated with slow LHS while shallow affect and antisocial tendencies are related to fast LHS. The interactions between psychopathy and family risk-factors revealed that parental criminal behaviour enhances the relation between fast LHS and psychopathic traits, including the manipulative interpersonal style. The findings are in accordance with the Life History Theory and provide a deeper understanding of the preservation of psychopathy in contemporary populations.

  13. [The Salernitan School of Medicine: Its History and Contribution to European Medical Education].

    Science.gov (United States)

    Sakai, Tatsuo

    2015-12-01

    The Salernitan School of Medicine was founded in the late 10th century as a loose association of medical teachers. The period before the middle 13th century was divided into three phases. In the early phase, before the end of 11th century, "practica" books were written, utilizing extant ancient literature, Arabic medical treatises were translated into Latin, and the medical text "Articella" was compiled. In the high phase before the end of the 12th century, the "Articella" was commented upon and new pharmacopeia and practica books were written. In the late phase before the middle of the 13th century, physicians who graduated from Salerno were active in various countries in Europe. After the middle of the 13th century the school developed organizations and rules, became a university at the end of 16th century, and was closed in 1811. The Salernitan school produced "Articella", which pioneered in theoretical medical education, and produced "practica", which dealt with both local diseases from head to foot and systemic fever diseases, and it continued until the end of 18th century. The two major disciplines of medical education before the end of 18th century, theoretica and practica, were derived from Salerno.

  14. History and status of embryology and developmental biology at Polish Medical Faculties and Schools.

    Science.gov (United States)

    Bartel, Hieronim

    2008-01-01

    In Poland, medical embryology (both scientific research and teaching of the subject) has traditionally involved Chairs of Histology and Embryology rather than Obstetrics and Gynecology. Before World War II, the most buoyant centers for embryological research among the five universities at the time (in Warsaw, Krakow, Poznan, Lvov and Vilnius), were the Chairs of Embryology and Histology at Medical Faculties of the Jagiellonian University in Krakow and the University of Vilnius. After World War II, eleven Medical Academies (Universities of Medicine) came into being (Warsaw, Krakow, Poznan, Lodz, Gdansk, Bialystok, Bydgoszcz, Szczecin, Wroclaw, Katowice and Lublin). They conduct scientific research on normal development of the human embryo as well as teratology studies. In the XX century, eminent medicine-related embryologist included professors Emil Godlewski Jr., Stanislaw Hiller and Stefan Baginski.

  15. Motor-vehicle crash history and licensing outcomes for older drivers reported as medically impaired in Missouri.

    Science.gov (United States)

    Meuser, Thomas M; Carr, David B; Ulfarsson, Gudmundur F

    2009-03-01

    The identification and evaluation of medically impaired drivers is an important safety issue. Medical fitness to drive is applicable to all ages but is particularly salient for older adults. Voluntary procedures, whereby various professionals and family members may report medical fitness concerns to State driver license bureaus, are common in the United States. This paper examines traffic crashes of drivers reported during 2001-2005 under the State of Missouri's voluntary reporting law (House Bill HB-1536) and the resulting licensing outcomes. Missouri's law is non-specific as to age, but the mean age of reported drivers was 80. Reports were submitted by police officers (30%), license office staff (27%), physicians (20%), family members (16%), and others (7%). The most common medical condition was dementia/cognitive (45%). Crash history for reported drivers was higher than that of controls, dating back to 1993, reaching a peak in 2001 when the crash involvement of reported drivers was 9.3% vs. 2.2% for controls--a fourfold difference. The crash involvement of reported drivers decreased rapidly after, indicating the impact of HB-1536 reporting with subsequent license revocation and to a lesser degree, mortality. Of the 4,100 reported individuals, 144 (3.5%) retained a driver's license after the process.

  16. Hospitalizations among HIV controllers and persons with medically controlled HIV in the U.S. Military HIV Natural History Study

    Directory of Open Access Journals (Sweden)

    Trevor A Crowell

    2016-03-01

    Full Text Available Introduction: HIV controllers (HICs experience relatively low-level viraemia and CD4 preservation without antiretroviral therapy (ART, but also immune activation that may predispose to adverse clinical events such as cardiovascular disease and hospitalization. The objective of this study was to characterize the rates and reasons for hospitalization among HICs and persons with medically controlled HIV. Methods: Subjects with consistently well-controlled HIV were identified in the U.S. Military HIV Natural History Study. ART prescription and HIV-1 RNA data were used to categorize subjects as HICs or medically controlled as defined by ≥3 HIV-1 RNA measurements ≤2000 or ≤400 copies/mL, respectively, representing the majority of measurements spanning ≥12 months. Hospitalizations were tallied and assigned diagnostic categories. All-cause hospitalization rates were compared between groups using negative binomial regression. Results and discussion: Of 3106 subjects followed from 2000 to 2013, 221 were HICs, including 33 elite (1.1% and 188 viraemic (6.0% controllers, who contributed 882 person-years (PY of observation time. An additional 870 subjects with medically controlled HIV contributed 4217 PY. Mean hospitalization rates were 9.4/100 PY among HICs and 8.8/100 PY among medically controlled subjects. Non-AIDS-defining infections were the most common reason for hospitalization (2.95/100 PY and 2.70/100 PY, respectively and rates of cardiovascular hospitalization were similar in both groups (0.45/100 PY and 0.76/100 PY. There was no difference in hospitalization rate for HICs compared with subjects with medically controlled HIV (adjusted incidence rate ratio 1.15 [95% confidence interval 0.80 to 1.65]. Conclusions: All-cause and cardiovascular hospitalization rates did not differ between HICs and persons with medically controlled HIV. Non-AIDS defining infections were common in this young, healthy, predominantly male cohort of military

  17. Natural History of Multi-Drug Resistant Organisms in a New Military Medical Facility

    Science.gov (United States)

    2012-10-01

    Shigella flexneri  Pediatric Ward  06.248  COMPOSITE 1  Rhizobium  radiobacter  Medical Telemetry  07.334  Sink top  Staphyloccus saprophyticus  Medical...chair  Pseudomonas putida  Surgical Ward  06.342  Sink top  Aerococcous viridans  Surgical Ward  06.342  Call box  Rhizobium  radiobacter  Surgical Ward

  18. Factors Affecting Medical Services Utilization: A Behavioral Approach.

    Science.gov (United States)

    Kelly, Terence F.; Schieber, George J.

    This study describes behavioral response--both its theoretical specification and its estimation--which relates health service utilization and expenditures to a number of variables: demographic, psychological, economic, medical, and policy-related. By incorporating these behavioral relations into a recently developed microsimulation model, national…

  19. Acculturation, Behavioral Factors, and Family History of Breast Cancer among Mexican and Mexican-American Women.

    Science.gov (United States)

    Nodora, Jesse N; Cooper, Renee; Talavera, Gregory A; Gallo, Linda; Meza Montenegro, María Mercedes; Komenaka, Ian; Natarajan, Loki; Gutiérrez Millán, Luis Enrique; Daneri-Navarro, Adrian; Bondy, Melissa; Brewster, Abenaa; Thompson, Patricia; Martinez, María Elena

    2015-01-01

    Incidence rates for breast cancer are higher among Mexican-American (MA) women in the United States than women living in Mexico. Studies have shown higher prevalence of breast cancer risk factors in more acculturated than less acculturated Hispanic/Latinas in the United States. We compared the prevalence of behavioral risk factors and family history of breast cancer by level of acculturation and country of residence in women of Mexican descent. Data were collected from 1,201 newly diagnosed breast cancer patients living in Mexico (n = 581) and MAs in the United States (n = 620). MA participants were categorized into three acculturation groups (Spanish dominant, bilingual, and English dominant); women living in Mexico were used as the referent group. The prevalence of behavioral risk factors and family history of breast cancer were assessed according to acculturation level, adjusting for age at diagnosis and education. In the adjusted models, bilingual and English-dominant MAs were significantly more likely to have a body mass index of 30 kg/m(2) or greater, consume more than one alcoholic beverage a week, and report having a family history of breast cancer than women living in Mexico. All three U.S. acculturation groups were significantly more likely to have lower total energy expenditure (≤533 kcal/d) than women in Mexico. English-dominant women were significantly less likely to ever smoke cigarettes than the Mexican group. Our findings add to the limited scientific literature on the relationships among acculturation, health behavior, and family history of breast cancer in Mexican and MA women. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  20. Mental Development of Children with Non-epileptic Paroxysmal States in Medical History

    Directory of Open Access Journals (Sweden)

    Turovskaya N.G.,

    2015-10-01

    Full Text Available The author studied mental functions disorders in children with a history of paroxysmal states of various etiologies and compared mental development disorder patterns in patients with epileptic and non-epileptic paroxysms. Study sample were 107 children, aged 6 to 10 years. The study used experimental psychological and neuropsychological techniques. According to the empirical study results, non-epileptic paroxysms unlike epileptic much less combined with a number of mental functions disorders and intelligence in general. However, non-epileptic paroxysmal states as well as epileptic seizure associated with increasing activity exhaustion and abnormal function of the motor analyzer (dynamic and kinesthetic dyspraxia. Visual memory disorders and modal-nonspecific memory disorders have more pronounced importance in the mental ontogenesis structure in children with convulsive paroxysms compared to children with cerebral pathology without paroxysms history

  1. Selective Serotonin Reuptake Inhibitors: Medical History of Fatally Injured Aviation Accident Pilots

    Science.gov (United States)

    2007-07-01

    Civil Aviation Safety Authority; 2005 Sep. 13. Silberman WS. Medications in civil aviation: what is acceptable and what is not? Aviat Space Environ Med...2003; 74:85–6. 14. Silberman WS. SSRI policy reminder. Fed Air Surg Med Bull 2005; 43(2):9. 15. Sweetman SC, ed. Martindale: the complete drug

  2. Specialty choice preference of medical students according to personality traits by Five-Factor Model

    Directory of Open Access Journals (Sweden)

    Oh Young Kwon

    2016-03-01

    Full Text Available Purpose: The purpose of this study was to determine the relationship between personality traits, using the Five-Factor Model, and characteristics and motivational factors affecting specialty choice in Korean medical students. Methods: A questionnaire survey of Year 4 medical students (n=110 in July 2015 was administered. We evaluated the personality traits of Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness by using the Korean version of Big Five Inventory. Questions about general characteristics, medical specialties most preferred as a career, motivational factors in determining specialty choice were included. Data between five personality traits and general characteristics and motivational factors affecting specialty choice were analyzed using Student t-test, Mann-Whitney test and analysis of variance. Results: Of the 110 eligible medical students, 105 (95.4% response rate completed the questionnaire. More Agreeableness students preferred clinical medicine to basic medicine (p=0.010 and more Openness students preferred medical departments to others (p=0.031. Personal interest was the significant motivational factors in more Openness students (p=0.003 and Conscientiousness students (p=0.003. Conclusion: Medical students with more Agreeableness were more likely to prefer clinical medicine and those with more Openness preferred medical departments. Personal interest was a significant influential factor determining specialty choice in more Openness and Conscientiousness students. These findings may be helpful to medical educators or career counselors in the specialty choice process.

  3. Specialty choice preference of medical students according to personality traits by Five-Factor Model.

    Science.gov (United States)

    Kwon, Oh Young; Park, So Youn

    2016-03-01

    The purpose of this study was to determine the relationship between personality traits, using the Five-Factor Model, and characteristics and motivational factors affecting specialty choice in Korean medical students. A questionnaire survey of Year 4 medical students (n=110) in July 2015 was administered. We evaluated the personality traits of Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness by using the Korean version of Big Five Inventory. Questions about general characteristics, medical specialties most preferred as a career, motivational factors in determining specialty choice were included. Data between five personality traits and general characteristics and motivational factors affecting specialty choice were analyzed using Student t-test, Mann-Whitney test and analysis of variance. Of the 110 eligible medical students, 105 (95.4% response rate) completed the questionnaire. More Agreeableness students preferred clinical medicine to basic medicine (p=0.010) and more Openness students preferred medical departments to others (p=0.031). Personal interest was the significant motivational factors in more Openness students (p=0.003) and Conscientiousness students (p=0.003). Medical students with more Agreeableness were more likely to prefer clinical medicine and those with more Openness preferred medical departments. Personal interest was a significant influential factor determining specialty choice in more Openness and Conscientiousness students. These findings may be helpful to medical educators or career counselors in the specialty choice process.

  4. Prosthodontic treatment in a partially edentulous patient with a complex medical history of epilepsy and deep vein thrombosis: a case report.

    Science.gov (United States)

    Kosyfaki, Panagiota; Woerner, Wolf; Att, Wael

    2011-05-01

    This report describes the prosthodontic rehabilitation of a partially edentulous patient by means of a maxillary implant-supported removable dental prosthesis and mandibular telescopic crown prosthesis. Due to the patient's contributory medical history for epilepsy and deep vein thrombosis, clinical management considerations are outlined along with an evidence-based, medically oriented treatment sequence concerning the surgical and prosthodontic stages of the case.

  5. Protective factors in male adolescents with a history of sexual and/or violent offending: a comparison between three subgroups

    NARCIS (Netherlands)

    van der Put, C.E.; Asscher, J.J.

    2015-01-01

    This study aimed to examine the presence and impact of dynamic protective factors for delinquency in male adolescents with a history of sexual and/or violent offending. Bipolar factors (factors with risk and protective factors being the ends of the same continuum) were examined in male adolescents w

  6. Imitative and Direct Learning as Interacting Factors in Life History Evolution.

    Science.gov (United States)

    Bullinaria, John A

    2017-01-01

    The idea that lifetime learning can have a significant effect on life history evolution has recently been explored using a series of artificial life simulations. These involved populations of competing individuals evolving by natural selection to learn to perform well on simplified abstract tasks, with the learning consisting of identifying regularities in their environment. In reality, there is more to learning than that type of direct individual experience, because it often includes a substantial degree of social learning that involves various forms of imitation of what other individuals have learned before them. This article rectifies that omission by incorporating memes and imitative learning into revised versions of the previous approach. To do this reliably requires formulating and testing a general framework for meme-based simulations that will enable more complete investigations of learning as a factor in any life history evolution scenarios. It does that by simulating imitative information transfer in terms of memes being passed between individuals, and developing a process for merging that information with the (possibly inconsistent) information acquired by direct experience, leading to a consistent overall body of learning. The proposed framework is tested on a range of learning variations and a representative set of life history factors to confirm the robustness of the approach. The simulations presented illustrate the types of interactions and tradeoffs that can emerge, and indicate the kinds of species-specific models that could be developed with this approach in the future.

  7. Family history, comorbidity, smoking and other risk factors in microscopic colitis: a case-control study.

    Science.gov (United States)

    Wickbom, Anna; Nyhlin, Nils; Montgomery, Scott M; Bohr, Johan; Tysk, Curt

    2017-05-01

    Data on heredity, risk factors and comorbidity in microscopic colitis, encompassing collagenous colitis (CC) and lymphocytic colitis (LC), are limited. The aim was to carry out a case-control study of family history, childhood circumstances, educational level, marital status, smoking and comorbidity in microscopic colitis. A postal questionnaire was sent in 2008-2009 to microscopic colitis patients resident in Sweden and three population-based controls per patient, matched for age, sex and municipality. Some 212 patients and 627 controls participated in the study. There was an association with a family history of microscopic colitis in both CC [odds ratio (OR): 10.3; 95% confidence interval (CI): 2.1-50.4, P=0.004] and LC (OR not estimated, P=0.008). Current smoking was associated with CC [OR: 4.7; 95% CI: 2.4-9.2, Pmicroscopic colitis indicates that familial factors may be important. The association with a history of UC should be studied further as it may present new insights into the pathogenesis of microscopic colitis and UC.

  8. [Factors associated with self-directed learning among medical students].

    Science.gov (United States)

    Spormann R, Camila; Pérez V, Cristhian; Fasce H, Eduardo; Ortega B, Javiera; Bastías V, Nancy; Bustamante D, Carolina; Ibáñez G, Pilar

    2015-03-01

    Self-directed learning is a skill that must be taught and evaluated in future physicians. To analyze the association between self-directed learning, self-esteem, self-efficacy, time management and academic commitment among medical students. The self-directed learning, Rosemberg self-esteem, general self- efficacy, time management and Utrecht work engagement scales were applied to 297 first year medical students. A multiple regression analysis showed a significant association between self-efficacy, time management and academic commitment with self-directed learning. Self-esteem and satisfaction with studies did not enter in the model. self-esteem, academic commitment and a good time management were associated with self-directed learning in these students.

  9. What factors influence UK medical students’ choice of foundation school?

    OpenAIRE

    Miah S; Pang KH; Rebello W; Rubakumar Z; Fung V; Venugopal S.; Begum H

    2017-01-01

    Saiful Miah,1,2 Karl H Pang,3 Wayne Rebello,4 Zoe Rubakumar,4 Victoria Fung,5 Suresh Venugopal,6 Hena Begum4 1Division of Surgery and Interventional science, University College London, London, UK; 2Department of Urology, Charing Cross Hospital Imperial College Healthcare NHS Trust, London, UK; 3Academic Urology Unit, University of Sheffield, Sheffield, UK; 4Medical School, University of Sheffield, Sheffield, UK; 5Department of Plastic Surgery, Royal Hallamshire Hospital, Sheffield, UK; 6Depar...

  10. Association of American Veterinary Medical Colleges (AAVMC): 50 Years of History and Service.

    Science.gov (United States)

    Maccabe, Andrew T; Crawford, Lester; Heider, Lawrence E; Hooper, Billy; Mann, Curt J; Pappaioanou, Marguerite

    2015-01-01

    The mission of the Association of American Veterinary Medical Colleges (AAVMC) is to advance the quality of academic veterinary medicine. Founded in 1966 by the 18 US colleges of veterinary medicine and 3 Canadian colleges of veterinary medicine then in existence, the AAVMC is celebrating 50 years of public service. Initially, the AAVMC comprised the Council of Deans, the Council of Educators, and the Council of Chairs. In 1984, the tri-cameral structure was abandoned and a new governing structure with a board of directors was created. In 1997, the AAVMC was incorporated in Washington, DC and a common application service was created. Matters such as workforce issues and the cost of veterinary medical education have persisted for decades. The AAVMC is a champion of diversity in the veterinary profession and a strong advocate for One Health. The AAVMC has adopted a global perspective as more international colleges of veterinary medicine have earned COE accreditation and become members.

  11. History of neurosurgery in Sher-I-Kashmir Institute of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Abrar Ahad Wani

    2015-01-01

    Full Text Available Sher-i-Kashmir Institute of Medical Sciences (SKIMS is the only tertiary care institute in the state of Jammu and Kashmir. The department of neurosurgery was established nearly three decades ago and continues to be the leader in providing high quality neurosurgical services in the region. The article provides an insight into the genesis of the department and its sustained growth over these years. It also describes the plans for its future development.

  12. [Thesis for induction into the Venezuelan Society for the History of Medicine: Medical deontology in Venezuela].

    Science.gov (United States)

    Rago, V

    1992-12-01

    After a brief reference to his predecessor, the author presents a review on deontological principles put to use in the Venezuelan medicine, from the discovery to this century, after some considerations on the roles played by the state, the universities and the society. Finally, the importance of the moral compromise of the medical doctor as a professional who must have a faultless behaviour is highlighted.

  13. Rhazes, a Genius Physician in the Diagnosis and Treatment of Nocturnal Enuresis in Medical History

    OpenAIRE

    Changizi Ashtiyani, Saeed; Shamsi, Mohsen; Cyrus, Ali; Tabatabayei, Seyed Mohammad

    2013-01-01

    Context Nocturnal enuresis has undoubtedly occurred since man's earliest days and the first references are found in the Ebers papyri of 1550 BC. The purpose of this study is to review of Rhazes opinion about diagnosis and treatment of nocturnal enuresis and compare his belief and clinical methods with modern medical practice. Evidence Acquisition In the review study we searched all available and reliable electronic and paper sources using appropriate keywords about the views of Rhazes, and co...

  14. Rembrandt’s Jewish Physician—Dr Ephraim Bueno (1599–1665: A Brief Medical History

    Directory of Open Access Journals (Sweden)

    George M. Weisz

    2013-04-01

    Full Text Available Medicine in the Middle Ages was, and ever since remained, one of the main preoccupations of the professionally restricted Jews. One of the medical dynasties on the Iberian Peninsula was the Bueno (Bonus family. Following the expulsion of the Jews from Spain and their spread in Europe, these Iberian physicians became successful everywhere—just as the Buenos were in the Netherlands.

  15. From Roentgen to magnetic resonance imaging: the history of medical imaging.

    Science.gov (United States)

    Scatliff, James H; Morris, Peter J

    2014-01-01

    Medical imaging has advanced in remarkable ways since the discovery of x-rays 120 years ago. Today's radiologists can image the human body in intricate detail using computed tomography, magnetic resonance imaging, positron emission tomography, ultrasound, and various other modalities. Such technology allows for improved screening, diagnosis, and monitoring of disease, but it also comes with risks. Many imaging modalities expose patients to ionizing radiation, which potentially increases their risk of developing cancer in the future, and imaging may also be associated with possible allergic reactions or risks related to the use of intravenous contrast agents. In addition, the financial costs of imaging are taxing our health care system, and incidental findings can trigger anxiety and further testing. This issue of the NCMJ addresses the pros and cons of medical imaging and discusses in detail the following uses of medical imaging: screening for breast cancer with mammography, screening for osteoporosis and monitoring of bone mineral density with dual-energy x-ray absorptiometry, screening for congenital hip dysplasia in infants with ultrasound, and evaluation of various heart conditions with cardiac imaging. Together, these articles show the challenges that must be met as we seek to harness the power of today's imaging technologies, as well as the potential benefits that can be achieved when these hurdles are overcome.

  16. Air, rail and road: Medical Guidelines for Employees with a History of Cerebrovascular Disease.

    Science.gov (United States)

    Klein, Rebecca; Menon, Bijoy K; Rabi, Doreen; Stell, William; Hill, Michael D

    2016-10-01

    Background An acute medical condition following a previous stroke among those who operate trains, airplanes, and commercial vehicles can result in serious accidents. There are guidelines in place to assist physicians and employers in assessing the risks of returning to work after stroke but the extent and comprehensiveness across nations and among safety-critical occupations are not widely known. Methods Medical guidelines currently in place to regulate safety critical occupations including railway engineers, pilots and commercial vehicle drivers were systematically reviewed. Electronic and hand literature searches as well as review of grey literature for Canada, the USA, the UK, and Australia were conducted. Results There is no consistent set of guidelines that address the risk of a second catastrophic event after an initial cerebrovascular event in those employed in safety critical occupations in the four countries assessed. Some broad principles existed between the different countries and occupations but there was major variation in the approach to cerebrovascular disease and its impact on those working in safety-critical occupations. Conclusions A synthesis of current knowledge would assist in establishing risks of a catastrophic event in those who have already suffered from cerebrovascular illness. This will allow the creation of medical guidelines which could be applied to any safety critical occupation in any nation.

  17. Expansion through Separation. The Linguistic Conflicts at the University of Leuven in the 1960s from a Medical History Perspective

    Directory of Open Access Journals (Sweden)

    Joris Vandendriessche

    2017-03-01

    Full Text Available This article rereads a well-known chapter in Belgium’s political history – the linguistic struggles that led to the splitting of the University of Leuven in 1968 – as a chapter in medical history. We argue that the particular circumstances in the medical field, such as the struggle for patients’ rights and the ideological competition over the implementation of new academic hospitals, accelerated ongoing disputes over language. We show that the logic of tying academic expansion to linguistic separation, which later underpinned the splitting of the university as a whole, was put into practice first in the Leuven Faculty of Medicine. Our analysis reveals that the matter of linguistic separation was linked to different social, professional and ideological ambitions, and was sometimes regarded as an instrument of medical expansion, rather than as a goal in itself. Expansie door splitsing. Een medisch-historisch perspectief op de taalkwestie aan de Leuvense universiteit in de jaren 1960Dit artikel herbekijkt een bekend hoofdstuk uit de politieke geschiedenis van België – de taalkwestie en de splitsing van de Leuvense universiteit in 1968 – vanuit een medisch-historisch perspectief. Het stelt dat specifieke omstandigheden in het medische veld, zoals de strijd voor de rechten van de patiënt en de ideologische strijd rond de inplanting van nieuwe academische ziekenhuizen, als een katalysator hebben gewerkt voor taalspanningen. De logica om academische expansie en taalkundige splitsing met elkaar te verbinden, die later werd toegepast op de hele universiteit, werd in eerste instantie ontwikkeld aan de Faculteit Geneeskunde. Onze analyse maakt duidelijk dat de taalkwestie verweven was met diverse sociale, professionele en ideologische ambities, en in sommige gevallen werd beschouwd als een instrument voor medische expansie, veeleer dan als een doel op zich.

  18. The Frequency of Medication-related Osteonecrosis of the Jaw and its Associated Risk Factors.

    Science.gov (United States)

    Dodson, Thomas B

    2015-11-01

    This article provides the best current frequency estimate of medication-related osteonecrosis of the jaws (MRONJ), and identifies factors associated with the risk of developing osteonecrosis of the jaw (ONJ) among patients exposed to relevant medications (ie, antiresorptive or antiangiogenic agents). MRONJ is a rare but serious complication of cancer treatment or osteoporosis management. This review confirms that antiresorptive medications such as oral or intravenous bisphosphonates and denosumab are the most common risk factors for developing ONJ. The risk of MRONJ is greater in patients with cancer than in those receiving antiresorptive treatments for osteoporosis by a factor of 10.

  19. IMASIS computer-based medical record project: dealing with the human factor.

    Science.gov (United States)

    Martín-Baranera, M; Planas, I; Palau, J; Sanz, F

    1995-01-01

    level, problems to be solved in utilization of the system, errors detected in the systems' database, and the personal interest in participating in the IMASIS project. The questionnaire was also intended to be a tool to monitor IMASIS evolution. Our study showed that medical staff had a lack of information about the current HIS, leading to a poor utilization of some system options. Another major characteristic, related to the above, was the feeling that the project would negatively affect the organization of work at the hospitals. A computer-based medical record was feared to degrade physician-patient relationship, introduce supplementary administrative burden in clinicians day-to-day work, unnecessarily slow history taking, and imply too-rigid patterns of work. The most frequent problems in using the current system could be classified into two groups: problems related to lack of agility and consistency in user interface design, and those derived from lack of a common patient identification number. Duplication of medical records was the most frequent error detected by physicians. Analysis of physicians' attitudes towards IMASIS revealed a lack of confidence globally. This was probably the consequence of two current features: a lack of complete information about IMASIS possibilities and problems faced when using the system. To deal with such factors, three types of measures have been planned. First, an effort is to be done to ensure that every physician is able to adequately use the current system and understands long-term benefits of the project. This task will be better accomplished by personal interaction between clinicians and a physician from the Informatics Department than through formal teaching of IMASIS. Secondly, a protocol for evaluating the HIS is being developed and will be systematically applied to detect both database errors and systemUs design pitfalls. Finally, the IMASIS project has to find a convenient point for starting, to offer short-term re

  20. Positive and Negative Factors of Economic Development in Economic History of South Korea

    Directory of Open Access Journals (Sweden)

    Park Jong Min

    2017-01-01

    Full Text Available Purpose: the aim of the article is to analyze the Korean economic strategy from the beginning of its development until modern stage. Examination of how this strategy has changed depending on changes within domestic and international economic environment, assumptions, set goals, their effectiveness and significance of all the taken measures. It will demonstrate waypoints for the future economic development and will become a trigger towards recognition of the successful development of the Korean economy by other countries. Methods: the methodological bases of this article are the economic and statistical methods of analysis of the Korean economys, graphical methods displaying economic indicators. Results: economic history of South Korea over the past century shows the positive and negative factors of the development from an economically weak country into a developing country. The history of the Japanese occupation of Korea, lasting from 1910 to 1945, showed that for a country which has lost its national sovereignty, expropriated the state's economy has no effect after the restoration of independence, and that the economy cannot develop in conditions of chaos within the political, economic and social spheres. Even after the establishment of a military dictatorship, it is possible to note that despite limitations of citizens’ rights, the economy can still grow if the people want it. In addition to the development of internal political system, unstable factors in the process of promotion of social reforms and hastily adopted policy of "open doors" in order to enhance the international status are unreasonable political, economic and social changes. In turn, the inability to control currency exchange in Asian countries, which is a policy of economic development, has shown the existence of a risk of national bankruptcy. Moreover, the adoption of policies of excessive decrease of interest rates in order to revive the recession may be counterproductive

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

    DEFF Research Database (Denmark)

    O’Neill, Lotte Dyhrberg

    2010-01-01

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

  2. Risk factors for delays between intake and veterinary approval for adoption on medical grounds in shelter puppies and kittens.

    Science.gov (United States)

    Litster, Annette; Allen, Joselyn; Mohamed, Ahmed; He, Shuang

    2011-08-01

    To maximize their capacity to save lives and optimize resource allocation, animal shelters need to identify highly adoptable animals that are unlikely to be delayed on medical grounds before they can be made available for adoption. In this retrospective cohort study, our objective was to identify risk factors for delays from intake to approval for adoption on medical grounds in shelter puppies and kittens. Shelter medical records from 2008 for 335 puppies and 370 kittens were selected randomly at a large metropolitan adoption-guarantee shelter. Data including signalment, source shelter, intake veterinary examination findings, clinical history and days from intake until approval by a veterinarian for adoption on medical grounds were extracted from shelter records and analyzed using multivariate Cox regression. Puppies and kittens with clinical signs of respiratory or gastrointestinal disease at intake took significantly longer to receive approval for adoption on medical grounds (puppies - respiratory pkittens - respiratory pkittens were more likely to be delayed than owner-relinquished kittens or those transferred from other shelters (pkittens were less likely to be delayed (pkittens with respiratory and/or ocular signs within 24h of intake significantly reduced time to approval on medical grounds for adoption (puppies p=0.02; kittens p=0.03). The analyses suggested that puppies and kittens with respiratory or gastrointestinal signs on intake are more likely to experience delays between intake and veterinary approval for adoption on medical grounds. Prompt antimicrobial treatment of animals with respiratory and/or ocular signs may decrease length of stay in the shelter.

  3. No Evidence for Disease History as a Risk Factor for Narcolepsy after A(H1N1pdm09 Vaccination.

    Directory of Open Access Journals (Sweden)

    Favelle Lamb

    Full Text Available To investigate disease history before A(H1N1pdm09 vaccination as a risk factor for narcolepsy.Case-control study in Sweden. Cases included persons referred for a Multiple Sleep Latency Test between 2009 and 2010, identified through diagnostic sleep centres and confirmed through independent review of medical charts. Controls, selected from the total population register, were matched to cases on age, gender, MSLT-referral date and county of residence. Disease history (prescriptions and diagnoses and vaccination history was collected through telephone interviews and population-based healthcare registers. Conditional logistic regression was used to investigate disease history before A(H1N1pdm09 vaccination as a risk-factor for narcolepsy.In total, 72 narcolepsy cases and 251 controls were included (range 3-69 years mean19-years. Risk of narcolepsy was increased in individuals with a disease history of nervous system disorders (OR range = 3.6-8.8 and mental and behavioural disorders (OR = 3.8, 95% CI 1.6-8.8 before referral. In a second analysis of vaccinated individuals only, nearly all initial associations were no longer statistically significant and effect sizes were smaller (OR range = 1.3-2.6. A significant effect for antibiotics (OR = 0.4, 95% CI 0.2-0.8 and a marginally significant effect for nervous system disorders was observed. In a third case-only analysis, comparing cases referred before vaccination to those referred after; prescriptions for nervous system disorders (OR = 26.0 95% CI 4.0-170.2 and ADHD (OR = 35.3 95% CI 3.4-369.9 were statistically significant during the vaccination period, suggesting initial associations were due to confounding by indication.The findings of this study do not support disease history before A(H1N1pdm09 vaccination as a risk factor for narcolepsy.

  4. No Evidence for Disease History as a Risk Factor for Narcolepsy after A(H1N1)pdm09 Vaccination.

    Science.gov (United States)

    Lamb, Favelle; Ploner, Alexander; Fink, Katharina; Maeurer, Markus; Bergman, Peter; Piehl, Fredrik; Weibel, Daniel; Sparén, Pär; Dahlström, Lisen Arnheim

    2016-01-01

    To investigate disease history before A(H1N1)pdm09 vaccination as a risk factor for narcolepsy. Case-control study in Sweden. Cases included persons referred for a Multiple Sleep Latency Test between 2009 and 2010, identified through diagnostic sleep centres and confirmed through independent review of medical charts. Controls, selected from the total population register, were matched to cases on age, gender, MSLT-referral date and county of residence. Disease history (prescriptions and diagnoses) and vaccination history was collected through telephone interviews and population-based healthcare registers. Conditional logistic regression was used to investigate disease history before A(H1N1)pdm09 vaccination as a risk-factor for narcolepsy. In total, 72 narcolepsy cases and 251 controls were included (range 3-69 years mean19-years). Risk of narcolepsy was increased in individuals with a disease history of nervous system disorders (OR range = 3.6-8.8) and mental and behavioural disorders (OR = 3.8, 95% CI 1.6-8.8) before referral. In a second analysis of vaccinated individuals only, nearly all initial associations were no longer statistically significant and effect sizes were smaller (OR range = 1.3-2.6). A significant effect for antibiotics (OR = 0.4, 95% CI 0.2-0.8) and a marginally significant effect for nervous system disorders was observed. In a third case-only analysis, comparing cases referred before vaccination to those referred after; prescriptions for nervous system disorders (OR = 26.0 95% CI 4.0-170.2) and ADHD (OR = 35.3 95% CI 3.4-369.9) were statistically significant during the vaccination period, suggesting initial associations were due to confounding by indication. The findings of this study do not support disease history before A(H1N1)pdm09 vaccination as a risk factor for narcolepsy.

  5. Factors in medical student beliefs about electronic health record use.

    Science.gov (United States)

    Harle, Christopher A; Gruber, Laura A; Dewar, Marvin A

    2014-01-01

    Healthcare providers' ongoing investment in electronic health records (EHRs) necessitates an understanding of physicians' expectations about using EHRs. Such understanding may aid educators and administrators when utilizing scarce resources during EHR training and implementation activities. This study aimed to link individual medical student characteristics to their perceptions of EHRs' ease of use and usefulness. This study employed a cross-sectional survey of 126 third-year medical students at a large southeastern university. Using a questionnaire designed for this study and containing previously validated items, the study team measured and related students' expectations about EHR ease of use and usefulness to their computer self-efficacy, openness to change, personality traits, and demographic characteristics. On a seven-point scale, men reported, on average, ease-of-use scores that were 0.71 higher than women's (p < .001). Also, increased computer self-efficacy related to higher expectations of EHR ease of use (p < .01) and usefulness (p < .05). Openness-to-change scores were also associated with higher expectations of EHR ease of use (p < .01) and usefulness (p < .001). Finally, a more conscientious personality was positively associated with EHR ease of use (p < .01). Our findings suggest that medical educators and administrators may consider targeting EHR management strategies on the basis of individual differences. Enhanced training and support interventions may be helpful to women or to clinicians with lower computer self-efficacy, lower openness to change, or less conscientious personalities. Also, current and future physicians who rate higher in terms of self-efficacy, openness to change, or conscientiousness may be useful as champions of EHR use among their peers.

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

    OpenAIRE

    Zeleke, Abebe; Chanie, Tesfahun; Woldie, Mirkuzie

    2014-01-01

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

  7. Factors influencing choice of paediatrics as a career among medical ...

    African Journals Online (AJOL)

    female students (30%) considered gender distribution to be a factor influencing their career choice (p=0.046). ... role models in the specialty, job opportunities and financial .... of non-responder bias, although the relatively high response.

  8. History of computer-assisted data processing in the medical laboratory.

    Science.gov (United States)

    Porth, A J; Lübke, B

    1996-03-01

    Computer-assisted processing of medical laboratory data started in the sixties. The earliest systems, which arose in English- and German-speaking laboratories, pointed the way for the development of laboratory data processing. The significance and evolution of the fundamental components of a laboratory information system, such as the placing of the request to the laboratory, identification of patients and samples, recording of data, quality control, plausibility control and results, are presented. The subject is given a wider perspective by the inclusion of a comprehensive (chronological) literature index.

  9. A brief history of the evolution of the medical research article

    Science.gov (United States)

    MARTA, MONICA MIHAELA

    2015-01-01

    Given the current importance of publishing medical research articles in high-impact international journals, this article briefly presents key moments in the evolution of this reporting genre for a better understanding of the diachronic changes that have shaped it into a highly useful tool for creating and spreading knowledge, as well as for establishing academic hierarchies at both individual and institutional level. Therefore, focus will be placed not only on the evolution of its structure and purpose, but also on issues such as knowledge construction, knowledge claims, writer-reader interaction and the appropriate writing conventions and rhetorical strategies required for successful scientific communication. PMID:26733758

  10. Deafness and liver disease in a 57-year-old man: a medical history of Beethoven.

    Science.gov (United States)

    Hui, A C; Wong, S M

    2000-12-01

    Ludwig van Beethoven had a number of medical conditions, including deafness and chronic liver disease, for which there are contemporary descriptions. An autopsy was performed on the day after his death. Physicians and historians have tried to reinterpret original sources to determine the causes of his deafness and systemic illnesses. We have reviewed the differential diagnoses that have been proposed by otologists and physicians. Clinical and post-mortem findings point to renal papillary necrosis and liver cirrhosis of unknown aetiology. In the absence of further histological examination, there is no definitive answer to the cause of his deafness and gastro-intestinal symptoms.

  11. Spatial differences of mortality: social and medical factors

    Directory of Open Access Journals (Sweden)

    Farida LAOUDJ CHEKRAOUI

    2014-09-01

    Full Text Available The spatial differences of mortality are partially explained by an irregular dividing up of social groups between territories and by an unequal granting of medical resources between various territories. In metropolitan France, since the beginning of 1980s, the almost regular increase of the life expectancy at birth in all areas is accompanied by maintaining the regional disparities of mortality. The irregular dividing up of the social groups between regions, combined with regional specificities as far as behaviours, environment and structures of economic activities are concerned, explains a part of these regional differences. The underprivileged people are the most affected by the regional differences of mortality. In Nord-Pas-de-Calais, labours die earlier on average compared with those who live in Ile-de-France. We can see easily that what applies to France applies all the more so to Algeria, a country less advanced at socioeconomic level. In this country, the unequal granting of health structures between territories and their variable efficiency makes worse the spatial differences of both health and mortality. Reduction, not to say disappearance of these differences is obtained by an improvement of working conditions and better granting of medical capacities.

  12. Applying to plastic surgery residency: factors associated with medical student career choice.

    Science.gov (United States)

    Greene, Arin K; May, James W

    2008-03-01

    Applications to plastic surgery residency increased 34 percent from 2002 to 2005, despite decreasing applications to other surgical subspecialties. During this period, medical education, reimbursement, work hours, and media coverage have changed. To determine factors responsible for rising applications to plastic surgery residencies, medical student applicants to plastic surgery residencies for 2005 were surveyed. Applicants recorded exposure to plastic surgery during medical school and graded the influence of personality, lifestyle, income potential, and media coverage on their decision to choose plastic surgery training. To further study the effects of plastic surgery exposure on career choice, the percentage of graduating students applying to plastic surgery residency was compared between medical schools with and without plastic surgery training programs. Medical schools that provided greater exposure to plastic surgery and schools with plastic surgery training programs had a higher percentage of graduates applying to plastic surgery residency (p personality of plastic surgeons as a significant factor in their career choice. Lifestyle and income potential were moderately important, whereas media coverage minimally affected career decision. Applicants typically decided on a plastic surgical career during the third year of medical school. Medical student exposure to plastic surgery is the most influential factor in a student's decision to pursue a career in plastic surgery. To continue the increasing applicant trend toward plastic surgery, plastic surgeon engagement of medical students should be emphasized, ideally before the third year of medical school.

  13. A study of the factors influencing school-going students considering medical careers.

    LENUS (Irish Health Repository)

    McHugh, S M

    2011-08-01

    Obtaining a place in an Irish medical school is extremely competitive, a situation mirrored in many other countries. We aimed to determine the factors influencing school students in deciding to study medicine in university. We further determined what level of interest exists in pursuing a surgical career after completion of medical school.

  14. Factors influencing alcohol and illicit drug use amongst first year medical students

    NARCIS (Netherlands)

    Popescu, Codruta Alina; Bob, Mihai Horatiu; Junjan, Veronica; Armean, Sebastian Mihai; Buzoianu, Anca Dana

    2014-01-01

    The aims of this study were a) to investigate patterns of alcohol, smoking and illicit drug use and b) evaluate the relationship between substance abuse and personality factors in a cohort of 267 first year medical students. 12.3 % (men) and 11.8% (female) medical students reported to be drinking

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

    Directory of Open Access Journals (Sweden)

    Kalaiselvi Selvaraj

    2014-01-01

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

  16. [The centralization of medical studies in universities under Napoleon I. History and consequences].

    Science.gov (United States)

    Vichard, Philippe

    2005-01-01

    The so called "Loi du 19 ventose au XI" is two centuries old. It is a very important text of the French universitary story. It stands out the end of the Revolution in the medical studies. It enjoyed the most part of the contemporary people. But other arrangements of the law are more debatable. Thus, medical and surgical unity was already acquired before French Revolution. Furthermore, the absence of surgical practical training was a serious gap. At last, universitary Centralisation, which contrasts, with previous Decentralisation and the historical evolution of many countries, is an option with later pejorative consequences. Il was necessary to remind the events which consolidated centralisation (creation of School of medicine without autonomy in 1820, 1958 ordonnances, 1968 Revolution and after 1981, "internat national", "internat qualifiant", Lastly, the creation of C-NRS and INSERM took the leadership of research from University. Of course, other events hindered centralisation (Epic of "Internat des hôpitaux", 1871-1878 crisis, and 1910 campaign against agregation). But today, the faculties of Medicine have no real autonomy. The consequences are the standardization of the studies, the absence of competition and a poor overall result. The components of this result are not peculiar to centralisation. But this one prevents any reform. Is this logical reform really whished by the French people?

  17. History of preeclampsia is more predictive of cardiometabolic and cardiovascular risk factors than obesity.

    Science.gov (United States)

    Heidema, Wieteke M; Scholten, Ralph R; Lotgering, Fred K; Spaanderman, Marc E A

    2015-11-01

    To determine to what extent a history of preeclampsia affects traditional cardiometabolic (insulin resistance and dyslipidemia) and cardiovascular (hypertension and micro-albuminuria) risk factors of the metabolic syndrome irrespective of BMI. In a retrospective case-control study we compared 90 formerly preeclamptic women, divided in 3 BMI-classes (BMI 19.5-24.9, 25.0-29.9, ≥30.0kg/m(2)) to 30 controls, matched for BMI, age and parity. Cardiometabolic and cardiovascular risk factors (WHO-criteria) were tested 6-18 months post partum. Statistical analysis included unpaired t-tests, Mann-Whitney U test, or Chi square test and two-way ANOVA. Constituents of the metabolic syndrome (glucose, insulin, HOMAIR, HDL-cholesterol, triglycerides, blood pressure, micro-albuminuria) were higher in formerly preeclamptic women than in BMI-matched controls. Resultantly, traditional risk factors were more prevalent in formerly preeclamptic women than in controls (insulin resistance 80% vs 30%, dyslipidemia 52% vs 3%, hypertension 24% vs 0%, micro-albuminuria 30% vs 0%). Cardiometabolic risk factors increased with BMI, to the same extent in both groups. Formerly preeclamptic women had metabolic syndrome more often than their BMI-matched controls (38% vs 3%, prisk factors of the metabolic syndrome are more prevalent in formerly preeclamptic women than in BMI-matched controls and increase with BMI to the same extent in both groups. A history of preeclampsia seems to be a stronger indicator of cardiovascular risk than obesity per se. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Disparities in bone density measurement history and osteoporosis medication utilisation in Swiss women: results from the Swiss Health Survey 2007

    Directory of Open Access Journals (Sweden)

    Born Rita

    2013-01-01

    Full Text Available Abstract Background Although factors associated with the utilisation of bone density measurement (BDM and osteoporosis treatment have been regularly assessed in the US and Canada, they have not been effectively analysed in European countries. This study assessed factors associated with the utilisation of BDM and osteoporosis medication (OM in Switzerland. Methods The Swiss Health Survey 2007 data included self-reported information on BDM and OM for women aged 40 years and older who were living in private households. Multivariable logistic regression analysis was used to identify sociodemographic, socioeconomic, healthcare-related and osteoporosis risk factors associated with BDM and OM utilisation. Results The lifetime prevalence of BDM was 25.6% (95% CI: 24.3-26.9% for women aged 40 years and older. BDM utilisation was associated with most sociodemographic factors, all the socioeconomic and healthcare-related factors, and with major osteoporosis risk factors analysed. The prevalence of current OM was 7.8% (95% CI: 7.0-8.6% and it was associated with some sociodemographic and most healthcare-related factors but only with one socioeconomic factor. Conclusions In Swiss women, ever having had a BDM and current OM were low and utilisation disparities exist according to sociodemographic, socioeconomic and healthcare-related factors. This might foster further health inequalities. The reasons for these findings should be addressed in further studies of the elderly women, including those living in institutions.

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

    Directory of Open Access Journals (Sweden)

    Anurag Srivastava

    2013-06-01

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

  20. Searching for the Final Answer: Factors Contributing to Medication Administration Errors.

    Science.gov (United States)

    Pape, Tess M.

    2001-01-01

    Causal factors contributing to errors in medication administration should be thoroughly investigated, focusing on systems rather than individual nurses. Unless systemic causes are addressed, many errors will go unreported for fear of reprisal. (Contains 42 references.) (SK)

  1. Medical and Psychological Risk Factors for Incident Hypertension in Type 1 Diabetic African-Americans

    Directory of Open Access Journals (Sweden)

    Monique S. Roy

    2011-01-01

    Conclusions. The development of hypertension in African-Americans living with type 1 diabetes appears to be multifactorial and includes both medical (overt proteinuria as well as psychological (high hostility risk factors.

  2. Risk factors identified for certain lymphoma subtypes

    Science.gov (United States)

    In a large international collaborative analysis of risk factors for non-Hodgkin lymphoma (NHL), scientists were able to quantify risk associated with medical history, lifestyle factors, family history of blood or lymph-borne cancers, and occupation for 11

  3. A multicentre, double-blind, randomised, controlled, parallel-group study of the effectiveness of a pharmacist-acquired medication history in an emergency department

    Science.gov (United States)

    2013-01-01

    Background Admission to an emergency department (ED) is a key vulnerable moment when patients are at increased risk of medication discrepancies and medication histories are an effective way of ensuring that fewer errors are made. This study measured whether a pharmacist-acquired medication history in an ED focusing on a patient’s current home medication regimen, and available to be used by a doctor when consulting in the ED, would reduce the number of patients having at least 1 medication discrepancy related to home medication. Methods This multicentre, double-blind, randomised, controlled parallel-group study was conducted at 3 large teaching hospitals. Two hundred and seventy participants were randomly allocated to an intervention (n = 134) or a standard care (n = 136) arm. All consecutive patients >18 years old admitted through the ED were eligible. The intervention consisted of pharmacists conducting a standardised comprehensive medication history interview focusing on a patient’s current home medication regimen, prior to being seen by a doctor. Data recorded on the admission medication order form was available to be used by a doctor during consultation in the ED. The admission medication order form was given to doctors at a later stage in the control arm for them to amend prescriptions. The effect of the intervention was assessed primarily by comparing the number of patients having at least 1 admission medication discrepancy regarding medication being taken at home. Secondary outcomes concerned the characteristics and clinical severity of such medication discrepancies. Results The intervention reduced discrepancies occurring by 33% (p medication occurred most frequently (55.1%) and most discrepancies (42.7%) were judged to have the potential to cause moderate discomfort or clinical deterioration. Conclusions A pharmacist-acquired medication history in an ED focusing on a patient’s current home medication regimen available to be used by a doctor

  4. Key success factors behind electronic medical record adoption in Thailand.

    Science.gov (United States)

    Narattharaksa, Kanida; Speece, Mark; Newton, Charles; Bulyalert, Damrongsak

    2016-09-19

    Purpose The purpose of this paper is to investigate the elements that health care personnel in Thailand believe are necessary for successful adoption of electronic medical record (EMR) systems. Design/methodology/approach Initial qualitative in-depth interviews with physicians to adapt key elements from the literature to the Thai context. The 12 elements identified included things related to managing the implementation and to IT expertise. The nationwide survey was supported by the Ministry of Public Health and returned 1,069 usable questionnaires (response rate 42 percent) from a range of medical personnel. Findings The key elements clearly separated into a managerial dimension and an IT dimension. All were considered fairly important, but managerial expertise was more critical. In particular, there should be clear EMR project goals and scope, adequate budget allocation, clinical staff must be involved in implementation, and the IT should facilitate good electronic communication. Research limitations/implications Thailand is representative of middle-income developing countries, but there is no guarantee findings can be generalized. National policies differ, as do economic structures of health care industries. The focus is on management at the organizational level, but future research must also examine macro-level issues, as well as gain more depth into thinking of individual health care personnel. Practical implications Technical issues of EMR implementation are certainly important. However, it is clear actual adoption and use of the system also depends very heavily on managerial issues. Originality/value Most research on EMR implementation has been in developed countries, and has often focussed more on technical issues rather than examining managerial issues closely. Health IT is also critical in developing economies, and management of health IT implementation must be well understood.

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  6. Predictive factors of Osaka Medical College (OMC) brace treatment in patients with adolescent idiopathic scoliosis.

    Science.gov (United States)

    Kuroki, Hiroshi; Inomata, Naoki; Hamanaka, Hideaki; Higa, Kiyoshi; Chosa, Etsuo; Tajima, Naoya

    2015-01-01

    Factors influencing clinical course of brace treatment apply to adolescent idiopathic scoliosis (AIS) patients remain unclear. By making clear them, we may select suitable patients for brace treatment and alleviate overtreatment. The purpose of this study was to explore predictive factors of Osaka Medical College (OMC) brace treatment for AIS patients in accordance with the modified standardized criteria proposed by the Scoliosis Research Society (SRS) committee on bracing and non-operative management. From 1999 through 2010, 31 consecutive patients with AIS who were newly prescribed the OMC brace and met the modified SRS criteria were studied. The study included 2 boys and 29 girls with a mean age of 12 years and 0 month. We investigated the clinical course and evaluated the impacts of compliance, initial brace correction rate, curve flexibility, curve pattern, Cobb angle, chronological age, and Risser stage to clinical outcomes. The clinical course of the brace treatment was considered progression if ≥6° curvature increase occurred and improvement if ≥6° curvature decrease occurred according to SRS judgment criteria. The curve progressed in 10 cases, the curve improved in 6 cases, and the curve remained unchanged in 15 cases (success rate: 67.7%). The success rate was statistically higher in the patient group whose instruction adherence rate was greater than 50% as compared with in those 50% or less. Initial brace correction rate, curve flexibility, curve pattern, the magnitude of Cobb angle, chronological age, and Risser stage did not have any significant effect for clinical courses. However, success rate was insignificantly higher in the cases whose Cobb angle in brace was smaller than that in hanging position. OMC brace treatment could alter the natural history of AIS, however, that was significantly affected by compliance of brace wear.

  7. Study on the prevalence and underlying factors of myopia among the students of a medical college in Kerala

    Directory of Open Access Journals (Sweden)

    Shiny George, Biju Baby Joseph

    2014-04-01

    Full Text Available Background: Few decades earlier, wearing spectacles was a province of adults over 40 years of age. Now we see more children and adolescents with spectacles/contact lenses. Various studies in Asian population show a dramatic increase in refractive error, especially myopia among school and college students. More advanced levels of education like medical education that involves extensive near work such as reading and writing have been repeatedly associated with greater myopia prevalence Objective: To study the prevalence and the underlying factors of myopia in MBBS students of a Medical college in Kerala. Research methodology: One hundred and sixty two MBBS students (2009 – 2012 batches were examined. 40 students were selected from each class by systematic random sampling technique, their visual acuity was checked using Snellen’s Chart and Diopters were obtained. Details of factors were obtained using a questionnaire. Results: Prevalence of myopia was observed as 39.5%. First and second year students had a greater percentage of myopia with 40% & 52.5% respectively. 40.6% of myopics had positive family history of myopia (p = 0.003. Duration of TV watching and computer use showed a significant relation with myopia. (p = 0. 033, 0.009. Reading hours, type of light used, playing or texting with cell phone and sleeping habits of students were not significant. Conclusion: Prevalence of myopia was high among medical students (39.5%. Significance of genetic predisposition was well appreciated in our study.

  8. Identifying factors that influence workplace learning in postgraduate medical education.

    NARCIS (Netherlands)

    Stok-Koch, E.G.H.J.; Bolhuis, S.M.; Koopmans, R.T.C.M.

    2007-01-01

    CONTEXT: In their postgraduate educational programs, residents are immersed in a complex workplace. To improve the quality of the training program, it is necessary to gain insight into the factors that influence the process of learning in the workplace. METHODS: An exploratory study was carried out

  9. Identifying factors that influence workplace learning in postgraduate medical educaton

    NARCIS (Netherlands)

    L. Stok-Koch; R. Koopmans; Dr. S. Bolhuis

    2007-01-01

    In their postgraduate educational programs, residents are immersed in a complex workplace. To improve the quality of the training program, it is necessary to gain insight into the factors that influence the process of learning in the workplace. An exploratory study was carried out among 56 nursing

  10. Identifying factors that influence workplace learning in postgraduate medical education.

    NARCIS (Netherlands)

    Stok-Koch, E.G.H.J.; Bolhuis, S.M.; Koopmans, R.T.C.M.

    2007-01-01

    CONTEXT: In their postgraduate educational programs, residents are immersed in a complex workplace. To improve the quality of the training program, it is necessary to gain insight into the factors that influence the process of learning in the workplace. METHODS: An exploratory study was carried out

  11. Identifying factors that influence workplace learning in postgraduate medical educaton

    NARCIS (Netherlands)

    Stok-Koch, L.; Bolhuis, S.; Koopmans, R.

    2007-01-01

    In their postgraduate educational programs, residents are immersed in a complex workplace. To improve the quality of the training program, it is necessary to gain insight into the factors that influence the process of learning in the workplace. An exploratory study was carried out among 56 nursing h

  12. Patient-directed intelligent and interactive computer medical history-gathering systems: a utility and feasibility study in the emergency department.

    Science.gov (United States)

    Benaroia, Mark; Elinson, Roman; Zarnke, Kelly

    2007-04-01

    Patients can be used as a resource to enter their own pertinent medical information. This study will evaluate the feasibility of an intelligent computer medical history-taking device directed at patients in the emergency department (ED). Two of the authors (MB, RE) developed an expert system that can take patient-directed medical histories. Patients interacted with the computer in the ED waiting room while it gathered a medical history based on chief complaint (CC). A survey was completed post history. A sub-study assessed the computer's ability to take an adequate history for an index CC. We compared the computer and emergency physician histories for the presence or absence of important historical elements. Sixty-seven patients used the interactive computer system. The mean time to complete the history was 5 min and 32s +/- 1 min and 21s. The patient response rate was 97%. Over 83% felt that the computer was very easy to use and over 92% would very much use the computer again. A total of 15 patients with abdominal pain (index CC) were evaluated for the sub-study. The computer history asked 90+/-7%, and the emergency physician asked 55+/-18%, of the important historical elements. These groups were statistically different with a p-value of computer history-taking device is well accepted by patients and that such a system can be integrated into the normal process of patient triage without delaying patient care. Such a system can serve as an initial mode for documentation and data acquisition directly from the patient.

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

    Science.gov (United States)

    Shin, Young-Jeon

    2007-06-01

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

  14. A History of Korean Medical Association’s Emblem : the Caduceus of Asklepios and Hermes

    Directory of Open Access Journals (Sweden)

    SHIN Young-Jeon

    2007-06-01

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

  15. [The history of antitobacco actions in the last 500 years. Part. II. Medical actions].

    Science.gov (United States)

    Grzybowski, Andrzej

    2006-01-01

    Tobacco was brought to Europe by Christopher Columbus, who discovered it in Cuba in October, 1492. Spread of tobacco consumption was initiated by the French diplomat Jean Nicot de Villemain, who in 1560 recommended it in the form of powdered tobacco leaves to the French Queen Catherine de Medice to combat her migraine headaches, and introduced the term Nicotiana tobaccum. Tobacco consumption greatly rose after the I World War, and after the II World War it became very common, especially among man. In the first half of the 20th century the sale of tobacco products rose by 61%, and cigarettes dominated the market of tobacco products. At the beginning of the 20th century cigarettes constituted only 2% of the total sale of tobacco products, while in the middle of the 20th century--more than 80%. Although the first epidemiological papers indicating that "smoking is connected with the shortening of life span" were published in the first half of the 20th century, not until 1950 did Hill and Doll in Great Britain, and Wynder and Graham in USA in 1951 show a statistically significant correlation between cigarettes smoking and lung cancer occurrence. Many controversies according the use of tobacco accompanied it from the beginning of its presence in Europe. The conflicting opinions according to its influence to health coexisted in the 16th to 19th centuries. In this period, especially in the 19th century dominated moral and religious arguments against tobacco. In the 20th century however, and particularly in its second part, development in medical research was enhanced by civil voluntary actions against advertisement and passive smoking. This lead to the significant limitation of tobacco expansion in Europe, USA and Canada in the end of the 20th century.

  16. [The history of antitobacco actions in the last 500 years. part. 1. Non-medical actions].

    Science.gov (United States)

    Grzybowski, Andrzej

    2006-01-01

    Tobacco was brought to Europe by Christopher Columbus, who discovered it in Cuba in October, 1492. Spread of tobacco consumption was initiated by the French diplomat Jean Nicot de Villemain, who in 1560 recommended it in the form of powdered tobacco leaves to the French Queen Catherine de Medice to combat her migraine headaches, and introduced the term Nicotiana tobaccum. Tobacco consumption greatly rose after the I World War, and after the II World War it became very common, especially among man. In the first half of the 20th century the sale of tobacco products rose by 61%, and cigarettes dominated the market of tobacco products. At the beginning of the 20th century cigarettes constituted only 2% of the total sale of tobacco products, while in the middle of the 20th century--more than 80%. Although the first epidemiological papers indicating that "smoking is connected with the shortening of life span" were published in the first half of the 20th century, not until 1950 did Hill and Doll in Great Britain, and Wynder and Graham in USA in 1951 show a statistically significant correlation between cigarettes smoking and lung cancer occurrence. Many controversies according the use of tobacco accompanied it from the beginning of its presence in Europe. The conflicting opinions according to its influence to health coexisted in the 16th to 19th centuries. In this period, especially in the 19th century dominated moral and religious arguments against tobacco. In the 20th century however, and particularly in its second part, development in medical research was enhanced by civil voluntary actions against advertisement and passive smoking. This lead to the significant limitation of tobacco expansion in Europe, USA and Canada in the end of the 20th century.

  17. Medication Adherence and its Related Factors in Patients with Type II Diabetes

    Directory of Open Access Journals (Sweden)

    Behzad Gholamaliei

    2016-03-01

    Full Text Available Background and Objectives: Low levels of medication adherence in patients with type 2 diabetes is one of the greatest challenges in the treatment and control of diabetes. This study was designed to determine medication adherence and its related factors in patients with type II diabetes. Materials and Methods: In this cross-sectional study, a total of 300patients with type 2diabetes records in the health centers of Tuyserkan city were randomly selected in 2015. Data collection instrument was a self-made questionnaire, which consisted of factors related to the medication adherence. Questionnaires were completed after confirmation of validity and reliability, by interviews. To analyze the data, descriptive and inferential statistics (T-test, AnOVA, Simple and multiple linear regression were applied, using SPSS software, version 19. Results: Overall, %26.3 of patients were male and %73.7 were female. Also, %65 of patients were illiterate, %24 had some degree of symptoms, and %59.4 had poor medication adherence. There was a significant relationship between age, education, patient care and treatment expenditure, health care team and health system, therapy-related factors and condition-related factors, beliefs about illness, efficacy, and concerns about drugs and medication adherence (P < 0.05. Conclusions: This study showed that medication adherence in patients with diabetes was not suitable and individual, economical and social factors were influential.Therefore, the role of these factors must be considered when designing intervention programs.

  18. [Who decides what data should be recorded in the medical history in relation to the biological origin?

    Science.gov (United States)

    Gallego Riestra, Sergio; Riaño Galán, Isolina

    2017-06-05

    There is an increasing request by patients or their representatives not to have some data registered in their clinical history or if such data exists to be deleted. Without doubt, this is so because such clinical data is accessed by various professionals who in most cases are not directly involved in caring for such patients. On the other hand, such data is copied and iteratively and unnecessary reproduced in various discharge reports and others forms. The problem arises when such controversial data refer to particularly sensitive clinical aspects such as assisted reproduction techniques, which invades personal and family privacy. Therefore, the question is who determines what data should be recorded in the medical records and according to what criteria should be taken that decision? Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  19. Sami in the History of the Norwegian-Russian Borderland: Factor of Tension or Regional Integration?

    Directory of Open Access Journals (Sweden)

    Vladislav I. Goldin

    2015-09-01

    Full Text Available This article is based of an extensive array of documents and cartographic materials of the leading archives of the Russian Federation and Norway. The authors focus their attention on the history of Russian-Norwegian border and the Sami aspect of its development. On the Scandinavian continent, the population of frontier areas was often a factor of political tension, but the ethnic picture of the Russian-Norwegian borderland distinguished by the fact that the frontier status of the Skolt was the integration factor for the formation of economic cooperation between the border provinces of Russia and Norway. This thesis the authors explain by the peculiarities of the States policy regarding the border territories, ethnic groups, economic activities and economic interaction of Skolt with other communities, as well as their perception of own inhabited space.

  20. Here or There: Recent U.S. Immigrants' Medical and Dental Tourism and Associated Factors.

    Science.gov (United States)

    Jang, Sou Hyun

    2017-01-01

    Applying Andersen's health care utilization model, this paper shows the prevalence of immigrants' medical and dental tourism and associated factors. An analysis of the 2003 New Immigrant Survey data shows that about 17% of immigrants received medical care in a foreign country, whereas about one-third obtained dental care outside the United States. Latino immigrants have a higher prevalence of both types of tourism than their Asian counterparts. Race, level of education, and health insured status are commonly associated with medical and dental tourism. The findings contribute to the scarce literature on immigrants' health care utilization and medical and dental tourism.

  1. Family history: impact on coronary heart disease risk assessment beyond guideline-defined factors.

    Science.gov (United States)

    Hasanaj, Q; Wilson, B J; Little, J; Montazeri, Z; Carroll, J C

    2013-01-01

    Family history (FH) provides insights into the effects of shared genomic susceptibilities, environments and behaviors, making it a potentially valuable risk assessment tool for chronic diseases. We assessed whether coronary heart disease (CHD) risk assessment is improved when FH information is added to other clinical information recommended in guidelines. We applied logistic regression analyses to cross-sectional data originally obtained from a UK study of women who delivered a live-born infant between 1951 and 1970. We developed 3 models: Model 1 included only the covariates in a guideline applicable to the population, Model 2 added FH to Model 1, and Model 3 included a fuller range of risk factors. For each model, its ability to discriminate between study subjects with and those without CHD was evaluated and its impact on risk classification examined using the net reclassification index. FH was an independent risk factor for CHD (odds ratio = 1.7, 95% confidence interval = 1.26-2.47) and improved discrimination beyond guideline-defined clinical factors (p risk factor for CHD, it added little to risk factors typically included in guidelines. © 2013 S. Karger AG, Basel.

  2. Medical History for Prognostic Risk Assessment and Diagnosis of Stable Patients with Suspected Coronary Artery Disease

    NARCIS (Netherlands)

    J.K. Min (James); A. Dunning (Allison); H. Gransar (Heidi); S. Achenbach (Stephan); F.Y. Lin (Fay); M. Al-Mallah (Mouaz); M.J. Budoff (Matthew J.); T.Q. Callister (Tracy); H.-J. Chang (Hyuk-Jae); F. Cademartiri (Filippo); E. Maffei (Erica); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); R.B. D'Agostino (Ralph); A. Delago (Augustin); J. Friedman (John); M. Hadamitzky (Martin); J. Hausleiter (Jörg); S.W. Hayes (Sean W.); P.A. Kaufmann (Philipp A.); G.L. Raff (Gilbert); L.J. Shaw (Leslee J.); L.E.J. Thomson (Louise); T.C. Villines (Todd); R.C. Cury (Ricardo); G.M. Feuchtner (Gudrun); Y.-J. Kim (Yong-Jin); J. Leipsic (Jonathon); H. Marques (Hugo); D.S. Berman (Daniel S.); M. Pencina (Michael)

    2015-01-01

    textabstractObjective To develop a clinical cardiac risk algorithm for stable patients with suspected coronary artery disease based upon angina typicality and coronary artery disease risk factors. Methods Between 2004 and 2011, 14,004 adults with suspected coronary artery disease referred for cardia

  3. Medical History for Prognostic Risk Assessment and Diagnosis of Stable Patients with Suspected Coronary Artery Disease

    NARCIS (Netherlands)

    J.K. Min (James); A. Dunning (Allison); H. Gransar (Heidi); S. Achenbach (Stephan); F.Y. Lin (Fay); M. Al-Mallah (Mouaz); M.J. Budoff (Matthew J.); T.Q. Callister (Tracy); H.-J. Chang (Hyuk-Jae); F. Cademartiri (Filippo); E. Maffei (Erica); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); R.B. D'Agostino (Ralph); A. Delago (Augustin); J. Friedman (John); M. Hadamitzky (Martin); J. Hausleiter (Jörg); S.W. Hayes (Sean W.); P.A. Kaufmann (Philipp A.); G.L. Raff (Gilbert); L.J. Shaw (Leslee J.); L.E.J. Thomson (Louise); T.C. Villines (Todd); R.C. Cury (Ricardo); G.M. Feuchtner (Gudrun); Y.-J. Kim (Yong-Jin); J. Leipsic (Jonathon); H. Marques (Hugo); D.S. Berman (Daniel S.); M. Pencina (Michael)

    2015-01-01

    textabstractObjective To develop a clinical cardiac risk algorithm for stable patients with suspected coronary artery disease based upon angina typicality and coronary artery disease risk factors. Methods Between 2004 and 2011, 14,004 adults with suspected coronary artery disease referred for cardia

  4. Factors related to prediabetes among postpartum Thai women with a history of gestational diabetes mellitus.

    Science.gov (United States)

    Youngwanichsetha, Sununta; Phumdoung, Sasitorn

    2013-12-01

    Women with a history of gestational diabetes mellitus are at risk of developing prediabetes. Using a cross-sectional analytic design, the factors related to prediabetes among Thai women (n = 210) with a history of gestational diabetes mellitus were investigated. The main outcomes measured were two-hour plasma glucose after taking a 75 g oral glucose tolerance test at a six week postpartum visit. Data were analyzed using descriptive statistics and Pearson's correlation. The study showed that the incidence of prediabetes among postpartum Thai women was 26.67%. Factors associated with prediabetes were: (i) being over 35 years of age; (ii) three or more pregnancies; (iii) recurrent gestational diabetes mellitus; (iv) high plasma glucose before taking a 100 g glucose tolerance test and high postprandial plasma glucose during pregnancy; and (v) being overweight or obese at six weeks' postpartum. The results showed that nursing interventions need to be implemented to reduce plasma glucose and body mass index in order to prevent or reverse prediabetes.

  5. Family history of schizophrenia and bipolar disorder as risk factors for autism.

    Science.gov (United States)

    Sullivan, Patrick F; Magnusson, Cecilia; Reichenberg, Abraham; Boman, Marcus; Dalman, Christina; Davidson, Michael; Fruchter, Eyal; Hultman, Christina M; Lundberg, Michael; Långström, Niklas; Weiser, Mark; Svensson, Anna C; Lichtenstein, Paul

    2012-11-01

    The clinical and etiologic relation between autism spectrum disorders (ASDs) and schizophrenia is unclear. The degree to which these disorders share a basis in etiology has important implications for clinicians, researchers, and those affected by the disorders. To determine whether a family history of schizophrenia and/or bipolar disorder is a risk factor for ASD. We conducted a case-control evaluation of histories of schizophrenia or bipolar disorder in first-degree relatives of probands in 3 samples—population registers in Sweden, Stockholm County (in Sweden), and Israel. Probands met criteria for ASD, and affection status of parents and siblings for schizophrenia and bipolar disorder were established. The presence of schizophrenia in parents was associated with an increased risk for ASD in a Swedish national cohort (odds ratio [OR], 2.9; 95% CI, 2.5-3.4) and a Stockholm County cohort (OR, 2.9; 95% CI, 2.0-4.1). Similarly, schizophrenia in a sibling was associated with an increased risk for ASD in a Swedish national cohort (OR, 2.6; 95% CI, 2.0-3.2) and an Israeli conscription cohort (OR, 12.1; 95% CI, 4.5-32.0). Bipolar disorder showed a similar pattern of associations but of lesser magnitude. Findings from these 3 registers along with consistent findings from a similar study in Denmark suggest that ASD, schizophrenia, and bipolar disorder share common etiologic factors.

  6. Identifying factors that influence workplace learning in postgraduate medical educaton

    OpenAIRE

    Stok-Koch, L.; Bolhuis, S.; Koopmans, R.

    2007-01-01

    In their postgraduate educational programs, residents are immersed in a complex workplace. To improve the quality of the training program, it is necessary to gain insight into the factors that influence the process of learning in the workplace. An exploratory study was carried out among 56 nursing home physicians in training (NHPT) and 62 supervisors. They participated in semi-structured group interviews, in which they discussed four questions regarding workplace learning. Qualitative analysi...

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

    DEFF Research Database (Denmark)

    O'Neill, Lotte Dyhrberg

    2010-01-01

    of Aarhus; Jan Hartvigsen, PhD, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark.   Title: Factors associated with dropping out of medical school: a literature review.      Background: Considerable resources are spent on medical school selection and the competition...... for places is usually fierce. Dropping out must therefore be the worst possible performance outcome in medical education. What do we know about factors associated with dropping out of medical school? Summary of work: A systematic critical literature review of the international peer-reviewed research......  Presenter: Lotte D. O'Neill, MMedEd, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark. Co-authors: Birgitta Wallstedt, MSc, Unit for Educational Development, University of Southern Denmark; Berit Eika, MD, MHPE, MI, PhD, Unit for Medical Education, University...

  8. The “Natural” History of Medically Treated Temporal Lobe Epilepsy: What Can an Evidence-Based Approach Tell Us?

    Directory of Open Access Journals (Sweden)

    Colin Bruce Josephson

    2012-01-01

    Full Text Available We systematically reviewed the literature to describe the “natural” history of medically treated temporal lobe epilepsy (TLE. No population-based studies recruiting incident cases of TLE irrespective of age exist. Prospective, population-based studies were limited to those recruiting only childhood-onset TLE or those reporting TLE as a subgroup of cohorts of focal epilepsies. Few studies have been performed in the “MRI era” limiting information on natural history secondary to specific pathologies. Available data suggests that TLE is highly variable, with unpredictable transient remissions and low rates of seizure freedom (30 to 50%. Etiology and failure of first and second drug seem to be the most important predictors for treatment prognosis. The role of initial precipitating injuries remains speculative, as imaging information of related events is either missing or conflicting. Prospective cohorts of new-onset TLE with long-term followup using advanced MRI techniques, timely EEG recordings, and assessments of psychiatric comorbidities are needed.

  9. [Risk factor calculator for medical underwriting of life insurers based on the PROCAM study].

    Science.gov (United States)

    Geritse, A; Müller, G; Trompetter, T; Schulte, H; Assmann, G

    2008-06-01

    For its electronic manual GEM, used to perform medical risk assessment in life insurance, SCOR Global Life Germany has developed an innovative and evidence-based calculator of the mortality risk depending on cardiovascular risk factors. The calculator contains several new findings regarding medical underwriting, which were gained from the analysis of the PROCAM (Prospective Cardiovascular Münster) study. For instance, in the overall consideration of all risk factors of a medically examined applicant, BMI is not an independent risk factor. Further, given sufficient information, the total extra mortality of a person no longer results from adding up the ratings for the single risk factors. In fact, this new approach of risk assessment considers the interdependencies between the different risk factors. The new calculator is expected to improve risk selection and standard acceptances will probably increase.

  10. Doctor Alfredo Méndez Aguirre. Renowned doctor of Cienfuegos medical history in the twentieth century

    Directory of Open Access Journals (Sweden)

    Reinaldo José Pino Blanco

    2011-04-01

    Full Text Available Doctor Alfredo Méndez Aguirre was an outstanding medical and social personality in Cienfuegos during the first third of the xx century. The most significant aspects about his life and studies of Medicine are highlighted, as well as the postgraduate courses that he received later in France. Analyzed through different scenarios where he acted as an eminent surgeon, we refer to his contribution to the spreading of abdominal, prostatic and gynecological surgery in Cienfuegos, besides other innovations of high importance for the Cuban Medicine at that time. It is described his brilliant performance as director of the Hospital Civil and the Sanatorio Purísima Concepción de la Colonia Española, enhancing all the transformations, improvements, amplifications and openings of new services carried out in both centers under his guidance and supervision. all the recognitions received for different institutions and people in general were mentioned too, for his fruitful work and, particularly, for their performance during the epidemic of Influenza of 1918, that deserved him the title of exemplary citizen.

  11. Factors that influence the medication decision making of persons with HIV/AIDS: a taxonomic exploration.

    Science.gov (United States)

    Russell, Cynthia K; Bunting, Sheila M; Graney, Marshall; Hartig, Margaret T; Kisner, Patricia; Brown, Brian

    2003-01-01

    It is well known that patients often alter their medication regimens and that these changes may have profound consequences for their health outcomes. Not so well known are the factors that influence the medication decision making of persons managing their own treatment in their day-to-day home situations. In this study, persons living with HIV/AIDS (PLWH) were asked about factors that affected the taking of their medications. Using semistructured interviews in this study of 57 PLWH, the authors used intensive analysis of the narratives to create taxonomies of the barriers and facilitators to taking HIV medications and the decisions that were involved. Categories of identified facilitators included motivation, factors of faith, routines, and others' influences. Categories of identified barriers included perceptions, psycho-emotional issues, provider/clinic issues, interpersonal factors, and disease and treatment factors. This study showed medication decision making to be a complex process, influenced by often-competing life and treatment issues and affected by participants' beliefs and values. These findings call for research into the everyday selfcare of PLWH to understand the reasoned decision-making that PLWH use in managing not only their medications but also their lives.

  12. [The "impact factor" and the impact of medical journals].

    Science.gov (United States)

    Reyes, H

    1998-02-01

    Original articles published in scientific journals are important parameters for committees when they evaluate academic promotions or research grant applications. The analysis usually tries to give each paper a qualitative/quantitative assessment. An article's citation by others is accepted as a fair estimate of the value assigned to its originality and importance. A main determinant of every citation index is the international relevance attained by the journal where the article appeared. The "impact factor" of journals enlisted in the mainstream literature, as defined by the Journal Citation Reports (ISI), is being used by many assessors worldwide. But this index appears to be an unfair unit of measurement for journals that, although included in the main international data bases, are published in non-English languages. Furthermore, some local journals that are not enlisted by the Institute for Scientific Information apply external peer review to select their publications. In contrast, those same journals may have great relevance for their contributing authors and a high impact in their readers. The Editor's proposal is to classify original articles published in biomedical sciences, clinical medicine and public health topics using a three steps scale: a low score to articles published in local journals that use the peer review system, even though they were not enlisted in international data bases; a higher score to articles published in journals included in the mainstream literature, without considering their "impact factors" as differential values; and the highest score to articles published in journals recognized as international leaders in biomedicine, general medicine or in the subspecialties. Therefore, mainstream journals published in non-English languages would not be discriminated from other journals having higher "impact factors" mainly due to their use of the English language.

  13. Medical and social factors influencing reproduction in Serbia

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    Šulović Vojin

    2002-01-01

    Full Text Available The authors present results of researches whose aim was to determine the factors that may substantially influence population reproduction in the Republic of Serbia, taking into consideration all specific factors, like cultural background, economic situation, health education, health service organization, religious and historical factors, etc. The research was based on the population census from 1981. Seventeen regions of the inner part of the Republic of Serbia, Vojvodina and Kosovo were included in this research. Stratification was made according to the place of living (village, town age, occupation (farmer, housewife, non and half-qualified, qualified and highly qualified workers and education (without education, with unfinished or finished primary school, with secondary school, with college or university degree. In this way 2,141 women were questioned with 101 questions by the method of interview. Interviews were conducted exclusively by doctors - gynaecologists. We determined the frequency of the use of contraceptives, intentional abortions, spontaneous abortions, pre-term deliveries, marriage infertility and term deliveries. Thus, 57.4% of women had basic knowledge of contraception, but only 15.9% of them used it; 58.9% of women had intentional abortions; 16.2% of women had spontaneous abortions, 5.1% of them had pre-term deliveries, and 67% of women had term deliveries. Marriage infertility was found in 8.6% of women. When evaluating population health and behavior, we obtained some information and data concerning addicted diseases (alcohol, smoking, drugs, tranquilizers homosexuality and ways of sexual intercourse. It was concluded that enormous differences existed among certain regions in the Republic of Serbia, which were conditioned by the diversity of the above mentioned influences. Proposals for the measures to be undertaken in the Republic of Serbia in order to regulate population policy, are given.

  14. History and Guideline of Emergency Medicine Residency Discipline in Shahid Beheshti University of Medical Sciences, Iran; Review of 2014

    Directory of Open Access Journals (Sweden)

    Majid Shojaee

    2014-09-01

    directly declared to him. Lastly, in ministry time of Dr. Farhadi in 2001 this major was initiated for the first time in Iran University of Medical Sciences. The present report was addressed to the education guideline of emergency medicine at Shahid Beheshti University of Medical Sciences besides evaluating the formation history of emergency medicine discipline in Iran. 

  15. The use of instant medical history in a rural clinic. Case study of the use of computers in an Arkansas physician's office.

    Science.gov (United States)

    Pierce, B

    2000-05-01

    This study evaluated the acceptance of using computers to take a medical history by rural Arkansas patients. Sex, age, race, education, previous computer experience and owning a computer were used as variables. Patients were asked a series of questions to rate their comfort level with using a computer to take their medical history. Comfort ratings ranged from 30 to 45, with a mean of 36.8 (SEM = 0.67). Neither sex, race, age, education, owning a personal computer, nor prior computer experience had a significant effect on the comfort rating. This study helps alleviate one of the concerns--patient acceptance--about the increasing use of computers in practicing medicine.

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  17. Case-control geographic clustering for residential histories accounting for risk factors and covariates

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    Goovaerts Pierre

    2006-08-01

    Full Text Available Abstract Background Methods for analyzing space-time variation in risk in case-control studies typically ignore residential mobility. We develop an approach for analyzing case-control data for mobile individuals and apply it to study bladder cancer in 11 counties in southeastern Michigan. At this time data collection is incomplete and no inferences should be drawn – we analyze these data to demonstrate the novel methods. Global, local and focused clustering of residential histories for 219 cases and 437 controls is quantified using time-dependent nearest neighbor relationships. Business address histories for 268 industries that release known or suspected bladder cancer carcinogens are analyzed. A logistic model accounting for smoking, gender, age, race and education specifies the probability of being a case, and is incorporated into the cluster randomization procedures. Sensitivity of clustering to definition of the proximity metric is assessed for 1 to 75 k nearest neighbors. Results Global clustering is partly explained by the covariates but remains statistically significant at 12 of the 14 levels of k considered. After accounting for the covariates 26 Local clusters are found in Lapeer, Ingham, Oakland and Jackson counties, with the clusters in Ingham and Oakland counties appearing in 1950 and persisting to the present. Statistically significant focused clusters are found about the business address histories of 22 industries located in Oakland (19 clusters, Ingham (2 and Jackson (1 counties. Clusters in central and southeastern Oakland County appear in the 1930's and persist to the present day. Conclusion These methods provide a systematic approach for evaluating a series of increasingly realistic alternative hypotheses regarding the sources of excess risk. So long as selection of cases and controls is population-based and not geographically biased, these tools can provide insights into geographic risk factors that were not specifically

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

    Science.gov (United States)

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

    2013-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Salih Bin Salih

    2013-01-01

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

  20. Student-Life Stress Level and its Related Factors among Medical Students of Hamadan University of Medical Sciences in 2015

    Directory of Open Access Journals (Sweden)

    Roya Nikanjam

    2016-03-01

    Full Text Available Background and Objectives: Student-life stress can lead to various negative consequences such as physical illness, mental disorders or exhaustion. The present study was conducted to evaluate the level of student life stress and its related factors among medical students of Hamadan University of Medical Sciences. Materials and Methods: This cross-sectional study applied multistage random sampling to select 500university students at Hamadan University of Medical Sciences during 2015. The data collection tool used in this study was a self-report questionnaire containing two parts: a section on subjects' demographic details and another section for Student-Life Stress Inventory (SLSI. Data were analyzed in SPSS20-using descriptive and inferential statistics, such as independent t-test, Pearson’s correlation test and one-way ANOVA. Results: This study revealed that %57of the students had moderate levels of stress. The most important stressors included self-impose and pressure, and also the most important reactions to stressors included cognitive appraisal and emotional reactions, respectively. There was a significant association between exam stressors and branch, educational level, and mother's and father's education level (P< 0.05. Conclusions: According to the high level of stress in students and the recognition of demographic factors, effective educational interventions can be conducted to reduce stress.

  1. Prevalence of and factors associated with smoking among Japanese medical students.

    Science.gov (United States)

    Tamaki, Tetsuo; Kaneita, Yoshitaka; Ohida, Takashi; Yokoyama, Eise; Osaki, Yoneatsu; Kanda, Hideyuki; Takemura, Shinji; Hayashi, Kenji

    2010-01-01

    The aim of the present study was to determine the prevalence of and factors associated with smoking among Japanese medical students, to help promote effective antismoking measures in this population. From the 80 university medical schools in Japan, 20 were randomly selected and invited to participate in our survey. The survey focused on medical students and employed an anonymous self-administered questionnaire. Information on each university's antismoking measures was obtained using a separate questionnaire administered to teaching staff. The survey was conducted from December 2006 through March 2007. Factors associated with smoking were identified by using the chi-square test and multiple logistic regression analysis. A total of 1619 valid surveys were returned. The overall prevalence of smoking was 13.7% (18.1% among men and 5.1% among women). Factors associated with smoking among medical students were male sex, enrollment at a private medical university, smoking by siblings, alcohol consumption, coffee consumption, insomnia, and less than 6 hours of sleep per night. Antismoking education must be further promoted to Japanese medical students, with consideration given to the factors associated with smoking behavior found in the present study.

  2. Factors affecting the attractiveness of medical tourism destination: an empirical study on India- review article.

    Science.gov (United States)

    Sultana, Seyama; Haque, Ahasanul; Momen, Abdul; Yasmin, Farzana

    2014-07-01

    In this edge, medical tourism is not a new idea. Medical treatment is one of the essential demands of human beings and it requires high quality and intensive care. Beside western world, few developing countries are playing key roles as medical tourism destinations. India is one of the leading names among these countries. The purpose of the paper is to find the factors influencing the attractiveness of India as a health tourism destination. The study has found the major contributing factors and their relative importance in the attractiveness of the health tourism destination that is India from consumers' perspectives by conducting survey with an application of structural equation modelling approach. In Indian context, medical tourists consider service quality and cost mostly to select any medical destination. In addition they also give value to the destination competitiveness but tourist attitude is less important in comparison with other factors affecting their destination choice. Since the study has used structural equation modelling approach to test the hypothesis and figure out the relative importance of the factors, the fundamental indices such as Normed Chi square(less than 3), RMSEA (less than 0.08) and CFI (more than 0.90) values show the overall model fit of the proposed model. In order to transform a country such as India as an attractive and competitive medical tourist destination in this time of globalization, a step should be taken to control cost ensuring the quality of services.

  3. Stability of and Factors Related to Medical Student Specialty Choice of Psychiatry.

    Science.gov (United States)

    Goldenberg, Matthew N; Williams, D Keith; Spollen, John J

    2017-09-01

    Targeted efforts are needed to increase the number of medical students choosing psychiatry, but little is known about when students decide on their specialty or what factors influence their choice. The authors examined the timing and stability of student career choice of psychiatry compared with other specialties and determined what pre- and intra-medical school factors were associated with choosing a career in psychiatry. Using survey data from students who graduated from U.S. allopathic medical schools in 2013 and 2014 (N=29,713), the authors computed rates of psychiatry specialty choice at the beginning and end of medical school and assessed the stability of that choice. A multivariate-adjusted logistic regression and recursive partitioning were used to determine the association of 29 factors with psychiatry specialty choice. Choice of psychiatry increased from 1.6% at the start of medical school to 4.1% at graduation. The stability of psychiatry specialty choice from matriculation to graduation, at just over 50%, was greater than for any other specialty. However, almost 80% of future psychiatrists did not indicate an inclination toward the specialty at matriculation. A rating of "excellent" for the psychiatry clerkship (odds ratio=2.66), a major in psychology in college (odds ratio=2.58), and valuing work-life balance (odds ratio=2.25) were the factors most strongly associated with psychiatry career choice. Students who enter medical school planning to become psychiatrists are likely to do so, but the vast majority of students who choose psychiatry do so during medical school. Increasing the percentage of medical students with undergraduate psychology majors and providing an exemplary psychiatry clerkship are modifiable factors that may increase the rate of psychiatry specialty choice.

  4. Factors Affecting on Military Medical Job Satisfaction Staff

    Directory of Open Access Journals (Sweden)

    Habibi

    2015-04-01

    Full Text Available Background Job satisfaction (JS in the workplace affects absenteeism, turnover and performance. Objectives Considering the importance of JS, this study conducted with aim studying the factors affecting JS in a military hospital. Patients and Methods This descriptive analytical cross sectional study was carried out on 301 workers who worked in a military hospital in year 2009 using of stratified random sampling. In this study JSS questioner was used for measuring JS, ANOVA and Dunnett post hoc and SPSS and Excel software were used for statistical analysis and data analysis respectively. Results In this study, age, work experience, type of job and work position shown relationship with JS but gender, marriage status and education were not shown any statistical significant relationship with JS. In this study technician operating room and anesthesia (TORA had less, physicians and specialist and par clinical jobs had more and handy jobs and administrative jobs had same JS compare with nurses. Conclusions According to results of this study, we propose actions like modified and increased salaries and benefits of employees, making effective communication, improved working conditions, reform official promotion and more attention to TORA and nurses can be useful way for improving JS.

  5. Families, nurses and organisations contributing factors to medication administration error in paediatrics: a literature review

    Directory of Open Access Journals (Sweden)

    Albara Alomari

    2015-05-01

    Full Text Available Background: Medication error is the most common adverse event for hospitalised children and can lead to significant harm. Despite decades of research and implementation of a number of initiatives, the error rates continue to rise, particularly those associated with administration. Objectives: The objective of this literature review is to explore the factors involving nurses, families and healthcare systems that impact on medication administration errors in paediatric patients. Design: A review was undertaken of studies that reported on factors that contribute to a rise or fall in medication administration errors, from family, nurse and organisational perspectives. The following databases were searched: Medline, Embase, CINAHL and the Cochrane library. The title, abstract and full article were reviewed for relevance. Articles were excluded if they were not research studies, they related to medications and not medication administration errors or they referred to medical errors rather than medication errors. Results: A total of 15 studies met the inclusion criteria. The factors contributing to medication administration errors are communication failure between the parents and healthcare professionals, nurse workload, failure to adhere to policy and guidelines, interruptions, inexperience and insufficient nurse education from organisations. Strategies that were reported to reduce errors were doublechecking by two nurses, implementing educational sessions, use of computerised prescribing and barcoding administration systems. Yet despite such interventions, errors persist. The review highlighted families that have a central role in caring for the child and therefore are key to the administration process, but have largely been ignored in research studies relating to medication administration. Conclusions: While there is a consensus about the factors that contribute to errors, sustainable and effective solutions remain elusive. To date, families have not

  6. Family history of schizophrenia as a risk factor for axis I psychiatric conditions.

    Science.gov (United States)

    DeVylder, Jordan E; Lukens, Ellen P

    2013-02-01

    People with first-degree relatives with schizophrenia are at an elevated risk of developing the disorder themselves. High rates of psychotic symptoms in non-psychotic disorders, high rates of comorbidity in psychotic disorders, and diversity of outcomes following psychosis-risk states together suggest that this vulnerability may be for psychiatric conditions in general, not limited to schizophrenia. In this study, data from the National Survey of American Life (NSAL) were used to examine the association between having a first-degree relative with schizophrenia and the lifetime development of a range of non-psychotic axis I psychiatric disorders using adjusted odds ratios. Having a relative with schizophrenia was associated with increased risk for most non-psychotic psychiatric conditions examined, including those expected to be associated with schizophrenia (affective, anxiety, and substance use disorders) and those not expected (bulimia, disorders of childhood onset), excluding respondents with lifetime psychotic symptoms and controlling for demographic factors. Family history of schizophrenia among this predominantly African-American and Afro-Caribbean sample appears to be a risk factor for a range of axis I diagnoses, supporting a continuous rather than categorical nature of psychiatric vulnerability. Future studies should examine whether these associations are due to genetic or environmental factors, or both. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Viking voyages: the origin of multiple sclerosis? An essay in medical history.

    Science.gov (United States)

    Poser, C M

    1995-01-01

    Multiple sclerosis is most frequently found in Scandinavia, Iceland, the British Isles and the countries settled by their inhabitants and their descendants, i.e. the United States, Canada, Australia and New Zealand. This suggests that the Vikings may have been instrumental in disseminating genetic susceptibility to the disease in those areas, as well as in other parts of the world. The Vikings raided most European countries and settled in Normandy and in Sicily and southern Italy. They engaged in trade with the Arabs along the river routes to the Caucasus, to the Black and Caspian Seas, and penetrated Persia, India and probably China. They also migrated to the East and established the Russian state. Under the name Varangians, they became part of the Byzantine army and were active in all the military activities of the Byzantine Empire. They participated in the Crusades. Russians, many of Scandinavian origin also constituted a regiment of the Mongol army and roamed throughout that Empire as well. The custom of capturing and keeping or selling women and children, which was widespread in the early Middle Ages, as well as the flourishing slave trade in men, were important factors in this genetic dissemination.

  8. [Erwin H. Ackerknecht and the Berg/Rath Affair in 1964. On the coping of German medical historians with their history].

    Science.gov (United States)

    Morgeli, C; Jobmann, A

    1997-01-01

    In 1964, the Zurich medical historian Erwin H. Ackerknect announced his decision to resign from the German Society of Medical History, Natural Science and Technology (Deutsche Gesellschaft fur Geschichte der Medizin, Naturwissenschaft und Technik - DGGMNT) in a letter to 150 colleagues and prominent personalities in scientific, academic and political circles. Ackerknecht explained that he was resigning from the Society because the medical faculty of the University of Gottingen, supported by its professor of medical history, Gernot Rath - also chairman of the DGGMNT - had awarded the Venia legendi medical history chair to the x-ray specialist and medical historian Alexander Berg. Berg was ideologically compromised by his co-authorship of a book that embraced the ideals of National Socialism and in which he was mentioned as a Obersturmfuhrer of SS. Apart from describing the events surrounding Berg's promotion to the teaching position, this article presents Ackerknecht's perspective on the situation, the continuing influence of further Nazi era's leading historians of medicine the war - enabling Berg to assume his position - as well as the DGGMNT's controversial reactions to Ackerknecht's resignation and the consequences that the affair was to have for the Society.

  9. Perceived psychological stress among undergraduate medical students: Role of academic factors.

    Science.gov (United States)

    Chowdhury, Ranadip; Mukherjee, Abhijit; Mitra, Kaushik; Naskar, Somnath; Karmakar, Prasanta Ray; Lahiri, Saibendu Kumar

    2017-01-01

    Recently, there is a growing concern about stress during undergraduate medical training. The objectives of our study were to assess perceived stress among undergraduate medical students and to find out academic factors as determinants. A cross-sectional, questionnaire-based survey was carried out among undergraduate medical students of R. G. Kar Medical College, India, during July 2011-June 2012. Perceived stress was assessed using the Perceived Stress Scale-14. A 10-item questionnaire was used to assess academic sources of stress and their severity. The overall mean perceived stress score was 29.58 (standard deviation [SD] = 6.60), and 46.3% of the participants were in the group of more stressed (perceived stress score ≥28). The academic stressor factors predicted 78% of variability of perceived stress. A higher level of perceived stress was reported by the students. The students should be taught different stress management techniques to improve their ability to cope with a demanding professional course.

  10. Does a medical history of hypertension influence disclosing genetic testing results of the risk for salt-sensitive hypertension, in primary care?

    Directory of Open Access Journals (Sweden)

    Okayama M

    2016-07-01

    Full Text Available Masanobu Okayama,1,2 Taro Takeshima,2 Masanori Harada,3 Ryusuke Ae,4 Eiji Kajii2 1Division of Community Medicine and Medical Education, Kobe University Graduate School of Medicine, Kobe, Hyogo, 2Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Tochigi, 3Department of Support of Rural Medicine, Yamaguchi Grand Medical Center, Hofu, Yamaguchi, 4Division of Public Health, Center for Community Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan Objective: Disclosing genetic testing results may contribute to the prevention and management of many common diseases. However, whether the presence of a disease influences these effects is unclear. This study aimed to clarify the difference in the effects of disclosing genetic testing results of the risk for developing salt-sensitive hypertension on the behavioral modifications with respect to salt intake in hypertensive and nonhypertensive patients.Methods: A cross-sectional study using a self-administered questionnaire was conducted for outpatients aged >20 years (N=2,237 at six primary care clinics and hospitals in Japan. The main factors assessed were medical histories of hypertension, salt preferences, reduced salt intakes, and behavior modifications for reducing salt intake. Behavioral modifications of participants were assessed using their behavior stages before and after disclosure of the hypothetical genetic testing results. Results: Of the 2,237 participants, 1,644 (73.5% responded to the survey. Of these respondents, 558 (33.9% patients were hypertensive and 1,086 (66.1% were nonhypertensive. After being notified of the result “If with genetic risk”, the nonhypertensive participants were more likely to make positive behavioral modifications compared to the hypertensive patients among all participants and in those aged <65 years (adjusted relative ratio [ad-RR], 1.76; 95% confidence interval, 1.12−2.76 and ad-RR, 1

  11. The impact of site of graduate medical education training and other factors on physician employee retention.

    Science.gov (United States)

    Petrou, Steven P; Lee, Marian D; Griffis, Julie; Rawal, Bhupendra; Robinson, Nell; Murray, Peter M

    2014-01-01

    This study sought to determine if the site of graduate medical training or other factors impact the length of institutional employment. Physician hires for the home institution were catalogued from January 1, 1996, through December 31, 2006. In analyzing the 253 physician hires, we found no statistically significant advantage in employee retention associated with hiring "one's own" or with U.S. medical school graduates.

  12. Confounding factors in using upward feedback to assess the quality of medical training: a systematic review

    OpenAIRE

    Anli Yue Zhou Zhou; Paul Baker

    2014-01-01

    Purpose: Upward feedback is becoming more widely used in medical training as a means of quality control. Multiple biases exist, thus the accuracy of upward feedback is debatable. This study aims to identify factors that could influence upward feedback, especially in medical training. Methods: A systematic review using a structured search strategy was performed. Thirty-five databases were searched. Results were reviewed and relevant abstracts were shortlisted. All studies in English, both medi...

  13. Factors Influencing Residency Program Selection by Medical Students Pursuing Obstetrics and Gynecology.

    Science.gov (United States)

    Alston, Meredith J; Metz, Torri D; Fothergill, Russell; Meg Autry, Amy; Wagner, Sarah A; Allshouse, Amanda A; Stephenson-Famy, Alyssa

    2017-02-01

    Little is known about the factors that influence medical student selection of obstetrics and gynecology (ob-gyn) residency programs. We assessed the factors influencing residency program selection by fourth-year medical students pursuing ob-gyn training. A voluntary, anonymous, 19-question survey of residency selection factors was distributed to all fourth-year medical students interviewing at 1 of 5 academic ob-gyn departments for a residency position during the 2013-2014 interview season. Participants were surveyed about the relative importance (not important, somewhat important, important) of various residency selection factors, including operative experience, exposure to subspecialties, curricular experience, access to fellowships, and administrative aspects of residency, including adherence to duty hour restrictions. Of 322 potential respondents, 262 (81%) completed the survey. Surgical training and training in laparoscopic surgery were deemed "important" by nearly all respondents (98%, 258 of 262, and 97%, 253 of 262, respectively). Factors that were considered "not important" by a significant group of respondents included maternity/paternity leave policies (22%, 58 of 259); opportunity for international rotations/electives (20%, 51 of 259); exposure to quality and safety initiatives (13%, 34 of 259); and training in abortion (13%, 34 of 262). Fourth-year medical students identified surgical training as the most important factor in selecting an ob-gyn residency, a finding that is particularly relevant as decreasing and changing surgical volumes affect residency training in this specialty.

  14. Medical ultrasound imaging method combining minimum variance beamforming and general coherence factor

    Institute of Scientific and Technical Information of China (English)

    WU Wentao; PU Jie; LU Yi

    2012-01-01

    In medical ultrasound imaging field, in order to obtain high resolution and correct the phase errors induced by the velocity in-homogeneity of the tissue, a high-resolution medical ultrasound imaging method combining minimum variance beamforming and general coherence factor was presented. First, the data from the elements is delayed for focusing; then the multi-channel data is used for minimum variance beamforming; at the same time, the data is transformed from array space to beam space to calculate the general coherence factor; in the end, the general coherence factor is used to weight the results of minimum variance beamforming. The medical images are gotten by the imaging system. Experiments based on point object and anechoic cyst object are used to verify the proposed method. The results show the proposed method in the aspects of resolution, contrast and robustness is better than minimum variance beamforming and conventional beamforming.

  15. Risk factors for medication errors in the electronic and manual prescription 1

    Science.gov (United States)

    Volpe, Cris Renata Grou; de Melo, Eveline Maria Magalhães; de Aguiar, Lucas Barbosa; Pinho, Diana Lúcia Moura; Stival, Marina Morato

    2016-01-01

    ABSTRACT Objective: to compare electronic and manual prescriptions of a public hospital of Brasilia, identifying risk factors for the occurrence of medication errors. Method: descriptive-exploratory, comparative and retrospective study. Data collection occurred from July 2012 to January 2013, using an instrument for the review of the information contained in medical records related to the medication process. A total of 190 manual and 199 electronic records composed the sample, with 2027 prescriptions each. Results: compared to the manual prescription, a significant reduction was observed in the risk factors after implantation of the electronic prescription, in items such as "lack of the form of dilution" (71.1% to 22.3%) and "prescription with brand name" (99.5% to 31.5%). Conversely, the risk factors "no check" and "lack of CRM of the prescriber" increased. The lack of the allergy registration and the occurrences related to medication were the same for both groups. Conclusion: generally, the use of the electronic prescription system was associated with a significant reduction in risk factors for medication errors, concerning the following aspects: illegibility, prescription with brand name and presence of essential items that provide a safe and effective prescription. PMID:27508913

  16. Knowledge regarding risk factors of hypertension among entry year students of a medical university.

    Science.gov (United States)

    Shaikh, Rizwana B; Mathew, Elsheba; Sreedharan, Jayadevan; Muttappallymyalil, Jayakumary; Sharbatti, Shatha Al; Basha, Shaikh A

    2011-09-01

    Hypertension in youth is increasing, but there is a dearth of data about the knowledge of risk factors in this age group. To assess the knowledge of risk factors of hypertension among university students and associate it with the blood pressure, physical activity, family history of cardiovascular disease (CVD), and sociodemographic variables. A cross-sectional survey among students enrolled in the first year, in the four academic programs, with the use of a validated, self-administered questionnaire on physical activity in the past 30 days and knowledge of risk factors of hypertension. A score of 6 on 11 was considered as good knowledge for modifiable risk factors. Blood pressure was also measured. The data was analyzed using PASW-17, Chi square test, and binary logistic regression analysis was done. Of the 110 participants, 69.2% were coffee consumption 35.5%, physical inactivity 47%, and oral contraceptives 13.6%. Half the group did not consider a family history of CVD as a risk factor, 60% did not consider older age as a risk factor, and 88% did not think male gender was a risk factor. Knowledge of modifiable risk factors was better than that of non-modifiable risk factors. Although nationality, course of study, raised blood pressure, and history of diabetes showed significant association with good knowledge, their net effect was not significant by the Adjusted Odd's Ratio. The study identified some gaps in knowledge regarding both modifiable and non-modifiable risk factors of hypertension among students. A larger study would enable health promotion activities tailored to the needs of this age group.

  17. [Surgery for respiratory tuberculosis at the Research Institute of Phthisiopulmonology, I. M. Sechenov Moscow Medical Academy: history and current trends].

    Science.gov (United States)

    Sinitsyn, M V; Semenov, G I; Latyshev, A N; Agkatsev, T V; Kessel', M M

    2009-01-01

    The authors present concise data on the history of surgical treatment for pulmonary tuberculosis at the Research Institute of Phthisiopulmonology, I. M. Sechenov Moscow Medical Academy (1918-2008). They analyze the results of surgical treatment in 1007 patients with different forms of pulmonary tuberculosis in the past 10 years. The most common indications for surgical treatment are tuberculoma (44.2%), fibrocavernous and cirrhotic tuberculosis (37.8%), chronic pleuritis and pleural empyema (7.3%). There are prevalent resection-type operations (77.7%), with fatal cases after pneumonectomy (3.9%), lobectomy (0.6), and minor resections (0%). The proportion of thorocoplastic operations was 4.1% without fatal cases. Mini-invasive surgery using video-assisted technologies have received wide recognition in the diagnosis and surgical treatment of pulmonary tuberculosis. The results of treatment depend on the extent and presence of complications of a tuberculous process, comorbidity, suppressed immunity, and the scope of a surgical intervention. Overall, the efficiency of surgical treatment of patients with pulmonary tuberculosis is 90% or more.

  18. Trajectories of antidepressant medication before and after retirement: the contribution of socio-demographic factors.

    Science.gov (United States)

    Leinonen, Taina; Lahelma, Eero; Martikainen, Pekka

    2013-05-01

    The association between retirement and mental health is assumed to depend on socio-demographic factors, but there is a lack of empirical evidence. We examined antidepressant medication before and after retirement by age, gender, living arrangements, and social class. The material comprised nationally representative register data from Finland. Linear regression analysis was used to calculate changes in antidepressant medication 7.5 years before and after disability (N = 42,937) and old-age (N = 19,877) retirement in 1997-2007 by socio-demographic factors. No changes in antidepressant medication (mean DDD/3-month period) were observed around old-age retirement regardless of the socio-demographic factors. After a slight initial increase in antidepressant medication there was a substantial rise 1.5-0 years before disability retirement, after which there was a marked decrease, particularly during the first 3 years. These effects were less pronounced in retirement due to somatic causes. Age was the strongest modifying factor in retirement due to both depression and somatic causes, with a stronger increase and limited decrease in antidepressant medication among the younger age groups. The post-retirement decrease was also somewhat stronger among men, and among those in higher social classes and those living with a spouse in depression-related retirement. In somatic causes, the pre-retirement increase was stronger among those in higher social classes. Prevention and rehabilitation of mental-health problems in association with work disability should focus particularly on young adults, among whom the strong increase in antidepressant medication before disability retirement, and the continued high levels of medication after the transition signify long periods of morbidity and premature retirement.

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

    Directory of Open Access Journals (Sweden)

    Sun Juan

    2013-01-01

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

  20. Phylogeography, Risk Factors and Genetic History of Hepatitis C Virus in Gabon, Central Africa

    Science.gov (United States)

    Besson, Guillaume; Ndong-Atome, Guy-Roger; Makuwa, Maria; Pouillot, Régis; Nkoghé, Dieudonné; Leroy, Eric; Kazanji, Mirdad

    2012-01-01

    Background The epidemiological and molecular characteristics of hepatitis C virus (HCV) infection in the general population have been poorly investigated in Africa. The aim of this study was to determine the prevalence, genotype distribution and epidemic history of HCV in the Gabonese general population. Methods/Principal Findings A total of 4042 sera collected from adults in 220 villages in all nine administrative areas of the country were screened for antibodies to HCV. HCV NS5B region sequencing was performed for molecular characterization and population genetic analyses. Of 4042 tested sera, 455 (11.2%) were positive. The seroprevalence of HCV varied significantly by administrative area, with the highest rate in Ogooué-Lolo province (20.4%) and the lowest in Ogooué-Maritine province (3.7%). History of parenteral injections, past hospital admission and age over 55 years were independent risk factors for HCV infection (p<0.0001). Phylogenetic analyses showed that 91.9% of the strains were genotype 4 (HCV-4), 5.7% genotype 1 and 2.2% genotype 2. HCV-4 strains were highly heterogeneous, with more than eight subtypes; subtype 4e predominated (57.3%). Coalescence analyses indicated that subtype 4e was the oldest, with an estimated most recent common ancestor of 1702 [95% CI, 1418–1884]. The epidemic profile indicated that it spread exponentially during the first part of the 20th century, probably by iatrogenic transmission. Conclusions/Significance These results confirm the endemicity of HCV subtype 4e in Gabon and show that its spread is due to a cohort effect, with previous, possibly iatrogenic events. More extensive epidemiological studies are needed to better characterize the route of transmission and the dissemination of HCV in Gabon. PMID:22870274

  1. Phylogeography, risk factors and genetic history of hepatitis C virus in Gabon, central Africa.

    Directory of Open Access Journals (Sweden)

    Richard Njouom

    Full Text Available BACKGROUND: The epidemiological and molecular characteristics of hepatitis C virus (HCV infection in the general population have been poorly investigated in Africa. The aim of this study was to determine the prevalence, genotype distribution and epidemic history of HCV in the Gabonese general population. METHODS/PRINCIPAL FINDINGS: A total of 4042 sera collected from adults in 220 villages in all nine administrative areas of the country were screened for antibodies to HCV. HCV NS5B region sequencing was performed for molecular characterization and population genetic analyses. Of 4042 tested sera, 455 (11.2% were positive. The seroprevalence of HCV varied significantly by administrative area, with the highest rate in Ogooué-Lolo province (20.4% and the lowest in Ogooué-Maritine province (3.7%. History of parenteral injections, past hospital admission and age over 55 years were independent risk factors for HCV infection (p<0.0001. Phylogenetic analyses showed that 91.9% of the strains were genotype 4 (HCV-4, 5.7% genotype 1 and 2.2% genotype 2. HCV-4 strains were highly heterogeneous, with more than eight subtypes; subtype 4e predominated (57.3%. Coalescence analyses indicated that subtype 4e was the oldest, with an estimated most recent common ancestor of 1702 [95% CI, 1418-1884]. The epidemic profile indicated that it spread exponentially during the first part of the 20th century, probably by iatrogenic transmission. CONCLUSIONS/SIGNIFICANCE: These results confirm the endemicity of HCV subtype 4e in Gabon and show that its spread is due to a cohort effect, with previous, possibly iatrogenic events. More extensive epidemiological studies are needed to better characterize the route of transmission and the dissemination of HCV in Gabon.

  2. Factors associated with young adults' knowledge regarding family history of Stroke.

    Science.gov (United States)

    Lima, Maria Jose Melo Ramos; Moreira, Thereza Maria Magalhães; Florêncio, Raquel Sampaio; Braga, Predro

    2016-11-21

    to analyze the factors associated with young adults' knowledge regarding family history of stroke. an analytical transversal study, with 579 young adults from state schools, with collection of sociodemographic, clinical and risk factor-related variables, analyzed using logistic regression (backward elimination). a statistical association was detected between age, civil status, and classification of arterial blood pressure and abdominal circumference with knowledge of family history of stroke. In the final logistic regression model, a statistical association was observed between knowledge regarding family history of stroke and the civil status of having a partner (ORa=1.61[1.07-2.42]; p=0.023), abdominal circumference (ORa=0.98[0.96-0.99]; p=0.012) and normal arterial blood pressure (ORa=2.56[1.19-5.52]; p=0.016). an association was observed between socioeconomic factors and risk factors for stroke and knowledge of family history of stroke, suggesting the need for health education or even educational programs on this topic for the clientele in question. analisar os fatores associados ao conhecimento dos adultos jovens sobre histórico familiar de Acidente Vascular Cerebral (AVC). estudo transversal analítico, com 579 adultos jovens de escolas públicas, com coleta de variáveis sociodemográficas, clínicas e de fatores de risco em formulário, analisados utilizando-se regressão logística (backward elimination). detectou-se associação estatística de idade, situação conjugal, classificação da pressão arterial e circunferência abdominal com conhecimento do histórico familiar de AVC. No modelo final de regressão logística, observou-se associação estatística do conhecimento sobre histórico familiar de AVC com situação conjugal com companheiro (ORa=1,61[1,07-2,42]; p=0,023), circunferência abdominal (ORa=0,98[0,96-0,99]; p=0,012) e pressão arterial normal (ORa=2,56[1,19-5,52]; p=0,016). foi constatada associação de fatores socioeconômicos e de

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

    Directory of Open Access Journals (Sweden)

    Amrita Mishra

    2015-01-01

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

  4. Identification of medication non-adherence factors in adolescent transplant patients: the patient's viewpoint.

    Science.gov (United States)

    Bullington, Pamela; Pawola, Larry; Walker, Rosemary; Valenta, Annette; Briars, Leslie; John, Eunice

    2007-12-01

    Studies report a clear association between medication non-adherence and an unfavorable transplant outcome. The adolescent population, in particular, has difficulty adhering to post-transplant medication regimens. The purpose of this study is to identify, categorize and understand the opinions of adolescent transplant patients regarding why they may not take their medications as prescribed. From January to August 2005, nine adolescent kidney transplant patients at an urban medical center were surveyed and asked to rank-order 33 statements regarding their opinions on why adolescents may not take their medications as prescribed. Q-methodology, a powerful tool in subjective study, was used to identify and categorize the viewpoints of adolescents on this subject. Three factors emerged and were labeled to reflect their distinct viewpoints: (1) Medication Issues (e.g. taste, size, frequency, schedule), (2) Troubled Adolescent (e.g. poor home life, depression, overwhelming situation), and (3) Deliberate Non-Adherer (e.g. attention-seeker, infallible attitude). By understanding these different viewpoints and the factors that contribute to them, it may be easier to identify which management approach to non-adherence works best in specific subgroups of patients.

  5. Predictive Factors for Medical Consultation for Sore Throat in Adults with Recurrent Pharyngotonsillitis

    Directory of Open Access Journals (Sweden)

    T. Koskenkorva

    2016-01-01

    Full Text Available Objects. To seek patient- and episode-related factors that associate with medical consultation for acute sore throat because these factors may affect the patient being referred to specialist care and tonsillectomy for recurrent pharyngotonsillitis. Methods. In a secondary analysis of two prior randomised controlled trials, sore throat episodes and medical visits were explored among 156 adult patients referred for tonsillectomy because of recurrent pharyngotonsillitis. Results. The 156 patients (104 females, mean age of 26 years suffered from 208 acute pharyngotonsillitis episodes during 5-6 months of follow-up. Forty (25% patients visited a physician, and female gender (adjusted hazard ratio, HR, 3.3; 95% confidence interval 1.4–8.0 and finding of chronically infected tonsils (HR 2.7; 1.2–6.1 were associated with medical consultation. Thirty-six (17% episodes led to medical consultation during the first 7 days of symptoms. Presence of severe throat pain was related to medical visit (HR 4.3; 1.0–18.5. Conclusions. Even among patients with recurrent pharyngotonsillitis, the acute sore throat episodes were usually mild and only few resulted in medical consultation, with female gender, chronically infected tonsils, and having severe throat pain increasing the consultation rate.

  6. Medication adherence among Nigerians with schizophrenia: correlation between clinico-demographic factors and quality of life

    Directory of Open Access Journals (Sweden)

    Oluseun P. Ogunnubi

    2017-03-01

    Full Text Available Medication adherence contributes significantly to symptom remission, recovery and wellbeing in mental illnesses. We evaluated how medication adherence correlates with clinico-demographic factors and quality of life (QoL in a sample of Nigerians with schizophrenia. This descriptive crosssectional study involved 160 randomly selected participants with confirmed diagnosis of schizophrenia based on MINI International Neuropsychiatric Interview. Data on socio-demographic and clinical characteristics of participants were collected with a questionnaire. Medication adherence was assessed with Morisky Medication Adherence Questionnaire, and participants completed the World Health Organization Quality of Life Scale-BREF. The mean age of participants was 38.54 (±11.30 years, and all the participants were on antipsychotics, but only 45% were adherent to their medication. Out of all the participants, 45 (28.2% considered their overall QoL to be good, 97 (60.6% considered theirs to be fair, while 18 (11.2% reported poor QoL. Medication non-adherence correlated negatively with good QoL across multiple dimensions including overall QoL (r=- 0.175, health satisfaction (r=-0.161, physical (r=-0.186 and psychological domain (r=-0.175. Again, participant’s age (r=- 0.190 and age of onset of illness (r=-0.172 correlated negatively with medication nonadherence, and a trend towards relapse delay with medication adherence was also observed (r=-0.155. The effect size of these correlations were however small. Our findings suggest a link between medication adherence and QoL in schizophrenia, such that strategy that addresses medication nonadherence and its determinants may have potential benefits on wellbeing. Further hypotheses-driven studies are desirable.

  7. Family history, body mass index, selected dietary factors, menstrual history, and risk of moderate to severe acne in adolescents and young adults.

    Science.gov (United States)

    Di Landro, Anna; Cazzaniga, Simone; Parazzini, Fabio; Ingordo, Vito; Cusano, Francesco; Atzori, Laura; Cutrì, Francesco Tripodi; Musumeci, Maria Letizia; Zinetti, Cornelia; Pezzarossa, Enrico; Bettoli, Vincenzo; Caproni, Marzia; Lo Scocco, Giovanni; Bonci, Angela; Bencini, Pierluca; Naldi, Luigi

    2012-12-01

    Genetic and environmental components may contribute to acne causation. We sought to assess the impact of family history, personal habits, dietary factors, and menstrual history on a new diagnosis of moderate to severe acne. We conducted a case-control study in dermatologic outpatient clinics in Italy. Cases (205) were consecutive those receiving a new diagnosis of moderate to severe acne. Control subjects (358) were people with no or mild acne, coming for a dermatologic consultation other than for acne. Moderate to severe acne was strongly associated with a family history of acne in first-degree relatives (odds ratio 3.41, 95% confidence interval 2.31-5.05). The risk was reduced in people with lower body mass index with a more pronounced effect in male compared with female individuals. No association with smoking emerged. The risk increased with increased milk consumption (odds ratio 1.78, 95% confidence interval 1.22-2.59) in those consuming more than 3 portions per week. The association was more marked for skim than for whole milk. Consumption of fish was associated with a protective effect (odds ratio 0.68, 95% confidence interval 0.47-0.99). No association emerged between menstrual variables and acne risk. Some degree of overmatching may arise from choosing dermatologic control subjects and from inclusion of mild acne in the control group. Family history, body mass index, and diet may influence the risk of moderate to severe acne. The influence of environmental and dietetic factors in acne should be further explored. Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  8. Smart environment as a service: three factor cloud based user authentication for telecare medical information system.

    Science.gov (United States)

    Siddiqui, Zeeshan; Abdullah, Abdul Hanan; Khan, Muhammad Khurram; Alghamdi, Abdullah S

    2014-01-01

    The Telecare Medical Information System (TMIS) provides a set of different medical services to the patient and medical practitioner. The patients and medical practitioners can easily connect to the services remotely from their own premises. There are several studies carried out to enhance and authenticate smartcard-based remote user authentication protocols for TMIS system. In this article, we propose a set of enhanced and authentic Three Factor (3FA) remote user authentication protocols utilizing a smartphone capability over a dynamic Cloud Computing (CC) environment. A user can access the TMIS services presented in the form of CC services using his smart device e.g. smartphone. Our framework transforms a smartphone to act as a unique and only identity required to access the TMIS system remotely. Methods, Protocols and Authentication techniques are proposed followed by security analysis and a performance analysis with the two recent authentication protocols proposed for the healthcare TMIS system.

  9. WHY BECOME A DOCTOR? EVALUATION OF MOTIVATIONAL FACTORS FOR SELECTING MEDICAL PROFESS ION AS CAREER

    Directory of Open Access Journals (Sweden)

    Santhosh Kuriakose

    2015-01-01

    Full Text Available After pre - university course, students have to take an important decision regarding their career depending on their interest, family aspirations, past experiences and their limited knowledge of various careers. The objective of the study was to evaluate the various reasons of the students to choose medical career. A semi - structured questionnaire was given to 100 first MBBS students of A J Institute of Medical Sciences, Mangalore and the responses were statistically analyzed . The majority of students (93% have chosen the medical profession to serve the poor and needy, out of their own interest. Nearly 45% of students have one doctor in family. 10% saw their near ones suffering from chronic illness or cancer, 3% were themselves suffering from health problems, 2% were influenced by the lack of health care in rural areas KEYWORDS:Medicine as profession; career; motivational factors; first year medical students.

  10. Health Care Professional Factors Influencing Shared Medical Decision Making in Korea

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    Kae-Hwa Jo

    2015-11-01

    Full Text Available Till date, the medical decision-making process in Korea has followed the paternalist model, relying on the instructions of physicians. However, in recent years, shared decision making at the end-of-life between physicians and nurses is now emphasized in Korea. The purpose of this study was conducted to explore how health care professionals’ characteristics, attitude toward dignified dying, and moral sensitivity affect their shared medical decision making. The design was descriptive survey. This study was undertaken in two university hospitals in two metropolitan cities, South Korea. The participants were 344 nurses and 80 physicians who work at university hospitals selected by convenience sampling method. Data were collected from January 10 through March 20, 2014 using the Dignified Dying Scale, Moral Sensitivity Scale, and Shared Medical Decision-Making Scale. Shared medical decision making, attitude toward dignified dying, moral sensitivity, age, and working experience had a significant correlation with each other. The factors affecting shared medical decision making of Korean health care professionals were moral sensitivity and attitude toward dignified dying. These variables explained 22.4% of the shared medical decision making. Moral sensitivity and a positive attitude toward dignified dying should be promoted among health care professionals as a part of an educational program for shared medical decision making.

  11. Examining influential factors in providers’ chronic pain treatment decisions: a comparison of physicians and medical students

    OpenAIRE

    2015-01-01

    Background Chronic pain treatment guidelines are unclear and conflicting, which contributes to inconsistent pain care. In order to improve pain care, it is important to understand the various factors that providers rely on to make treatment decisions. The purpose of this study was to examine factors that reportedly influence providers’ chronic pain treatment decisions. A secondary aim was to examine differences across participant training level. Methods Eighty-five participants (35 medical st...

  12. Primary care specialty career choice among Canadian medical students: Understanding the factors that influence their decisions.

    Science.gov (United States)

    Osborn, Heather Ann; Glicksman, Jordan T; Brandt, Michael G; Doyle, Philip C; Fung, Kevin

    2017-02-01

    To identify which factors influence medical students' decision to choose a career in family medicine and pediatrics, and which factors influence their decision to choose careers in non-front-line specialties. Survey that was created based on a comprehensive literature review to determine which factors are considered important when choosing practice specialty. Ontario medical school. An open cohort of medical students in the graduating classes of 2008 to 2011 (inclusive). The main factors that influenced participants' decision to choose a career in primary care or pediatrics, and the main factors that influenced participants' decision to choose a career in a non-front-line specialty. A total of 323 participants were included in this study. Factors that significantly influenced participants' career choice in family medicine or pediatrics involved work-life balance (acceptable hours of practice [P = .005], acceptable on-call demands [P = .012], and lifestyle flexibility [P = .006]); a robust physician-patient relationship (ability to promote individual health promotion [P = .014] and the opportunity to form long-term relationships [P high income (P students' career choice in family medicine and pediatrics, and 6 factors influenced the decision to choose a career in a non-front-line specialty. Medical students can be encouraged to explore a career in family medicine or pediatrics by addressing misinformation, by encouraging realistic expectations of career outcomes in the various specialties, and by demonstrating the capacity of primary care fields to incorporate specific motivating factors. Copyright© the College of Family Physicians of Canada.

  13. Factors associated with poor controller medication use in children with high asthma emergency department use.

    Science.gov (United States)

    Butz, Arlene; Morphew, Tricia; Lewis-Land, Cassia; Kub, Joan; Bellin, Melissa; Ogborn, Jean; Mudd, Shawna S; Bollinger, Mary Elizabeth; Tsoukleris, Mona

    2017-04-01

    Understanding health and social factors associated with controller medication use in children with high-risk asthma may inform disease management in the home and community. To examine health and social factors associated with the Asthma Medication Ratio (AMR), a measure of guideline-based care and controller medication use, in children with persistent asthma and frequent emergency department (ED) use. Study questionnaires, serum allergen sensitization, salivary cotinine, and pharmacy record data were collected for 222 children enrolled from August 2013 to February 2016 in a randomized clinical trial that tested the efficacy of an ED- and home-based intervention. Logistic regression was used to examine factors associated with an AMR greater than 0.50, reflecting appropriate controller medication use. Most children were male (64%), African American (93%), Medicaid insured (93%), and classified as having uncontrolled asthma (44%). Almost half (48%) received non-guideline-based care or low controller medication use based on an AMR less than 0.50. The final regression model predicting an AMR greater than 0.50 indicated that children receiving specialty care (odds ratio [OR], 4.87; 95% confidence interval [CI], 2.06-11.50), caregivers reporting minimal worry about medication adverse effects (OR, 0.50; 95% CI, 0.25-1.00), positive sensitization to ragweed allergen (OR, 3.82; 95% CI, 1.63-8.96), and negative specific IgE for dust mite (OR, 0.33; 95% CI, 0.15-0.76) were significantly associated with achieving an AMR greater than 0.50. Clinical decision making for high-risk children with asthma may be enhanced by identification of sensitization to environmental allergens, ascertaining caregiver's concerns about controller medication adverse effects and increased referral to specialty care. ClinicalTrials.gov Identifier: NCT01981564. Copyright © 2017 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  14. Provider risk factors for medication administration error alerts: analyses of a large-scale closed-loop medication administration system using RFID and barcode.

    Science.gov (United States)

    Hwang, Yeonsoo; Yoon, Dukyong; Ahn, Eun Kyoung; Hwang, Hee; Park, Rae Woong

    2016-12-01

    To determine the risk factors and rate of medication administration error (MAE) alerts by analyzing large-scale medication administration data and related error logs automatically recorded in a closed-loop medication administration system using radio-frequency identification and barcodes. The subject hospital adopted a closed-loop medication administration system. All medication administrations in the general wards were automatically recorded in real-time using radio-frequency identification, barcodes, and hand-held point-of-care devices. MAE alert logs recorded during a full 1 year of 2012. We evaluated risk factors for MAE alerts including administration time, order type, medication route, the number of medication doses administered, and factors associated with nurse practices by logistic regression analysis. A total of 2 874 539 medication dose records from 30 232 patients (882.6 patient-years) were included in 2012. We identified 35 082 MAE alerts (1.22% of total medication doses). The MAE alerts were significantly related to administration at non-standard time [odds ratio (OR) 1.559, 95% confidence interval (CI) 1.515-1.604], emergency order (OR 1.527, 95%CI 1.464-1.594), and the number of medication doses administered (OR 0.993, 95%CI 0.992-0.993). Medication route, nurse's employment duration, and working schedule were also significantly related. The MAE alert rate was 1.22% over the 1-year observation period in the hospital examined in this study. The MAE alerts were significantly related to administration time, order type, medication route, the number of medication doses administered, nurse's employment duration, and working schedule. The real-time closed-loop medication administration system contributed to improving patient safety by preventing potential MAEs. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  15. Psychosocial factors associated with migraine and tension-type headache in medical students

    DEFF Research Database (Denmark)

    Lebedeva, Elena R; Kobzeva, Natalia R; Gilev, Denis V

    2017-01-01

    BACKGROUND: In our previous study of workers, blood donors and medical students, students stood out with a higher 1-year prevalence of migraine (28%) and tension-type headache (TTH) (74%). General factors associated with headache were common for all groups except low physical activity...

  16. Impact factor trends for general medical journals: non-English-language journals are lagging behind

    DEFF Research Database (Denmark)

    Vinther, Siri; Rosenberg, Jacob

    2012-01-01

    The impact factor (IF) is a common citation metric used for evaluating and comparing scientific journals within a certain field. Previous studies have shown that IFs are increasing. However, rates may depend on journal publication language. The aim of this study was to determine IF values...... and trends for general medical journals, comparing non-English-language with English-language journals....

  17. Factors Affecting the Choice of Anesthesiology by Medical Students for Specialty Training.

    Science.gov (United States)

    Chandra, Phool; Hughes, Mark

    1984-01-01

    A study of medical students' choice of anesthesiology as a specialty and the quality of clerkships available established several factors in students' choice, including the negative effect of certified registered nurse anesthetists on the operating room floor. A study of relationships with nurse practitioners, physician's assistants, and…

  18. A Case Study of Career Emegency Medical Technicians: Factors That Influenced Their Decision to Stay

    Science.gov (United States)

    Miller, Denine V.

    2013-01-01

    This case study (Stake, 1995) examined the perceptions of long-term Emergency Medical Technicians (EMTs) to identify factors influencing their decision to remain employed as EMTs for the duration of a career. EMT retention plans frequently utilize data from either employee exit interviews or workers with intent to leave, and since privacy law…

  19. Preliminary Investigation of the 1991 Medical College Admission Test Factor Structure.

    Science.gov (United States)

    Li, Weichang; Mitchell, Karen J.

    A substantially revised Medical College Admission Test (MCAT) was introduced in spring 1991. The new examination is designed to assess critical thinking skills, basic concepts and problem solving facility in science, and writing skills. This paper reports preliminary findings on the factor structure of the revised MCAT, which consists of four…

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

    Science.gov (United States)

    Swahn, Monica H.; Potter, Lloyd B.

    2002-01-01

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

  1. No Evidence for Disease History as a Risk Factor for Narcolepsy after A(H1N1)pdm09 Vaccination

    Science.gov (United States)

    Lamb, Favelle; Ploner, Alexander; Fink, Katharina; Maeurer, Markus; Bergman, Peter; Piehl, Fredrik; Weibel, Daniel; Sparén, Pär; Dahlström, Lisen Arnheim

    2016-01-01

    Objectives To investigate disease history before A(H1N1)pdm09 vaccination as a risk factor for narcolepsy. Methods Case-control study in Sweden. Cases included persons referred for a Multiple Sleep Latency Test between 2009 and 2010, identified through diagnostic sleep centres and confirmed through independent review of medical charts. Controls, selected from the total population register, were matched to cases on age, gender, MSLT-referral date and county of residence. Disease history (prescriptions and diagnoses) and vaccination history was collected through telephone interviews and population-based healthcare registers. Conditional logistic regression was used to investigate disease history before A(H1N1)pdm09 vaccination as a risk-factor for narcolepsy. Results In total, 72 narcolepsy cases and 251 controls were included (range 3–69 years mean19-years). Risk of narcolepsy was increased in individuals with a disease history of nervous system disorders (OR range = 3.6–8.8) and mental and behavioural disorders (OR = 3.8, 95% CI 1.6–8.8) before referral. In a second analysis of vaccinated individuals only, nearly all initial associations were no longer statistically significant and effect sizes were smaller (OR range = 1.3–2.6). A significant effect for antibiotics (OR = 0.4, 95% CI 0.2–0.8) and a marginally significant effect for nervous system disorders was observed. In a third case-only analysis, comparing cases referred before vaccination to those referred after; prescriptions for nervous system disorders (OR = 26.0 95% CI 4.0–170.2) and ADHD (OR = 35.3 95% CI 3.4–369.9) were statistically significant during the vaccination period, suggesting initial associations were due to confounding by indication. Conclusion The findings of this study do not support disease history before A(H1N1)pdm09 vaccination as a risk factor for narcolepsy. PMID:27120092

  2. The blood pressure variability, arterial elasticity and humoral factors in subjects with family history of hypertension.

    Science.gov (United States)

    Rafidah, H M; Azizi, A; Suhaimi, H; Noriah, M N

    2008-03-01

    Normotensive subjects with family history of hypertension (FHT) have been reported to have increased left ventricular mass index and reduced ventricular compliance. Of interest is whether blood pressure variability (BPV), which has been associated with target organ damage, is then part of this complex inherited syndrome? The objectives of this study are to determine whether there are any significant differences in BPV, arterial compliance and humoral factors in subjects with FHT as compared to controls. Thirty-five subjects with self reported FHT and 35 matched controls underwent 24 hour BP monitoring (BR-102, Schiller Inc. Germany). Arterial compliance was measured using systolic pulse wave tonometry (HDI/Pulsewave Cardiovascular Profiling Instrument, Hypertension Diagnostic Inc. USA). None of the subjects were hypertensive or diabetic. Out of these numbers, 25 subjects with FHT and 26 controls had measurements of plasma catecholamines, plasma renin and serum aldosterone. Catecholamines were assayed with high performance liquid chromatography, while both renin and aldosterone measurements were by radioimmunoassay. Subjects with FHT have higher night time BPV. There was no significant difference in arterial compliances between both groups. There were increased level of norepinephrine (NE) in subjects with FHT but epinephrine (E), renin and aldosterone levels were similar in both groups. There were no correlations between NE and BPV but E was negatively associated with daytime and mean arterial systolic BPV. In conclusion subjects with FHT demonstrated a higher night time BPV and NE level as compared to controls.

  3. Psychologic factors in the development of complex regional pain syndrome: history, myth, and evidence.

    Science.gov (United States)

    Feliu, Miriam H; Edwards, Christopher L

    2010-01-01

    The present paper examines the literature that addresses psychologic aspects involved in complex regional pain syndrome from a historic perspective to provide a rationale for the emergence of psychologic theories to explain its pathogenesis. The support of such perspective is then analyzed through the review of evidence-based studies. A review of the literature from a historic perspective was presented since its first description to the present time, including the clinical presentation and associated symptoms. An evidence-based approach was used to review the literature on complex regional pain syndrome and psychologic factors associated with the etiology or as predictors in the development of the disorder. After reviewing the literature on the history and the myths associated with complex regional pain syndrome, a hypothesis is provided based on an analysis of the Zeitgeist in the development of the psychologic theory associated with the disorder. We also concluded there is no evidence to support a linear relationship that establishes a psychologic predisposition to develop the disorder. An analysis of the Zeitgeist when complex regional pain syndrome was first described helps to understand the long-standing theories associated with a psychological theory of its etiology. This understanding should help to undermine the perpetuation of such claims which may contribute to undertreatment and misdiagnosis. To be consistent with todays Zeitgeist we must incorporate psychologic aspects, which while not causal in nature or exclusive of complex regional pain syndrome, are strongly associated with a wide spectrum of chronic pain disorders.

  4. [Natural history of and risk factors for idiopathic atrial fibrillation recurrence (FAP Registry)].

    Science.gov (United States)

    Planas, Francesc; Romero-Menor, César; Vázquez-Oliva, Gabriel; Poblet, Teresa; Navarro-López, Francesc

    2006-11-01

    The natural history of idiopathic atrial fibrillation is not well understood. The aim of this study was to investigate the frequency of and risk factors for disease recurrence. The study involved 115 patients with a first episode of paroxysmal atrial fibrillation of unknown origin who were included the FAP registry, which contains data from 11 district hospitals in Catalonia, Spain. All patients underwent comprehensive clinical, laboratory, electro-cardiographic and echocardiographic investigations at baseline and were followed up periodically every 6 months to identify the occurrence of new symptomatic episodes and their complications. During a mean follow-up period of 912 (445) days, 32 (27.8%) patients experienced recurrence of atrial fibrillation. Those who experienced recurrence had a significantly higher left ventricular ejection fraction (P=.023) and smaller end-systolic volume (P<.001), and they were more likely to consume alcohol regularly (P=.013). Cox regression analysis confirmed that these variables had independent prognostic value. In contrast, the occurrence of syncope during the initial episode was associated with a lower likelihood of recurrence (P=.017). The risk of recurrence of idiopathic atrial fibrillation was high, and was enhanced by moderate alcohol consumption and increased left ventricular activity, probably of sympathetic origin. This trend was less marked in paroxysmal atrial fibrillation of vagal origin.

  5. Short report: factors that affect specialty choice and career plans of Wisconsin's medical students.

    Science.gov (United States)

    Knox, Kjersti E; Getzin, Anne; Bergum, Alison; McBride, Patrick; Rieselbach, Richard; Friedsam, Donna

    2008-12-01

    To identify factors that influence specialty choice among Wisconsin medical students and provide insight into approaches to encourage more students to pursue careers in primary care. The importance of several factors in medical student career choice was surveyed using a Web survey convenience sample of all Wisconsin medical students. Students intending to pursue a career in primary care and in other specialties were compared. Respondents, regardless of specialty choice or gender, identified a similar group of factors as highly influential, and similar group of factors as non-influential in their decision-making. However, significantly more primary care students than other specialty students considered interest in underserved populations, relationships with patients, scope of practice, and role models important in their career choice. Significantly more primary care students than other specialty students responded that salary and competitiveness were "not at all" important. A greater number of other specialty students than primary care students stated that interest in scope of practice, role models, and training years were "not at all" important. Debt-related factors were reported as "not at all" important by nearly one-third of respondents. Although primary care and other specialty students report making their career plans based on the impact of similar factors, significant differences between primary care and other specialty students were reported in key areas. These results validate many previously reported factors, and indicate that salary and years of training may have been overemphasized in understanding student career choice. The results of this survey may be useful for Wisconsin medical schools in order to sustain, support, and foster student interest in primary care.

  6. Factors affecting residency rank-listing: A Maxdiff survey of graduating Canadian medical students

    Directory of Open Access Journals (Sweden)

    Forgie Melissa

    2011-08-01

    Full Text Available Abstract Background In Canada, graduating medical students consider many factors, including geographic, social, and academic, when ranking residency programs through the Canadian Residency Matching Service (CaRMS. The relative significance of these factors is poorly studied in Canada. It is also unknown how students differentiate between their top program choices. This survey study addresses the influence of various factors on applicant decision making. Methods Graduating medical students from all six Ontario medical schools were invited to participate in an online survey available for three weeks prior to the CaRMS match day in 2010. Max-Diff discrete choice scaling, multiple choice, and drop-list style questions were employed. The Max-Diff data was analyzed using a scaled simple count method. Data for how students distinguish between top programs was analyzed as percentages. Comparisons were made between male and female applicants as well as between family medicine and specialist applicants; statistical significance was determined by the Mann-Whitney test. Results In total, 339 of 819 (41.4% eligible students responded. The variety of clinical experiences and resident morale were weighed heavily in choosing a residency program; whereas financial incentives and parental leave attitudes had low influence. Major reasons that applicants selected their first choice program over their second choice included the distance to relatives and desirability of the city. Both genders had similar priorities when selecting programs. Family medicine applicants rated the variety of clinical experiences more importantly; whereas specialty applicants emphasized academic factors more. Conclusions Graduating medical students consider program characteristics such as the variety of clinical experiences and resident morale heavily in terms of overall priority. However, differentiation between their top two choice programs is often dependent on social/geographic factors

  7. Knowledge regarding risk factors of hypertension among entry year students of a medical university

    Directory of Open Access Journals (Sweden)

    Rizwana B Shaikh

    2011-01-01

    Full Text Available Context: Hypertension in youth is increasing, but there is a dearth of data about the knowledge of risk factors in this age group. Aims: To assess the knowledge of risk factors of hypertension among university students and associate it with the blood pressure, physical activity, family history of cardiovascular disease (CVD, and sociodemographic variables. Materials and Methods: A cross-sectional survey among students enrolled in the first year, in the four academic programs, with the use of a validated, self-administered questionnaire on physical activity in the past 30 days and knowledge of risk factors of hypertension. A score of 6 on 11 was considered as good knowledge for modifiable risk factors. Blood pressure was also measured. The data was analyzed using PASW-17, Chi square test, and binary logistic regression analysis was done. Results: Of the 110 participants, 69.2% were < 20 years of age, 76.4% were females, and 40% were Arabs. Stress, high cholesterol, obesity, and smoking were identified as risk factors by 75.5, 73.6, 77.6, and 71.8%, respectively; 69.1% considered high salt intake and 62.7% considered high calorie diet as risk factors. Energy drink was considered as a risk factor by 64.5%, coffee consumption 35.5%, physical inactivity 47%, and oral contraceptives 13.6%. Half the group did not consider a family history of CVD as a risk factor, 60% did not consider older age as a risk factor, and 88% did not think male gender was a risk factor. Knowledge of modifiable risk factors was better than that of non-modifiable risk factors. Although nationality, course of study, raised blood pressure, and history of diabetes showed significant association with good knowledge, their net effect was not significant by the Adjusted Odd′s Ratio. Conclusions: The study identified some gaps in knowledge regarding both modifiable and non-modifiable risk factors of hypertension among students. A larger study would enable health promotion activities

  8. Factors associated with the choice of general medicine as a career among Japanese medical students

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    Ryuichi Kawamoto

    2016-05-01

    Full Text Available Background: In Japan, there is a shortage of young physicians in various specialties; the present situation of general medicine or family medicine (GM/FM in particular is risky. The factors influencing the career choice of Japanese medical students are poorly understood. This study aims to identify factors related to choosing GM/FM as a career. Methods: The study was designed as a cross-sectional survey. Students at one medical school in Japan filled out a questionnaire. Students were asked to state their intended medical specialty, and they rated the importance of specific individual and occupational aspects using a 4-point likert scale. Factor analysis was performed on the variables. Reliability of the factor scores was estimated using Cronbach‘s alpha coefficients; biserial correlations between the factors and career choices were calculated. Furthermore, multiple linear regression analysis was performed using career choice (GM/FM vs. others as the criterion variable and the factors plus demographic characteristics as confounding variables. Results: Factor analysis produced six factors that explained future career plans. Medical students in this study had a positive and realistic idea about GM/FM, but only 18.8% of them chose GM/FM first as a career. The significant variables associated with choosing GM/FM first as a career were: ‘Admission from hometown’ (β=0.189, P=0.001, ‘Student preparing for the entrance exam’ (β=0.172; P=0.001, ‘Intent for rural practice’ (β=0.123, P=0.016, and ‘Work–life balance’ (β=0.126, P=0.013. While significant variables that were negatively associated with choosing GM/FM were ‘Presence of medical relatives’ (β=−0.107, P=0.037 and ‘Scientific orientation’ (β=−0.125, P=0.013. Conclusions: Strategies have been suggested, such as recruiting medical students with significant variables that were associated with choosing GM/FM first as a career. By engaging students early in their

  9. Assessing obstetric risk factors for maternal morbidity: congruity between medical records and mothers' reports of obstetric exposures.

    Science.gov (United States)

    Gartland, Deirdre; Lansakara, Nirosha; Flood, Margaret; Brown, Stephanie J

    2012-02-01

    We sought to assess congruity between data abstracted from medical records with answers to self-administered questionnaires. This was a multicenter prospective nulliparous pregnancy cohort. A total of 1507 women enrolled. Analyses were reported for 1296 with medical record data and 3-month postpartum follow-up. There was near-perfect agreement (κ ≥ 0.80) between maternal report and abstracted data for reproductive history, induction/augmentation method, epidural/spinal analgesia, method of birth, perineal repair, infant birthweight, and gestation. Agreement was poor to moderate for maternal position in second stage and duration of pushing. Maternal report of pregnancy, labor, and birth factors was very reliable and considered more accurate in relation to maternal position in labor and birth, smoking, prior terminations, and miscarriages. Use of routine birthing outcome summaries may introduce measurement error as hospitals differ in their definitions and reporting practices. Using primary data sources (eg, partograms) with clearly defined prespecified criteria will provide the most accurate obstetric exposure and outcome data. Copyright © 2012 Mosby, Inc. All rights reserved.

  10. Medical and Surgical Management of Postpartum Hemorrhage in a Woman with Factor XIII Deficiency

    Directory of Open Access Journals (Sweden)

    Michael Cheng

    2016-01-01

    Full Text Available Factor XIII deficiency is a rare inherited coagulopathy. Factor XIII is the last clotting factor in the coagulation cascade to insure strength and stability to fibrin clots. Without this enzyme, the fibrous clot is unstable and nonresistant to fibrinolysis. Gravid women with this congenital disease are especially at risk for complications including miscarriages and hemorrhage without appropriate interventions. We present a case of a woman in her 20s with Factor XIII deficiency who was treated with cryoprecipitate and had a successful normal spontaneous vaginal delivery; subsequently, patient suffered from postpartum hemorrhage and consumptive coagulopathy due to consumption of Factor XIII, requiring emergency surgical intervention. Intraoperative management was challenged by an ethical dilemma involving the patient’s religious beliefs about not receiving blood. This paper will discuss the mechanism of Factor XIII and the medical and surgical management involved with this patient.

  11. Why are you draining your brain? Factors underlying decisions of graduating Lebanese medical students to migrate.

    Science.gov (United States)

    Akl, Elie A; Maroun, Nancy; Major, Stella; Afif, Claude; Chahoud, Bechara; Choucair, Jacques; Sakr, Mazen; Schünemann, Holger J

    2007-03-01

    In the context of a worldwide physician brain drain phenomenon, Lebanon has the highest emigration factor in the Middle East and North Africa. In this manuscript we aim to identify and develop a conceptual framework for the factors underlying the decisions of graduating Lebanese medical students to train abroad. We conducted two focus groups and seven semi-structured individual interviews with 23 students. In the deductive analysis (based on the push-pull theory), students reported push factors in Lebanon and pull factors abroad related to five dimensions. They focused predominantly on how training abroad provides them with a competitive advantage in an oversaturated Lebanese job market. An inductive analysis revealed the following emerging concepts: repel factors abroad and retain factors locally; societal expectations that students should train abroad; marketing of abroad training; and an established culture of migration. The marketing of abroad training and the culture of migration are prevalent in the academic institutions.

  12. Description of risk and resilience factors among military medical personnel before deployment to Iraq.

    Science.gov (United States)

    Maguen, Shira; Turcotte, Diane M; Peterson, Alan L; Dremsa, Theresa L; Garb, Howard N; McNally, Richard J; Litz, Brett T

    2008-01-01

    Military medical personnel preparing for deployment to Iraq (N = 328) participated in a survey concerning predeployment risk and resilience factors. Participants reported exposure to an average of 2.5 potentially traumatic events before deployment and 76% (n = 229) reported at least two current concerns about predeployment stressors. Military personnel also endorsed a series of positive appraisals of the military, the mission, and their unit. Fairly low levels of post-traumatic stress disorder symptoms before deployment were reported and positive affect was significantly higher than reported negative affect. Post-traumatic stress disorder symptoms that were present before deployment were most strongly associated with risk factors, whereas positive affect was most strongly associated with resilience factors. Predeployment negative affect was associated with a combination of risk and resilience factors. These findings have implications for possible interventions and preparation of medical personnel before military deployment. A better understanding of the factors related to risk and resilience in military medical personnel will allow for improved screening, educational, training, and clinical programs aimed at increasing resilience before military deployments.

  13. Voice complaints, risk factors for voice problems and history of voice problems in relation to puberty in female student teachers.

    NARCIS (Netherlands)

    Thomas, G.; Jong, F.I.C.R.S. de; Kooijman, P.G.C.; Donders, A.R.T.; Cremers, C.W.R.J.

    2006-01-01

    The aim of the study was to estimate voice complaints, risk factors for voice complaints and history of voice problems in student teachers before they embarked on their professional teaching career. A cross-sectional questionnaire survey was performed among female student teachers. The response rate

  14. Factors from Durkheim's Family Integration Related to Suicidal Ideation among Men with Histories of Child Sexual Abuse

    Science.gov (United States)

    Easton, Scott D.; Renner, Lynette M.

    2013-01-01

    Men who were sexually abused during childhood represent a highly stigmatized, marginalized population at risk for a variety of long-term mental health problems. Using the family integration dimension of Durkheim's theory of suicide, factors associated with suicidal ideation among a purposive sample of 487 men with histories of child sexual…

  15. Voice complaints, risk factors for voice problems and history of voice problems in relation to puberty in female student teachers.

    NARCIS (Netherlands)

    Thomas, G.; Jong, F.I.C.R.S. de; Kooijman, P.G.C.; Donders, A.R.T.; Cremers, C.W.R.J.

    2006-01-01

    The aim of the study was to estimate voice complaints, risk factors for voice complaints and history of voice problems in student teachers before they embarked on their professional teaching career. A cross-sectional questionnaire survey was performed among female student teachers. The response rate

  16. Factors from Durkheim's Family Integration Related to Suicidal Ideation among Men with Histories of Child Sexual Abuse

    Science.gov (United States)

    Easton, Scott D.; Renner, Lynette M.

    2013-01-01

    Men who were sexually abused during childhood represent a highly stigmatized, marginalized population at risk for a variety of long-term mental health problems. Using the family integration dimension of Durkheim's theory of suicide, factors associated with suicidal ideation among a purposive sample of 487 men with histories of child sexual…

  17. New strategies in the assessment of psychological factors affecting medical conditions.

    Science.gov (United States)

    Sirri, Laura; Fabbri, Stefania; Fava, Giovanni A; Sonino, Nicoletta

    2007-12-01

    In this article, we examine research that may lead to a better assessment of psychological factors affecting medical conditions. We performed a review of the psychosomatic literature using both Medline and manual searches. We selected papers that were judged to be relevant to new strategies of assessment, with particular reference to the use of the Diagnostic Criteria for Psychosomatic Research. We assessed 8 areas concerned with the assessment of psychological factors in the setting of medical disease: hypochondriasis, disease phobia, persistent somatization, conversion symptoms, illness denial, demoralization, irritable mood, and Type A behavior. A new subclassification of the Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM-V]; not yet published) category of psychological factors affecting physical conditions appears to be feasible and may provide the clinician with better tools for identifying psychological distress.

  18. Factors that impact medical student and house-staff career interest in brain related specialties.

    Science.gov (United States)

    Kamour, Abdulbaset H; Han, Dong Y; Mannino, David M; Hessler, Amy B; Kedar, Sachin

    2016-10-15

    There is a national shortage of physicians in brain related specialties (neurology, neurosurgery and psychiatry), with fewer students training in these specialties. This study explored socio-economic and experiential factors that determined medical trainees' interest in brain related specialties. Medical students and house-staff at a state university medical school completed a 46-item questionnaire sent as an anonymous email survey. Survey response rate was 22% (n=258). Eighty-eight (34.1%) trainees were interested in brain related specialties. Prior neuroscience experience (29.6%) and effective medical school neuroscience courses (23.9%) were identified as important by those interested in brain related specialties, while "neurophobia" was reported by 30% of those not interested. Multivariate regression model showed that effective college neuroscience course increased the likelihood for interest in brain related specialties (OR=2.28, 95% CI 1.22, 4.28). Factors which decreased the likelihood included parent's possessing professional degree (OR=0.37, 95% CI 0.17, 0.80), personal annual income>$50,000 (OR=0.40, 0.18, 0.87) and current debt level≥$100,000 (OR=0.33, 0.17, 0.64). The proportion of trainees interested in brain related specialties decreased from 51.7% (1st year medical students) to 27% (4th year students) and 25.3% among house-staff (χ(2) test of trend p=0.001). Socioeconomic (current personal debt and annual income) and experiential factors (college neuroscience course) influence a medical trainee's interest in brain related specialties. Career guidance and improved, better and early exposure to neurosciences may help mitigate trend for decreased interest in brain related specialties. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. The Adult Reading History Questionnaire (ARHQ) in Icelandic: Psychometric Properties and Factor Structure

    Science.gov (United States)

    Bjornsdottir, Gyda; Halldorsson, Jonas G.; Steinberg, Stacy; Hansdottir, Ingunn; Kristjansson, Kristleifur; Stefansson, Hreinn; Stefansson, Kari

    2014-01-01

    This article describes psychometric testing of an Icelandic adaptation of the "Adult Reading History Questionnaire" (ARHQ), designed to detect a history of reading difficulties indicative of dyslexia. Tested in a large and diverse sample of 2,187 adults, the Icelandic adaptation demonstrated internal consistency reliability (Cronbach's…

  20. The Adult Reading History Questionnaire (ARHQ) in Icelandic: Psychometric Properties and Factor Structure

    Science.gov (United States)

    Bjornsdottir, Gyda; Halldorsson, Jonas G.; Steinberg, Stacy; Hansdottir, Ingunn; Kristjansson, Kristleifur; Stefansson, Hreinn; Stefansson, Kari

    2014-01-01

    This article describes psychometric testing of an Icelandic adaptation of the "Adult Reading History Questionnaire" (ARHQ), designed to detect a history of reading difficulties indicative of dyslexia. Tested in a large and diverse sample of 2,187 adults, the Icelandic adaptation demonstrated internal consistency reliability…

  1. Factors affecting adherence to antihypertensive medication in Greece: results from a qualitative study

    Directory of Open Access Journals (Sweden)

    Vassiliki Tsiantou

    2010-08-01

    Full Text Available Vassiliki Tsiantou1, Polina Pantzou2, Elpida Pavi1, George Koulierakis2, John Kyriopoulos11Department of Health Economics, National School of Public Health, Athens, Greece; 2Department of Sociology, National School of Public Health, Athens, GreeceIntroduction: Although hypertension constitutes a major risk factor for cardiovascular morbidity and mortality, research on adherence to antihypertensive treatment has shown that at least 75% of patients are not adherent because of the combined demographic, organizational, psychological, and disease- and medication-related factors. This study aimed to elicit hypertensive patients’ beliefs on hypertension and antihypertensive treatment, and their role to adherence.Methods: Transcripts from semistructured interviews and focus groups were content analyzed to extract participants’ beliefs about hypertension and antihypertensive treatment, and attitudes toward patient–physician and patient–pharmacist relationships.Results: Hypertension was considered a very serious disease, responsible for stroke and myocardial infarction. Participants expressed concerns regarding the use of medicines and the adverse drug reactions. Previous experience with hypertension, fear of complications, systematic disease management, acceptance of hypertension as a chronic disease, incorporation of the role of the patient and a more personal relationship with the doctor facilitated adherence to the treatment. On the other hand, some patients discontinued treatment when they believed that they had controlled their blood pressure.Conclusion: Cognitive and communication factors affect medication adherence. Results could be used to develop intervention techniques to improve medication adherence.Keywords: hypertension, medication adherence, patient compliance, doctor–patient communication, antihypertensive medicine

  2. Awareness of the Family History as a Factor in Psychological Well-being in Adolescence

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    Yakimova T.V.,

    2015-02-01

    Full Text Available We present the results of the study of connection of psychological well-being of adolescents with their awareness of their own family history. We briefly overview the main trends and individual empirical studies on the influence of family history of psychological well-being of the individual. In the present study, we focuses not on pathological influence of family history, but on its resource and supporting effect during the difficulties of adolescence. The study involved 32 teenagers. The empirical study is based on data obtained using a questionnaire designed to examine the links of teenager with extended family members and his awareness of family history. We found that adolescents who know their family history, have an interest in it and keep in touch with the extended family, are characterized by high values of the level of psychological well-being.

  3. An Evaluation of the Significance of Work-Related Influence Factors on Fitness and the Development of Medical and Orthopaedic Conditions in Military Executives

    Science.gov (United States)

    Becker, Michael; Finze, Susanne; Holtherm, Christoph; Hinder, Jens; Lison, Andreas

    2016-01-01

    Occupational health promotion is an effective tool to improve the state of health of employees. As part of occupational health promotion in the German Bundeswehr, top-ranking military executives are offered a medical examination and training programme. Health-related data is collected as a basis for training and lifestyle counselling. This data was subjected to a retrospective evaluation in order to identify occupational risk factors and their correlation with cardiovascular resilience, trunk strength, and the development of orthopaedic and internal disorders. A total of 122 military executives (all male, age 54.6 ± 4.2 years) answered a questionnaire aimed at evaluating private and occupational stress factors. The medical history was followed by a medical and orthopaedic examination involving a lactate performance test (treadmill or bicycle ergometry) and an isometric trunk strength measurement. The data obtained was then statistically evaluated. For military executives, work-related travelling and commuting involve a high risk of medical and orthopaedic conditions. Regular exercise leads to improved fitness levels. In order to prevent medical problems, military executives working long hours should regularly take part in fitness and weight training under professional instructions.

  4. An Evaluation of the Significance of Work-Related Influence Factors on Fitness and the Development of Medical and Orthopaedic Conditions in Military Executives

    Directory of Open Access Journals (Sweden)

    Christoph Schulze

    2016-01-01

    Full Text Available Occupational health promotion is an effective tool to improve the state of health of employees. As part of occupational health promotion in the German Bundeswehr, top-ranking military executives are offered a medical examination and training programme. Health-related data is collected as a basis for training and lifestyle counselling. This data was subjected to a retrospective evaluation in order to identify occupational risk factors and their correlation with cardiovascular resilience, trunk strength, and the development of orthopaedic and internal disorders. A total of 122 military executives (all male, age 54.6±4.2 years answered a questionnaire aimed at evaluating private and occupational stress factors. The medical history was followed by a medical and orthopaedic examination involving a lactate performance test (treadmill or bicycle ergometry and an isometric trunk strength measurement. The data obtained was then statistically evaluated. For military executives, work-related travelling and commuting involve a high risk of medical and orthopaedic conditions. Regular exercise leads to improved fitness levels. In order to prevent medical problems, military executives working long hours should regularly take part in fitness and weight training under professional instructions.

  5. [Study on restriction factors and countermeasures of influence of China medical devices competitiveness].

    Science.gov (United States)

    Zhang, Zhijun

    2012-07-01

    Recent years, China medical devices industry has been a sunrise industry with widely-ranged products, high-tech innovation, and booming market demands. But with the globalization of market economy, China industry is still in the inferior position of competition. How to promote the industrial structure transition, increase scientific and technological level, speed up the updating of products, enhance the international competitiveness is one of the major tasks to maintain the healthy development of industry. This article makes a study on current situation of China medical devices industry, analyses the new opportunities, challenges and restriction factors, provides the countermeasures of strengthening industry competitiveness as well.

  6. Becoming a general practitioner--which factors have most impact on career choice of medical students?

    Science.gov (United States)

    Kiolbassa, Kathrin; Miksch, Antje; Hermann, Katja; Loh, Andreas; Szecsenyi, Joachim; Joos, Stefanie; Goetz, Katja

    2011-05-09

    In Germany, there is a shortage of young physicians in several specialties, the situation of general practitioners (GP) being especially precarious. The factors influencing the career choice of German medical students are poorly understood. This study aims to identify factors influencing medical students' specialty choice laying a special focus on general practice. The study was designed as a cross-sectional survey. In 2010, students at the five medical schools in the federal state of Baden-Wuerttemberg (Germany) filled out an online-questionnaire. On 27 items with 5-point Likert scales, the students rated the importance of specified individual and occupational aspects. Furthermore, students were asked to assign their intended medical specialty. 1,299 students participated in the survey. Thereof, 1,114 students stated a current choice for a specialty, with 708 students choosing a career in one of the following 6 specialties: internal medicine, surgery, gynaecology and obstetrics, paediatrics, anaesthetics and general practice. Overall, individual aspects ('Personal ambition', 'Future perspective', 'Work-life balance') were rated as more important than occupational aspects (i.e. 'Variety in job', 'Job-related ambition') for career choice. For students favouring a career as a GP individual aspects and the factor 'Patient orientation' among the occupational aspects were significantly more important and 'Job-related ambition' less important compared to students with other specialty choices. This study confirms that future GPs differ from students intending to choose other specialties particularly in terms of patient-orientation and individual aspects such as personal ambition, future perspective and work-life balance. Improving job-conditions in terms of family compatibility and work-life balance could help to increase the attractiveness of general practice. Due to the shortage of GPs those factors should be made explicit at an early stage at medical school to increase

  7. Becoming a general practitioner - Which factors have most impact on career choice of medical students?

    Directory of Open Access Journals (Sweden)

    Loh Andreas

    2011-05-01

    Full Text Available Abstract Background In Germany, there is a shortage of young physicians in several specialties, the situation of general practitioners (GP being especially precarious. The factors influencing the career choice of German medical students are poorly understood. This study aims to identify factors influencing medical students' specialty choice laying a special focus on general practice. Methods The study was designed as a cross-sectional survey. In 2010, students at the five medical schools in the federal state of Baden-Wuerttemberg (Germany filled out an online-questionnaire. On 27 items with 5-point Likert scales, the students rated the importance of specified individual and occupational aspects. Furthermore, students were asked to assign their intended medical specialty. Results 1,299 students participated in the survey. Thereof, 1,114 students stated a current choice for a specialty, with 708 students choosing a career in one of the following 6 specialties: internal medicine, surgery, gynaecology and obstetrics, paediatrics, anaesthetics and general practice. Overall, individual aspects ('Personal ambition', 'Future perspective', 'Work-life balance' were rated as more important than occupational aspects (i.e. 'Variety in job', 'Job-related ambition' for career choice. For students favouring a career as a GP individual aspects and the factor 'Patient orientation' among the occupational aspects were significantly more important and 'Job-related ambition' less important compared to students with other specialty choices. Conclusions This study confirms that future GPs differ from students intending to choose other specialties particularly in terms of patient-orientation and individual aspects such as personal ambition, future perspective and work-life balance. Improving job-conditions in terms of family compatibility and work-life balance could help to increase the attractiveness of general practice. Due to the shortage of GPs those factors should

  8. Factors influencing medication adherence in patients with gout: A descriptive correlational study.

    Science.gov (United States)

    Chua, Xin Hui Jasmine; Lim, Siriwan; Lim, Fui Ping; Lim, Yee Nah Anita; He, Hong-Gu; Teng, Gim Gee

    2017-06-15

    To examine the factors influencing adherence to urate-lowering therapy in patients with gout in Singapore. Gout is the most common type of chronic inflammatory arthritis. Urate-lowering therapy (ULT) is used to treat gout by reducing serum uric acid levels. However, adherence to ULT among patients remains poor. To date, there have been no available studies based on a conceptual framework that examined factors influencing medication adherence in patients with gout. Cross-sectional, descriptive correlational study. A convenience sample of outpatients (n = 108) was recruited between October 2014 and January 2015 from a tertiary hospital in Singapore. Outcomes were measured by relevant valid and reliable instruments. Descriptive statistics and parametric tests including multiple linear regression were used to analyse the data. Although 44.4% of the participants were high adherers to urate-lowering therapy, the mean adherence level was moderate. Significant differences in medication adherence scores were found among the subgroups of gender, ethnicity, marital status, employment status, and presence of comorbidity. Medication adherence was positively significantly correlated with age, number of comorbidities, and beliefs about medicines. Linear regression showed that higher level of beliefs about medicines, presence of comorbidity, and being married were factors positively influencing medication adherence. This study revealed moderate adherence to ULT in patients with gout in Singapore, indicating the need for strategies to improve adherence by considering its main influencing factors. Future research should be conducted to develop interventions targeted at modifying patients' beliefs about medicines in order to improve medication adherence. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  9. Factors associated with consumption of caffeinated-beverage among Siriraj pre-clinical year medical students, A 2-year consecutive survey.

    Science.gov (United States)

    Pandejpong, Denla; Paisansudhi, Supalerg; Udompunthurak, Suthipol

    2014-03-01

    Previous studies showed that significant proportion of medical students consumed caffeine to face sleep-deprived daily schedules. To monitor the trend of caffeinated-beverage consumption among Siriraj medical students as well as to study possible factors associated with caffeine dependency. The questionnaire was distributed to a class of medical students for 2 consecutive years. Statistical analysis was performed for descriptive purpose. 269 (89.7%) and 225 (74.5%) questionnaires were returned in year 1 and year 2, respectively 16.2% refused to take caffeine-beverages totally. 13% of those who consumed caffeinated-beverages developed caffeine dependence. From logistical analysis, positive history of smoking-family member and female sex were the only other two factors associated with caffeine dependency (OR 2.19, 95% CI 1.04-4.61 and 1.76, 95% CI 1.01-3.07, respectively). Other investigated factors included: exercise (p = 0.08); sleep hours (p = 0.24); reading beverage labels (p = 0.87); alcohol consumption (p = 0.59); class performance (p = 0.87); family member coffee-drinking habits (p = 0.66);family member alcohol-drinking habits (p = 0.18); and family income (p = 0.06). Caffeinated-beverage consumption was common among Siriraj medical students. No significant change was detected in the pattern of caffeinated-beverage consumption within the study period. Positive history of smoking family members and female sex were found as the only other two factors correlated with caffeine dependency.

  10. Demographic Histories, Isolation and Social Factors as Determinants of the Genetic Structure of Alpine Linguistic Groups

    Science.gov (United States)

    Coia, Valentina; Capocasa, Marco; Anagnostou, Paolo; Pascali, Vincenzo; Scarnicci, Francesca; Boschi, Ilaria; Battaggia, Cinzia; Crivellaro, Federica; Ferri, Gianmarco; Alù, Milena; Brisighelli, Francesca; Busby, George B. J.; Capelli, Cristian; Maixner, Frank; Cipollini, Giovanna; Viazzo, Pier Paolo; Zink, Albert; Destro Bisol, Giovanni

    2013-01-01

    Great European mountain ranges have acted as barriers to gene flow for resident populations since prehistory and have offered a place for the settlement of small, and sometimes culturally diverse, communities. Therefore, the human groups that have settled in these areas are worth exploring as an important potential source of diversity in the genetic structure of European populations. In this study, we present new high resolution data concerning Y chromosomal variation in three distinct Alpine ethno-linguistic groups, Italian, Ladin and German. Combining unpublished and literature data on Y chromosome and mitochondrial variation, we were able to detect different genetic patterns. In fact, within and among population diversity values observed vary across linguistic groups, with German and Italian speakers at the two extremes, and seem to reflect their different demographic histories. Using simulations we inferred that the joint effect of continued genetic isolation and reduced founding group size may explain the apportionment of genetic diversity observed in all groups. Extending the analysis to other continental populations, we observed that the genetic differentiation of Ladins and German speakers from Europeans is comparable or even greater to that observed for well known outliers like Sardinian and Basques. Finally, we found that in south Tyroleans, the social practice of Geschlossener Hof, a hereditary norm which might have favored male dispersal, coincides with a significant intra-group diversity for mtDNA but not for Y chromosome, a genetic pattern which is opposite to those expected among patrilocal populations. Together with previous evidence regarding the possible effects of “local ethnicity” on the genetic structure of German speakers that have settled in the eastern Italian Alps, this finding suggests that taking socio-cultural factors into account together with geographical variables and linguistic diversity may help unveil some yet to be understood

  11. Demographic histories, isolation and social factors as determinants of the genetic structure of Alpine linguistic groups.

    Science.gov (United States)

    Coia, Valentina; Capocasa, Marco; Anagnostou, Paolo; Pascali, Vincenzo; Scarnicci, Francesca; Boschi, Ilaria; Battaggia, Cinzia; Crivellaro, Federica; Ferri, Gianmarco; Alù, Milena; Brisighelli, Francesca; Busby, George B J; Capelli, Cristian; Maixner, Frank; Cipollini, Giovanna; Viazzo, Pier Paolo; Zink, Albert; Destro Bisol, Giovanni

    2013-01-01

    Great European mountain ranges have acted as barriers to gene flow for resident populations since prehistory and have offered a place for the settlement of small, and sometimes culturally diverse, communities. Therefore, the human groups that have settled in these areas are worth exploring as an important potential source of diversity in the genetic structure of European populations. In this study, we present new high resolution data concerning Y chromosomal variation in three distinct Alpine ethno-linguistic groups, Italian, Ladin and German. Combining unpublished and literature data on Y chromosome and mitochondrial variation, we were able to detect different genetic patterns. In fact, within and among population diversity values observed vary across linguistic groups, with German and Italian speakers at the two extremes, and seem to reflect their different demographic histories. Using simulations we inferred that the joint effect of continued genetic isolation and reduced founding group size may explain the apportionment of genetic diversity observed in all groups. Extending the analysis to other continental populations, we observed that the genetic differentiation of Ladins and German speakers from Europeans is comparable or even greater to that observed for well known outliers like Sardinian and Basques. Finally, we found that in south Tyroleans, the social practice of Geschlossener Hof, a hereditary norm which might have favored male dispersal, coincides with a significant intra-group diversity for mtDNA but not for Y chromosome, a genetic pattern which is opposite to those expected among patrilocal populations. Together with previous evidence regarding the possible effects of "local ethnicity" on the genetic structure of German speakers that have settled in the eastern Italian Alps, this finding suggests that taking socio-cultural factors into account together with geographical variables and linguistic diversity may help unveil some yet to be understood

  12. Demographic histories, isolation and social factors as determinants of the genetic structure of Alpine linguistic groups.

    Directory of Open Access Journals (Sweden)

    Valentina Coia

    Full Text Available Great European mountain ranges have acted as barriers to gene flow for resident populations since prehistory and have offered a place for the settlement of small, and sometimes culturally diverse, communities. Therefore, the human groups that have settled in these areas are worth exploring as an important potential source of diversity in the genetic structure of European populations. In this study, we present new high resolution data concerning Y chromosomal variation in three distinct Alpine ethno-linguistic groups, Italian, Ladin and German. Combining unpublished and literature data on Y chromosome and mitochondrial variation, we were able to detect different genetic patterns. In fact, within and among population diversity values observed vary across linguistic groups, with German and Italian speakers at the two extremes, and seem to reflect their different demographic histories. Using simulations we inferred that the joint effect of continued genetic isolation and reduced founding group size may explain the apportionment of genetic diversity observed in all groups. Extending the analysis to other continental populations, we observed that the genetic differentiation of Ladins and German speakers from Europeans is comparable or even greater to that observed for well known outliers like Sardinian and Basques. Finally, we found that in south Tyroleans, the social practice of Geschlossener Hof, a hereditary norm which might have favored male dispersal, coincides with a significant intra-group diversity for mtDNA but not for Y chromosome, a genetic pattern which is opposite to those expected among patrilocal populations. Together with previous evidence regarding the possible effects of "local ethnicity" on the genetic structure of German speakers that have settled in the eastern Italian Alps, this finding suggests that taking socio-cultural factors into account together with geographical variables and linguistic diversity may help unveil some yet

  13. Career motivation and burnout among medical students in Hungary - could altruism be a protection factor?

    Science.gov (United States)

    Győrffy, Zsuzsa; Birkás, Emma; Sándor, Imola

    2016-07-18

    Burnout is a major issue among medical students. Its general characteristics are loss of interest in study and lack of motivation. A study of the phenomenon must extend beyond the university environment and personality factors to consider whether career choice has a role in the occurrence of burnout. Quantitative, national survey (n = 733) among medical students, using a 12-item career motivation list compiled from published research results and a pilot study. We measured burnout by the validated Hungarian version of MBI-SS. The most significant career choice factor was altruistic motivation, followed by extrinsic motivations: gaining a degree, finding a job, accessing career opportunities. Lack of altruism was found to be a major risk factor, in addition to the traditional risk factors, for cynicism and reduced academic efficacy. Our study confirmed the influence of gender differences on both career choice motivations and burnout. The structure of career motivation is a major issue in the transformation of the medical profession. Since altruism is a prominent motivation for many women studying medicine, their entry into the profession in increasing numbers may reinforce its traditional character and act against the present trend of deprofessionalization.

  14. Determinants and associated factors influencing medication adherence and persistence to oral anticancer drugs: a systematic review.

    Science.gov (United States)

    Verbrugghe, M; Verhaeghe, S; Lauwaert, K; Beeckman, D; Van Hecke, A

    2013-10-01

    The use of oral anticancer drugs has increased in modern oncology treatment. The move from intravenous treatments towards oral anticancer drugs has increased the patients' own responsibility to take oral anticancer drugs as being prescribed. High rates of non-adherence to oral anticancer drugs have been reported. A systematic literature review was conducted to gain insight into determinants and associated factors of non-adherence and non-persistence in patients taking oral anticancer therapy. PubMed, Cochrane, Web of Science and Cinahl were systematically searched for studies focusing on determinants and associated factors of medication non-adherence and non-persistence to oral anticancer drugs. The methodological quality of the included studies was assessed by two independent reviewers. No studies were excluded based on the quality assessment. Twenty-five studies were included and systematically reviewed. The quality of the studies was moderate. Associated factors influencing medication non-adherence and non-persistence to oral anticancer drugs are multifactorial and interrelated. Older and younger age, and the influence of therapy related side effects were found to be predominant factors. Non-adherence and non-persistence to oral anticancer drug therapy are complex phenomena. More qualitative research is needed to facilitate the development of patient tailored complex interventions by exploring patients' needs and underlying processes influencing medication non-adherence and non-persistence to oral anticancer drugs. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Common and unique associated factors for medically unexplained chronic widespread pain and chronic fatigue.

    Science.gov (United States)

    McBeth, J; Tomenson, B; Chew-Graham, C A; Macfarlane, G J; Jackson, J; Littlewood, A; Creed, F H

    2015-12-01

    Chronic widespread pain and chronic fatigue share common associated factors but these associations may be explained by the presence of concurrent depression and anxiety. We mailed questionnaires to a randomly selected sample of people in the UK to identify participants with chronic widespread pain (ACR 1990 definition) and those with chronic fatigue. The questionnaire assessed sociodemographic factors, health status, healthcare use, childhood factors, adult attachment, and psychological stress including anxiety and depression. To identify persons with unexplained chronic widespread pain or unexplained chronic fatigue; we examined participant's medical records to exclude medical illness that might cause these symptoms. Of 1443 participants (58.0% response rate) medical records of 990 were examined. 9.4% (N=93) had unexplained chronic widespread pain and 12.6% (N=125) had unexplained chronic fatigue. Marital status, childhood psychological abuse, recent threatening experiences and other somatic symptoms were commonly associated with both widespread pain and fatigue. No common effect was found for few years of education and current medical illnesses (more strongly associated with chronic widespread pain) or recent illness in a close relative, neuroticism, depression and anxiety scores (more strongly associated with chronic fatigue). Putative associated factors with a common effect were associated with unexplained chronic widespread pain or unexplained chronic fatigue only when there was concurrent anxiety and/or depression. This study suggests that the associated factors for chronic widespread pain and chronic fatigue need to be studied in conjunction with concurrent depression/anxiety. Clinicians should be aware of the importance of concurrent anxiety or depression. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  16. Common and unique associated factors for medically unexplained chronic widespread pain and chronic fatigue☆

    Science.gov (United States)

    McBeth, J.; Tomenson, B.; Chew-Graham, C.A.; Macfarlane, G.J.; Jackson, J.; Littlewood, A.; Creed, F.H.

    2015-01-01

    Objective Chronic widespread pain and chronic fatigue share common associated factors but these associations may be explained by the presence of concurrent depression and anxiety. Methods We mailed questionnaires to a randomly selected sample of people in the UK to identify participants with chronic widespread pain (ACR 1990 definition) and those with chronic fatigue. The questionnaire assessed sociodemographic factors, health status, healthcare use, childhood factors, adult attachment, and psychological stress including anxiety and depression. To identify persons with unexplained chronic widespread pain or unexplained chronic fatigue; we examined participant's medical records to exclude medical illness that might cause these symptoms. Results Of 1443 participants (58.0% response rate) medical records of 990 were examined. 9.4% (N = 93) had unexplained chronic widespread pain and 12.6% (N = 125) had unexplained chronic fatigue. Marital status, childhood psychological abuse, recent threatening experiences and other somatic symptoms were commonly associated with both widespread pain and fatigue. No common effect was found for few years of education and current medical illnesses (more strongly associated with chronic widespread pain) or recent illness in a close relative, neuroticism, depression and anxiety scores (more strongly associated with chronic fatigue). Putative associated factors with a common effect were associated with unexplained chronic widespread pain or unexplained chronic fatigue only when there was concurrent anxiety and/or depression. Discussion This study suggests that the associated factors for chronic widespread pain and chronic fatigue need to be studied in conjunction with concurrent depression/anxiety. Clinicians should be aware of the importance of concurrent anxiety or depression. PMID:26652592

  17. A case control study on family history as a risk factor for herpes zoster and associated outcomes, Beijing, China.

    Science.gov (United States)

    Suo, Luodan; Lu, Li; Li, Juan; Sun, Mu; Wang, Haihong; Peng, Xinhui; Yang, Fan; Pang, Xinghuo; Marin, Mona; Wang, Chengbin

    2017-05-09

    Hospital-based case control studies have found family history of herpes zoster (HZ) was associated with risk of HZ, but the role of family history is not fully examined for other HZ-associated outcomes such as recurrent HZ, occurrence of postherpetic neuralgia (PHN), and HZ with different pain severities. We conducted a population-based matched case control study. HZ cases that occurred during December 1, 2011 to November 30, 2012 were identified by face-to-face interview with all residents of eight selected communities/villages from three districts of Beijing, China. Medical records were reviewed for those who sought healthcare for HZ. For each case-patient, three, age-matched controls (±5 years) without HZ were enrolled from the same community/village of the matched case. Data on family history of HZ were collected by interview and only defined among first-degree relatives. A total of 227 case-patients and 678 matched controls were enrolled. Case-patients were more likely to report a family history of HZ [odds ratio (OR) =2.4, P = 0.002]. Compared with controls, association of family history decreased from HZ with PHN to HZ without PHN (OR = 6.0 and 2.3, respectively; P = 0.002 for trend), from recurrent HZ to primary HZ (OR = 9.4 and 2.2, respectively; P = 0.005 for trend), and from HZ with moderate or severe pain to HZ with mild or no pain (OR = 3.2 and 0.8, respectively; P < 0.001 for trend). Family history of HZ was associated with HZ occurrence and was more likely in HZ case-patients with PHN, recurrences, and painful HZ.

  18. Integration of human factors and ergonomics during medical device design and development: it's all about communication.

    Science.gov (United States)

    Vincent, Christopher James; Li, Yunqiu; Blandford, Ann

    2014-05-01

    Manufacturers of interactive medical devices, such as infusion pumps, need to ensure that devices minimise the risk of unintended harm during use. However, development teams face challenges in incorporating Human Factors. The aim of the research reported here was to better understand the constraints under which medical device design and development take place. We report the results of a qualitative study based on 19 semi-structured interviews with professionals involved in the design, development and deployment of interactive medical devices. A thematic analysis was conducted. Multiple barriers to designing for safety and usability were identified. In particular, we identified barriers to communication both between the development organisation and the intended users and between different teams within the development organisation. We propose the use of mediating representations. Artefacts such as personas and scenarios, known to provide integration across multiple perspectives, are an essential component of designing for safety and usability.

  19. Human factors perspective on the prescribing behavior of recent medical graduates: implications for educators

    Directory of Open Access Journals (Sweden)

    Gordon M

    2013-01-01

    Full Text Available Morris Gordon,1,2 Ken Catchpole,3 Paul Baker1,41Faculty of Health and Social Care, University of Salford, Salford, UK; 2Department of Paediatrics, Fairfield General Hospital, Bury, UK; 3Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA; 4North Western Deanery, Manchester, UKBackground: Junior doctors are at high risk of involvement in medication errors. Educational interventions to enhance human factors and specifically nontechnical skills in health care are increasingly reported, but there is no work in the context of prescribing improvement to guide such education. We set out to determine the elements that influence prescribing from a human factors perspective by recent medical graduates and use this to guide education in this area.Methods: A total of 206 recent medical graduates of the North Western Foundation School were asked to describe their views on safety practices and behaviors. Free text data regarding prescribing behaviors were collected 1, 2, and 4 months after starting their posts. A 94.1% response rate was achieved. Qualitative analysis of data was completed using the constant comparison method. Five initial categories were developed, and the researchers subsequently developed thematic indices according to their understanding of the emerging content of the data. Further data were collected through group interviews 8–9 months into the placement to ensure thematic saturation.Results: Six themes were established at the axial coding level, ie, contributors to inappropriate prescribing, contributors to appropriate prescribing, professional responsibility, prescribing error, current practices, and methods for improvement of prescribing. Utilizing appropriate theoretical elements, we describe how recent medical graduates employ situational and error awareness to guide risk assessment.Conclusion: We have modeled the human factors of prescribing behavior by recent medical graduates. As these factors are related to

  20. Risk Factors for Medical Complication after Cervical Spine Surgery: a multivariate analysis of 582 patients

    Science.gov (United States)

    Lee, Michael J.; Konodi, Mark A.; Cizik, Amy M.; Weinreich, Mark A.; Bransford, Richard J.; Bellabarba, Carlo; Chapman, Jens

    2012-01-01

    Study Design Multivariate analysis of prospectively collected registry data Objective Using multivariate analysis, to determine significant risk factors for medical complication after cervical spine surgery. Summary of Background Data Several studies have examined the occurrence of medical complication after spine surgery. However many of these studies have been done utilizing large national databases. While these allow for analysis of thousands of patients, potentially influential co-variates are not accounted for in these retrospective studies. Furthermore, the accuracy of these retrospective data collection in these databases has been called into question. Methods The Spine End Results Registry (2003–2004) is a collection prospectively collected data on all patients who underwent spine surgery at our two institutions. Extensive demographic and medical information were prospectively recorded as described previously by Mirza et al. Complications were defined in detail a priori and were prospectively recorded for at least 2 years after surgery. We analyzed risk factors for medical complication after lumbar spine surgery using univariate and multivariate analysis. Results We analayzed data from 582 patients who met out inclusion criteria. The cumulative incidences of complication after cervical spine surgery per organ system are as follows: cardiac – 8.4%, pulmonary – 13%, gastrointestinal – 3.9%, neurological – 7.4%, hematological – 10.8% and urologic complications – 9.2%. The occurrence of cardiac or respiratory complication after cervical spine surgery was significantly associated with death within 2 years (RR 4.32, 6.43 respectively). Relative risk values with 95% confidence intervals and p values are listed individually in Tables 2 and 3. Conclusion Risk factors identified in this study can be beneficial to clinicians and patients alike when considering surgical treatment of the cervical spine. Future analyses and models that predict the

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

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    Legese Chelkeba

    2013-06-01

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

  2. Perceived psychological stress among undergraduate medical students: Role of academic factors

    Directory of Open Access Journals (Sweden)

    Ranadip Chowdhury

    2017-01-01

    Full Text Available Recently, there is a growing concern about stress during undergraduate medical training. The objectives of our study were to assess perceived stress among undergraduate medical students and to find out academic factors as determinants. A cross-sectional, questionnaire-based survey was carried out among undergraduate medical students of R. G. Kar Medical College, India, during July 2011–June 2012. Perceived stress was assessed using the Perceived Stress Scale-14. A 10-item questionnaire was used to assess academic sources of stress and their severity. The overall mean perceived stress score was 29.58 (standard deviation [SD] = 6.60, and 46.3% of the participants were in the group of more stressed (perceived stress score ≥28. The academic stressor factors predicted 78% of variability of perceived stress. A higher level of perceived stress was reported by the students. The students should be taught different stress management techniques to improve their ability to cope with a demanding professional course.

  3. Confounding factors in using upward feedback to assess the quality of medical training: a systematic review.

    Science.gov (United States)

    Zhou, Anli Yue; Baker, Paul

    2014-01-01

    Upward feedback is becoming more widely used in medical training as a means of quality control. Multiple biases exist, thus the accuracy of upward feedback is debatable. This study aims to identify factors that could influence upward feedback, especially in medical training. A systematic review using a structured search strategy was performed. Thirty-five databases were searched. Results were reviewed and relevant abstracts were shortlisted. All studies in English, both medical and non-medical literature, were included. A simple pro-forma was used initially to identify the pertinent areas of upward feedback, so that a focused pro-forma could be designed for data extraction. A total of 204 articles were reviewed. Most studies on upward feedback bias were evaluative studies and only covered Kirkpatrick level 1-reaction. Most studies evaluated trainers or training, were used for formative purposes and presented quantitative data. Accountability and confidentiality were the most common overt biases, whereas method of feedback was the most commonly implied bias within articles. Although different types of bias do exist, upward feedback does have a role in evaluating medical training. Accountability and confidentiality were the most common biases. Further research is required to evaluate which types of bias are associated with specific survey characteristics and which are potentially modifiable.

  4. Factors influencing adherence to psychopharmacological medications in psychiatric patients: a structural equation modeling approach

    Science.gov (United States)

    De las Cuevas, Carlos; de Leon, Jose; Peñate, Wenceslao; Betancort, Moisés

    2017-01-01

    Purpose To evaluate pathways through which sociodemographic, clinical, attitudinal, and perceived health control variables impact psychiatric patients’ adherence to psychopharmacological medications. Method A sample of 966 consecutive psychiatric outpatients was studied. The variables were sociodemographic (age, gender, and education), clinical (diagnoses, drug treatment, and treatment duration), attitudinal (attitudes toward psychopharmacological medication and preferences regarding participation in decision-making), perception of control over health (health locus of control, self-efficacy, and psychological reactance), and level of adherence to psychopharmacological medications. Structural equation modeling was applied to examine the nonstraightforward relationships and the interactive effects among the analyzed variables. Results Structural equation modeling demonstrated that psychiatric patients’ treatment adherence was associated: 1) negatively with cognitive psychological reactance (adherence decreased as cognitive psychological reactance increased), 2) positively with patients’ trust in their psychiatrists (doctors’ subscale), 3) negatively with patients’ belief that they are in control of their mental health and that their mental health depends on their own actions (internal subscale), and 4) positively (although weakly) with age. Self-efficacy indirectly influenced treatment adherence through internal health locus of control. Conclusion This study provides support for the hypothesis that perceived health control variables play a relevant role in psychiatric patients’ adherence to psychopharmacological medications. The findings highlight the importance of considering prospective studies of patients’ psychological reactance and health locus of control as they may be clinically relevant factors contributing to adherence to psychopharmacological medications.

  5. Risk factor detection for heart disease by applying text analytics in electronic medical records.

    Science.gov (United States)

    Torii, Manabu; Fan, Jung-Wei; Yang, Wei-Li; Lee, Theodore; Wiley, Matthew T; Zisook, Daniel S; Huang, Yang

    2015-12-01

    In the United States, about 600,000 people die of heart disease every year. The annual cost of care services, medications, and lost productivity reportedly exceeds 108.9 billion dollars. Effective disease risk assessment is critical to prevention, care, and treatment planning. Recent advancements in text analytics have opened up new possibilities of using the rich information in electronic medical records (EMRs) to identify relevant risk factors. The 2014 i2b2/UTHealth Challenge brought together researchers and practitioners of clinical natural language processing (NLP) to tackle the identification of heart disease risk factors reported in EMRs. We participated in this track and developed an NLP system by leveraging existing tools and resources, both public and proprietary. Our system was a hybrid of several machine-learning and rule-based components. The system achieved an overall F1 score of 0.9185, with a recall of 0.9409 and a precision of 0.8972.

  6. Factors influencing medication errors according to nurses' decisions to do self-report

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    Foad Rahimi

    2015-02-01

    Conclusions: The results of this study showed that the most important factors affecting the incidence of errors include workplace stress, working in the intensive care units, tiredness due to work load, and inappropriate nurse physician relationship. Hence, identification of these factors helps nurses to reduce errors and helps reduce other medical consequences and improve in the quality of patient care and patient safety. Regarding the importance of patient safety it is necessary to improve positive relationship between nurse managers and nursing staff. Therefore, an environment of close collaboration, in-service training for new nurses regarding medication errors, and creating a reporting system is necessary. [Int J Basic Clin Pharmacol 2015; 4(1.000: 130-133

  7. [The evaluation of health of medical personnel of ambulance care and impacting factors].

    Science.gov (United States)

    2012-01-01

    The analysis of self-assessment of medical personnel of ambulance care revealed that 13.2% of respondents consider themselves as healthy persons, 35.1%--as practically healthy, 39.2%--as rarely being ill, 12%--as often being ill According to the poll data, deterioration of health is promoted by such personal factors as disregard of one's health (35%) and chronic diseases (25.3%). Its own role play such external factors as professional characteristics (34%). ecological conditions (23%), poor conditions of work (22.2%). The amelioration of health is supported mainly by sport exercises (42.8%). The significant role in this process play the improvement of work conditions, the enhancement of quality of medical examninations and the introduction of professional dispanserization.

  8. The effective factors on the academic progress of the students of Tehran University of Medical Science.

    Science.gov (United States)

    Roudbari, Masoud; Ahmadi, Azadeh; Roudbari, Soudeh; Sedghi, Shahram

    2014-01-01

    To examine factors influencing the academic performance of students at Tehran University of Medical Sciences. The retrospective cross-sectional study was conducted between 2008 and 2009 at the Tehran University of Medical Sciences, Iran. Data was obtained from the education office of the university and SPSS version 15 was used for data analysis. Of the 670 students in the study, 230 (34.3%) were boys and 440 (65.6%) were girls.The highest mean score of courses belonged to the Psychiatry Institute (18.68) and the lowest was in the School of Medicine (15.20). Twenty nine per cent of students had failed course and 8.4% had failed semester. The variables gender, level of education, and school are the most important factors affecting the educational progress of students. Overall, students' failure ratios varied significantly between schools and educational levels.

  9. Factors contributing to the low uptake of medical male circumcision in Mutare Rural District, Zimbabwe

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    Irene O. Chiringa

    2016-03-01

    Full Text Available Background: Medical male circumcision (MMC has become a significant dimension of HIV prevention interventions, after the results of three randomised controlled trials in Uganda, South Africa and Kenya demonstrated that circumcision has a protective effect against contracting HIV of up to 60%. Following recommendations by the World Health Organization, Zimbabwe in 2009 adopted voluntary MMC as an additional HIV prevention strategy to the existing ABC behaviour change model.Purpose: The purpose of this study is thus to investigate the factors contributing to the low uptake of MMC.Methods: The study was a quantitative cross-sectional survey conducted in Mutare rural district, Zimbabwe. Questionnaires with open- and closed-ended questions were administered to the eligible respondents. The target population were male participants aged 15–29 who met the inclusion criteria. The households were systematically selected with a sample size of 234. Statistical Package for the Social Sciences was used to analyse the data.Results: Socioculturally, circumcised men are viewed as worthless (37%, shameful (30% and are tainted as promiscuous (20%, psychological factors reported were infection and delayed healing (39%, being ashamed and dehumanised (58%, stigmatised and discriminated (40.2% and fear of having an erection during treatment period (89.7% whilst socio-economic factors were not having time, as it will take their time from work (58% and complications may arise leading to spending money on treatment (84%.Conclusion: Knowledge deficits regarding male medical circumcision lead to low uptake, education on male medical circumcision and its benefits. Comprehensive sexual health education should target men and dispel negative attitudes related to the use of health services.Keywords: Factors, Low uptake, Medical Male Circumcision (MMC

  10. Medication Errors in Hospitals: A Study of Factors Affecting Nursing Reporting in a Selected Center Affiliated with Shahid Beheshti University of Medical Sciences

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    HamidReza Mirzaee

    2015-10-01

    Full Text Available Background: Medication errors are mentioned as the most common important challenges threatening healthcare system in all countries worldwide. This study is conducted to investigate the most significant factors in refusal to report medication errors among nursing staff.Methods: The cross-sectional study was conducted on all nursing staff of a selected Education& Treatment Center in 2013. Data was collected through a teacher made questionnaire. The questionnaires’ face and content validity was confirmed by experts and for measuring its reliability test-retest was used. Data was analyzed by descriptive and analytic statistics. 16th  version of SPSS was also used for related statistics.Results: The most important factors in refusal to report medication errors respectively are: lack of reporting system in the hospital(3.3%, non-significance of reporting medication errors to hospital authorities and lack of appropriate feedback(3.1%, and lack of a clear definition for a medication error (3%. there was a significant relationship between the most important factors of refusal to report medication errors and work shift (p:0.002, age(p:0.003, gender(p:0.005, work experience(p<0.001 and employment type of nurses(p:0.002.Conclusion: Factors pertaining to management in hospitals as well as the fear of the consequences of reporting are two broad fields among the factors that make nurses not report their medication errors. In this regard, providing enough education to nurses, boosting the job security for nurses, management support and revising related processes and definitions are some factors that can help decreasing medication errors and increasing their report in case of occurrence.

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

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    Vincent Boima

    2015-01-01

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

  12. Prevalence of internet addiction and associated factors among medical students from mashhad, iran in 2013.

    Science.gov (United States)

    Salehi, Maryam; Norozi Khalili, Mina; Hojjat, Seyed Kaveh; Salehi, Mahta; Danesh, Ali

    2014-05-01

    Problematic internet use is on the increase and has caused serious problems in many areas. This issue seems to be more important for medical students. This study was designed to explore the prevalence of internet addiction and its related factors among the students of Mashhad University of Medical Sciences. A cross sectional study was conducted on 383 medical students of Mashhad in 2013. Four hundred participants were selected through two-stage stratified sampling method proportional to the number of students in each stage of education. Data Collection was done through using the Chen Internet Addiction Scale (CIAS) and a checklist of demographic details and characteristics of internet usage behavior. It was found that 2.1% of the studied population were at risk and 5.2% were addicted users. Chatting with new people, communicating with friends and families, and playing games were the most popular activities in these groups. The factors related to internet addiction included: male sex, stage of education, daily time spent on using internet, most frequent time of internet use, monthly cost of use, and tea consumption. Although our study showed the prevalence of internet addiction was not more than other populations and universities, since the prevalence of internet addiction is rapidly increasing worldwide, this population might also be at risk of addiction. Thus, focusing on related factors can help us in designing more effective interventions and treatments for this susceptible group.

  13. Risk factors of coronary heart disease among medical students in King Abdulaziz University, Jeddah, Saudi Arabia.

    Science.gov (United States)

    Ibrahim, Nahla Khamis; Mahnashi, Morooj; Al-Dhaheri, Amal; Al-Zahrani, Borooj; Al-Wadie, Ebtihal; Aljabri, Mydaa; Al-Shanketi, Rajaa; Al-Shehri, Rawiah; Al-Sayes, Fatin M; Bashawri, Jamil

    2014-04-28

    Nowadays, Cardiovascular Diseases (CVDs) represents an escalating worldwide public health problem. Providing consistent data on the magnitude and risk factors of CVDs among young population will help in controlling the risks and avoiding their consequences. The objective was to estimate the prevalence of risk factors of Coronary Heart Disease (CHD) among medical students during their clinical clerkship (4th - 6th years). A cross-sectional study was done during the educational year 2012-2013 at King Abdulaziz University (KAU), Jeddah. Ethical standards were followed and a multistage stratified random sample method was used for selection of 214 medical students. Data was collected through an interviewing questionnaire, measurements and laboratory investigations. Both descriptive and analytical statistics were done by SPSS version 21. CHD risk percent in thirty years was calculated using Framingham algorithm for each student, then the risk among all students was determined. The commonest risk factors of CHDs were daily intake of high fat diet (73.4%), physical inactivity (57.9%), overweight/or obesity (31.2%) and daily consumption of fast food (13.1%). Hyper-cholesterolemia (17.2%) and hypertension (9.3%) were also prevalent risk factors. Smoking prevalence was low (2.8%). Males had significantly higher mean scores for most of CHD risk factors compared to females (p < 0.05). Systolic Blood pressure was higher among males (119.47 ± 11.17) compared to females (112.26 ± 9.06). A highly statistical significant difference was present (Students't test = 4.74, p < 0.001). Framingham Risk Score revealed that CHD risk percent in thirty-years among all students was 10.7%, 2.3% and 0.5% for mild, moderate and severe risk, respectively. An alarmingly high prevalence of CHD risk factors was prevailed among medical students, especially among males. However, a low prevalence of smoking may indicate the success of "Smoke-free Campus" program. Screening risk

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

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    Al Ghobain M

    2016-08-01

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

  15. A study of the factors influencing school-going students considering medical careers.

    LENUS (Irish Health Repository)

    McHugh, S M

    2012-02-01

    INTRODUCTION: Obtaining a place in an Irish medical school is extremely competitive, a situation mirrored in many other countries. We aimed to determine the factors influencing school students in deciding to study medicine in university. We further determined what level of interest exists in pursuing a surgical career after completion of medical school. METHODS: The Royal College of Surgeons in Ireland hosts an annual "Introduction to Medicine" programme for senior school children. Attendees were surveyed using a Likert scale to examine the factors influencing the group in choosing to study medicine, and pursue surgery as their ultimate career choice. RESULTS: A total of 128 completed the survey, giving a response rate of 100%. The opportunity to help others was most the most influential factors cited by students (97%). Males were significantly more likely to have an interest in a career in surgery rather than medicine (p = 0.003), and ranked "financial reward" (p = 0.036) as a more significant factors in influencing career choice than did females. CONCLUSIONS: A clear understanding of these factors influencing our students in their career choices and a strategy of recruitment based on these is imperative in order to optimize recruitment of students most suited to working as doctors.

  16. Identification of factors that affect the adoption of an ergonomic intervention among Emergency Medical Service workers.

    Science.gov (United States)

    Weiler, Monica R; Lavender, Steven A; Crawford, J Mac; Reichelt, Paul A; Conrad, Karen M; Browne, Michael W

    2012-01-01

    This study explored factors contributing to intervention adoption decisions among Emergency Medical Service (EMS) workers. Emergency Medical Service workers (n = 190), from six different organisations, participated in a two-month longitudinal study following the introduction of a patient transfer-board (also known as slide-board) designed to ease lateral transfers of patients to and from ambulance cots. Surveys administered at baseline, after one month and after two months sampled factors potentially influencing the EMS providers' decision process. 'Ergonomics Advantage' and 'Patient Advantage' entered into a stepwise regression model predicting 'intention to use' at the end of month one (R (2 )= 0.78). After the second month, the stepwise regression indicated only two factors were predictive of intention to use: 'Ergonomics Advantage,' and 'Endorsed by Champions' (R (2 )= 0.58). Actual use was predicted by: 'Ergonomics Advantage' and 'Previous Tool Experience.' These results relate to key concepts identified in the diffusion of innovation literature and have the potential to further ergonomics intervention adoption efforts. Practitioner Summary. This study explored factors that potentially facilitate the adoption of voluntarily used ergonomics interventions. EMS workers were provided with foldable transfer-boards (slideboards) designed to reduce the physical demands when laterally transferring patients. Factors predictive of adoption measures included perceived ergonomics advantage, the endorsement by champions, and prior tool experience.

  17. Availability and quality of coronary heart disease family history in primary care medical records: implications for cardiovascular risk assessment.

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    Paula Dhiman

    Full Text Available BACKGROUND: The potential to use data on family history of premature disease to assess disease risk is increasingly recognised, particularly in scoring risk for coronary heart disease (CHD. However the quality of family health information in primary care records is unclear. AIM: To assess the availability and quality of family history of CHD documented in electronic primary care records. DESIGN: Cross-sectional study. SETTING: 537 UK family practices contributing to The Health Improvement Network database. METHOD: Data were obtained from patients aged 20 years or more, registered with their current practice between 1(st January 1998 and 31(st December 2008, for at least one year. The availability and quality of recorded CHD family history was assessed using multilevel logistic and ordinal logistic regression respectively. RESULTS: In a cross-section of 1,504,535 patients, 19% had a positive or negative family history of CHD recorded. Multilevel logistic regression showed patients aged 50-59 had higher odds of having their family history recorded compared to those aged 20-29 (OR:1.23 (1.21 to 1.25, however most deprived patients had lower odds compared to those least deprived (OR: 0.86 (0.85 to 0.88. Of the 140,058 patients with a positive family history recorded (9% of total cohort, age of onset was available in 45%; with data specifying both age of onset and relative affected available in only 11% of records. Multilevel ordinal logistic regression confirmed no statistical association between the quality of family history recording and age, gender, deprivation and year of registration. CONCLUSION: Family history of CHD is documented in a small proportion of primary care records; and where positive family history is documented the details are insufficient to assess familial risk or populate cardiovascular risk assessment tools. Data capture needs to be improved particularly for more disadvantaged patients who may be most likely to benefit from

  18. Availability and quality of coronary heart disease family history in primary care medical records: implications for cardiovascular risk assessment.

    Science.gov (United States)

    Dhiman, Paula; Kai, Joe; Horsfall, Laura; Walters, Kate; Qureshi, Nadeem

    2014-01-01

    The potential to use data on family history of premature disease to assess disease risk is increasingly recognised, particularly in scoring risk for coronary heart disease (CHD). However the quality of family health information in primary care records is unclear. To assess the availability and quality of family history of CHD documented in electronic primary care records. Cross-sectional study. 537 UK family practices contributing to The Health Improvement Network database. Data were obtained from patients aged 20 years or more, registered with their current practice between 1(st) January 1998 and 31(st) December 2008, for at least one year. The availability and quality of recorded CHD family history was assessed using multilevel logistic and ordinal logistic regression respectively. In a cross-section of 1,504,535 patients, 19% had a positive or negative family history of CHD recorded. Multilevel logistic regression showed patients aged 50-59 had higher odds of having their family history recorded compared to those aged 20-29 (OR:1.23 (1.21 to 1.25)), however most deprived patients had lower odds compared to those least deprived (OR: 0.86 (0.85 to 0.88)). Of the 140,058 patients with a positive family history recorded (9% of total cohort), age of onset was available in 45%; with data specifying both age of onset and relative affected available in only 11% of records. Multilevel ordinal logistic regression confirmed no statistical association between the quality of family history recording and age, gender, deprivation and year of registration. Family history of CHD is documented in a small proportion of primary care records; and where positive family history is documented the details are insufficient to assess familial risk or populate cardiovascular risk assessment tools. Data capture needs to be improved particularly for more disadvantaged patients who may be most likely to benefit from CHD risk assessment.

  19. Fibroblast Growth Factor 21 (FGF-21 in Peritoneal Dialysis Patients: Natural History and Metabolic Implications.

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    Elena González

    Full Text Available Human fibroblast growth factor 21 (FGF-21 is an endocrine liver hormone that stimulates adipocyte glucose uptake independently of insulin, suppresses hepatic glucose production and is involved in the regulation of body fat. Peritoneal dialysis (PD patients suffer potential interference with FGF-21 status with as yet unknown repercussions.The aim of this study was to define the natural history of FGF-21 in PD patients, to analyze its relationship with glucose homeostasis parameters and to study the influence of residual renal function and peritoneal functional parameters on FGF-21 levels and their variation over time.We studied 48 patients with uremia undergoing PD. Plasma samples were routinely obtained from each patient at baseline and at 1, 2 and 3 years after starting PD therapy.Plasma FGF-21 levels substantially increased over the first year and were maintained at high levels during the remainder of the study period (253 pg/ml (59; 685 at baseline; 582 pg/ml (60.5-949 at first year and 647 pg/ml (120.5-1116.6 at third year (p<0.01. We found a positive correlation between time on dialysis and FGF-21 levels (p<0.001, and also, those patients with residual renal function (RRF had significantly lower levels of FGF-21 than those without RRF (ρ -0.484, p<0.05. Lastly, there was also a significant association between FGF-21 levels and peritoneal protein losses (PPL, independent of the time on dialysis (ρ 0.410, p<0.05.Our study shows that FGF-21 plasma levels in incident PD patients significantly increase during the first 3 years. This increment is dependent on or is associated with RRF and PPL (higher levels in patients with lower RRF and higher PPL. FGF-21 might be an important endocrine agent in PD patients and could act as hormonal signaling to maintain glucose homeostasis and prevent potential insulin resistance. These preliminary results suggest that FGF-21 might play a protective role as against the development of insulin resistance over

  20. The North Atlantic Ocean as habitat for Calanus finmarchicus: Environmental factors and life history traits

    Science.gov (United States)

    Melle, Webjørn; Runge, Jeffrey; Head, Erica; Plourde, Stéphane; Castellani, Claudia; Licandro, Priscilla; Pierson, James; Jonasdottir, Sigrun; Johnson, Catherine; Broms, Cecilie; Debes, Høgni; Falkenhaug, Tone; Gaard, Eilif; Gislason, Astthor; Heath, Michael; Niehoff, Barbara; Nielsen, Torkel Gissel; Pepin, Pierre; Stenevik, Erling Kaare; Chust, Guillem

    2014-12-01

    Here we present a new, pan-Atlantic compilation and analysis of data on Calanus finmarchicus abundance, demography, dormancy, egg production and mortality in relation to basin-scale patterns of temperature, phytoplankton biomass, circulation and other environmental characteristics in the context of understanding factors determining the distribution and abundance of C. finmarchicus across its North Atlantic habitat. A number of themes emerge: (1) the south-to-north transport of plankton in the northeast Atlantic contrasts with north-to-south transport in the western North Atlantic, which has implications for understanding population responses of C. finmarchicus to climate forcing, (2) recruitment to the youngest copepodite stages occurs during or just after the phytoplankton bloom in the east whereas it occurs after the bloom at many western sites, with up to 3.5 months difference in recruitment timing, (3) the deep basin and gyre of the southern Norwegian Sea is the centre of production and overwintering of C. finmarchicus, upon which the surrounding waters depend, whereas, in the Labrador/Irminger Seas production mainly occurs along the margins, such that the deep basins serve as collection areas and refugia for the overwintering populations, rather than as centres of production, (4) the western North Atlantic marginal seas have an important role in sustaining high C. finmarchicus abundance on the nearby coastal shelves, (5) differences in mean temperature and chlorophyll concentration between the western and eastern North Atlantic are reflected in regional differences in female body size and egg production, (6) regional differences in functional responses of egg production rate may reflect genetic differences between western and eastern populations, (7) dormancy duration is generally shorter in the deep waters adjacent to the lower latitude western North Atlantic shelves than in the east, (8) there are differences in stage-specific daily mortality rates between

  1. Factors that influence the choice to work in rural township health centers among 4,669 clinical medical students from five medical universities in Guangxi, China.

    Science.gov (United States)

    Qing, Yunbo; Hu, Guijie; Chen, Qingyun; Peng, Hailun; Li, Kailan; Wei, Jinling; Yi, Yanhua

    2015-01-01

    To produce competent undergraduate-level medical doctors for rural township health centers (THCs), the Chinese government mandated that medical colleges in Central and Western China recruit rural-oriented, tuition-waived medical students (RTMSs) starting in 2010. This study aimed to identify and assess factors that influence the choice to work in rural township health centers among both RTMSs and other students from five medical universities in Guangxi, China. An internet-based self-administered questionnaire survey was conducted with medical students in Guangxi province. Multinomial logistic regression was used to identify factors related to the attitudes toward work in a rural township health center. Among 4,669 medical students, 1,523 (33%) had a positive attitude and 2,574 (55%) had a neutral attitude toward working in THCs. Demographic characteristics, personal job concerns, and knowledge of THCs were associated with the choice of a career in THCs. The factors related to a positive attitude included the following: three-year program, a rural-oriented medical program, being male, an expectation of working in a county or township, a focus on medical career development, some perceived difficulty of getting a job, having family support, sufficient knowledge of THCs, optimism toward THC development, seeking lower working pressure, and a lower expected monthly salary. Male students in a three-year program or a rural-oriented tuition-waived medical education program were more likely to work in THCs. Selecting medical students through interviews to identify their family support and intentions to work in THCs would increase recruitment and retention. Establishing favorable policies and financial incentives to improve living conditions and the social status of rural physicians is necessary.

  2. Factors that influence the choice to work in rural township health centers among 4,669 clinical medical students from five medical universities in Guangxi, China

    Directory of Open Access Journals (Sweden)

    Yunbo Qing

    2015-07-01

    Full Text Available Purpose: To produce competent undergraduate-level medical doctors for rural township health centers (THCs, the Chinese government mandated that medical colleges in Central and Western China recruit rural-oriented, tuition-waived medical students (RTMSs starting in 2010. This study aimed to identify and assess factors that influence the choice to work in rural township health centers among both RTMSs and other students from five medical universities in Guangxi, China. Methods: An internet-based self-administered questionnaire survey was conducted with medical students in Guangxi province. Multinomial logistic regression was used to identify factors related to the attitudes toward work in a rural township health center. Results: Among 4,669 medical students, 1,523 (33% had a positive attitude and 2,574 (55% had a neutral attitude toward working in THCs. Demographic characteristics, personal job concerns, and knowledge of THCs were associated with the choice of a career in THCs. The factors related to a positive attitude included the following: three-year program, a rural-oriented medical program, being male, an expectation of working in a county or township, a focus on medical career development, some perceived difficulty of getting a job, having family support, sufficient knowledge of THCs, optimism toward THC development, seeking lower working pressure, and a lower expected monthly salary. Conclusion: Male students in a three-year program or a rural-oriented tuition-waived medical education program were more likely to work in THCs. Selecting medical students through interviews to identify their family support and intentions to work in THCs would increase recruitment and retention. Establishing favorable policies and financial incentives to improve living conditions and the social status of rural physicians is necessary.

  3. A Brief History of the Philosophical Foundations of Exploratory Factor Analysis.

    Science.gov (United States)

    Mulaik, Stanley A.

    1987-01-01

    Exploratory factor analysis derives its key ideas from many sources, including Aristotle, Francis Bacon, Descartes, Pearson and Yule, and Kant. The conclusions of exploratory factor analysis are never complete without subsequent confirmatory factor analysis. (Author/GDC)

  4. Depression during pregnancy in women with a medical disorder: risk factors and perinatal outcomes

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    Gláucia Rosana Guerra Benute

    2010-01-01

    Full Text Available BACKGROUND: Approximately one-fifth of women present depression during pregnancy and puerperium, and almost 13% of pregnant women experience a major depressive disorder. OBJECTIVE: The aim of this study was to identify risk factors for depression among pregnant women with a medical disorder and to evaluate the influence of depression on perinatal outcomes. METHODS: Three hundred and twenty-six pregnant women with a medical disorder were interviewed. A semistructured interview was conducted for each participant using a questionnaire that had been developed previously. Major depression was diagnosed using the Portuguese version of the Primary Care Evaluation of Mental Disorders (PRIME-MD. The medical records of the participants were thoroughly reviewed to evaluate the perinatal results. RESULTS: Major depressive disorder was diagnosed in 29 cases (9.0%. The prevalence of major depression was as follows: 7.1% for preeclampsia or chronic hypertension, 12.1% for cardiac disorder, 7.1% for diabetes mellitus, 6.3% for maternal anemia, 8.3% for collagenosis and 12.5% for a high risk of premature delivery. An univariate analysis showed a significant positive correlation between an average household income below minimum wage and a PRIME-MD diagnosis of major depression. A multiple regression analysis identified unplanned pregnancy as an independent predictor of major depression (86.2% in the group with a diagnosis of major depression by PRIME-MD vs. 68.4% in the group without major depression. A comparison between women who presented major depression and those who did not revealed no significant differences in the perinatal results (i.e., preterm delivery, birth weight and low Apgar scores. CONCLUSION: In the present study, unplanned pregnancy in women with a medical disorder was identified as a risk factor for major depression during gestation. Major depression during pregnancy in women with a medical disorder should be routinely investigated using

  5. Study of an investigation on factors influencing human resources productivity in Shiraz University of Medical Sciences

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    Zahra Ghasemi

    2016-01-01

    Full Text Available Introduction: Human resources development is one of the most important components of any organization and detecting important factors influencing human resources management plays an essential role in the success of the firms. In this study, we investigated different factors influencing human resources productivity of Shiraz University of Medical Sciences staff. Method: The present research was a cross-sectional study. Sample size was calculated 208 individuals. To access information about the human resource productivity, a valid and reliable questionnaire was used. The data were analyzed using SPSS software. Pearson correlation was used for statistical analysis of the data (p=0.05. Results:The results showed that there was a statistically significant relationship (p-value<0.001 between human resources productivity and factors affecting the productivity of human resources (motivational factors, leadership style, creativity and innovation, general and applied education, and competitive spirit. Motivational factors (r =0.89 and general education (r =0.65 had the most and the least effects on human resources productivity. Conclusion: Considering the fact that motivational factors were the most effective factors on human resource productivity, we recommend that managers should care more than before about this factor; also, in order to motivate the employees, they should consider the staff’s individual differences.

  6. Retention factors in relation to organisational commitment in medical and information technology services

    Directory of Open Access Journals (Sweden)

    Jeannette van Dyk

    2012-02-01

    Full Text Available Orientation: Retaining staff with scarce and critical skills in the medical and information technology (IT industry has become a top priority because of skills shortages.Research purpose: The objectives of the study were to investigate empirically: (1 the relationship between employees’ satisfaction with organisational retention factors (measured by the Retention Factors Scale and their organisational commitment (measured by the Organisational Commitment Questionnaire and (2 whether gender, age, race and tenure groups differ significantly in terms of these variables.Motivation for the study: Medical and information technology professionals have specialised and hard to replace skills. They also have strong tendencies to leave their organisations and countries. Understanding the retention factors that will increase their organisational commitment may benefit the organisations who want to retain their valuable talent.Research design, approach and method: The researchers used a cross-sectional survey design to collect data from a purposive sample of 206 staff members who had scarce skills in a South African medical and information technology services company. Correlational and inferential statistics were computed to achieve the objectives.Main findings: The results showed that the participants’ satisfaction with retention factors has a significant relationship with their organisational commitment and that the biographical groups differ significantly in terms of the variables.Practical/managerial implications: The measured retention factors were all associated with human resource management practices that influence employees’ intentions to leave.Contribution/value-add: The results are important to managers who are interested in retaining staff who have scarce skills and provide valuable pointers for designing effective retention strategies.

  7. Factors that influence physicians' and medical students' confidence in counseling patients about physical activity.

    Science.gov (United States)

    Stanford, Fatima Cody; Durkin, Martin W; Stallworth, James Rast; Powell, Caroline Keller; Poston, Mary Beth; Blair, Steven N

    2014-06-01

    Less than half of US adults and two-thirds of US high school students do not meet current US guidelines for physical activity. We examined which factors promoted physicians' and medical students' confidence in counseling patients about physical activity. We established an online exercise survey targeting attending physicians, resident and fellow phy