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Sample records for factors medical history

  1. Medical history, lifestyle, family history, and occupational risk factors for adult acute lymphocytic leukemia: the InterLymph Non-Hodgkin Lymphoma Subtypes Project.

    Science.gov (United States)

    Skibola, Christine F; Slager, Susan L; Berndt, Sonja I; Lightfoot, Tracy; Sampson, Joshua N; Morton, Lindsay M; Weisenburger, Dennis D

    2014-08-01

    Acute lymphoblastic leukemia/lymphoma (ALL) in adults is a rare malignancy with a poor clinical outcome, and few reported etiologic risk factors. We performed an exploratory pooled study of 152 ALL cases and 23096 controls from 16 case-control studies to investigate the role of medical history, lifestyle, family history, and occupational risk factors and risk of ALL. Age- race/ethnicity-, sex-, and study-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression. An increased risk of ALL was found in those with a family history of a hematological malignancy (OR = 2.6, 95% CI = 1.22 to 5.54) and in leather (OR = 3.91, 95% CI = 1.35 to 11.35) and sewing/embroidery workers (OR = 2.92, 95% CI = 1.00 to 8.49). Consumers of alcohol had an increased risk of B-cell ALL (OR = 2.87, 95% CI = 1.18 to 6.95). The small number of statistically significant risk factors identified out of the 112 variables examined could be chance findings and will require further replication to assess their role in the etiology of adult ALL. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Factors Influencing Suicidal Tendencies of Patients with Diagnosis of Attempted Suicide in Medical History and Potential Prevention of Relapse Prevention.

    Science.gov (United States)

    Kotrbová, Kvetoslava; Dóci, Ivan; Hamplová, Lidmila; Dvořák, Vít; Selingerová, Šárka; Růžičková, Veronika; Chmelařová, Šárka

    2017-12-01

    The authors researched the incidence of suicidal thoughts and related factors in 123 patients of the psychiatric ward of the Hospital of České Budějovice with diagnosed attempted suicide in their medical history for the period from January 2013 – June 2015. The research was carried out in two stages. At the beginning of the hospitalization, quantitative data collection was implemented using a semi-structured questionnaire, followed by qualitative research conducted with semi-structured phone conversation, based on previous patient's written consent. The research data were statistically processed to obtain information about the character of relations among individual characteristics. To quantify them, the Bayesian Network (BN) was constructed, and to identify relations among individual characteristics, the Hill-Climbing algorithm was used. Before deriving the network, variables were discretized. The network parameters were set based on a data matrix using the maximal plausibility method. The results of analysed set show that the probability of suicidal thoughts is high, achieving a value of 0.750 (0.781 for women and 0.724 for men). If the patient visits a contact centre for drug-addicted persons, the probability of suicidal thoughts decreases to 0.683. If the patient visits a psychotherapist, the values of 0.736 are achieved. If a daily care centre is visited, the estimated risk rises to 0.832 and the probability of the patient repetitively attempting suicide is 0.606. If the interviewed person regularly consumes alcohol, the probable relapse amounts to 0.616. But if the person consumes alcohol from time to time, the probability rises to 0.701. In case of abstinence, the probable relapse decreases to 0.565. The incidence of suicidal thoughts in observed patients was high, and the amount of risk was influenced by gender, by visiting follow-up care facilities, psychotherapy, and particularly by the frequency of alcohol consumption. Intermittent alcohol

  4. Factors affecting frequency of communication about family health history with family members and doctors in a medically underserved population.

    Science.gov (United States)

    Kaphingst, Kimberly A; Goodman, Melody; Pandya, Chintan; Garg, Priyanka; Stafford, Jewel; Lachance, Christina

    2012-08-01

    Family history contributes to risk for many common chronic diseases. Little research has investigated patient factors affecting communication of this information. 1061 adult community health center patients were surveyed. We examined factors related to frequency of discussions about family health history (FHH) with family members and doctors. Patients who talked frequently with family members about FHH were more likely to report a family history of cancer (p =.012) and heart disease (p history of heart disease (p = .011), meet physical activity recommendations (p = .022), seek health information frequently in newspapers (p history of some diseases, those not meeting physical activity recommendations, and those who do not frequently seek health information may not have ongoing FHH discussions. Interventions are needed to encourage providers to update patients' family histories systematically and assist patients in initiating FHH conversations in order to use this information for disease prevention and control. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  5. Level of Agreement and Factors Associated With Discrepancies Between Nationwide Medical History Questionnaires and Hospital Claims Data

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    Yeon-Yong Kim

    2017-09-01

    Full Text Available Objectives The objectives of this study were to investigate the agreement between medical history questionnaire data and claims data and to identify the factors that were associated with discrepancies between these data types. Methods Data from self-reported questionnaires that assessed an individual’s history of hypertension, diabetes mellitus, dyslipidemia, stroke, heart disease, and pulmonary tuberculosis were collected from a general health screening database for 2014. Data for these diseases were collected from a healthcare utilization claims database between 2009 and 2014. Overall agreement, sensitivity, specificity, and kappa values were calculated. Multiple logistic regression analysis was performed to identify factors associated with discrepancies and was adjusted for age, gender, insurance type, insurance contribution, residential area, and comorbidities. Results Agreement was highest between questionnaire data and claims data based on primary codes up to 1 year before the completion of self-reported questionnaires and was lowest for claims data based on primary and secondary codes up to 5 years before the completion of self-reported questionnaires. When comparing data based on primary codes up to 1 year before the completion of self-reported questionnaires, the overall agreement, sensitivity, specificity, and kappa values ranged from 93.2 to 98.8%, 26.2 to 84.3%, 95.7 to 99.6%, and 0.09 to 0.78, respectively. Agreement was excellent for hypertension and diabetes, fair to good for stroke and heart disease, and poor for pulmonary tuberculosis and dyslipidemia. Women, younger individuals, and employed individuals were most likely to under-report disease. Conclusions Detailed patient characteristics that had an impact on information bias were identified through the differing levels of agreement.

  6. Level of Agreement and Factors Associated With Discrepancies Between Nationwide Medical History Questionnaires and Hospital Claims Data.

    Science.gov (United States)

    Kim, Yeon-Yong; Park, Jong Heon; Kang, Hee-Jin; Lee, Eun Joo; Ha, Seongjun; Shin, Soon-Ae

    2017-09-01

    The objectives of this study were to investigate the agreement between medical history questionnaire data and claims data and to identify the factors that were associated with discrepancies between these data types. Data from self-reported questionnaires that assessed an individual's history of hypertension, diabetes mellitus, dyslipidemia, stroke, heart disease, and pulmonary tuberculosis were collected from a general health screening database for 2014. Data for these diseases were collected from a healthcare utilization claims database between 2009 and 2014. Overall agreement, sensitivity, specificity, and kappa values were calculated. Multiple logistic regression analysis was performed to identify factors associated with discrepancies and was adjusted for age, gender, insurance type, insurance contribution, residential area, and comorbidities. Agreement was highest between questionnaire data and claims data based on primary codes up to 1 year before the completion of self-reported questionnaires and was lowest for claims data based on primary and secondary codes up to 5 years before the completion of self-reported questionnaires. When comparing data based on primary codes up to 1 year before the completion of self-reported questionnaires, the overall agreement, sensitivity, specificity, and kappa values ranged from 93.2 to 98.8%, 26.2 to 84.3%, 95.7 to 99.6%, and 0.09 to 0.78, respectively. Agreement was excellent for hypertension and diabetes, fair to good for stroke and heart disease, and poor for pulmonary tuberculosis and dyslipidemia. Women, younger individuals, and employed individuals were most likely to under-report disease. Detailed patient characteristics that had an impact on information bias were identified through the differing levels of agreement.

  7. History of medical radionuclide production.

    Science.gov (United States)

    Ice, R D

    1995-11-01

    Radionuclide production for medical use originally was incidental to isotope discoveries by physicists and chemists. Once the available radionuclides were identified they were evaluated for potential medical use. Hevesy first used 32P in 1935 to study phosphorous metabolism in rats. Since that time, the development of cyclotrons, linear accelerators, and nuclear reactors have produced hundreds of radionuclides for potential medical use. The history of medical radionuclide production represents an evolutionary, interdisciplinary development of applied nuclear technology. Today the technology is represented by a mature industry and provides medical benefits to millions of patients annually.

  8. Medizinhistorische Literatur [Medical history literature

    Directory of Open Access Journals (Sweden)

    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. Hydronephrosis in Infants and Children: Natural History and Risk Factors for Persistence in Children Followed by a Medical Service

    Directory of Open Access Journals (Sweden)

    Kristy Van Dervoort

    2009-01-01

    Full Text Available Background Infants with neonatal hydronephrosis and a normal voiding cystourethrogram (VCUG are presumed to have ureteropelvic junction obstruction (UPJO. There is little current information about the natural history of children with hydronephrosis or clinical factors that predict resolution of the radiological abnormality. Objective To determine the time course until spontaneous resolution of neonatal hydronephrosis and define risk factors for persistence of the abnormality. Methods This retrospective single center review examined infants and children <5 years of age with hydronephrosis who were followed for at least 12 months. Results 136 children were identified (96 male:40 female. The mean age at diagnosis of hydronephrosis was 3.3 ± 9.7 months and 76% of the patients were diagnosed at birth. The hydronephrosis was unilateral in 98 (72% of cases, and hydronephrosis was at least moderate in severity in 22% of affected kidneys. At last follow-up at 30 ± 10 months, the abnormality had resolved in 77 out of 115 (67% available patients, 30 (26% had been referred to urology, and 12 (10% had persistent hydronephrosis. Severity of hydronephrosis was the only clinical feature that predicted persistence of the abnormality (P < 0.001. There was an association between detection at birth and lack of resolution of hydronephrosis. Conclusions Children with hydronephrosis and presumed UPJO and normal kidney parenchyma can be followed for at least 2 years to allow for spontaneous resolution before referral to urology. Serial sonography can be performed at 6 month intervals in uncomplicated cases. More severe hydronephrosis and presence of the lesion at birth may predict infants and children requiring closer observation and referral for possible surgical correction of the hydronephrosis.

  10. Medical History: Compiling Your Medical Family Tree

    Science.gov (United States)

    ... are missing. If you're adopted, ask your adoptive parents if they received any medical information about your biological parents at the time of your adoption. Adoption agencies also might have family medical information on file. If you were adopted ...

  11. USE OF ELECTRONIC CASE HISTORIES IN OPERATION OF MEDICAL UNITS

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    I. B. Boltenkova

    2016-01-01

    Full Text Available Introduction of electronic case histories to medical units including TB units is one of the factors allowing enhancing quality of medical care provision. Use of the electronic case histories provides conditions for information transparency improvement in a medical unit: financial, statistic and medico-technological. Information contained in the electronic case history is important and required both for internal and external use. Use of electronic case histories contributes to reduction of labor costs of workers in medical units, provides fast access of medical personnel to information, formalizes data, provides preservation, invariance and reliability of the information entered into electronic case history during the whole period of storage, regulates the access rights and confidentiality, personifies data and allows unifying health data of all Russian population into one pool.

  12. Learning medical history in Oslo: training for medical practice.

    Science.gov (United States)

    Larsen, O

    1999-03-01

    The teaching in medical history at the University of Oslo, Norway, is given as an integrated part of the student training for practical work in health care and community health. I summarize here the underlying argumentation and the teaching experiences, concluding that this is felt as an effective way to convey relevant medical historical knowledge and skills to the future doctors.

  13. Factors Affecting Medical Service Quality.

    Science.gov (United States)

    Mosadeghrad, Ali Mohammad

    2014-02-01

    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. Quality of medical services depends on the personal factors of the physician and patient, and factors pertaining to the healthcare setting and the broader environment. Differences in internal and external factors such as availability of resources, patient cooperation and collaboration among providers affect the quality of medical services and patient outcomes. Supportive leadership, proper planning, education and training and effective management of resources and processes improve the quality of medical services. This article contributes to healthcare theory and practice by developing a conceptual framework for understanding factors that influence medical services quality.

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

    Science.gov (United States)

    ... know my family medical history? Why is it important to know my family medical history? A family ... for Links Data Files & API Site Map Subscribe Customer Support USA.gov Copyright Privacy Accessibility FOIA Viewers & ...

  15. Experience with a pharmacy technician medication history program.

    Science.gov (United States)

    Cooper, Julie B; Lilliston, Michelle; Brooks, DeAnne; Swords, Bruce

    2014-09-15

    The implementation and outcomes of a pharmacy technician medication history program are described. An interprofessional medication reconciliation team, led by a clinical pharmacist and a clinical nurse specialist, was charged with implementing a new electronic medication reconciliation system to improve compliance with medication reconciliation at discharge and capture compliance-linked reimbursement. The team recommended that the pharmacy department be allocated new pharmacy technician full-time-equivalent positions to assume ownership of the medication history process. Concurrent with the implementation of this program, a medication history standard was developed to define rules for documentation of what a patient reports he or she is actually taking. The standard requires a structured interview with the patient or caregiver and validation with outside sources as indicated to determine which medications to document in the medication history. The standard is based on four medication administration category rules: scheduled, as-needed, short-term, and discontinued medications. The medication history standard forms the core of the medication history technician training and accountability program. Pharmacy technicians are supervised by pharmacists, using a defined accountability plan based on a set of medical staff approved rules for what medications comprise a best possible medication history. Medication history accuracy and completeness rates have been consistently over 90% and rates of provider compliance with medication reconciliation rose from under 20% to 100% since program implementation. A defined medication history based on a medication history standard served as an effective foundation for a pharmacy technician medication history program, which helped improve provider compliance with discharge medication reconciliation. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  16. Pharmacy collected medication histories in an observation unit

    Directory of Open Access Journals (Sweden)

    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.

  17. Dispatch from the non-HITECH-incented Health IT world: electronic medication history adoption and utilization.

    Science.gov (United States)

    Gabriel, Meghan Hufstader; Smith, Jaime Y; Sow, Max; Charles, Dustin; Joseph, Seth; Wilkins, Tricia Lee

    2016-05-01

    To document national trends of electronic medication history use in the ambulatory setting and describe the characteristics and predicting factors of providers who regularly use medication history transaction capabilities through their e-prescribing systems. The study used provider-initiated medication history data requests, electronically sent over an e-prescribing network from all 50 states and the District of Columbia. Data from 138,000 prescribers were evaluated using multivariate analyses from 2007 to 2013. Medication history use showed significant growth, increasing from 8 to 850 million history requests during the study period. Prescribers on the network for histories more often than those in large and small cities, these findings were not significant in multivariate analyses. Providers in orthopedic surgery and internal medicine had a higher likelihood of more requests than family practice prescribers, with 12% and 7% higher likelihood, respectively. Early adopters of e-prescribing have remained medication history users and have continually increased their volume of requests for medication histories. Despite the fact that the use of medication histories through e-prescribing networks in the ambulatory care setting has not been encouraged through federal incentive programs, there has been substantial growth in the use of medication histories offered through e-prescribing networks. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. History of Medical Specialty Interest Assessment

    Science.gov (United States)

    Burns, Stephanie T.

    2016-01-01

    Medical specialties require decidedly different abilities, skills, and talents; which results in divergent experiences, lifestyles, skill sets, and income levels. To help medical students select their preferred medical specialty and alleviate shortages in medical specialty staffing, US medical schools and associations invest time and money in…

  19. 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....

  20. An Effective Teaching Method to Enhance History-Taking Skills for Chinese Medical Students

    Science.gov (United States)

    Huang, Simin; Xu, Peng; Feng, Lie; Lu, Chunting; Yang, Jing

    2018-01-01

    History taking is an extremely important skill for medical students to master. In China, medical students usually have opportunities to practise this skill on real patients after they have learned diagnostics and basic relevant theoretical knowledge. Today, however, several factors, such as increased enrolment of medical students and the need to…

  1. Human Factors and Medical Devices

    International Nuclear Information System (INIS)

    Dick Sawyer

    1998-01-01

    Medical device hardware- and software-driven user interfaces should be designed to minimize the likelihood of use-related errors and their consequences. The role of design-induced errors in medical device incidents is attracting widespread attention. The U.S. Food and Drug Administration (FDA) is fully cognizant that human factors engineering is critical to the design of safe medical devices, and user interface design is receiving substantial attention by the agency. Companies are paying more attention to the impact of device design, including user instructions, upon the performance of those health professionals and lay users who operate medical devices. Concurrently, the FDA is monitoring human factors issues in its site inspections, premarket device approvals, and postmarket incident evaluations. Overall, the outlook for improved designs and safer device operation is bright

  2. 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

  3. 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.

  4. 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 co...

  5. 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.

  6. CHRONICLES OF MEDICAL HISTORY IN AFRICA Medical Icon and ...

    African Journals Online (AJOL)

    Joly was the Foundation Dean of the Faculty of Medicine, University. College, Ibadan (1948 ... when female education was considered unimportant. Beatrice made up ... best prizes. She went on to pursue a successful postgraduate medical.

  7. [Medical history impressions of Karl Marx 1983].

    Science.gov (United States)

    Kaiser, W

    1983-12-15

    Excerpts of his London era first published on the occasion of the Karl Marx testimonials of 1983 gave rise to extend the memory of the fundamental achievements of Karl Marx to medico-historical aspects. In this case Karl Marx paid special attention to the working and living conditions of the working class and an analysis of his adequate statements and records shows multifarious details which give a research basis also for the history of medicine. Marx and Engels had friendly contacts with several physicians who shared the opinions of the two classics: their way of life is shown in the most important points.

  8. 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…

  9. Brief histories of medical physics in Asia-Oceania.

    Science.gov (United States)

    Round, W H; Jafari, S; Kron, T; Azhari, H A; Chhom, S; Hu, Y; Mauldon, G F; Cheung, K Y; Kuppusamy, T; Pawiro, S A; Lubis, L E; Soejoko, D S; Haryanto, F; Endo, M; Han, Y; Suh, T S; Ng, K H; Luvsan-Ish, A; Maung, S O; Chaurasia, P P; Jafri, S M A; Farrukh, S; Peralta, A; Toh, H J; Sarasanandarajah, S; Shiau, A C; Krisanachinda, A; Suriyapee, S; Vinijsorn, S; Nguyen, T C

    2015-09-01

    The history of medical physics in Asia-Oceania goes back to the late nineteenth century when X-ray imaging was introduced, although medical physicists were not appointed until much later. Medical physics developed very quickly in some countries, but in others the socio-economic situation as such prevented it being established for many years. In others, the political situation and war has impeded its development. In many countries their medical physics history has not been well recorded and there is a danger that it will be lost to future generations. In this paper, brief histories of the development of medical physics in most countries in Asia-Oceania are presented by a large number of authors to serve as a record. The histories are necessarily brief; otherwise the paper would quickly turn into a book of hundreds of pages. The emphasis in each history as recorded here varies as the focus and culture of the countries as well as the length of their histories varies considerably.

  10. 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

  11. The history of parkinsonism: descriptions in ancient Indian medical literature.

    Science.gov (United States)

    Ovallath, Sujith; Deepa, P

    2013-05-01

    The clinical syndrome of parkinsonism was identified in ancient India even before the period of Christ and was treated methodically. The earliest reference to bradykinesia dates to 600 bc. Evidences prove that as early as 300 bc, Charaka proposed a coherent picture of parkinsonism by describing tremor, rigidity, bradykinesia, and gait disturbances as its components. The scenario was further developed by Madhava, Vagbhata, and Dalhana all through history. The 15th-century classic "Bhasava rajyam" introduced the term kampavata, which may be regarded as an ayurvedic analogue of parkinsonism. The pathogenesis of kampavata centered on the concept of imbalance in the vata factor, which controls psychomotor activities. The essential element in therapy was the administration of powdered seed of Mucuna pruriens, or atmagupta, which as per reports, contains 4%-6% of levodopa. In addition to proving the existence and identification of parkinsonism in ancient India, the study points to the significance of ancient Indian Sanskrit works in medical history. Copyright © 2013 Movement Disorder Society.

  12. 'What is not written does not exist': the importance of proper documentation of medication use history.

    Science.gov (United States)

    Silvestre, Carina Carvalho; Santos, Lincoln Marques Cavalcante; de Oliveira-Filho, Alfredo Dias; de Lyra, Divaldo Pereira

    2017-10-01

    Medications are perceived as health risk factors, because they might cause damage if used improperly. In this context, an adequate assessment of medication use history should be encouraged, especially in transitions of care to avoid unintended medication discrepancies (UMDs). In a case-controlled study, we investigated potential risk factors for UMDs at hospital admission and found that 150 (42%) of the 358 patients evaluated had one or more UMDs. We were surprised to find that there was no record of a patient and/or relative interview on previous use of medication in 117 medical charts of adult patients (44.8%). Similarly, in the medical charts of 52 (53.6%) paediatric patients, there was no record of parents and/or relatives interviews about prior use of medications. One hundred thirty-seven medical charts of adult patients (52.4%) and seventy-two medical charts of paediatric patients (74.2%) had no record about medication allergies and intolerances. In other words, there was a lack of basic documentation regarding the patient's medication use history. As patients move between settings in care, there is insufficient tracking of verbal and written information related to medication changes, which results in a progressive and cumulative loss of information, as evidenced by problems associated with clinical transfers and medication orders. Proper documentation of medication information during transfer is a key step in the procedure; hence, it should be rightly performed. It remains unclear whether interviews, and other investigations about medication use history have been performed but have not been recorded as health-care data. Therefore, it is crucial to the improvement of medication use safety that documentation of all drug-related information-even if not directly related to the actual event-become routine practice in health-care organizations, since 'what is not written does not exist'.

  13. Hypertension in Asymptomatic, Young Medical Students with Parental History of Hypertension

    Directory of Open Access Journals (Sweden)

    Simran Sidhu

    2017-11-01

    Full Text Available Introduction: Family history of hypertension in medical students is an important, non-modifiable risk factor for hypertension in future. Aim: To determine the prevalence of sustained hypertension in young asymptomatic medical students with a parental history of hypertension. Materials and Methods: A cross-sectional study was conducted in a medical college of Dehradun. A total of 104 medical students with parental history of hypertension (Group A and 100 medical students without a parental history of hypertension (Group B were included. Electronically blood pressures were recorded on two separate occasions at an interval of 15 days. Comparison was done using Chi-square test/Likelihood ratio, Un-paired t-test and ANCOVA. Results: Overall, Group A had significantly higher percentage of prehypertensive (56.7% and hypertensive (17.3% students as compared to Group B which were 19% and 1%, respectively. Group A students had significantly higher Systolic Blood Pressure (SBP and Diastolic Blood Pressure (DBP as compared to Group B, even after controlling for the differences in Body Mass Index (BMI and gender (p<0.001. Conclusion: Hypertension was significantly higher in asymptomatic, healthy medical students with parental history of hypertension as compared to those with normotensive parents. We need to orient medical students to improve their knowledge, attitude and lifestyle practices early in life to prevent, treat hypertension and prevent its subsequent morbidity and mortality.

  14. History of Medicine in US Medical School Curricula.

    Science.gov (United States)

    Caramiciu, Justin; Arcella, David; Desai, Manisha S

    2015-10-01

    To determine the extent to which the history of medicine (HOM) and its related topics are included within the curriculum of accredited medical schools in the United States. Survey instrument. US allopathic medical schools. An online survey was sent to officials from every medical school in the US. Respondents were asked to provide institutional identifiers, the presence of an HOM elective offered to medical students, the years during which the elective is offered, the existence of an HOM department, and the contact information for that particular department. Nonresponders were contacted by phone to elicit the same information. History of medicine electives included didactic sessions and seminars with varying degrees of credit offered in different years of medical school. Based on responses from 119 of 121 contacted medical schools (98%), 45 (37%) included formal lectures or weekly seminars in the medical school curriculum. Five (11%) curricula had or have required HOM, whereas 89% offered elective HOM instruction. Course duration and credit awarded varied. Eighteen (15%) medical schools included departments dedicated to HOM. Providing education in HOM was limited by faculty interest, clinical training hours, and low interest. Data collected by our study suggest that substantial barriers exist within the academic medical community towards a wider acceptance of the importance of HOM. Causes for such lack of interest include absence of questions on written or oral tests related to HOM, difficulty in publishing articles related to HOM in peer reviewed journals, near absence of research grants in HOM, difficulty in getting academic promotions or recognition for activities related to HOM, and a lack of support from academic chairpersons for activities related to HOM. Copyright © 2015 Anesthesia History Association. Published by Elsevier Inc. All rights reserved.

  15. [Medical history as an academic subject at the Bamberg University].

    Science.gov (United States)

    Locher, W

    2000-01-01

    A full program of medicine was taught at the Catholic University of Bamberg (founded 1648 as the Academia Ottonia) from 1773 through 1803. Within this period of time, the History of Medicine was taught from 1790 through 1795 by Johann Baptist Dominicus Fin(c)k. This paper elucidates how in this instance protestant universities served as models for catholic universities. Interestingly, it was not the medical faculty itself which developed an interest in teaching medical history. Rather, it was Adalbert Friedrich Marcus (1753-1816), physician-in-waiting of the Prince-Bishop Franz Ludwig von Erthal and medical officer in the principality of Bamberg since June 22, 1790, who was charged by the Prince-Bishop with developing guidelines for medical education. The start of the History of Medicine lectures brought with it a heated dispute about an appropriate textbook. The discussion is evidence of a transition from historiography understood as an account of learned doctors of the past to a study of history in a modern sense.

  16. Adolescents' knowledge of medical terminology and family health history.

    Science.gov (United States)

    Hastrup, J L; Phillips, S M; Vullo, K; Kang, G; Slomka, L

    1992-01-01

    Compared 309 youths ages 11 to 15 years and their parents with respect to their comprehension of terms for seven common medical disorders: heart attack, stroke, atherosclerosis, ulcer, hypertension, diabetes, and cancer. For two thirds of the adolescent sample, accuracy of reporting of these disorders among the parents and grandparents was assessed. Results indicated considerable variation among disorders with respect to both comprehension of terms and accuracy of family health history. Adolescents' age was a major predictor of knowledge of medical terms (r = .41). Age was not related to accuracy of family health information. Consonant with this finding, adolescents' level of accuracy regarding family health history was generally similar to that of previous adult samples, suggesting that family health information is acquired and retained at an early age. Adolescents were more accurate concerning parents' compared with grandparents' history of hypertension.

  17. Cardiovascular Risk Factors among First Year Medical Students

    Directory of Open Access Journals (Sweden)

    Raj Krishna Dangol

    2017-12-01

    Full Text Available Introduction: Detection of cardiovascular risk in young age is important to motivate them to modify life styles and seek health care early to lower the chances of acquiring cardiovascular disease in later age. This study was done to assess cardiovascular risk factors among first year medical students. Methods: A cross-sectional study was conducted throughout September and October 2017 in which all first year medical students from a medical college were assessed for the presence of cardiovascular risk factors. Participants’ demography, family history of illness, anthropometric measurements, and blood reports of lipid profile and fasting glucose were acquired. Data were analyzed with Statistical Package for Social Sciences (SPSS-21. Result: There were 99 participants; 55 males and 44 females. One or more risk factors were present in 87 (87.9% participants. Moreover, 67.7% (n = 67 participants had more than one risk factors. Low HDL-cholesterol was the most common (n = 55, 55.6% risk factor followed by elevated triacylglycerol (n = 47, 47.5% and family history of hypertension (n = 45, 45.5%. There was no significant difference in presence of various risk factors between genders. Conclusion: There was higher prevalence of cardiovascular risk factors among first year medical students. Majority of them had more than one risk factors. Low HDL-cholesterol was the most common risk factor. The risk factors were comparable in males and females.

  18. Teaching history taking to medical students: a systematic review.

    Science.gov (United States)

    Keifenheim, Katharina E; Teufel, Martin; Ip, Julianne; Speiser, Natalie; Leehr, Elisabeth J; Zipfel, Stephan; Herrmann-Werner, Anne

    2015-09-28

    This paper is an up-to-date systematic review on educational interventions addressing history taking. The authors noted that despite the plethora of specialized training programs designed to enhance students' interviewing skills there had not been a review of the literature to assess the quality of each published method of teaching history taking in undergraduate medical education based on the evidence of the program's efficacy. The databases PubMed, PsycINFO, Google Scholar, opengrey, opendoar and SSRN were searched using key words related to medical education and history taking. Articles that described an educational intervention to improve medical students' history-taking skills were selected and reviewed. Included studies had to evaluate learning progress. Study quality was assessed using the Medical Education Research Study Quality Instrument (MERSQI). Seventy-eight full-text articles were identified and reviewed; of these, 23 studies met the final inclusion criteria. Three studies applied an instructional approach using scripts, lectures, demonstrations and an online course. Seventeen studies applied a more experiential approach by implementing small group workshops including role-play, interviews with patients and feedback. Three studies applied a creative approach. Two of these studies made use of improvisational theatre and one introduced a simulation using Lego® building blocks. Twenty-two studies reported an improvement in students' history taking skills. Mean MERSQI score was 10.4 (range 6.5 to 14; SD = 2.65). These findings suggest that several different educational interventions are effective in teaching history taking skills to medical students. Small group workshops including role-play and interviews with real patients, followed by feedback and discussion, are widespread and best investigated. Feedback using videotape review was also reported as particularly instructive. Students in the early preclinical state might profit from approaches helping

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

    Directory of Open Access Journals (Sweden)

    Vanda Abi Raad

    2016-11-01

    Full Text Available Abstract Background 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. Methods 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. Results 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. Conclusions 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.

  20. 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.

  1. Key Success Factors in Medical Tourism Marketing

    OpenAIRE

    Yung-Sheng Yang

    2013-01-01

    The planners in tourism businesses and medical institutes, the evaluation criteria and dimensions for Medical Tourism Marketing are determined by experts through expert interviews. The weights and correlations among the dimensions and criteria are determined by Analytic Hierarchy Process (AHP) to construct an evaluating indicator model suitable for Medical Tourism Marketing. By organizing the overall weight of the key success factors in Medical Tourism Marketing, the top five indicators conta...

  2. 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

  3. 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)

  4. 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.

  5. Factors Influencing Medical Students' Choice of Specialty

    OpenAIRE

    Chang, Pei-Yeh; Hung, Chih-Young; Wang, Kuei-lng; Huang, Yuan-Huei; Chang, King-Jen

    2006-01-01

    Medical school graduates are the source of a country's physicians. Determining how the graduates of these schools select their areas of specialization is the key to achieving a balanced distribution of doctors among all specialties. The purposes of this study were to determine the factors that influence medical students' choice of medical specialty, and to derive the relative weight of each factor. Methods: We constructed a two-tiered analytic hierarchy process (AHP) model which was repres...

  6. Moonshot Acceleration Factor: Medical Imaging.

    Science.gov (United States)

    Sevick-Muraca, Eva M; Frank, Richard A; Giger, Maryellen L; Mulshine, James L

    2017-11-01

    Medical imaging is essential to screening, early diagnosis, and monitoring responses to cancer treatments and, when used with other diagnostics, provides guidance for clinicians in choosing the most effective patient management plan that maximizes survivorship and quality of life. At a gathering of agency officials, patient advocacy organizations, industry/professional stakeholder groups, and clinical/basic science academicians, recommendations were made on why and how one should build a "cancer knowledge network" that includes imaging. Steps to accelerate the translation and clinical adoption of cancer discoveries to meet the goals of the Cancer Moonshot include harnessing computational power and architectures, developing data sharing policies, and standardizing medical imaging and in vitro diagnostics. Cancer Res; 77(21); 5717-20. ©2017 AACR . ©2017 American Association for Cancer Research.

  7. Previous medical history of diseases in children with attention deficit hyperactivity disorder and their parents

    Directory of Open Access Journals (Sweden)

    Ayyoub Malek

    2014-02-01

    Full Text Available Introduction: The etiology of Attention deficit hyperactivity disorder (ADHD is complex and most likely includes genetic and environmental factors. This study was conducted to evaluatethe role of previous medical history of diseases in ADHD children and their parents during theearlier years of the ADHD children's lives. Methods: In this case-control study, 164 ADHD children attending to Child and AdolescentPsychiatric Clinics of Tabriz University of Medical Sciences, Iran, compared with 166 normal children selected in a random-cluster method from primary and guidance schools. ADHDrating scale (Parents version and clinical interview based on schedule for Schedule forAffective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version(K-SADS were used to diagnose ADHD cases and to select the control group. Two groupswere compared for the existence of previous medical history of diseases in children andparents. Fisher's exact test and logistic regression model were used for data analysis. Results: The frequency of maternal history of medical disorders (28.7% vs. 12.0%; P = 0.001was significantly higher in children with ADHD compared with the control group. The frequency of jaundice, dysentery, epilepsy, asthma, allergy, and head trauma in the medicalhistory of children were not significantly differed between the two groups. Conclusion: According to this preliminary study, it may be concluded that the maternal historyof medical disorders is one of contributing risk factors for ADHD.

  8. History and development of medical physics and medical physicist in Japan

    International Nuclear Information System (INIS)

    Toyofuku, F.

    2014-01-01

    The history of medical physics in Japan dates back to the mid-1950's when radioisotope sources such as cobalt-60 were initiated into hospitals. In 1961, a total of about 30 medical physics researchers created a sub-committee of medical physics under the Japan Radiological Society (JRS), which flourished throughout the decade, and the number of members exceeded to more than 200 in 1970. Although there were great advances in medical technologies, the number of members of the medical physics community did not grow for the next two decades from 1980 to 2000. Then, the JRS began to officially recognize medical physicists as a professional group in 1987. Qualifications of candidacy for the examination included having the education equivalent of a Bachelor of Science/Engineering and being a member of the JRS. For the first official examination, 70 medical physicists were approved by the JRS. As of 2013, there are currently 700 medical physicists, however, the number of practicing clinical medical physicists remains only about 150. The main reason for this limited number of medical physicists is that the certification is not recognized as a national license and therefore is challenging to find professional employment as qualified medical personnel at hospitals. (author)

  9. What goes around, comes around: a history of medical tuition*

    Science.gov (United States)

    Duffin, Jacalyn

    2001-01-01

    IN THIS ARTICLE THE ACTUAL AND RELATIVE COSTS OF TUITION AT 3 Ontario medical schools are traced over the past 150 years. In addition, the factors that led to Ontario's nearly 4-decade experiment in private medical education (and to its eventual demise) are presented. In relative terms, tuition was stable for over a century, then declined (after 1960) as government support rose. Access to medical training for students from middle-income families may also have improved steadily until the late 1980s. Because there is no shortage of people wanting to become doctors, there seems to be no limit to the price that could be set for a medical education. The recent hikes in tuition have outstripped inflation and may be reducing accessibility to restrictive levels, similar to those that prevailed in the 19th century. The author invites readers to question current trends. PMID:11202668

  10. What goes around, comes around: a history of medical tuition.

    Science.gov (United States)

    Duffin, J

    2001-01-09

    In this article the actual and relative costs of tuition at 3 Ontario medical schools are traced over the past 150 years. In addition, the factors that led to Ontario's nearly 4-decade experiment in private medical education (and to its eventual demise) are presented. In relative terms, tuition was stable for over a century, then declined (after 1960) as government support rose. Access to medical training for students from middle-income families may also have improved steadily until the late 1980s. Because there is no shortage of people wanting to become doctors, there seems to be no limit to the price that could be set for a medical education. The recent hikes in tuition have outstripped inflation and may be reducing accessibility to restrictive levels, similar to those that prevailed in the 19th century. The author invites readers to question current trends.

  11. Teaching history of medicine in the perspective of "medical humanities".

    Science.gov (United States)

    von Engelhardt, D

    1999-03-01

    The current interest in philosophical questions and ethical aspects of medicine turns attention towards the past and obtains suggestions and perspectives from previous descriptions and interpretations of sickness, therapy, and the relation between the patient and physician. Culture as therapy and therapy as culture are fundamental challenges for the present; physician, patient, and society, i.e., humans and humane medicine, need this dialogue, which should also be constitutive for teaching history of medicine. Through the separation of the natural sciences and the humanities, modern progress of medicine has produced many benefits but has, at the same time, raised many problems. Negative consequences of this development exist not only for the patient, but also for his personal environment and for the physician. In the course of modern history, there have been several reactions aimed at overcoming these one-sided tendencies: in the Renaissance, in the epoch of Romanticism and Idealism, and at the beginning and the end of the 19th century. This article outlines, with historical examples and contemporary reflections, the concept of teaching history of medicine in the perspective of "medical humanities".

  12. [The origin, diffusion and development of healing doctrines in medical history--exemplified by homeopathy].

    Science.gov (United States)

    Schmidt, Josef M

    2007-01-01

    As a paradigmatic case study of the origin, spread, and development of medical systems, this paper investigates the 200-years history of homeopathy from different perspectives of medical history. On the basis of new research on Samuel Hahnemann (1755-1843), first, a concise and critical overview on the principles, explanations, and implications of his doctrine is presented. The historical, conceptual, and social background of the founder of homeopathy is then elaborated in terms of history of medicine, science, philosophy, sociology, culture, and ideas, as well as theory of science, theory of communication, and sociology of science. The process of the world wide spread of homeopathy is examined from different points of view, ranging from history of heroes, institutions, professionalisation, politics, economics, religion, and organisations to history of patients, perception, and semiotics. Finally, a comparative approach to the different development and status of homeopathy in different countries results in the extraction of a set of crucial variables, such as charismatic personage, influential patronage, economic sponsorship, political protection, media support, and patients' demand, which might explane a major part of these differences. Eventually, the notorious splits of homeopathy's doctrine suggest the idea that--in analogy to theory of evolution--a variety of concurrent strains (rather than one monolithic block) of a doctrine may prove to be a kind of advantage for survival. In conclusion, acceptance and relevance of medical systems are determined by many factors. Since external ones are usually outweighing internal ones, medical history may offer a broader and more comprehensive understanding of the dynamics of their spread and development than clinical trials and scientific objection alone.

  13. 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.

  14. A study on the optimization of referring method about medical images using MIH (Medical Image History)

    International Nuclear Information System (INIS)

    Kim, Sun Chil; Kim, Jung Min

    2002-01-01

    The recent development of embodiment technology of the medical images makes most medical institutions introduce PACS (Picture Archiving and Communication System) in haste. However lots of PACS solutions, currently developed and distributed, haven't been able to serve the convenience of users and to satisfy user's demand because of economic limitations and administrator-oriented con-siderations in the process of development. So we have developed MIH (Medical Image History), by which we can search and refer to the patient's medical images and information with few restrictions of time and space for diagnosis and treatment. The program will contribute to the improvement in the medical environment and meet the clients' need. We'll make more effort to develop the application which insures the better quality of medical images. MIH manages the patient's image files and medical records like film chart in connection with time. This trial will contribute to the reduction of the economical loss caused by unnecessary references and improve the quality in the medical services. The demand on the development of the program which refers to the medical data quickly and keeps them stable will be continued by the medical institute. This will satisfy the client's demand and improve the service to the patients in that the program will be modified from the standpoint of the users. MIH is trying to keep user-oriented policy and to apply the benefit of the analog system to the digital environment. It is necessary to lead the public to the better understanding that the systematic management and referring of the medical images is as important as the quality of the images

  15. A study on the optimization of referring method about medical images using MIH (Medical Image History)

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sun Chil; Kim, Jung Min [College of Health Sciences, Korea University, Seoul (Korea, Republic of)

    2002-09-15

    The recent development of embodiment technology of the medical images makes most medical institutions introduce PACS (Picture Archiving and Communication System) in haste. However lots of PACS solutions, currently developed and distributed, haven't been able to serve the convenience of users and to satisfy user's demand because of economic limitations and administrator-oriented con-siderations in the process of development. So we have developed MIH (Medical Image History), by which we can search and refer to the patient's medical images and information with few restrictions of time and space for diagnosis and treatment. The program will contribute to the improvement in the medical environment and meet the clients' need. We'll make more effort to develop the application which insures the better quality of medical images. MIH manages the patient's image files and medical records like film chart in connection with time. This trial will contribute to the reduction of the economical loss caused by unnecessary references and improve the quality in the medical services. The demand on the development of the program which refers to the medical data quickly and keeps them stable will be continued by the medical institute. This will satisfy the client's demand and improve the service to the patients in that the program will be modified from the standpoint of the users. MIH is trying to keep user-oriented policy and to apply the benefit of the analog system to the digital environment. It is necessary to lead the public to the better understanding that the systematic management and referring of the medical images is as important as the quality of the images.

  16. Family History Is a Risk Factor for COPD

    Science.gov (United States)

    Hokanson, John E.; Lynch, David A.; Washko, George R.; Make, Barry J.; Crapo, James D.; Silverman, Edwin K.

    2011-01-01

    Background: Studies have shown that family history is a risk factor for COPD, but have not accounted for family history of smoking. Therefore, we sought to identify the effects of family history of smoking and family history of COPD on COPD susceptibility. Methods: We compared 821 patients with COPD to 776 control smokers from the Genetic Epidemiology of COPD (COPDGene) Study. Questionnaires captured parental histories of smoking and COPD, as well as childhood environmental tobacco smoke (ETS) exposure. Socioeconomic status was defined by educational achievement. Results: Parental history of smoking (85.5% case patients, 82.9% control subjects) was more common than parental history of COPD (43.0% case patients, 30.8% control subjects). In a logistic regression model, parental history of COPD (OR, 1.73; P < .0001) and educational level (OR, 0.48 for some college vs no college; P < .0001) were significant predictors of COPD, but parental history of smoking and childhood ETS exposure were not significant. The population-attributable risk from COPD family history was 18.6%. Patients with COPD with a parental history had more severe disease, with lower lung function, worse quality of life, and more frequent exacerbations. There were nonsignificant trends for more severe emphysema and airway disease on quantitative chest CT scans. Conclusions: Family history of COPD is a strong risk factor for COPD, independent of family history of smoking, personal lifetime smoking, or childhood ETS exposure. Although further studies are required to identify genetic variants that influence COPD susceptibility, clinicians should question all smokers, especially those with known or suspected COPD, regarding COPD family history. PMID:21310839

  17. Factors Modifying Burnout in Osteopathic Medical Students.

    Science.gov (United States)

    Lapinski, Jessica; Yost, Morgan; Sexton, Patricia; LaBaere, Richard J

    2016-02-01

    The purposes of the current study are to examine factors modifying burnout and identify which of these factors place osteopathic medical students at risk for developing burnout. The current study used a cross-sectional study design and an anonymous, web-based survey to assess burnout and depression in osteopathic medical students. The survey included Maslach Burnout Inventory, the Patient Health Questionnaire, the Stressors and their impact scale, students' sleeping and studying habits, and students' extracurricular involvement. In total, 1294 osteopathic medical students completed the survey. Burnout was present in 516 (39.9%) osteopathic medical students, and 1006 (77.0%) met criteria for depression. Females were 1.5 times more likely to be burned out in comparison to males. For the burnout subscales, males had lower emotional exhaustion, slightly higher depersonalization, and lower personal accomplishment. Lesbian/gay/bisexual/asexual students were 2.62 times more likely to be burned out compared with heterosexual students. Depression and academic, personal, and family stressors were all strongly linked to overall burnout. Finally, for modifiable factors, average hours of sleep, average hours spent studying, and club involvement appeared to be linked to burnout. The current study suggested that a variety of factors, including non-modifiable, situational, and modifiable, impact burnout in osteopathic medical students. Future research is necessary since burnout in physicians affects the quality of care provided to patients.

  18. Medical history and the onset of complex regional pain syndrome (CRPS).

    Science.gov (United States)

    de Mos, M; Huygen, F J P M; Dieleman, J P; Koopman, J S H A; Stricker, B H Ch; Sturkenboom, M C J M

    2008-10-15

    Knowledge concerning the medical history prior to the onset of complex regional pain syndrome (CRPS) might provide insight into its risk factors and potential underlying disease mechanisms. To evaluate prior to CRPS medical conditions, a case-control study was conducted in the Integrated Primary Care Information (IPCI) project, a general practice (GP) database in the Netherlands. CRPS patients were identified from the records and validated through examination by the investigator (IASP criteria) or through specialist confirmation. Cases were matched to controls on age, gender and injury type. All diagnoses prior to the index date were assessed by manual review of the medical records. Some pre-specified medical conditions were studied for their association with CRPS, whereas all other diagnoses, grouped by pathogenesis, were tested in a hypothesis-generating approach. Of the identified 259 CRPS patients, 186 cases (697 controls) were included, based on validation by the investigator during a visit (102 of 134 visited patients) or on specialist confirmation (84 of 125 unvisited patients). A medical history of migraine (OR: 2.43, 95% CI: 1.18-5.02) and osteoporosis (OR: 2.44, 95% CI: 1.17-5.14) was associated with CRPS. In a recent history (1-year before CRPS), cases had more menstrual cycle-related problems (OR: 2.60, 95% CI: 1.16-5.83) and neuropathies (OR: 5.7; 95% CI: 1.8-18.7). In a sensitivity analysis, including only visited cases, asthma (OR: 3.0; 95% CI: 1.3-6.9) and CRPS were related. Psychological factors were not associated with CRPS onset. Because of the hypothesis-generating character of this study, the findings should be confirmed by other studies.

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

    OpenAIRE

    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 u...

  20. 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.

  1. Medical Genetics at McGill: The History of a Pioneering Research Group.

    Science.gov (United States)

    Canning, Christopher; Weisz, George; Tone, Andrea; Cambrosio, Alberto

    2013-01-01

    The McGill Group in Medical Genetics was formed in 1972, supported by the Medical Research Council and successor Canadian Institutes for Health Research until September 2009, making it the longest active biomedical research group in the history of Canada. We document the history of the McGill Group and situate its research within a broader history of medical genetics. Drawing on original oral histories with the Group's members, surviving documents, and archival materials, we explore how the Group's development was structured around epistemological trends in medical genetics, policy choices made by research agencies, and the development of genetics at McGill University and its hospitals.

  2. 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

  3. Medical History in the Hellenic Journal of Nuclear Medicine.

    Science.gov (United States)

    Otte, Andreas

    2017-01-01

    The Hellenic Journal of Nuclear Medicine is about to celebrate its 20th anniversary end of 2017. On board of the editorial team since 2003, this journal has influenced me like a good friend over the many past years. From time to time, the journal has published interesting and valuable historical notes. They show that nuclear medicine has a history and that medicine is its basis. They also teach us today, and some of the ancient perspectives and approaches are still valid. The reader of HJNM may be interested in these historical contributions, as they are timeless. Therefore, it was our idea to summarize these in the following pages. Where there is a link to the free article, this is noted. Upon opening all articles, you will find out that these are a book or so of its own. In thanks to the editor-in-chief of the Journal for his continuing support on the historical section. Below we refer to the historical papers of the Journal: History of Nuclear Medicine. Nuclear Medicine and History of Science and Philosophy: Atomic Theory of the Matter. G.N. Sfakianakis, 2001; 4(3); 155-60. Editorial. Pioneers of nuclear medicine, Madame Curie. P.C. Grammaticos. 2004; 7(1); 29-30. http://nuclmed.web.auth.gr/ magazine/eng/jan04/editorial.htm Editor's note. Hippocrates' Oath. The editor. 2004; 7(1); 31. Editorial. Useful known and unknown views of the father of modern medicine, Hippocrates and his teacher Democritus. P. Grammaticos, A. Diamantis. 2008; 11(1): 2-4. http://nuclmed.web.auth.gr/magazine/eng/jan08/2.pdf Special Article. The contribution of Maria Sklodowska-Curie and Pierre Curie to Nuclear and Medical Physics. A hundred and ten years after the discovery of radium. A. Diamantis, E. Magiorkinis, 2008; 11(1): 33-8. http://nuclmed.web.auth.gr/magazine/ eng/jan08/33.pdf Brief Historical Review. Lymphatic system and lymphoscintigraphy. P. Valsamaki. 2009; 12(1): 87-89. http://nuclmed.web. auth.gr/magazine/eng/jan09/89.pdf (In Greek) Historical Review. The philosophic and

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

    Science.gov (United States)

    Davies, M J

    2000-11-01

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

  5. [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.

  6. The Establishment and operation of Longjing Medical College - The History of Longjing Medical College as Frontier History: Focusing on its ‘Disconnection’ and ‘Continuity’ -

    Directory of Open Access Journals (Sweden)

    Mira MOON

    2017-08-01

    Full Text Available Longjing Medial College, established in Longjing, Yanbian, China on September 12, 1945, existed for about 1 year and 6 months until it was renamed as the Medical Department of Dongbei Junzheng Daxue Jilin Fenxiao in April 1947. However, there are only few records and studies on Longjing Medical College in Yanbian as well as in Korea. In order to fill the gap, this study attempted to restore the history of Longjing Medical College built in Yanbian, China immediately after the liberation. In particular, it analyzed how and why the Longjing Medical College was founded and operated, and which relations the college had with the post-war medical educational institutions, focusing on the ‘disconnection’ and ‘continuity’ in the historical sense. Since the establishment of Manchukuo, the Japanese colonial government had made it a major “frontier” and actively promoted the mass migration of Japanese and Koreans. For them, the government also set up three Exploitation Medical Schools in 1940. As a part of these three institutions, Longjing Exploitation Medical School educated more than 150 students by 1945, of which about one third was Korean. After the liberation, the Longjing Educational Alliance decided to pursue the return-movement of the Longjing Exploitation Medical School and took over the institution. On September 12, 1945, Longjing Medical College opened at the school site of Longjing Exploitation Medical School. Longjing Medical College was founded by people who had ‘the perspective of Korean nationality’ in an atmosphere where the ‘ethnicity’ of the Koreans exercised considerable power. Nevertheless, in 1946, when the Chinese Civil War began and the Yanbian region became an important base of the Chinese Communist Party, the Party began to expand and strengthen their influences in the region. Accordingly, the operation rights of Longjing Medical College were transferred to the Yanbian Administrative offices of Supervision and

  7. 77 FR 45717 - Proposed Information Collection (Former Prisoner of War Medical History); Comment Request

    Science.gov (United States)

    2012-08-01

    ... use of other forms of information technology. Title: Former Prisoner of War (FPOW) Medical History, VA... Prisoner of War veteran. VA will use the data collected as a guide and reference for treatment planning for... Prisoner of War Medical History); Comment Request AGENCY: Veterans Health Administration, Department of...

  8. 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.

  9. 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.

  10. 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

  11. Medication refusal in children with oppositional defiant disorder or conduct disorder and comorbid attention-deficit/hyperactivity disorder: medication history and clinical correlates.

    Science.gov (United States)

    Demidovich, Mark; Kolko, David J; Bukstein, Oscar G; Hart, Jonathan

    2011-02-01

    Abstract Objective: This study examines the characteristics of 96 children with attention-deficit/hyperactivity disorder (ADHD) and their families who refused a recommendation for medication as part of their treatment for disruptive disorders. The ADHD cases were taken from a sample of 139 youth (age 6-11) who were recruited for a clinical trial that compared the administration of a modular psychosocial treatment in an outpatient clinic or community settings. Medication management was an optional treatment module for children with ADHD in both conditions. Children who were (vs. were not) taking medication at intake, and children who accepted (vs. refused) medication recommendations during the study were compared on diagnostic and clinical measures related to child, school, parent, and family domains of functioning. Parents of 30% of the children refused study medication for ADHD. Parental medication acceptability and intake correlated highly with both medication history and study refusal of medication. Increased parental self-efficacy and emotional support for their youth correlated with medication refusal. No demographics and few child or school factors were associated with medication refusal. Medication use was associated with reductions in some key ADHD symptoms, but did not affect disruptive behaviors as did the psychosocial interventions. Medication refusers remain poorly understood but certain correlates, such as parental self-efficacy, parental emotional support for their youth, and medication acceptability, warrant further evaluation.

  12. 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

  13. An Unbiased View of the History of Polish Medical Physics by a Senior Polish Medical Physicist

    International Nuclear Information System (INIS)

    Chomicki, O. A.

    2008-01-01

    Here is a story told by Maria Sklodowska-Curie at the meeting of the International Committee of Intellectual Cooperation in 1921: 'In a free literary competition on the role and importance of elephants the Englishman's story was 'My adventures while shooting elephants in South Africa', the Frenchman was more concerned with 'The sexual and erotic life of elephants', while the Polish approach was invariably 'The elephant versus Poland's national independence', which seemed quite understandable in the light of over 120 years when Poland was partitioned and lost its independence. Since then this saying has become proverbial and came to express the unmistakably Polish tendency to see everything in terms of Polish interests. In my remarks and reminiscences on the history of the Polish Society of Medical Physics you will quickly recognize the same tendency. First, I will, among other things, try to open some old cupboards to 'produce good [things] from the store of good' (Matthew 12:35), especially concerning the first few years of the activity in medical physics in Poland, and second, I will draw some conclusions and/or offer suggestions based on what a senior medical physicist has seen for more than 50 years of his activity in this field. (author)

  14. 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.

  15. Market factors and electronic medical record adoption in medical practices.

    Science.gov (United States)

    Menachemi, Nir; Mazurenko, Olena; Kazley, Abby Swanson; Diana, Mark L; Ford, Eric W

    2012-01-01

    Previous studies identified individual or practice factors that influence practice-based physicians' electronic medical record (EMR) adoption. Less is known about the market factors that influence physicians' EMR adoption. The aim of this study was to explore the relationship between environmental market characteristics and physicians' EMR adoption. The Health Tracking Physician Survey 2008 and Area Resource File (2008) were combined and analyzed. Binary logistic regression was used to examine the relationship between three dimensions of the market environment (munificence, dynamism, and complexity) and EMR adoption controlling for several physician and practice characteristics. In a nationally representative sample of 4,720 physicians, measures of market dynamism including increases in unemployment, odds ratio (OR) = 0.95, 95% confidence interval (CI) [0.91, 0.99], or poverty rates, OR = 0.93, 95% CI [0.89, 0.96], were negatively associated with EMR adoption. Health maintenance organization penetration, OR = 3.01, 95% CI [1.49, 6.05], another measure of dynamism, was positively associated with EMR adoption. Physicians practicing in areas with a malpractice crisis, OR = 0.82, 95% CI [0.71, 0.94], representing environmental complexity, had lower EMR adoption rates. Understanding how market factors relate to practice-based physicians' EMR adoption can assist policymakers to better target limited resources as they work to realize the national goal of universal EMR adoption and meaningful use.

  16. Social factors in marijuana use for medical and recreational purposes.

    Science.gov (United States)

    Szaflarski, Magdalena; Sirven, Joseph I

    2017-05-01

    Of all the various treatment options for epilepsy, no other therapy comes close to the polarity that cannabis engenders. The rationale for this reaction is firmly rooted in the social factors that enshroud the use of marijuana for both medical and recreational purposes. In order to best understand how to approach this controversial treatment, it is essential to explore the social, demographic, and historical variables that have led to the current opinions on cannabis therapy and how this has converged on epilepsy treatment. Utilizing a sociological conceptual framework, this review discusses in depth the social, cultural, and historical dimensions of cannabis use in the US for medical purposes and its impact on epilepsy treatment. Moreover, it posits that cannabis therapy and the opinions surrounding its use are products of history and assesses this treatment option through the lens of our current times. This article is part of a Special Issue titled Cannabinoids and Epilepsy. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Factors influencing French medical students towards a career in psychiatry.

    Science.gov (United States)

    Andlauer, Olivier; Guicherd, William; Haffen, Emmanuel; Sechter, Daniel; Bonin, Bernard; Seed, Kitty; Lydall, Gregory; Malik, Amit; Bhugra, Dinesh; Howard, Rob

    2012-09-01

    There is a need to increase the recruitment to psychiatry in France. Our aim in this study was to compare factors influencing career choice between French medical students considering and not considering psychiatry as a specialty. Quantitative cross-sectional online survey on 145 French students in their last year of medical school. 22.7% of our sample considered choosing a career in psychiatry. A preference for a career in psychiatry was associated with more frequent history of personal/familial mental illness, higher ratings of psychiatric teaching, more weeks of compulsory psychiatry teaching and placement, during which students had more often met patients in recovery and been asked their opinion on patients. Students considering psychiatry as a career also emphasized more the need for a good work-life balance, and presented better attitudes toward psychiatry. Improving opportunities of interactions between students and psychiatrists or psychiatric patients might help to improve recruitment in psychiatry.

  18. Oral health Status, Medical History, Xerostomia dan Quality of Life of elderly In Luwu Timur, Sulawesi Selatan

    OpenAIRE

    Samad, Rasmidar

    2013-01-01

    Xerostomia is a common condition in elderly people which may result in permanent impairtment that would be one risk factor for decreased quality of life Objective the aim of this study is to determine the relathionship of sociodemographic status, medical history, xerostomia, tooth loss and caries status with quality of life of elderly in luwu timur Xerostomia is a common condition in elderly people which may result in permanent impairtment that would be one risk factor for decreased qua...

  19. 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.

  20. 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.

  1. chronicles of medical history biomimetics: the early years

    African Journals Online (AJOL)

    2014-12-22

    Dec 22, 2014 ... basic sciences of physics, mathematics and chemistry ... Department of Pharmacology and Therapeutics, Faculty of Basic Medical Sciences, College of ... approach man's tool for the ultimate conquest of sickness and disease ...

  2. [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.

  3. Medical record validation of maternally reported history of preeclampsia

    NARCIS (Netherlands)

    M. Coolman (Marianne); C.J.M. de Groot (Christianne); V.W.V. Jaddoe (Vincent); A. Hofman (Albert); H. Raat (Hein); E.A.P. Steegers (Eric)

    2010-01-01

    textabstractObjective: In this study, we assessed the validity of maternally self-reported history of preeclampsia. Study Design and Setting: This study was embedded in the Generation R Study, a population-based prospective cohort study. Data were obtained from prenatal questionnaires and one

  4. An educational tool for teaching medication history taking to pharmacy students.

    Science.gov (United States)

    Sando, Karen R; Elliott, Jennifer; Stanton, Melonie L; Doty, Randell

    2013-06-12

    To implement and evaluate the use of a situated-learning experience to prepare second-year pharmacy students to conduct medication history interviews in preparation for introductory pharmacy practice experiences (IPPE) at ambulatory clinic sites. Second-year doctor of pharmacy (PharmD) students (n=200) used the Medication Mysteries Infinite Case Tool, a game-like educational tool in which groups of 3 students assumed the roles of pharmacist, patient, and observer and rolled a die and drew cards to determine the drugs, patient personality, medication problems, and other variables that guided a medication history taking session. After the laboratory session, faculty members assessed students' medication history-taking skills. One hundred sixteen (58%) and 78 (39%) of 200 students achieved excellence or competence, respectively, on the final assessment. Two weeks after the assessment, 53 of 200 (26.5%) students completed a survey instrument. The respondents indicated that their self-confidence in conducting medical history taking significantly improved following completion of the learning experience. Using the Medication Mysteries Infinite Case Tool increased students' confidence and skills in conducting medication history taking prior to their clinical IPPE experience.

  5. [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.

  6. Factors affecting medication-order processing time.

    Science.gov (United States)

    Beaman, M A; Kotzan, J A

    1982-11-01

    The factors affecting medication-order processing time at one hospital were studied. The order processing time was determined by directly observing the time to process randomly selected new drug orders on all three work shifts during two one-week periods. An order could list more than one drug for an individual patient. The observer recorded the nature, location, and cost of the drugs ordered, as well as the time to process the order. The time and type of interruptions also were noted. The time to process a drug order was classified as six dependent variables: (1) total time, (2) work time, (3) check time, (4) waiting time I--time from arrival on the dumbwaiter until work was initiated, (5) waiting time II--time between completion of the work and initiation of checking, and (6) waiting time III--time after the check was completed until the order left on the dumbwaiter. The significant predictors of each of the six dependent variables were determined using stepwise multiple regression. The total time to process a prescription order was 58.33 +/- 48.72 minutes; the urgency status of the order was the only significant determinant of total time. Urgency status also significantly predicted the three waiting-time variables. Interruptions and the number of drugs on the order were significant determinants of work time and check time. Each telephone interruption increased the work time by 1.72 minutes. While the results of this study cannot be generalized to other institutions, pharmacy managers can use the method of determining factors that affect medication-order processing time to identify problem areas in their institutions.

  7. Medical profession and nuclear war: a social history

    International Nuclear Information System (INIS)

    Day, B.; Waitzkin, H.

    1985-01-01

    Since World War II, individual physicians and medical organizations in the US have cooperated with the federal government in preparing for nuclear war. While most physicians have maintained a neutral stance, a minority have resisted federal policies. Health professionals participated actively at the wartime laboratories that developed the atomic bomb and in the medical research that followed Hiroshima and Nagasaki. Professional organizations helped with civil defense planning for nuclear conflict during the Cold War of the late 1950s and early 1960s. Medical resistance to nuclear war began in the same period, gained wide attention with the growth of Physicians for Social Responsibility in the early 1960s, declined during the Vietnam War, and vastly increased in the early 1980s. Activism by health professionals usually has responded to government policies that have increased the perceived risk of nuclear conflict. The recent return of civil defense planning has stimulated opposition in medical circles. Ambiguities of medical professionalism limit the scope of activism in the nuclear arena. These ambiguities concern the interplay of organized medicine and government, tensions between science and politics, and the difficulties of day-to-day work in medicine while the arms race continues

  8. 78 FR 50136 - Notice of Information Collection Under Emergency Review: Medical History and Examination for...

    Science.gov (United States)

    2013-08-16

    ...: Medical History and Examination for Foreign Service DS-1843 and DS-1622 ACTION: Notice of request for... methods: Web: Persons with access to the Internet may use the Federal Docket Management System (FDMS) to... History and Examination for Foreign Service. OMB Control Number: 1405-0068. Type of Request: Emergency...

  9. History of TB in the Sudan | Zaki | Sudan Journal of Medical Sciences

    African Journals Online (AJOL)

    Introduction: Medical history in Sudan is far from being complete. There are no reliable records. Attempt to write on the projects and development of history of TB in the Sudan is a difficult task. Objective: To study and trace the progress of TB in Sudan during the last century through their historical development. Design: A ...

  10. Antidiabetic medication adherence and associated factors among ...

    African Journals Online (AJOL)

    Godfrey Mutashambara Rwegerera

    2017-03-06

    Mar 6, 2017 ... tive of the study was to determine current antidiabetic medication adherence in ...... A systematic review of adherence with medications for diabetes. .... Pascal IGU, Ofoedu JN, Uchenna NP, Nkwa AA, Uchamma GUE.

  11. A Preoperative Medical History and Physical Should Not Be a Requirement for All Cataract Patients.

    Science.gov (United States)

    Schein, Oliver D; Pronovost, Peter J

    2017-07-01

    Cataract surgery poses minimal systemic medical risk, yet a preoperative general medical history and physical is required by the Centers for Medicare and Medicaid Services and other regulatory bodies within 1 month of cataract surgery. Based on prior research and practice guidelines, there is professional consensus that preoperative laboratory testing confers no benefit when routinely performed on cataract surgical patients. Such testing remains commonplace. Although not yet tested in a large-scale trial, there is also no evidence that the required history and physical yields a benefit for most cataract surgical patients above and beyond the screening performed by anesthesia staff on the day of surgery. We propose that the minority of patients who might benefit from a preoperative medical history and physical can be identified prospectively. Regulatory agencies should not constrain medical practice in a way that adds enormous cost and patient burden in the absence of value.

  12. Wandering spleen: a medical enigma, its natural history and rationalization.

    Science.gov (United States)

    Magowska, Anita

    2013-03-01

    Wandering spleen is a rare condition in which the spleen is not located in the left upper quadrant but is found lower in the abdomen or in the pelvic region because of the laxity of the peritoneal attachments. Many patients with wandering spleen are asymptomatic, hence the condition can be discovered only by abdominal examination or at a hospital emergency department if a patient is admitted to hospital because of severe abdominal pain, vomiting or obstipation. This article aims to provide a historical overview of wandering spleen diagnostics and surgical treatment supplemented with an analyses of articles on wandering spleen included in the PubMed database. One of the first clinical descriptions of a wandering spleen was written by Józef Dietl in 1854. The next years of vital importance are 1877 when A. Martin conducted the first splenectomy and in 1895 when Ludwik Rydygier carried out the first splenopexy to immobilize a wandering spleen. Since that time various techniques of splenectomy and splenopexy have been developed. Introducing medical technologies was a watershed in the development and treatment of wandering spleen, which is confirmed by the PubMed database. Despite the increased number of publications medical literature shows that a wandering spleen still remains a misdiagnosed condition, especially among children.

  13. [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.

  14. Identifying factors affecting destination choice of medical tourists: a ...

    African Journals Online (AJOL)

    medical tourism”, has emerged as a new source of competitive advantage all over the world. The present study seeks to identify the factors that affect destination choice of medical tourists. Methods: We systematically searched relevant databases ...

  15. Urolithiasis: evaluation, dietary factors, and medical management

    DEFF Research Database (Denmark)

    Jung, Helene; Andonian, Sero; Assimos, Dean

    2017-01-01

    PURPOSE: The aim of this review was to provide current best evidence for evaluation, dietary, and medical management of patients with urolithiasis. METHODS: Literature addressing evaluation, dietary, and medical management of urolithiasis was searched. Papers were analyzed and rated according...... the life of stone-forming individuals very differently, and that evaluation and medical management should be personalized according to risk of recurrence, severity of stone disease, presence of associated medical conditions, and patient's motivation. With regard to evaluation, dietary and medical...... management of patients with urolithiasis evidence from the literature suggest that selective metabolic evaluation may lead to rational dietary and medical management. Statements based on LOE and GOR are provided to guide clinical practice. CONCLUSION: The provided evidence for evaluation of patients...

  16. Factors Influencing Patronage Of Medical Tourism In Metropolitan Lagos Nigeria

    OpenAIRE

    Omisore; E.O.; Agbabiaka; H. I.

    2015-01-01

    Since medical tourism attract patient from various origin to seek medical services at different destinations it is paramount to consider the factors that motivate patrons decision on medical tourism. Hence this study assesses the factors influencing patronage of medical tourism in Lagos metropolis Nigeria. Lagos State is situated in the southwestern corner of Nigeria it lies within Latitudes 62N to 64N of the Equator and Longitudes 245E to 420E of the Greenwich meridian. Metropolitan Lagos is...

  17. Comparison of Pilot Medical History and Medications Found In Postmortem Specimens

    National Research Council Canada - National Science Library

    Canfield, Dennis V; Salazar, Guillermo J; Lewis, Russell J; Whinnery, James E

    2006-01-01

    Pilots are required by FAA regulations to report all medications and medical conditions to the FAA Office of Aerospace Medicine for review as to the overall suitability of the pilot for flight activities...

  18. [The red face: art, history and medical representations].

    Science.gov (United States)

    Cribier, B

    2011-09-01

    For millennia, a red face has been a handicap in social relations, mainly because of the associated bias against alcoholics. The color red is also the color of emotion, betrayal of the person who blushes. Since the color red is one of the main characteristics of rosacea, it contributes to the bad reputation this disorder has, which is therefore the subject of a pressing therapeutic demand, principally in women. Nineteenth-century French novelists such as Balzac and later Proust, admirably described blotchy, red, or sanguine faces, which always announced a difficult, violent temperament, or was simply the mark of the laboring class. The color red remains ambivalent today, on the one hand denoting blood and life and on the other suffering, shame, and death. The history of dermatology shows that the semiology of rosacea was very well described in the earliest reports, notably those written in the Middle Ages. The term "acne rosacea" appeared in Bateman's writings, who made it a clinical form of acne. This confusion lasted throughout the nineteenth century. It was not until Hebra in Austria and Darier in France that the differential diagnosis was clearly made between acne and rosacea. A "couperosis" previously referred to the entire range of the disease, particularly the papules and pustules, and it was not until the twentieth century that the current meaning of rosacea progressively gained ground: this term today designates facial telangiectasia, whether or not it is associated with a characteristic redness. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  19. [Medication reconciliation: an innovative experience in an internal medicine unit to decrease errors due to inacurrate medication histories].

    Science.gov (United States)

    Pérennes, Maud; Carde, Axel; Nicolas, Xavier; Dolz, Manuel; Bihannic, René; Grimont, Pauline; Chapot, Thierry; Granier, Hervé

    2012-03-01

    An inaccurate medication history may prevent the discovery of a pre-admission iatrogenic event or lead to interrupted drug therapy during hospitalization. Medication reconciliation is a process that ensures the transfer of medication information at admission to the hospital. The aims of this prospective study were to evaluate the interest in clinical practice of this concept and the resources needed for its implementation. We chose to include patients aged 65 years or over admitted in the internal medicine unit between June and October 2010. We obtained an accurate list of each patient's home medications. This list was then compared with medication orders. All medication variances were classified as intended or unintended. An internist and a pharmacist classified the clinical importance of each unintended variance. Sixty-one patients (mean age: 78 ± 7.4 years) were included in our study. We identified 38 unintended discrepancies. The average number of unintended discrepancies was 0.62 per patient. Twenty-five patients (41%) had one or more unintended discrepancies at admission. The contact with the community pharmacist permitted us to identify 21 (55%) unintended discrepancies. The most common errors were the omission of a regularly used medication (76%) and an incorrect dosage (16%). Our intervention resulted in order changes by the physician for 30 (79%) unintended discrepancies. Fifty percent of the unintended variances were judged by the internist and 76% by the pharmacist to be clinically significant. The admission to the hospital is a critical transition point for the continuity of care in medication management. Medication reconciliation can identify and resolve errors due to inaccurate medication histories. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  20. The red face: art, history and medical representations.

    Science.gov (United States)

    Cribier, B

    2011-11-01

    For millennia, a red face has been a handicap in social relations, mainly because of the associated bias against alcoholics. The color red is also the color of emotion, betrayal of the person who blushes. Since the color red is one of the main characteristics of rosacea, it contributes to the bad reputation this disorder has, which is therefore the subject of a pressing therapeutic demand, principally in women. Nineteenth-century French novelists such as Balzac and later Proust, admirably described blotchy, red, or sanguine faces, which always announced a difficult, violent temperament, or was simply the mark of the laboring class. The color red remains ambivalent today, on the one hand denoting blood and life and on the other suffering, shame, and death. The history of dermatology shows that the semiology of rosacea was very well described in the earliest reports, notably those written in the Middle Ages. The term "acne rosacea" appeared in Bateman's writings, who made it a clinical form of acne. This confusion lasted throughout the nineteenth century. It was not until Hebra in Austria and Darier in France that the differential diagnosis was clearly made between acne and rosacea. A "couperosis" previously referred to the entire range of the disease, particularly the papules and pustules, and it was not until the twentieth century that the current meaning of rosacea progressively gained ground: this term today designates facial telangiectasia, whether or not it is associated with a characteristic redness. Rosacea is a conspicuous disease, since the lesions involve the central portion of the face.Among the many manifestations of rosacea, redness is the most characteristic [1]. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  1. Analysis of differences in exercise recognition by constraints on physical activity of hospitalized cancer patients based on their medical history.

    Science.gov (United States)

    Choi, Mi-Ri; Jeon, Sang-Wan; Yi, Eun-Surk

    2018-04-01

    The purpose of this study is to analyze the differences among the hospitalized cancer patients on their perception of exercise and physical activity constraints based on their medical history. The study used questionnaire survey as measurement tool for 194 cancer patients (male or female, aged 20 or older) living in Seoul metropolitan area (Seoul, Gyeonggi, Incheon). The collected data were analyzed using frequency analysis, exploratory factor analysis, reliability analysis t -test, and one-way distribution using statistical program SPSS 18.0. The following results were obtained. First, there was no statistically significant difference between cancer stage and exercise recognition/physical activity constraint. Second, there was a significant difference between cancer stage and sociocultural constraint/facility constraint/program constraint. Third, there was a significant difference between cancer operation history and physical/socio-cultural/facility/program constraint. Fourth, there was a significant difference between cancer operation history and negative perception/facility/program constraint. Fifth, there was a significant difference between ancillary cancer treatment method and negative perception/facility/program constraint. Sixth, there was a significant difference between hospitalization period and positive perception/negative perception/physical constraint/cognitive constraint. In conclusion, this study will provide information necessary to create patient-centered healthcare service system by analyzing exercise recognition of hospitalized cancer patients based on their medical history and to investigate the constraint factors that prevents patients from actually making efforts to exercise.

  2. 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.

  3. Giuseppe and Aloysius Frari's works on rabies and history of Frari medical family of Sibenik, Dalmatia.

    Science.gov (United States)

    Krnić, Anton

    2007-06-01

    This article is an attempt to reconstruct the family history of the Fraris, the famous Sibenik medical family. Three generations of physicians from the Frari family played an important role not only at medical and social scene of Sibenik in the 18th and 19th century, but also in Croatian and Italian medical history. I will try to provide important details on the lives, medical and social work, and publications of 5 members of the family, Giuseppe (Josip), Angelo Antonio (Andeo Antun), Sebastiano (Sebastijan), Michele Carlo (Mihovil), and Aloysius (Luigi) Frari. I would also like to pay a special attention to the works on rabies, written by Giuseppe and Luigi Frari, which are among the earliest and most accurate Croatian works on the subject. To reconstruct the history of the family, I studied the relevant editions about the medical and social history of Sibenik, Dalmatia, Venice, and Croatia, together with the Fraris' publications and reflections. This was the first time Italian and Latin language works by Giuseppe and Luigi Frari on rabies were analyzed. The story on Fraris also documents that medical publishing was a common practice in Dalmatia in the 18th and the 19th century.

  4. Predicting Risk of Suicide Attempt Using History of Physical Illnesses From Electronic Medical Records

    Science.gov (United States)

    Luo, Wei; Tran, Truyen; Berk, Michael; Venkatesh, Svetha

    2016-01-01

    Background Although physical illnesses, routinely documented in electronic medical records (EMR), have been found to be a contributing factor to suicides, no automated systems use this information to predict suicide risk. Objective The aim of this study is to quantify the impact of physical illnesses on suicide risk, and develop a predictive model that captures this relationship using EMR data. Methods We used history of physical illnesses (except chapter V: Mental and behavioral disorders) from EMR data over different time-periods to build a lookup table that contains the probability of suicide risk for each chapter of the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) codes. The lookup table was then used to predict the probability of suicide risk for any new assessment. Based on the different lengths of history of physical illnesses, we developed six different models to predict suicide risk. We tested the performance of developed models to predict 90-day risk using historical data over differing time-periods ranging from 3 to 48 months. A total of 16,858 assessments from 7399 mental health patients with at least one risk assessment was used for the validation of the developed model. The performance was measured using area under the receiver operating characteristic curve (AUC). Results The best predictive results were derived (AUC=0.71) using combined data across all time-periods, which significantly outperformed the clinical baseline derived from routine risk assessment (AUC=0.56). The proposed approach thus shows potential to be incorporated in the broader risk assessment processes used by clinicians. Conclusions This study provides a novel approach to exploit the history of physical illnesses extracted from EMR (ICD-10 codes without chapter V-mental and behavioral disorders) to predict suicide risk, and this model outperforms existing clinical assessments of suicide risk. PMID:27400764

  5. Importance of philosophy of science to the history of medical thinking.

    Science.gov (United States)

    Zalewski, Z

    1999-03-01

    Popular approach to the history of medicine rests on naive assumptions that: 1) only the present state of medical knowledge can be counted as scientific and only those elements of the former knowledge and practice which fitted the body of contemporary science should be regarded by the historians of medicine (presentism); 2) medical sciences, like the other natural sciences, portray natural phenomena as they really are (naturalism); 3) progress in sciences consists of cumulative growth of information and explanation. The twentieth century philosophical critique of science revealed that none of these assumptions were true. Empirical facts, which are taken as a basis for any true knowledge, are dependent on the presumed theories; theories are intertwined into a broader socio-cultural context; theory-changing processes are caused by social factors rather than by the theoretical content. Therefore, it is a common task of historians of medicine and philosophers of science to reveal all theoretical and cultural premises on which our comprehension of the contemporary medicine is founded.

  6. Case studies in cholera: lessons in medical history and science.

    Science.gov (United States)

    Kavic, S. M.; Frehm, E. J.; Segal, A. S.

    1999-01-01

    Cholera, a prototypical secretory diarrheal disease, is an ancient scourge that has both wrought great suffering and taught many valuable lessons, from basic sanitation to molecular signal transduction. Victims experience the voluminous loss of bicarbonate-rich isotonic saline at a rate that may lead to hypovolemic shock, metabolic acidosis, and death within afew hours. Intravenous solution therapy as we know it was first developed in an attempt to provide life-saving volume replacement for cholera patients. Breakthroughs in epithelial membrane transport physiology, such as the discovery of sugar and salt cotransport, have paved the way for oral replacement therapy in areas of the world where intravenous replacement is not readily available. In addition, the discovery of the cholera toxin has yielded vital information about toxigenic infectious diseases, providing a framework in which to study fundamental elements of intracellular signal transduction pathways, such as G-proteins. Cholera may even shed light on the evolution and pathophysiology of cystic fibrosis, the most commonly inherited disease among Caucasians. The goal of this paper is to review, using case studies, some of the lessons learned from cholera throughout the ages, acknowledging those pioneers whose seminal work led to our understanding of many basic concepts in medical epidemiology, microbiology, physiology, and therapeutics. PMID:11138935

  7. Cardiovascular risk factors in Chinese women with a history of gestational diabetes mellitus.

    Science.gov (United States)

    Mai, Caiyuan; Hou, Minming; Chen, Rong; Duan, Dongmei; Xu, Huikun; Lin, Xiaohong; Wen, Jiying; Lv, Lijuan; Lei, Qiong; Niu, Jianmin

    2015-01-01

    Women with a history of gestational diabetes (GDM) are at increased risk of developing cardiovascular diseases compared with normal women. This study aimed to evaluate the cardiovascular risk factors in Chinese women with GDM. 453 women with GDM (cases) and 1,180 healthy women (controls) were included in this study. The post-partum examinations included 2 h 75 g oral glucose tolerance tests, lipid profiles, anthropometric measurements (blood pressure, height, weight) and documentation of medical history, diet, and lifestyle. Compared with controls, the risks of abnormal glucose metabolism, obesity, hypertension, metabolic syndrome in women with a history of GDM were 4.61, 1.30, 1.57 and 3.52, respectively. Fasting blood glucose, progestational body mass index (pBMI) and antenatal insulin resistance at antenatal visit were predictors for abnormal glucose metabolism. pBMI and antenatal diastolic blood pressure were predictors for hypertension. pBMI and weight gain during pregnancy were predictors for obesity/overweight. pBMI, antenatal systolic blood pressure and antenatal triglyceride were predictors for metabolic syndrome. Women with a history of GDM have increased rates of cardiovascular disease risk factors including abnormal glucose metabolism, obesity, hypertension, metabolic syndrome. pBMI is the common independent predictors of cardiometabolic disease in the post-partum.

  8. Risk factors for colorectal cancer in subjects with family history of the disease.

    Science.gov (United States)

    Fernandez, E; La Vecchia, C; D'Avanzo, B; Negri, E; Franceschi, S

    1997-01-01

    The relationship between lifestyle factors, past medical conditions, daily meal frequency, diet and the risk of 'familial' colorectal cancer has been analysed using data from a case-control study conducted in northern Italy. A total of 1584 colorectal cancer patients and 2879 control subjects were admitted to a network of hospitals in the Greater Milan area and the Pordenone province. The subjects included for analysis were the 112 cases and the 108 control subjects who reported a family history of colorectal cancer in first-degree relatives. Colorectal cancer cases and control subjects with family history were similarly distributed according to sex, age, marital status, years of schooling and social class. Familial colorectal cancer was associated with meal frequency, medical history of diabetes (relative risk, RR = 4.6) and cholelithiasis (RR = 5.2). Significant positive trends of increasing risk with more frequent consumption were observed for pasta (RR = 2.5, for the highest vs the lowest intake tertile), pastries (RR = 2.4), red meat (RR = 2.9), canned meat (RR = 1.9), cheese (RR = 3.5) and butter (RR = 1.9). Significant inverse associations and trends in risk were observed for consumption of poultry (RR = 0.4), tomatoes (RR = 0.2), peppers (RR = 0.3) and lettuce (RR = 0.3). Significant inverse trends in risk with increasing consumption for beta-carotene and ascorbic acid were observed (RR = 0.5 and 0.4 respectively, highest vs lowest intake tertile). These results suggest that risk factors for subjects with a family history of colorectal cancer in first-degree relatives are not appreciably different from recognized risk factors of the disease in the general population.

  9. 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.

  10. 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.

  11. On the borderland of medical and disability history: a survey of the fields.

    Science.gov (United States)

    Linker, Beth

    2013-01-01

    This essay explores the multiple sites where disability appears in the history of medicine and suggests ways in which medical historians can self-consciously incorporate a disability perspective into their own work. Just as medical historians have much to learn from disability historians, disability historians could benefit from looking more closely at the history of medicine. While disability cannot (and should not) be reduced to disease, the fact remains that some forms of disability are brought about by disease processes, and some require daily regimes of home health care, therapy, and pain management. How the disabled have interacted with health care institutions, caretakers, and the medical establishment is too significant to be written out of its history.

  12. Utility of an Algorithm to Increase the Accuracy of Medication History in an Obstetrical Setting.

    Science.gov (United States)

    Corbel, Aline; Baud, David; Chaouch, Aziz; Beney, Johnny; Csajka, Chantal; Panchaud, Alice

    2016-01-01

    In an obstetrical setting, inaccurate medication histories at hospital admission may result in failure to identify potentially harmful treatments for patients and/or their fetus(es). This prospective study was conducted to assess average concordance rates between (1) a medication list obtained with a one-page structured medication history algorithm developed for the obstetrical setting and (2) the medication list reported in medical records and obtained by open-ended questions based on standard procedures. Both lists were converted into concordance rate using a best possible medication history approach as the reference (information obtained by patients, prescribers and community pharmacists' interviews). The algorithm-based method obtained a higher average concordance rate than the standard method, with respectively 90.2% [CI95% 85.8-94.3] versus 24.6% [CI95%15.3-34.4] concordance rates (phistory in our obstetric population, without using substantial resources. Its implementation is an effective first step to the medication reconciliation process, which has been recognized as a very important component of patients' drug safety.

  13. Fracture History in Osteoporosis: Risk Factors and its Effect on Quality of Life

    Directory of Open Access Journals (Sweden)

    Pınar Kuru

    2014-12-01

    Full Text Available Background: Fractures are one of the main outcomes in osteoporosis and have an important effect on the general health status. Aims: The purpose of this study was to determine the effect of major fracture history on quality of life. We also investigated the important risk factors and their effect on bone mineral density and fracture history. Study Design: Cross-sectional study. Methods: We recruited 105 patients who were admitted to an osteoporosis outpatient clinic. Medical history, family history, calcium intake, physical activity level and biochemical tests were evaluated. Lumbar spine and femur neck bone mineral density were measured. The Qualeffo- 41 questionnaire was also used for evaluating quality of life. Results: The average age of the 105 patients included in the study was 56.04±13.73 and 89% of them were post-menopausal women. The average body mass index was 26.84±5.99, which means that the women were overweight. Also, 48.5% of the patients were diagnosed with osteoporosis and 51.5% of them were diagnosed as low bone density. A total of 34 patients had a fracture history with minor trauma and some of the patients had more than one fracture (12 ankle and foot, 10 forearm, 9 vertebral, 4 hand, 3 hip, 2 rib, 1 tibial. When the patients with and without fracture history were compared, the mean Qualeffo-41 score in patients with fracture was 43.85±2.57 and in the non-fracture group was 36.27±2.01. Conclusion: Forearm, ankle and foot fractures can be commonly seen in osteoporosis patients with fracture history. We suggest that it is important to recognise osteoporosis prior to first fracture and disease-specific quality of life assessment should be done.

  14. Fracture history in osteoporosis: risk factors and its effect on quality of life.

    Science.gov (United States)

    Kuru, Pınar; Akyüz, Gülseren; Cerşit, Hülya Peynirci; Çelenlioğlu, Alp Eren; Cumhur, Ahmet; Biricik, Şefikcan; Kozan, Seda; Gökşen, Aylin; Özdemir, Mikail; Lüleci, Emel

    2014-12-01

    Fractures are one of the main outcomes in osteoporosis and have an important effect on the general health status. The purpose of this study was to determine the effect of major fracture history on quality of life. We also investigated the important risk factors and their effect on bone mineral density and fracture history. Cross-sectional study. We recruited 105 patients who were admitted to an osteoporosis outpatient clinic. Medical history, family history, calcium intake, physical activity level and biochemical tests were evaluated. Lumbar spine and femur neck bone mineral density were measured. The Qualeffo-41 questionnaire was also used for evaluating quality of life. The average age of the 105 patients included in the study was 56.04±13.73 and 89% of them were post-menopausal women. The average body mass index was 26.84±5.99, which means that the women were overweight. Also, 48.5% of the patients were diagnosed with osteoporosis and 51.5% of them were diagnosed as low bone density. A total of 34 patients had a fracture history with minor trauma and some of the patients had more than one fracture (12 ankle and foot, 10 forearm, 9 vertebral, 4 hand, 3 hip, 2 rib, 1 tibial). When the patients with and without fracture history were compared, the mean Qualeffo-41 score in patients with fracture was 43.85±2.57 and in the non-fracture group was 36.27±2.01. Forearm, ankle and foot fractures can be commonly seen in osteoporosis patients with fracture history. We suggest that it is important to recognise osteoporosis prior to first fracture and disease-specific quality of life assessment should be done.

  15. 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

    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. 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)). 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. 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 impact. Therefore the teaching of GTE

  16. 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

  17. On history of medical radiology in Ukraine: main directions of scientific development (1920-1941)

    International Nuclear Information System (INIS)

    Pilipenko, M.Yi.; Artamonova, N.O.; Busigyina, N.O.

    1994-01-01

    The work is devoted to the history of medical radiology in Ukraine. It deals with principal problems of scientific research development during 1920-1941. The authors describe both known and little known facts of the history of foundation and development of the first Ukrainian radiological, roentgenological and oncological institutes. Main achievements in radiology development i.e. foundation of large specialized research centres in Kharkov, kiev, Odessa, independent departments of roentgenology both at the majority of medical institutes and three advanced training institutes for doctors, organization of ALL-Union and Republican Congresses and Conferences of Radiologists, publication of a special journal > (Problems of Oncology) are described

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

    Science.gov (United States)

    Slack, Warner V; 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.

  19. 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.

  20. [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.

  1. Factors affecting future specialty choice among medical students in Kuwait

    OpenAIRE

    Marwan, Yousef; Al-Fouzan, Rawan; Al-Ajlan, Sarah; Al-Saleh, Mervat

    2012-01-01

    Background: Choosing a medical specialty can be either a daunting and confusing experience for some medical students and junior doctors or a foregone conclusion to others. The aim of this study is to evaluate factors affecting future specialty choice among medical students in Kuwait University. Methods: A self-administered questionnaire was used to collect data from medical students registered in Kuwait University during the academic year 2011/2012. Chi-square test and logistic regression wer...

  2. FACTORS AFFECTING THE DEVELOPMENT OF MEDICAL TOURISM IN PUBLIC HOSPITALS

    OpenAIRE

    YİĞİT, Vahit

    2016-01-01

    Medical tourism is a burgeoning industry in the world. Nowadays, over 50countries have been identified medical tourism as a national industry. AlthoughAsian countries where India, Thailand, Singapore and Malaysia popular medicaltourism destination, medical tourism in Turkey has not reached the desiredlevel and and could not get enough share of the medical tourism market. The aimof this study is to determine the factors influencing the development ofmedical tourism in Turkey. This research was...

  3. Factors influencing medical students in pursuing a career in surgery ...

    African Journals Online (AJOL)

    Background: Many factors play a role in the decision of a medical student to pursue a career in surgery. With a decline in numbers of applications into surgical programmes seen globally, the aim of this study was to determine the factors that influence medical students in pursuing a career in surgery. Methods: A descriptive ...

  4. Effect of teaching and checklist implementation on accuracy of medication history recording at hospital admission.

    Science.gov (United States)

    Lea, Marianne; Barstad, Ingeborg; Mathiesen, Liv; Mowe, Morten; Molden, Espen

    2016-02-01

    Medication discrepancies at hospital admission is an extensive problem and knowledge is limited regarding improvement strategies. To investigate the effect of teaching and checklist implementation on accuracy of medication history recording during hospitalization. Patients admitted to an internal medicine ward were prospectively included in two consecutive periods. Between the periods, non-mandatory teaching lessons were provided and a checklist assisting medication history recording implemented. Discrepancies between the recorded medications at admission and the patient's actual drug use, as revealed by pharmacist-conducted medication reconciliation, were compared between the periods. The primary endpoint was difference between the periods in proportion of patients with minimum one discrepancy. Difference in median number of discrepancies was included as a secondary endpoint. 56 and 119 patients were included in period 1 (P1) and period 2 (P2), respectively. There was no significant difference in proportion of patients with minimum one discrepancy in P2 (68.9 %) versus P1 (76.8 %, p = 0.36), but a tendency of lower median number of discrepancies was observed in P2 than P1, i.e. 1 and 2, respectively (p = 0.087). More powerful strategies than non-mandatory teaching activities and checklist implementation are required to achieve sufficient improvements in medication history recording during hospitalization.

  5. Factors associated with high-severity disciplinary action by a state medical board: a Texas study of medical license revocation.

    Science.gov (United States)

    Cardarelli, Roberto; Licciardone, John C

    2006-03-01

    There has been an increase in research evaluating factors associated with disciplinary action of physicians by state medical boards. However, factors related to the severity of disciplinary action are lacking. By investigating these factors while controlling for the type of violation, the authors sought to determine whether physician characteristics influenced the process of disciplinary action by state medical boards. Physicians disciplined by the Texas Medical Board between January 1, 1989, and December 31, 1998, were included in this case-controlled study (N=1129). Multivariate logistic regression analysis was used to compute odds ratios (ORs) and 95% confidence intervals (CIs) for factors associated with license revocation, the most severe disciplinary action, compared with all other forms of disciplinary action combined. Anesthesiologists (OR, 2.45; 95% CI, 1.05-5.74), general practitioners (OR, 1.80; 95% CI, 1.01-3.19), and psychiatrists (OR, 2.68; 95% CI, 1.41-5.13), as well as those with multiple disciplinary actions (OR, 1.91; 95% CI, 1.29-2.83) were most susceptible to license revocation. The more years a disciplined physician was in practice, the greater risk he or she had of license revocation (OR, 1.05; 95% CI, 1.04-1.07). Factors associated with a greater likelihood of license revocation for physicians are: primary medical specialty, number of years in practice, and a history of multiple disciplinary actions.

  6. Family history and medical examination of occupationally exposed employees against ionizing radiation

    International Nuclear Information System (INIS)

    Heinemann, G.

    2000-01-01

    Searching for individual radiosensitivity could improve the quality of the medical examination of occupationally exposed employees and thus provide real protection of the individual against ionizing radiation. For this purpose genetic family history should be recorded by a skilled interviewer. (orig.) [de

  7. Self-reported medical, medication and laboratory error in eight countries: risk factors for chronically ill adults.

    Science.gov (United States)

    Scobie, Andrea

    2011-04-01

    To identify risk factors associated with self-reported medical, medication and laboratory error in eight countries. The Commonwealth Fund's 2008 International Health Policy Survey of chronically ill patients in eight countries. None. A multi-country telephone survey was conducted between 3 March and 30 May 2008 with patients in Australia, Canada, France, Germany, the Netherlands, New Zealand, the UK and the USA who self-reported being chronically ill. A bivariate analysis was performed to determine significant explanatory variables of medical, medication and laboratory error (P error: age 65 and under, education level of some college or less, presence of two or more chronic conditions, high prescription drug use (four+ drugs), four or more doctors seen within 2 years, a care coordination problem, poor doctor-patient communication and use of an emergency department. Risk factors with the greatest ability to predict experiencing an error encompassed issues with coordination of care and provider knowledge of a patient's medical history. The identification of these risk factors could help policymakers and organizations to proactively reduce the likelihood of error through greater examination of system- and organization-level practices.

  8. 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.

  9. A history and overview of the certification exam for medical dosimetrists

    International Nuclear Information System (INIS)

    Pusey, Damien; Smith, Lisette; Zeman, Elaine M.; Adams, Robert

    2005-01-01

    During the last century, the creation and implementation of board certification has had a powerful impact on the medical community. Board certification has helped to shape the scope and practice of medical professionals and the care they provide, as well as to influence the way the health insurance industry sets standards for reimbursement. One profession that offers board certification to its members is medical dosimetry. The Medical Dosimetrist Certification Board exam has been administered since 1988 and its content covers a broad spectrum of information from the radiation therapy sciences. The exam has strict application requirements and is rather difficult to pass. Those who pass the exam can then call themselves Certified Medical Dosimetrists. For data purposes of this study, several members of the dosimetry community were solicited to participate in a survey regarding the exam's content and history, and to provide relevant statistical data. Currently 2,177 medical dosimetrists are board certified, with an additional 1,500 estimated to be working without certification. Although board certification is not currently required to practice medical dosimetry, new legislation known as the CARE Bill could change this. The CARE Bill, if passed, would mandate nationwide compulsory licensure and/or certification for medical dosimetrists and other medical professionals who want to work in radiation-related health care. Health maintenance organizations and other insurance carriers may likewise require certification for reimbursement purposes

  10. 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.

  11. 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/

  12. Risk factors of coronary heart disease among medical diagnostic X-ray workers

    International Nuclear Information System (INIS)

    Zhang Wei; Wang Jixian; Zhao Yongcheng; Li Benxiao; Fan Tiqiang; Zhao Zhigang; Lin Zhidong

    2002-01-01

    Objective: To investigate risk factors of coronary heart disease (CHD) in medical diagnostic X-ray workers in China, especially the relationship of CHD with occupational irradiation. Methods: A 1:2 matched case-control study was carried out. The study subjects consisted of 112 pair-matched cases and controls coming from different hospitals in China. Information about occupational and non-occupational risk factors obtained by interviewing every subjects personally. Individual doses were estimated by normalized work load method. SAS 6.12 software conditional Logistic regression method was applied to data analysis. Results: Variables such as family history of CHD (OR=17.298, P = 0.0001), history of hypertension (OR = 6.172, P = 0.0003), overweight (OR = 2.679, P = 0.0150), physical exercises (OR = 0.421, P0.0333), diabetes (OR = 7.823, P = 0.0200), radiation protection condition (OR = 3.992, P 0.0027), and accumulated radiation dose (OR = 1.612, P 0.0454) were included in the last model. Conclusions: For the medical diagnostic X-ray workers, family history of coronary heart disease, history of hypertension, diabetes, etc. are the main risk factors of CHD, and occupational exposure may be a potential risk factor. As for the mechanism, further studies are needed

  13. Critical factors which shaped Iranian cities in History

    International Nuclear Information System (INIS)

    Tabibian, M.

    1997-01-01

    The history of Iranian Cities and its associated urban a paces are long and colourful. the role of urban areas has always been an important one. It is important for the purpose at hand, to examine, albeit in a cursory fashion, some of critical factors which shaped the development of Iranian Cities, including urban spaces. Moreover, I believe that these forces created, in Iran, a variable, rational urban system and that the currency set of p roblems i n Iranian Cities results from new technological forces interacting with l der, historical forces. Of course, making generalizations about Persian towns is at best, a risky business, The wide range of natural and historical forces which have played across the face of this country have created special conditions in each urban settlement. But, in spite of the fact that each Persian town has a distinct character and ambience, one can easily see that these differences occur within a framework which is remarkably similar in both basic principles and details. Now, however, even greater forces are operating in Iran, as all over the world, to alter towns almost beyond recognition. The internal combustion engine is introducing a new scale of distance to the city; telecommunications are giving the city a new time scale; industrialization is challenging the traditional economic bases of cities. Tine and again, for both the East and West, these new forces have overwhelmed the more modest human scale of old towns. Times and again, planners and administrators have realized very late in the process that the other scales must be preserved as well. Iran is no exception. This article offers some suggestion as to how Iranian planners and administrators might preserve the human scale in Persian towns. It begins with a look at the history of Persian towns in an attempt to define (implicitly) the Persian human scale by describing the rational urban systems and details which developed in Iran over some 5,000 years of urbanisation. Then we

  14. Factors Influencing Medical Students' Choice of Specialty

    Directory of Open Access Journals (Sweden)

    Pei-Yeh Chang

    2006-01-01

    Conclusion: This study found that personal intelligence/ability preference and career opportunities were more important factors to the current generation of students in choosing a specialty. Knowledge of these students' attitudes could form the basis for the development of strategies to enhance the attractiveness of specialties facing the problem of a shortage of manpower.

  15. 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…

  16. 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.

  17. Factors affecting the utilisation of electronic medical records system ...

    African Journals Online (AJOL)

    Malawi Medical Journal 29 (3): September 2017. Electronic medical ... care, as they enable storage of large amounts of data and ... EMRs. This study assessed factors that affect the use of EMRs in Malawi, particularly at Queen Elizabeth and Kamuzu Central ..... paperless hospitals in Norway : A socio-technical perspective.

  18. Risk factors for medical complications of acute hemorrhagic stroke

    Directory of Open Access Journals (Sweden)

    Jangala Mohan Sidhartha

    2015-08-01

    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.

  19. factors associated with discharge against medical advice among

    African Journals Online (AJOL)

    Hospital environmental factors have a significant relationship with discharge against medical advice. A similar study ..... contractors, and by reinforcing the infection control committee this will .... Sources: Field survey, 2015. The results in Table ...

  20. [A history of internal medicine: medical specialization: as old as antiquity].

    Science.gov (United States)

    Echenberg, Donald

    2007-11-28

    This article presents a short review of the history of medical specialization and the evolution of internal medicine within the last two centuries. Medical specialization, far from being a recent phenomenon, existed in the Hellenistic world and in Rome. The development of specialization during the latter part of the 19th century and early 20th century is credited to the rapid expansion of medical knowledge which made it impossible for a single doctor to encompass all the different spheres of the profession. The term innere medizin or internal medicine was adopted from German terminology in the 1880's. The Canadian society of internal medicine was formed in 1983 and its main goal is to promote a broad perspective of medical care and to master the complexity in medicine through a generalist approach.

  1. A risk-factor analysis of medical litigation judgments related to fall injuries in Korea.

    Science.gov (United States)

    Kim, Insook; Won, Seonae; Lee, Mijin; Lee, Won

    2018-01-01

    The aim of this study was to find out the risk factors through analysis of seven medical malpractice judgments related to fall injuries. The risk factors were analysed by using the framework that approaches falls from a systems perspective and comprised people, organisational or environmental factors, with each factor being comprised of subfactors. The risk factors found in each of the seven judgments were aggregated into one framework. The risk factors related to patients (i.e. the people factor) were age, pain, related disease, activities and functional status, urination state, cognitive function impairment, past history of fall, blood transfusion, sleep endoscopy state and uncooperative attitude. The risk factors related to the medical staff and caregivers (i.e. people factor) were observation negligence, no fall prevention activities and negligence in managing high-risk group for fall. Organisational risk factors were a lack of workforce, a lack of training, neglecting the management of the high-risk group, neglecting the management of caregivers and the absence of a fall prevention procedure. Regarding the environment, the risk factors were found to be the emergency room, chairs without a backrest and the examination table. Identifying risk factors is essential for preventing fall accidents, since falls are preventable patient-safety incidents. Falls do not happen as a result of a single risk factor. Therefore, a systems approach is effective to identify risk factors, especially organisational and environmental factors.

  2. 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....

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

    Science.gov (United States)

    van Tongeren-Alers, Margret; van Esch, Maartje; Verdonk, Petra; Johansson, Eva; Hamberg, Katarina; Lagro-Janssen, Toine

    2011-01-01

    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 importance stipulated to motivational factors. Our study investigates new medical students' early specialization preferences and motivational factors. New students at a Dutch medical school (n = 657) filled in a questionnaire about specialty preferences (response rate = 94%; 69.5% female, 30.5% male). The students chose out of internal medicine, psychiatry, neurology, pediatrics, surgery, gynecology and family medicine, "other" or "I don't know." Finally, they valued ten motivational factors. Forty percent of the medical students reported no specialty preference yet. Taken together, female medical students preferred pediatrics and wished to combine work and care, whereas male students opted for surgery and valued career opportunities. Gender-driven professional preferences in new medical students should be noticed in order to use competencies. Changes in specialty preferences and motivational factors in pre- and post graduates should further assess the role of medical education.

  4. Non medical factors associated with psychological disorders in cancer patients

    International Nuclear Information System (INIS)

    Iqbal, A.; Intikhab, K.; Saeed, K.

    2002-01-01

    Objective: To find out major non-medial factors associated with psychological disorders in cancer patients. Design: An observational study conducted on adult cancer patients. Place and Duration of Study: The study was conducted at Shaukat Khanum Memorial Cancer Hospital and Research Center Lahore Pakistan from January 1999. Patients and Methods: Two hundred and twenty-four newly-diagnosed adult cancer patients were interviewed by the clinical psychologist and data was collected regarding non-medical causal factors, patients age, gender family support system, general home atmosphere and marital status. Collected data was analyzed by utilizing. SPSS for windows version 10.0. Results: Of the 224 patients 142 (63.4%) reported non-medical factors causing psychological distress and 82 (36.6%) reported that medical sources are the most distressing. Ten most common non-medical sources of developing psychological disorders were identified. It was observed that family support system and general home atmosphere were significantly associated with the development of psychological disorders whereas the other variables such as age, gender and marital status had no significant relationship with the non Medical factors. Conclusion: It was concluded that non-medical factors causing psychological problems are significant in cancer patients. The results suggest that we should identify these factors and target psychosocial intervention for those patients most at risk. (author)

  5. 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...

  6. A tale of Congress, continuing medical education, and the history of medicine.

    Science.gov (United States)

    Partin, Clyde; Kushner, Howard I; Horton, Mary E Kollmer

    2014-04-01

    Well-intentioned attempts by the Senate Finance Committee to improve the content and quality of continuing medical education (CME) offerings had the unanticipated consequence of decimating academically oriented history of medicine conferences. New guidelines intended to keep CME courses free of commercial bias from the pharmaceutical industry were worded in a fashion that caused CME officials at academic institutions to be reluctant to offer CME credit for history of medicine gatherings. At the 2013 annual conference of the American Association for the History of Medicine, we offered a novel solution for determining CME credit in line with current guidelines. We asked attendees to provide narrative critiques for each presentation for which they desired CME credit. In this essay, we evaluate the efficacy of this approach.

  7. Medical History of Elderly Patients in the Emergency Setting: Not an Easy Point-of-Care Diagnostic Marker

    Directory of Open Access Journals (Sweden)

    Tobias Lindner

    2015-01-01

    Full Text Available Background. Medical histories are a crucially important diagnostic tool. Elderly patients represent a large and increasing group of emergency patients. Due to cognitive deficits, taking a reliable medical history in this patient group can be difficult. We sought to evaluate the medical history-taking in emergency patients above 75 years of age with respect to duration and completeness. Methods. Anonymous data of consecutive patients were recorded. Times for the defined basic medical history-taking were documented, as were the availability of other sources and times to assess these. Results. Data of 104 patients were included in the analysis. In a quarter of patients (25%, n=26 no complete basic medical history could be obtained. In the group of patients where complete data could be gathered, only 16 patients were able to provide all necessary information on their own. Including other sources like relatives or GPs prolonged the time until complete medical history from 7.3 minutes (patient only to 26.4 (+relatives and 56.3 (+GP minutes. Conclusions. Medical histories are important diagnostic tools in the emergency setting and are prolonged in the elderly, especially if additional documentation and third parties need to be involved. New technologies like emergency medical cards might help to improve the availability of important patient data but implementation of these technologies is costly and faces data protection issues.

  8. 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.

  9. Using Medical History Embedded in Biometrics Medical Card for User Identity Authentication: Privacy Preserving Authentication Model by Features Matching

    Directory of Open Access Journals (Sweden)

    Simon Fong

    2012-01-01

    Full Text Available 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.

  10. [The life of Dr. RO Kishun, a reflection of modern Korean medical history of the borders].

    Science.gov (United States)

    Shin, Young-Jeon; Park, Se-Hong

    2009-06-01

    borderlands or frontiers of Joseon Korea, China, and Japan, where the history of the three nations met and intermingled with one another. He was a biochemist and researcher, practicing physician and medical professor of the era under Japanese Rule and the one following it. In modern Korean medicine, his life is viewed as a history of the borders, or a transnational legacy going beyond individual history of Korea, China, and Japan.

  11. Factors influencing US medical students' decision to pursue surgery.

    Science.gov (United States)

    Schmidt, Lauren E; Cooper, Clairice A; Guo, Weidun Alan

    2016-06-01

    Interest and applications to surgery have steadily decreased over recent years in the United States. The goal of this review is to collect the current literature regarding US medical students' experience in surgery and factors influencing their intention to pursue surgery as a career. We hypothesize that multiple factors influence US medical students' career choice in surgery. Six electronic databases (PubMed, SCOPUS, Web of Science, Education Resources Information Center, Embase, and PsycINFO) were searched. The inclusion criteria were studies published after the new century related to factors influencing surgical career choice among US medical students. Factors influencing US medical student surgical career decision-making were recorded. A quality index score was given to each article selected to minimize risk of bias. We identified 38 relevant articles of more than 1000 nonduplicated titles. The factors influencing medical student decision for a surgical career were categorized into five domains: mentorship and role model (n = 12), experience (clerkship n = 9, stereotype n = 4), timing of exposure (n = 9), personal (lifestyle n = 8, gender n = 6, finance n = 3), and others (n = 2). This comprehensive systemic review identifies mentorship, experience in surgery, stereotypes, timing of exposure, and personal factors to be major determinants in medical students' decisions to pursue surgery. These represent areas that can be improved to attract applicants to general surgery residencies. Surgical faculty and residents can have a positive influence on medical students' decisions to pursue surgery as a career. Early introduction to the field of surgery, as well as recruitment strategies during the preclinical and clinical years of medical school can increase students' interest in a surgical career. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. The many and conflicting histories of medical education in Canada and the USA: an introduction to the paradigm wars.

    Science.gov (United States)

    Hodges, Brian

    2005-06-01

    Medical education research is a maturing field of inquiry that derives theoretical perspectives from many domains. Yet while such theoretical diversity holds the promise of rich paradigmatic writing and debate, too often medical education researchers do not place their work in a historical or cultural context, giving the impression that they have somehow unearthed universal 'truths' about medical education. This paper introduces some of the key 'histories' of medical education from the contexts of Anglophone Canada and the USA following a review of major works in the history of medical education. There are many and conflicting histories of medical education in North America that can be classified according to different socio-historical paradigms. To avoid the error of over-generalisation, a much greater effort must be made to include historical, sociological, economic and other social science perspectives in the design, interpretation and application of medical education research.

  13. Specialty preferences and motivating factors: A national survey on medical students from five uae medical schools.

    Science.gov (United States)

    Abdulrahman, Mahera; Makki, Maryam; Shaaban, Sami; Al Shamsi, Maryam; Venkatramana, Manda; Sulaiman, Nabil; Sami, Manal M; Abdelmannan, Dima K; Salih, AbdulJabbar M A; AlShaer, Laila

    2016-01-01

    Workforce planning is critical for being able to deliver appropriate health service and thus is relevant to medical education. It is, therefore, important to understand medical students' future specialty choices and the factors that influence them. This study was conducted to identify, explore, and analyze the factors influencing specialty preferences among medical students of the United Arab Emirates (UAE). A multiyear, multicenter survey of medical student career choice was conducted with all five UAE medical schools. The questionnaire consisted of five sections. Chi-squared tests, regression analysis, and stepwise logistic regression were performed. The overall response rate was 46% (956/2079). Factors that students reported to be extremely important when considering their future career preferences were intellectual satisfaction (87%), work-life balance (71%), having the required talent (70%), and having a stable and secure future (69%). The majority of students (60%) preferred internal medicine, surgery, emergency medicine, or family Medicine. The most common reason given for choosing a particular specialty was personal interest (21%), followed by flexibility of working hours (17%). The data show that a variety of factors inspires medical students in the UAE in their choice of a future medical specialty. These factors can be used by health policymakers, university mentors, and directors of residency training programs to motivate students to choose specialties that are scarce in the UAE and therefore better serve the health-care system and the national community.

  14. 42 CFR 412.322 - Indirect medical education adjustment factor.

    Science.gov (United States)

    2010-10-01

    ... Payment System for Inpatient Hospital Capital Costs Basic Methodology for Determining the Federal Rate for Capital-Related Costs § 412.322 Indirect medical education adjustment factor. (a) Basic data. CMS.... The indirect teaching adjustment factor equals [e (raised to the power of .2822×the ratio of residents...

  15. 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.

  16. 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. © 2013 National Association for Healthcare Quality.

  17. Factors affecting future specialty choice among medical students in Kuwait.

    Science.gov (United States)

    Al-Fouzan, Rawan; Al-Ajlan, Sarah; Marwan, Yousef; Al-Saleh, Mervat

    2012-01-01

    Choosing a medical specialty can be either a daunting and confusing experience for some medical students and junior doctors or a foregone conclusion to others. The aim of this study is to evaluate factors affecting future specialty choice among medical students in Kuwait University. A self-administered questionnaire was used to collect data from medical students registered in Kuwait University during the academic year 2011/2012. Chi-square test and logistic regression were used to test the association between deciding a future specialty and students' sociodemographic and academic factors. Of the 422 students approached, 387 (91.7%) decided to participate. A total of 144 (37.2%) students made a decision regarding their choice of future medical specialty. Pediatrics, general surgery, and cardiology were the most desired specialties - 18 (12.5%), 17 (11.8%), and 16 (11.1%) students requested these specialties, respectively. Only 61 (42.4%) of those who selected a future specialty received advice regarding their choice. Looking for a good treatment outcome for patients (66; 45.8%) and a challenging specialty (58; 40.3%) were the most influencing incentives when selecting a future specialty. Students in the clinical phase of their study were 3.014 (95% CI: 1.498-6.065) more likely to report on their decision regarding a future specialty compared to students in the basic medical sciences phase (p=0.002). A variety of factors appeared to inspire medical students in Kuwait to choose a future medical specialty. When identified, these factors can be used by mentors of medical students and directors of residency training programs to motivate students to choose specialties that are limited in Kuwait.

  18. Factors affecting future specialty choice among medical students in Kuwait

    Directory of Open Access Journals (Sweden)

    Rawan Al-Fouzan

    2012-12-01

    Full Text Available Background: Choosing a medical specialty can be either a daunting and confusing experience for some medical students and junior doctors or a foregone conclusion to others. The aim of this study is to evaluate factors affecting future specialty choice among medical students in Kuwait University. Methods: A self-administered questionnaire was used to collect data from medical students registered in Kuwait University during the academic year 2011/2012. Chi-square test and logistic regression were used to test the association between deciding a future specialty and students’ sociodemographic and academic factors. Results: Of the 422 students approached, 387 (91.7% decided to participate. A total of 144 (37.2% students made a decision regarding their choice of future medical specialty. Pediatrics, general surgery, and cardiology were the most desired specialties – 18 (12.5%, 17 (11.8%, and 16 (11.1% students requested these specialties, respectively. Only 61 (42.4% of those who selected a future specialty received advice regarding their choice. Looking for a good treatment outcome for patients (66; 45.8% and a challenging specialty (58; 40.3% were the most influencing incentives when selecting a future specialty. Students in the clinical phase of their study were 3.014 (95% CI: 1.498–6.065 more likely to report on their decision regarding a future specialty compared to students in the basic medical sciences phase (p=0.002. Conclusion : A variety of factors appeared to inspire medical students in Kuwait to choose a future medical specialty. When identified, these factors can be used by mentors of medical students and directors of residency training programs to motivate students to choose specialties that are limited in Kuwait.

  19. 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.

  20. Evaluation of medical record quality and communication skills among pediatric interns after standardized parent training history-taking in China.

    Science.gov (United States)

    Yu, Mu Xue; Jiang, Xiao Yun; Li, Yi Juan; Shen, Zhen Yu; Zhuang, Si Qi; Gu, Yu Fen

    2018-02-01

    The effect of using standardized parent training history-taking on the quality of medical records and communication skills among pediatric interns was determined. Fifth-year interns who were undertaking a pediatric clinical practice rotation were randomized to intervention and control groups. All of the pediatric interns received history-taking training by lecture and bedside teaching. The pediatric interns in the intervention group also received standardized parent history-taking training. The following two outcome measures were used: the scores of medical records, which were written by the pediatric interns after history-taking from real parents of pediatric patients; and the communication assessment tool (CAT) assessed by real parents. The general information, history of present illness (HPI), past medical history, personal history, family history, diagnosis, diagnostic analysis, and differential diagnosis scores in the intervention group were significantly higher than the control group (p history-taking is effective in improving the quality of medical records by pediatric interns. Standardized parent training history-taking is a superior teaching tool for clinical reasoning ability, as well as communication skills in clinical pediatric practice.

  1. 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)

  2. Medical residents' job satisfaction and their related factors.

    Science.gov (United States)

    Chung, Eun-Kyung; Han, Eui-Ryoung; Woo, Young-Jong

    2013-03-01

    This study was conducted to investigate medical residents' job satisfaction and their related factors to improve the quality of residency program. The study subjects were 159 medical residents being trained at Chonnam National University Hospital, South Korea, in 2011. The participants were asked to complete a short form Minnesota satisfaction questionnaire (MSQ). The mean score for 20 items on the short form MSQ varied between 2.91 and 3.64 on a 5-point Likert scale. The assessment of related factors with job satisfaction revealed that medical residents had higher levels for job satisfaction, particularly those who were women (beta=0.200, p=0.022), and those who had mentorship experience (beta=0.219, p=0.008). This study results indicate that we should expand and support the mentorship program during medical residency to promote job satisfaction.

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

    NARCIS (Netherlands)

    Jobsen, J.J.; Meerwaldt, J.H.; van der Palen, Jacobus Adrianus Maria

    2000-01-01

    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

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

    Science.gov (United States)

    Miah, Saiful; Pang, Karl H; Rebello, Wayne; Rubakumar, Zoe; Fung, Victoria; Venugopal, Suresh; Begum, Hena

    2017-01-01

    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. 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. 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). UK medical schools should make their foundation program applicants aware of the importance of choosing rotations based on specialties that will be undertaken. Individual foundation schools could provide a more favorable linked application system and greater choice and flexibility of specialties within their 2-year program, potentially making their institution more attractive to future applicants.

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

    Science.gov (United States)

    Miah, Saiful; Pang, Karl H; Rebello, Wayne; Rubakumar, Zoe; Fung, Victoria; Venugopal, Suresh; Begum, Hena

    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 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 of the importance of choosing rotations based on specialties that will be undertaken. Individual foundation schools could provide a more favorable linked application system and greater choice and flexibility of specialties within their 2-year program, potentially making their institution more attractive to future applicants. PMID:28458589

  6. Pakistani medical students' specialty preference and the influencing factors.

    Science.gov (United States)

    Rehman, Anis; Rehman, Tariq; Shaikh, Muhammad Ateeb; Yasmin, Haleema; Asif, Ammara; Kafil, Hina

    2011-07-01

    To elucidate the specialty preferences of Pakistani medical students and the factors which influence medical students to make the decision regarding which specialty to pursue. Both basic sciences and clinical students from four medical colleges of Pakistan, i.e., Dow Medical College, Sindh Medical College, Liaquat National Medical College and Muhammad Medical College, were included in the cross-sectional survey during the period of July 2008 to Jan' 2009. After ethical acceptance, data was collected using convenient sampling technique. The questionnaire covered the following demographic details: 13 common specialties and 15 influencing factors. Questionnaires included in the analysis were 771. Most students gave preference to surgery and its associated sub-specialties (50.3%) followed by internal medicine (26.8%), paediatrics (23.2%), dermatology (16.7%), gynaecology and obstetrics (16.7%), psychiatry (13.1%), radiology (10.8%), ENT (8.8%), anaesthesiology (8.7%), administrative medicine (8.6%), orthopaedics (8.2%), ophthalmology (7.5%), and laboratory medicine (6.1%). The highly considered factors (regarding specialties) chosen by 70% of the medical students were: applicable to respective personalities of the individuals, prestige and respect, international opportunities, and time commitment. Surgical-skills, job availability, financial rating, academic performance, and a role model were moderately influencing factors. Hospital environment, parents, general practice, peer-pressure and personal health were the least influential. This trend suggests competition in surgery and its sub-specialties along with internal medicine, paediatrics, dermatology, gynaecology and obstetrics. Specialty suited to personality, time commitment, prestige/respect and international opportunity, influenced more than 70% of the students.

  7. 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.

  8. Factors associated with metabolic syndrome and related medical costs by the scale of enterprise in Korea.

    Science.gov (United States)

    Kong, Hyung-Sik; Lee, Kang-Sook; Yim, Eun-Shil; Lee, Seon-Young; Cho, Hyun-Young; Lee, Bin Na; Park, Jee Young

    2013-10-21

    The purpose of this study was to identify the risk factors of metabolic syndrome (MS) and to analyze the relationship between the risk factors of MS and medical cost of major diseases related to MS in Korean workers, according to the scale of the enterprise. Data was obtained from annual physical examinations, health insurance qualification and premiums, and health insurance benefits of 4,094,217 male and female workers who underwent medical examinations provided by the National Health Insurance Corporation in 2009. Logistic regression analyses were used to the identify risk factors of MS and multiple regression was used to find factors associated with medical expenditures due to major diseases related to MS. The study found that low-income workers were more likely to work in small-scale enterprises. The prevalence rate of MS in males and females, respectively, was 17.2% and 9.4% in small-scale enterprises, 15.9% and 8.9% in medium-scale enterprises, and 15.9% and 5.5% in large-scale enterprises. The risks of MS increased with age, lower income status, and smoking in small-scale enterprise workers. The medical costs increased in workers with old age and past smoking history. There was also a gender difference in the pattern of medical expenditures related to MS. Health promotion programs to manage metabolic syndrome should be developed to focus on workers who smoke, drink, and do little exercise in small scale enterprises.

  9. 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.

  10. 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

  11. Factors Influencing Patronage Of Medical Tourism In Metropolitan Lagos Nigeria

    Directory of Open Access Journals (Sweden)

    Omisore

    2015-08-01

    Full Text Available Since medical tourism attract patient from various origin to seek medical services at different destinations it is paramount to consider the factors that motivate patrons decision on medical tourism. Hence this study assesses the factors influencing patronage of medical tourism in Lagos metropolis Nigeria. Lagos State is situated in the southwestern corner of Nigeria it lies within Latitudes 62N to 64N of the Equator and Longitudes 245E to 420E of the Greenwich meridian. Metropolitan Lagos is a statistical division and not an administrative unit it extends over 16 of the 20 LGAs of Lagos State it contains 88 of the population of Lagos State and includes semi-rural areas. Data were collected from primary source. Primary data collection was carried out through the use of structured questionnaire. Systematic sampling technique was employed to select 15 specialized private hospitals and 14 Public hospitals in the study area resulting to a sample size of 29 hospitals. Ten 10 patrons were contacted in each of the selected hospitals consequently 290 patrons were sampled. The study revealed three factors influencing patronage of medical tourism in the study area to be service related economic and facilities. These were further established by factor analysis result which combine service related economic factor as factor one with 29.5 variance explained and Eigen value of 5.605 Facility factor as factor two with 28.6 variance explained and Eigen value of 5.435 Service related factor as factor three with 14.7 variance explained and Eigen value of 2.788 and Economic factor as factor four with 9.2 variance explained and Eigen value of 1.754. The relevant authority in charge of health facilities in the study area would have to employ adequate manpower in-terms of doctors and other healthcare personnel across the public hospital while also regulating the scale of charges of the registered private hospitals in the study area. There is need to improve upon the

  12. Factors affecting smartphone adoption for accessing information in medical settings.

    Science.gov (United States)

    Tahamtan, Iman; Pajouhanfar, Sara; Sedghi, Shahram; Azad, Mohsen; Roudbari, Masoud

    2017-06-01

    This study aimed to acquire knowledge about the factors affecting smartphone adoption for accessing information in medical settings in Iranian Hospitals. A qualitative and quantitative approach was used to conduct this study. Semi-structured interviews were conducted with 21 medical residents and interns in 2013 to identify determinant factors for smartphone adoption. Afterwards, nine relationships were hypothesised. We developed a questionnaire to test these hypotheses and to evaluate the importance of each factor. Structural equation modelling was used to analyse the causal relations between model parameters and to accurately identify determinant factors. Eight factors were identified in the qualitative phase of the study, including perceived usefulness, perceived ease of use, training, internal environment, personal experience, social impacts, observability and job related characteristics. Among the studied factors, perceived usefulness, personal experience and job related characteristics were significantly associated with attitude to use a smartphone which accounted for 64% of the variance in attitude. Perceived usefulness had the strongest impact on attitude to use a smartphone. The factors that emerged from interviews were consistent with the Technology Acceptance Model (TAM) and some previous studies. TAM is a reliable model for understanding the factors of smartphone acceptance in medical settings. © 2017 Health Libraries Group.

  13. 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.

  14. Lessons of History: Organizational Factors in Three Aviation Mishaps

    Science.gov (United States)

    Merlin, Peter William

    2013-01-01

    This presentation examines organizational factors that contributed to three aircraft mishaps and provides analysis of lessons learned. Three historical aviation mishaps were studied from a human factors perspective, and organizational factors identified and analyzed. These case studies provide valuable lessons for understanding the interaction of people with aircraft systems and with each other during flight operations.

  15. [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

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

    NARCIS (Netherlands)

    Haring, C.M.; Cools, B.M.; Gurp, P.J.M. van; Meer, J.W.M. van der; Postma, C.T.

    2017-01-01

    BACKGROUND: 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. METHODS: A

  17. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. Social, psychological and psychosomatic disorders in the people with combat stress in their medical histories

    Directory of Open Access Journals (Sweden)

    L. V. Gracheva

    2013-01-01

    Full Text Available The authors examined three groups of patients – military men (40 men in each group with combat stress of different intensity in their medical histories (two main groups and a  control group – without combat stress. The results showed that the military men with a high level combat stress in the past (more than 5 years ago more frequently demonstrated socialmental disadaptation against the background of subclinical chronic posttraumatic stress disorder (PTSD. The conclusion is that this group of people requires dynamic followup and adequate medicopsychological aid.

  20. [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

  1. Critical factors in career decision making for women medical graduates.

    Science.gov (United States)

    Lawrence, Joanna; Poole, Phillippa; Diener, Scott

    2003-04-01

    Within the next 30 years there will be equal numbers of women and men in the medical workforce. Indications are that women are increasing their participation in specialties other than general practice, although at a slower rate than their participation in the workforce as a whole. To inform those involved in training and employment of medical women, this study investigated the influencing factors in career decision making for female medical graduates. A total of 305 women medical graduates from the University of Auckland responded to a mail survey (73% response rate) which examined influences on decision making, in both qualitative and quantitative ways, as part of a larger survey. Most women were satisfied with their careers. The principal component analysis of the influencing factors identified four distinct factors important in career choice - interest, flexibility, women friendliness and job security, although the first two of these were rated more highly than the others. Barriers to full participation by medical women in training and employment need to be systematically examined and removed. This is not only to allow women themselves to reach their full potential, but for workforce and socio-economic reasons. Initiatives that allow and value more flexible training and work practices, particularly through the years of child raising, are necessary for women and the health care workforce at large.

  2. Education at the Dittrick Museum of Medical History, Case Western Reserve University, Cleveland, Ohio, USA.

    Science.gov (United States)

    Edmonson, James M

    2009-01-01

    The Dittrick Museum of Medical History pursues an educational mission as being part of a major research university. While the Dittrick dates to 1899 as a historical committee of the Cleveland Medical Library Association, it first affiliated with Case Western Reserve University in 1966, and became a department of the College of Arts and Sciences of CWRU in 1998. The Dittrick maintains a museum exhibition gallery that is open to the public free of charge, and museum staff provide guided tours on appointment. Much of the teaching and instruction at the Dittrick is conducted by university professors; their classes meet in the museum and use museum resources in the form of artifacts, images, archives, and rare books. Class projects using Dittrick collections may take the form of research papers, exhibitions, and online presentations. Dittrick staff assist in these classes and are available to help researchers use museum resources.

  3. 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.

  4. Medical conditions, family history of cancer, and the risk of biliary tract cancers.

    Science.gov (United States)

    Rosato, Valentina; Bosetti, Cristina; Dal Maso, Luigino; Montella, Maurizio; Serraino, Diego; Negri, Eva; La Vecchia, Carlo

    2016-06-02

    Scanty data exist on the role of personal medical conditions, except for gallstones, and family history of cancer on the risk of biliary tract cancers (BTC). We analyzed this issue using data from two Italian case-control studies, including 159 cases of BTC and 795 matched hospital controls. Odds ratios (ORs) of BTC and corresponding 95% confidence intervals (CIs) were estimated using multiple logistic regression models. Gallstones were associated with a 2-fold excess risk of BTC (95% CI 1.24-3.45). No significant associations were observed with other conditions investigated, including diabetes (OR 1.15, 95% CI 0.63-2.11), hypertension (OR 0.65, 95% CI 0.39-1.11), hyperlipidemia (OR 0.61, 95% CI 0.31-1.21), allergy (OR 0.64, 95% CI 0.29-1.40), gastroduodenal ulcer (OR 0.52, 95% CI 0.24-1.12), hepatitis (OR 2.02, 95% CI 0.35-11.67), benign thyroid diseases (OR 1.16, 95% CI 0.56-2.40), hysterectomy (OR 1.19, 95% CI 0.53-2.68), unilateral oophorectomy (OR 1.75, 95% CI 0.44-6.93), and bilateral oophorectomy (OR 2.48, 95% CI 0.79-7.82). We found an excess risk of BTC in relation to family history of any cancer (OR 1.52, 95% CI 1.03-2.24) and family history of gallbladder cancer (OR 3.83, 95% CI 0.59-24.75). The present study confirms a strong association between BTC and history of gallstones, and provides further evidence of a positive association with family history of cancer.

  5. Factors predictive of successful learning in postgraduate medical education

    NARCIS (Netherlands)

    Smits, P. B. A.; Verbeek, J. H. A. M.; Nauta, M. C. E.; ten Cate, Th J.; Metz, J. C. M.; van Dijk, F. J. H.

    2004-01-01

    PURPOSE To establish which personal and contextual factors are predictive of successful outcomes in postgraduate medical education. METHOD We performed a follow-up study of 118 doctors on a postgraduate occupational health training programme on the management of mental health problems. The following

  6. Evaluating medical and systemic factors related to maternal and ...

    African Journals Online (AJOL)

    Background: This study examined maternal morbidity and mortality and neonatal mortality over a multi-year period from de-identified retrospective medical records at Nyakahanga Designated District Hospital in north-western Tanzania. The study aimed to examine factors related to maternal mortality (MMR) and morbidity in ...

  7. Implementation of an IT-guided checklist to improve the quality of medication history records at hospital admission.

    Science.gov (United States)

    Huber, Tanja; Brinkmann, Franziska; Lim, Silke; Schröder, Christoph; Stekhoven, Daniel Johannes; Marti, Walter Richard; Egger, Richard Robert

    2017-12-01

    Background Medication discrepancies often occur at transition of care such as hospital admission and discharge. Obtaining a complete and accurate medication history on admission is essential as further treatment is based on it. Objective The goal of this study was to reduce the proportion of patients with at least one medication discrepancy in the medication history at admission by implementing an IT-guided checklist. Setting Surgery ward focused on vascular and visceral surgery at a Swiss Cantonal Hospital. Method The study was divided into two phases, before and after implementation of an IT-guided checklist. For both phases a pharmacist collected and compared the medication history (defined as gold standard) with that of the admitting physician. Medication discrepancies were subdivided in omissions and commissions, incorrect medications or dose changes, and incorrect dosage forms or strength. Main outcome measure The proportion of patients with at least one medication discrepancy in the medication history before and after intervention was assessed. Results Out of 415 admissions, 228 patients that met the inclusion criteria were enrolled in the study, 113 before and 115 patients after intervention. After intervention, medication discrepancies declined from 69.9 to 29.6% (p < 0.0001) of patients, the mean medication discrepancy per patient was reduced from 2.3 to 0.6 (p < 0.0001), and the most common error, omission of a regularly used medication, was reduced from 76.4 to 44.1% (p < 0.001). Conclusion The implementation of the IT-guided checklist is associated with a significant reduction of medication discrepancies at admission and potentially improves the medication safety for the patient.

  8. [[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.

  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. Factors associated with initiation of antihyperglycaemic medication in UK patients with newly diagnosed type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Sinclair Alan J

    2012-03-01

    Full Text Available Abstract Aim To assess the factors associated with antihyperglycaemic medication initiation in UK patients with newly diagnosed type 2 diabetes. Methods In a retrospective cohort study, patients with newly diagnosed type 2 diabetes were identified during the index period of 2003-2005. Eligible patients were ≥ 30 years old at the date of the first observed diabetes diagnosis (referred to as index date and had at least 2 years of follow-up medical history (N = 9,158. Initiation of antihyperglycaemic medication (i.e., treatment was assessed in the 2-year period following the index date. Adjusted Cox regression models were used to examine the association between time to medication initiation and patient age and other factors. Results Mean (SD HbA1c at diagnosis was 8.1% (2.3. Overall, 51% of patients initiated antihyperglycaemic medication within 2 years (65%, 55%, 46% and 40% for patients in the 30- th, 75th percentile time to treatment initiation was 63 (8, 257 days. Of the patients with HbA1c ≥ 7.5% at diagnosis, 87% initiated treatment within 2 years. These patients with a higher HbA1c also had shorter time to treatment initiation (adjusted hazard ratio (HR = 2.44 [95% confidence interval (CI: 1.61, 3.70]; p Conclusions In this UK cohort of patients with newly diagnosed type 2 diabetes, only 51% had antihyperglycaemic medication initiated over a 2-year period following diagnosis. Older patients were significantly less likely to have been prescribed antihyperglycaemic medications. Elevated HbA1c was the strongest factor associated with initiating antihyperglycaemic medication in these patients.

  11. 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

  12. Human Factors in Training: Space Medical Proficiency Training

    Science.gov (United States)

    Byrne, Vicky E.; Barshi, I.; Arsintescu, L.; Connell, E.

    2010-01-01

    The early Constellation space missions are expected to have medical capabilities very similar to those currently on the Space Shuttle and the International Space Station (ISS). For Crew Exploration Vehicle (CEV) missions to the ISS, medical equipment will be located on the ISS, and carried into CEV in the event of an emergency. Flight surgeons (FS) on the ground in Mission Control will be expected to direct the crew medical officer (CMO) during medical situations. If there is a loss of signal and the crew is unable to communicate with the ground, a CMO would be expected to carry out medical procedures without the aid of a FS. In these situations, performance support tools can be used to reduce errors and time to perform emergency medical tasks. The space medical training work is part of the Human Factors in Training Directed Research Project (DRP) of the Space Human Factors Engineering (SHFE) Project under the Space Human Factors and Habitability (SHFH) Element of the Human Research Program (HRP). This is a joint project consisting of human factors team from the Ames Research Center (ARC) with Immanuel Barshi as Principal Investigator and the Johnson Space Center (JSC). Human factors researchers at JSC have recently investigated medical performance support tools for CMOs on-orbit, and FSs on the ground, and researchers at the Ames Research Center performed a literature review on medical errors. Work on medical training has been conducted in collaboration with the Medical Training Group at the Johnson Space Center (JSC) and with Wyle Laboratories that provides medical training to crew members, biomedical engineers (BMEs), and to flight surgeons under the Bioastronautics contract. One area of research building on activities from FY08, involved the feasibility of just-in-time (JIT) training techniques and concepts for real-time medical procedures. A second area of research involves FS performance support tools. Information needed by the FS during the ISS mission

  13. 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

  14. A general factor of personality in a sample of inmates: Associations with indicators of life-history strategy and covitality

    Directory of Open Access Journals (Sweden)

    Međedović Janko

    2017-01-01

    Full Text Available This study looked for a General Factor of Personality (GFP in a sample of male convicts (N=226; mean age 32 years. The GFP was extracted from seven broad personality traits: FFM factors, Amoralism (the negative pole of the lexical Honesty-Humility factor and Disintegration (operationalization of Schizotypy. Three first-order factors were extracted, labeled Dysfunctionality, Antisociality and Openness, and GFP was found through the hierarchical factor analysis. The nature of the GFP was explored through analysis of its relations with markers of fast Life-History strategy and covitality. The results demonstrated that the GFP is associated with unrestricted sexual behavior, medical problems, mental problems, early involvement in criminal activity and stability of criminal behavior. The evidence shows that the GFP is a meaningful construct on the highest level of personality structure. It may represent a personality indicator of fitness-related characteristics and could be useful in research of personality in an evolutionary context.

  15. Introducing medical genetics services in Ethiopia using the MiGene Family History App.

    Science.gov (United States)

    Quinonez, Shane C; Yeshidinber, Abate; Lourie, Michael A; Bekele, Delayehu; Mekonnen, Yemisrach; Nigatu, Balkachew; Metaferia, Gesit; Jebessa, Solomie

    2018-06-11

    Almost all low-income countries and many middle-income countries lack the capacity to deliver medical genetics services. We developed the MiGene Family History App (MFHA), which assists doctors with family history collection and population-level epidemiologic analysis. The MFHA was studied at St. Paul's Hospital in Addis Ababa, Ethiopia. A needs assessment was used to assess Ethiopian physicians' experience with genetics services. The MFHA then collected patient data over a 6-month period. The majority of doctors provide genetics services, with only 16% reporting their genetics knowledge is sufficient. A total of 1699 patients from the pediatric ward (n = 367), neonatal intensive care unit (NICU) (n = 477), and antenatal clinic (n = 855) were collected using the MFHA with a 4% incidence of a MFHA-screened condition present. The incidence was 11.7% in the pediatric ward, 3% in the NICU, and 0.5% in the antenatal clinic. Heart malformations (5.5% of patients) and trisomy 21 (4.4% of patients) were the most common conditions in the pediatric ward. Medical genetics services are needed in Ethiopia. As other countries increase their genetics capacity, the MFHA can provide fundamental genetics services and collect necessary epidemiologic data.

  16. [Study on medical records of acupuncture-moxibustion in The Twenty-four Histories].

    Science.gov (United States)

    Huang, Kai-Wen

    2012-03-01

    Through the combination of manual retrieval and computerized retrieval, medical records of acupuncture-moxibustion in The Twenty-Four Histories were collected. Acupuncture cases from the Spring and Autumn Period (770-476 B.C.) to the end of the Ming Dynasty (1368-1644)were retrieved. From the medical records of acupuncture-moxibustion in Chinese official history books, it can be found that systematic diseases or emergent and severe diseases were already treated by physicians with the combination of acupuncture and medicine as early as in the Spring and Autumn Period as well as the Warring States Period(475-221 B.C.). CANG Gong, a famous physician of the Western Han Dynasty (206 B. C.-A. D. 24), cured diseases by selecting points along the running courses of meridians where the illness inhabited, which indicates that the theory of meridians and collaterals was served as a guide for clinical practice as early as in the Western Han Dynasty. Blood letting therapy, which has surprising effect, was often adopted by physicians of various historical periods to treat diseases. And treatment of diseases with single point was approved to be easy and effective.

  17. The Roman-Irish Bath: Medical/health history as therapeutic assemblage.

    Science.gov (United States)

    Foley, Ronan

    2014-04-01

    The invention of a new form of hot-air bath in Blarney, Ireland in 1856, variously known in its lifetime as the Roman-Irish or Turkish Bath, acted as the starting point for a the production of a globalised therapeutic landscape. Tracking the diffusion of the Roman-Irish bath template from its local invention in Ireland to a global reach across the Victorian world and recognizing its place within a wider hydrotherapeutic history, this paper frames that diffusion as a valuable empirical addition to assemblage theory. The specific empirical history of the spread of the Roman-Irish/Turkish bath idea is drawn from primary archival and secondary historical sources. It is then discussed and, drawing from work on assemblage theory, analyzed against three broad themes: mobile networks, socio-material practices and contested emergence. The emergent relational geographies of the Roman-Irish Bath identify important roles for the diffusion and transformation of specific medical settings, identities and functions. These were linked in turn to competing social-healing pathways wherein bodies were technologically and morally managed, to produce a more inhabited form of therapeutic assemblage. In all cases the differential diffusion of the bath idea, it's shifting and fractured material forms and multiple inhabitations and discourses were contested and mobile and spoke to an assemblage approach which has ripe potential for exploration across a range of medical/health geography settings. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Human Factors Science: Brief History and Applications to Healthcare.

    Science.gov (United States)

    Parker, Sarah Henrickson

    2015-12-01

    This section will define the science of human factors, its origins, its impact on safety in other domains, and its impact and potential for impact on patient safety. Copyright © 2015 Mosby, Inc. All rights reserved.

  19. OBJECTIVE AND SUBJECTIVE FACTORS OF MEDICAL DRUG CHOICE

    Directory of Open Access Journals (Sweden)

    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.

  20. 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.

  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. Best possible medication history for hemodialysis patients obtained by a pharmacy technician.

    Science.gov (United States)

    Leung, Marianna; Jung, Joanne; Lau, Wynnie; Kiaii, Mercedeh; Jung, Beverly

    2009-09-01

    Outpatients undergoing hemodialysis are at high risk for adverse drug events. Limited resources make it challenging for pharmacists to routinely obtain a best possible medication history (BPMH). The primary objective was to determine whether, for patients undergoing hemodialysis, a pharmacy technician has the skills to obtain a BPMH that would allow a pharmacist to identify drug-related problems. The secondary objectives were to determine the number and types of medication discrepancies and drug-related problems identified and the time required by the technician to complete the BPMH. All patients treated in the hemodialysis unit during the study period were included, except for those who required an interpreter or were unable to participate in an in-person interview. A single technician was taught how to interview patients according to a structured format. For each patient, the technician's BMPH was verified by a pharmacist. The agreement rate between technician and pharmacists was determined, along with the number and types of discrepancies and drug-related problems identified. The technician interviewed 99 patients. Of the 1334 medication orders reviewed, the technician and pharmacists agreed on all but 15 (agreement rate 98.9%). A total of 358 medication discrepancies were noted for 93 patients (3.8 discrepancies per patient). Of these, 210 (59%) were undocumented intentional discrepancies, and 148 (41%) were unintentional discrepancies (most commonly errors of commission). Of the 135 drug-related problems identified, the majority involved dosing problems or nonadherence. The technician required an average of 17 min for each interview. An adequately trained technician was capable of interviewing patients to create a BPMH. A variety of medication discrepancies and drug-related problems were identified. Generation of a BPMH by a technician is a useful approach allowing pharmacists to identify drug-related problems.

  3. The choice of surgical specialization by medical students and their syncopal history.

    Science.gov (United States)

    Rudnicki, Jerzy; Zyśko, Dorota; Kozłowski, Dariusz; Kuliczkowski, Wiktor; Koźluk, Edward; Lelonek, Małgorzata; Piątkowska, Agnieszka; Gajek, Jacek; Negrusz-Kawecka, Marta; Agrawal, Anil Kumar

    2013-01-01

    The aim of the study was to assess whether medical students' fainting outside the university or while witnessing surgical procedures and/or autopsies influenced their choice of a specialization. The study group consisted of 605 medical students (from fourth to sixth year of study) from five medical universities in Poland (325 women, 212 men and 8 responders of an unspecified gender). The median age of subjects studied was 23 years, and the interquartile range was 23-24 years. The students at each university were chosen randomly by the author who worked there and had contact with them. An anonymous questionnaire was developed to gather information regarding demographics, the specialization which each student wanted to choose, the syncope occurrence in the medical history, the syncope and presyncope occurrence during surgery and autopsy as well as the syncopal events' characteristics. The group of 15% of women and 30% of men declared to have pursued the surgical specialization (P<0.001), 29% of women and 56% of men declared the intention to pursue an invasive specialization (P<0.001). As many as 36.0% of women studied and 13.1% of men studied reported syncopal spells outside university (P<0.001). Only 41 students (6.8%) reported that syncope or presyncope in any studied circumstances had an impact on their specialization choice. The multivariate analysis showed that the choice of surgical specialization is related to the male gender and the absence of syncopal spells outside the university. Syncopal and presyncopal spells may affect the professional choices of the medical students. The male gender and a lack of syncope occurrence outside operating room are related to the choice of surgical specialization.

  4. The choice of surgical specialization by medical students and their syncopal history.

    Directory of Open Access Journals (Sweden)

    Jerzy Rudnicki

    Full Text Available BACKGROUND: The aim of the study was to assess whether medical students' fainting outside the university or while witnessing surgical procedures and/or autopsies influenced their choice of a specialization. MATERIALS AND METHODS: The study group consisted of 605 medical students (from fourth to sixth year of study from five medical universities in Poland (325 women, 212 men and 8 responders of an unspecified gender. The median age of subjects studied was 23 years, and the interquartile range was 23-24 years. The students at each university were chosen randomly by the author who worked there and had contact with them. An anonymous questionnaire was developed to gather information regarding demographics, the specialization which each student wanted to choose, the syncope occurrence in the medical history, the syncope and presyncope occurrence during surgery and autopsy as well as the syncopal events' characteristics. RESULTS: The group of 15% of women and 30% of men declared to have pursued the surgical specialization (P<0.001, 29% of women and 56% of men declared the intention to pursue an invasive specialization (P<0.001. As many as 36.0% of women studied and 13.1% of men studied reported syncopal spells outside university (P<0.001. Only 41 students (6.8% reported that syncope or presyncope in any studied circumstances had an impact on their specialization choice. The multivariate analysis showed that the choice of surgical specialization is related to the male gender and the absence of syncopal spells outside the university. CONCLUSIONS: Syncopal and presyncopal spells may affect the professional choices of the medical students. The male gender and a lack of syncope occurrence outside operating room are related to the choice of surgical specialization.

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

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    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.

  6. 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.

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

    Science.gov (United States)

    Kinay, Tugba; Basarir, Zehra O; Tuncer, Serap F; Akpinar, Funda; Kayikcioglu, Fulya; Koc, Sevgi; Karakaya, Jale

    2016-08-01

    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. 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 diagnosed based on histopathological examination of hysterectomy specimens. Demographic characteristics, and laboratory and histopathological findings were compared between patients with uterine leiomyoma with and without abnormal uterine bleeding. In total, 501 (57.9%) patients had abnormal uterine bleeding and 364 (42.1%) patients had other symptoms. A history of cesarean section was more common in patients with abnormal uterine bleeding than in those with other symptoms (17.6% versus 9.3%, p=0.001; odds ratio [OR]: 2.1; 95% confidence interval [CI]: 1.4-3.3). The presence of a submucosal leiomyoma (OR: 2.1; 95% CI: 1.5-3.1) and coexistent adenomyosis (OR: 1.6; 95% CI: 1.1-2.4) were also associated with abnormal uterine bleeding. A history of cesarean section was an independent risk factor for abnormal uterine bleeding in patients with uterine leiomyomas; submucosal leiomyoma and coexisting adenomyosis were also independent risk factors.

  8. [The Impact of Medical And Non-Medical Factors on Population Mortality: Environment Factors].

    Science.gov (United States)

    Samorodskaia, I V; Semenov, V Yu; Boitsov, S A

    2017-09-01

    The second analysis was implemented concerning results of study evaluating impact of environmental factors on indices of population mortality on the basis of hard copy and digital publications in Russian and English in 1990-2016. It is established that air pollution by tiny particles of different origin results in a reliable increasing of risk of premature death independently of level of economic development and geographical positioning of country. In European countries this occurrence conditions shortage of of life-span on 8-13 months. The industrial factors are a cause of about 30% of involuntary occupational traumas. The limitation of access to clear drinking water specific to developing countries conditions death of more than 3 million people annually. The impact of waves of cold and heat on mortality depends on particular region, their duration and intensity, level of economic development of country, social economic conditions and age of particular groups of population and is estimated in 1-16% of additional deaths. The global climate warming is associated with decreasing of level of mortality. the negative impact of environment is increased by residing in underdeveloped regions, lower social economic status, lower level of education, population density, shortcomings of architecture and public space, the factors of environment play a significant role in population mortality. As regards their impact an uncertainty exists: it is quite difficult to separate an impact of single factor. So, different approaches are applied in different studies.

  9. 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, pparents, siblings and friends smokers of shisha were found to be significantly associated with shisha smoking status (pproblems, problems with friends, financial problems and university life were found to significantly associated with shisha smoking status among medical students (pstudents. 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 products.

  10. Choosing child and adolescent psychiatry: factors influencing medical students.

    Science.gov (United States)

    Volpe, Tiziana; Boydell, Katherine M; Pignatiello, Antonio

    2013-11-01

    To examine the factors influencing medical students to choose child and adolescent psychiatry as a career specialty. Quantitative and qualitative methods were used. A web-based survey was distributed to child and adolescent psychiatrists at the University of Toronto. In-depth interviews were held with select child and adolescent psychiatrists as well as a focus group with psychiatry residents. Retrospective accounts of the factors that influenced their decision to choose psychiatry and/or child and adolescent psychiatry as a specialty were collected. Ninety-two percent of participants indicated that recruitment of child psychiatrists in Canada is a problem. The recent decision by the Royal College of Physicians and Surgeons to recognize child and adolescent psychiatry as a subspecialty and introduce an extra year of training was identified as a further challenge to recruitment efforts. Other deterrents included lower salary than other subspecialties, lack of exposure during training, stigma, and lack of interest in treating children. Recruitment into psychiatry was enhanced by good role modeling, early exposure in medical school, an interest in brain research, and career and lifestyle issues. A rebranding of the role and perception of psychiatry is needed to attract future psychiatrists. Early exposure to innovations in child and adolescent psychiatry and positive role models are critical in attracting medical students. Recruitment should begin in the first year of medical school and include an enriched paediatric curriculum.

  11. Choosing Child and Adolescent Psychiatry: Factors Influencing Medical Students

    Science.gov (United States)

    Volpe, Tiziana; Boydell, Katherine M.; Pignatiello, Antonio

    2013-01-01

    Objective: To examine the factors influencing medical students to choose child and adolescent psychiatry as a career specialty. Method: Quantitative and qualitative methods were used. A web-based survey was distributed to child and adolescent psychiatrists at the University of Toronto. In-depth interviews were held with select child and adolescent psychiatrists as well as a focus group with psychiatry residents. Retrospective accounts of the factors that influenced their decision to choose psychiatry and/or child and adolescent psychiatry as a specialty were collected. Results: Ninety-two percent of participants indicated that recruitment of child psychiatrists in Canada is a problem. The recent decision by the Royal College of Physicians and Surgeons to recognize child and adolescent psychiatry as a subspecialty and introduce an extra year of training was identified as a further challenge to recruitment efforts. Other deterrents included lower salary than other subspecialties, lack of exposure during training, stigma, and lack of interest in treating children. Recruitment into psychiatry was enhanced by good role modeling, early exposure in medical school, an interest in brain research, and career and lifestyle issues. Conclusions: A rebranding of the role and perception of psychiatry is needed to attract future psychiatrists. Early exposure to innovations in child and adolescent psychiatry and positive role models are critical in attracting medical students. Recruitment should begin in the first year of medical school and include an enriched paediatric curriculum. PMID:24223044

  12. 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.

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

    Science.gov (United States)

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

    2011-05-01

    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. This review aimed to systematically and critically review studies dealing with factors found to be associated with dropping out of medical school. A systematic critical literature review of the international peer-reviewed research literature on medical education was performed. A primary search was conducted and subsequently supplemented with ancestry and descendancy searches. The population of interest was medical students and the outcome was dropout. Abstract/title screening and quality assessment were performed by two independent researchers. Studies were assessed on six domains of quality: study participation; study attrition; predictor measurement; measurement of and accounting for confounders; outcome measurement, and analysis. Only studies that accounted for confounding were included in the final analysis. Of 625 studies found, 48 were quality-assessed and 13 of these were eventually included based on their fulfilment of our quality-related criteria. A range of entry qualifications seemed to be associated with greater chances of a student dropping out (odds ratio [OR] = 1.65-4.00). Struggling academically in medical school may be strongly associated with dropout. By contrast, no specific pattern of demographic variables was particularly important in relation to dropout. The effects of socio-economic, psychological and educational variables on dropout were not well investigated. More research into causal models and theory testing, which considers the effects of education, organisation and institution, is necessary if we are to learn more about how we can actively prevent medical student withdrawal. © Blackwell Publishing Ltd 2011.

  14. 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 

  15. Endogenous Digitalis-like Factors: An Overview of the History

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    Vardaman eBuckalew

    2015-04-01

    Full Text Available The sodium pump is a ubiquitous cell surface enzyme, a Na, K ATPase, which maintains ion gradients between cells and the extracellular fluid (ECF. The extracellular domain of this enzyme contains a highly conserved binding site, a receptor for a plant derived family of compounds, the digitalis glycosides. These compounds inhibit the enzyme and are used in the treatment of congestive heart failure, and certain cardiac arrhythmias. The highly conserved nature of this enzyme and its digitalis receptor led to early suggestions that endogenous regulators might exist. Recent examination of this hypothesis emerged from research in two separate areas: the regulation of ECF volume by a natriuretic hormone (NH, and the regulation of peripheral vascular resistance by a circulating inhibitor of vascular Na, K ATPase. These two areas merged with the hypothesis that NH and the vascular Na, K ATPase inhibitor were in fact the same entity, and that it played a causative role in the pathophysiology of certain types of hypertension. The possibility that multiple endogenous digitalis-like factors (EDLFs exist emerged from efforts to characterize the circulating enzyme inhibitory activity. In this review, the development of this field from its beginnings is traced, the current status of the structure of EDLFs is briefly discussed, and areas for future development are suggested. Key Words: natriuretic hormone, digitalis-like factor, hypertension, Na, K ATPase, ouabain, marinobufagenin, bufodienolides, cardenolides

  16. Factors Influencing Enrollment in the Medication Therapy Management Clinic at an Academic Ambulatory Care Clinic.

    Science.gov (United States)

    Shah, Mansi; Tilton, Jessica; Kim, Shiyun

    2016-04-01

    In 2001, the University of Illinois Hospital and Health Sciences System (UI Health) established a pharmacist-run, referral-based medication therapy management clinic (MTMC). Referrals are obtained from any UI Health provider or by self-referral. Although there is a high volume of referrals, a large percentage of patients do not enroll. This study was designed to determine the various factors that influence patient enrollment in the MTMC. This study was a retrospective chart review of demographic and patient variable data during years 2010 and 2011. Disabilities, distance from MTMC, mode of transportation, past medical history, and appointment dates were extracted from the medical records. Results were analyzed using descriptive statistics and logistic regression analysis. A total of 103 referrals were made; however, only 17% of patients remain enrolled in MTMC. The baseline demographics included a mean age of 63 years, 68% female, 70% African American, and 81% English speaking. Patients lived an average of 8 miles from MTMC; most utilized public or government-supplemented transport services; 24% of patients reported some type of disability, most commonly utilizing a walker or a wheelchair. On average, patients were prescribed 13 medications with hypertension (70%), diabetes (56%), and hyperlipidemia (48%) being the most common chronic disease states. The reason for referral included medication management, education, medication reconciliation, and disease state management. Five patients were unable to be contacted to schedule an initial appointment. Additionally, 18 patients failed their scheduled initial appointment and did not reschedule. Logistic regression analysis demonstrated distance traveled for clinic visit, age, and history of hypertension affected the probability of patients showing for their appointments (chi-square = 19.7, P < .001). This study demonstrated that distance from MTMC is the most common barrier in patient enrollment; therefore, strategies

  17. Workplace violence and influencing factors among medical professionals in China.

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    Wu, Siying; Zhu, Wei; Li, Huangyuan; Lin, Shaowei; Chai, Wenli; Wang, Xiaorong

    2012-11-01

    Workplace violence has attracted increasing public attention over the past few decades in China. This study was conducted to evaluate the frequency of workplace violence in healthcare settings by various job titles and hospital departments, and to explore the related risk factors among Chinese medical professionals. A total of 2,464 medical professionals in 12 hospitals of two provinces were surveyed by using a stratified cluster sampling method. The Chinese version of the Workplace Violence Scale was used to measure the frequencies of workplace violence, classified as physical assault, emotional abuse, threat of assault, verbal sexual harassment and sexual assault experienced by the subjects over the previous 12 months. A structured questionnaire was administered to collect information on potentially influencing factors for workplace violence. Multivariate analysis was applied to determine the risk factors for workplace violence. About 50% of study subjects reported at least one type of workplace violence. The rates of experiencing two episodes or more of physical assault, emotional abuse, threat of assault, verbal sexual harassment, and sexual assault were 11%, 26%, 12%, 3%, and 1%, respectively. Identified risk factors for workplace violence included working in the departments of psychiatry, emergency, pediatrics and surgery, male gender, divorce/widowed status, long working hours (≥10 hr/day), and night shift. The study suggested that workplace violence occurs commonly in Chinese healthcare settings. Effective intervention strategies targeting workplace violence should be formulated in terms of major risk factors. Copyright © 2012 Wiley Periodicals, Inc.

  18. 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. © 2011 by the American College of Nurse-Midwives.

  19. [Thoughts and methods of study on acupuncture medical history: an example of Mr. MA Ji-Xing].

    Science.gov (United States)

    Yang, Feng; Zhu, Ling

    2014-03-01

    Mr. MA Ji-xing has devoted himself into the study of acupuncture medical history for more than 70 years. As a result, a great work of Zhenjiuxue Tongshi (see text), History of Acupuncture-Moxibustion) has been completed. The author has expensively studied for history of acupuncture medicine in time and space. Base on abundant historical materials, deliberate textual research as well as strategically situated academic view, it is considered as a masterpiece of acupuncture on real significance. It is worthwhile to note that the book has a systematic and profound explanation on Bian-stone therapy, unearthed literature relics of acupuncture, the bronze figure or illustration of acupoint as well as special topics of Japan and Korea acupuncture history. Filled several gaps of the field, and explored some significant new paths of study, it laid the groundwork for the profound study and unscramble of traditional acupuncture theory as well as the investigation of the academic history, which is considered to have a profound and persistent influence. The careful sorting and profound digging of many distinguish thoughts and methods of Mr. MA Ji-xing in the study of acupuncture medical history has significant meaning in references and enlightenment of the future research on acupuncture medical history.

  20. Seroepidemiology of Varicella and value of self-reported history of Varicella infection in Iranian medical students.

    Science.gov (United States)

    Allami, Abbas; Mohammadi, Navid; Najar, Azade

    2014-04-01

    We conducted this study to assess the seroprevalence of Varicella zoster virus (VZV) antibodies in a group of Iranian medical sciences students that were at risk of Varicella and the value of self-reported history as a predictor of immunity. 255 medical, nursing and obstetrics students who had not entered as a student or worked in a hospital from 3 different schools were enrolled in the study in 2012 (Qazvin province, Iran). Demographics and other information as well as the history of Varicella were obtained through a self-administered questionnaire. Blood samples were collected to determine the Varicella IgG levels via an enzyme-linked immunosorbent assay. A statistical analysis was performed by calculating prevalences and their 95% confidence intervals. Sensitivity, specificity, positive and negative predictive values, Cohen's kappa and positive and negative likelihood ratios of recalled history were determined. p history with immunity against the virus were statistically significant. The overall rate of reported history was 57%. The positive and negative predictive values of self-reported history of Varicella were 91% and 47.3%, respectively. Immunization of students of Iranian medical sciences seems logical in the near future. Also, they should be tested for Varicella immunity regardless of the history of previous infection.

  1. Analysis of Factors Affecting Patients’ Compliance to Topical Antiglaucoma Medications in Egypt as a Developing Country Model

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    Nahla B. Abu Hussein

    2015-01-01

    Full Text Available Purpose. To study factors affecting patients’ compliance to antiglaucoma medications in Egypt where there are unique factors as a developing country. Patients and Methods. A cross-sectional descriptive study on 440 Egyptian patients with open angle glaucoma (OAG recruited for over two years. The patients were thoroughly interviewed about their age, education level, duration of glaucoma, difficulty in instilling the drops, medication regimens, a family history of glaucoma, knowledge of the disease, and the presence of medical insurance. Results. 236 (53.6% were noncompliant compared to 204 (46.4% who were compliant. Females had a tendency for higher compliance (p=0.061. Patient age above 50 years and low level of education and negative family history of glaucoma were factors significantly associated with poor compliance (p<0.0001. Polytherapy and lack of medical insurance could be contributing factors. Conclusion. Egyptian patients have a high rate of noncompliance compared to the average in literature. Great effort is needed in educating patients about the importance of medications and the risk and the prognosis of this disease. Economic factors must also be taken into consideration in developing countries with large number of poor patients. We recommend simplifying drug regimens, incorporating electronic dose monitors, and creating reminders for follow-up visits of glaucoma patients.

  2. Pilot Trial of an Electronic Family Medical History in US Faith-Based Communities.

    Science.gov (United States)

    Newcomb, Patricia; Canclini, Sharon; Cauble, Denise; Raudonis, Barbara; Golden, Paulette

    2014-07-01

    In spite of the acknowledged importance of collecting family health information, methods of collecting, organizing, and storage of pedigree data are not uniformly utilized in practice, though several electronic tools have been developed for the purpose. Using electronic tools to gather health information may empower individuals to take responsibility in managing their family health history. The purpose of this study was to describe the feasibility and outcomes of introducing small groups to the My Family Health Portrait tool in faith-based communities using faith community nurses (FCNs). This pilot project adopted a mixed methods approach to assess the potential of an educational intervention delivered by FCNs for increasing the use of electronic technologies for organizing and storing family health histories among the general public. Treatment and control groups were recruited from four faith-based communities in north Texas using a parallel-groups quasi-experimental design. Qualitative data were gleaned from field notes made by investigators interacting with FCNs and observing their teaching. A majority of respondents believed that knowing one's health history and passing it on to family and medical personnel is important. Those receiving face-to-face instruction on the electronic tool were significantly more likely to have written down family health information than the control group who received only an informational handout (χ(2) = 5.96, P = .015). Barriers to teaching about and using the electronic tool included FCNs' lack of facility with computers in the educational context and FCN and respondent mistrust of electronic storage for family health information. © The Author(s) 2014.

  3. Key Success Factors in E-Learning in Medical Education

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    Hassan Emami

    2009-08-01

    Full Text Available Background and purpose: As in many countries, Medical Education (ME is offered in three levels including Undergraduate ME, Graduate ME, and Continuing ME. Informtion tehnology development has provided a suitable chance for ME. E-learning in ME is growing more and more. The present study seeks to determine the key success factors (KSF in E-learning in medical fields.Methods: KSF has been scrutinized in the literature following of which, and due to similarity, a classification with seven groupings was established including institutional factor, technology, interested parties, information knowledge, methods and approaches educational resources, and environmental factors. Through a questionnaire, the data were gatered from the information technology (IT directors in all medical universities throughout the country. The data collected were subjected to factorial analysis. Data from heads of educational groups were obtained through focus group discussion. Cronbach reliability coefficient was calculated for questionnaire used. Factorial analysis was used to identify meaningful KSF. T-Test, and one-way variance analysis as well as Pearson’s correlation were used. The analysis was conducted with SPSS softwareResults: The results showed no significant differences between age, sex, career, and level of education, and KSF. The preparedness factors were analyzed through group discussions with the heads of the academic departments under the study. By factorial analyses, five factors were found including the departmental interest and potential (27.3%, task performance potential (25.1%, E-teaching development in basic and clinical sciences , and continuing education (20.1%, suitable cultural environment (16.8%, and infrastructures (10.8%. Fisher Exeact Test was used to compare the obtained ratios in 5% curve whose results showed that among the three factors including legal and technocal environment, specialized hardwareand software, and high speed internet

  4. From papyrus to the electronic tablet: a brief history of the clinical medical record with lessons for the digital age.

    Science.gov (United States)

    Gillum, Richard F

    2013-10-01

    A major transition is underway in documentation of patient-related data in clinical settings with rapidly accelerating adoption of the electronic health record and electronic medical record. This article examines the history of the development of medical records in the West in order to suggest lessons applicable to the current transition. The first documented major transition in the evolution of the clinical medical record occurred in antiquity, with the development of written case history reports for didactic purposes. Benefiting from Classical and Hellenistic models earlier than physicians in the West, medieval Islamic physicians continued the development of case histories for didactic use. A forerunner of modern medical records first appeared in Paris and Berlin by the early 19th century. Development of the clinical record in America was pioneered in the 19th century in major teaching hospitals. However, a clinical medical record useful for direct patient care in hospital and ambulatory settings was not developed until the 20th century. Several lessons are drawn from the 4000-year history of the medical record that may help physicians improve patient care in the digital age. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Giuseppe and Aloysius Frari’s Works on Rabies and History of Frari Medical Family of Šibenik, Dalmatia

    Science.gov (United States)

    Krnić, Anton

    2007-01-01

    This article is an attempt to reconstruct the family history of the Fraris, the famous Šibenik medical family. Three generations of physicians from the Frari family played an important role not only at medical and social scene of Šibenik in the 18th and 19th century, but also in Croatian and Italian medical history. I will try to provide important details on the lives, medical and social work, and publications of 5 members of the family, Giuseppe (Josip), Angelo Antonio (Anđeo Antun), Sebastiano (Sebastijan), Michele Carlo (Mihovil), and Aloysius (Luigi) Frari. I would also like to pay a special attention to the works on rabies, written by Giuseppe and Luigi Frari, which are among the earliest and most accurate Croatian works on the subject. To reconstruct the history of the family, I studied the relevant editions about the medical and social history of Šibenik, Dalmatia, Venice, and Croatia, together with the Fraris’ publications and reflections. This was the first time Italian and Latin language works by Giuseppe and Luigi Frari on rabies were analyzed. The story on Fraris also documents that medical publishing was a common practice in Dalmatia in the 18th and the 19th century. PMID:17589982

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

    Science.gov (United States)

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

    2014-12-01

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

  7. Argentina enacts first law on medical use of the cannabis plant. History and perspectives

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    Eduardo L De Vito

    2017-10-01

    Full Text Available In the last few years, great expectations have risen in the society concerning the eventual therapeutic usefulness of compounds derived from the cannabis plant. It is well known that these compounds are being used in treating certain health conditions, either through medical prescription or self-administration. Extreme opinions range from believing that it is a harmful and dangerous drug to sustaining that it is a panacea. However, the sheer existence of an endocannabinoid system in the brain compels us to study its dimensions and derivations thoroughly. It is expected that controversies and knowledge gaps will be clarified within the framework of this new law. Prohibitionism should not be a category of analysis. Regardless of the therapeutic effects of cannabinoid compounds, demonstrated or to be demonstrated, there are already severe restrictions on their use, which mirror the still existing restrictions to the use of opioids (drugs of definite utility but on which a huge taboo persists. This review presents the first Argentine law on the medical use of cannabis. Milestones in the history of marijuana at the national level are pointed out, which are inextricably linked to world trends either in favor or against prohibition. The current status of the use of cannabis oil in the country and evidences for its therapeutic value are also analyzed. Evidences on its therapeutic value are also analyzed as well as the current status of the use of cannabis oil in our country.

  8. [2000 year history of tonsillectomy. Images from the history of otorhinolaryngology, highlighted by instruments from the collection of the German Medical History Museum in Ingolstadt].

    Science.gov (United States)

    Feldmann, H

    1997-12-01

    The etymology of the anatomical terms and their use in history are elucidated: "Tonsil" (from Latin tonsa = the oar) in use since Celsus (about 40 AD). The Greek terms of that time, "antiádes", "paristhmia", were not adopted in later medical terminology. "Amygdala" (Greek/Latin = the almond) was introduced by Vesalius in 1543. Vesalius was also the first to depict the tonsils in a specimen of the whole human body; Duverney (1761) gives the first exact depiction of the pharyngeal region. Special anatomical and histological studies of the tonsils were carried out in the 19 century. Cornelius Celsus in Rome (about 40 AD) described the blunt removal of the tonsils by use of the finger. This method was favoured anew by numerous laryngologists at the beginning of the 20th century when it had been realised that a gentle enucleation of the entire tonsil including its capsule was advisable against cutting off a slice, but before long this procedure was discarded again for hygienic reasons. Precursors of special instruments for tonsillectomy were instruments designed for shortening the uvula: uvulotomy. Paré (1564) and Scultetus (1655) devised instruments that permitted placing a thread shaped like a snare around the uvula and cutting it off by strangulation. Hildanus (1646), Scultetus (1655) and Heister (1763) presented an instrument of the guillotine-type for uvulotomy. This instrument was modified by P. S. Physick (USA 1828) and used for tonsillotomy. It became the prototype for a number of similar instruments which were to follow: W. M. F. Fahnestock (USA 1832). M. Mackenzie (London 1880), G. Sluder (USA 1911). Besides these guillotines snares were also perfected and used for tonsillotomy, e.g. by W. Brünings (1908). The concentration on tonsillotomy aimed at performing the operation as quickly as possible, especially in children, as it was not yet possible to sustain general anaesthesia for a longer period of time while doing surgery in the pharynx. The operation of

  9. Social Factors Determine the Emergency Medical Admission Workload

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    Seán Cournane

    2017-06-01

    Full Text Available We related social factors with the annual rate of emergency medical admissions using census small area statistics. All emergency medical admissions (70,543 episodes in 33,343 patients within the catchment area of St. James’s Hospital, Dublin, were examined between 2002 and 2016. Deprivation Index, Single-Parent status, Educational level and Unemployment rates were regressed against admission rates. High deprivation areas had an approximately fourfold (Incidence Rate Ratio (IRR 4.0 (3.96, 4.12 increase in annual admission rate incidence/1000 population from Quintile 1(Q1, from 9.2/1000 (95% Confidence Interval (CI: 9.0, 9.4 to Q5 37.3 (37.0, 37.5. Single-Parent families comprised 40.6% of households (95% CI: 32.4, 49.7; small areas with more Single Parents had a higher admission rate-IRR (Q1 vs. for Q5 of 2.92 (95% CI: 2.83, 3.01. The admission incidence rate was higher for Single-Parent status (IRR 1.50 (95% CI: 1.46, 1.52 where the educational completion level was limited to primary level (Incidence Rate Ratio 1.45 (95% CI: 1.43, 1.47. Small areas with higher educational quintiles predicted lower Admission Rates (IRR 0.85 (95% CI: 0.84, 0.86. Social factors strongly predict the annual incidence rate of emergency medical admissions.

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

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    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

  11. 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.

  12. 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.

  13. Details acquired from medical history and patients’ experience of empathy – two sides of the same coin

    Science.gov (United States)

    2013-01-01

    Background 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. Methods 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. Results 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 (p 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. PMID:23659369

  14. Impact of a Student Pharmacist Driven Medication Reconciliation and Antidepressant Treatment History Project at a Depression Clinic: A Pilot Study

    Science.gov (United States)

    Tang, Stella S.; Jaward, Leanna; Ward, Kristen; Parikh, Sagar V.; Bostwick, Jolene R.

    2017-01-01

    Objectives To improve treatment of patients with depression, a new pilot service project involving student pharmacists who would conduct medication reconciliation and review of antidepressant treatment history was created and evaluated. Experimental design A prospective study conducted at the University of Michigan Depression Center. Principal observations From an initial sample of 78 referrals, 41 subjects were reached by phone, with 34 completing medication reconciliation and antidepressant treatment history. Of the 34 patients, 25 (73.5%) had at least one discrepancy identified in their medication list, resulting in 164 medication changes in the electronic medical record (EMR). A total of 105 past antidepressant trials were documented in the 34 individuals, with 34 (32.4%) trials found to be inadequate. Thirteen (38.2%) patients reported failure to respond to two different antidepressants from different classes. All 34 patients participated well in the phone calls and were willing to consult a pharmacist at their upcoming clinic visit. Conclusions A student pharmacist pilot was feasible, identified many discrepancies in the medication record, and identified important medication treatment history in patients with depression in advance of the clinic visit. The project provides support for a specialized role for student pharmacists and demonstrates that interprofessional care can contribute to improved treatment of depression. PMID:28626270

  15. Factors associated with future commitment and past history of human papilloma virus vaccination among female college students in northern Taiwan.

    Science.gov (United States)

    Kuo, Ping-Fen; Yeh, Ying-Tse; Sheu, Shuh-Jen; Wang, Tze-Fang

    2014-07-01

    To investigate factors influencing commitment to human papilloma virus (HPV) vaccination and prior vaccination among female college students in northern Taiwan. A quota sample of 400 female college students was recruited from nine colleges in northern Taiwan during March 2013. Of these, 398 completed the self administered questionnaire which was designed based on the health promotion model. The results showed that factors associated with prior vaccination behavior were family history of gynecologic malignancy, ever being advised to get HPV vaccination, perceived barriers of action and perceived self-efficacy. Predictors for commitment to HPV vaccination in the next 6 months were the cost of vaccination, ever being advised to get HPV vaccination, perceived self-efficacy and situational influences. Perceived self-efficacy was significantly influenced by relationship status, past receipt of a recommendation for HPV vaccination and level of knowledge about HPV. When formulating vaccination policies, governmental or medical institutions should include these factors to promote vaccination.

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

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    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.

  17. Factors associated to chronic migraine with medication overuse: A cross-sectional study.

    Science.gov (United States)

    Viana, Michele; Bottiroli, Sara; Sances, Grazia; Ghiotto, Natascia; Allena, Marta; Guaschino, Elena; Nappi, Giuseppe; Tassorelli, Cristina

    2018-01-01

    Background and aim Factors implicated in the evolution of episodic migraine into chronic migraine are largely elusive. Medication overuse is considered to be one of the main determinants, but other possible clinical and psychological factors can play a role. The aim of this study is to identify factors that are associated with chronic migraine with medication overuse. Method We enrolled consecutive migraine patients, subdividing them in two groups: Subjects with a long history of episodic migraine and subjects with chronic migraine and medication overuse. We then compared their clinical and psychological variables in a cross-sectional study. Results Three hundred and eighteen patients were enrolled, of which 156 were episodic migraine and 162 were chronic migraine and medication overuse patients. The mean age was 42.1 ± 10.3, 80.8% were female. The duration of migraine was 24.6 years in episodic migraine and 24.0 years in chronic migraine and medication overuse ( p = 0.57). After the multivariate analysis, the factors associated to chronic migraine and medication overuse were: Marital status (married vs. unmarried, OR 3.65, 95% CI 1.63-8.19, p = 0.002; separated/divorced/widowed vs. unmarried, OR 4.19, 95% CI 1.13-15.47, p = 0.031), physical activity (OR 0.42, 95% CI 0.19-0.91, p = 0.029), age at onset of migraine (OR 0.94, 95% CI 0.89-0.98, p = 0.016), use of at least one migraine preventive medication (OR 2.36, 95% CI 1.18-4.71, p = 0.014), history of depression (OR 2.91, 95% CI 1.25-6.73, p = 0.012), insomnia associated with the use of hypnotics (OR 5.59, 95% CI 1.65-18.93, p = 0.006), traumatic head injuries (OR 3.54, 95% CI 1.57-7.99, p = 0.002), snoring (OR 2.24, 95% CI 1.05-4.79, p = 0.036), previous and/or actual use of combined oral contraceptives (OR 3.38, 95% CI 1.10-10.3, p = 0.031) and higher scores in the Childhood Trauma questionnaire (OR 1.48, 95% CI 1.09-2.02, p = 0.012). Conclusion We considered

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

    Science.gov (United States)

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

    2015-10-05

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

  19. Tobacco Use and Associated Factors in Medical Students

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    Hamideh Ebrahimi

    2017-02-01

    Full Text Available Background Many studies indicate that one of the leading preventable causes of premature death, disease and disability around the world is Tobacco use. Unfortunately, adolescents and young adults of colleges are often targeted of marketing by the tobacco industry. The aim of this study was to assess the relative frequency of tobacco use and associated factors in medical students. Methods This cross-sectional study has done among medical students in 2014 - 2015. Totally, 284 students from 4 levels (basic, extern, intern and residents were selected by random sampling from each category. We used a checklist for collecting demographic information that was distributed among participants by a trained interviewer. SPSS-11.5 software was used for data analysis andsignificance level was considered < 0.05. Results Among 284 medical students, 17 (6% smoked cigarette and 3 (1.05% used illicit substance. All of the users were male, 15 (88% of which were single. 1 (1.4 % of the basic level students, 6 (6.9 % of the externs, 9 (14.8 % of the Interns and 1(1.6 % of the residents used cigarette but the differences among these groups were not significant (P = 0.36. Generally, 13 (76.5% of the users resided in dormitory and the others lived in parental home, which shows a significant difference among these groups (P = 0.01.The logistic regression indicated stage level was positively associated with cigarette use (P < 0.007. Conclusions In this study, we evaluated how several environmental factors may influence illicit substance and tobacco use. We found an association between living in a dormitory and smoking cigarette, so it is an important factor to be considered in program planning for new students who entered into this environment.

  20. Peer-Assisted History-Taking Groups: A Subjective Assessment of their Impact Upon Medical Students' Interview Skills

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    Keifenheim, Katharina Eva

    2017-08-01

    Full Text Available Background and Objectives: Among the clinical skills needed by all physicians, history taking is one of the most important. The teaching model for peer-assisted history-taking groups investigated in the present study consists of small-group courses in which students practice conducting medical interviews with real patients. The purpose of this pilot study was to investigate the expectations, experiences, and subjective learning progress of participants in peer-assisted history-taking groups.Methods: The 42 medical student participants completed a 4-month, peer-assisted, elective history-taking course, which both began and ended with a subjective assessment of their interview skills by way of a pseudonymized questionnaire. Measures comprised the students’ self-assessment of their interview skills, their expectations of, and their experiences with the course and especially with the peer tutors. Results: Medical students’ most important motivations in attending peer-assisted history-taking groups were becoming able to complete a structured medical interview, to mitigate difficult interviewing situations, and to address patients’ emotional demands appropriately. By the end of the course, students’ self-assessment of both their interview skills and management of emotional issues improved significantly. Students especially benefitted from individual feedback regarding interview style and relationship formation, as well as generally accepted and had their expectations met by peer tutors. Conclusions: To meet the important learning objectives of history-taking and management of emotional issues, as well as self-reflection and reflection of student–patient interactions, students in the field greatly appreciate practicing medical interviewing in small, peer-assisted groups with real patients. At the same time, peer tutors are experienced to be helpful and supportive and can help students to overcome inhibitions in making contact with patients.

  1. The use of virtual patients to teach medical students history taking and communication skills.

    Science.gov (United States)

    Stevens, Amy; Hernandez, Jonathan; Johnsen, Kyle; Dickerson, Robert; Raij, Andrew; Harrison, Cyrus; DiPietro, Meredith; Allen, Bryan; Ferdig, Richard; Foti, Sebastian; Jackson, Jonathan; Shin, Min; Cendan, Juan; Watson, Robert; Duerson, Margaret; Lok, Benjamin; Cohen, Marc; Wagner, Peggy; Lind, D Scott

    2006-06-01

    At most institutions, medical students learn communication skills through the use of standardized patients (SPs), but SPs are time and resource expensive. Virtual patients (VPs) may offer several advantages over SPs, but little data exist regarding the use of VPs in teaching communication skills. Therefore, we report our initial efforts to create an interactive virtual clinical scenario of a patient with acute abdominal pain to teach medical students history-taking and communication skills. In the virtual scenario, a life-sized VP is projected on the wall of an examination room. Before the virtual encounter, the student reviews patient information on a handheld tablet personal computer, and they are directed to take a history and develop a differential diagnosis. The virtual system includes 2 networked personal computers (PCs), 1 data projector, 2 USB2 Web cameras to track the user's head and hand movement, a tablet PC, and a microphone. The VP is programmed with specific answers and gestures in response to questions asked by students. The VP responses to student questions were developed by reviewing videotapes of students' performances with real SPs. After obtaining informed consent, 20 students underwent voice recognition training followed by a videotaped VP encounter. Immediately after the virtual scenario, students completed a technology and SP questionnaire (Maastricht Simulated Patient Assessment). All participants had prior experience with real SPs. Initially, the VP correctly recognized approximately 60% of the student's questions, and improving the script depth and variability of the VP responses enhanced most incorrect voice recognition. Student comments were favorable particularly related to feedback provided by the virtual instructor. The overall student rating of the virtual experience was 6.47 +/- 1.63 (1 = lowest, 10 = highest) for version 1.0 and 7.22 +/- 1.76 for version 2.0 (4 months later) reflecting enhanced voice recognition and other

  2. Factors Associated with Medical Knowledge Acquisition During Internal Medicine Residency

    Science.gov (United States)

    Zeger, Scott L.; Kolars, Joseph C.

    2007-01-01

    BACKGROUND Knowledge acquisition is a goal of residency and is measurable by in-training exams. Little is known about factors associated with medical knowledge acquisition. OBJECTIVE To examine associations of learning habits on medical knowledge acquisition. DESIGN, PARTICIPANTS Cohort study of all 195 residents who took the Internal Medicine In-Training Examination (IM-ITE) 421 times over 4 years while enrolled in the Internal Medicine Residency, Mayo Clinic, Rochester, MN. MEASUREMENTS Score (percent questions correct) on the IM-ITE adjusted for variables known or hypothesized to be associated with score using a random effects model. RESULTS When adjusting for demographic, training, and prior achievement variables, yearly advancement within residency was associated with an IM-ITE score increase of 5.1% per year (95%CI 4.1%, 6.2%; p international medical school graduation, −3.4% (95%CI −6.5%, −0.36%; p = .03). CONCLUSIONS Conference attendance and self-directed reading of an electronic knowledge resource had statistically and educationally significant independent associations with knowledge acquisition that were comparable to the benefit of a year in residency training. PMID:17468889

  3. 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.

  4. 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.

  5. 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.

  6. Factors impacting public acceptance of medical radiation exposure

    International Nuclear Information System (INIS)

    Tsuji, Satsuki; Kanda, Reiko

    2009-01-01

    We undertook a survey to determine the public acceptance of medical radiation exposure throughout Japan, and 1,357 responses (67.9% response rate) were obtained using a two-stage systematic stratified random sampling method. The acceptance of exposure of children was generally similar to that of adults. For each of the attributes, 45-60% of the participants were accepting of exposure for cancer treatment and diagnosis, but only 30% were accepting of exposure for X-ray diagnoses of bone fractures and dental caries. In general, the presence of a child did not markedly affect women's acceptance of exposure. Factor analyses identified 3 factors influencing the acceptance of child exposure: symptomatic diseases to determine treatment, the possibility of high-risk diseases (or major organ diseases), and the association with cancer. Cluster analysis showed 4 clusters: a positive group regarding children's exposure for the diagnosis of bone fractures and dental caries (12.9% of all participants), a positive group for major organ disease and cancer (15.5%), a negative group excluding cancer (55.2%), and a positive group for all cases (16.4%). The cluster distributions revealed that mothers with 10- to 18-year-old firstborn children showed a tendency to accept the medical radiation exposure of their children in all cases. (author)

  7. 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. © The Author(s) 2015.

  8. Social factors affecting education quality of Iranian medical & dental students.

    Science.gov (United States)

    Zafarmand, A Hamid; Sabour, Siamak

    2014-09-01

    Positive social behavior of student is an important factor in the integrity of educational quality. Unbalanced behavior can disrupt the progress of students in learning. The present study evaluates the effect of social factors on education quality of dental and medical students. This descriptive cross-sectional study was conducted on 227 randomly selected students (109 dental and 118 medical). The questionnaire contained three domains of cultural collectivism, self-concept, and social adjustment adapted from California Test of Personality. It also included demographic questions like; field of study, gender and home city of residence. Data was analyzed using SPSS (version#19) software. Pearsons' correlation coefficient and independent t-test were used at the P-value of 0.05. Generally, girl students showed higher cultural collectivism (P=0.028) and social adjustment (P=0.04). On the contrary, boys were better in self-concept behavior (P=0.34). Home city of residence evidenced with no significant effect on any aspects of social attitudes of subjects. Pearsons' correlation coefficient test showed a weak correlation between cultural collectivism and self-concept (r=0.134, P=0.04) and between cultural collectivism and social adjustment, as well. (r=0.252, P=0.001) Independent t-test showed a significant difference between male and female students concerning cultural collectivism and social adjustment. Reliability of cultural collectivism, self-concept and social adjustment scales ranged from very good to moderate, α=0.83, α=0.63, and α=0.54 respectively. The results of this study indicated that female students show better cultural collectivism and social adjustment skills. It also proved that home city of residence has no significant effect upon social behavior of either medical or dental students.

  9. Hannah's Feeding Journey: A Multidisciplinary Treatment Approach to Establishing Oral Acceptance for a Toddler with a Complex Medical History

    Science.gov (United States)

    Dunn, Dena M.; Galbally, Sandra Lynn; Markowitz, Goldie; Pucci, Kristy N.; Brochi, Ligia; Cohen, Sherri Shubin

    2017-01-01

    This article presents the importance of multidisciplinary, family-centered care, and a developmental bio-psycho-social approach to treating feeding difficulties in a child with a complex medical history. Hannah spent the first 9 months of her life in the hospital and was discharged dependent on nasogastric tube feeding. Her journey to recovery…

  10. A Study of Factors Influencing Brain Drain among Medical ...

    African Journals Online (AJOL)

    This economic situation deeply affected the medical groups that migration became the chorus of the medical personnel. ... purposively selected medical personnel, to ferret the causes of immigration and the corresponding effect on the provision of medical services and development of future medical personnel in the country.

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

    Science.gov (United States)

    van der Put, Claudia E; Asscher, Jessica J

    2015-02-01

    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 with a history of sexual offenses against younger children (CSOs; n = 341), a history of sexual offenses against peers and/or adult victims (PSOs; n = 207), and a history of nonsexual violent offenses (VOs; n = 1,356). We conducted secondary analyses on data collected with the Washington State Juvenile Court Assessment and on general recidivism data. ANOVA, correlations, Fisher's z tests, and logistic regression analyses were applied. Results showed that, in VOs, the number of risk factors was greater than the number of protective factors, whereas in PSOs, and especially CSOs, the number of protective factors was greater than the number of risk factors. Protective factors appeared to be especially important for juveniles with a history of sexual offenses for two reasons. First, the impact of most protective factors on recidivism was larger among juveniles with a history of sexual offenses than among those with a history of violent offenses. Second, protective factors added to the predictive accuracy over and above risk factors in juveniles with a history of sexual offenses, but not in those with a history of violent offenses. © The Author(s) 2014.

  12. Are medical students confident in taking a sexual history? An assessment on attitude and skills from an upper middle income country

    OpenAIRE

    Ariffin, Farnaza; Chin, Ken Lee; Ng, ChirkJenn; Miskan, Maizatullifah; Lee, Verna KarMun; Isa, Mohammad Rodi

    2015-01-01

    Background Sexual history training during undergraduate education is essential for preparing future doctors to handle patients? sexual health concerns. The purpose of this study was to assess the attitudes and perceptions of final-year medical students in Malaysia toward sexual history taking and the training they receive from their medical schools. Methods The study used a cross-sectional survey of 379 final-year medical students from three medical schools in Malaysia. Students were asked to...

  13. 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

  14. [Teaching courses on aspects of medical history taking and communication skills in Germany: a survey among students of 12 medical faculties].

    Science.gov (United States)

    Schildmann, Jan; Kampmann, Margareta; Schwantes, Ulrich

    2004-06-01

    Good communication between patients and doctors has positive effects on health and the patients' quality of life. Communication skills can be trained. In many countries communication skills training is an important part of medical education and continuing medical education. In this study German medical students were questioned about current communication training. Questionnaires were sent to 28 Medical Schools in Germany and distributed in General Practice courses. Using Likert scales students were asked to rate both existing teaching courses on communication skills and their ability to communicate. 377 students of 12 Medical Schools participated in this study. Two Medical Schools offer teaching courses on communication skills as part of their regular curriculum. On a scale ranging from 1 (no such courses available) to 7 (courses fully available) students assessed the practical teaching of communication skills to be 3 (median). In addition, on a scale ranging from 1 to 7 students rated their general communication skills as 3 (median) and their ability of taking a sexual history and breaking bad news as 4 (median). Although these results are not representative, they give a general idea of communication skills teaching in Germany. During their clinical education students should be especially trained for difficult situations in the patient-doctor encounter. The international experience of other Medical Schools should be taken into account when implementing communication skills training as part of medical education.

  15. 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.

  16. 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.

  17. Factors Impacting On Patient Compliance with Medical Advice: Empirical Study

    Directory of Open Access Journals (Sweden)

    Krot Katarzyna

    2017-06-01

    Full Text Available The purpose of this paper to identify factors which have a bearing on compliance with medical advice in various age groups. The survey was conducted, using the CAWI method, on a representative sample of 1000 respondents who declared having used healthcare services in the previous six months. Control of competences is one of the strongest factors which is common for the oldest and youngest groups. Interestingly, trust in the integrity and honesty of doctors is significant for the youngest patients, i.e., the higher is the level of trust, the lower is the tendency to non-comply. Another type of trust is related to the benevolence of doctors and is significant to patients of the middle age group. Satisfaction is a significant predictor in the two oldest groups of patients. High levels of satisfaction seem to deter people from non-adherence to recommended treatment regimens. The results of the present study provide knowledge about the nature and diversity of factors behind patient compliance in various age groups.

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

    NARCIS (Netherlands)

    Heidema, W.M.; Scholten, R.R.; Lotgering, F.K.; Spaanderman, M.E.A.

    2015-01-01

    OBJECTIVE: 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. STUDY DESIGN: In a retrospective case-control

  19. 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.

  20. Power Factor Improvement Using Automatic Power Factor Compensation (APFC Device for Medical Industries in Malaysia

    Directory of Open Access Journals (Sweden)

    Zaidi Maryam Nabihah

    2018-01-01

    Full Text Available This paper present the project designed to correcting power factor for medical industries in Malaysia automatically. Which with hope to make the cost and energy usage efficient, because the energy source are depleting due to increase in population. Power factor is the ratio of real power and apparent power. This definition is mathematically represented as kW/kVA where kW is active power and kVA is apparent power (active + reactive. Reactive power is the non-working power generated by the magnetic and inductive load to generate magnetic flux. The increase in reactive power increase the apparent power so the power factor will decrease. Low pF will cause the industry to meet high demand thus making it less efficient. The main aim of this project is to increasing the current power factor of medical industries from 0.85 to 0.90. Power factor compensation contribute to reduction in current-dependent losses and increase energy efficiency while expanding the reliability of planning for future energy network. As technology develops, the gradual cost and efficiency penalty should reduce. Therefore, automatic power factor compensation device should become cost-effective and smaller device over time. That is the reason this project is using programmable device as it is a miniature architecture device.

  1. Age-related macular degeneration: the importance of family history as a risk factor.

    Science.gov (United States)

    Shahid, Humma; Khan, Jane C; Cipriani, Valentina; Sepp, Tiina; Matharu, Baljinder K; Bunce, Catey; Harding, Simon P; Clayton, David G; Moore, Anthony T; Yates, John R W

    2012-03-01

    Family history is considered a risk factor for age-related macular degeneration (AMD). With the advent of effective therapy for the disease, the importance of family history merits further investigation. This study quantifies the risk associated with family history, first, by a case-control study of reported family history and, second, by examining the siblings of AMD cases. The authors recruited cases with advanced AMD, spouses and siblings. All subjects were carefully phenotyped. Clinical findings in the siblings were compared with spouses. Information about family history was collected. The ORs for reported family history of AMD were calculated. Analyses were adjusted for age, smoking and genotype. 495 AMD cases, 259 spouses and 171 siblings were recruited. The OR for AMD was 27.8 (CI 3.8 to 203.0; p=0.001) with a reported family history of an affected parent and 12.0 (CI 3.7 to 38.6; p<0.0001) with a history of an affected sibling. ORs adjusted for age and smoking were higher. Examination of siblings confirmed their increased risk with 23% affected by AMD and an OR of 10.8 (4.5 to 25.8; p<0.0001). Adjusting for age increased the OR to 16.1 (6.2 to 41.8). The risk of AMD is greatly increased by having an affected first-degree relative. Those at risk need to be made aware of this and AMD patients should advise siblings and children to seek prompt ophthalmological advice if they develop visual symptoms of distortion or reduced vision.

  2. 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

    2016-12-01

    To analyze the prevalence and associated factors regarding the use of medicines by self-medication in Brazil. 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. 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%). 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. Analisar a prevalência e os fatores associados à utilização de medicamentos por automedicação no Brasil. Este estudo transversal de base populacional foi realizado com dados da Pesquisa Nacional de Acesso, Utilização e Promoção do Uso Racional de medicamentos (PNAUM

  3. Health aspects of Arctic exploration – Alaska's medical history based on the research files of Dr. Robert Fortuine

    Directory of Open Access Journals (Sweden)

    Kathleen Murray

    2013-08-01

    Full Text Available Background . Robert Fortuine provided basic medical care to Alaska Native people, chronicled the Health Aspects of Arctic Exploration and through a number of influential publications, was the first to thoroughly document and analyse Alaska's Medical History. This overview of his published work will provide the reader with a detailed overview, so that they can begin to explore Dr. Fortuine's many published works in more detail. Objective . This review will explore Alaska's Medical History and the Health Aspects of Arctic Exploration through the research files and the 10 most significant publications of Dr. Robert Fortuine. Design . Review of Dr. Fortuine's major works and the master bibliography has over 3,000 references and 81 subjects. The master bibliography is a merger of 55 separate bibliographies, which provides a wealth of bibliographic information. This paper will describe his 10 most significant publications, 2 of which began as a journal issue. Results . Dr. Fortuine was a prolific writer throughout his career, publishing 134 articles and books. He wrote papers and books on Alaska's medical history, tuberculosis and health care delivery from Russian–America through the Public Health Service efforts in the territory and then the State of Alaska. The master bibliography has over 3,000 references and 81 subjects. This list has a significant number of entries for tuberculosis with almost one-third of the entries including this heading. Others dwell on the history of “pre-contact” health, the history of Alaska Native health care, the history of the Alaska Department of Health, especially the tuberculosis programme, the role of the US Public Health Service and traditional medicine. He completely reviewed every Governors’ and the US Surgeon General's reports in regard to Alaska content. This paper describes his 10 most significant publications. Conclusions . Robert Fortuine's published works offer a wealth of information and insight

  4. Job insecurity and the use of antidepressant medication among Danish employees with and without a history of prolonged unemployment: a 3.5-year follow-up study

    DEFF Research Database (Denmark)

    Rugulies, R; Thielen, K; Nygaard, E

    2010-01-01

    A study was undertaken to investigate whether job insecurity predicts incident use of antidepressant medication and whether the association is modified by a history of prolonged unemployment.......A study was undertaken to investigate whether job insecurity predicts incident use of antidepressant medication and whether the association is modified by a history of prolonged unemployment....

  5. 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.

  6. Post-Mastectomy and Phantom Breast Pain: Risk Factors, Natural History, and Impact on Quality of Life

    National Research Council Canada - National Science Library

    Dworkin, Robert

    2003-01-01

    .... The primary aims of this research were to identify risk factors for these chronic pain syndromes following surgical procedures for breast cancer, characterize their natural history, and examine...

  7. 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

  8. Power Factor Improvement Using Automatic Power Factor Compensation (APFC) Device for Medical Industries in Malaysia

    OpenAIRE

    Zaidi Maryam Nabihah; Ali Adlan

    2018-01-01

    This paper present the project designed to correcting power factor for medical industries in Malaysia automatically. Which with hope to make the cost and energy usage efficient, because the energy source are depleting due to increase in population. Power factor is the ratio of real power and apparent power. This definition is mathematically represented as kW/kVA where kW is active power and kVA is apparent power (active + reactive). Reactive power is the non-working power generated by the mag...

  9. Sociodemographic and Medical Risk Factors Associated With Antepartum Depression

    Directory of Open Access Journals (Sweden)

    Giridhara R. Babu

    2018-05-01

    Full Text Available BackgroundThe increasing recognition of antenatal depression is an emerging area of concern in developing countries. We conducted a study to estimate the prevalence of antenatal mental distress and its relation with sociodemographic factors, obstetric factors, and physiological wellbeing in pregnant women attending public health facilities in Bengaluru, South India.MethodsNested within a cohort study, we assessed the mental status in 823 pregnant women in two public referral hospitals. Kessler Psychological Distress Scale (K-10 scale was used to assess maternal depression. We collected information related to social-demographic characteristics and recent medical complaints. Descriptive statistics and odds ratios were calculated using SPSS version 20.ResultsResults show that 8.7% of the women exhibited symptoms of antenatal depression. Sociodemographic characteristics, such as respondent occupation, husband education, husband’s occupation, total family income showed significance. First time pregnancy, anemia, and high blood pressure were also associated with mental distress.ConclusionOur study has demonstrated feasibility of screening for mental health problems in public hospitals. Early detection of mental distress during pregnancy is crucial as it has a direct impact on the fetus. The public health facilities in low- and middle-income countries such as India should consider piloting and scaling up screening services for mental health conditions for pregnant women.

  10. History of the Rochester Epidemiology Project: half a century of medical records linkage in a US population.

    Science.gov (United States)

    Rocca, Walter A; Yawn, Barbara P; St Sauver, Jennifer L; Grossardt, Brandon R; Melton, L Joseph

    2012-12-01

    The Rochester Epidemiology Project (REP) has maintained a comprehensive medical records linkage system for nearly half a century for almost all persons residing in Olmsted County, Minnesota. Herein, we provide a brief history of the REP before and after 1966, the year in which the REP was officially established. The key protagonists before 1966 were Henry Plummer, Mabel Root, and Joseph Berkson, who developed a medical records linkage system at Mayo Clinic. In 1966, Leonard Kurland established collaborative agreements with other local health care providers (hospitals, physician groups, and clinics [primarily Olmsted Medical Center]) to develop a medical records linkage system that covered the entire population of Olmsted County, and he obtained funding from the National Institutes of Health to support the new system. In 1997, L. Joseph Melton III addressed emerging concerns about the confidentiality of medical record information by introducing a broad patient research authorization as per Minnesota state law. We describe how the key protagonists of the REP have responded to challenges posed by evolving medical knowledge, information technology, and public expectation and policy. In addition, we provide a general description of the system; discuss issues of data quality, reliability, and validity; describe the research team structure; provide information about funding; and compare the REP with other medical information systems. The REP can serve as a model for the development of similar research infrastructures in the United States and worldwide. Copyright © 2012 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  11. 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

  12. Medication errors of nurses and factors in refusal to report medication errors among nurses in a teaching medical center of iran in 2012.

    Science.gov (United States)

    Mostafaei, Davoud; Barati Marnani, Ahmad; Mosavi Esfahani, Haleh; Estebsari, Fatemeh; Shahzaidi, Shiva; Jamshidi, Ensiyeh; Aghamiri, Seyed Samad

    2014-10-01

    About one third of unwanted reported medication consequences are due to medication errors, resulting in one-fifth of hospital injuries. The aim of this study was determined formal and informal medication errors of nurses and the level of importance of factors in refusal to report medication errors among nurses. The cross-sectional study was done on the nursing staff of Shohada Tajrish Hospital, Tehran, Iran in 2012. The data was gathered through a questionnaire, made by the researchers. The questionnaires' face and content validity was confirmed by experts and for measuring its reliability test-retest was used. The data was analyzed by descriptive statistics. We used SPSS for related statistical analyses. The most important factors in refusal to report medication errors respectively were: lack of medication error recording and reporting system in the hospital (3.3%), non-significant error reporting to hospital authorities and lack of appropriate feedback (3.1%), and lack of a clear definition for a medication error (3%). There were both formal and informal reporting of medication errors in this study. 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.

  13. Structured communicative skills training for medical interns improves history taking skills on sensitive issues: An interventional study

    Directory of Open Access Journals (Sweden)

    Anupama Sukhlecha

    2016-01-01

    Full Text Available Background: Communication is a process that allows us to interact with other people. Medical professionals need to possess good communication skills for history taking, diagnosis, and treatment. Communicative skills are hardly taught in medical schools of India. The students are expected to learn them on their own. To address this issue, we introduced communicative skills training (CST for medical interns. Objective: Primary – To determine the effectiveness of CST in improving history taking on sensitive issues by medical interns. Secondary – To improve patients' satisfaction through improved communicative skills. Materials and Methods: This was a randomized control study carried out on medical interns at Jamnagar. The interns were randomized to either Group A or Group B. Intervention in the form of CST was given to Group A while Group B was control. The topic of CST was “eliciting sexual history.” Assessment of participants was done by pre- and post-intervention objective structured clinical examination. For ethical reasons, Group B was also given CST by experts after completion of our study but their results were not included for analysis. Results: Although mean scores increased in both the groups, (from 6.4 to 13.4 in the intervention group and from 6.5 to 7.5 in controls, the percent increase was much larger in the intervention group than controls (109% vs. 15%. Students gave a positive feedback to CST. Opinion of teachers was favoring CST. Among the patients allotted to intervention group, 83% were satisfied. Conclusion: CST imparted to medical interns helps in improving doctor–patient relationship.

  14. Factors Affecting Sexual History Taking in a Health Center Serving Homeless Persons.

    Science.gov (United States)

    Sowicz, Timothy Joseph; Bradway, Christine K

    2018-03-01

    Low rates of documentation of sexual histories have been reported and research on sexual history taking (SHT) has focused on the content of, barriers to collecting, and interventions to improve documentation of sexual histories. Absent from this literature is an understanding of the contextual factors affecting SHT. To address this gap, a focused ethnography of one health center was conducted. Data were collected through observations of health care encounters and interviews with health care providers (HCPs). No SHT was observed and this was likely influenced by patients' characteristics, communication between patients and HCPs, the prioritization of patients' basic needs, and time constraints imposed upon encounters. Given that the health center studied serves patients experiencing homelessness, behavioral health concerns, and opioid use disorder, findings illuminate areas for future inquiry into a patient population affected by social as well as physiologic determinants of health and potentially at high risk for adverse sexual health outcomes.

  15. Psychosocial Risk Factors for Child Welfare among Postpartum Mothers with a History of Childhood Maltreatment and Neglect.

    Science.gov (United States)

    Koenig, A M; Schury, K; Reister, F; Köhler-Dauner, F; Schauer, M; Ruf-Leuschner, M; Gündel, H; Ziegenhain, U; Fegert, J M; Kolassa, I-T

    2016-03-01

    Background: Childhood maltreatment (CM) can increase the risk of psychosocial risk factors in adulthood (e. g. intimate partner violence, financial problems, substance abuse or medical problems). The transition to parenthood presents those affected by CM with particular challenges, in addition to usual birth-related stressors. Methods: In this cross-sectional study a total of 240 women were interviewed in the puerperium with respect to CM experiences, using the German version of the Childhood Trauma Questionnaire (CTQ). Current psychosocial risk factors (e. g. financial concerns, maternal mental illness, single parent) were assessed using the Constance Index (KINDEX) for early childhood risk factors. Associations between CM experience and psychosocial risk factors were calculated using simple correlation. Results: The average age of participants was 33 years. On the CTQ 13.8 % of participants reported emotional abuse, 6.7 % physical abuse and 12.5 % sexual abuse, while 32.1 % reported emotional neglect and 7.5 % physical neglect during childhood. With rising severity of CM, more psychosocial risk factors (KINDEX) were present. Conclusions: This study shows a clear association between experiences of maltreatment during childhood and the presence of psychosocial stressors among women in the puerperium. Regular screening for a history of CM and parental psychosocial stressors should be conducted early, i.e. during pregnancy, to avoid negative consequences for the child.

  16. 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 (pexercising both skills combined as required in physicians' daily practice.

  17. 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.

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

    DEFF Research Database (Denmark)

    O'Neill, Lotte; 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....

  19. Predictive factors of adrenal insufficiency in patients admitted to acute medical wards: a case control study

    Directory of Open Access Journals (Sweden)

    Oboni Jean-Baptiste

    2013-01-01

    Full Text Available Abstract Background Adrenal insufficiency is a rare and potentially lethal disease if untreated. Several clinical signs and biological markers are associated with glucocorticoid failure but the importance of these factors for diagnosing adrenal insufficiency is not known. In this study, we aimed to assess the prevalence of and the factors associated with adrenal insufficiency among patients admitted to an acute internal medicine ward. Methods Retrospective, case-control study including all patients with high-dose (250 μg ACTH-stimulation tests for suspected adrenal insufficiency performed between 2008 and 2010 in an acute internal medicine ward (n = 281. Cortisol values Results 32 patients (11.4% presented adrenal insufficiency; the others served as controls. Among all clinical and biological parameters studied, history of glucocorticoid withdrawal was the only independent factor significantly associated with patients with adrenal insufficiency (Odds Ratio: 6.71, 95% CI: 3.08 –14.62. Using a logistic regression, a model with four significant and independent variable was obtained, regrouping history of glucocorticoid withdrawal (OR 7.38, 95% CI [3.18 ; 17.11], p-value p-value 0.044, eosinophilia (OR 17.6, 95% CI [1.02; 302.3], p-value 0.048 and hyperkalemia (OR 2.41, 95% CI [0.87; 6.69], p-value 0.092. The AROC (95% CI was 0.75 (0.70; 0.80 for this model, with 6.3 (0.8 – 20.8 for sensitivity and 99.2 (97.1 – 99.9 for specificity. Conclusions 11.4% of patients with suspected adrenal insufficient admitted to acute medical ward actually do present with adrenal insufficiency, defined by an abnormal response to high-dose (250 μg ACTH-stimulation test. A history of glucocorticoid withdrawal was the strongest factor predicting the potential adrenal failure. The combination of a history of glucocorticoid withdrawal, nausea, eosinophilia and hyperkaliemia might be of interest to suspect adrenal insufficiency.

  20. 78 FR 17917 - Medical Waivers for Merchant Mariner Credential Applicants With a History of Seizure Disorders

    Science.gov (United States)

    2013-03-25

    ... be considered for a waiver. (1) Mariners with a history of epilepsy or seizure disorder may be... Waivers for Merchant Mariner Credential Applicants With a History of Seizure Disorders AGENCY: Coast Guard... of seizure disorders. Coast Guard regulations provide that convulsive disorders (also known as...

  1. Fatigue damage estimation using irregularity factor. First report, irregularity factor calculations for narrow and broadband random time histories

    Science.gov (United States)

    Susuki, I.

    1981-11-01

    The results of an analysis of the irregularity factors of stationary and Gaussian random processes which are generated by filtering the output of a pure or a band-limited white noise are presented. An ideal band pass filter, a trapezoidal filter, and a Butterworth type band pass filter were examined. It was found that the values of the irregularity factors were approximately equal among these filters if only the end-slopes were the same rates. As the band width of filters increases, irregularity factors increase monotonically and approach the respective constant values depending on the end-slopes. This implies that the noise characteristics relevant to the fatigue damage such as statistical aspects of the height of the rise and fall or the distribution of the peak values are not changed for a broad band random time history. It was also found that the effect of band limitation of input white noise on irregularity factors is negligibly small.

  2. Student-Life Stress Level and its Related Factors among Medical Students of Hamadan University of Medical Sciences in 2015

    OpenAIRE

    Roya Nikanjam; Majid Barati; Saeed Bashirian*; Mohammad Babamiri; Ali Fattahi; Alireza Soltanian

    2016-01-01

    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 dat...

  3. 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

  4. 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

  5. [Psychic factors in case histories of patients with alopecia areata--preliminary report].

    Science.gov (United States)

    Wygledowska-Kania, M; Bogdanowski, T

    1996-01-01

    We tested the significance of psychic factors in the etiopathogenesis of alopecia areata. We analysed the patient on the basis of a detailed examination based on the case history, including important events in his/her life, personality traits, serious events and the loss of emotional attachment. General important events happened to 80% of the patients, personality traits able to cause the disease were present in 73%, serious events in 62% and the loss of emotional attachment was also found in 62% of the patients. We tested 60 patients (31 women and 29 men). The evidence obtained from the detailed examination based on case histories indicated significantly frequent occurrence of the psychic factors preceding the occurrence of alopecia areata.

  6. Extrinsic and intrinsic factors that shape the life history of the short living scallop Argopecten ventricosus

    OpenAIRE

    Guerra, Citlali

    2011-01-01

    The scallop Argopecten ventricosus is characterized by its high swimming activity, fast growth, high reproductive effort and the early age to get first sexual maturity. These traits may be the result of the adaptation to a specific environment that favors an active lifestyle and a short lifespan (2 years). This opens the question of how environmental factors modulate the way a short living marine ectotherm budget energy investments among life history traits and how this modulation impacts the...

  7. Cardiovascular risk factors in Chinese women with a history of gestational diabetes mellitus

    OpenAIRE

    Mai, Caiyuan; Hou, Minming; Chen, Rong; Duan, Dongmei; Xu, Huikun; Lin, Xiaohong; Wen, Jiying; Lv, Lijuan; Lei, Qiong; Niu, Jianmin

    2015-01-01

    Background: Women with a history of gestational diabetes (GDM) are at increased risk of developing cardiovascular diseases compared with normal women. This study aimed to evaluate the cardiovascular risk factors in Chinese women with GDM. Methods: 453 women with GDM (cases) and 1,180 healthy women (controls) were included in this study. The post-partum examinations included 2 h 75 g oral glucose tolerance tests, lipid profiles, anthropometric measurements (blood pressure, height, weight) and ...

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

    Science.gov (United States)

    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 aim was to compare medical students’ career preferences upon entry into and exit from undergraduate medical degree programmes. Methods This was a cross-sectional questionnaire survey. Two cohorts [2009–10, 2010–11] of first and final year medical students at the four Scottish graduating medical schools took part in career preference questionnaire surveys. Questions were asked about demographic factors, career preferences and influencing factors. Results The response rate was 80.9% [2682/3285]. Significant differences were found across the four schools, most obviously in terms of student origin [Scotland, rest of UK or overseas], age group, and specialty preferences in Year 1 and Year 5. Year 1 and Year 5 students’ specialty preferences also differed within each school and, while there were some common patterns, each medical school had a different profile of students’ career preferences on exit. When the analysis was adjusted for demographic and job-related preferences, specialty preferences differed by gender, and wish for work-life balance and intellectual satisfaction. Conclusions This is the first multi-centre study exploring students’ career preferences and preference influences upon entry into and exit from undergraduate medical degree programmes. We found various factors influenced career preference, confirming prior findings. What this study adds is that, while acknowledging student intake differs by medical school, medical school itself seems to influence

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

    Science.gov (United States)

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

    2014-07-23

    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 aim was to compare medical students' career preferences upon entry into and exit from undergraduate medical degree programmes. This was a cross-sectional questionnaire survey. Two cohorts [2009-10, 2010-11] of first and final year medical students at the four Scottish graduating medical schools took part in career preference questionnaire surveys. Questions were asked about demographic factors, career preferences and influencing factors. The response rate was 80.9% [2682/3285]. Significant differences were found across the four schools, most obviously in terms of student origin [Scotland, rest of UK or overseas], age group, and specialty preferences in Year 1 and Year 5. Year 1 and Year 5 students' specialty preferences also differed within each school and, while there were some common patterns, each medical school had a different profile of students' career preferences on exit. When the analysis was adjusted for demographic and job-related preferences, specialty preferences differed by gender, and wish for work-life balance and intellectual satisfaction. This is the first multi-centre study exploring students' career preferences and preference influences upon entry into and exit from undergraduate medical degree programmes. We found various factors influenced career preference, confirming prior findings. What this study adds is that, while acknowledging student intake differs by medical school, medical school itself seems to influence career preference. Comparisons across medical school

  10. The Stability of Factors Influencing the Choice of Medical Specialty Among Medical Students and Postgraduate Radiology Trainees.

    Science.gov (United States)

    Yen, Adam J; Webb, Emily M; Jordan, Eric J; Kallianos, Kimberly; Naeger, David M

    2018-06-01

    To investigate whether general psychological motivating factors that guide career selection of a medical specialty differ over the course of medical school and to compare differences in motivating factors among students choosing "controllable" lifestyle specialties, students choosing "uncontrollable" lifestyle specialties, and a cohort of radiology residents. An anonymous survey was distributed to first- through fourth-year medical students and radiology residents at a single institution. Participants were asked to select their top three of seven factors that most influenced their choice of medical specialty. Fourth-year students were asked to designate the specialty to which they had applied. The survey was distributed to 259 students and 47 radiology residents with a response rate of 93.8% (243 of 259) and 95.7% (45 of 47), respectively. The top three factors indicated by medical students were finding the daily work fulfilling, work-life balance, and interest in the subject. These top three factors were common to all medical student classes and did not differ between students choosing "controllable" versus "uncontrollable" fields. The factors uncommonly selected were similar personality to others in the field, attending income, competitiveness or prestige, and job market conditions. For radiology residents, the top three motivating factors were the same as for medical students. Three out of seven motivating factors were universally important to trainees, regardless of their stage of medical training or their selection of a controllable versus uncontrollable lifestyle specialty. These data suggest the variety of career choices made by students may not derive from differing underlying values. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  11. Risk factors for prostate cancer in Universiti Kebangsaan Malaysia Medical Centre: a case-control study.

    Science.gov (United States)

    Subahir, Mohd Nizam; Shah, Shamsul Azhar; Zainuddin, Zulkifli Md

    2009-01-01

    In Malaysia, prostate cancer is ranked 6th among male cancer and expected to increase in the future. Several factors have shown to be related to prostate cancer such as sociodemographic, lifestyle, diet, occupational exposure, medical and health status. This is the first time a similar study was conducted in Malaysia to recognize the risk factors for prostate cancer patients who came for treatment at University Kebangsaan Malaysia Medical Centre (UKMMC). Prostate cancer cases diagnosed between 2003 and 2008 which met with the inclusion criteria were included in the study. One hundred and twelfth (112) pairs of cases and controls matched by age and ethnicity were analysed. McNemar Odds Ratios (OR(M)) were calculated using McNemar Calculator software for univariate analysis while conditional logistic regression was used for multivariate analysis, both using SPSS version 12.0. Most of the prostate cancer patients (68.8%) that came for treatment in UKMMC were above 70 years old. The majority were Chinese (50.0%) followed by Malay (46.4%) and Indian (3.6%). Multivariate analysis showed cases were more likely to have a first-degree relative with a history of cancer (OR= 3.77, 95% CI= 1.19-11.85), to have been exposed to pesticides (OR= 5.57, 95% CI= 1.75-17.78) and consumed more meat (OR= 12.23, 95% CI= 3.89-39.01). Significantly reduced risks of prostate cancer were noted among those consuming more vegetables (OR= 0.12, 95% CI= 0.02-0.84), more tomatoes (OR= 0.35, 95% CI= 0.13-0.93) and those who had frequent sexual intercourse (OR= 0.44, 95% CI= 0.19-0.96). Some lifestyle and occupation factors are strong predictors of the occurrence of prostate cancer among patients in UKMMC. More importantly, with the identification of the potentially modifiable risk factors, proper public health intervention can be improved.

  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. 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

    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. 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. 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.

  14. 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.

  15. The effective factors on library anxiety of students in Isfahan University of Medical Sciences and Shiraz University of Medical Sciences.

    Science.gov (United States)

    Ashrafi-Rizi, Hasan; Sajad, Maryam Sadat; Rahmani, Sedigheh; Bahrami, Susan; Papi, Ahmad

    2014-01-01

    The efficient use of libraries can be an important factor in determining the educational quality of Universities. Therefore, investigation and identification of factors affecting library anxiety becomes increasingly necessary. The purpose of this research is to determine the factors effecting library anxiety of students in Isfahan University of Medical Sciences and Shiraz University of Medical Sciences. This was an applied survey research using Bostick's Library Anxiety questionnaire as data gathering tool. The statistical population consisted of all students of Isfahan University of Medical Sciences and Shiraz University of Medical Sciences (15011 students) with the sample size of 375 using stratified random sampling. The validity of data gathering tool was confirmed by experts in the library and information science and its reliability was determined by Cronbach's alpha (r = 0.92). Descriptive statistics (frequency, percentage, mean and standard deviation) and inferential statistics (t-test and ANOVA) were used for data analysis using SPSS 18 software. Findings showed that the mean of library anxiety score was 2.68 and 2.66 for students of Isfahan University of Medical Sciences and Shiraz University of Medical Sciences respectively which is above average (2.5). Furthermore, age and gender had no meaningful effect on the library anxiety of students of Isfahan University of Medical Sciences, but gender had a meaningful effect on library anxiety of students of Shiraz University of Medical Sciences while age had no such effect. The results showed that the mean of factors effecting library anxiety in students of Isfahan University of Medical Sciences and students of Shiraz University of Medical Sciences is higher than average and therefore not satisfactory and only factors relating to feeling comfortable in the library is lower than average and somewhat satisfactory.

  16. 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.

  17. Single versus recurrent depression history: differentiating risk factors among current US smokers.

    Science.gov (United States)

    Strong, David R; Cameron, Amy; Feuer, Shelley; Cohn, Amy; Abrantes, Ana M; Brown, Richard A

    2010-06-01

    The strong relationship between persistent tobacco use and Major Depressive Disorder (MDD) has motivated clinical trials of specialized treatments targeting smokers with a history of MDD. Meta-analyses suggest positive responses to specialized treatments have been observed consistently among smokers with history of recurrent rather than a single episode of MDD. Approximately 15% of current US smokers have a history of recurrent MDD. Little is known about the risk factors that contribute to persistent smoking and differentiate these at-risk smokers, US. The National Comorbidity Survey - Replication (NCS-R) included a survey of 1560 smokers participants aged 18 and older in the United States. Lifetime history of MDD was categorized according to chronicity: no history (No MDD), single episode (MDD-S) and recurrent depression (MDD-R). The relationship between the chronicity of MDD, smoking characteristics, cessation history, nicotine dependence, comorbidity with psychiatric disorders, and current functional impairments were examined. MDD-R smokers reported fewer lifetime cessation efforts, smoked more cigarettes, had higher levels of nicotine dependence, had higher rates of comorbid psychiatric disorders and greater functional impairment than smokers with No MDD. MDD-S smokers were not consistently distinguished from No MDD smokers on cessation attempts, level of daily smoking, nicotine dependence or functional impairment indices. The study highlights the importance of chronicity when characterizing depression-related risk of persistent smoking behavior. Although, clinical trials suggest MDD-R smokers specifically benefit from specialized behavioral treatments, these services are not widely available and more efforts are needed to engage MDD-R smokers in efficacious treatments. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  18. 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 (women treated). Hypercholesterolemia was controlled (low-density lipoprotein cholesterol 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 DM2 were adequately controlled; hypercholesterolemia control was particularly low. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  19. 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.

  20. Analysis of Factors that Predict Clinical Performance in Medical School

    Science.gov (United States)

    White, Casey B.; Dey, Eric L.; Fantone, Joseph C.

    2009-01-01

    Academic achievement indices including GPAs and MCAT scores are used to predict the spectrum of medical student academic performance types. However, use of these measures ignores two changes influencing medical school admissions: student diversity and affirmative action, and an increased focus on communication skills. To determine if GPA and MCAT…

  1. Factors that affect medical students' performance in Anatomy in the ...

    African Journals Online (AJOL)

    Background: Much attention has been drawn to the area of medical education in contemporary times with the aim of developing effective teaching strategies in our medical schools. Objectives: To identify the problems encountered by students in the study of Anatomy and suggest ways of enhancing their performance in the ...

  2. [History of diaphanoscopy. Pictures from the history of otorhinolaryngology, illustrated by instruments from the collection of the Ingolstadt German Medical History Museum].

    Science.gov (United States)

    Feldmann, H

    1998-05-01

    introduced this technique prior to Voltolini. Voltolini had died in 1889 and could not comment on this. A careful study of the original publications, however, shows that Cozzolino had only inspected the nasal cavity with retronasal illumination, but had not demonstrated the maxillary sinus by transillumination. The diaphanoscopy of the paranal sinuses was very soon elaborated to perfection: Vohse in 1890 applied it to the frontal sinuses, Gerber in 1900 invented a double diaphanoscope for examining both frontal sinuses simultaneously. Although the shortcomings of diaphanoscopy soon became apparent, the method was widely used for about half a century, but in the end could not compete with modern techniques of radiography and ultrasound. The history is related in detail and illustrated with numerous figures.

  3. Smoking Prevalence and Associated Factors to Quit among Tabriz Dormitory University Medical Students, Tabriz, Iran

    Directory of Open Access Journals (Sweden)

    Shamsipour M.

    2012-04-01

    Full Text Available Background and Objectives: Cigarette smoking as a major public health problem contributes extra health costs, and smoking cessation among youths is a priority for any prevention program. This study aimed to determine the prevalence of smoking and examined factors associated with having attempts to quit smoking and the motivations to quit among medical university students. Methods: A cross-sectional survey using a random sampling was carried out among 523 (293 male, and 246 female, aged 22.48±3.33years students in Tabriz University of Medical Sciences. Data were collected by using a self-administered questionnaire. The data were analyzed by t-test, chi-square test and Fisher exact tests.Results: The overal prevalence of smoking was 8.9%. (male 18% and 1.4% female. There were significant relationships between smoking status with male gender and alcohol consumption (p<0.001. The reasons for smoking initiation were: satisfying their curiosity, new experience (37.76%, pleasure and entertainment (17.48%, mental, emotional problems and sedation (16.08%, smoker friends (15.38%, inexperience and ignorance (4.89%. 54.16% of the current smokers had a history of smoking cessation.Conclusion: Regarding the higher prevalence of cigarette smoking in students, especialy in male and attempting to quit smoking in majority of them, preventive interventions in younger age and providing cigarette smoking cessation services for students seem necessary.

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

    Science.gov (United States)

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

    2007-10-01

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

  5. 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.

  6. Individual and hospital-specific factors influencing medical graduates' time to medical specialization.

    Science.gov (United States)

    Johannessen, Karl-Arne; Hagen, Terje P

    2013-11-01

    Previous studies of gender differences in relation to medical specialization have focused more on social variables than hospital-specific factors. In a multivariate analysis with extended Cox regression, we used register data for socio-demographic variables (gender, family and having a child born during the study period) together with hospital-specific variables (the amount of supervision available, efficiency pressure and the type of teaching hospital) to study the concurrent effect of these variables on specialty qualification among all 2474 Norwegian residents who began specialization in 1999-2001. We followed the residents until 2010. A lower proportion of women qualified for a specialty in the study period (67.9% compared with 78.7% of men, p specialization qualification (p specialization: working at university hospitals (regional) or central hospitals was associated with a reduction in the time taken to complete the specialization, whereas an increased patient load and less supervision had the opposite effect. Multivariate analysis showed that the smaller proportion of women who qualified for a specialty was explained principally by childbirth and by the number of children aged under 18 years. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. "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. © The Author 2013. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Cross-sectional study of frequency and factors associated with stethoscope cleaning among medical practitioners in Pakistan.

    Science.gov (United States)

    Hyder, O

    2012-07-01

    Stethoscope diaphragms are frequently colonized by bacteria. This cross-sectional study described the frequency and factors associated with reporting ever cleaning stethoscopes among 408 medical students and doctors at a medical college and 2 teaching hospitals in Rawalpindi, Pakistan. A minority of the respondents (37.7%) reported having ever cleaned their stethoscope. Following normal clinical use, wiping with a dry cloth was the most frequently reported method of cleaning (53.2%). After contamination of the diaphragm with blood or secretions, cleaning with an alcoholic swab was the most common method (64.3%). In univariate and multivariate analyses, history of receiving information on stethoscope cleaning, utilization of personal stethoscope at last use and affiliation with internal medicine department were factors strongly associated with ever cleaning of stethoscope. Future research for improving stethoscope cleaning practices should explore educational interventions aimed at health care professionals.

  9. 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

  10. The Prevalence of and Factors Associated with Neck, Shoulder, and Low-Back Pains among Medical Students at University Hospitals in Central Saudi Arabia.

    Science.gov (United States)

    Algarni, Abdulrahman D; Al-Saran, Yazeed; Al-Moawi, Ahlam; Bin Dous, Abdullah; Al-Ahaideb, Abdulaziz; Kachanathu, Shaji John

    2017-01-01

    The study aim was to determine the prevalence of neck, shoulder, and low-back pains and to explore the factors associated with musculoskeletal pain (MSP) among medical students at university hospitals in central Saudi Arabia. This cross-sectional study was conducted at a government institution using an online self-administered, modified version of the Standardised Nordic Questionnaire in the English language. A total of 469 students responded to our survey. The prevalence of MSP in at least one body site at any time, in the past week, and in the past year was 85.3%, 54.4%, and 81.9%, respectively. Factors significantly associated with MSP in at least one body site at any time were being in the clinical year ( P = 0.032), history of trauma ( P   =  0.036), history of depressive symptoms ( P < 0.001), and history of psychosomatic symptoms ( P < 0.001). On multivariable regression analysis, factors associated with MSP were history of trauma ( P = 0.016) and depressive ( P = 0.002) or psychosomatic symptoms ( P = 0.004). MSP among Saudi medical students is high, particularly among those in the clinical years and those with history of trauma and with depressive or psychosomatic symptoms. Medical institutions should be aware of this serious health issue and preventive measures are warranted.

  11. [From otoscope to ophthalmoscope and back. The interwoven history of their invention and introduction into medical practice. Pictures from the history of otorhinolaryngology, illustrated by instruments from the collection of the Ingolstadt German Medical History Museum].

    Science.gov (United States)

    Feldmann, H

    1995-11-01

    Friedrich Hofmann, medical officer in Burgsteinfurt, Westphalia, Germany, in 1841 described a concave mirror with a central aperture in it as the ideal instrument that allowed reflecting and focussing light into the external auditory canal and simultaneously inspecting the tympanic membrane without obstructing either the light or the view. He recommended his device also for the inspection of other concealed regions of the body. His invention was referred to by Martell Frank in his textbook of otology in 1845, but otherwise attracted no attention. Hermann Helmholtz, physiologist in Königsberg, East Prussia, devised his ophthalmoscope in 1850-51 in order to study the phenomenon of glowing eyes. With this instrument he was the first to see the retina of a living human. As means of illumination he used small panes of glass similar to cover-glasses which were introduced into the common visual axis of the observer and the subject at such an angle that light from a lamp was reflected into the subject's eye while the observer inspected the subject's retina through the glass and an appropriate lens. He recommended this type of illumination also for otoscopy. His invention was at once acclaimed throughout the world and opened completely new opportunities in ophthalmology. The slanting panes of glass, however, were not the ideal solution for illumination. It was only one year later that Ruete in Göttingen replaced them with a concave mirror with a central aperture, and there is every indication that Frank's report on Hofmann's mirror had suggested this technique to him. During the following two years quite a number of other modifications of the ophthalmoscope were constructed, all of them using the concave mirror with a central aperture, which soon became synonymous with the ophthalmoscope as such. Von Tröltsch, otologist and ophthalmologist in Würzburg, presented a concave mirror with a central aperture for otoscopy in Paris in 1855-56. His instrument was obviously

  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. The relationship between patient-related factors and medication ...

    African Journals Online (AJOL)

    2017-09-03

    Sep 3, 2017 ... Health Outcomes and Pharmacy Practice Division, The University of Texas at Austin College of Pharmacy,. Austin ... medication for life with at as high as 95% adherence for ..... for improving patients' organizational skills.

  14. Factors affecting medical waste management in lowlevel health ...

    African Journals Online (AJOL)

    African Journal of Environmental Science and Technology ... evaluation of medical waste management systems was conducted in the low-level health ... In Ilala, 70% of the health facilities burn wastes in poorly designed incinerators, open pit ...

  15. 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

  16. 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.

  17. Clinical relevance of and risk factors associated with medication administration time errors

    NARCIS (Netherlands)

    Teunissen, R.; Bos, J.; Pot, H.; Pluim, M.; Kramers, C.

    2013-01-01

    PURPOSE: The clinical relevance of and risk factors associated with errors related to medication administration time were studied. METHODS: In this explorative study, 66 medication administration rounds were studied on two wards (surgery and neurology) of a hospital. Data on medication errors were

  18. 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

  19. Serum alpha-fetoprotein in the three trimesters of pregnancy: effects of maternal characteristics and medical history.

    Science.gov (United States)

    Bredaki, F E; Sciorio, C; Wright, A; Wright, D; Nicolaides, K H

    2015-07-01

    To define the contribution of maternal variables which influence the measured level of maternal serum alpha-fetoprotein (AFP) in screening for pregnancy complications. Maternal characteristics and medical history were recorded and serum AFP was measured in women with a singleton pregnancy attending for three routine hospital visits at 11 + 0 to 13 + 6, 19 + 0 to 24 + 6 and 30 + 0 to 34 + 6 weeks' gestation. For pregnancies delivering phenotypically normal live births or stillbirths ≥ 24 weeks' gestation, variables from maternal demographic characteristics and medical history that are important in the prediction of AFP were determined from a linear mixed-effects multiple regression. Serum AFP was measured in 17 071 cases in the first trimester, 8583 in the second trimester and 8607 in the third trimester. Significant independent contributions to serum AFP were provided by gestational age, maternal weight, racial origin, gestational age at delivery and birth-weight Z-score of the neonate of the previous pregnancy and interpregnancy interval. Cigarette smoking was found to significantly affect serum AFP in the first trimester only. The machine used to measure serum AFP was also found to have a significant effect. Random-effects multiple regression analysis was used to define the contribution of maternal variables that influence the measured level of serum AFP and express the values as multiples of the median (MoMs). The model was shown to provide an adequate fit of MoM values for all covariates, both in pregnancies that developed pre-eclampsia and in those without this pregnancy complication. A model was fitted to express measured serum AFP across the three trimesters of pregnancy as MoMs, after adjusting for variables from maternal characteristics and medical history that affect this measurement. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

  20. 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.

  1. The Research on Influencing Factors of Medical Logistics Cost Based on ISM Model

    Directory of Open Access Journals (Sweden)

    Zhai Yunkai

    2017-01-01

    Full Text Available The reason why medical logistics cost remains high is a system problem, this paper analyzes the system through the ISM model. The result presents that medical logistics cost factors have four levels of relationship, primary factor is the national policies, secondary factors are the talent construction and pharmaceutical enterprise scale, Intermediate factors are medical information management system and inventory cost, the key factors are transportation cost and distribution center location. Finally, according to the four levels of relationship, this paper put forward specific suggestions to reduce logistics cost.

  2. On history of medical radiology development in Ukraine: war period and after war reconstruction (1941-1947)

    International Nuclear Information System (INIS)

    Pilipenko, M.Yi.; Artamonova, N.O.; Busigyina, N.O.; Kononenko, O.K.

    1994-01-01

    The paper is devoted to history of Ukrainian medical radiology development, namely main problems of its scientific and practical aspects of development during 1941-1947. The authors describe the work of Ukrainian roentgenologists and radiologists during the war and after war restoration of radiological service. Contribution of Ukrainian scientists to practical and theoretical achievements of military roentgenology is shown. Operative mobilization of all the forces for restoration of destroyed during the war years roentgenological service allowed to start scientific research within a short term (already in 1945)

  3. Comparison of lifestyle risk factors by family history for gastric, breast, lung and colorectal cancer.

    Science.gov (United States)

    Huang, Xin-En; Hirose, Kaoru; Wakai, Kenji; Matsuo, Keitaro; Ito, Hidemi; Xiang, Jin; Takezaki, Toshiro; Tajima, Kazuo

    2004-01-01

    To assess the theoretical impact of lifestyle of a cancer family history in first-degree relatives (CFH) and clarify interactions between CFH and lifestyle factors, hospital-based comparison and case-reference studies were conducted in Nagoya, Japan. Totals of 1988 gastric, 2455 breast, 1398 lung and 1352 colorectal cancer patients, as well as 50,706 non-cancer outpatients collected from 1988 to 1998, were checked for lifestyle factors, which included dietary and physical exercise habits, as well as smoking/drinking status. General lifestyle factors with non-cancer outpatients did not differ by the CFH status. Case-reference analyses showed that frequent intake of fruits, raw vegetables, carrots, pumpkin, cabbage and lettuce, as well as frequent physical exercise, were associated with decreased risk for all four sites of cancer, while habitual smoking increasing the risk of gastric, and more particularly, lung cancer. Interestingly, the study revealed the magnitude of odds ratios for the above lifestyle factors obtained from CFH positives to be similar to those from CFH negatives for these four sites of cancer. There were no significant interactions between CFH and any particular lifestyle factor. In conclusion, our results suggest no appreciable influence of CFH on lifestyle related risk factors for gastric, breast, lung, and colorectal cancer. Habitual smoking increased, while frequent physical exercise and raw vegetables intake decreased cancer risk, regardless of the CFH status.

  4. Development of a Computerized Medical History Profile for Children in Out-of-Home Placement Using Medicaid Data

    Science.gov (United States)

    Chisolm, Deena J.; Scribano, Philip V.; Purnell, Tanjala S.; Kelleher, Kelly J.

    2010-01-01

    Children in out-of-home placements (foster children) often undergo multiple placement changes while under the care of child protective services. This instability can result in lack of health care continuity and poor health outcomes. This brief describes the development of a medical history profile, or passport, developed from Medicaid administrative data. A purposive sample of 25 youths was provided from a county child protective services agency. The patients were systematically matched with data from the state Medicaid agency. Using Medicaid claims/encounter data we generated health care profiles that provided information on historical use of ambulatory care, diagnoses, providers seen, medications used, and inpatient admissions. Profiles were however limited by missing provider information and non-specific diagnostic coding. Despite these limitations, Medicaid data-based profiles show the potential to be a cost efficient method for improving continuity of care for children in out-of-home placement. PMID:19648702

  5. 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%, p<0.001). Traditional risk 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.

  6. From Risk factors to health resources in medical practice

    DEFF Research Database (Denmark)

    Hollnagel, Hanne; Malterud, Kirsti

    2000-01-01

    autonomy, communication, empowerment, epidemiology, general practice, healing, health resources, informed consent, preventive medicine, risk factors, salutogenesis......autonomy, communication, empowerment, epidemiology, general practice, healing, health resources, informed consent, preventive medicine, risk factors, salutogenesis...

  7. The joint impact of family history of myocardial infarction and other risk factors on 12-year coronary heart disease mortality

    NARCIS (Netherlands)

    Boer, J M; Feskens, E.J.; Verschuren, W M Monique; Seidell, J C; Kromhout, D.

    1999-01-01

    We investigated the impact of family history of myocardial infarction on 12-year coronary heart disease mortality. Men and women with a family history had an increased risk for coronary heart disease death, irrespective of other risk factors (RR = 1.58; 95% CI = 1.17-2.13 and RR = 2.12; 95% CI =

  8. A systematic review of factors influencing student ratings in undergraduate medical education course evaluations

    OpenAIRE

    Schiekirka, Sarah; Raupach, Tobias

    2015-01-01

    Background Student ratings are a popular source of course evaluations in undergraduate medical education. Data on the reliability and validity of such ratings have mostly been derived from studies unrelated to medical education. Since medical education differs considerably from other higher education settings, an analysis of factors influencing overall student ratings with a specific focus on medical education was needed. Methods For the purpose of this systematic review, online databases (Pu...

  9. 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

  10. 50th Anniversary International Medical Informatics Association (IMIA) History Working Group and Its Projects.

    Science.gov (United States)

    Kulikowski, Casimir A; Mihalas, George; Greenes, Robert; Yacubsohn, Valerio; Park, Hyeoun-Ae

    2017-01-01

    The IMIA History Working Group has as its first goal the editing of a volume of contributions from pioneers and leaders in the field of biomedical and health informatics (BMHI) to commemorate the 50th anniversary of IMIA's predecessor IFIP-TC4. This paper describes how the IMIA History WG evolved from an earlier Taskforce, and has focused on producing the edited book of original contributions. We describe its proposed outline of objectives for the personal stories, and national and regional society narratives, together with some comments on the evolution of Medinfo meeting contributions over the years, to provide a reference source for the early motivations of the scientific, clinical, educational, and professional changes that have influenced the historical course of our field.

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

    African Journals Online (AJOL)

    None of the male students but 12 of the female students (30%) considered gender distribution to be a factor influencing their career choice (p=0.046). Conclusion. This study indicates that paediatrics is popular among female students and that several factors influence choice of this specialty. Understanding these factors may ...

  12. Becoming a general practitioner - Which factors have most impact on career choice of medical students?

    OpenAIRE

    Loh Andreas; Hermann Katja; Miksch Antje; Kiolbassa Kathrin; Szecsenyi Joachim; Joos Stefanie; Goetz Katja

    2011-01-01

    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 ...

  13. 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.

  14. Factors influencing the decision to pursue emergency medicine as a career among medical students in Singapore.

    Science.gov (United States)

    Chew, Shi Hao; Ibrahim, Irwani; Yong, Yan Zhen; Shi, Lu Ming; Zheng, Qi Shi; Samarasekera, Dujeepa D; Ooi, Shirley Beng Suat

    2018-03-01

    The introduction of the residency programme in Singapore allows medical students to apply for residency in their graduating year. Our study aimed to determine the interest levels and motivating factors for pursuing emergency medicine (EM) as a career among medical students in Singapore. A self-administered questionnaire was distributed to Year 1-5 medical students in 2012. Participants indicated their interest in pursuing EM as a career and the degree to which a series of variables influenced their choices. Influencing factors were analysed using multinomial logistic regression. A total of 800 completed questionnaires were collected. 21.0% of the participants expressed interest in pursuing EM. Perceived personality fit and having done an elective in EM were strongly positive influencing factors. Junior medical students were more likely to cite the wide diversity of medical conditions and the lack of a long-term doctor-patient relationship to be negative factors, while senior medical students were more likely to cite personality fit and perceived prestige of EM as negative factors. Careful selection of EM applicants is important to the future development of EM in Singapore. Our study showed that personality fit might be the most important influencing factor in choosing EM as a career. Therefore, greater effort should be made to help medical students explore their interest in and suitability for a particular specialty. These include giving medical students earlier exposure to EM, encouraging participation in student interest groups and using appropriate personality tests for career guidance. Copyright: © Singapore Medical Association.

  15. [Maimonides, a physician in the 12 century. Contribution to the history of medical ethics and deontology].

    Science.gov (United States)

    Pavlović, B

    2000-01-01

    Maimonides, Moses ben Maimon (1135-1204), Jewish physician, philosopher and scholar was the first after Hippocrates to write a text of a "prayer" he spoke out at the beginning of his medical profession, e. i. when he took oath. The text of "Maimonides's prayer" is today obligatory in some schools of medicine in the United States of America.

  16. 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. © The Author(s) 2014.

  17. Factors associated with motivation in medical education: a path analysis.

    Science.gov (United States)

    Kunanitthaworn, Natchaya; Wongpakaran, Tinakon; Wongpakaran, Nahathai; Paiboonsithiwong, Salilthip; Songtrijuck, Natchaphon; Kuntawong, Pimolpun; Wedding, Danny

    2018-06-18

    This study identified and investigated the relationship between demographics, mental health problems, positive personality traits and perceived social support and motivation in medical education (MME) among first year medical students. One hundred-thirty eight first year medical students completed the Academic Motivation Scale, Outcome Inventory, Strength Based Inventory, and Multidimensional Scale for Perceived Social Support. Path analysis was conducted to identify relationships between the variables of interest and each type of motivation, including intrinsic and extrinsic motivation and amotivation. The mean age of the sample was 18.86 ± 0.74 and 60% of the subjects were female. Path analysis showed that extrinsic motivation was positively associated with being female, personal choice for studying medicine, and grade point average at high school. Intrinsic motivation was correlated with perceived family support, personal choice for studying medicine and the positive attribute of determination. Amotivation was related to being male, personal choice, and depression. While both extrinsic and intrinsic motivation were correlated, they were uncorrelated with amotivation. All variables accounted for 18, 13, and 45% of variance of intrinsic motivation, extrinsic motivation and amotivation, respectively. Each type of motivation has different but related predictors. Extrinsic and intrinsic motivation can be promoted, whereas amotivation represents an exclusive issue, one related more to depression, that needs to be reduced to not interfere with academic achievement and quality of life of medical students.

  18. 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.

  19. Post-Mastectomy and Phantom Breast Pain: Risk Factors, Natural History, and Impact on Quality of Life

    National Research Council Canada - National Science Library

    Dworkin, Robert

    1999-01-01

    ... from substantial reductions in quality of life. The primary aims of this research project are to identify risk factors for these chronic pain syndromes following surgical procedures for breast cancer, characterize their natural history...

  20. Concern beliefs in medications: changes over time and medication use factors related to a change in beliefs.

    Science.gov (United States)

    Shiyanbola, Olayinka O; Farris, Karen B; Chrischilles, Elizabeth

    2013-01-01

    Concern belief in medication is a construct that may characterize patients' attitude toward managing medicines, and this could change with time. Understanding the factors that would impact a change in concern beliefs would be helpful in interventions that could reframe patients' perceptions about their medicines. To examine if patient concern beliefs in medications change over time, assess the characteristics of individuals whose beliefs change, and determine what factors might impact a change in patient beliefs. Secondary data analysis using 2 longitudinal studies. The first study was an Internet-based survey of Medicare enrollees pre-post Medicare Part D. The second study was a randomized controlled trial evaluating a medication management intervention among adults with physical limitations. Respondents were classified as those whose beliefs remained stable and those whose beliefs increased and decreased over 2 separate periods. Chi-square analysis examined significant differences across the groups. Multiple linear regressions examined factors that influence changes in patient beliefs. Among older adults, there were differences in perceived health status (χ(2)=26.05, P=.001), number of pharmacies used (χ(2)=17.41, P=.008), and number of medicines used after the start of Medicare Part D. There were no significant differences among adults with physical limitations. Among older adults, having an increased number of medicines over time and reporting a self-reported adverse effect to a physician were positively associated with an increase in concern beliefs in medication. Having an increase in adherence was associated with a decrease in concern beliefs over time. Concern beliefs in medications may contribute independent information about individuals' response to drug programs and policies. Outcomes of medication use may influence patient anxieties about medicines. The instability of patient concerns in medications that occurs with prescription drug coverage changes

  1. 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***, pstudents were overweight, high prevalence of cardiovascular risk factors like family history, elevated blood pressure and less SpO2.

  2. A history of shaker nurse-herbalists, health reform, and the american botanical medical movement (1830-1860).

    Science.gov (United States)

    Libster, Martha M

    2009-12-01

    During the mid 19th century, herbal remedies were the platform for a major health reform movement in America known as the Botanical Medical Movement (BMM). A number of histories have been written on the BMM from the perspectives of physicians and pharmacists. This article describes the history of nurse-herbalism during the period and the impact that Shaker nurses, in particular, had on the BMM. The article traces the history and findings of a triangulated case study. Shaker nurses used herbs extensively in their caring and curing practices. They applied the botanical remedies recommended by BMM leaders. The nurses were also expert herbal medicine makers who used their own remedies in patient care. The Shaker infirmary was the nurses' behind-the-scenes research and development laboratory for the Shaker herbal cottage industry, which ultimately developed into an international, entrepreneurial endeavor. The Shaker infirmary was the nurses' organized proving ground for the implementation of the botanical health reforms of the mid 19th century. The nurse-herbalists' contribution to the promotion and production of herbal remedies had a significant impact on the success of botanical health reform in America.

  3. [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.

  4. History and Outcomes of 50 Years of Physician-Scientist Training in Medical Scientist Training Programs.

    Science.gov (United States)

    Harding, Clifford V; Akabas, Myles H; Andersen, Olaf S

    2017-10-01

    Physician-scientists are needed to continue the great pace of recent biomedical research and translate scientific findings to clinical applications. MD-PhD programs represent one approach to train physician-scientists. MD-PhD training started in the 1950s and expanded greatly with the Medical Scientist Training Program (MSTP), launched in 1964 by the National Institute of General Medical Sciences (NIGMS) at the National Institutes of Health. MD-PhD training has been influenced by substantial changes in medical education, science, and clinical fields since its inception. In 2014, NIGMS held a 50th Anniversary MSTP Symposium highlighting the program and assessing its outcomes. In 2016, there were over 90 active MD-PhD programs in the United States, of which 45 were MSTP supported, with a total of 988 trainee slots. Over 10,000 students have received MSTP support since 1964. The authors present data for the demographic characteristics and outcomes for 9,683 MSTP trainees from 1975-2014. The integration of MD and PhD training has allowed trainees to develop a rigorous foundation in research in concert with clinical training. MSTP graduates have had relative success in obtaining research grants and have become prominent leaders in many biomedical research fields. Many challenges remain, however, including the need to maintain rigorous scientific components in evolving medical curricula, to enhance research-oriented residency and fellowship opportunities in a widening scope of fields targeted by MSTP graduates, to achieve greater racial diversity and gender balance in the physician-scientist workforce, and to sustain subsequent research activities of physician-scientists.

  5. 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.

  6. 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.

  7. Anti-tuberculosis medication-induced oculogyric crisis and the importance of proper history taking

    Directory of Open Access Journals (Sweden)

    Wong LH

    2017-10-01

    Full Text Available Lin Ho Wong,1 Endean Tan2 1University College Cork, Cork, Ireland; 2Tan Tock Seng Hospital, Singapore Abstract: Oculogyric crisis (OGC, frequently caused by medications such as antiemetics, antidepressants, and anti-epileptics, is an acute dystonic reaction of the ocular muscles. It consists of wide-staring gaze (lasting variably from seconds to minutes, seizures, and a widely-opened mouth. To date, there have been no reports of anti-tuberculosis medications such as rifampicin, isoniazid, pyrazinamide or ethambutol inducing OGC. It is of utmost importance to recognize this adverse reaction, which could be incorrectly diagnosed as an anaphylactic-like reaction. In this paper, we highlight a case of a 66-year-old Indian man who presented with OGC induced by anti-tuberculosis medications which was initially suspected to be an anaphylactic reaction and was subsequently halted with the administration of diphenhydramine. Keywords: oculogyric crisis, tuberculosis, rifampicin, isoniazid, ethambutol, adverse drug reaction 

  8. History of the medical uses of radiation regulatory and voluntary standards of protection

    International Nuclear Information System (INIS)

    Brodsky, A.; Kathren, R.L.; Willis, Ch.A.

    1996-01-01

    The main focus of this paper is on the historical development of safety in the use of radiation or radioactive materials in medicine. However, to provide better understanding and perspective on this history, it must be interwoven with major events and advancements in the development and use of radiation, particularly in the field of medicine. Since this history, as well as that of major events that stimulated the development of radiation protection standard, is extensive, only a very brief overview can be given here. Thus, a sufficient list of references is also provided to allow further examination of detailed historical documentation, and to provide an easier entry into further research. Also, some identification of individuals who have made important contributions to the development of standards, but who are not widely identified in either the relevant standards or the historical literature, is included. This will aid the serious historian in examining files of organizations to uncover facts or nationals that could better explain historical events or developments. (author), 233 Refs., 1 Tabs

  9. Impulsive aggression, delay discounting, and adolescent suicide attempts: effects of current psychotropic medication use and family history of suicidal behavior.

    Science.gov (United States)

    Bridge, Jeffrey A; Reynolds, Brady; McBee-Strayer, Sandra M; Sheftall, Arielle H; Ackerman, John; Stevens, Jack; Mendoza, Kristen; Campo, John V; Brent, David A

    2015-03-01

    Impulsive-aggressive behaviors have been consistently implicated in the phenomenology, neurobiology, and familial aggregation of suicidal behavior. The purpose of this study was to extend previous work by examining laboratory behavioral measures of delayed reward impulsivity and impulsive aggression in adolescent suicide attempters and never-suicidal comparison subjects. Using the Point Subtraction Aggression Paradigm (PSAP) and the Delay Discounting Task (DDQ), the authors examined delay discounting and impulsive aggression in 40 adolescent suicide attempters, ages 13-18, and 40 never-suicidal, demographically matched psychiatric comparison subjects. Overall, suicide attempters and comparison subjects performed similarly on the PSAP and DDQ. There was a significant group by current psychotropic medication use interaction (p=0.013) for mean aggressive responses on the PSAP. Group comparisons revealed that attempters emitted more aggressive responses per provocation than comparison subjects, only in those not on psychotropic medication (p=0.049), whereas for those currently treated with psychotropic medication, there were no group differences (p>0.05). This interaction effect was specific to current antidepressant use. Among all subjects, family history of suicidal behavior (suicide or suicide attempt) in first degree relatives was significantly correlated with both delay discounting (r=-0.22, p=0.049), and aggressive responding (r=0.27, p=0.015). Family history of suicidal behavior was associated with delay discounting, but not with aggressive responding on the PSAP, after controlling for relevant covariates. In this study, impulsive-aggressive responding was associated with suicide attempt only in those not being treated with antidepressants. Future work to replicate and extend these findings could have important therapeutic implications for the treatment of depressed suicide attempters, many of whom are affected by impulsive aggression.

  10. Texas Medication Algorithm Project, phase 3 (TMAP-3): clinical results for patients with a history of mania.

    Science.gov (United States)

    Suppes, Trisha; Rush, A John; Dennehy, Ellen B; Crismon, M Lynn; Kashner, T Michael; Toprac, Marcia G; Carmody, Thomas J; Brown, E Sherwood; Biggs, Melanie M; Shores-Wilson, Kathy; Witte, Bradley P; Trivedi, Madhukar H; Miller, Alexander L; Altshuler, Kenneth Z; Shon, Steven P

    2003-04-01

    The Texas Medication Algorithm Project (TMAP) assessed the clinical and economic impact of algorithm-driven treatment (ALGO) as compared with treatment-as-usual (TAU) in patients served in public mental health centers. This report presents clinical outcomes in patients with a history of mania (BD), including bipolar I and schizoaffective disorder, bipolar type, during 12 months of treatment beginning March 1998 and ending with the final active patient visit in April 2000. Patients were diagnosed with bipolar I disorder or schizoaffective disorder, bipolar type, according to DSM-IV criteria. ALGO was comprised of a medication algorithm and manual to guide treatment decisions. Physicians and clinical coordinators received training and expert consultation throughout the project. ALGO also provided a disorder-specific patient and family education package. TAU clinics had no exposure to the medication algorithms. Quarterly outcome evaluations were obtained by independent raters. Hierarchical linear modeling, based on a declining effects model, was used to assess clinical outcome of ALGO versus TAU. ALGO and TAU patients showed significant initial decreases in symptoms (p =.03 and p <.001, respectively) measured by the 24-item Brief Psychiatric Rating Scale (BPRS-24) at the 3-month assessment interval, with significantly greater effects for the ALGO group. Limited catch-up by TAU was observed over the remaining 3 quarters. Differences were also observed in measures of mania and psychosis but not in depression, side-effect burden, or functioning. For patients with a history of mania, relative to TAU, the ALGO intervention package was associated with greater initial and sustained improvement on the primary clinical outcome measure, the BPRS-24, and the secondary outcome measure, the Clinician-Administered Rating Scale for Mania (CARS-M). Further research is planned to clarify which elements of the ALGO package contributed to this between-group difference.

  11. 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.

  12. 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.

  13. Factors influencing medical students' choice of emergency medicine as a career specialty-a descriptive study of Saudi medical students.

    Science.gov (United States)

    Alkhaneen, Hadeel; Alhusain, Faisal; Alshahri, Khalid; Al Jerian, Nawfal

    2018-03-07

    Choosing a medical specialty is a poorly understood process. Although studies conducted around the world have attempted to identify the factors that affect medical students' choice of specialty, data is scarce on the factors that influence the choice of specialty of Saudi Arabian medical students, in particular those planning a career in emergency medicine (EM). In this study, we investigated whether Saudi medical students choosing EM are influenced by different factors to those choosing other specialties. A cross-sectional survey was conducted at King Saud bin Abdulaziz University for Health Sciences (KSAUHS), Riyadh, Saudi Arabia. The questionnaire distributed among all undergraduate and postgraduate medical students of both sexes in the second and third phases (57% were males and 43% were females). A total of 436 students answered the questionnaire, a response rate of 53.4%. EM group was most influenced by hospital orientation and lifestyle and least influenced by social orientation and prestige provided by their specialty. Unlike controllable lifestyle (CL) group and primary care (PC) group, EM reported lesser influence of social orientation on their career choice. When compared with students primarily interested in the surgical subspecialties (SS), EM group were less likely to report prestige as an important influence. Moreover, students interested in SS reported a leaser influence of medical lifestyle in comparison to EM group. When compared with CL group, EM group reported more interest in medical lifestyle. We found that students primarily interested in EM had different values and career expectations to other specialty groups. The trends in specialty choice should be appraised to meet future needs.

  14. Are medical students confident in taking a sexual history? An assessment on attitude and skills from an upper middle income country.

    Science.gov (United States)

    Ariffin, Farnaza; Chin, Ken Lee; Ng, ChirkJenn; Miskan, Maizatullifah; Lee, Verna KarMun; Isa, Mohammad Rodi

    2015-06-17

    Sexual history training during undergraduate education is essential for preparing future doctors to handle patients' sexual health concerns. The purpose of this study was to assess the attitudes and perceptions of final-year medical students in Malaysia toward sexual history taking and the training they receive from their medical schools. The study used a cross-sectional survey of 379 final-year medical students from three medical schools in Malaysia. Students were asked to rate their attitudes and perceptions regarding training on taking sexual histories using a newly developed questionnaire with good internal consistency (Cronbach's alpha = 0.73). Ethics approval was obtained from the relevant medical schools, and the statistical analysis was conducted using SPSS, Version 20.0. The mean age of participants was 23.58 ± 0.65 SD. Participants reported high interest in sexual health and felt it was important for doctors to know how to take a sexual history (95%). Among the participants, only half felt comfortable in taking sexual histories from patients. The participants identified cultural and religious differences between the doctor and the patient as a potential barrier for discussing sexual health. Participants were aware of their own practice and ability, as well as their limitations, in taking sexual histories. Less than half (46%) felt that the training they received adequately prepared them to take sexual histories. This study identified gaps in sexual health training among medical schools in Malaysia. The delivery of sexual health education program should incorporate confidence building and to make students feel comfortable to take sexual histories from patients. The barrier caused by differences in culture or religion between a doctor and a patient may be overcome through cross cultural and cultural competency training. This is important for multi-faith, multi cultural societies such as Malaysia and other similar countries.

  15. Case-control geographic clustering for residential histories accounting for risk factors and covariates

    Science.gov (United States)

    2006-01-01

    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 assessed in the case

  16. Case-control geographic clustering for residential histories accounting for risk factors and covariates

    Directory of Open Access Journals (Sweden)

    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

  17. Factors and Prevalence of Depression in Students at Iran’s Urmia University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Hamid Reza Khalkhali

    2018-02-01

    Full Text Available Background: Depression is characterized by decreased tendency to work, reduced pleasure from work, increased or decreased weight, increased or decreased appetite, insomnia or narcolepsy, irritability, fatigue, loss of energy, feelings of worthlessness, feelings of guilt, reduced ability to concentrate and think, and thoughts of suicide or actual suicide attempts. In this 2016 study, we examined the factors and prevalence of depression in students at Urmia University of Medical Sciences in Urmia, Iran. Methods: This cross-sectional study was conducted on 400 students. Data were collected through the Beck Depression Inventory II (BDI-II: a 21- item standard questionnaire in multiple-choice format to evaluate depression. The questionnaires were distributed randomly by trained students over a period of 5 months. Data were analyzed using SPSS ver. 19 software and by descriptive statistics, independent t-tests, logistic regression models, and the chi-squared test. Results: The mean BDI score was 14.67 ± 11.30. Of the study population, 278 (69.8% were men and 120 (30.2% were women. In terms of depression, 40.2% of the students were in the normal range and had no depression, 23.6% were slightly depressed, and 18.3% were partially depressed. Also, 6.03% of students had severe depression, and 3.51% of students had very severe depression. No statistically signi cant relationship was observed between depression and sex (P = 0.11. However, signi cant relationships were observed between depression and education level (P = 0.001, smoking history (P = 0.001, and age (P = 0.023. P values less than 0.05 were considered statistically signi cant. Conclusion: The prevalence of different degrees of depression in the plurality of students at Urmia University of Medical Sciences necessitates the development and institution of psychological training classes.

  18. Tool for Predicting Medical Student Burnout From Sustained Stress Levels: Factor Analysis of the Medical Education Hassles Scale-R.

    Science.gov (United States)

    Johnson, Jane C; Degenhardt, Brian F; Smith, Carol K; Wolf, Thomas M; Peterson, D Fred

    2018-03-01

    Acute stress during medical school affects the health of students and is associated with burnout. The Medical Education Hassles Scale-R (MEHS-R) is designed to measure acute stress among medical students. Researchers using the MEHS-R primarily report overall hassles scores, which are unable to discriminate between different categories of hassles encountered. The present study examined the factor structure of the MEHS-R to identify subscales that would be useful to categorize hassles for research and assessment purposes. Longitudinal, observational study. Two osteopathic medical schools. Five hundred six first-year medical students. The MEHS-R was administered at orientation and 9 to 10 times throughout the first year, classified into examination, vacation, and routine medical school activity periods. Students rated the 101 items on a 4-point scale (0=none to 3=a great deal) to indicate how much of a hassle each item had been during the previous week. Demographic subgroups were males, females, married students, single students, whites, and ethnic minorities. Exploratory factor analysis was conducted on data collected at the first school during orientation. Seven subscales were identified: Academic and Time Pressures, Financial, Social, External Influences, Day-to-Day Functioning, Relationships With Immediate Family, and Health. Cronbach α were ≥0.75. Stability of these subscales was examined using confirmatory factor analysis. Both of the fit indices used indicated the 7-subscale model for the MEHS-R adequately fit the data obtained during examination and routine medical school activity periods, one fit index indicated adequate fit for the vacation period, and neither indicated adequate fit for the data from the second school. Of the 7 subscales, 5 had a strong correspondence with categories identified by the scale developers. Fit indices also indicated the 7-subscale model was adequately generalizable to the demographic subgroups with the exception of the ethnic

  19. John Foster Dulles, his medical history and its impact on Cold War politics.

    Science.gov (United States)

    Pappas, Theodore N; Willett, Christopher G

    2018-01-01

    John Foster Dulles was the United States Secretary of State during the administration of President Dwight D Eisenhower. At the height of the Cold War, Dulles was Eisenhower's emissary, traveling over 450,000 international miles, leading United States foreign policy. In November of 1956, during an international crisis involving the Suez Canal, Dulles became ill and underwent an operation for a perforated colon cancer. During much of his impactful term as Secretary of State, Dulles was being treated for this cancer that ultimately resulted in his death in May of 1959. This paper highlights the medical care of John Foster Dulles and the global events during his illness.

  20. 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

  1. Role of environmental factors and history of low back pain in sciatica symptoms among Finnish adolescents.

    Science.gov (United States)

    Karjalainen, Ulla; Paananen, Markus; Okuloff, Annaleena; Taimela, Simo; Auvinen, Juha; Männikkö, Minna; Karppinen, Jaro

    2013-06-01

    Cross-sectional study in a subcohort of the 1986 Northern Finland Birth Cohort (n = 1987). To investigate the role of environmental factors and LBP history in sciatica symptoms among Finnish young adults. History of low back pain (LBP), smoking, and male sex are associated with sciatica in adult populations. The role of the environmental determinants of sciatica has not been evaluated in populations consisting of only adolescents. Sciatic symptoms and environmental exposures were elicited by a mailed questionnaire and the associations were analyzed using multinomial logistic regression. Female sex was associated with severe sciatica at 18 years (OR, 3.9; 95% confidence interval (CI), 1.6-9.3). Both reported LBP at 16 years and LBP requiring consultation of a health care professional were associated with mild sciatica at 18 years (OR, 2.5; 95% CI, 1.3-4.9; and OR, 3.8; 95% CI, 1.2-11.9). In addition, LBP at 16 years requiring consultation of a health care professional was associated with severe sciatica at 18 years (OR, 5.0; 95% CI, 1.7-15.3). Smoking, obesity, physical workload, and level of physical activity were not associated with sciatica. Females reported sciatic pain more often than males. LBP at 16 years predicted sciatica at 18 years. 2.

  2. [The prevalence of burnout and the related factors among some medical students in Korea].

    Science.gov (United States)

    Choi, Jaewon; Son, Shill Lee; Kim, Suh Hee; Kim, Hyunsoo; Hong, Jee-Young; Lee, Moo-Sik

    2015-12-01

    This study was conducted to examine the relationship between the prevalence of burnout and its related factors in medical students in Korea. All available medical students in the metropolitan city of Daejeon, Korea, were asked to answer self-administered questionnaires from July 1 to July 26 in 2013. A total of 534 medical students participated. The Maslach Burnout Inventory-Student Survey (MBI-SS) and structured questionnaires on related factors were used. Confirmatory factor analysis and Cronbach's α were used to verify the applicability of the MBI-SS to medical students in Korea. We also performed chi-square test and logistic regression analysis to identify the factors that were associated with burnout. The MBI-SS was reliable and valid in measuring burnout in Korean medical students. Our confirmatory factor analysis approved and explained the appropriateness of the model fit. The prevalence of burnout among medical students was 26.4% (n=141). Suchrates were higher in students who were female, experienced greater levels of depression, had poor academic performance, feared dropping out, and were stressed by the poor quality of the class facilities. The MBI-SS is a valid instrument to measure academic burnout in Korean medical students. Further studies should be performed, because improvements in the mental health of medical students will benefit these doctors-to-be and their future patients.

  3. Gestational Diabetes Mellitus and Associated Risk Factors in Patients Attending Diabetic Association Medical College Hospital in Faridpur

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    Poly Begum

    2017-09-01

    Full Text Available Background: The prevalence of gestational diabetes mellitus (GDM is increasing all over the world and varies widely depending on the region of the country, dietary habits and socio-economic status. The prevalence of GDM with its associated risk factors has important health complications for both mother and child. Objectives: The aim of this study was to evaluate the prevalence of GDM and risk factors associated with it in women attending Diabetic Association Medical College Hospital in Faridpur for ante-natal care. Materials and Methods: In this cross-sectional study, screening for GDM was performed in 303 pregnant women. Women who consented to participate underwent a standardized 2-hour 75 gm oral glucose tolerance test (OGTT. A proforma containing general information on demographic characteristics, socio-economic status, education level, parity, family history of diabetes and past history of GDM etc. was filled in. American Diabetes Association (ADA criteria for 75 gm 2-hour OGTT was used for diagnosing GDM. Results: A total of 303 women participated in the study and GDM was diagnosed in 22 (7.3% women. A single abnormal value was observed in additional 33 (10.89% women. On bivariate analysis risk factors found to be significantly associated with GDM were age, household income, parity, educational level, socio-economic status, hypertension, BMI, weight gain, acanthosis nigricans, family history of diabetes and past history of GDM; but on multivariate analysis only upper middle class and presence of acanthosis nigricans were found to be significantly associated with GDM. Conclusion: This study demonstrates a high prevalence of GDM in Bangladesh. These estimates for GDM may help for new suggestions to prevent and manage gestational diabetes.

  4. Admission factors associated with international medical graduate certification success: a collaborative retrospective review of postgraduate medical education programs in Ontario.

    Science.gov (United States)

    Grierson, Lawrence E M; Mercuri, Mathew; Brailovsky, Carlos; Cole, Gary; Abrahams, Caroline; Archibald, Douglas; Bandiera, Glen; Phillips, Susan P; Stirrett, Glenna; Walton, J Mark; Wong, Eric; Schabort, Inge

    2017-11-24

    The failure rate on certification examinations of The College of Family Physicians of Canada (CFPC) and the Royal College of Physicians and Surgeons of Canada (RCPSC) is significantly higher for international medical graduates than for Canadian medical school graduates. The purpose of the current study was to generate evidence that supports or refutes the validity of hypotheses proposed to explain the lower success rates. We conducted retrospective analyses of admissions and certification data to determine the factors associated with success of international medical graduate residents on the certification examinations. International medical graduates who entered an Ontario residency program between 2005 and 2012 and had written a certification examination by the time of the analysis (2015) were included in the study. Data available at the time of admission for each resident, including demographic characteristics, previous experiences and previous professional experiences, were collected from each of the 6 Ontario medical schools and matched with certification examination results provided by The CFPC and the RCPSC. We developed logistic regression models to determine the association of each factor with success on the examinations. Data for 900 residents were analyzed. The models revealed resident age to be strongly associated with performance across all examinations. Fluency in English, female sex and the Human Development Index value associated with the country of medical school training had differential associations across the examinations. The findings should contribute to an improved understanding of certification success by international medical graduates, help residency programs identify at-risk residents and underpin the development of specific educational and remedial interventions. In considering the results, it should be kept in mind that some variables are not amenable to changes in selection criteria. Copyright 2017, Joule Inc. or its licensors.

  5. Factors Affecting the Use of Indigenous Publications by Medical and Dental Students in Nigerian Universities

    Directory of Open Access Journals (Sweden)

    Ahiaoma Ibegwam

    2012-06-01

    Full Text Available This study examined the indigenous medical publications used by medical and dental students in Nigeria with a view to discovering factors that affects their usage. Data was gathered through a questionnaire survey. The population of the study was 1,264 undergraduate medical and dental students from ten universities in all the geopolitical zones of Nigeria. Data gathered was analysed using SPSS to obtain the summaries of the variables in form of frequency distribution and other descriptive statistics. The findings reveal several factors affecting the usage of indigenous medical publications. In spite of all the inhibitors, 88.2% of the respondents indicated that they need indigenous medical publications for a well-rounded medical education.

  6. 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

  7. Remarkable Works and Cases in the History of Medical Mycology in Japan.

    Science.gov (United States)

    Nishimoto, Katsutaro

    2017-01-01

    Several pathogenic fungi and cases related to Japanese medical mycologists were reviewed. Trichosporon inkin (as Sarcinomyces inkin) was reported as a pathogen of scrotal lesion by Oho in 1921, and Trichosporon asahii was isolated from generalized keratotic lesions in 1922 by Akagi in Japan. They were once included in Trichophyton beigelii, but then based on revision using DNA molecular technology, were returned to their original names.Microsporum ferrugineum was reported by Ota as a causative dermatophyte of tinea capitis in Japan and surrounding areas. It was once classified under the genus Trichophyton, but after the discovery of characteristic rough-walled macroconidia belonging to genus Microsporum, the fungus was again assigned to the original name.

  8. Factors influencing stethoscope cleanliness among clinical medical students.

    Science.gov (United States)

    Saunders, C; Hryhorskyj, L; Skinner, J

    2013-07-01

    This study aims to identify current stethoscope hygiene habits and attitudes in a UK medical school setting. Students completed a questionnaire using Likert-scale questions and free-text answers. A total of 308 questionnaires were completed from a potential 750 students (41%); 22.4% of respondents had never cleaned their stethoscope and only 3.9% cleaned their stethoscope after every patient. Significant correlations were identified between cleaning frequency and: others acting as role models (P = 0.001), students having confidence in how to clean stethoscopes (P = 0.001), and students thinking cleaning was important (P = 0.01), thereby highlighting inadequate education and role models as potential problems. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  9. Analysis of factors correlating with medical radiological examination frequencies

    International Nuclear Information System (INIS)

    Jahnen, A.; Jaervinen, H.; Bly, R.; Olerud, H.; Vassilieva, J.; Vogiatzi, S.; Shannoun, F.

    2015-01-01

    The European Commission (EC) funded project Dose Datamed 2 (DDM2) had two objectives: to collect available data on patient doses from the radiodiagnostic procedures (X-ray and nuclear medicine) in Europe, and to facilitate the implementation of the Radiation Protection 154 Guidelines (RP154). Besides the collection of frequency and dose data, two questionnaires were issued to gather information about medical radiological imaging. This article analyses a possible correlation between the collected frequency data, selected variables from the results of the detailed questionnaire and national economic data. Based on a 35 countries dataset, there is no correlation between the gross domestic product (GDP) and the total number of X-ray examinations in a country. However, there is a significant correlation ( p < 0.01) between the GDP and the overall CT examination frequency. High income countries perform more CT examinations per inhabitant. That suggests that planar X-ray examinations are replaced by CT examinations. (authors)

  10. [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.

  11. Factors Influencing Prescribing Practices of Medical Practitioners in ...

    African Journals Online (AJOL)

    the currently used drugs, influence of pharmaceutical sales representatives and inadequate training and professional development [2,7]. Other factors include poor communication between health professional and patients regarding the basic information about the use of drugs. Most of the studies done in Tanzania on this ...

  12. Out-of-Hospital Administration of Medication without Prescription and Associated Factors among Preschool Children

    OpenAIRE

    Andritsou, Fotini; Benetou, Vassiliki; Michail, Koralia A.; Pantazis, Nikolaos; Pavlopoulou, Ioanna D.

    2017-01-01

    The increasing trend of administering nonprescribed medicines in children is a significant public health issue. The aim of the present study was to assess the use of medication without a prescription (MWP), including both nonprescribed medication (NPM) and prescription-only medication (POM), and identify associated factors, among preschoolers in Athens, Greece. A predesigned questionnaire was distributed to parents from May through June 2011. Multivariable binary logistic regression analysis ...

  13. Factors Affecting the Use of Indigenous Publications by Medical and Dental Students in Nigerian Universities

    OpenAIRE

    Ahiaoma Ibegwam; Oshiotse Andrew Okwilagwe

    2012-01-01

    This study examined the indigenous medical publications used by medical and dental students in Nigeria with a view to discovering factors that affects their usage. Data was gathered through a questionnaire survey. The population of the study was 1,264 undergraduate medical and dental students from ten universities in all the geopolitical zones of Nigeria. Data gathered was analysed using SPSS to obtain the summaries of the variables in form of frequency distribution and other descriptive stat...

  14. [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

    2018-02-01

    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.

  15. Factors Influencing Electronic Clinical Information Exchange in Small Medical Group Practices

    Science.gov (United States)

    Kralewski, John E.; Zink, Therese; Boyle, Raymond

    2012-01-01

    Purpose: The purpose of this study was to identify the organizational factors that influence electronic health information exchange (HIE) by medical group practices in rural areas. Methods: A purposive sample of 8 small medical group practices in 3 experimental HIE regions were interviewed to determine the extent of clinical information exchange…

  16. 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.

  17. 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

  18. 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.

  19. 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.

  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. 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....

  2. Proportion of medication error reporting and associated factors among nurses: a cross sectional study.

    Science.gov (United States)

    Jember, Abebaw; Hailu, Mignote; Messele, Anteneh; Demeke, Tesfaye; Hassen, Mohammed

    2018-01-01

    A medication error (ME) is any preventable event that may cause or lead to inappropriate medication use or patient harm. Voluntary reporting has a principal role in appreciating the extent and impact of medication errors. Thus, exploration of the proportion of medication error reporting and associated factors among nurses is important to inform service providers and program implementers so as to improve the quality of the healthcare services. Institution based quantitative cross-sectional study was conducted among 397 nurses from March 6 to May 10, 2015. Stratified sampling followed by simple random sampling technique was used to select the study participants. The data were collected using structured self-administered questionnaire which was adopted from studies conducted in Australia and Jordan. A pilot study was carried out to validate the questionnaire before data collection for this study. Bivariate and multivariate logistic regression models were fitted to identify factors associated with the proportion of medication error reporting among nurses. An adjusted odds ratio with 95% confidence interval was computed to determine the level of significance. The proportion of medication error reporting among nurses was found to be 57.4%. Regression analysis showed that sex, marital status, having made a medication error and medication error experience were significantly associated with medication error reporting. The proportion of medication error reporting among nurses in this study was found to be higher than other studies.

  3. Influence Of Demographic Factors And History Of Malaria With The Incidence Malaria In MORU PHC

    Directory of Open Access Journals (Sweden)

    Sudirman Manumpa

    2017-01-01

    Full Text Available Malaria morbidity in Moru health center, with parameter Annual Parasite Incident (API, amounted to 16.9% in 2014. This figure was still high when compared to the target of eliminating malaria in Indonesia about <1% in 2030. Incidence of malaria is more common in children aged 5 months - <12 years. This high rates of malaria leads to poverty, low level of learning achievement of children and in pregnant women causing low birth weight in babies and death. The purpose of this study was to analyze the factors that influence the incidence of tertian and Tropikana malaria or combined Tropikana and tertian (mix in Moru PHC in sub-district Alor Southwestern, Alor Regency.This study used a cross-sectional design, the population of study were all patients undergoing peripheral blood examination in Moru PHC’s laboratory from June to October 2015. The number of samples in this study was 173 respondents. The sampling technique was Simple Random Sampling. Instruments of data collection were a questionnaire and observation sheet.Results of the study by Chi-Square test showed that the factors influencing the incidence of malaria were socioeconomic status (sig 0,000, education level (sig 0.001. By using multivariate analysis with logistic regression test, results were obtained the age of 5 months - <12 value (sig 0.025 and socioeconomic status (sig 0,000 influencing the incidence of malaria.Variables that affect the incidence of malaria were demographic factors such as age, education level, socioeconomic status. It is advisable to harness swamp thus improving the economic status of society and build permanent house. Keywords: incidence malaria, demographic factors, history of malaria

  4. [History of training and certification programs of medical specialists in Peru].

    Science.gov (United States)

    Burstein Alva, Zuño

    2014-01-01

    In this paper, historical reference is made about legal provisions for recognition of the training and certification of medical specialists in Peru through university programs provided since 1928 and culminating in 1973 with the legal authorization by the relevant state authority to implement the Second Specialization Program in Human Medicine and to grant the Certification of Specialist in the Name of the Nation upon completion of a university residency program and specialized training by the “regular modality”, and the recognition by the university with the “non-regular modality”. In Peru it has been established to the present that the Professional Certifications of Specialists in Human Medicine “in the Name of the Nation”, both in “regular modality” as well as in “non-regular modality”, can only be granted by public or private universities authorized for this mission and, besides, no other public or private institution can claim this role that corresponds exclusively for the Peruvian University.

  5. 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.

  6. Familial history, age and smoking are important risk factors for disc degeneration disease in Arabic pedigrees

    International Nuclear Information System (INIS)

    Livshits, Gregory; Cohen, Zvi; Higla, Orabi; Yakovenko, Konstantin

    2001-01-01

    The present study used computed tomography imaging to evaluate the extent and pattern of the intergenerational transmission of spinal disc degeneration disease (DDD) in complex pedigrees. Contribution of a number of the potential covariates was also studied using univariate and multivariate logistic regression analysis, as well as two types of complex segregation analysis models. Among 161 individuals studied, DDD was diagnosed in 60 individuals. The number of protruded discs varied from 1 to 4, mostly in lumbar or lumbosacral regions. The average age at onset of the disease was similar for both women (36.0 years) and men (34.8 years). The proportion of the individuals affected by the DDD status of their parents ranged from 10% in families of two healthy parents to 55.5% of two affected parents (p < 0.01). The results of the logistic regression analyses and complex segregation analysis were qualitatively the same: DDD status of parents, age and smoking were the main risk factors for disc herniation in the Arabic families we examined. All analyses showed a predominating role of the family history as a risk factor for DDD in offsprings. It showed, for example, four times higher risk at age 50 for individuals with two affected parents vs. those who have two non-affected parents. However, the results of models-fitting genetic analysis, did not confirm a monogenic Mendelian pattern of inheritance

  7. The natural history and prognostic factors of Graves' disease in Korean children and adolescents

    Directory of Open Access Journals (Sweden)

    Seung Min Song

    2010-04-01

    Full Text Available Purpose : Graves' disease is the most common cause of hyperthyroidism in children and adolescents. In this study, we investigated the natural course and the prognostic factors of Graves' disease in Korean children and adolescents. Methods : One-hundred thirteen (88 girls and 25 boys patients were included in this study. A retrospective analysis was made of all patients who were diagnosed with Graves' disease. The following parameters were recorded and analyzed: patient's sex, age at diagnosis, duration of disease, laboratory findings, symptoms and signs, and family history of autoimmune thyroid disease. Results : All patients were initially treated with antithyroid drugs, either methimazole (93.8% or propylthiouracil (6.2%. Antithyroid drugs had been discontinued in 75 (66.4% of 113 patients. Of these 75 patients, 23 (20.4% relapsed after 25.5¡?#?3.7; months. Thirteen (11.5% of 23 patients, who experienced the first relapse, showed a second remission. However, 2 (1.8% of 13 patients relapsed again. Euthyroid state could not be achieved by antithyroid drugs in 1 patient, and radioactive iodine therapy was performed. The older the patient at diagnosis, the greater the likelihood of remission (P =0.034. Conclusion : Age at diagnosis seems to be a prognostic factor in Korean children and adolescents with Graves' disease, and should be taken into account in treatment plan determination.

  8. Objective and subjective factors of efficiency and performance of medical audit

    Directory of Open Access Journals (Sweden)

    V. S. Biryukov

    2017-01-01

    Full Text Available The work is devoted to analysis factors affecting the effective operation of quality management systems in health care institutions. It is shown important role of quality of carrying out audits, internal and external, in elimination of various kinds of risks and discrepancies in activity of medical institutions. Two main factors were revealed which influencing the quality of audit: 1. Subjective or "human" factor, consisting in sufficient motivation of the top management and internal auditors of medical institutions. 2. Objective or technological factor, consisting in sufficient training of internal auditors, adequacy selected audit methodology, etc.

  9. INVESTIGATION OF THE FACTORS THAT SHAPE MEDICAL TOURISM: THE CASE OF TURKEY

    OpenAIRE

    YAĞAR, Fedayi; DÖKME, Sema

    2017-01-01

    This study aims to investigate the factors that shape medical tourism and to evaluate these factors in the context of Turkey. Studies and reviews that examine the factors affecting the preferences of patients admitted within the scope of the medical tourism were taken into consideration. Kahramanmaraş Sütçü İmam University electronic library, Sagem, Pubmed and Google academics were used in the literature search conducted. It was observed that the studies mainly focused on up to 9 factors, inc...

  10. Medical and social factors influencing reproduction in Serbia

    Directory of Open Access Journals (Sweden)

    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.

  11. 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.

  12. 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.

  13. Here or There: Recent U.S. Immigrants' Medical and Dental Tourism and Associated Factors.

    Science.gov (United States)

    Jang, Sou Hyun

    2018-01-01

    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.

  14. 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

  15. Medical and Non-Medical Factors Influencing Utilization of Delayed Pushing in the Second Stage

    Science.gov (United States)

    FREY, Heather A.; TUULI, Methodius G.; CORTEZ, Sarah; ODIBO, Anthony O.; ROEHL, Kimberly A.; SHANKS, Anthony L.; MACONES, George A.; CAHILL, Alison G.

    2014-01-01

    Objective To evaluate factors impacting selection to delayed pushing in the second stage of labor. Study design This case-control study was a secondary analysis of a large retrospective cohort study. Cases included women who delayed pushing for 60 minutes or more in the second stage of labor. Controls began pushing prior to 60 minutes from the time of diagnosis of complete dilation. Demographic, labor, and nonmedical factors were compared among cases and controls. Logistic regression modelling was used to identify factors independently associated with delayed pushing. Results We identified 471 women who delayed pushing and 4,819 controls. Nulliparity, maternal body mass index > 25, high fetal station at complete dilation, regional anesthesia use, and start of second stage during staffing shift change were independent factors associated with increased use of delayed pushing. On the other hand, black race and second stage management during night shift were associated with lower odds of employing delayed pushing. Delayed pushing was more commonly employed in nulliparous women, but 38.9% of multiparous women also delayed pushing. Conclusion We identified multiple factors associated with use of delayed pushing. This study helps to define current patterns of second stage labor management. PMID:23208765

  16. Electronic medical history designed by a multidisciplinary unit mastology; Historia clinica electronica disenada por una unidad de mastologia multidisciplinaria

    Energy Technology Data Exchange (ETDEWEB)

    Camejo, N.; Castillo, C.; Vaca, N.; Camargo, B.; Artagaveytia, N.; Acuna, S.; Milans, S.; Lavina, G.; Carzoglio, J.; Jacobo, O.; Pressa, C.; Delgado, L. [Servicio de Oncologia, Hospital de Clinicas, Montevideo (Uruguay)

    2012-11-15

    Full text: Objective: To facilitate the collection, organization and analysis of data from patients Unit assisted in Mastology by producing an electronic health record. Materials and Methods: We evaluated forms provided by medical oncologists, radio therapists, radiologists, pathologists, and plastic surgeons mastologists collect data interrogation, physical examination, complementary examinations, diagnoses, anatomy pathological evolution and treatment instituted and generating the system was computerized {sup U}nit Mastology - Electronic Health Record ( UMAHCE){sup .} Results: The story was designed in modules that collect data on instances arising diagnostic, treatment and monitoring of patients. Each module is represented by an icon that changes color to enter data, allowing the objectify doctor if they are or not the data for that module. The system can attach images recorded by breast exam photos, photos of study, imaging (mammography, CT, MRI) in the same way that the surgeon to enter the protocol surgical or anatomical pathologist enter a pathological report of a study untimely or after definitive surgery. The system can generate an automatic report of the input data that can be printed and placed in the patient's medical history. It also can generate the e mail alerts doctors on pathological results were entered into regarding the diagnosis or treatment breast cancer (eg, mammography B I-Rads 4 or 5, report positive cytologic puncture malignancy, H R and Her status). Conclusions: We developed an electronic medical record that allows different doctors involved in the management of breast disease can be accessed through the web regardless of where they are ( pathology laboratory, room radiology reports, clinic, operation theater), both for information about a patient to enter data the same in relation to their specialty. Moreover, homogenize manages the type and quality of the data and therefore can improve the care and research activities as well as

  17. 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. 

  18. Comparison of Factors Associated with Fear of Falling between Older Adults with and without a Fall History.

    Science.gov (United States)

    Lee, Seonhye; Oh, Eunmi; Hong, Gwi-Ryung Son

    2018-05-14

    Background : Although fear of falling (FOF) has been studied since FOF has negative consequences for the elderly, there is limited information about the risk factors of FOF, including the environment. The purpose of this study was to describe individual and environmental factors of FOF between those with and without a fall history from an ecological aspect and to examine whether individual and environmental factors differently affect the FOF according to the state of fall history in community-dwelling older adults in Korea. Methods : Data from the 2014 Survey of Living Conditions and Welfare Needs of Korean Older Adults were used. Participants were 7730 older adults. Hierarchical logistic regression analysis was conducted to examine the predictors of FOF. Results : According to the ecological model, female and discomfort with the neighborhood environment were significantly associated with greater odds of reporting FOF in both older adults with fall history and those without. A significant interaction was not observed between any variable of FOF in participants with and without a fall history. Conclusions : An ecological model including individual and environmental factors should be considered when conducting research and designing programs and decision policies related to FOF for older adults with and without a history of falling.

  19. The Modified Risk Factors of Health Heads of the Medical Organizations

    Directory of Open Access Journals (Sweden)

    O. L. Zadvornaya

    2017-01-01

    Full Text Available Purpose: study and evaluation of modifiable potential risk factors of health of heads of medical organizations in terms of structural and technological modernization of the health system, the growing need for highly qualified management personnel. Efficiency of activity of medical associations largely due to the level of health managers, allowing to solve problems of activities of medical organizations in the modern fastchanging environmental conditions. Based on international experience and our own research the authors identified features of the state of health of heads of medical organizations, and the degree of exposure to risk factors for no communicable diseases; considered approaches to assess motivation and psychological readiness to promote the health and potential of managerial personnel in the formation of health-saving behavior. Methods: in the present study, the following methods were used: systemic approach, content analysis, methods of social diagnosis (questionnaires, interviews, comparative analysis, method of expert evaluations, and method of statistical processing of information. Results: reviewed and proposed approaches to use preventive measures prevention of risk factors of non-communicable diseases healthcare leaders, forming health-preserving behavior. Conclusions and Relevance: in modern scientific studies on the health of medical workers, including heads of medical institutions, defined the modern methodological approaches to formation of health-saving behavior and maintaining healthy lifestyle health care workers. Despite the high awareness of heads of medical organizations in the area of influence of risk factors on health, accessibility of medical care for the diagnosis and correction of risk factors of chronic no communicable diseases, risk factors of health among healthcare leaders have sufficient prevalence. Health-promoting behavior model is not a conscious lifestyle leader and formed as a reaction if you have

  20. 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.

  1. Molar-incisor-hypomineralisation (MIH). A retrospective clinical study in Greek children. II. Possible medical aetiological factors.

    Science.gov (United States)

    Lygidakis, N A; Dimou, G; Marinou, D

    2008-12-01

    This was to examine the potential medical aetiological factors involved in the development of MIH. During the years 2003--2005, all MIH cases diagnosed according to set criteria were selected from the new patients clinic of a Community Dental Centre for Children (Athens). The age, gender and teeth involved were recorded. A control group of socio-demographically matched controls was also identified. The potential aetiological factors were retrieved through personal interview with the parents and from each child and mother's medical book. Only verified aetiological factors were recorded. Evaluation of the correlation of affected teeth and the timing of the insult was performed in a separate group of 225 affected children aged 8-12 with their entire 12 'index' teeth erupted. From the 3,518, 5.5 to 12 years old children examined, 360 (10.2%) had MIH. Aetiology of MIH: 44 children (12.2%), presented without any relevant medical history, the remaining 316 (87.8%) recorded various medical problems associated with MIH, compared with 18.9% for controls. Perinatal (163, 33.6%) and postnatal (162, 33.9%) problems were the most frequently found and prenatal the least (33, 8.6%). For 42 children (11.7%) problems occurred in more than one chronological period, mainly during both the perinatal and postnatal period (11.1%). The most common prenatal problem was repeated episodes of high fever (12/33), in the perinatal period birth by Caesarean section (92/163) and other birth complications (34/163). Various respiratory conditions (88/162), repeated episodes of high fever (31/162) and neonatal illness (28/162) were the commonly reported problems in the postnatal period. Many MIH cases presented with more than one medical problem during the peri-and postnatal period. Children with MIH recorded 68.9% more frequent medical problems than controls (pMIH children with all their 'index' teeth erupted. Children with MIH present with more medical problems than controls during their prenatal

  2. Factors Associated With Medication-Overuse Headache in Patients Seeking Treatment for Primary Headache.

    Science.gov (United States)

    Peck, Kelly R; Roland, Malcolm M; Smitherman, Todd A

    2018-03-09

    Although risk factors for medication-overuse headache have been identified within the general population, most studies have neglected clinical samples. The present study examined the relative and combined associations of these factors with medication-overuse headache in a sample of US adults seeking treatment for primary headache disorders. Treatment-seeking headache patients provided data on demographics, headache variables, psychiatric variables, use of headache medications, and use of other prescription medications and substances. A classification tree selection strategy was utilized within this cross-sectional study to differentiate between those with and without medication-overuse headache, and a final multivariable model assessed their combined utility. Forty-three of 164 participants (26.2%) met diagnostic criteria for medication-overuse headache. Relative to non-medication-overuse headache participants, participants with medication-overuse headache reported greater headache-related disability (odds ratio = 1.09, 95% confidence interval = 1.01-1.18), escape and avoidance responses indicative of fear of pain (odds ratio = 1.07, 95% confidence interval = 1.00-1.15), and use of combination medications for headache (odds ratio = 3.10, 95% confidence interval = 1.51-6.36). The final multivariable model differentiated well between the 2 groups (area under the receiver operating characteristic curve = .78; 95% confidence interval = .71-.86). Items that assess headache-related disability, use of combination medications, and fear of pain help identify patients who are currently overusing acute headache medications and may serve as indicators of treatment progress. Future studies should apply similar analytic approaches longitudinally to identify headache sufferers at risk for medication-overuse headache prior to headache progression. © 2018 American Headache Society.

  3. Risk factors for a delay in medical education: Results of an online survey among four German medical schools.

    Science.gov (United States)

    Walldorf, Jens; Fischer, Martin R

    2018-01-01

    Delayed study progress in medical school is a challenging issue for the tax paying community, the faculty and the medical students themselves. Reasons for a delay might be different from known risk factors for academic difficulties. An online survey regarding delays in the study progress and including a personality test (BFI-10) was presented to medical students from four German medical schools after completion of their 3rd year of study. Of 617 students, 51.2% reported a mean delay of 2.1 ± 1.5 semesters. Frequent risk factors were secondary employment (69.5%, odds ratio (OR) 1.7, p = 0.004), female gender (69.8%, OR 1.6, p = 0.007), work or study abroad (35.9%, OR 1.5, p = 0.02), a late graduation (5.9%, OR 2.4, p = 0.02), as well as support through scholarship or mentoring (19.9%, OR 1.8, p = 0.004). "Working on doctoral thesis" (11.3%, OR 1.9, p = 0.03) and structural curricular issues (36.6%, OR 0.9, p = 0.7) were frequently identified as obstacles. "Support by friends/family" was considered helpful by 24.1% (OR 1.4, p = 0.09), as well as a high intrinsic motivation (19.1%, OR 0.5, p = 0.01). In the BFI-10, students with study delay were more prone to openness and agreeableness. Risk factors for delay are not identical to those for academic difficulties. To decrease the risk for delays, firm curricular structures should be identified and alleviated. Intrinsic motivation is a strong impetus of study progress and additionally might be strengthened by curricular changes.

  4. The Natural History and Risk Factors of Musculoskeletal Conditions Resulting in Disability Among US Army Personnel

    National Research Council Canada - National Science Library

    Lincoln, Andrew

    2002-01-01

    We describe the natural history of 13 musculoskeletal conditions requiring hospitalization and identify demographic, behavioral, psychosocial, occupational, and clinical characteristics most strongly...

  5. The effect of utilising age and sex dependent factors for calculating detriment from medical irradiation

    International Nuclear Information System (INIS)

    Mettler, F.A.; Davis, M.; Moseley, R.D.; Kelsey, C.A.

    1986-01-01

    Proposals have been made for a quantity that can be used to estimate possible detriment from medical radiology better than the ICRP's collective effective dose equivalent. One such approach utilises age and sex dependent 'weighting' factors. The magnitude of the effect obtained by utilising such factors when applied to an actual population has not been previously assessed. When age and sex dependent weighting factors are applied to diagnostic medical radiology for all hospital examinations conducted in the United States in 1980, estimates of detriment are reduced by one-third. (author)

  6. Risk factors for new-onset late postpartum preeclampsia in women without a history of preeclampsia.

    Science.gov (United States)

    Bigelow, Catherine A; Pereira, Guilherme A; Warmsley, Amber; Cohen, Jennifer; Getrajdman, Chloe; Moshier, Erin; Paris, Julia; Bianco, Angela; Factor, Stephanie H; Stone, Joanne

    2014-04-01

    Risk factors for the development of new-onset late postpartum preeclampsia (LPP) in women without any history of preeclampsia are not known. Because identification of women who are at risk may lead to an earlier diagnosis of disease and improved maternal outcomes, this study identified risk factors (associated patient characteristics) for new-onset LPP. A case-control study of 34 women with new-onset LPP and 68 women without new-onset LPP after normal delivery, who were matched on date of delivery, was conducted at Mount Sinai Hospital, New York, NY. Data were collected by chart review. Exact conditional logistic regression identified patient characteristics that were associated with new-onset LPP. New-onset LPP was associated with age ≥40 years (adjusted odds ratio, 24.83; 95% confidence interval [CI], 1.43-infinity; P = .03), black race (adjusted odds ratio, 78.35; 95% CI, 7.25-infinity; P infinity; P = .001), final pregnancy body mass index of ≥30 kg/m(2) (adjusted odds ratio, 13.38; 95% CI, 1.87-infinity; P = .01), and gestational diabetes mellitus (adjusted odds ratio, 72.91; 95% CI, 5.52-infinity; P < .001). As predictive tests for new-onset LPP, the sensitivity and specificity of having ≥1 of these characteristics was 100% and 59%, respectively, and the sensitivity and specificity of having ≥2 was 56% and 93%, respectively. Older age, black race, Latino ethnicity, obesity, and a pregnancy complicated by gestational diabetes mellitus all are associated positively with the development of new-onset LPP. Closer observation may be warranted in these populations. Copyright © 2014 Mosby, Inc. All rights reserved.

  7. Self-Medication and Contributing Factors: A Questionnaire Survey Among Iranian Households

    Directory of Open Access Journals (Sweden)

    Nadia Abdarzadeh

    2016-08-01

    Full Text Available Background: Self-medication is a serious danger in every health sector which potentially brings harmful side effects for the society. The aim of this research was to investigate self-medication and its contributing factors among residents of Yazd province in Iran in 2014. Methods: A descriptive, cross sectional study was conducted in 2014 using a self-constructed questionnaire. A total of 580 families living in Yazd in the time period of study were contributed to fill out the questions organized in two sections of demographic and self-medication factors. Data were analyzed by SPSS software version 16 through appropriate descriptive and analytical statistical tests. Results: Self-medication was reported in 53.4% of the cases. The most frequent self-prescribed medications were related to pain killer drugs (26.6%. There was a significant statistical relation between self-medication and households’ age, occupation and income, level of parents’ education, number of children and place of residence. Among different reasons for self-medication the most important one was reported to be accessibility (3.44+1.3. Conclusion: Due to the considerable prevalence of self-medication and its harmful effects on every society, such an issue should be appropriately controlled through legal regulations particularly in the area of selling dangerous drugs. Furthermore, provision of proper information and warning the population about harmful side effects can be helpful in this regard. 

  8. Rethinking the social history in the era of biolegitimacy: global health and medical education in the care of Palestinian and Syrian refugees in Beirut, Lebanon.

    Science.gov (United States)

    Premkumar, Ashish; Raad, Kareem; Haidar, Mona H

    2016-01-01

    The critiques leveled towards medical humanitarianism by the social sciences have yet to be felt in medical education. The elevation of biological suffering, at the detriment of sociopolitical contextualization, has been shown to clearly impact both acute and long-term care of individuals and communities. With many medical students spending a portion of their educational time in global learning experiences, exposure to humanitarianism and its consequences becomes a unique component of biomedical education. How does the medical field reconcile global health education with the critiques of humanitarianism? This paper argues that the medical response to humanitarian reason should begin at the level of a social history. Using experiential data culled from fieldwork with Palestinian and Syrian refugees in Lebanon, the authors argue that an expanded social history, combined with knowledge derived from the social sciences, can have significant clinical implications. The ability to contextualize an individual's disease and life within a complex sociopolitical framework means that students must draw on disciplines as varied as anthropology, sociology, and political history to further their knowledge base. Moreover, situating these educational goals within the framework of physician advocacy can build a strong base in medical education from both a biomedical and activist perspective.

  9. 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

    2014-01-01

    Abstract Background 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. Methods 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. Results 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. Conclusion 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. PMID:25909055

  10. 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.

  11. 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.

  12. 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.

  13. Burnout and its Associated Factors in Medical Students of Lahore, Pakistan.

    Science.gov (United States)

    Muzafar, Yumna; Khan, Hibbah H; Ashraf, Huma; Hussain, Waqas; Sajid, Hifsa; Tahir, Marium; Rehman, Abdul; Sohail, Aleena; Waqas, Ahmed; Ahmad, Waqas

    2015-11-29

    Burnout is a widely known phenomenon. It is defined as a state of prolonged physical and psychological exhaustion and is experienced virtually by every medical student due to the highly demanding nature of medical education. This study probes into the prevalence and psychosocial determinants of burnout in Pakistani medical students. A descriptive, cross-sectional study design and convenience (non-probability) sampling technique were employed in undergraduate medical students from years 1-5. A total of 777 medical students from two medical colleges were included in the study from May-August, 2014. An English version of the Copenhagen Burnout Inventory (CBI) and a series of demographic questions, intermixed with questions from other topics, were included in the questionnaire. Data was analysed by using SPSS ver.21. The majority of students were females and enrolled in the third year of MBBS. Of the medical students involved, 30.6% were found to have high/very high levels of burnout (Kristenson's burnout scoring). Although 38.7% of students said that they did not feel burned out after reading the definition of burnout given in the questionnaire, 35.9% out of these students actually had high levels of burnout according to CBI. According to the multiple regression analysis, burnout in medical students was significantly associated with age, gender, doctor parents, no help or no supportive resources (e.g., from colleagues), lack of time off, lack of belief in what you do, fear of big consequences of failure, family responsibilities, and uncertain future. Perception of teachers lacking leadership skills and doing too much study with little balance was associated with low burnout scores. There is a high prevalence of burnout in Pakistani medical students. The present study identifies several factors associated with burnout in Pakistani medical students. Although these factors are a part of daily life of medical students, their identification should prompt the use of

  14. 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

  15. 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

  16. Awareness of the Family History as a Factor in Psychological Well-being in Adolescence

    Directory of Open Access Journals (Sweden)

    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.

  17. 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…

  18. History of Gestational Diabetes Mellitus in Relation to Cardiovascular Disease and Cardiovascular Risk Factors in US Women.

    Science.gov (United States)

    Shostrom, Derrick C V; Sun, Yangbo; Oleson, Jacob J; Snetselaar, Linda G; Bao, Wei

    2017-01-01

    Findings from previous studies examining the association between gestational diabetes mellitus (GDM) and subsequent risk of cardiovascular disease (CVD) have been inconsistent and inconclusive. We aimed to examine the associations of a previous history of GDM with risk of CVD and status of cardiovascular risk factors in a nationwide population-based study in the United States. This study included 8,127 parous women aged 20 years or older in the 2007-2014 cycles of the National Health and Nutrition Examination Survey in the United States. The exposure was self-reported diagnostic history of GDM and the outcomes were self-reported diagnostic history of CVD and measurements of cardiovascular risk factors, including blood pressure and blood lipids. Regression models with sample weights were used to examine the associations of GDM with CVD and cardiovascular risk factors. Among women with a history of both GDM and CVD, CVD was diagnosed on average 22.9 years after the diagnosis of GDM. After adjustment for demographic, socioeconomic, and lifestyle factors, a history of GDM was associated with 63% higher odds of CVD [odds ratio (OR) 1.63, 95% confidence interval (CI) 1.02, 2.62, p -value = 0.04]. Further adjustment for body mass index (BMI) modestly attenuated the association (OR 1.52, 95% CI 0.95, 2.44, p -value = 0.08). A history of GDM was significantly associated with lower serum level of HDL-cholesterol (adjusted β-coefficient -3.33, 95% CI -5.17, -1.50, p -value ≤ 0.001), but not associated with total cholesterol, LDL-cholesterol, triglycerides, or systolic or diastolic blood pressure. Similarly, the association between a history of GDM and HDL cholesterol was attenuated after additional adjustment for BMI (adjusted β-coefficient -1.68, 95% CI -3.38, 0.03, p -value = 0.54). Women with a previous history of GDM have significantly higher risk for developing CVD and lower serum level of HDL cholesterol, compared to women without a history of

  19. The Hidden History of a Famous Drug : Tracing the Medical and Public Acculturation of Peruvian Bark in Early Modern Western Europe (c. 1650-1720)

    NARCIS (Netherlands)

    Klein, Wouter; Pieters, Toine

    2016-01-01

    The history of the introduction of exotic therapeutic drugs in early modern Europe is usually rife with legend and obscurity and Peruvian bark is a case in point. The famous antimalarial drug entered the European medical market around 1640, yet it took decades before the bark was firmly established

  20. Factors affecting UK medical students' decision to train in urology: a national survey.

    Science.gov (United States)

    Jayakumar, Nithish; Ahmed, Kamran; Challacombe, Ben

    2016-10-01

    Our aim was to understand the specific factors which influence medical students' choice to train in urology, in order to attract the best and the brightest into the specialty during a challenging time for surgical training in the United Kingdom A cross-sectional web-based survey was generated to evaluate: 1) perceptions of urology; 2) attitudes about urology as a career; 3) exposure to urology at medical school; and 4) proficiency in common urological procedures. The survey was sent to all 33 medical schools in the UK and advertised to all medical students. The survey received 488 responses were received from 14 medical schools; 59.8% of respondents did not consider a career in urology. Factors affecting a career choice in urology included: 1) year of study; 2) male gender; 3) favorable perceptions of urology; 4) favorable attitudes about urology as a career; 5) more hours of urology teaching in preclinical years; 6) attendance at urology theatre sessions; 7) confidence in performing urological procedures; and 8) more attempts at male catheterization. The commonest reason for not considering urology was inadequate exposure to urology. Students in Year 3 were more likely to consider urology than final-year students, due to multifactorial reasons. Year of study is a novel factor affecting students' consideration of urology as a career. This paper clearly shows that early and sustained exposure to urology positively correlated with considering a career in urology. Urologists must be more active in promoting the specialty to medical students.

  1. Factors affecting self-regulated learning in medical students: a qualitative study.

    Science.gov (United States)

    Jouhari, Zahra; Haghani, Fariba; Changiz, Tahereh

    2015-01-01

    Clinical courses are required of all medical students and means that they must develop the key skill of self-regulation during learning. The ability to self-regulate learning strategies is affected by different factors. This study determined the views of medical students on the factors affecting self-regulated learning (SRL). This study uses a qualitative approach and the content analysis method. Nineteen medical students in their fourth, fifth, and sixth years of study at Isfahan University of Medical Science participated in semi-structured, in-depth interviews. The students were selected using purposive sampling based on their overall grade point average (GPA). Five main themes were found to affect SRL. These themes included family with the two subthemes of family supervisory and supportive roles; peers with the two subthemes of facilitating and inhibiting roles; instructors with the two subthemes of personal and educational instructor's characteristics; educational environment with the two subthemes of facilitator and inhibitor roles; and student with the two subthemes of facilitating and inhibiting personal factors. The outcomes of student understanding of the factors affecting self-regulation indicate that facilitating factors should be used on an individual basis to reduce the effect of inhibiting factors to improve self-regulation in students.

  2. Understanding factors associated with early therapeutic alliance in PTSD treatment: adherence, childhood sexual abuse history, and social support.

    Science.gov (United States)

    Keller, Stephanie M; Zoellner, Lori A; Feeny, Norah C

    2010-12-01

    Therapeutic alliance has been associated with better treatment engagement, better adherence, and less dropout across various treatments and disorders. In treatment of posttraumatic stress disorder (PTSD), it may be particularly important to establish a strong early alliance to facilitate treatment adherence. However, factors such as childhood sexual abuse (CSA) history and poor social support may impede the development of early alliance in those receiving PTSD treatment. We sought to examine treatment adherence, CSA history, and social support as factors associated with early alliance in individuals with chronic PTSD who were receiving either prolonged exposure therapy (PE) or sertraline. At pretreatment, participants (76.6% female; 64.9% Caucasian; mean age = 37.1 years, SD = 11.3) completed measures of trauma history, general support (Inventory of Socially Supportive Behaviors), and trauma-related social support (Social Reactions Questionnaire). Over the course of 10 weeks of PE or sertraline, they completed early therapeutic alliance (Working Alliance Inventory) and treatment adherence measures. Early alliance was associated with PE adherence (r = .32, p history was not predictive of a lower early alliance. Given the associations with adherence, clinicians may find it useful to routinely assess alliance early in treatment. Positive trauma support, not CSA history, may be particularly important in the development of a strong early therapeutic alliance. (c) 2010 APA, all rights reserved.

  3. 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

  4. 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

  5. Medical School Factors That Prepare Students to Become Leaders in Medicine.

    Science.gov (United States)

    Arnold, Louise; Cuddy, Paul G; Hathaway, Susan B; Quaintance, Jennifer L; Kanter, Steven L

    2018-02-01

    To identify medical school factors graduates in major leadership positions perceive as contributing to their leadership development. Using a phenomenological, qualitative approach, in August-November 2015 the authors conducted semistructured interviews with 48 medical leaders who were 1976-1999 baccalaureate-MD graduates of the University of Missouri-Kansas City School of Medicine (UMKC). At UMKC, they participated in longitudinal learning communities, the centerpiece for learning professional values and behaviors plus clinical skills, knowledge, and judgment, but received no formal leadership instruction. The authors subjected interview comments to directed, largely qualitative content analysis with iterative coding cycles. Most graduates said their experiences and the people at UMKC positively influenced their leadership growth. Medical school factors that emerged as contributing to that growth were the longitudinal learning communities including docents, junior-senior partners, and team experiences; expectations set for students to achieve; a clinically oriented but integrated curriculum; admission policies seeking students with academic and nonacademic qualifications; supportive student-student and student-faculty relationships; and a positive overall learning environment. Graduates viewed a combination of factors as best preparing them for leadership and excellence in clinical medicine; together these factors enabled them to assume leadership opportunities after graduation. This study adds medical leaders' perspective to the leadership development literature and offers guidance from theory and practice for medical schools to consider in shaping leadership education: Namely, informal leadership preparation coupled with extensive longitudinal clinical education in a nurturing, authentic environment can develop students effectively for leadership in medicine.

  6. Learning from mistakes. Factors that influence how students and residents learn from medical errors.

    Science.gov (United States)

    Fischer, Melissa A; Mazor, Kathleen M; Baril, Joann; Alper, Eric; DeMarco, Deborah; Pugnaire, Michele

    2006-05-01

    Trainees are exposed to medical errors throughout medical school and residency. Little is known about what facilitates and limits learning from these experiences. To identify major factors and areas of tension in trainees' learning from medical errors. Structured telephone interviews with 59 trainees (medical students and residents) from 1 academic medical center. Five authors reviewed transcripts of audiotaped interviews using content analysis. Trainees were aware that medical errors occur from early in medical school. Many had an intense emotional response to the idea of committing errors in patient care. Students and residents noted variation and conflict in institutional recommendations and individual actions. Many expressed role confusion regarding whether and how to initiate discussion after errors occurred. Some noted the conflict between reporting errors to seniors who were responsible for their evaluation. Learners requested more open discussion of actual errors and faculty disclosure. No students or residents felt that they learned better from near misses than from actual errors, and many believed that they learned the most when harm was caused. Trainees are aware of medical errors, but remaining tensions may limit learning. Institutions can immediately address variability in faculty response and local culture by disseminating clear, accessible algorithms to guide behavior when errors occur. Educators should develop longitudinal curricula that integrate actual cases and faculty disclosure. Future multi-institutional work should focus on identified themes such as teaching and learning in emotionally charged situations, learning from errors and near misses and balance between individual and systems responsibility.

  7. Psychological factors affecting medical condition: a new proposal for DSM-V.

    Science.gov (United States)

    Fava, Giovanni A; Fabbri, Stefania; Sirri, Laura; Wise, Thomas N

    2007-01-01

    The DSM category of "psychological factors affecting medical condition" had virtually no impact on clinical practice. However, several clinically relevant psychosomatic syndromes have been described in the literature: disease phobia, persistent somatization, conversion symptoms, illness denial, demoralization, and irritable mood. These syndromes, in addition to the DSM definition of hypochondriasis, can yield clinical specification in the category of "psychological factors affecting medical condition" and eliminate the need for the highly criticized DSM classification of somatoform disorders. This new classification is supported by a growing body of research evidence and is in line with psychosomatic medicine as a recognized subspecialty.

  8. The contribution of reproductive factors and family history towards premenopausal breast cancer risk in Kuala Lumpur, Malaysia.

    Science.gov (United States)

    Razif, S Mohd; Sulaiman, S; Hanie, S Soraya; Aina, E Nor; Rohaizak, M; Fuad, I; Nurismah, M I; Sharifah, N A

    2011-08-01

    Breast cancer is the most common cancer among Malaysian women. This study aimed to determine the reproductive for premenopausal breast cancer risk in Kuala Lumpur, Malaysia. A case-control study was conducted in 216 histopathologically confirmed cases of premenopausal breast cancer and 216 community-based controls that were matched by age within a 5-year period and ethnicity. The results of this study showed that premenopausal breast cancer risks were strongly related to parity, number of live births and family history of breast cancer. Premenopausal women with these known reproductive and family history risk factors should take extra measures to undergo appropriate screening method for early detection of breast cancer.

  9. 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.

  10. Premenstrual dysphoric disorder in medical students residing in hostel and its association with lifestyle factors.

    Science.gov (United States)

    Mishra, Amrita; Banwari, Girish; Yadav, Priyanka

    2015-01-01

    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. 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. 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. 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.

  11. Influence of gender and other factors on medical student specialty interest.

    Science.gov (United States)

    Boyle, Veronica; Shulruf, Boaz; Poole, Phillippa

    2014-09-12

    Medical schools must select and educate to meet anticipated health needs. Factors influencing career choice include those of the student and their background as well as subsequent experience. Women have comprised over 50% of medical classes for over 20 years. This study describes gender patterns of current specialty interest among medical students at the University of Auckland, and models the predictive effect of gender compared to other career influencing factors. The study analysed career intention survey data from 711 graduating medical students (response rate, 79%) from 2006 to 2011. Interest level was highest for medicine, followed by subspecialty surgery, general practice and paediatrics. There were differences by gender for most specialties, but not for general practice. Women were more likely than men to be interested in Obstetrics and Gynaecology, Paediatrics, Geriatrics, Public Health or General Medicine, and less interested in Surgery, Anaesthesia, Emergency Medicine or post graduate study. Each specialty had a different pattern of influencing factors with the most important factor being the experience on a clinical attachment. Factors in career choice are complex and vary by gender and specialty. General practice levels of interest are too low for workforce needs. Predictive models need to be validated in longer term studies but may help guide selection and curriculum design.

  12. Pitfalls in training simulated patients to respond appropriately to questions from medical students in family history-taking activities: the current situation surrounding the training of simulated patients for learning activities at Nippon Medical School.

    Science.gov (United States)

    Aso, Ryoko; Inoue, Chikako; Yoshimura, Akinobu; Shimura, Toshiro

    2013-01-01

    Our goal was to train simulated patients (SPs) to respond appropriately to questions about family history from medical students in simulated medical interviews. To this end, we carried out a survey of 91 SPs and 76 4th-year medical students to investigate their notions of what constitutes a family. All of the SPs and students surveyed deemed parents and children living together to be members of a family. In a situation where one spouse's parents live together with the basic family unit, 93% of the SPs considered them to be members of the family, whereas only 79% of the students did. Married children living apart from their parents were considered members of the family by 18% of the SPs and 39% of the students. These results indicate clear differences between the SPs and students in their notions of the family. To verify the level of understanding of the definitions of family and blood relatives in particular scenarios used in simulated medical interviews, we administered a written test to 14 SPs who were training to assist in the nationwide common achievement test in medicine, the Objective Structured Clinical Examination (OSCE). The overall score of the SPs was 93.5%; the incorrect answers were "a sibling is not a blood relative" and "a spouse is a blood relative." We analyzed the performance of these 14 SPs in medical interviews carried out after training for the OSCE, in which they were asked questions that required them to reveal their understanding of blood relatives, cohabiting relatives, and the family. All of the SPs responded appropriately to the students' questions about family history. After the OSCE, we asked the SPs to assess themselves on how well they had given their family histories and to evaluate the usefulness of the SP training they had received. Their mean self-assessment score on providing a family history was 3.6 (scale: 1-4); on the usefulness of training, it was 3.4 (scale: 1-4). In conclusion, training SPs to respond appropriately to

  13. Socio-demography and medical history as predictors of health-related quality of life of breast cancer survivors.

    Science.gov (United States)

    Ramadas, Amutha; Qureshi, Ahmad Munir; Dominic, Nisha Angela; Botross, Nevein Philip; Riad, Amgad; Thirunavuk Arasoo, Valliammai Jayanthi; Elangovan, Soman

    2015-01-01

    Even after completion of conventional treatment, breast cancer survivors continue to exhibit a variety of psychological and physical symptoms, affecting their quality of life. The study aimed to investigate the relationship between socio-demography, medical characteristics and health-related quality of life (HR-QOL) of a sample of breast cancer survivors in Malaysia. This pilot cross-sectional survey was conducted among breast cancer survivors (n=40) who were members of Breast Cancer Support Group Centre Johor Bahru. A validated self-administered questionnaire was used to identify the relationships between socio-demography, medical characteristics and HR-QOL of the participants. Living with family and completion of treatment were significant predictive factors of self-rated QOL, while living with family and ever giving birth significantly predicted satisfaction with health and physical health. Psychological health had moderate correlations with number of children and early cancer stage. Survivors' higher personal income (>MYR4,500) was the only significant predictor of social relationship, while age, income more than MYR4,500 and giving birth significantly predicted environment domain score. The findings suggested the survivors coped better in all four HR-QOL domains if they were married, lived with family, had children and were employed.

  14. Family history of psychiatric illness as a risk factor for schizoaffective disorder: a Danish register-based cohort study

    DEFF Research Database (Denmark)

    Laursen, Thomas Munk; Labouriau, Rodrigo; Licht, Rasmus Wentzer

    2005-01-01

    , or schizophrenia among parents and siblings is a risk factor for developing a schizoaffective disorder, and whether a specific pattern of family history of psychiatric illness exists in persons with schizoaffective disorder compared with persons with bipolar disorder or schizophrenia. DESIGN: Register-based cohort...... study. SETTING: Denmark. COHORT: The 2.4 million persons born in Denmark after 1952. MAIN OUTCOME MEASURES: Relative risks of the 3 illnesses estimated by Poisson regression. RESULTS: In total, 1925 persons had a schizoaffective disorder, 3721 had a bipolar disorder, and 12 501 had schizophrenia....... The relative risk of schizoaffective disorder was 2.76 (95% confidence interval, 2.49-3.06) if a first-degree relative had a history of mental illness compared with a person with no first-degree relatives with such a history. There was an additional risk (95% confidence interval) of 2.57 (2.11-3.13), 3.23 (2...

  15. 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.

  16. Medical-and-psychosocial factors influencing on the quality of life in patients with cervix cancer

    International Nuclear Information System (INIS)

    Chun, Mi Son; Kang, Seung Hee; Ryu, Hee Sug; Lee, Eun Hyun; Moon, Seong Mi

    2005-01-01

    Quality of life in patients with cancer may be influenced by various kinds of variables, such as personal, environmental, and medical factors. the purpose of this study was to identify the influencing factors on the quality of life in patients with cancer. One hundred and forty seven patients, who were taking medical therapy or following up after surgery for cervix cancer, participated in the present study. Quality of life, medical variables (cancer stage, type of treatment, follow-up status, and symptom distress), and psychosocial variables (mood disturbance, orientation to life, and social support) were measured. The obtained data were computed using multiple regression analyses. The medical-and-psychosocial variables explained 63.3% of the total variance in the quality of life (R 2 = 0.633, F = 16.969, ρ = .000). Cancer stage, symptom distress, mood disturbance, social support (family), and optimistic orientation to life were significant factors influencing on the quality of life in patients with cervix cancer. An integrative care program which includes medical-and-psychosocial characteristics of patients is essential to improve quality of life in patients with cervix cancer

  17. Medical-and-psychosocial factors influencing on the quality of life in patients with cervix cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chun, Mi Son; Kang, Seung Hee; Ryu, Hee Sug [Ajou University School of Medicine, Suwon (Korea, Republic of); Lee, Eun Hyun [Ajou Univerisity, Suwon (Korea, Republic of); Moon, Seong Mi [Ajou University Hospital, Suwon (Korea, Republic of)

    2005-12-15

    Quality of life in patients with cancer may be influenced by various kinds of variables, such as personal, environmental, and medical factors. the purpose of this study was to identify the influencing factors on the quality of life in patients with cancer. One hundred and forty seven patients, who were taking medical therapy or following up after surgery for cervix cancer, participated in the present study. Quality of life, medical variables (cancer stage, type of treatment, follow-up status, and symptom distress), and psychosocial variables (mood disturbance, orientation to life, and social support) were measured. The obtained data were computed using multiple regression analyses. The medical-and-psychosocial variables explained 63.3% of the total variance in the quality of life (R{sup 2} = 0.633, F = 16.969, {rho} = .000). Cancer stage, symptom distress, mood disturbance, social support (family), and optimistic orientation to life were significant factors influencing on the quality of life in patients with cervix cancer. An integrative care program which includes medical-and-psychosocial characteristics of patients is essential to improve quality of life in patients with cervix cancer.

  18. Confirmatory Factor Analysis of the Universiti Sains Malaysia Emotional Quotient Inventory Among Medical Students in Malaysia

    Directory of Open Access Journals (Sweden)

    Wan Nor Arifin

    2016-05-01

    Full Text Available The Universiti Sains Malaysia Emotional Quotient Inventory (USMEQ-i is a Malay-language emotional intelligence (EI inventory that was based on a mixed-model approach of EI. It was specifically developed and validated for use among medical course applicants. However, evidence to support its use among medical students is inadequate. This study aims to provide further construct validity evidence for the USMEQ-i among medical students through confirmatory factor analysis (CFA. A cross-sectional study was carried out on a sample of 479 medical students in Universiti Sains Malaysia (USM. After a preliminary analysis, data from only 317 respondents were found suitable for inclusion in CFA. CFA was performed using the maximum likelihood estimation method with bootstrapping due to the nonnormality of items at the multivariate level. The results of the analysis support the two-factor model of the EI component and the one-factor model of the faking component. However, the USMEQ-i should be administered with caution until further cross-validation studies are conducted among students in other medical schools in Malaysia.

  19. Protection status against hepatitis B infection assessed fromanti-HBs level, history of vaccination andhistory of infection based on anti-HBc in medical students

    Science.gov (United States)

    Annisa; Zain, LH; Loesnihari, R.

    2018-03-01

    Hepatitis B virus (HBV) is one of the most contagious pathogens where the risk of exposure is very high among health care workers, especially students in the clerkship. This study describes the protection status by measuring anti-HBs level, history of vaccination, and history of HBV infection in medical students.Forty-four (44) students over 18 years old were randomly selected, interviewed for their vaccination history and then had their blood serum taken for anti-HBs and anti-HBc examinations to determine the protectivity and history of infection.There were 81.8% students without a protective anti-HBs level. Before starting their clerkship, 18.2% students received thevaccination, and only one-fourth formed protective antibody level above 10mIU/mL. Seventeen (38.6%) students had been exposed to HBV(positive anti-HBc), and only six of them showed protective anti-HBs level. None of the students that received vaccine underwent a post-vaccination serological test (PVST) to determine their immune response. These results indicated the vulnerability of medical students to the risk of HBV transmission while performing medical care. With the high incidence of HBV transmission, educational institutions are encouraged to make provisions for vulnerable students to receive a booster and an adequate PVST before their clerkship.

  20. Risk factors of falls in inpatients and their practical use in identifying high-risk persons at admission: Fukushima Medical University Hospital cohort study.

    Science.gov (United States)

    Hayakawa, Takehito; Hashimoto, Shigeatsu; Kanda, Hideyuki; Hirano, Noriko; Kurihara, Yumi; Kawashima, Takako; Fukushima, Tetsuhito

    2014-01-01

    To clarify the risk factors for falls in hospital settings and to propose the use of such factors to identify high-risk persons at admission. Prospective cohort study. Fukushima Medical University Hospital, Japan, from August 2008 and September 2009. 9957 adult consecutive inpatients admitted to our hospital. Information was collected at admission from clinical records obtained from a structured questionnaire conducted in face-to-face interviews with subjects by nurses and doctors and fall events were collected from clinical records. The proportion of patients who fell during follow-up was 2.5% and the incidence of falls was 3.28 per 100 person-days. There were significant differences in age, history of falling, cognitive dysfunction, planned surgery, wheelchair use, need for help to move, use of a remote caring system, rehabilitation, use of laxative, hypnotic or psychotropic medications and need for help with activities of daily living (ADL) between patients who did and did not fall. Multivariable adjusted ORs for falls showed that age, history of falls and need for help with ADL were common risk factors in both men and women. Using psychotropic medication also increased the risk of falling in men while cognitive dysfunction and use of hypnotic medication increased the risk of falling in women. Planned surgery was associated with a low risk of falls in women. To prevent falls in inpatients it is important to identify high-risk persons. Age, history of falling and the need for help with ADL are the most important pieces of information to be obtained at admission. Care plans for patients including fall prevention should be clear and considered.

  1. Neighborhood Factors and Fall-Related Injuries among Older Adults Seen by Emergency Medical Service Providers

    OpenAIRE

    Lee, Sungmin; Lee, Chanam; Rodiek, Susan

    2017-01-01

    Falls are serious health problems among older adults, and are the leading cause of fatal and nonfatal injuries treated by emergency medical services (EMS). Although considerable research has examined the risk factors of falls at the individual level, relatively few studies have addressed the risk factors at the neighborhood level. This study examines the characteristics of neighborhood environments associated with fall injuries reported to EMS providers. A total of 13,163 EMS records from 201...

  2. 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 Students't test = 4.74, p 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 factors of CHD among medical students and implementation of intervention programs are recommended. Programs to raise awareness about CHD risk factors, encourage young adult students to adopt a healthy dietary behavior and promote physical exercise should be initiated.

  3. 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

  4. Perceived stress among male medical students in Egypt and Saudi Arabia : Effect of sociodemographic factors

    International Nuclear Information System (INIS)

    Abdel-Hady El-Gilany; Mostafa Amr; Sabry Hammad

    2010-01-01

    In Arab countries, epidemiological data about psychological morbidity among medical undergraduate students are scarce. This study sought to determine whether there was a difference in perceived stress levels of male medical students at Mansoura University, Egypt, compared with male medical students at King Faisal University, Saudi Arabia.The sample consisted of 304 male medical students in Egypt and and 284 male medical students in Saudi Arabia. The self-reported questionnaire covered four categories, including 15 items, on sources of stress (stressors). The perceived stress scale and hospital anxiety and depression scale were used to measure stress, anxiety and depression.There was no significant difference between the two groups in number of stressors. However, Egyptian students were more likely to cite relationship, academic and environmental problems than Saudis. The prevalence of high stress was nearly equal in both groups. However, anxiety and depression were significantly higher among Egyptian than Saudi students. A logistic regression analysis of independent predictors of severe stress among both groups combined revealed that a satisfactory family income and university-graduated father were independent protective factors. The independent risk predictors were anxiety and number of stressors.Stress, anxiety and depression are frequent among medical students. Counseling and preventive mental health services should be an integral part of the routine clinical facilities caring for medical students (Author).

  5. Health Care Professional Factors Influencing Shared Medical Decision Making in Korea

    Directory of Open Access Journals (Sweden)

    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.

  6. Psychological factors determining success in a medical career: a 10-year longitudinal study.

    Science.gov (United States)

    Tartas, Malgorzata; Walkiewicz, Maciej; Majkowicz, Mikolaj; Budzinski, Waldemar

    2011-01-01

    Systemic review of predictors of success in medical career is an important tool to recognize the indicators of proper training. To determine psychological factors that predict success in a medical career. The success is defined as professional competence, satisfaction with medicine as a career, occupational stress and burnout and quality of life (QOF). Part I (1999-2005), medical students were examined each subsequent year, beginning with admission. Assessment included academic achievement (high school final examination results, entrance exam results, academic results during medical school) and psychological characteristics (sense of coherence (SOC), depression, anxiety, coping styles, value system and need for social approval). Part II (2008-2009), the same participants completed an Internet survey 4 years after graduation. Results of the postgraduate medical exam were taken under consideration. Academic achievement predicts only professional competence. Coping styles are significant indicators of satisfaction with medicine as a career. SOC, while assessed with anxiety and depression during studies, enabled us to recognize future QOF of medical graduates. Professional stress is not predictable to such an extent as other success indicators. There are significant psychological qualities useful to draw the outline of the future job and life performance of medical graduates.

  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. Medical History's Moment in Art Photography (1920 to 1950): How Lejaren à Hiller and Valentino Sarra Created a Fashion for Scenes of Early Surgery.

    Science.gov (United States)

    Hansen, Bert

    2017-10-01

    Two groups of black-and-white photographs are found in medical rare book rooms and the collections of historically minded physicians. They were created by artists Hiller and Sarra to bring medical history to life for members of the health professions and, to some extent, for a wider public. These were not didactic illustrations for a textbook, but elegant scenes of great figures from Antiquity to the nineteenth century, evocation not documentation even though they were based on research. As pieces of fine art, cherished in portfolios or framed on the wall, the quality prints were intended to stimulate curiosity about the achievements of the figures portrayed. While familiar to some archivists and librarians, these photographs have received almost no attention in the scholarship of medical history. Only one short article examined them in 1983. In recent years these photographers have been given new consideration by scholars of advertising and photography. Using those works and primary sources, this article expands both men's biographies, and it explores their working methods, their artistry, and their achievements. An appreciation of these photographs enlarges our understanding of the place of medical history in American culture during the first half of the twentieth century. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Factors influencing a nurse's decision to question medication administration in a neonatal clinical care unit.

    Science.gov (United States)

    Aydon, Laurene; Hauck, Yvonne; Zimmer, Margo; Murdoch, Jamee

    2016-09-01

    The aim of this study was to identify factors that influence nurse's decisions to question concerning aspects of medication administration within the context of a neonatal clinical care unit. Medication error in the neonatal setting can be high with this particularly vulnerable population. As the care giver responsible for medication administration, nurses are deemed accountable for most errors. However, they are recognised as the forefront of prevention. Minimal evidence is available around reasoning, decision making and questioning around medication administration. Therefore, this study focuses upon addressing the gap in knowledge around what nurses believe influences their decision to question. A critical incident design was employed where nurses were asked to describe clinical incidents around their decision to question a medication issue. Nurses were recruited from a neonatal clinical care unit and participated in an individual digitally recorded interview. One hundred and three nurses participated between December 2013-August 2014. Use of the constant comparative method revealed commonalities within transcripts. Thirty-six categories were grouped into three major themes: 'Working environment', 'Doing the right thing' and 'Knowledge about medications'. Findings highlight factors that influence nurses' decision to question issues around medication administration. Nurses feel it is their responsibility to do the right thing and speak up for their vulnerable patients to enhance patient safety. Negative dimensions within the themes will inform planning of educational strategies to improve patient safety, whereas positive dimensions must be reinforced within the multidisciplinary team. The working environment must support nurses to question and ultimately provide safe patient care. Clear and up to date policies, formal and informal education, role modelling by senior nurses, effective use of communication skills and a team approach can facilitate nurses to

  10. Designing medical technology for resilience : integrating health economics and human factors approaches

    NARCIS (Netherlands)

    Borsci, Simone; Uchegbu, Ijeoma; Buckle, Peter; Ni, Zhifang; Walne, Simon; Hanna, George B.

    2018-01-01

    Introduction: The slow adoption of innovation into healthcare calls into question the manner of evidence generation for medical technology. This paper identifies potential reasons for this including a lack of attention to human factors, poor evaluation of economic benefits, lack of understanding of

  11. 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. The hypoth...

  12. 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…

  13. Factors Associated with Medical Doctors' Intentions to Discriminate Against Transgender Patients in Kuala Lumpur, Malaysia

    OpenAIRE

    Vijay, Aishwarya; Earnshaw, Valerie A.; Tee, Ying Chew; Pillai, Veena; White Hughto, Jaclyn M.; Clark, Kirsty; Kamarulzaman, Adeeba; Altice, Frederick L.; Wickersham, Jeffrey A.

    2018-01-01

    Purpose: Transgender people are frequent targets of discrimination. Discrimination against transgender people in the context of healthcare can lead to poor health outcomes and facilitate the growth of health disparities. This study explores factors associated with medical doctors' intentions to discriminate against transgender people in Malaysia.

  14. 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....

  15. Factors contributing to registered nurse medication administration error: a narrative review.

    Science.gov (United States)

    Parry, Angela M; Barriball, K Louise; While, Alison E

    2015-01-01

    To explore the factors contributing to Registered Nurse medication administration error behaviour. A narrative review. Electronic databases (Cochrane, CINAHL, MEDLINE, BNI, EmBase, and PsycINFO) were searched from 1 January 1999 to 31 December 2012 in the English language. 1127 papers were identified and 26 papers were included in the review. Data were extracted by one reviewer and checked by a second reviewer. A thematic analysis and narrative synthesis of the factors contributing to Registered Nurses' medication administration behaviour. Bandura's (1986) theory of reciprocal determinism was used as an organising framework. This theory proposes that there is a reciprocal interplay between the environment, the person and their behaviour. Medication administration error is an outcome of RN behaviour. The 26 papers reported studies conducted in 4 continents across 11 countries predominantly in North America and Europe, with one multi-national study incorporating 27 countries. Within both the environment and person domain of the reciprocal determinism framework, a number of factors emerged as influencing Registered Nurse medication administration error behaviour. Within the environment domain, two key themes of clinical workload and work setting emerged, and within the person domain the Registered Nurses' characteristics and their lived experience of work emerged as themes. Overall, greater attention has been given to the contribution of the environment domain rather than the person domain as contributing to error, with the literature viewing an error as an event rather than the outcome of behaviour. The interplay between factors that influence behaviour were poorly accounted for within the selected studies. It is proposed that a shift away from error as an event to a focus on the relationships between the person, the environment and Registered Nurse medication administration behaviour is needed to better understand medication administration error. Copyright © 2014

  16. Medication administration error: magnitude and associated factors among nurses in Ethiopia.

    Science.gov (United States)

    Feleke, Senafikish Amsalu; Mulatu, Muluadam Abebe; Yesmaw, Yeshaneh Seyoum

    2015-01-01

    The significant impact of medication administration errors affect patients in terms of morbidity, mortality, adverse drug events, and increased length of hospital stay. It also increases costs for clinicians and healthcare systems. Due to this, assessing the magnitude and associated factors of medication administration error has a significant contribution for improving the quality of patient care. The aim of this study was to assess the magnitude and associated factors of medication administration errors among nurses at the Felege Hiwot Referral Hospital inpatient department. A prospective, observation-based, cross-sectional study was conducted from March 24-April 7, 2014 at the Felege Hiwot Referral Hospital inpatient department. A total of 82 nurses were interviewed using a pre-tested structured questionnaire, and observed while administering 360 medications by using a checklist supplemented with a review of medication charts. Data were analyzed by using SPSS version 20 software package and logistic regression was done to identify possible factors associated with medication administration error. The incidence of medication administration error was 199 (56.4 %). The majority (87.5 %) of the medications have documentation error, followed by technique error 263 (73.1 %) and time error 193 (53.6 %). Variables which were significantly associated with medication administration error include nurses between the ages of 18-25 years [Adjusted Odds Ratio (AOR) = 2.9, 95 % CI (1.65,6.38)], 26-30 years [AOR = 2.3, 95 % CI (1.55, 7.26)] and 31-40 years [AOR = 2.1, 95 % CI (1.07, 4.12)], work experience of less than or equal to 10 years [AOR = 1.7, 95 % CI (1.33, 4.99)], nurse to patient ratio of 7-10 [AOR = 1.6, 95 % CI (1.44, 3.19)] and greater than 10 [AOR = 1.5, 95 % CI (1.38, 3.89)], interruption of the respondent at the time of medication administration [AOR = 1.5, 95 % CI (1.14, 3.21)], night shift of medication administration

  17. Factors affecting residency rank-listing: A Maxdiff survey of graduating Canadian medical students

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    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

  18. Factors associated with the choice of general medicine as a career among Japanese medical students

    Science.gov (United States)

    Kawamoto, Ryuichi; Ninomiya, Daisuke; Kasai, Yoshihisa; Kusunoki, Tomo; Ohtsuka, Nobuyuki; Kumagi, Teru; Abe, Masanori

    2016-01-01

    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 choice of career

  19. Factors associated with the choice of general medicine as a career among Japanese medical students.

    Science.gov (United States)

    Kawamoto, Ryuichi; Ninomiya, Daisuke; Kasai, Yoshihisa; Kusunoki, Tomo; Ohtsuka, Nobuyuki; Kumagi, Teru; Abe, Masanori

    2016-01-01

    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. 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. 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). 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 choice of career, we may be able to increase enthusiasm for this specialty.

  20. Factors associated with the choice of general medicine as a career among Japanese medical students

    Directory of Open Access Journals (Sweden)

    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

  1. Factors Associated With Self-reported and Medically Diagnosed Urinary Incontinence Among Community-Dwelling Older Women In Korea

    Directory of Open Access Journals (Sweden)

    Jeongok Park

    2015-06-01

    Full Text Available Purpose: The purpose of this study was to examine the prevalence of urinary incontinence (UI in community-dwelling Korean women 60 years or older, and to identify factors associated with self-reported and medically diagnosed UI. Methods: This study was a secondary analysis of data from the 2008 Actual Living Condition of the Elderly and Welfare Need Survey, which used a stratified two-stage cluster sampling method to select a representative sample of 8,961 elderly Korean women. Results: Of the 8,961 women in this study, 579 (6.5% had self-reported UI, and 209 (2.3% were medically diagnosed with UI. As patient age and exercise ability of the upper extremities increased, risk for self-reported UI decreased (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.96–0.99; OR, 0.99; 95% CI, 0.98–0.99, respectively. In contrast, as the number of limited instrumental activities of daily living (IADL increased, the risk for self-reported UI increased (OR, 1.30; 95% CI, 1.24–1.35. Overweight women were 1.94 times more likely to have self-reported UI compared to underweight women. Women with a history of stroke or asthma were more likely to have self-reported UI compared to women with no history. Also, women who reported being in good health were less likely to have UI, compared to women who reported being in poor health (OR, 0.47; 95% CI, 0.31–0.70. Medically diagnosed UI was negatively associated with the number of limited IADL and exercise ability scores for the lower extremities (OR, 0.86; 95% CI, 0.80–0.92; OR, 0.98; 95% CI, 0.97–0.99, respectively. In contrast, as the exercise ability score for the upper extremities increased, so did the risk for medically diagnosed UI (OR, 1.02; 95% CI, 1.01–1.03. Conclusions: An interventional program for home visit health services is needed for incontinent women who are highly dependent on others for IADL.

  2. 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  < .001], provide comprehensive care [ P = .001], and treat patients and their families [ P = .006]); and duration of residency program ( P = .001). The career-related factors that significantly influenced participants' decision to choose a non-front-line specialty were as follows: becoming an expert ( P  < .001), maintaining a focused scope of practice ( P  < .001), having a procedure-focused practice ( P = .001), seeing immediate results from one's actions ( P  < .001), potentially earning a high income ( P  < .001), and having a perceived status among colleagues ( P  < .001). In this study, 8 factors were found to positively influence medical 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

  3. 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.

  4. 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.

  5. Family history, not lack of medication use, is associated with the development of postpartum depression in a high-risk sample.

    Science.gov (United States)

    Kimmel, Mary; Hess, Edward; Roy, Patricia S; Palmer, Jennifer Teitelbaum; Meltzer-Brody, Samantha; Meuchel, Jennifer M; Bost-Baxter, Emily; Payne, Jennifer L

    2015-02-01

    We sought to determine clinical predictors of postpartum depression (PPD), including the role of medication, in a sample of women followed prospectively during and after pregnancy. Women with a history of mood disorder were recruited and evaluated during each trimester and 1 week, 1 month, and 3 months postpartum. DSM-IV criteria for a major depressive episode were assessed by a psychiatric interview at each time point. Sixty-three women with major depression and 30 women with bipolar disorder entered the study and 75.4 % met DSM-IV criteria for a MDE during pregnancy, postpartum, or both. We modeled depression in a given time period (second trimester, third trimester, or 1 month postpartum) as a function of medication use during the preceding period (first, second, or third trimester). The odds of being depressed for those who did not use medication in the previous period was approximately 2.8 times that of those who used medication (OR 2.79, 95 % CI 1.38-5.66, p = 0.0048). Of 38 subjects who were psychiatrically well during the third trimester, 39.5 % (N = 15) met the criteria for a MDE by 4 weeks postpartum. In women who developed PPD, there was a high rate of a family history of PPD (53.3 %) compared to women who did not develop PPD (11.8 %, p = 0.02). While the use of psychiatric medications during pregnancy reduced the odds of being depressed overall, the use of psychiatric medications during pregnancy may not protect against PPD in women at high risk, particularly those with a family history of PPD.

  6. The relationship of intrinsic fall risk factors to a recent history of falling in older women with osteoporosis.

    Science.gov (United States)

    Arnold, Cathy M; Busch, Angela J; Schachter, Candice L; Harrison, Liz; Olszynski, Wojciech

    2005-07-01

    Cross-sectional descriptive analysis investigating intrinsic fall risk factors in postmenopausal women with osteoporosis. To examine the relationships between history of recent falls and balance, pain, quality of life, function, posture, strength, and mobility. Women with osteoporosis who fall are at a high risk of fracture due to decreased bone strength. Identifying fall risk factors for older women with osteoporosis is a crucial step in decreasing the incidence of falls and fracture. METHOD AND MEASURES: Seventy-three women over 60 years of age with established osteoporosis participated in comprehensive testing of fall history, physical function, and quality of life. Significant correlations were found between a recent history of falls and degree of kyphosis (r = 0.29), fear of falls/emotional status (r = -0.27), and balance (r = -0.27). Degree of kyphosis and fear of falls/emotional status explained 20% of the variance of recent fall history using binary logistic regression. Women with an increased kyphosis were more likely to have had a recent fall (odds ratio [OR], 1.17; 95% CI, 1.03-1.34) and those with better emotional status and less fear of falling were less likely to have had a recent fall (OR, 0.61; 95% CI, 0.38-0.97). Increased thoracic kyphosis and fear of falling are 2 intrinsic factors associated with recent falls in women with osteoporosis. To design more effective interventions to decrease fall risk in this population, future prospective, longitudinal studies should monitor kyphosis, fear of falling, balance reactions, and other potential risk factors not identified in this study.

  7. Risk factors for human immunodeficiency virus among blood donors in Cameroon: evidence for the design of an Africa-specific donor history questionnaire.

    Science.gov (United States)

    Tagny, Claude T; Nguefack-Tsague, Georges; Fopa, Diderot; Ashu, Celestin; Tante, Estel; Ngo Balogog, Pauline; Donfack, Olivier; Mbanya, Dora; Laperche, Syria; Murphy, Edward

    2017-08-01

    In sub-Saharan Africa improving the deferral of at-risk blood donors would be a cost-effective approach to reducing transfusion-transmitted human immunodeficiency virus (HIV) infections. We performed a pilot case-control