Prevalence of drug-related problems in self-medication in Danish community pharmacies

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Bente Frøkjær

2012-01-01

Full Text Available Background: Drug-related problems are known to be a major problem associated with pharmacotherapy. A broad range of studies, mainly in the area of prescription-only medicines, supports this fact. Only a few studies have evaluated drug-related problems with over-the-counter medicine and the role of community pharmacies in this. Purpose: To quantify drug-related problems in self-medication (use of over-the-counter medicine identified by community pharmacies in Denmark and to document the interventions by pharmacy staff in relation to the identified drug-related problems. Method: A descriptive study mapping drug-related problems in self-medication registered at the counter at a selected number of Danish community pharmacies. Results: Data for 3,868 consecutive customers with requests for over-the-counter (OTC medicines were registered at 39 community pharmacies. The pharmacies registered a total number of 4,324 OTC medicines requests, illustrating that a customer requested 1.1 OTC medicines on average. Drug-related problems (DRPs were identified for 813 customers, equivalent to DRPs for 21.0 % of all customers, presenting symptoms or requesting OTC medicines, and for 20 % of all over-the-counter medicines requests. 1,239 DRPs were registered, corresponding to an average of 1.5 DRPs per customer requesting OTC medicines. Community pharmacies estimated that they solved or partly solved 76.2 % of the detected DRPs; 73 % were solved without involving a general practitioner. Conclusions: DRPs were identified for 21.0 % of the pharmacy customers presenting a symptom or asking for an OTC medicine. The community pharmacy counselled the customers with DRPs more thoroughly than other customers by giving 2.4 pieces of professional advice, compared to an average of 2.1 to customers in general. It is not possible to determine the magnitude of the safety risk involved. Based on the most frequent categories of DRPs, there were risks of insufficient effect

Prevalence of drug-related problems in self-medication in Danish community pharmacies

Directory of Open Access Journals (Sweden)

Charlotte Rossing

2012-01-01

Full Text Available Background: Drug-related problems are known to be a major problem associated with pharmacotherapy. A broad range of studies, mainly in the area of prescription-only medicines, supports this fact. Only a few studies have evaluated drug-related problems with over-the-counter medicine and the role of community pharmacies in this.Purpose: To quantify drug-related problems in self-medication (use of over-the-counter medicine identified by community pharmacies in Denmark and to document the interventions by pharmacy staff in relation to the identified drug-related problems.Method: A descriptive study mapping drug-related problems in self-medication registered at the counter at a selected number of Danish community pharmacies.Results: Data for 3,868 consecutive customers with requests for over-the-counter (OTC medicines were registered at 39 community pharmacies. The pharmacies registered a total number of 4,324 OTC medicines requests, illustrating that a customer requested 1.1 OTC medicines on average. Drug-related problems (DRPs were identified for 813 customers, equivalent to DRPs for 21.0 % of all customers, presenting symptoms or requesting OTC medicines, and for 20 % of all over-the-counter medicines requests. 1,239 DRPs were registered, corresponding to an average of 1.5 DRPs per customer requesting OTC medicines.Community pharmacies estimated that they solved or partly solved 76.2 % of the detected DRPs; 73 % were solved without involving a general practitioner.Conclusions: DRPs were identified for 21.0 % of the pharmacy customers presenting a symptom or asking for an OTC medicine. The community pharmacy counselled the customers with DRPs more thoroughly than other customers by giving 2.4 pieces of professional advice, compared to an average of 2.1 to customers in general. It is not possible to determine the magnitude of the safety risk involved. Based on the most frequent categories of DRPs, there were risks of insufficient effect, unintended

Spectrum of general surgical problems in the developmentally disabled adults

International Nuclear Information System (INIS)

Khalid, K.; Al-Salamah, Saleh M.

2006-01-01

This study highlights the spectrum of general surgical problems necessitating admission on intellectually disabled adult patients. Problems encountered in the management and the ways to overcome various difficulties are highlighted. Prospective collection of data on 63 consecutive developmentally disabled adult patients admitted to the Department of General Surgery, Riyadh Medical Complex (RMC), Riyadh, Kingdom of Saudi Arabia for various indications from January 2000 through December 2004. Demographic details, clinical presentation, diagnostic modalities, associated physical and neurological disabilities, coexisting medical condition, treatment options, morbidity and mortality were analyzed. Various difficulties encountered during the management and mean to overcome these problems are addressed. Sixty-three patients accounted for 71 admissions. Mean age was 26.7 years with a male preponderance (4.25:1). Fifty-four patients were admitted for various emergency conditions. History of pica could be obtained in 33% of the cases. Twenty-seven patients were admitted for acute abdomen. Volvulus of the colon (22.2%) and pseudo-obstruction (18.5%) were the most common causes of acute abdomen. Twenty-one patients were admitted with upper gastrointestinal bleeding. Reflux esophagitis was the most common cause of bleeding (62%). Overall morbidity was 41% for emergency admissions and 22% for elective surgery. Hospital mortality was 21.4% for emergency surgery. There was no death in elective cases. Developmentally disabled patients comprise a special class of patients with peculiar management problems. The treating clinician should be aware of various unexpected conditions not found as frequently in the normal patient population. Apparent lack of pain does not exclude an acute emergency. Possible surgical condition should be suspected if there is vomiting, abdominal distension, fever, increased irritability of recent onset. Male gender and history of pica are added risk factors

Statistical problems in medical research

African Journals Online (AJOL)

STORAGESEVER

2008-12-29

Dec 29, 2008 ... medical research, there are some common problems in using statistical methodology which may result ... optimal combination of diagnostic tests for osteoporosis .... randomization used include stratification and minimize-.

Management in general practice: the challenge of the new General Medical Services contract.

Science.gov (United States)

Checkland, Kath

2004-10-01

Managers in general practice perform a variety of roles, from purely administrative to higher-level strategic planning. There has been little research investigating in detail how they perform these roles and the problems that they encounter. The new General Medical Services (GMS) contract contains new management challenges and it is not clear how practices will meet these. To improve understanding of the roles performed by managers in general practice and to consider the implications of this for the implementation of the new GMS contract. In-depth qualitative case studies covering the period before and immediately after the vote in favour of the new GMS contract. Three general practices in England, chosen using purposeful sampling. Semi-structured interviews with all clinical and managerial personnel in each practice, participant and non-participant observation, and examination of documents. Understanding about what constitutes the legitimate role of managers in general practice varies both within and between practices. Those practices in the study that employed a manager to work at a strategic level with input into the direction of the organisation demonstrated significant problems with this in practice. These included lack of clarity about what the legitimate role of the manager involved, problems relating to the authority of managers in the context of a partnership, and lack of time available to them to do higher-level work. In addition, general practitioners (GPs) were not confident about their ability to manage their managers' performance. The new GMS contract will place significant demands on practice management. These results suggest that it cannot be assumed that simply employing a manager with high-level skills will enable these demands to be met; there must first be clarity about what the manager should be doing, and attention must be directed at questions about the legitimacy enjoyed by such a manager, the limits of his or her authority, and the

Perceptions among general medical practitioners toward implementation of medication reconciliation program for patients discharged from hospitals in Penang, Malaysia.

Science.gov (United States)

Hassali, Mohamed Azmi Ahmad; Al-Haddad, Mahmoud; Shafie, Asrul Akmal; Tangiisuran, Balamurugan; Saleem, Fahad; Atif, Muhammad; Al-Qazaz, Harith

2012-06-01

This study aims to explore the perceptions of general practitioners (GPs) from the state of Penang toward the feasibility of implementing the medication reconciliation program in Malaysia. A cross-sectional descriptive study using a validated, self-completed anonymous 18-item questionnaire was undertaken over a period of 2 months in 2010. The study was conducted in the state of Penang, Malaysia. A letter consisting of survey questionnaires and prepaid return envelope were mailed to 429 GPs identified from the Private Medical Practice Control Department Registry. A total of 86 responses were received with response rate of 20.1%. Majority (90.1%) of the respondents agreed that medication reconciliation can be a feasible strategy to improve medication safety, and 97.7% confirmed that having an accurate up-to-date list of the patient's previous medication will be useful in the rational prescribing process. However, about half (56.9%) of them felt that standardization of the medication reconciliation process in all clinics will be difficult to achieve. Three quarters (73.2%) of the respondents believed that the involvement of GPs alone is insufficient, and 74.5% agreed that this program should be expanded to community pharmacy setting. More than 90% of the respondents agreed upon the medication reconciliation card proposed by the researchers. General practitioners in Penang are generally in favor of the implementation of medication reconciliation program in their practice. Because medication reconciliation has been shown to reduce many medicine-related problems, it is thus worth considering the feasibility of nationwide implementation of such program.

Provision of undergraduate otorhinolaryngology teaching within General Medical Council approved UK medical schools: what is current practice?

Science.gov (United States)

Khan, M M; Saeed, S R

2012-04-01

Despite longstanding concern, provision of undergraduate ENT teaching has not improved in response to the aims of the UK General Medical Council's initiative Tomorrow's Doctors. Previous studies have demonstrated poor representation of ENT within the undergraduate curriculum. We aimed to identify current practice in order to establish undergraduate ENT experience across UK medical schools, a timely endeavour in light of the General Medical Council's new 2011-2013 education strategy. Questionnaires were sent to ENT consultants, medical school deans and students. All schools with a clinical curriculum were anonymously represented. Our outcome measures were the provision of mandatory or optional ENT placements, and their duration and content. A compulsory ENT placement was available to over half (53 per cent) of the students. Ten of the 26 participating schools did not offer an ENT attachment. The mean mandatory placement was 8 days. Overall, 38 per cent of students reported a satisfactory compulsory ENT placement. Most ENT consultants questioned considered that newly qualified doctors were not proficient in managing common ENT problems that did not require specialist referral. Little improvement in the provision of undergraduate ENT teaching was demonstrated. An increase in the proportion of students undertaking ENT training is necessary. Time and curriculum constraints on medical schools mean that optimisation of available resources is required.

Drug-related problems identified in medication reviews by Australian pharmacists

DEFF Research Database (Denmark)

Stafford, Andrew C; Tenni, Peter C; Peterson, Gregory M

2009-01-01

OBJECTIVE: In Australia, accredited pharmacists perform medication reviews for patients to identify and resolve drug-related problems. We analysed the drug-related problems identified in reviews for both home-dwelling and residential care-facility patients. The objective of this study was to exam......OBJECTIVE: In Australia, accredited pharmacists perform medication reviews for patients to identify and resolve drug-related problems. We analysed the drug-related problems identified in reviews for both home-dwelling and residential care-facility patients. The objective of this study....... These reviews had been self-selected by pharmacists and submitted as part of the reaccreditation process to the primary body responsible for accrediting Australian pharmacists to perform medication reviews. The drug-related problems identified in each review were classified by type and drugs involved. MAIN...... OUTCOME MEASURE: The number and nature of drug-related problems identified in pharmacist-conducted medication reviews. RESULTS: There were 1,038 drug-related problems identified in 234 medication reviews (mean 4.6 (+/-2.2) problems per review). The number of problems was higher (4.9 +/- 2.0 vs. 3.9 +/- 2...

Therminological problems in medical thermography

International Nuclear Information System (INIS)

Rozenfel'd, L.G.; Kolotilov, N.N.

1988-01-01

Some problems of medicotechnical terminology of clinical thermography are discussed. A short hystorical review of stages of the recovery of infrared rays and their medical application was given. An analysis of a number of terms is based on the rules of medical terminology and state standards. An obligatory use in literature of correct terms, mainly of the Greek and Latin origin, is proposed. Commonly used terms on the basis of modern anatomical terminology are recommended for thermogram description

Therminological problems in medical thermography

Energy Technology Data Exchange (ETDEWEB)

Rozenfel' d, L G; Kolotilov, N N

1988-01-01

Some problems of medicotechnical terminology of clinical thermography are discussed. A short hystorical review of stages of the recovery of infrared rays and their medical application was given. An analysis of a number of terms is based on the rules of medical terminology and state standards. An obligatory use in literature of correct terms, mainly of the Greek and Latin origin, is proposed. Commonly used terms on the basis of modern anatomical terminology are recommended for thermogram description.

Algorithm for the Stochastic Generalized Transportation Problem

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Marcin Anholcer

2012-01-01

Full Text Available The equalization method for the stochastic generalized transportation problem has been presented. The algorithm allows us to find the optimal solution to the problem of minimizing the expected total cost in the generalized transportation problem with random demand. After a short introduction and literature review, the algorithm is presented. It is a version of the method proposed by the author for the nonlinear generalized transportation problem. It is shown that this version of the method generates a sequence of solutions convergent to the KKT point. This guarantees the global optimality of the obtained solution, as the expected cost functions are convex and twice differentiable. The computational experiments performed for test problems of reasonable size show that the method is fast. (original abstract

Generalized network improvement and packing problems

CERN Document Server

Holzhauser, Michael

2016-01-01

Michael Holzhauser discusses generalizations of well-known network flow and packing problems by additional or modified side constraints. By exploiting the inherent connection between the two problem classes, the author investigates the complexity and approximability of several novel network flow and packing problems and presents combinatorial solution and approximation algorithms. Contents Fractional Packing and Parametric Search Frameworks Budget-Constrained Minimum Cost Flows: The Continuous Case Budget-Constrained Minimum Cost Flows: The Discrete Case Generalized Processing Networks Convex Generalized Flows Target Groups Researchers and students in the fields of mathematics, computer science, and economics Practitioners in operations research and logistics The Author Dr. Michael Holzhauser studied computer science at the University of Kaiserslautern and is now a research fellow in the Optimization Research Group at the Department of Mathematics of the University of Kaiserslautern.

Evolution of general surgical problems in patients with left ventricular assist devices.

Science.gov (United States)

McKellar, Stephen H; Morris, David S; Mauermann, William J; Park, Soon J; Zietlow, Scott P

2012-11-01

Left ventricular assist devices (LVADs) are increasingly used to treat patients with end-stage heart failure. These patients may develop acute noncardiac surgical problems around the time of LVAD implantation or, as survival continues to improve, chronic surgical problems as ambulatory patients remote from the LVAD implant. Previous reports of noncardiac surgical problems in LVAD patients included patients with older, first-generation devices and do not address newer, second-generation devices. We describe the frequency and management of noncardiac surgical problems encountered during LVAD support with these newer-generation devices to assist noncardiac surgeons involved in the care of patients with LVADs. We retrospectively reviewed the medical records of consecutive patients receiving LVADs at our institution. We collected data for any consultation by noncardiac surgeons within the scope of general surgery during LVAD support and subsequent treatment. Ninety-nine patients received implantable LVADs between 2003 and 2009 (first-generation, n = 19; second-generation, n = 80). Excluding intestinal hemorrhage, general surgical opinions were rendered for 34 patients with 49 problems, mostly in the acute recovery phase after LVAD implantation. Of those, 27 patients underwent 28 operations. Respiratory failure and intra-abdominal pathologies were the most common problems addressed, and LVAD rarely precluded operation. Patients with second-generation LVADs were more likely to survive hospitalization (P = .04) and develop chronic, rather than emergent, surgical problems. Patients with LVADs frequently require consultation from noncardiac surgeons within the scope of general surgeons and often require operation. Patients with second-generation LVADs are more likely to become outpatients and develop more elective surgical problems. Noncardiac surgeons will be increasingly involved in caring for patients with LVADs and should anticipate the problems unique to this patient

Impact of Pharmacist-Conducted Comprehensive Medication Reviews for Older Adult Patients to Reduce Medication Related Problems.

Science.gov (United States)

Kiel, Whitney J; Phillips, Shaun W

2017-12-31

Older adults are demanding increased healthcare attention with regards to prescription use due in large part to highly complex medication regimens. As patients age, medications often have a more pronounced effect on older adults, negatively impacting patient safety and increasing healthcare costs. Comprehensive medication reviews (CMRs) optimize medications for elderly patients and help to avoid inappropriate medication use. Previous literature has shown that such CMRs can successfully identify and reduce the number of medication-related problems and improve acute healthcare utilization. The purpose of this pharmacy resident research study is to examine the impact of pharmacist-conducted geriatric medication reviews to reduce medication-related problems within a leading community health system in southwest Michigan. Furthermore, the study examines type of pharmacist interventions made during medication reviews, acute healthcare utilization, and physician assessment of the pharmacist's value. The study was conducted as a retrospective post-hoc analysis on ambulatory patients who received a CMR by a pharmacist at a primary care practice. Inclusion criteria included patients over 65 years of age with concurrent use of at least five medications who were a recent recipient of a CMR. Exclusion criteria included patients with renal failure, or those with multiple providers involved in primary care. The primary outcome was the difference in number of medication-related problems, as defined by the START and STOPP Criteria (Screening Tool to Alert doctors to Right Treatment/Screening Tool of Older Persons' Prescriptions). Secondary outcomes included hospitalizations, emergency department visits, number and type of pharmacist interventions, acceptance rate of pharmacist recommendations, and assessment of the pharmacist's value by clinic providers. There were a total of 26 patients that received a comprehensive medication review from the pharmacist and were compared to a

Dimensional reduction of a generalized flux problem

International Nuclear Information System (INIS)

Moroz, A.

1992-01-01

In this paper, a generalized flux problem with Abelian and non-Abelian fluxes is considered. In the Abelian case we shall show that the generalized flux problem for tight-binding models of noninteracting electrons on either 2n- or (2n + 1)-dimensional lattice can always be reduced to an n-dimensional hopping problem. A residual freedom in this reduction enables one to identify equivalence classes of hopping Hamiltonians which have the same spectrum. In the non-Abelian case, the reduction is not possible in general unless the flux tensor factorizes into an Abelian one times are element of the corresponding algebra

Medical device problem reporting for the betterment of healthcare.

Science.gov (United States)

1998-08-01

Given that there are nearly 5,000 individual classes of medical devices, tens of thousands of medical device suppliers, and millions of healthcare providers around the world, device-related problems are bound to happen. But effective problem reporting can help reduce or eliminate many of these problems--not only within an institution, but also potentially around the world. In this article, we trace the problem reporting process from its beginnings in the hospital to its global impact in making critical information available throughout the healthcare community.

Using a general problem-solving strategy to promote transfer.

Science.gov (United States)

Youssef-Shalala, Amina; Ayres, Paul; Schubert, Carina; Sweller, John

2014-09-01

Cognitive load theory was used to hypothesize that a general problem-solving strategy based on a make-as-many-moves-as-possible heuristic could facilitate problem solutions for transfer problems. In four experiments, school students were required to learn about a topic through practice with a general problem-solving strategy, through a conventional problem solving strategy or by studying worked examples. In Experiments 1 and 2 using junior high school students learning geometry, low knowledge students in the general problem-solving group scored significantly higher on near or far transfer tests than the conventional problem-solving group. In Experiment 3, an advantage for a general problem-solving group over a group presented worked examples was obtained on far transfer tests using the same curriculum materials, again presented to junior high school students. No differences between conditions were found in Experiments 1, 2, or 3 using test problems similar to the acquisition problems. Experiment 4 used senior high school students studying economics and found the general problem-solving group scored significantly higher than the conventional problem-solving group on both similar and transfer tests. It was concluded that the general problem-solving strategy was helpful for novices, but not for students that had access to domain-specific knowledge. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Safety problems with the use of medical equipment/devices

NARCIS (Netherlands)

Rademakers, C.

2009-01-01

In the past decennia medical technology has rapidly developed. Nowadays it plays an important role in all medical fields. It introduced technologic solutions for many medical problems and it definitely increased the possibilities in the medical field to increase the quality of life. However with

Abstract generalized vector quasi-equilibrium problems in noncompact Hadamard manifolds

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Haishu Lu

2017-05-01

Full Text Available Abstract This paper deals with the abstract generalized vector quasi-equilibrium problem in noncompact Hadamard manifolds. We prove the existence of solutions to the abstract generalized vector quasi-equilibrium problem under suitable conditions and provide applications to an abstract vector quasi-equilibrium problem, a generalized scalar equilibrium problem, a scalar equilibrium problem, and a perturbed saddle point problem. Finally, as an application of the existence of solutions to the generalized scalar equilibrium problem, we obtain a weakly mixed variational inequality and two mixed variational inequalities. The results presented in this paper unify and generalize many known results in the literature.

[Methods for teaching problem-solving in medical schools].

Science.gov (United States)

Shumway, J M; Vargas, M E; Heller, L E

1984-01-01

The need to include in the medical curriculum instructional activities to promote the development of problem-solving abilities has been asserted at the national and international levels. In research on the mental process involved in the solution of problems in medicine, problem-solving has been defined as a hypothetical-deductive activity engaged in by experienced physicians, in which the early generation of hypotheses influences the subsequent gathering of information. This article comments briefly on research on the mental process by which medical problems are solved. It describes the methods that research has shown to be most applicable in instruction to develop problem-solving abilities, and presents some educational principles that justify their application. The "trail-following" approach is the method that has been most commonly used to study the physician's problem-solving behavior. The salient conclusions from this research are that in the problem-solving process the diagnostic hypothesis is generated very early on and with limited data; the number of hypotheses is small; the problem-solving approach is specific to the type of medical problem and case in hand; and the accumulation of medical knowledge and experience forms the basis of clinical competence. Four methods for teaching the solution of problems are described: case presentation, the rain of ideas, the nominal groups technique and decision-making consensus, the census and analysis of forces in the field, and the analysis of clinical decisions. These methods are carried out in small groups. The advantages of the small groups are that the students are active participants in the learning process, they receive formative evaluation of their performance in a setting conductive to learning, and are able to interact with their instructor if he makes proper use of the right questioning techniques. While no single problem-solving method can be useful to all students or in all the problems they encounter

Flexible but boring: medical students' perceptions of a career in general practice.

Science.gov (United States)

Koehler, Nicole; McMenamin, Christine

2016-07-01

Australia will continue to face a general practitioner (GP) shortage unless a significant number of medical students make general practice their chosen career. Perceptions regarding general practice may influence career choices. Thus this study investigated what Australian medical students perceived to be the advantages and disadvantages of pursuing a career in general practice via an anonymous online survey. Fifty-one students indicated general practice to be their first ranked career preference, 200 indicated a career other than general practice, and 106 were undecided. Two-hundred and two students reported having been on a GP placement, whereas 88 students had not. Flexibility, continuity of patient care and work-life balance were the three most common stated advantages to pursuing a career in general practice whereas general practice being boring, poorly paid, and of low prestige were the three most common disadvantages stated. Some disadvantages stated by those with a non-GP preference were not stated by those with a GP preference (e.g. lack of procedural skills, lack of career advancement opportunities). Students with more than 80 h of GP placement experience were more likely to list the advantages of work-life balance and a diversity of problems/illnesses/patients than those with no placement experience but were also more likely to list the disadvantage of low prestige. Negative stereotypes regarding general practice continue to exist which may influence students' career choices.

Medical problems of porters and trekkers in the Nepal Himalaya.

Science.gov (United States)

Basnyat, B; Litch, J A

1997-05-01

The purpose of this study was to assess the incidence of medical illness among members of trekking groups in the Nepal Himalaya. The design was a cohort study using interview and clinical examination by a single physician. The setting was the Manaslu area in the central Nepal Himalaya along a 22-day trekking route with elevations ranging from 487 m to 5100 m. Subjects were 155 members of commercial trekking groups: 102 Nepali porters, 31 Nepali trek staff, and 22 Western trekkers. We found that medical problems occurred in 45% of party members. The porter cohort contained the highest diversity and severity of illness. The relatively larger porter cohort experienced 77% of the medical problems recorded compared with 17% among Western trekkers and 6% among trek staff. The incidence of medical problems was not significantly different in the porter staff (52%) and Western trekkers (55%) and was significantly lower for the trek staff (13%). High-altitude pharyngitis/bronchitis was the most common illness in the party (12%) followed by acute mountain sickness (8%) and gastroenteritis (6%). Other conditions included anxiety (3%), cellulitis (3%), scabies (3%), snow blindness (3%), acute alcohol intoxication (2%), conjunctivitis (2%), fever (2%), lacerations (2%), and hemorrhoids (1%). Illness with infectious etiologies comprised 33% of the medical problems. The incidence of altitude illness was not significantly less in the Nepali porter staff than in the Western trekkers. Evacuation was required in 5% of party members, all from the porter group. This study should alert expedition medical providers and trip leaders of the need to be observant for and prepared to treat the frequent and diverse medical problems among the porter staff in their party, in addition to the Western members. Medical problems are common in remote mountainous areas, indicating that trip physicians should be experienced in primary care.

[Trends among medical students towards general practice or specialization].

Science.gov (United States)

Breinbauer K, Hayo; Fromm R, Germán; Fleck L, Daniela; Araya C, Luis

2009-07-01

A 60/40 ratio has been estimated as a country's ideal proportion between general practitioners and specialists. In Chile this proportion was 36/ 64 in 2004, exactly the opposite of the ideal. Trends towards specialization or general practice among medical students have not been thoughtfully studied. To assess trends among medical students towards becoming general practitioners or specialists, exploring associated factors. Descriptive survey of 822 first to seventh year medical students at the University of Chile, School of Medicine. Desired activity to pursue (general practice or specialization) after graduation and general orientations within clinical practice were explored. Fifty three percent of students desired to enter a specialization program. Only 20% would work as a general practitioner (27% were still indecisive). Furthermore, a trend in early years of medical training towards an integral medicine is gradually reversed within later years. Seventh year students give significantly more importance to specialization than to integral medicine (p specialized medicine in the teaching environment. Most students prefer to enter a specialization program immediately after finishing medical school. Moreover, there is a social trend, at least within the teacher-attending environment, promoting not only the desire to specialize, but a pro-specialist culture.

Assessment of health seeking behaviour and self-medication among general public in the state of Penang, Malaysia.

Science.gov (United States)

Dawood, Omar T; Hassali, Mohamed A; Saleem, Fahad; Ibrahim, Inas R; Abdulameer, Aseel H; Jasim, Hanan H

2017-01-01

Patients' behaviour in making decisions regarding health is currently changing from passive recipients to recipients who play an active role in taking action to control their health and taking self-care initiatives. This study was conducted to evaluate the health seeking behaviour among general public and its associated factors; and to evaluate the medicine taking behaviour in public and the practice of self-medication. A cross-sectional study was undertaken among general public in Penang Island, Malaysia. A convenience sampling of 888 participants successfully completed the survey. Self-administered questionnaires were distributed among the residents in the north east of Penang Island. This study showed that most of the participants chose to consult the physician when they experience any health problems (66.7%), followed by self-medication (20.9%). The first action for consulting the physician was significantly predicted by Malay respondents and retired people (OR 3.05, 95% CI 1.04-8.89). The prevalence of self-medication was 54%. The practice of self-medication was significantly associated with Chinese participants, educated people, people with alone living status and people with more self-care orientation. Increasing the awareness of the public about the rational choice of getting medical assistance is a very important issue to control their health. A health education program is needed to increase the awareness about the use of medicines among the general public and to enable them to make the right decisions relating to health problems.

Problem Solving with General Semantics.

Science.gov (United States)

Hewson, David

1996-01-01

Discusses how to use general semantics formulations to improve problem solving at home or at work--methods come from the areas of artificial intelligence/computer science, engineering, operations research, and psychology. (PA)

Ancient medical texts, modern reading problems

Directory of Open Access Journals (Sweden)

Maria Carlota Rosa

2006-12-01

Full Text Available The word tradition has a very specific meaning in linguistics: the passing down of a text, which may have been completed or corrected by different copyists at different times, when the concept of authorship was not the same as it is today. When reading an ancient text the word tradition must be in the reader's mind. To discuss one of the problems an ancient text poses to its modern readers, this work deals with one of the first printed medical texts in Portuguese, the Regimento proueytoso contra ha pestenença, and draws a parallel between it and two related texts, A moche profitable treatise against the pestilence, and the Recopilaçam das cousas que conuem guardar se no modo de preseruar à Cidade de Lixboa E os sãos, & curar os que esteuerem enfermos de Peste. The problems which arise out of the textual structure of those books show how difficult is to establish a tradition of another type, the medical tradition. The linguistic study of the innumerable medieval plague treatises may throw light on the continuities and on the disruptions of the so-called hippocratic-galenical medical tradition.

Sleep-related problems in common medical conditions.

Science.gov (United States)

Parish, James M

2009-02-01

Common medical problems are often associated with abnormalities of sleep. Patients with chronic medical disorders often have fewer hours of sleep and less restorative sleep compared to healthy individuals, and this poor sleep may worsen the subjective symptoms of the disorder. Individuals with lung disease often have disturbed sleep related to oxygen desaturations, coughing, or dyspnea. Both obstructive lung disease and restrictive lung diseases are associated with poor quality sleep. Awakenings from sleep are common in untreated or undertreated asthma, and cause sleep disruption. Gastroesophageal reflux is a major cause of disrupted sleep due to awakenings from heartburn, dyspepsia, acid brash, coughing, or choking. Patients with chronic renal disease commonly have sleep complaints often due to insomnia, insufficient sleep, sleep apnea, or restless legs syndrome. Complaints related to sleep are very common in patients with fibromyalgia and other causes of chronic pain. Sleep disruption increases the sensation of pain and decreases quality of life. Patients with infectious diseases, including acute viral illnesses, HIV-related disease, and Lyme disease, may have significant problems with insomnia and hypersomnolence. Women with menopause have from insomnia, sleep-disordered breathing, restless legs syndrome, or fibromyalgia. Patients with cancer or receiving cancer therapy are often bothered by insomnia or other sleep disturbances that affect quality of life and daytime energy. The objective of this article is to review frequently encountered medical conditions and examine their impact on sleep, and to review frequent sleep-related problems associated with these common medical conditions.

DO GENERAL MEDICAL PRACTITIONERS EXAMINE INJURED RUNNERS?

DEFF Research Database (Denmark)

Videbæk, Solvej; Jensen, A V; Rasmussen, S

2017-01-01

BACKGROUND: General Medical Practitioners (GMP) in Denmark perform clinical examinations of patients with musculoskeletal pain. However, the prevalence proportion of examinations caused by running-related injuries remains unknown. PURPOSE: The primary purpose of the present study was to estimate...... the prevalence proportion of consultations in general medical practice caused by running-related injuries. The secondary purpose was to estimate the prevalence proportion of injured runners, who consult their GMP, that are referred to additional examinations or treatments. STUDY DESIGN: A survey-based study...

Problems of medical personnel deontology during radiation emergency response

International Nuclear Information System (INIS)

Poplavskij, K.K.; Popov, A.O.

1990-01-01

Problems of deontology in the process of liquidation of radiation accident consequences are considered in the article. It is noted, that shortages of ethical nature in the activities of physicians are related to insufficient qualification of medical personnel in the area of radiation medicine. Problems of medical personnel participation in the large scale propaganda activities among various groups of population are considered. 5 refs

Medical care of employees long-term sick listed due to mental health problems: a cohort study to describe and compare the care of the occupational physician and the general practitioner.

Science.gov (United States)

Anema, J R; Jettinghoff, K; Houtman, I; Schoemaker, C G; Buijs, P C; van den Berg, R

2006-03-01

To describe medical management by the general practitioner (GP) and occupational physician (OP) of workers sick listed due to mental health problems, and to determine agreement in diagnosis, main cause of sickness absence and obstacles in return to work. A cohort of 555 employees being sick listed for 12 to 20 weeks due to mental health problems was recruited and followed for 1 year. These employees were interviewed about their mental health and contacts with GP, OP, other specialists and employer. In addition, the GP and/or the OP of 72 employees were interviewed about the medical diagnosis and management. Most employees sick listed for 12-20 weeks visited their GP and OP. According to the employees most interventions applied by the GP were medical interventions, such as referral of employees and prescription of medical drugs. Working conditions were seldom discussed by the GP and work-related interventions were never applied. Most interventions applied by the OP were work-related interventions and/or contact with the employer. The OP more often talked about working conditions and conflicts. According to the employees, the communication between GP and OP only took place in 8% of the cases. Agreement in the diagnosis, main cause of sickness absence, and obstacles in return to work reported by the GPs and OPs of the same employee was poor. In addition, similarity in reported diagnosis by GP and/or OP and the employees' scores on valid questionnaires on (mental) health was limited. The lack of communication and agreement by Dutch GPs and OPs in medical diagnosis and management of employees long-term sick listed due to mental health problems are indicators of sub-optimal medical treatment and return-to-work strategies.

Medical social consequences of the safety problems of oncological radiology

International Nuclear Information System (INIS)

Pilipenko, M.Yi.; Stadnik, L.L.; Shal'opa, O.Yu.; Rigan, M.M.; Skalets'kij, Yu.M.

2015-01-01

Actuality of the problem of patient safety in oncoradiology in Ukraine is grounded. The results of international audit TLD (IAEA/WHO) quality during dosimetry procedures cobalt-telegamma vehicles in Ukraine are investigated, as well as legal and regulatory framework providing for the safety of radiotherapy care, scientific publications on patient safety. Methods: statistical, analytical, bibliographical, systematic approach. On the example of radiation therapy using the results of the international program of the IAEA/WHO TLD audit quality dosimetry calibration devices for remote gamma therapy in Ukraine from 1998 to 2014 the attempt to assess the extent of medical and social consequences of underestimating of medical errors in oncoradiology is made. The problems of regulatory nature of medical errors in oncoradiology are preliminary identified. The problem of medical errors in the treatment of cancer radiation methods in Ukraine is extremely important. Usually the problems of errors in oncoradiology are considered in organizational, technical, personnel and technical aspects, while medical and social consequences of problem are not covered. About 10 thousand of cancer patients in year may suffer from errors related only to dose calculation according to the optimistic variant, while the number of patients for the same period on the pessimistic case can reach 15 thousand. There are a number of legal character problems in oncoradiology related to patient safety that require clarification. The first priority for improving the safety of patients in oncoradiology is the recording and analysis of radiation therapy defects and their consequences

Assessment of health seeking behaviour and self-medication among general public in the state of Penang, Malaysia

Directory of Open Access Journals (Sweden)

Dawood OT

2017-09-01

Full Text Available Background: Patients’ behaviour in making decisions regarding health is currently changing from passive recipients to recipients who play an active role in taking action to control their health and taking self-care initiatives. Objectives: This study was conducted to evaluate the health seeking behaviour among general public and its associated factors; and to evaluate the medicine taking behaviour in public and the practice of self-medication. Methods: A cross-sectional study was undertaken among general public in Penang Island, Malaysia. A convenience sampling of 888 participants successfully completed the survey. Self-administered questionnaires were distributed among the residents in the north east of Penang Island. Results: This study showed that most of the participants chose to consult the physician when they experience any health problems (66.7%, followed by self-medication (20.9%. The first action for consulting the physician was significantly predicted by Malay respondents and retired people (OR 3.05, 95% CI 1.04-8.89. The prevalence of self-medication was 54%. The practice of self-medication was significantly associated with Chinese participants, educated people, people with alone living status and people with more self-care orientation. Conclusion: Increasing the awareness of the public about the rational choice of getting medical assistance is a very important issue to control their health. A health education program is needed to increase the awareness about the use of medicines among the general public and to enable them to make the right decisions relating to health problems.

Quality Assessment of Medical Apps that Target Medication-Related Problems.

Science.gov (United States)

Loy, John Shiguang; Ali, Eskinder Eshetu; Yap, Kevin Yi-Lwern

2016-10-01

The advent of smartphones has enabled a plethora of medical apps for disease management. As of 2012, there are 40,000 health care-related mobile apps available in the market. Since most of these medical apps do not go through any stringent quality assessment, there is a risk of consumers being misinformed or misled by unreliable information. In this regard, apps that target medication-related problems (MRPs) are not an exception. There is little information on what constitutes quality in apps that target MRPs and how good the existing apps are. To develop a quality assessment tool for evaluating apps that target MRPs and assess the quality of such apps available in the major mobile app stores (iTunes and Google Play). The top 100 free and paid apps in the medical categories of iTunes and Google Play stores (total of 400 apps) were screened for inclusion in the final analysis. English language apps that targeted MRPs were downloaded on test devices to evaluate their quality. Apps intended for clinicians, patients, or both were eligible for evaluation. The quality assessment tool consisted of 4 sections (appropriateness, reliability, usability, privacy), which determined the overall quality of the apps. Apps that fulfilled the inclusion criteria were classified based on the presence of any 1 or more of the 5 features considered important for apps targeting MRPs (monitoring, interaction checker, dose calculator, medication information, medication record). Descriptive statistics and Mann-Whitney tests were used for analysis. Final analysis was based on 59 apps that fulfilled the study inclusion criteria. Apps with interaction checker (66.9%) and monitoring features (54.8%) had the highest and lowest overall qualities. Paid apps generally scored higher for usability than free apps (P = 0.006) but lower for privacy (P = 0.003). Half of the interaction checker apps were unable to detect interactions with herbal medications. Blood pressure and heart rate monitoring apps

Determinants of a successful problem list to support the implementation of the problem-oriented medical record according to recent literature

NARCIS (Netherlands)

Simons, S.M.; Cillessen, F.H.J.M.; Hazelzet, J.A.

2016-01-01

BACKGROUND: A problem-oriented approach is one of the possibilities to organize a medical record. The problem-oriented medical record (POMR) - a structured organization of patient information per presented medical problem- was introduced at the end of the sixties by Dr. Lawrence Weed to aid dealing

The Effect of Student Working Group Establishment on Teaching General Embryology Course to Medical Students

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Mozafar Khazaei

2012-11-01

Full Text Available Introduction: Quantitative and qualitative enhancement of educational activities is an essential issue. Learners’ cooperation in the teaching process in order to increase teaching effectiveness and promotion is considered significant. The aim of the present study was to determine the effect of establishment of student working group on the teaching general embryology course to medical students.Methods: Ten students (1% of medical embryology course were selected to analyze the topics to be taught before each session according to lesson plan, and observe the whole teaching process during lesson presentation. Then, having asked the other students’ viewpoints and discussing with one another, they provided the teacher with a written report on the strengths and weaknesses of the teaching and its problems. The teacher analyzed the problems proposed by the working group to improve teaching process in the next session. At the end of the semester, a questionnaire was administered to all the participants. Data were analyzed using descriptive statistics.Results: The mean of students’ scores was 74.26%. The most important findings obtained in this study included positive role of film projection in teaching the materials (95.34%, significance of presentation of various pictures from different books (88.4%, changing students’ attitude toward application of embryology in different diseases (86%, and repetition of previous session’s pictures (83.75%. The weak points mentioned, however, were physical problems of the classroom and deficiency of audio visual equipment.Conclusion: Student working group has a positive impact on the teaching medical general embryology.

National Institute of General Medical Sciences

Science.gov (United States)

... Over Navigation Links National Institute of General Medical Sciences Site Map Staff Search My Order Search the ... NIGMS Website Research Funding Research Training News & Meetings Science Education About NIGMS Feature Slides View All Slides ...

The effectiveness of clinical problem-based learning model of medico-jurisprudence education on general law knowledge for Obstetrics/Gynecological interns.

Science.gov (United States)

Chang, Hui-Chin; Wang, Ning-Yen; Ko, Wen-Ru; Yu, You-Tsz; Lin, Long-Yau; Tsai, Hui-Fang

2017-06-01

The effective education method of medico-jurisprudence for medical students is unclear. The study was designed to evaluate the effectiveness of problem-based learning (PBL) model teaching medico-jurisprudence in clinical setting on General Law Knowledge (GLK) for medical students. Senior medical students attending either campus-based law curriculum or Obstetrics/Gynecology (Ob/Gyn) clinical setting morning meeting from February to July in 2015 were enrolled. A validated questionnaire comprising 45 questions were completed before and after the law education. The interns attending clinical setting small group improvisation medico-jurisprudence problem-based learning education had significantly better GLK scores than the GLK of students attending campus-based medical law education course after the period studied. PBL teaching model of medico-jurisprudence is an ideal alternative pedagogy model in medical law education curriculum. Copyright © 2017. Published by Elsevier B.V.

Evaluation of problem-based learning in medical students’ education

Directory of Open Access Journals (Sweden)

MOHAMMAD HADI IMANIEH

2014-01-01

Full Text Available Introduction: In traditional medical education systems much interest is placed on the cramming of basic and clinical facts without considering their applicability in the future professional career. The aim of this study is to evaluate a novice medical training method (problem-based learning as compared to the contemporary teacher-based medical education or traditional methods. Methods: Selection of the study subjects was done through simple sampling and according to the division of medical students introduced from Medical Faculty to the Pediatrics Department with no personal involvement. 120 medical students were assigned to 8 groups of 15 students each. For four months, 4 groups were trained with traditional method and 4 other groups underwent problem-based learning method on selected subject materials. In each method, a pre-course test at the beginning and a post-course test at the end of each course were given to each group. The questionnaire used in this study as the instrument was composed of 39 questions, 37 multiple choice questions and two short answer questions. Three professors of pediatric gastroenterologist took part in the training. Two of these professors were responsible for solving task training method. The third professor used traditional teacher-centered methodology to eliminate any possible bias. Scores obtained from these tests were analyzed using paired t-test and independent t-test. P values of less than 0.05 were considered as significant. Results: The scores of the students undergoing the traditional method were 14.70±3.03 and 21.20±4.07 in the first and second test, respectively. In problembased learning, the scores were 15.82±3.29 in the first and 27.52±4.72 in the second test. There was a significant difference between the mean scores of post-course exams of the two groups (p=0.001, while no significant difference was observed between the mean scores of pre-course exams of the groups (p=0.550. Conclusion: It may be

How many people in Canada use prescription opioids non-medically in general and street drug using populations?

Science.gov (United States)

Popova, Svetlana; Patra, Jayadeep; Mohapatra, Satya; Fischer, Benedikt; Rehm, Jürgen

2009-01-01

Medical prescriptions for opioids as well as their non-medical use have increased in Canada in recent years. This study aimed to estimate the number of non-medical prescription opioid (PO) users in the general and street drug using populations in Canada. The number of non-medical PO users among the general population and the number of non-medical PO users, heroin users, or both among the street drug using population was estimated for Canada and for the most populous Canadian provinces. Different estimation methods were used: 1) the number of non-medical PO users in the Canadian general population was estimated based on Canadian availability data, and the ratio of US availability to non-medical PO use from US survey data; 2) numbers within the street drug using population were indirectly estimated based on overdose death data, and a key informants survey. Distribution and trends by usage of opioids were determined by using the multi-site Canadian OPICAN cohort data. Between 321,000 to 914,000 non-medical PO users were estimated to exist among the general population in Canada in 2003. The estimated number of non-medical PO users, heroin users, or both among the street drug using population was about 72,000, with more individuals using nonmedical PO than heroin in 2003. Based on data from the OPICAN survey, in 2005 the majority of the street drug using population in main Canadian cities was non-medical PO users, with the exception of Vancouver and Montreal. A relative increase of 24% was observed from 2002 to 2005 in the proportion of the street drug using population who used non-medical POs only. There is an urgent need to further assess the extent and patterns of non-medical prescription opioid use, related problems and drug distribution channels in Canada.

Does Preschool Self-Regulation Predict Later Behavior Problems in General or Specific Problem Behaviors?

Science.gov (United States)

Lonigan, Christopher J; Spiegel, Jamie A; Goodrich, J Marc; Morris, Brittany M; Osborne, Colleen M; Lerner, Matthew D; Phillips, Beth M

2017-11-01

Findings from prior research have consistently indicated significant associations between self-regulation and externalizing behaviors. Significant associations have also been reported between children's language skills and both externalizing behaviors and self-regulation. Few studies to date, however, have examined these relations longitudinally, simultaneously, or with respect to unique clusters of externalizing problems. The current study examined the influence of preschool self-regulation on general and specific externalizing behavior problems in early elementary school and whether these relations were independent of associations between language, self-regulation, and externalizing behaviors in a sample of 815 children (44% female). Additionally, given a general pattern of sex differences in the presentations of externalizing behavior problems, self-regulation, and language skills, sex differences for these associations were examined. Results indicated unique relations of preschool self-regulation and language with both general externalizing behavior problems and specific problems of inattention. In general, self-regulation was a stronger longitudinal correlate of externalizing behavior for boys than it was for girls, and language was a stronger longitudinal predictor of hyperactive/impulsive behavior for girls than it was for boys.

Medical engagement and organizational characteristics in general practice.

Science.gov (United States)

Ahnfeldt-Mollerup, Peder; dePont Christensen, René; Halling, Anders; Kristensen, Troels; Lykkegaard, Jesper; Nexøe, Jørgen; Barwell, Fred; Spurgeon, Peter; Søndergaard, Jens

2016-02-01

Medical engagement is a mutual concept of the active and positive contribution of doctors to maintaining and enhancing the performance of their health care organization, which itself recognizes this commitment in supporting and encouraging high quality care. A Medical Engagement Scale (MES) was developed by Applied Research Ltd (2008) on the basis of emerging evidence that medical engagement is critical for implementing radical improvements. To study the importance of medical engagement in general practice and to analyse patterns of association with individual and organizational characteristics. A cross-sectional study using a sampled survey questionnaire and the official register from the Danish General Practitioners' Organization comprising all registered Danish GPs. The Danish version of the MES Questionnaire was distributed and the survey results were analysed in conjunction with the GP register data. Statistically adjusted analyses revealed that the GPs' medical engagement varied substantially. GPs working in collaboration with colleagues were more engaged than GPs from single-handed practices, older GPs were less engaged than younger GPs and female GPs had higher medical engagement than their male colleagues. Furthermore, GPs participating in vocational training of junior doctors were more engaged than GPs not participating in vocational training. Medical engagement in general practice varies a great deal and this is determined by a complex interaction between both individual and organizational characteristics. Working in collaboration, having staff and being engaged in vocational training of junior doctors are all associated with enhanced levels of medical engagement among GPs. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Compendium to radiation physics for medical physicists. 300 problems and solutions

International Nuclear Information System (INIS)

Podgorsak, Ervin B.

2014-01-01

Can be used in combination with other textbooks. Exercise book for graduate and undergraduate students of medical physics and engineering. Well chosen and didactically presented problems. Perfect set for learning in connection with the textbook by Podgorsak and others. Detailed derivation of results with many detailed illustrations. Fully worked-out solutions to exercises/questions. Combines exercises in radiation physics and medical physics. This exercise book contains 300 typical problems and exercises in modern physics and radiation physics with complete solutions, detailed equations and graphs. This textbook is linked directly with the textbook ''Radiation Physics for Medical Physicists'', Springer (2010) but can also be used in combination with other related textbooks. For ease of use, this textbook has exactly the same organizational layout (14 chapters, 128 sections) as the ''Radiation Physics for Medical Physicists'' textbook and each section is covered by at least one problem with solution given. Equations, figures and tables are cross-referenced between the two books. It is the only large compilation of textbook material and associated solved problems in medical physics, radiation physics, and biophysics.

A generalization of the convex Kakeya problem

KAUST Repository

Ahn, Heekap; Bae, Sangwon; Cheong, Otfried; Gudmundsson, Joachim; Tokuyama, Takeshi; Vigneron, Antoine E.

2012-01-01

We consider the following geometric alignment problem: Given a set of line segments in the plane, find a convex region of smallest area that contains a translate of each input segment. This can be seen as a generalization of Kakeya's problem

Predictors of prescribed medication use for depression, anxiety, stress, and sleep problems in mid-aged Australian women.

Science.gov (United States)

Schofield, Margot J; Khan, Asaduzzaman

2014-11-01

The study examined prevalence of self-reported use of medication recommended or prescribed by a doctor for depression, anxiety, stress, and sleep problems; and modelled baseline factors that predicted use over 3 years for each condition. Analyses were undertaken on the 2001 and 2004 surveys of mid-aged women in the Australian Longitudinal Study on Women's Health. Dependent variables were self-reported use in past 4 weeks of medications recommended or prescribed by a doctor for depression, anxiety, stress, or sleep problems in 2001 and 2004. Generalized Estimating Equations (GEE) were used to predict medication use for each condition over 3 years. Prevalence of prescribed medication use (2001, 2004) for each condition was depression (7.2, 8.9 %), anxiety (7.4, 9.0 %), stress (4.8, 5.7 %), and sleep problems (8.7, 9.5 %). Multivariable analyses revealed that odds of medication use across 3 years in all four conditions were higher for women with poorer mental and physical health, using hormone replacement therapy (HRT), or having seen a counsellor; and increased over time for depression, anxiety, and stress models. Medication use for depression was also higher for overweight/obese women, ex-smokers, and unmarried. Medication use for anxiety was higher for unmarried and non-working/low occupational women. Medication use for stress was higher for non-working women. Additional predictors of medication for sleep were surgical menopause, and area of residence. Self-reported use of prescribed medication for four mental health conditions is increased over time after controlling for mental and physical health and other variables. Research needs to explore decision-making processes influencing differential rates of psychoactive medication use and their relationship with health outcomes.

Problems of radiation protection at medical use of radiation equipment

International Nuclear Information System (INIS)

Larwin, K.

1979-01-01

For medical use of radiation equipment man is not only operator, but also object (patient). The question, if or how much it is necessary to expose the patient, is a medical problem and therefore not to be discussed here. For the user of medical equipments we have often special conditions. For many diagnostic applications the physician has to stay in the application room in contact with the patient. As a typical example for the problems of radiation protection there is discussed the situation on a well known fluoroscopic unit for lung and stomach examinations. (author)

Higher-Order Generalized Invexity in Control Problems

Directory of Open Access Journals (Sweden)

S. K. Padhan

2011-01-01

Full Text Available We introduce a higher-order duality (Mangasarian type and Mond-Weir type for the control problem. Under the higher-order generalized invexity assumptions on the functions that compose the primal problems, higher-order duality results (weak duality, strong duality, and converse duality are derived for these pair of problems. Also, we establish few examples in support of our investigation.

Prevalence and incidence of mental health problems among Dutch medical students and the study-related and personal risk factors: a longitudinal study.

Science.gov (United States)

Borst, Jorien M; Frings-Dresen, Monique H W; Sluiter, Judith K

2016-11-01

A high prevalence of mental health problems (i.e. depression and/or anxiety) has been found in medical students in comparison with the general population. Therefore, the objective was first to study the prevalence and 1-year incidence of symptoms of depression, anxiety and any mental health problems among Dutch medical students and, second, to study which study-related and personal factors present a risk of these mental health problems. A 1-year prospective longitudinal study was performed among medical students of two medical faculties in the Netherlands (n=951). Health problems and study-related and personal factors were measured with an online questionnaire. Mental health problems were assessed by depression and/or anxiety symptoms (BSI-DEP and BSI-ANG). Univariate and multivariate hierarchical logistic regression analyses were performed to examine which of the study-related and personal factors predict mental health problems. At follow-up, 36%, 28% and 48% of the medical students reported symptoms of depression, anxiety and mental health problems, respectively. The incidence between 2010 and 2011 for depression was 20%, 17% for anxiety and 25% for mental health problems. Students who are worried about their own health during medical education are at an increased risk of future mental health problems (OR 2.0 [1.3-2.9], p=0.00). Excessive drinking behavior is a protective factor in this study (OR 0.7 [0.5-0.9], p=0.02). This study shows that only two out of nine factors are significantly associated with mental health problems among Dutch medical students, one risk factor and one protective factor.

Problem solving therapy - use and effectiveness in general practice.

Science.gov (United States)

Pierce, David

2012-09-01

Problem solving therapy (PST) is one of the focused psychological strategies supported by Medicare for use by appropriately trained general practitioners. This article reviews the evidence base for PST and its use in the general practice setting. Problem solving therapy involves patients learning or reactivating problem solving skills. These skills can then be applied to specific life problems associated with psychological and somatic symptoms. Problem solving therapy is suitable for use in general practice for patients experiencing common mental health conditions and has been shown to be as effective in the treatment of depression as antidepressants. Problem solving therapy involves a series of sequential stages. The clinician assists the patient to develop new empowering skills, and then supports them to work through the stages of therapy to determine and implement the solution selected by the patient. Many experienced GPs will identify their own existing problem solving skills. Learning about PST may involve refining and focusing these skills.

Learning styles of medical students, general surgery residents, and general surgeons: implications for surgical education

Directory of Open Access Journals (Sweden)

de Gara Chris

2010-06-01

Full Text Available Abstract Background Surgical education is evolving under the dual pressures of an enlarging body of knowledge required during residency and mounting work-hour restrictions. Changes in surgical residency training need to be based on available educational models and research to ensure successful training of surgeons. Experiential learning theory, developed by David Kolb, demonstrates the importance of individual learning styles in improving learning. This study helps elucidate the way in which medical students, surgical residents, and surgical faculty learn. Methods The Kolb Learning Style Inventory, which divides individual learning styles into Accommodating, Diverging, Converging, and Assimilating categories, was administered to the second year undergraduate medical students, general surgery resident body, and general surgery faculty at the University of Alberta. Results A total of 241 faculty, residents, and students were surveyed with an overall response rate of 73%. The predominant learning style of the medical students was assimilating and this was statistically significant (p Conclusions We conclude that medical students have a significantly different learning style from general surgical trainees and general surgeons. This has important implications in the education of general surgery residents.

Learning styles of medical students, general surgery residents, and general surgeons: implications for surgical education.

Science.gov (United States)

Engels, Paul T; de Gara, Chris

2010-06-30

Surgical education is evolving under the dual pressures of an enlarging body of knowledge required during residency and mounting work-hour restrictions. Changes in surgical residency training need to be based on available educational models and research to ensure successful training of surgeons. Experiential learning theory, developed by David Kolb, demonstrates the importance of individual learning styles in improving learning. This study helps elucidate the way in which medical students, surgical residents, and surgical faculty learn. The Kolb Learning Style Inventory, which divides individual learning styles into Accommodating, Diverging, Converging, and Assimilating categories, was administered to the second year undergraduate medical students, general surgery resident body, and general surgery faculty at the University of Alberta. A total of 241 faculty, residents, and students were surveyed with an overall response rate of 73%. The predominant learning style of the medical students was assimilating and this was statistically significant (p learning style found in the residents and faculty. The predominant learning styles of the residents and faculty were convergent and accommodative, with no statistically significant differences between the residents and the faculty. We conclude that medical students have a significantly different learning style from general surgical trainees and general surgeons. This has important implications in the education of general surgery residents.

Strong Duality and Optimality Conditions for Generalized Equilibrium Problems

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D. H. Fang

2013-01-01

Full Text Available We consider a generalized equilibrium problem involving DC functions. By using the properties of the epigraph of the conjugate functions, some sufficient and/or necessary conditions for the weak and strong duality results and optimality conditions for generalized equilibrium problems are provided.

Generalized Darcy–Oseen resolvent problem

Czech Academy of Sciences Publication Activity Database

Medková, Dagmar; Ptashnyk, M.; Varnhorn, W.

2016-01-01

Roč. 39, č. 6 (2016), s. 1621-1630 ISSN 0170-4214 Institutional support: RVO:67985840 Keywords : Darcy-Oseen resolvent problem * semipermeable membrane * Brinkman-Darcy equations * fluid flow between free-fluid domains and porous media Subject RIV: BA - General Mathematics Impact factor: 1.017, year: 2016 http://onlinelibrary.wiley.com/doi/10.1002/mma.3872/abstract

Compendium to radiation physics for medical physicists 300 problems and solutions

CERN Document Server

Podgorsak, Ervin B

2014-01-01

This exercise book contains 300 typical problems and exercises in modern physics and radiation physics with complete solutions, detailed equations and graphs. This textbook is linked directly with the textbook "Radiation Physics for Medical Physicists", Springer (2010) but can also be used in combination with other related textbooks. For ease of use, this textbook has exactly the same organizational layout (14 chapters, 128 sections) as the "Radiation Physics for Medical Physicists" textbook and each section is covered by at least one problem with solution given. Equations, figures and tables are cross-referenced between the two books. It is the only large compilation of textbook material and associated solved problems in medical physics, radiation physics, and biophysics.

Prevalence and incidence of mental health problems among Dutch medical students and the study-related and personal risk factors: a longitudinal study

NARCIS (Netherlands)

Borst, Jorien M.; Frings-Dresen, Monique H. W.; Sluiter, Judith K.

2016-01-01

A high prevalence of mental health problems (i.e. depression and/or anxiety) has been found in medical students in comparison with the general population. Therefore, the objective was first to study the prevalence and 1-year incidence of symptoms of depression, anxiety and any mental health problems

Self-Assessment of Problem Solving Disposition in Medical Students

OpenAIRE

Olivares-Olivares, Silvia Lizett; López-Cabrera, Mildred Vanessa

2014-01-01

Medical schools are committed to both students and society to develop capabilities required to succeed in health care environments. Present diagnosis and treatment methods become obsolete faster, demanding that medical schools incorporate competency-based education to keep pace with future demands. This study was conducted to assess the problem solving disposition of medical students. A three-subcategory model of the skill is proposed. The instrument was validated on content by a group of 17 ...

Effect of smartphone overuse on sleep problems in medical students

Directory of Open Access Journals (Sweden)

Pairoj Boonluksiri

2018-05-01

Full Text Available Background: Smartphones are used worldwide. Consequently, it does seem to be having an impact on health-related problems if overused. However, it is uncertain whether it is associated with sleep problems or poor learning. Objective: To determine the association between smartphone overuse and sleep problems in medical students as primary outcome and poor learning as secondary outcome. Methods: A cross-sectional study was conducted in 89 students having their own smartphones, at Hatyai Medical Education Centre, Thailand. The habits of using smartphone were obtained. Smartphone overuse during bedtime was defined as using longer than 1 hour according to Smartphone Addiction Scale (SAS. The primary outcome was napping in a classroom that was defined as a problem if it happened more than 20% of the time attending class. Sleep problems using Pittsburgh Sleep Quality Index (PSQI and Epworth Sleepiness Scale (ESS were obtained by self-assessment. Learning outcome measured by grade point average was the secondary outcome. Multivariable analysis was performed for the association between smartphone overuse and sleep problems. Results: Of all students, 77.5% had sleep problems and 43.6% had napped in the classroom. No personal characteristics, daily life behaviours, and physical environments were associated with sleep problems. 70.8% of all students found to over use smartphones during bedtime. The Facebook website was the most popular. Smartphone overuse was significantly associated with poor sleep quality (odds ratio= 3.46 and napping in the classroom (odds ratio=4.09 but not grade point average. Conclusion: Smartphone overuse during bedtime in medical students is associated with sleep problems but not learning achievement.

Determinants of a successful problem list to support the implementation of the problem-oriented medical record according to recent literature.

Science.gov (United States)

Simons, Sereh M J; Cillessen, Felix H J M; Hazelzet, Jan A

2016-08-02

A problem-oriented approach is one of the possibilities to organize a medical record. The problem-oriented medical record (POMR) - a structured organization of patient information per presented medical problem- was introduced at the end of the sixties by Dr. Lawrence Weed to aid dealing with the multiplicity of patient problems. The problem list as a precondition is the centerpiece of the problem-oriented medical record (POMR) also called problem-oriented record (POR). Prior to the digital era, paper records presented a flat list of medical problems to the healthcare professional without the features that are possible with current technology. In modern EHRs a POMR based on a structured problem list can be used for clinical decision support, registries, order management, population health, and potentially other innovative functionality in the future, thereby providing a new incentive to the implementation and use of the POMR. On both 12 May 2014 and 1 June 2015 a systematic literature search was conducted. From the retrieved articles statements regarding the POMR and related to successful or non-successful implementation, were categorized. Generic determinants were extracted from these statements. In this research 38 articles were included. The literature analysis led to 12 generic determinants: clinical practice/reasoning, complete and accurate problem list, data structure/content, efficiency, functionality, interoperability, multi-disciplinary, overview of patient information, quality of care, system support, training of staff, and usability. Two main subjects can be distinguished in the determinants: the system that the problem list and POMR is integrated in and the organization using that system. The combination of the two requires a sociotechnical approach and both are equally important for successful implementation of a POMR. All the determinants have to be taken into account, but the weight given to each of the determinants depends on the organizationusing

Predictors of a positive attitude of medical students towards general practice - a survey of three Bavarian medical faculties.

Science.gov (United States)

Schneider, Antonius; Karsch-Völk, Marlies; Rupp, Alica; Fischer, Martin R; Drexler, Hans; Schelling, Jörg; Berberat, Pascal

2013-01-01

Germany is witnessing an increasing shortage of general practitioners (GPs). The aim was to determine predictors of the job-related motivation of medical students of three medical faculties with different institutionalisation of general practice as an academic discipline. Medical students were surveyed with a standardised questionnaire about their attitudes towards general practice and their motivation to work as a GP in different working conditions. Predictors for positive attitudes and motivation were calculated using logistic regression models. 940 (15.2%) out of 6182 medical students from three Bavarian medical faculties participated in an online survey. 585 (62.7%) were female, and the average age was 25.0 (standard deviation 3.7). The average grade of a university-entrance diploma was 1.6 (standard deviation 0.5). 718 (76.4%) could imagine working as a GP. However, they favoured being employed within another organisation and not having their own private practice (65.5% vs. 35.1%). "Presence of a professorship of general practice" was associated with a positive attitude towards general practice (OR 1.57; 95%CI 1.13-2.417). Motivation for working as a GP was associated with "being female" (OR 2.56; 95%CI 1.80-3.56) and "presence of a professorship of general practice" (OR 1.68; 95%CI 1.14-2.46). Having a lower grade for one's university-entrance diploma was associated with a higher preference to work in one's own practice (OR 1.39; 95%CI 1.02-1.90). A high amount of medical students were open-minded towards general practice. However, they favoured employment within an organization over working in their own practice. Institutionalisation of general practice as an academic discipline might be of importance to gain positive attitudes towards general practice and motivate medical students to work as a GP.

Deep learning in medical imaging: General overview

Energy Technology Data Exchange (ETDEWEB)

Lee, June Goo; Jun, Sang Hoon; Cho, Young Won; Lee, Hyun Na; KIm, Guk Bae; Seo, Joon Beom; Kim, Nam Kug [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

2017-08-01

The artificial neural network (ANN)–a machine learning technique inspired by the human neuronal synapse system–was introduced in the 1950s. However, the ANN was previously limited in its ability to solve actual problems, due to the vanishing gradient and overfitting problems with training of deep architecture, lack of computing power, and primarily the absence of sufficient data to train the computer system. Interest in this concept has lately resurfaced, due to the availability of big data, enhanced computing power with the current graphics processing units, and novel algorithms to train the deep neural network. Recent studies on this technology suggest its potentially to perform better than humans in some visual and auditory recognition tasks, which may portend its applications in medicine and health care, especially in medical imaging, in the foreseeable future. This review article offers perspectives on the history, development, and applications of deep learning technology, particularly regarding its applications in medical imaging.

Deep learning in medical imaging: General overview

International Nuclear Information System (INIS)

Lee, June Goo; Jun, Sang Hoon; Cho, Young Won; Lee, Hyun Na; KIm, Guk Bae; Seo, Joon Beom; Kim, Nam Kug

2017-01-01

The artificial neural network (ANN)–a machine learning technique inspired by the human neuronal synapse system–was introduced in the 1950s. However, the ANN was previously limited in its ability to solve actual problems, due to the vanishing gradient and overfitting problems with training of deep architecture, lack of computing power, and primarily the absence of sufficient data to train the computer system. Interest in this concept has lately resurfaced, due to the availability of big data, enhanced computing power with the current graphics processing units, and novel algorithms to train the deep neural network. Recent studies on this technology suggest its potentially to perform better than humans in some visual and auditory recognition tasks, which may portend its applications in medicine and health care, especially in medical imaging, in the foreseeable future. This review article offers perspectives on the history, development, and applications of deep learning technology, particularly regarding its applications in medical imaging

Deep Learning in Medical Imaging: General Overview

Science.gov (United States)

Lee, June-Goo; Jun, Sanghoon; Cho, Young-Won; Lee, Hyunna; Kim, Guk Bae

2017-01-01

The artificial neural network (ANN)–a machine learning technique inspired by the human neuronal synapse system–was introduced in the 1950s. However, the ANN was previously limited in its ability to solve actual problems, due to the vanishing gradient and overfitting problems with training of deep architecture, lack of computing power, and primarily the absence of sufficient data to train the computer system. Interest in this concept has lately resurfaced, due to the availability of big data, enhanced computing power with the current graphics processing units, and novel algorithms to train the deep neural network. Recent studies on this technology suggest its potentially to perform better than humans in some visual and auditory recognition tasks, which may portend its applications in medicine and healthcare, especially in medical imaging, in the foreseeable future. This review article offers perspectives on the history, development, and applications of deep learning technology, particularly regarding its applications in medical imaging. PMID:28670152

Deep Learning in Medical Imaging: General Overview.

Science.gov (United States)

Lee, June-Goo; Jun, Sanghoon; Cho, Young-Won; Lee, Hyunna; Kim, Guk Bae; Seo, Joon Beom; Kim, Namkug

2017-01-01

The artificial neural network (ANN)-a machine learning technique inspired by the human neuronal synapse system-was introduced in the 1950s. However, the ANN was previously limited in its ability to solve actual problems, due to the vanishing gradient and overfitting problems with training of deep architecture, lack of computing power, and primarily the absence of sufficient data to train the computer system. Interest in this concept has lately resurfaced, due to the availability of big data, enhanced computing power with the current graphics processing units, and novel algorithms to train the deep neural network. Recent studies on this technology suggest its potentially to perform better than humans in some visual and auditory recognition tasks, which may portend its applications in medicine and healthcare, especially in medical imaging, in the foreseeable future. This review article offers perspectives on the history, development, and applications of deep learning technology, particularly regarding its applications in medical imaging.

Band Generalization of the Golub-Kahan Bidiagonalization, Generalized Jacobi Matrices, and the Core Problem

Czech Academy of Sciences Publication Activity Database

Hnětynková, Iveta; Plešinger, M.; Strakoš, Z.

2015-01-01

Roč. 36, č. 2 (2015), s. 417-434 ISSN 0895-4798 R&D Projects: GA ČR GA13-06684S Grant - others:GA MŠk(CZ) EE2.3.30.0065; GA MŠk(CZ) LL1202 Keywords : total least squares problem * multiple right-hand sides * core problem * Golub-Kahan bidiagonalization * generalized Jacobi matrices Subject RIV: BA - General Mathematics Impact factor: 1.883, year: 2015

Self-reported competency ratings of graduates of a problem-leased medical curriculum

NARCIS (Netherlands)

van der Molen, H. T.

Purpose. To study the self-reports of professional competencies by graduates of a problem-based medical curriculum. Method. All graduates from a medical school and a faculty of health sciences with a problem-based curriculum were sent a questionnaire asking them to compare their own performances in

Self-reported competency ratings of graduates of a problem-based medical curriculum

NARCIS (Netherlands)

H.G. Schmidt (Henk); H.M. van der Molen

2001-01-01

textabstractPurpose. To study the self-reports of professional competencies by graduates of a problem-based medical curriculum. Method. All graduates from a medical school and a faculty of health sciences with a problem-based curriculum were sent a questionnaire asking them to compare their own

Nurses' perceptions and problems in the usability of a medication safety app.

Science.gov (United States)

Ankem, Kalyani; Cho, Sookyung; Simpson, Diana

2017-10-16

The majority of medication apps support medication adherence. Equally, if not more important, is medication safety. Few apps report on medication safety, and fewer studies have been conducted with these apps. The usability of a medication safety app was tested with nurses to reveal their perceptions of the graphical user interface and to discover problems they encountered in using the app. Usability testing of the app was conducted with RN-BSN students and informatics students (n = 18). Perceptions of the graphical components were gathered in pretest and posttest questionnaires, and video recordings of the usability testing were transcribed. The significance of the difference in mean performance time for 8 tasks was tested, and qualitative analysis was deployed to identify problems encountered and to rate the severity of each problem. While all participants perceived the graphical user interface as easy to understand, nurses took significantly more time to complete certain tasks. More nurses found the medication app to be lacking in intuitiveness of user interface design, in capability to match real-world data, and in providing optimal information architecture. To successfully integrate mobile devices in healthcare, developers must address the problems that nurses encountered in use of the app.

Do general medical practitioners examine injured runners?

DEFF Research Database (Denmark)

Andersen, Solvej Videbæk; Jensen, A V; Rasmussen, Sten

2017-01-01

BACKGROUND: General Medical Practitioners (GMP) in Denmark perform clinical examinations of patients with musculoskeletal pain. However, the prevalence proportion of examinations caused by running-related injuries remains unknown. PURPOSE: The primary purpose of the present study was to estimate...... the prevalence proportion of consultations in general medical practice caused by running-related injuries. The secondary purpose was to estimate the prevalence proportion of injured runners, who consult their GMP, that are referred to additional examinations or treatments. STUDY DESIGN: A survey-based study....... METHODS: An online survey was distributed in October and November 2015 to more than 370 GMPs in Denmark and completed by 27. RESULTS: The median prevalence proportion of consultations caused by running-related injuries in the prior two weeks was 0.80% [25th percentile = 0.00%; 75th percentile = 1...

Bladder Control Problems: Medications for Treating Urinary Incontinence

Science.gov (United States)

... control problems, including how they work to treat urinary incontinence and possible side effects. By Mayo Clinic Staff ... a look at medications commonly prescribed to treat urinary incontinence and their possible side effects. Keep in mind ...

Applications of the Monte Carlo simulation in dosimetry and medical physics problems

International Nuclear Information System (INIS)

Rojas C, E. L.

2010-01-01

At the present time the computers use to solve important problems extends to all the areas. These areas can be of social, economic, of engineering, of basic and applied science, etc. With and appropriate handling of computation programs and information can be carried out calculations and simulations of real models, to study them and to solve theoretical or application problems. The processes that contain random variables are susceptible of being approached with the Monte Carlo method. This is a numeric method that, thanks to the improvements in the processors of the computers, it can apply in many tasks more than what was made in the principles of their practical application (at the beginning of the decade of 1950). In this work the application of the Monte Carlo method will be approached in the simulation of the radiation interaction with the matter, to investigate dosimetric aspects of some problems that exist in the medical physics area. Also, contain an introduction about some historical data and some general concepts related with the Monte Carlo simulation are revised. (Author)

Prevalence of alcohol problems in general practice

DEFF Research Database (Denmark)

Rambaldi, A; Todisco, N; Gluud, C

1996-01-01

The Michigan Alcoholism Screening Test (MAST) and the response to a question about heavy alcohol consumption were used to assess the prevalence of alcohol problems in consecutive patients (77 males and 46 females) consulting a general practitioner in an urban area in the South of Italy (Castellam...... as a screening question in order to detect alcohol problems and give advice regarding reduction of alcohol consumption....

Generalized production planning problem under interval uncertainty

Directory of Open Access Journals (Sweden)

Samir A. Abass

2010-06-01

Full Text Available Data in many real life engineering and economical problems suffer from inexactness. Herein we assume that we are given some intervals in which the data can simultaneously and independently perturb. We consider the generalized production planning problem with interval data. The interval data are in both of the objective function and constraints. The existing results concerning the qualitative and quantitative analysis of basic notions in parametric production planning problem. These notions are the set of feasible parameters, the solvability set and the stability set of the first kind.

Medical audit on problem analysis and implementing changes at the ...

African Journals Online (AJOL)

Infection control and continuing medical education committees were formed where they did not exist. Conclusion/Recommendation: Hospital medical audit on problem analysis and implementation of changes in health units is highly effective in stimulating and empowering health care workers and hospital administrators to ...

Revisiting the medical diagnosis problem

DEFF Research Database (Denmark)

Ejersbo, Lisser Rye; Leron, Uri

2014-01-01

in the context of probability, with special focus on one case study – the Medical Diagnosis Problem – which figures prominently in the cognitive psychology research literature and in the so-called rationality debate. Our case study involves a combination of theory, design and experiment: Using the extensive...... psychological research as a theoretical base, we design a new “bridging” task, which is on the one hand formally equivalent to the given “difficult” task, but on the other hand is much more accessible to students’ intuitions. Furthermore, this new task would serve as "stepping stone", enabling students to solve...

Medical-isotope supply hit by production problems

Science.gov (United States)

Gould, Paula

2008-10-01

A shortfall in the production of medical isotopes in Europe has forced hospitals to delay patient scans or offer alternative diagnostic tests. The problems began in August when all three nuclear reactors used to generate molybdenum-99, which then decays to form the key nuclear-imaging agent technetium-99, had to be unexpectedly shut down at the same time.

Learning environment, approaches to learning and learning preferences: medical students versus general education students.

Science.gov (United States)

Ullah, Raza

2016-05-01

The main objective of the study was to see whether medical students use more desirable approaches to studying than general education students. Survey method was used to collect data from both the medical students and the general education students. The survey of the medical students was carried out between January and March, 2012. The survey was administered to all the medical students present in lecture halls on day of data collection, while general education students were randomly selected from four subject areas at two universities. In total, 976 medical students and 912 general students participated in the study. Of the general students, 494(54%) were boys and 418(46%)were girls with an overall mean age of 20.53±1.77 years (range: 17-27 years). The medical students' perceptions of their learning environment and their learning preferences were broadly similar to that of general education students with the exception of workload. The medical students perceived the workload to be less appropriate (Mean = 2.06±0.72) than the students in general education (Mean = 2.84±0.90). The medical students were more likely to use the deep approach to studying (Mean = 3.66±0.59) than the students in general education (Mean = 3.16±0.91). The students in general education were slightly more likely to use the organized studying (Mean = 3.44±0.90) than the medical students (Mean =3.23±0.90). Both medical students and the students in general education tended to use the surface approaches along with other approaches to studying. There was not a great difference between the medical students and the students pursuing general education with regard to perceptions of the learning environment and approaches to learning.

Self medication amongst general outpatients in a nigerian community hospital.

Science.gov (United States)

Omolase, C O; Adeleke, O E; Afolabi, A O; Afolabi, O T

2007-12-01

This study was designed to determine the proportion of general out patients who practice self medication, the drugs employed and the reasons for resorting to self medication. This study was conducted between June and December, 2007 at the General Outpatient Clinic of the Federal Medical Centre, Owo, Ondo State, Nigeria. Two hundred consenting respondents were selected by simple random sampling and interviewed with the aid of semi structured questionnaire by the authors with three assistants. Information regarding their bio-data, history of self medication, drugs used and the reasons for resorting to self medication were obtained. Majority of the respondents (85%) admitted to self medication while the remaining proportion (15%) did not practice it. Drugs utilized could be single, usually analgesics (26.5%) and anti-malaria (15.9%) or in combinations, usually antimalaria-analgesics (22.4%), antimalariaanalgesic- antibiotic (15.3%) and antibiotic-analgesic (10.0%). The reasons cited by respondents for self medication were their perception of their complaints been minor enough to be amenable to self medication (54.7%) and financial constraint (22.4%). Majority of the respondents practiced self medication using an array of drugs like analgesics, anti-malaria and antibiotics used either singly or in combination. The main reasons identified for self medication were that the ailments were minor and financial constraint.

Renewed roles for librarians in problem-based learning in the medical curriculum.

Science.gov (United States)

Mi, Misa

2011-01-01

Problem-based learning (PBL) is a teaching-learning process or method of instruction that is widely used in medical education curricula. Librarians play important roles as facilitators for PBL as well as guides for information resources. Involvement in PBL activities presents unique opportunities to incorporate library resources and instruction into the medical curriculum. This article reviews the problem-based learning method within the conceptual framework of the learning theory of constructivism. It describes how a medical librarian at a U.S. medical school used emerging technologies to facilitate PBL small group case discussions, guide students to quality information resources, and enhance the learning environment for the PBL process.

General Practitioners’ Decisions about Discontinuation of Medication

DEFF Research Database (Denmark)

Nixon, Michael Simon; Vendelø, Morten Thanning

2016-01-01

insights about decision making when discontinuing medication. It also offers one of the first examinations of how the institutional context embedding GPs influences their decisions about discontinuation. For policymakers interested in the discontinuation of medication, the findings suggest that de......Purpose – The purpose of this paper is to investigate how general practitioners’ (GPs) decisions about discontinuation of medication are influenced by their institutional context. Design/methodology/approach – In total, 24 GPs were interviewed, three practices were observed and documents were...... a weak frame for discontinuation. Three reasons for this are identified: the guidelines provide dominating triggers for prescribing, they provide weak priming for discontinuation as an option, and they underscore a cognitive constraint against discontinuation. Originality/value – The analysis offers new...

Medication-related problem type and appearance rate in ambulatory hemodialysis patients

Directory of Open Access Journals (Sweden)

Drayer Debra K

2003-12-01

Full Text Available Abstract Background Hemodialysis (HD patients are at risk for medication-related problems (MRP. The MRP number, type, and appearance rate over time in ambulatory HD patients has not been investigated. Methods Randomly selected HD patients were enrolled to receive monthly pharmaceutical care visits. At each visit, MRP were identified through review of the patient chart, electronic medical record, patient interview, and communications with other healthcare disciplines. All MRP were categorized by type and medication class. MRP appearance rate was determined as the number of MRP identified per month/number of months in study. The number of MRP per patient-drug exposures were determined using: {[(number of patients × (mean number of medications]/(number of months of study} /number of MRP identified. Results were expressed as mean ± standard deviation or percentages. Results Patients were 62.6 ± 15.9 years old, had 6.4 ± 2.0 comorbid conditions, were taking 12.5 ± 4.2 medications, and 15.7 ± 7.2 doses per day at baseline. Medication-dosing problems (33.5%, adverse drug reactions (20.7%, and an indication that was not currently being treated (13.5% were the most common MRP. 5,373 medication orders were reviewed and a MRP was identified every 15.2 medication exposures. Overall MRP appearance rate was 0.68 ± 0.46 per patient per month. Conclusion MRP continue to occur at a high rate in ambulatory HD patients. Healthcare providers taking care of HD patients should be aware of this problem and efforts to avoid or resolve MRP should be undertaken at all HD clinics.

Educational Problems of Kermanshah Medical School: View Points of Students, Graduates and Faculty Members

Directory of Open Access Journals (Sweden)

soraia Siabani

2009-07-01

Full Text Available Background and purpose: In recent years although the number of students registering for medicines has decreased in Kermanshah University of Medical sciences parallel to other universities of medical sciences the quality of educational services has not improved the informal reports suggests that the competency of medical graduates is not satisfactory Since any intervention needs situation analysis this study was conducted to obtain viewpoints of three main groups of stockholders including faculty members, students and graduates on medical school problems and insufficiencies.Methods: In this qualitative study faculty members of medical schools, medical graduated of 2005-6, and medical students of different phases participated. With participation of these subjects Focus Group Discussion (FGD sessions were carried out. The goals of the projects were first explained for participants. In the end of each discussion session the discussions were careful transcribed. The sessions continued till the sessions get saturated. The transcript of discussion was thoroughly reviewed by researchers and codified. The problems were classified in 7 areas of management, planning, education goals, evaluation, ethics, teaching, and students.Results: The subjects believed that the most important problems in Kermanshah medical school include neglecting the student evaluation, no educational objectives or being inattentive to them, unwanted effects of pay for service plan, too much duties for interns (students, overload of medical duties and insufficiency in the number of faculty members, no rewarding system for teachers, inattention to needed outcomes, shortage of facilities for student in hospital and being negligent about mutual respect between students and teachers.Conclusion: some of the problems such as the effects of pay for service plan and insufficiency in the number of faculty members have solutions stemming beyond the university at Ministry of Health level

Customer satisfaction in medical service encounters -- a comparison between obstetrics and gynecology patients and general medical patients.

Science.gov (United States)

Chang, Ching-Sheng; Weng, Hui-Ching; Chang, Hsin-Hsin; Hsu, Tsuen-Ho

2006-03-01

This study is concerned with the "service encounter", and seeks to describe, by use of the Service Encounter Evaluation Model, how the processes involved in the service encounter affect customer satisfaction. Its findings have implications for management practice and research directions, and recommendations are made. With the implementation of a national health insurance scheme, an ever-prospering economy and continually improving educational levels in Taiwan, demand among citizens for good health and medical care is ever increasing. Obstetrics and gynecology patients often differ greatly from general patients, in terms of their moods and emotions. This research involved an empirical study, whose subjects were 590 customers of general clinics and 339 customers of gynecology clinics, in various medical centers in southern Taiwan. By factor analysis, the study established four influencing factors, which were "Medical professionals", "Nursing professionals", "Service personnel" and "Space and facilities". Using the Linear Structural Relation Model (LISREL), it found that medical professionals, nursing professionals, service personnel and space and facilities were effective predictors of medical treatment satisfaction. We also found that the greatest positive impact on overall medical treatment satisfaction resulted from rises in satisfaction with medical professionals, but that the least impact was achieved in relation to service personnel in the general and gynecology clinics.

Medical Problem-Solving: A Critique of the Literature.

Science.gov (United States)

McGuire, Christine H.

1985-01-01

Prescriptive, decision-analysis of medical problem-solving has been based on decision theory that involves calculation and manipulation of complex probability and utility values to arrive at optimal decisions that will maximize patient benefits. The studies offer a methodology for improving clinical judgment. (Author/MLW)

Generalized Benders’ Decomposition for topology optimization problems

DEFF Research Database (Denmark)

Munoz Queupumil, Eduardo Javier; Stolpe, Mathias

2011-01-01

) problems with discrete design variables to global optimality. We present the theoretical aspects of the method, including a proof of finite convergence and conditions for obtaining global optimal solutions. The method is also linked to, and compared with, an Outer-Approximation approach and a mixed 0......–1 semi definite programming formulation of the considered problem. Several ways to accelerate the method are suggested and an implementation is described. Finally, a set of truss topology optimization problems are numerically solved to global optimality.......This article considers the non-linear mixed 0–1 optimization problems that appear in topology optimization of load carrying structures. The main objective is to present a Generalized Benders’ Decomposition (GBD) method for solving single and multiple load minimum compliance (maximum stiffness...

Medical-biological problems

International Nuclear Information System (INIS)

1986-01-01

The report contains data on operational and emergency staff of the Chernobyl nuclear power plant who were exposed to radiation as a consequence of the reactor accident, the size of the doses received and consequences for health. 203 persons were found to have acute radiation sickness. Of the 22 patients suffering from an extremely severe degree of acute radiation sickness, 19 died. Of the 23 patients with severe bone marrow syndrome, 7 died. For the majority of patients, clinical recovery occurred toward the end of the second month following the accident. The main harmful factor for all victims was the relatively uniform gamma- and beta-radiation effect in a dosage exceeding 1 Gy and, in the case of 35 people exceeding 4 Gy. Radiation damage to wide areas of the skin was one of the main factors contributing to the overall severe condition of the patients, and was a determining factor in the main fatal complications. A preliminary evaluation of the use of some biochemical and immunological tests in the event of accidental exposure to radiation and the methods of treatment and preliminary assessment of their effectiveness are presented. Another part of the report contains data on the doses from radiation exposure to the population of the town of Pripyat' until the time of evacuation and to the population in the 30 km zone around Chernobyl' nuclear power plant and radiation consequences of the accident for the population of different regions in the European part of the USSR, especially the problems related to the contamination of food products. The last part of the report gives some data on the organization of medical examinations of the population from the region around the Chernobyl' plant and on the long-term programmes for the medical and biological monitoring of the population and personnel

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

Science.gov (United States)

Parker, Johanna E; Hudson, Ben; Wilkinson, Tim J

2014-03-01

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

[E-Learning--an important contribution to general medical training and continuing education?].

Science.gov (United States)

Ruf, D; Berner, M M; Kriston, L; Härter, M

2008-09-01

There is increasing activity in the development of e-learning modules for general medical training and continuing education. One of the central advantages of e-learning is flexibility regarding time and place of its use. The quality of the available e-learning opportunities varies quite considerably. For users it is often not easy to assess the quality of e-learning modules or to find offers of high quality. This could be a reason for the fact that despite the huge number of e-learning modules still only few students and physicians are using them. This is although e-learning has proven to be as effective as and even more efficient than learning in the classroom or with paper-based materials. This article summarizes the different models of e-learning, how and where to find offers of high quality, advantages of using e-learning, and the effectiveness and efficiency of such offers. In addition problems of e-learning and possibilities to overcome these problems are shown.

Modified and fuzzified general problem solver for 'monkey and banana' problem

International Nuclear Information System (INIS)

Sano, Norihide; Takahashi, Ryoichi.

1994-01-01

Automatic operation is important for the in-service inspection of nuclear power stations of the decommission of retired plants. Master and slave control will be introduced for work-robot control. It is desirable that the slave possess problem-solving capabilities. In this paper we assume that the slave incorporates the general problem solver (GPS) algorithm. In view of having solved the 'monkey and banana' problem, the slave system is regarded as reasonable alternative which incorporates the capability of problem-solving. Basically, the GPS solves a problem by reducing the difference between the initial state and goal state, and hence the performance of GPS depends on selection of the difference to be reduced. The conventional GPS is given the order of importance of the differences in advance. In this study, the GPS was improved by making use of the rules which determine the order. When several choices are available for the given difference, a fuzzified decision to determine the necessary action is made, as demonstrated in this paper. (author)

Training general practitioners in behavior change counseling to improve asthma medication adherence

NARCIS (Netherlands)

Broers, Sandra; Smets, Ellen; Bindels, Patrick; Bennebroek Evertsz', Floor; Calff, Mart; de Haes, Hanneke

2005-01-01

Objective: Adherence to asthma medication regimens is problematic in general practice. We developed and evaluated a communication training for general practitioners (GPs) to help them address medication adherence during routine consultations. This paper describes the development of the training and

Nanomedicine concepts in the general medical curriculum: initiating a discussion.

Science.gov (United States)

Sweeney, Aldrin E

2015-01-01

Various applications of nanoscale science to the field of medicine have resulted in the ongoing development of the subfield of nanomedicine. Within the past several years, there has been a concurrent proliferation of academic journals, textbooks, and other professional literature addressing fundamental basic science research and seminal clinical developments in nanomedicine. Additionally, there is now broad consensus among medical researchers and practitioners that along with personalized medicine and regenerative medicine, nanomedicine is likely to revolutionize our definitions of what constitutes human disease and its treatment. In light of these developments, incorporation of key nanomedicine concepts into the general medical curriculum ought to be considered. Here, I offer for consideration five key nanomedicine concepts, along with suggestions regarding the manner in which they might be incorporated effectively into the general medical curriculum. Related curricular issues and implications for medical education also are presented.

Generalized Riemann problem for reactive flows

International Nuclear Information System (INIS)

Ben-Artzi, M.

1989-01-01

A generalized Riemann problem is introduced for the equations of reactive non-viscous compressible flow in one space dimension. Initial data are assumed to be linearly distributed on both sides of a jump discontinuity. The resolution of the singularity is studied and the first-order variation (in time) of flow variables is given in exact form. copyright 1989 Academic Press, Inc

Reasons of general practitioners for not prescribing lipid-lowering medication to patients with diabetes: a qualitative study

Directory of Open Access Journals (Sweden)

AB Elisabeth

2009-04-01

Full Text Available Abstract Background Lipid-lowering medication remains underused, even in high-risk populations. The objective of this study was to determine factors underlying general practitioners' decisions not to prescribe such drugs to patients with type 2 diabetes. Methods A qualitative study with semi-structured interviews using real cases was conducted to explore reasons for not prescribing lipid-lowering medication after a guideline was distributed that recommended the use of statins in most patients with type 2 diabetes. Seven interviews were conducted with general practitioners (GPs in The Netherlands, and analysed using an analytic inductive approach. Results Reasons for not-prescribing could be divided into patient and physician-attributed factors. According to the GPs, some patients do not follow-up on agreed medication and others object to taking lipid-lowering medication, partly for legitimate reasons such as expected or perceived side effects. Furthermore, the GPs themselves perceived reservations for prescribing lipid-lowering medication in patients with short life expectancy, expected compliance problems or near goal lipid levels. GPs sometimes postponed the start of treatment because of other priorities. Finally, barriers were seen in the GPs' practice organisation, and at the primary-secondary care interface. Conclusion Some of the barriers mentioned by GPs seem to be valid reasons, showing that guideline non-adherence can be quite rational. On the other hand, treatment quality could improve by addressing issues, such as lack of knowledge or motivation of both the patient and the GP. More structured management in general practice may also lead to better treatment.

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

Science.gov (United States)

Bourke, Jane; Roper, Stephen

2014-10-01

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

Prescribing of pain medication in palliative care. A survey in general practice

NARCIS (Netherlands)

Borgsteede, Sander D.; Deliens, Luc; Zuurmond, Wouter W. A.; Schellevis, François G.; Willems, Dick L.; van der Wal, Gerrit; van Eijk, Jacques Th M.

2009-01-01

Purpose To examine what pain and adjuvant medication is prescribed in palliative care patients at home in The Netherlands. Methods In a nationwide, representative, prospective study in general practice in The Netherlands, prescribed medication was registered in 95 general practices with a listed

Prescribing of pain medication in palliative care: a survey in general practice.

NARCIS (Netherlands)

Borgsteede, S.D.; Deliens, L.; Zuurmond, W.W.A.; Schellevis, F.; Willems, D.L.; Wal, G. van der; Eijk, J.T.M. van

2009-01-01

PURPOSE: To examine what pain and adjuvant medication is prescribed in palliative care patients at home in The Netherlands. METHODS: In a nationwide, representative, prospective study in general practice in The Netherlands, prescribed medication was registered in 95 general practices with a listed

Effect of smartphone overuse on sleep problems in medical students

OpenAIRE

Pairoj Boonluksiri

2018-01-01

Background: Smartphones are used worldwide. Consequently, it does seem to be having an impact on health-related problems if overused. However, it is uncertain whether it is associated with sleep problems or poor learning. Objective: To determine the association between smartphone overuse and sleep problems in medical students as primary outcome and poor learning as secondary outcome. Methods: A cross-sectional study was conducted in 89 students having their own smartphones, at Hatyai...

Study of sleep habits and sleep problems among medical students of pravara institute of medical sciences loni, Western maharashtra, India.

Science.gov (United States)

Giri, Pa; Baviskar, Mp; Phalke, Db

2013-01-01

Good quality sleep and adequate amount of sleep are important in order to have better cognitive performance and avoid health problems and psychiatric disorders. The aim of this study was to describe sleep habits and sleep problems in a population of undergraduates, interns and postgraduate students of Pravara Institute of Medical Sciences (Deemed University), Loni, Maharashtra, India. Sleep habits and problems were investigated using a convenience sample of students from Pravara Institute of Medical Sciences (Deemed University), Loni, Maharashtra, India. The study was carried out during Oct. to Dec. 2011 with population consisted of total 150 medical students. A self-administered questionnaire developed based on Epworth Daytime Sleepiness Scale and Pittsburgh Sleep Quality Index was used. Data was analyzed by using Statistical Package of Social Sciences (SPSS) version 16.0. In this study, out of 150 medical students, 26/150 (17.3%) students had abnormal levels of daytime sleepiness while 20/150 (13.3%) were border line. Sleep quality in females was better than the male. Disorders related to poor sleep qualities are significant problems among medical students in our institution. Caffeine and alcohol ingestion affected sleep and there was high level of daytime sleepiness. Sleep difficulties resulted in irritability and affected lifestyle and interpersonal relationships.

Reduction of the general Spitzer-Haerm problem in plasma physics

International Nuclear Information System (INIS)

Ferreira, A.

1988-01-01

The general Spitzer-Haerm problem is unfolded through a redefinition of the dependent variable into two separate simpler problems. The first takes the form of a second order differential equation, and the second, that of an integration over the solution of the first problem, which provides the distribution function or, directly, the current and the heat flow. It is shown that the current and the heat flow can in general by synthesized from the solutions of the differential equation for two specific forms of the driving term. (author)

Medical students, early general practice placements and positive supervisor experiences.

Science.gov (United States)

Henderson, Margaret; Upham, Susan; King, David; Dick, Marie-Louise; van Driel, Mieke

2018-03-01

Introduction Community-based longitudinal clinical placements for medical students are becoming more common globally. The perspective of supervising clinicians about their experiences and processes involved in maximising these training experiences has received less attention than that of students. Aims This paper explores the general practitioner (GP) supervisor perspective of positive training experiences with medical students undertaking urban community-based, longitudinal clinical placements in the early years of medical training. Methods Year 2 medical students spent a half-day per week in general practice for either 13 or 26 weeks. Transcribed semi-structured interviews from a convenience sample of participating GPs were thematically analysed by two researchers, using a general inductive approach. Results Identified themes related to the attributes of participating persons and organisations: GPs, students, patients, practices and their supporting institution; GPs' perceptions of student development; and triggers enhancing the experience. A model was developed to reflect these themes. Conclusions Training experiences were enhanced for GPs supervising medical students in early longitudinal clinical placements by the synergy of motivated students and keen teachers with support from patients, practice staff and academic institutions. We developed an explanatory model to better understand the mechanism of positive experiences. Understanding the interaction of factors enhancing teaching satisfaction is important for clinical disciplines wishing to maintain sustainable, high quality teaching.

Correlation between General Health with Emotional Intelligence and Creativity in Medical College Students at Islamic Azad University, Sari Branch, Sari, Iran

Directory of Open Access Journals (Sweden)

MK Fakhri

2012-07-01

Full Text Available

Background and Objectives: Medical students are a particular class of students that Because of their specific problems, investigation of their general health has always been considered. This study is concerned with investigation of relationship between general health and emotional intelligence and creativity in medical college students at Islamic Azad University, Sari branch.

Methods: 150 medical college students at Islamic Azad University, Sari branch (45 males and 105 females, were randomly selected and Goldberg general health, Shring emotional intelligence and Abedi creativity questionnaire were completed. For data analysis, Pearson correlation and independent t-test were used.

Results: Results showed that: there is positive relationship between general health and emotional intelligence (r=0.53 and p<0.05, there is a positive relationship between general health and creativity (r=0.60 and p<0.01, and female college students are healthier than males (p<0.05.

Conclusion: results of this research indicated that there is a positive relationship between general health and emotional intelligence and creativity, and since these variables are effective in professional prospect of Medical students, employing cognitive and behavioral methods in promotion of general health in these students seem necessary.

Generalized coherent states for the Coulomb problem in one dimension

International Nuclear Information System (INIS)

Nouri, S.

2002-01-01

A set of generalized coherent states for the one-dimensional Coulomb problem in coordinate representation is constructed. At first, we obtain a mapping for proper transformation of the one-dimensional Coulomb problem into a nonrotating four-dimensional isotropic harmonic oscillator in the hyperspherical space, and the generalized coherent states for the one-dimensional Coulomb problem is then obtained in exact closed form. This exactly soluble model can provide an adequate means for a quantum coherency description of the Coulomb problem in one dimension, sample for coherent aspects of the exciton model in one-dimension example in high-temperature superconductivity, semiconductors, and polymers. Also, it can be useful for investigating the coherent scattering of the Coulomb particles in one dimension

Polymorphic Uncertain Linear Programming for Generalized Production Planning Problems

Directory of Open Access Journals (Sweden)

Xinbo Zhang

2014-01-01

Full Text Available A polymorphic uncertain linear programming (PULP model is constructed to formulate a class of generalized production planning problems. In accordance with the practical environment, some factors such as the consumption of raw material, the limitation of resource and the demand of product are incorporated into the model as parameters of interval and fuzzy subsets, respectively. Based on the theory of fuzzy interval program and the modified possibility degree for the order of interval numbers, a deterministic equivalent formulation for this model is derived such that a robust solution for the uncertain optimization problem is obtained. Case study indicates that the constructed model and the proposed solution are useful to search for an optimal production plan for the polymorphic uncertain generalized production planning problems.

Lobb's Generalization of Catalan's Parenthesization Problem

Science.gov (United States)

Koshy, Thomas

2009-01-01

A. Lobb discovered an interesting generalization of Catalan's parenthesization problem, namely: Find the number L(n, m) of arrangements of n + m positive ones and n - m negative ones such that every partial sum is nonnegative, where 0 = m = n. This article uses Lobb's formula, L(n, m) = (2m + 1)/(n + m + 1) C(2n, n + m), where C is the usual…

Nanomedicine concepts in the general medical curriculum: initiating a discussion

Directory of Open Access Journals (Sweden)

Sweeney AE

2015-12-01

Full Text Available Aldrin E Sweeney Center for Teaching & Learning, Ross University School of Medicine, Roseau, Commonwealth of Dominica Abstract: Various applications of nanoscale science to the field of medicine have resulted in the ongoing development of the subfield of nanomedicine. Within the past several years, there has been a concurrent proliferation of academic journals, textbooks, and other professional literature addressing fundamental basic science research and seminal clinical developments in nanomedicine. Additionally, there is now broad consensus among medical researchers and practitioners that along with personalized medicine and regenerative medicine, nanomedicine is likely to revolutionize our definitions of what constitutes human disease and its treatment. In light of these developments, incorporation of key nanomedicine concepts into the general medical curriculum ought to be considered. Here, I offer for consideration five key nanomedicine concepts, along with suggestions regarding the manner in which they might be incorporated effectively into the general medical curriculum. Related curricular issues and implications for medical education also are presented. Keywords: medical education, basic science, teaching, learning, assessment, nanoscience curriculum, nanomedicine concepts

Medical problems of survivors of nuclear war: Infection and the spread of communicable disease

International Nuclear Information System (INIS)

Abrams, H.L.; VonKaenel, W.E.

1984-01-01

The nature of the medical problems produced by the aftermath of nuclear war is discussed. The survivors of nuclear war will live without the social structure needed to assure food, water, and shelter. They will experience malnutrition, exposure, and fatigue, which are all favorable to infection and the epidemic spread of communicable disease. The authors analyze the problem of infectious illness in the postattack period, assuming the 6,559 megaton attack scenario used by the Federal Emergency Management Agency. A particular contribution of this analysis is that it is based on government technical reports that describe the available computer modeling of postattack conditions. Such simulations allow a semiquantitative estimate of deaths due to infection. They estimate that postattack infectious disease mortality will be 25%. These studies are not accessible to the general reader and are difficult for health professionals to interpret

Generalized Nash equilibrium problems, bilevel programming and mpec

CERN Document Server

Lalitha, CS

2017-01-01

The book discusses three classes of problems: the generalized Nash equilibrium problems, the bilevel problems and the mathematical programming with equilibrium constraints (MPEC). These problems interact through their mathematical analysis as well as their applications. The primary aim of the book is to present the modern tool of variational analysis and optimization, which are used to analyze these three classes of problems. All contributing authors are respected academicians, scientists and researchers from around the globe. These contributions are based on the lectures delivered by experts at CIMPA School, held at the University of Delhi, India, from 25 November–6 December 2013, and peer-reviewed by international experts. The book contains five chapters. Chapter 1 deals with nonsmooth, nonconvex bilevel optimization problems whose feasible set is described by using the graph of the solution set mapping of a parametric optimization problem. Chapter 2 describes a constraint qualification to MPECs considere...

Differences in the Volume of Pharmaceutical Advertisements between Print General Medical Journals

Science.gov (United States)

Gettings, Jennifer; O'Neill, Braden; Chokshi, Dave A.; Colbert, James A.; Gill, Peter; Lebovic, Gerald; Lexchin, Joel; Persaud, Navindra

2014-01-01

Background Pharmaceutical advertisements have been argued to provide revenue that medical journals require but they are intended to alter prescribing behaviour and they are known to include low quality information. We determined whether a difference exists in the current level of pharmaceutical advertising in print general medical journals, and we estimated the revenue generated from print pharmaceutical advertising. Methods Six print general medical journals in Canada, the United States, and the United Kingdom were sampled between 2007 and 2012. The number of advertisements and other journal content in selected issues of the Canadian Medical Association Journal (CMAJ), Canadian Family Physician (CFP), Journal of the American Medical Association (JAMA), New England Journal of Medicine (NEJM), British Medical Journal (BMJ), and Lancet were determined. Revenue gained from pharmaceutical advertising was estimated using each journal's 2013 advertising price list. Findings The two Canadian journals sampled (CMAJ, CFP) contained five times more advertisements than the two American journals (JAMA, NEJM), and two British journals (BMJ, Lancet) (padvertisements ranged from £0.025 million (for Lancet) to £3.8 million (for JAMA). The cost savings due to revenue from pharmaceutical advertising to each individual subscriber ranged from £0.02 (for Lancet) to £3.56 (for CFP) per issue. Conclusion The volume of pharmaceutical advertisements differs between general medical journals, with the two Canadian journals sampled containing the most advertisements. International and temporal variations suggest that there is an opportunity for all general medical journals to reduce the number of pharmaceutical advertisements, explore other sources of revenue, and increase transparency regarding sources of revenue. PMID:24416286

Differences in the volume of pharmaceutical advertisements between print general medical journals.

Science.gov (United States)

Gettings, Jennifer; O'Neill, Braden; Chokshi, Dave A; Colbert, James A; Gill, Peter; Lebovic, Gerald; Lexchin, Joel; Persaud, Navindra

2014-01-01

Pharmaceutical advertisements have been argued to provide revenue that medical journals require but they are intended to alter prescribing behaviour and they are known to include low quality information. We determined whether a difference exists in the current level of pharmaceutical advertising in print general medical journals, and we estimated the revenue generated from print pharmaceutical advertising. Six print general medical journals in Canada, the United States, and the United Kingdom were sampled between 2007 and 2012. The number of advertisements and other journal content in selected issues of the Canadian Medical Association Journal (CMAJ), Canadian Family Physician (CFP), Journal of the American Medical Association (JAMA), New England Journal of Medicine (NEJM), British Medical Journal (BMJ), and Lancet were determined. Revenue gained from pharmaceutical advertising was estimated using each journal's 2013 advertising price list. The two Canadian journals sampled (CMAJ, CFP) contained five times more advertisements than the two American journals (JAMA, NEJM), and two British journals (BMJ, Lancet) (padvertisements ranged from £0.025 million (for Lancet) to £3.8 million (for JAMA). The cost savings due to revenue from pharmaceutical advertising to each individual subscriber ranged from £0.02 (for Lancet) to £3.56 (for CFP) per issue. The volume of pharmaceutical advertisements differs between general medical journals, with the two Canadian journals sampled containing the most advertisements. International and temporal variations suggest that there is an opportunity for all general medical journals to reduce the number of pharmaceutical advertisements, explore other sources of revenue, and increase transparency regarding sources of revenue.

Medical taking-decisions in the health primary assistance context. Transcendence of a problem from a general comprehensive doctor´s perspective.

OpenAIRE

Luis Alberto Corona Martínez

2003-01-01

This article is aimed at deepening on the consequences of the deficient development of abilities in decision making in the speciality of medicine, analysed from the prospective of the Comprehensive General Doctor . A psychological and professional characterisation of the Comprehensive General Doctors are developed from the analysis of their environment and on these bases the paper presents how these problems are reflected in the professional assistance. The conclusions are good to recognise h...

The pattern of trauma in private general medical practice set-up Port ...

African Journals Online (AJOL)

BACKGROUND: Private general medical practice establishments appear to be treating a significant number of trauma cases including more serious ones. Aim: To find out the extent of such treatment of trauma and what has made this possible. METHODS: All trauma cases treated in a private general medical practice set up ...

Structured Medication Review to Improve Pharmacotherapy in People with Intellectual Disability and Behavioural Problems.

Science.gov (United States)

Scheifes, Arlette; Egberts, Toine C G; Stolker, Joost Jan; Nijman, Henk L I; Heerdink, Eibert R

2016-07-01

Polypharmacy and chronic drug use are common in people with intellectual disability and behavioural problems, although evidence of effectiveness and safety in this population is lacking. This study examined the effects of a structured medication review and aimed to improve pharmacotherapy in inpatients with intellectual disability. In a treatment facility for people with mild to borderline intellectual disability and severe behavioural problems, a structured medication review was performed. Prevalence and type of drug-related problems (DRPs) and of the recommended and executed actions were calculated. In a total of 55 patients with intellectual disability and behavioural problems, 284 medications were prescribed, in which a DRP was seen in 106 (34%). No indication/unclear indication was the most prevalent DRP (70). Almost 60% of the recommended actions were also executed. This high prevalence of DRPs is worrying. The structured medication review is a valuable instrument to optimize pharmacotherapy and to support psychiatrists in adequate prescribing of both psychotropic and somatic drugs. © 2015 John Wiley & Sons Ltd.

Application of Neutrosophic Set Theory in Generalized Assignment Problem

Directory of Open Access Journals (Sweden)

Supriya Kar

2015-09-01

Full Text Available This paper presents the application of Neutrosophic Set Theory (NST in solving Generalized Assignment Problem (GAP. GAP has been solved earlier under fuzzy environment. NST is a generalization of the concept of classical set, fuzzy set, interval-valued fuzzy set, intuitionistic fuzzy set. Elements of Neutrosophic set are characterized by a truth-membership function, falsity and also indeterminacy which is a more realistic way of expressing the parameters in real life problem. Here the elements of the cost matrix for the GAP are considered as neutrosophic elements which have not been considered earlier by any other author. The problem has been solved by evaluating score function matrix and then solving it by Extremum Difference Method (EDM [1] to get the optimal assignment. The method has been demonstrated by a suitable numerical example.

[Current situations and problems of quality control for medical imaging display systems].

Science.gov (United States)

Shibutani, Takayuki; Setojima, Tsuyoshi; Ueda, Katsumi; Takada, Katsumi; Okuno, Teiichi; Onoguchi, Masahisa; Nakajima, Tadashi; Fujisawa, Ichiro

2015-04-01

Diagnostic imaging has been shifted rapidly from film to monitor diagnostic. Consequently, Japan medical imaging and radiological systems industries association (JIRA) have recommended methods of quality control (QC) for medical imaging display systems. However, in spite of its need by majority of people, executing rate is low. The purpose of this study was to validate the problem including check items about QC for medical imaging display systems. We performed acceptance test of medical imaging display monitors based on Japanese engineering standards of radiological apparatus (JESRA) X-0093*A-2005 to 2009, and performed constancy test based on JESRA X-0093*A-2010 from 2010 to 2012. Furthermore, we investigated the cause of trouble and repaired number. Medical imaging display monitors had 23 inappropriate monitors about visual estimation, and all these monitors were not criteria of JESRA about luminance uniformity. Max luminance was significantly lower year-by-year about measurement estimation, and the 29 monitors did not meet the criteria of JESRA about luminance deviation. Repaired number of medical imaging display monitors had 25, and the cause was failure liquid crystal panel. We suggested the problems about medical imaging display systems.

National data analysis of general radiography projection method in medical imaging

Energy Technology Data Exchange (ETDEWEB)

Kim, Jung Su; Seo, Deok Nam; Choi, In Seok [Dept. of Bio-Convergence Engineering, Korea University Graduate School, Seoul (Korea, Republic of); and others

2014-09-15

According to database of medical institutions of health insurance review and assessment service in 2013, 1,118 hospitals and clinics have department of radiology in Korea. And there are CT, fluoroscopic and general radiographic equipment in those hospitals. Above all, general radiographic equipment is the most commonly used in the radiology department. And most of the general radiographic equipment are changing the digital radiography system from the film-screen types of the radiography system nowadays. However, most of the digital radiography department are used the film-screen types of the radiography system. Therefore, in this study, we confirmed present conditions of technical items for general radiography used in hospital and research on general radiographic techniques in domestic medical institutions. We analyzed 26 radiography projection method including chest, skull, spine and pelvis which are generally used in the radiography department.

[Problem areas and examples of best practice in intersectoral medication treatment--a literature review].

Science.gov (United States)

Mehrmann, Lena; Ollenschläger, Günter

2014-01-01

Transitions between the outpatient and inpatient sector are a critical phase in medication treatment. This article provides an overview of published problem areas and examples of best practice in the intersectoral medication treatment. Data with regard to related problem areas and examples of best practice was collected in August 2011 by a systematic literature research. The relevant literature was identified using the following databases and search engines: MEDLINE, The Cochrane Library, EMBASE, Google, and Google Scholar. Additionally, a hand search was done on the websites of SpringerLink and Thieme Connect. The initial search yielded a total of 4,409 records which were further selected in two screening steps and analysed according to their relevance. Of the remaining 63 records, 3 exclusively described problem areas, 11 of them examples of best practice, and 49 provided information on both problem areas and examples of best practice with regard to intersectoral medication treatment. Among other things, problem areas include varying legal regulations in inpatient and outpatient medication treatment, drug therapy interruptions after hospital discharge, or deficits in communication and continuity of care. Examples of best practice are projects, programmes, initiatives, recommendations, and points to consider with respect to medication reconciliation, pharmaceutical support, or transitions of care. Problem areas as well as examples of best practice are mainly focused on the transition from inpatient to outpatient care. Copyright © 2013. Published by Elsevier GmbH.

Undergraduate medical student's perceptions on traditional and problem based curricula: pilot study.

Science.gov (United States)

Meo, Sultan Ayoub

2014-07-01

To evaluate and compare students' perceptions about teaching and learning, knowledge and skills, outcomes of course materials and their satisfaction in traditional Lecture Based learning versus Problem-Based Learning curricula in two different medical schools. The comparative cross-sectional questionnaire-based study was conducted in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia, from July 2009 to January 2011. Two different undergraduate medical schools were selected; one followed the traditional curriculum, while the other followed the problem-based learning curriculum. Two equal groups of first year medical students were selected. They were taught in respiratory physiology and lung function lab according to their curriculum for a period of two weeks. At the completion of the study period, a five-point Likert scale was used to assess students' perceptions on satisfaction, academic environment, teaching and learning, knowledge and skills and outcomes of course materials about effectiveness of problem-based learning compared to traditional methods. SPSS 19 was used for statistical analysis. Students used to problem-based learning curriculum obtained marginally higher scores in their perceptions (24.10 +/- 3.63) compared to ones following the traditional curriculum (22.67 +/- 3.74). However, the difference in perceptions did not achieve a level of statistical significance. Students following problem-based learning curriculum have more positive perceptions on teaching and learning, knowledge and skills, outcomes of their course materials and satisfaction compared to the students belonging to the traditional style of medical school. However, the difference between the two groups was not statistically significant.

Medical and psychological problems faced by young Australian gap year travellers.

Science.gov (United States)

Furuya-Kanamori, Luis; Mills, Deborah; Sheridan, Sarah; Lau, Colleen

2017-09-01

Gap year travellers can potentially be exposed to many infectious diseases and other travel-related health problems including injuries and psychological problems. Currently, there is little information on health and wellbeing of this particular group of travellers. Participants were recruited from an organization that specialized in organising international gap year placements. Gap year travellers were asked to complete a pre-departure survey on demographics, placement destination and duration, previous travel experience, hobbies, risk taking behaviour, anticipated problems during the placement, and pre-travel preparations. After the placement, participants were asked to complete a post-trip survey on their experiences, problems, health issues, and medical treatment required. The 88 and 34 gap year travellers aged 17-23 years completed pre- and post-placement surveys respectively. The duration of placements ranged from 3 to 12 months. Psychological stressors were frequently reported [ n = 26 (76.5%) felt home sick; n = 18 (52.9%) experienced culture shock; n = 17 (50.0%) had difficulty communicating with the locals]. The majority of participants (91.2%) tried to work out a solution for the stressor on their own. Twenty-eight (82.4%) participants reported medical problems during their placement; the most common problems were sunburn ( n = 19; 55.9%), respiratory infections ( n = 15; 44.1%), weight change ( n = 14; 41.2%), and diarrhoea/food poisoning ( n = 13; 38.2%). Three participants (3.4%) were admitted to hospital; for a muscle injury, head injury and skin infection after getting a tribal tattoo. Psychological stressors were common, but most did not seek help. Some medical problems encountered during their placement may have been preventable with improved pre-departure preparation. Gap year, pre-departure, preparation. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e

Problems associated with the organization and planning of medical aid for radiation accident casualties

International Nuclear Information System (INIS)

Jammet, H.P.

1977-01-01

Problems associated with the organization and planning of medical treatment for radiation accident casualties are considered for different types of radiation accident: whole-body or partial irradiation, external or internal contamination and small or large numbers of cases. The problems posed are ones of competence, urgency and capacity; on the diagnostic side there is the problem of evaluating the exposure or contamination and assessing the resultant damage, while on the treatment side the questions of first aid, conventional treatment and specialized treatment have to be considered. The solutions envisaged involve organization at the local and national levels and planning of medical treatment by skilled, multidisciplinary medical teams. (author)

Differences in the volume of pharmaceutical advertisements between print general medical journals.

Directory of Open Access Journals (Sweden)

Jennifer Gettings

Full Text Available BACKGROUND: Pharmaceutical advertisements have been argued to provide revenue that medical journals require but they are intended to alter prescribing behaviour and they are known to include low quality information. We determined whether a difference exists in the current level of pharmaceutical advertising in print general medical journals, and we estimated the revenue generated from print pharmaceutical advertising. METHODS: Six print general medical journals in Canada, the United States, and the United Kingdom were sampled between 2007 and 2012. The number of advertisements and other journal content in selected issues of the Canadian Medical Association Journal (CMAJ, Canadian Family Physician (CFP, Journal of the American Medical Association (JAMA, New England Journal of Medicine (NEJM, British Medical Journal (BMJ, and Lancet were determined. Revenue gained from pharmaceutical advertising was estimated using each journal's 2013 advertising price list. FINDINGS: The two Canadian journals sampled (CMAJ, CFP contained five times more advertisements than the two American journals (JAMA, NEJM, and two British journals (BMJ, Lancet (p<0.0001. The estimated annual revenue from pharmaceutical advertisements ranged from £0.025 million (for Lancet to £3.8 million (for JAMA. The cost savings due to revenue from pharmaceutical advertising to each individual subscriber ranged from £0.02 (for Lancet to £3.56 (for CFP per issue. CONCLUSION: The volume of pharmaceutical advertisements differs between general medical journals, with the two Canadian journals sampled containing the most advertisements. International and temporal variations suggest that there is an opportunity for all general medical journals to reduce the number of pharmaceutical advertisements, explore other sources of revenue, and increase transparency regarding sources of revenue.

Medical engagement and organizational characteristics in general practice

DEFF Research Database (Denmark)

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

2016-01-01

BACKGROUND: Medical engagement is a mutual concept of the active and positive contribution of doctors to maintaining and enhancing the performance of their health care organization, which itself recognizes this commitment in supporting and encouraging high quality care. A Medical Engagement Scale...... and organizational characteristics. DESIGN AND SETTING: A cross-sectional study using a sampled survey questionnaire and the official register from the Danish General Practitioners' Organization comprising all registered Danish GPs. METHOD: The Danish version of the MES Questionnaire was distributed and the survey...... and this is determined by a complex interaction between both individual and organizational characteristics. Working in collaboration, having staff and being engaged in vocational training of junior doctors are all associated with enhanced levels of medical engagement among GPs....

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

Science.gov (United States)

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

2015-01-01

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

Stochastic programming problems with generalized integrated chance constraints

Czech Academy of Sciences Publication Activity Database

Branda, Martin

2012-01-01

Roč. 61, č. 8 (2012), s. 949-968 ISSN 0233-1934 R&D Projects: GA ČR GAP402/10/1610 Grant - others:SVV(CZ) 261315/2010 Institutional support: RVO:67985556 Keywords : chance constraints * integrated chance constraints * penalty functions * sample approximations * blending problem Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 0.707, year: 2012 http://library.utia.cas.cz/separaty/2012/E/branda-stochastic programming problems with generalized integrated.pdf

Development of a clinician reputation metric to identify appropriate problem-medication pairs in a crowdsourced knowledge base.

Science.gov (United States)

McCoy, Allison B; Wright, Adam; Rogith, Deevakar; Fathiamini, Safa; Ottenbacher, Allison J; Sittig, Dean F

2014-04-01

Correlation of data within electronic health records is necessary for implementation of various clinical decision support functions, including patient summarization. A key type of correlation is linking medications to clinical problems; while some databases of problem-medication links are available, they are not robust and depend on problems and medications being encoded in particular terminologies. Crowdsourcing represents one approach to generating robust knowledge bases across a variety of terminologies, but more sophisticated approaches are necessary to improve accuracy and reduce manual data review requirements. We sought to develop and evaluate a clinician reputation metric to facilitate the identification of appropriate problem-medication pairs through crowdsourcing without requiring extensive manual review. We retrieved medications from our clinical data warehouse that had been prescribed and manually linked to one or more problems by clinicians during e-prescribing between June 1, 2010 and May 31, 2011. We identified measures likely to be associated with the percentage of accurate problem-medication links made by clinicians. Using logistic regression, we created a metric for identifying clinicians who had made greater than or equal to 95% appropriate links. We evaluated the accuracy of the approach by comparing links made by those physicians identified as having appropriate links to a previously manually validated subset of problem-medication pairs. Of 867 clinicians who asserted a total of 237,748 problem-medication links during the study period, 125 had a reputation metric that predicted the percentage of appropriate links greater than or equal to 95%. These clinicians asserted a total of 2464 linked problem-medication pairs (983 distinct pairs). Compared to a previously validated set of problem-medication pairs, the reputation metric achieved a specificity of 99.5% and marginally improved the sensitivity of previously described knowledge bases. A

Variational P1 approximations of general-geometry multigroup transport problems

International Nuclear Information System (INIS)

Rulko, R.P.; Tomasevic, D.; Larsen, E.W.

1995-01-01

A variational approximation is developed for general-geometry multigroup transport problems with arbitrary anisotropic scattering. The variational principle is based on a functional that approximates a reaction rate in a subdomain of the system. In principle, approximations that result from this functional ''optimally'' determine such reaction rates. The functional contains an arbitrary parameter α and requires the approximate solutions of a forward and an adjoint transport problem. If the basis functions for the forward and adjoint solutions are chosen to be linear functions of the angular variable Ω, the functional yields the familiar multigroup P 1 equations for all values of α. However, the boundary conditions that result from the functional depend on α. In particular, for problems with vacuum boundaries, one obtains the conventional mixed boundary condition, but with an extrapolation distance that depends continuously on α. The choice α = 0 yields a generalization of boundary conditions derived earlier by Federighi and Pomraning for a more limited class of problems. The choice α = 1 yields a generalization of boundary conditions derived previously by Davis for monoenergetic problems. Other boundary conditions are obtained by choosing different values of α. The authors discuss this indeterminancy of α in conjunction with numerical experiments

Generalized multivalued equilibrium-like problems: auxiliary principle technique and predictor-corrector methods

Directory of Open Access Journals (Sweden)

Vahid Dadashi

2016-02-01

Full Text Available Abstract This paper is dedicated to the introduction a new class of equilibrium problems named generalized multivalued equilibrium-like problems which includes the classes of hemiequilibrium problems, equilibrium-like problems, equilibrium problems, hemivariational inequalities, and variational inequalities as special cases. By utilizing the auxiliary principle technique, some new predictor-corrector iterative algorithms for solving them are suggested and analyzed. The convergence analysis of the proposed iterative methods requires either partially relaxed monotonicity or jointly pseudomonotonicity of the bifunctions involved in generalized multivalued equilibrium-like problem. Results obtained in this paper include several new and known results as special cases.

Application of EGS and ETRAN to Problems in Medical Physics and Dosimetry

CERN Document Server

Nelson, W R

1980-01-01

The author looks at a few applications of Monte Carlo programs to problems of interest in medical physics and dosimetry. In particular, two areas are considered: 1) bremsstrahlung production from medical accelerators; 2) photon dosimetry at medium to low energies. (16 refs) .

Prevalence, associated factors and impact of loneliness and interpersonal problems on internet addiction: A study in Chiang Mai medical students.

Science.gov (United States)

Simcharoen, Sutapat; Pinyopornpanish, Manee; Haoprom, Pattaraporn; Kuntawong, Pimolpun; Wongpakaran, Nahathai; Wongpakaran, Tinakon

2018-01-01

Internet addiction is common among medical students, and the prevalence is higher than the general population. Identifying and creating solutions for this problem is important. The aim of this study was to examine the prevalence and associated factors, particularly loneliness and interpersonal problems among Chiang Mai medical students. Of 324 first to sixth year medical students, 56.8% comprised females with a mean age of 20.88 (SD 1.8). All completed questionnaires related to the objectives and activities of internet use, the Young Internet Addiction Test, the UCLA loneliness scale, and the Interpersonal Problems Inventory were employed to identify internet addiction. In all, 36.7% of the subjects exhibited internet addiction, mostly at mild level. Amount of time used daily, loneliness and interpersonal problems were strong predictors (beta = 0.441, p < 0.05, beta = 0.219, p < 0.001 and beta = 0.203 p < 0.001, respectively), whereas age and sex were not. All objectives of using internet contributed to the variance of internet addiction score. For internet activities, only non-academic or studying contributed. The final model accounted for 42.8% of total variance of the internet addiction score. Even though most addiction was at a mild level, careful strategies should be applied to better understand the situation. Along with a screening for potential internet addiction among medical students, attention should be paid to identifying those who experience loneliness and interpersonal problems, because both are strong predictors that can be improved by a variety of appropriate intervention. Copyright © 2017 Elsevier B.V. All rights reserved.

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

NARCIS (Netherlands)

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

2016-01-01

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

Procrustes Problems for General, Triangular, and Symmetric Toeplitz Matrices

Directory of Open Access Journals (Sweden)

Juan Yang

2013-01-01

Full Text Available The Toeplitz Procrustes problems are the least squares problems for the matrix equation AX=B over some Toeplitz matrix sets. In this paper the necessary and sufficient conditions are obtained about the existence and uniqueness for the solutions of the Toeplitz Procrustes problems when the unknown matrices are constrained to the general, the triangular, and the symmetric Toeplitz matrices, respectively. The algorithms are designed and the numerical examples show that these algorithms are feasible.

Validation of a Crowdsourcing Methodology for Developing a Knowledge Base of Related Problem-Medication Pairs.

Science.gov (United States)

McCoy, A B; Wright, A; Krousel-Wood, M; Thomas, E J; McCoy, J A; Sittig, D F

2015-01-01

Clinical knowledge bases of problem-medication pairs are necessary for many informatics solutions that improve patient safety, such as clinical summarization. However, developing these knowledge bases can be challenging. We sought to validate a previously developed crowdsourcing approach for generating a knowledge base of problem-medication pairs in a large, non-university health care system with a widely used, commercially available electronic health record. We first retrieved medications and problems entered in the electronic health record by clinicians during routine care during a six month study period. Following the previously published approach, we calculated the link frequency and link ratio for each pair then identified a threshold cutoff for estimated problem-medication pair appropriateness through clinician review; problem-medication pairs meeting the threshold were included in the resulting knowledge base. We selected 50 medications and their gold standard indications to compare the resulting knowledge base to the pilot knowledge base developed previously and determine its recall and precision. The resulting knowledge base contained 26,912 pairs, had a recall of 62.3% and a precision of 87.5%, and outperformed the pilot knowledge base containing 11,167 pairs from the previous study, which had a recall of 46.9% and a precision of 83.3%. We validated the crowdsourcing approach for generating a knowledge base of problem-medication pairs in a large non-university health care system with a widely used, commercially available electronic health record, indicating that the approach may be generalizable across healthcare settings and clinical systems. Further research is necessary to better evaluate the knowledge, to compare crowdsourcing with other approaches, and to evaluate if incorporating the knowledge into electronic health records improves patient outcomes.

A general heuristic for genome rearrangement problems.

Science.gov (United States)

Dias, Ulisses; Galvão, Gustavo Rodrigues; Lintzmayer, Carla Négri; Dias, Zanoni

2014-06-01

In this paper, we present a general heuristic for several problems in the genome rearrangement field. Our heuristic does not solve any problem directly, it is rather used to improve the solutions provided by any non-optimal algorithm that solve them. Therefore, we have implemented several algorithms described in the literature and several algorithms developed by ourselves. As a whole, we implemented 23 algorithms for 9 well known problems in the genome rearrangement field. A total of 13 algorithms were implemented for problems that use the notions of prefix and suffix operations. In addition, we worked on 5 algorithms for the classic problem of sorting by transposition and we conclude the experiments by presenting results for 3 approximation algorithms for the sorting by reversals and transpositions problem and 2 approximation algorithms for the sorting by reversals problem. Another algorithm with better approximation ratio can be found for the last genome rearrangement problem, but it is purely theoretical with no practical implementation. The algorithms we implemented in addition to our heuristic lead to the best practical results in each case. In particular, we were able to improve results on the sorting by transpositions problem, which is a very special case because many efforts have been made to generate algorithms with good results in practice and some of these algorithms provide results that equal the optimum solutions in many cases. Our source codes and benchmarks are freely available upon request from the authors so that it will be easier to compare new approaches against our results.

75 FR 63843 - National Institute of General Medical Sciences; Notice of Closed Meeting

Science.gov (United States)

2010-10-18

... Sciences Special Emphasis Panel; Review of Minority Biomedical Research Neuro Grant Applications. Date... General Medical Sciences; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... of General Medical Sciences, National Institutes of Health, Natcher Building, Room 3AN18J, Bethesda...

Agreement between questionnaire and medical records on some health and socioeconomic problems among poisoning cases

Directory of Open Access Journals (Sweden)

Fathelrahman Ahmed I

2009-09-01

Full Text Available Abstract Background The main objective of the present study was to evaluate the agreement between questionnaire and medical records on some health and socioeconomic problems among poisoning cases. Methods Cross-sectional sample of 100 poisoning cases consecutively admitted to the Hospital Pulau Pinang, Malaysia during the period from September 2003 to February 2004 were studied. Data on health and socioeconomic problems were collected both by self-administered questionnaire and from medical records. Agreement between the two sets of data was assessed by calculating the concordance rate, Kappa (k and PABAK. McNemar statistic was used to test differences between categories. Results Data collected by questionnaire and medical records showed excellent agreement on the "marital status"; good agreements on "chronic illness", "psychiatric illness", and "previous history of poisoning"; and fair agreements on "at least one health problem", and "boy-girl friends problem". PABAK values suggest better agreements' measures. Conclusion There were excellent to good agreements between questionnaire and medical records on the marital status and most of the health problems and fair to poor agreements on the majority of socioeconomic problems. The implications of those findings were discussed.

NIH's National Institute of General Medical Sciences celebrates 45 years of Discovery for Health

Science.gov (United States)

... Alison Davis NIH's National Institute of General Medical Sciences celebrates 45 years of Discovery for Health The National Institute of General Medical Sciences (NIGMS) is the NIH institute that primarily supports ...

Impact of supply problems of preservative-free glaucoma medications on patients and hospital staff.

Science.gov (United States)

Shah, Shima; Theodossiades, Julia; Chapman, Kristin; Murdoch, Ian

2015-03-01

Glaucoma is a chronic ocular disease, which is usually managed with long-term daily medical therapy, in the form of eye drops. Patients who are intolerant to preservatives in topical medicines require preservative-free versions. From early 2011 patients attending Moorfields Eye Hospital, London, UK, started to report recurring problems with the supply of the following preservative-free glaucoma medications: Timolol 0.25% (Timoptol 0.25%, MSD UK); Dorzolamide (Trusopt, MSD UK); Dorzolamide and Timolol 0.5% (Cosopt, MSD UK). This study investigates the impact of the supply problems of these medications at Moorfields Eye Hospital from a patient, administrative and clinical perspective. Information was sought by interviewing both patients and hospital staff, and by a retrospective case note review between April 2010 and May 2013. Many hospital roles, both administrative and clinical, were involved in attempting to resolve the impact of the supply problems. All staff reported a considerable increase in their workload. At the peak of the problem, the glaucoma secretaries received about 150 enquiries per week. A review of 83 sets of patient notes, retrieved from a random sample of 125 patients, showed that 22% encountered a supply problem. Of these, more than one-third attended Moorfields Eye Hospital Accident & Emergency (A&E) for repeat supplies and 89% eventually had their medication changed. In telephone interviews with 39 of a random sample of 50 patients (a subset of the 83 notes retrieved), 59% of the interviewees reported a supply problem. Of these, one-third attended Moorfields Eye Hospital A&E for repeat supplies and half eventually required an alternative medication. Some patients reported going to considerable lengths to obtain ongoing supplies in the community. This study shows that medication supply problems can have a major impact on patients and hospital services. Supply problems occur across many fields of medicine and with increasing frequency. The

Level of satisfaction of older persons with their general practitioner and practice: role of complexity of health problems.

Science.gov (United States)

Poot, Antonius J; den Elzen, Wendy P J; Blom, Jeanet W; Gussekloo, Jacobijn

2014-01-01

Satisfaction is widely used to evaluate and direct delivery of medical care; a complicated relationship exists between patient satisfaction, morbidity and age. This study investigates the relationships between complexity of health problems and level of patient satisfaction of older persons with their general practitioner (GP) and practice. This study is embedded in the ISCOPE (Integrated Systematic Care for Older Persons) study. Enlisted patients aged ≥75 years from 59 practices received a written questionnaire to screen for complex health problems (somatic, functional, psychological and social). For 2664 randomly chosen respondents (median age 82 years; 68% female) information was collected on level of satisfaction (satisfied, neutral, dissatisfied) with their GP and general practice, and demographic and clinical characteristics including complexity of health problems. Of all participants, 4% was dissatisfied with their GP care, 59% neutral and 37% satisfied. Between these three categories no differences were observed in age, gender, country of birth or education level. The percentage of participants dissatisfied with their GP care increased from 0.4% in those with 0 problem domains to 8% in those with 4 domains, i.e. having complex health problems (ppatient characteristic influencing the perception of care, or whether the care is unable to handle the demands of these patients. Prospective studies are needed to investigate the causal associations between care organization, patient characteristics, indicators of quality, and patient perceptions.

75 FR 65363 - National Institute of General Medical Sciences; Notice of Closed Meeting

Science.gov (United States)

2010-10-22

... Sciences Special Emphasis Panel; Review of Minority Biomedical Research Neuro Grant Applications. Date... General Medical Sciences; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... General Medical Sciences, National Institutes of Health, Natcher Building, Room 3AN18J, Bethesda, MD 20892...

Generalizing the classical fixed-centres problem in a non-Hamiltonian way

International Nuclear Information System (INIS)

Albouy, A; Stuchi, T J

2004-01-01

The problem of two gravitational (or Coulombian) fixed centres is a classical integrable problem, stated and integrated by Euler in 1760. The integrability is due to the unexpected first integral G. We introduce some straightforward generalizations of the problem that still have the generalization of G as a first integral, but do not possess the energy integral. We present some numerical integrations showing the main features of their dynamics. In the domain of bounded orbits the behaviour of these a priori non-Hamiltonian systems is very similar to the behaviour of usual near-integrable systems

New fuzzy support vector machine for the class imbalance problem in medical datasets classification.

Science.gov (United States)

Gu, Xiaoqing; Ni, Tongguang; Wang, Hongyuan

2014-01-01

In medical datasets classification, support vector machine (SVM) is considered to be one of the most successful methods. However, most of the real-world medical datasets usually contain some outliers/noise and data often have class imbalance problems. In this paper, a fuzzy support machine (FSVM) for the class imbalance problem (called FSVM-CIP) is presented, which can be seen as a modified class of FSVM by extending manifold regularization and assigning two misclassification costs for two classes. The proposed FSVM-CIP can be used to handle the class imbalance problem in the presence of outliers/noise, and enhance the locality maximum margin. Five real-world medical datasets, breast, heart, hepatitis, BUPA liver, and pima diabetes, from the UCI medical database are employed to illustrate the method presented in this paper. Experimental results on these datasets show the outperformed or comparable effectiveness of FSVM-CIP.

New Fuzzy Support Vector Machine for the Class Imbalance Problem in Medical Datasets Classification

Directory of Open Access Journals (Sweden)

Xiaoqing Gu

2014-01-01

Full Text Available In medical datasets classification, support vector machine (SVM is considered to be one of the most successful methods. However, most of the real-world medical datasets usually contain some outliers/noise and data often have class imbalance problems. In this paper, a fuzzy support machine (FSVM for the class imbalance problem (called FSVM-CIP is presented, which can be seen as a modified class of FSVM by extending manifold regularization and assigning two misclassification costs for two classes. The proposed FSVM-CIP can be used to handle the class imbalance problem in the presence of outliers/noise, and enhance the locality maximum margin. Five real-world medical datasets, breast, heart, hepatitis, BUPA liver, and pima diabetes, from the UCI medical database are employed to illustrate the method presented in this paper. Experimental results on these datasets show the outperformed or comparable effectiveness of FSVM-CIP.

Medical students' perceptions of general practice as a career; a phenomenological study using socialisation theory.

Science.gov (United States)

Reid, Katherine; Alberti, Hugh

2018-04-23

The ageing population and push to community care has significantly increased the workload of General Practitioners (GPs) in the UK and internationally. In an attempt to tackle this, NHS England has promised 5000 more GPs by 2020/21; however, recruitment is in crisis with GP training posts remaining unfilled. Little research has been carried out to assess the fundamental questions of what medical students' perceptions of General Practice are and what shapes their perceptions at medical school. We aimed to explore medical students' conceptualisations of being a GP and specifically the role of the medical school in shaping their perceptions. Two focus groups of year one and year four medical students were undertaken using an interpretive phenomenological approach. Our study has revealed that medical students perceive General Practice to lack prestige and challenge. These perceptions come, at least in part, from a process of socialisation within medical school, whereby medical students internalise and adopt their role models' perceptions and values, and the values portrayed by the hidden curriculum in their medical school culture. Perceived external pressures to pursue a career in General Practice can have a negative influence and medical schools should be made aware of this.

Study of Sleep Habits and Sleep Problems Among Medical Students ...

African Journals Online (AJOL)

characteristics, psychiatric illness, and some types of physical illness. ... to poor sleep qualities are significant problems among medical students in our institution. Caffeine and .... prepare for post graduation and also get to play a role (albeit a.

Anholonomic Cauchy problem in general relativity

International Nuclear Information System (INIS)

Stachel, J.

1980-01-01

The Lie derivative approach to the Cauchy problem in general relativity is applied to the evolution along an arbitrary timelike vector field for the case where the dynamical degrees of freedom are chosen as the (generally anholonomic) metric of the hypersurface elements orthogonal to the vector field. Generalizations of the shear, rotation, and acceleration are given for a nonunit timelike vector field, and applied to the three-plus-one breakup of the Riemann tensor into components parallel and orthogonal to the vector field, resulting in the anholonomic Gauss--Codazzi equations. A similar breakup of the Einstein field equations results in the form of the constraint and evolution equations for the anholonomic case. The results are applied to the case of a space--time with a timelike Killing vector field (stationary field) to demonstrate their utility. Other possible applications, such as in the numerical integration of the field equations, are mentioned. Definitions are given of three-index shear, rotation, and acceleration tensors, and their use in a two-plus-two decomposition of the Riemann tensor and field equations is indicated

Mediators for internalizing problems in adolescents of parents with chronic medical condition

NARCIS (Netherlands)

Sieh, D.S.; Oort, F.J.; Visser-Meily, J.M.A.; Meijer, A.M.

2014-01-01

Parents’ chronic medical condition (CMC) is related to internalizing problem behavior in adolescents. Following the transactional stress and coping (TSC) model of Hocking and Lochman, our study examines whether the effect of illness and demographic parameters on the child’s internalizing problems is

Medical education and cognitive continuum theory: an alternative perspective on medical problem solving and clinical reasoning.

Science.gov (United States)

Custers, Eugène J F M

2013-08-01

Recently, human reasoning, problem solving, and decision making have been viewed as products of two separate systems: "System 1," the unconscious, intuitive, or nonanalytic system, and "System 2," the conscious, analytic, or reflective system. This view has penetrated the medical education literature, yet the idea of two independent dichotomous cognitive systems is not entirely without problems.This article outlines the difficulties of this "two-system view" and presents an alternative, developed by K.R. Hammond and colleagues, called cognitive continuum theory (CCT). CCT is featured by three key assumptions. First, human reasoning, problem solving, and decision making can be arranged on a cognitive continuum, with pure intuition at one end, pure analysis at the other, and a large middle ground called "quasirationality." Second, the nature and requirements of the cognitive task, as perceived by the person performing the task, determine to a large extent whether a task will be approached more intuitively or more analytically. Third, for optimal task performance, this approach needs to match the cognitive properties and requirements of the task. Finally, the author makes a case that CCT is better able than a two-system view to describe medical problem solving and clinical reasoning and that it provides clear clues for how to organize training in clinical reasoning.

Validation of a Crowdsourcing Methodology for Developing a Knowledge Base of Related Problem-Medication Pairs

Science.gov (United States)

Wright, A.; Krousel-Wood, M.; Thomas, E. J.; McCoy, J. A.; Sittig, D. F.

2015-01-01

Summary Background Clinical knowledge bases of problem-medication pairs are necessary for many informatics solutions that improve patient safety, such as clinical summarization. However, developing these knowledge bases can be challenging. Objective We sought to validate a previously developed crowdsourcing approach for generating a knowledge base of problem-medication pairs in a large, non-university health care system with a widely used, commercially available electronic health record. Methods We first retrieved medications and problems entered in the electronic health record by clinicians during routine care during a six month study period. Following the previously published approach, we calculated the link frequency and link ratio for each pair then identified a threshold cutoff for estimated problem-medication pair appropriateness through clinician review; problem-medication pairs meeting the threshold were included in the resulting knowledge base. We selected 50 medications and their gold standard indications to compare the resulting knowledge base to the pilot knowledge base developed previously and determine its recall and precision. Results The resulting knowledge base contained 26,912 pairs, had a recall of 62.3% and a precision of 87.5%, and outperformed the pilot knowledge base containing 11,167 pairs from the previous study, which had a recall of 46.9% and a precision of 83.3%. Conclusions We validated the crowdsourcing approach for generating a knowledge base of problem-medication pairs in a large non-university health care system with a widely used, commercially available electronic health record, indicating that the approach may be generalizable across healthcare settings and clinical systems. Further research is necessary to better evaluate the knowledge, to compare crowdsourcing with other approaches, and to evaluate if incorporating the knowledge into electronic health records improves patient outcomes. PMID:26171079

76 FR 19104 - National Institute of General Medical Sciences; Notice of Closed Meeting

Science.gov (United States)

2011-04-06

... General Medical Sciences; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... clearly unwarranted invasion of personal privacy. Name of Committee: National Institute of General Medical Sciences Special Emphasis Panel; 2011 NIH Director's Pioneer Awards. Date: May 2-4, 2011. Time: 7:45 a.m...

Distribution of Problems, Medications and Lab Results in Electronic Health Records: The Pareto Principle at Work.

Science.gov (United States)

Wright, Adam; Bates, David W

2010-01-01

BACKGROUND: Many natural phenomena demonstrate power-law distributions, where very common items predominate. Problems, medications and lab results represent some of the most important data elements in medicine, but their overall distribution has not been reported. OBJECTIVE: Our objective is to determine whether problems, medications and lab results demonstrate a power law distribution. METHODS: Retrospective review of electronic medical record data for 100,000 randomly selected patients seen at least twice in 2006 and 2007 at the Brigham and Women's Hospital in Boston and its affiliated medical practices. RESULTS: All three data types exhibited a power law distribution. The 12.5% most frequently used problems account for 80% of all patient problems, the top 11.8% of medications account for 80% of all medication orders and the top 4.5% of lab result types account for all lab results. CONCLUSION: These three data elements exhibited power law distributions with a small number of common items representing a substantial proportion of all orders and observations, which has implications for electronic health record design.

Application of medical cases in general genetics teaching in universities.

Science.gov (United States)

He, Zhumei; Bie, Linsai; Li, Wei

2018-01-20

General genetics is a core course in life sciences, medicine, agriculture and other related fields. As one of the most fast-developing disciplines of life sciences in the 21th century, the influence of the genetics knowledge on daily life is expanding, especially on human health and reproduction. In order to make it easier for students to understand the profound principles of genetics and to better apply the theories to daily life, we have introduced appropriate medical cases in general genetics teaching and further extended them combined with theoretical basis of genetics. This approach will be beneficial to enhance students' abilities of genetic analysis and promote their enthusiasm to learn and master practical skills. In this paper, we enumerate medical cases related to the modern genetics teaching system to provide a reference for genetics teaching in general and normal universities.

Modified and fuzzified general problem solver for 'monkey and banana' problem, 2

International Nuclear Information System (INIS)

Sano, Norihide; Takahashi, Ryoichi.

1991-01-01

The automatic operation is important for the in-service inspection of the operating nuclear power station or the decommission of retired plants. The master and slave control will be introduced for work-robot control. It is desirable that the slave involves the capability of problem solving. This paper assumed that the slave involved the general problem solver algorithm. In view of having solved the puzzle of the 'monkey and banana', the slave system is regarded as the reasonable alternative which incorporates the capability of problem solving. Basically, the GPS solves a problem by reducing the difference between an initial state and a goal state, and hence the performance of GPS depends on selecting the difference to be reduced. The usual GPS is given in advance the ordering which indicates the importance of the differences. In this paper, the GPS was improved by making use of the rules which decide the order. When several choices are found on the given difference, the fuzzified decision to determine the action is demonstrated in this paper. (author)

Mentoring medical students in your general practice.

Science.gov (United States)

Fraser, John

2016-05-01

Mentoring medical students in general practices is becoming more common in Australia due to formalised scholarship programs and informal approaches by students. This paper defines mentoring in Australian general practice. Practical suggestions are made on how to structure a mentorship program in your practice. Mentoring differs from leadership and teaching. It is a long-term relationship between a student and an experienced general practitioner. Avoiding summative assessment in mentorship is important to its success. Mentoring is about forming a safe place to confidentially discuss personal and professional issues between a mentor and student. This is based on defining roles and mutual trust. At the same time, students crave formative feedback. Unfortunately, present feedback models are based on teaching principles that can blur the differences between assessor, teacher and mentor. Mentorship can provide students with orientation and learning experiences so that they are prepared for practice as an intern.

Prevalence and cost of hospital medical errors in the general and elderly United States populations.

Science.gov (United States)

Mallow, Peter J; Pandya, Bhavik; Horblyuk, Ruslan; Kaplan, Harold S

2013-12-01

The primary objective of this study was to quantify the differences in the prevalence rate and costs of hospital medical errors between the general population and an elderly population aged ≥65 years. Methods from an actuarial study of medical errors were modified to identify medical errors in the Premier Hospital Database using data from 2009. Visits with more than four medical errors were removed from the population to avoid over-estimation of cost. Prevalence rates were calculated based on the total number of inpatient visits. There were 3,466,596 total inpatient visits in 2009. Of these, 1,230,836 (36%) occurred in people aged ≥ 65. The prevalence rate was 49 medical errors per 1000 inpatient visits in the general cohort and 79 medical errors per 1000 inpatient visits for the elderly cohort. The top 10 medical errors accounted for more than 80% of the total in the general cohort and the 65+ cohort. The most costly medical error for the general population was postoperative infection ($569,287,000). Pressure ulcers were most costly ($347,166,257) in the elderly population. This study was conducted with a hospital administrative database, and assumptions were necessary to identify medical errors in the database. Further, there was no method to identify errors of omission or misdiagnoses within the database. This study indicates that prevalence of hospital medical errors for the elderly is greater than the general population and the associated cost of medical errors in the elderly population is quite substantial. Hospitals which further focus their attention on medical errors in the elderly population may see a significant reduction in costs due to medical errors as a disproportionate percentage of medical errors occur in this age group.

How doctors learn: the role of clinical problems across the medical school-to-practice continuum.

Science.gov (United States)

Slotnick, H B

1996-01-01

The author proposes a theory of how physicians learn that uses clinical problem solving as its central feature. His theory, which integrates insights from Maslow, Schön, Norman, and others, claims that physicians-in-training and practicing physicians learn largely by deriving insights from clinical experience. These insights allow the learner to solve future problems and thereby address the learner's basic human needs for security, affiliation, and self-esteem. Ensuring that students gain such insights means that the proper roles of the teacher are (1) to select problems for students to solve and offer guidance on how to solve them, and (2) to serve as a role model of how to reflect on the problem, its solution, and the solution's effectiveness. Three principles guide instruction within its framework for learning: (1) learners, whether physicians-in-training or practicing physicians, seek to solve problems they recognize they have; (2) learners want to be involved in their own learning; and (3) instruction must both be time-efficient and also demonstrate the range of ways in which students can apply what they learn. The author concludes by applying the theory to an aspect of undergraduate education and to the general process of continuing medical education.

General pathologist-helper: The new medical app about general pathology.

Science.gov (United States)

Fernández-Vega, Iván

2015-01-01

Smartphone applications (apps) have become increasingly prevalent in medicine. Due to most pathologists, pathology trainees, technicians, and medical students use smartphones; apps can be a different way for general pathology education. "General pathologist-helper (GP-HELPER)" is a novel app developed as a reference tool in general pathology and especially for general pathologists, developed for Android and iOS platforms. "GP-HELPER," was created using Mobincube website platform. This tool also integrates "FORUM GP-HELPER," an external website created using Miarroba website (http://forum-gp-helper.mboards.com) and "COMMUNITY GP-HELPER" a multichannel chat created using Chatango website platform. The application was released in July 2015, and it is been periodically updated since then. The app has permanent information (offline data) about different pathology protocols (TNM latest edition, protocols regarding management of tumors of unknown primary origin, and flowcharts for some of the most difficult tumors to diagnose) and a database with more than 5000 immunohistochemistry results from different tumors. Online data have links to more than 1100 reference pathology video lectures, 250 antibodies information, more than 70 pathology association websites, 46 pathology providers, and 78 outstanding pathology journal websites. Besides this information, the app has two interactive places such as "FORUM GP-HELPER" and "COMMUNITY GP-HELPER" that let users to stay in touch everywhere and every time. Expert consult section is also available. "GP-HELPER" pretends to integrate offline and online data about pathology with two interactive external places in order to represent a reference tool for general pathologists and associate members.

Two Efficient Generalized Laguerre Spectral Algorithms for Fractional Initial Value Problems

Directory of Open Access Journals (Sweden)

D. Baleanu

2013-01-01

Full Text Available We present a direct solution technique for approximating linear multiterm fractional differential equations (FDEs on semi-infinite interval, using generalized Laguerre polynomials. We derive the operational matrix of Caputo fractional derivative of the generalized Laguerre polynomials which is applied together with generalized Laguerre tau approximation for implementing a spectral solution of linear multiterm FDEs on semi-infinite interval subject to initial conditions. The generalized Laguerre pseudo-spectral approximation based on the generalized Laguerre operational matrix is investigated to reduce the nonlinear multiterm FDEs and its initial conditions to nonlinear algebraic system, thus greatly simplifying the problem. Through several numerical examples, we confirm the accuracy and performance of the proposed spectral algorithms. Indeed, the methods yield accurate results, and the exact solutions are achieved for some tested problems.

Homotopy Method for a General Multiobjective Programming Problem under Generalized Quasinormal Cone Condition

Directory of Open Access Journals (Sweden)

X. Zhao

2012-01-01

Full Text Available A combined interior point homotopy continuation method is proposed for solving general multiobjective programming problem. We prove the existence and convergence of a smooth homotopy path from almost any interior initial interior point to a solution of the KKT system under some basic assumptions.

Structure of the generalized momentum of a test charged particle and the inverse problem in general relativity theory

International Nuclear Information System (INIS)

Zakharov, A.V.; Singatullin, R.S.

1981-01-01

The inverse problem is solved in general relativity theory (GRT) consisting in determining the metric and potentials of an electromagnetic field by their values in the nonsingular point of the V 4 space and present functions, being the generalized momenta of a test charged particle. The Hamilton-Jacobi equation for a test charged particle in GRT is used. The general form of the generalized momentum dependence on the initial values is determined. It is noted that the inverse problem solution of dynamics in GRT contains arbitrariness which depends on the choice of the metric and potential values of the electromagnetic field in the nonsingular point [ru

A generalization of the convex Kakeya problem

KAUST Repository

Ahn, Heekap

2012-01-01

We consider the following geometric alignment problem: Given a set of line segments in the plane, find a convex region of smallest area that contains a translate of each input segment. This can be seen as a generalization of Kakeya\\'s problem of finding a convex region of smallest area such that a needle can be turned through 360 degrees within this region. Our main result is an optimal Θ(n log n)-time algorithm for our geometric alignment problem, when the input is a set of n line segments. We also show that, if the goal is to minimize the perimeter of the region instead of its area, then the optimum placement is when the midpoints of the segments coincide. Finally, we show that for any compact convex figure G, the smallest enclosing disk of G is a smallest-perimeter region containing a translate of any rotated copy of G. © 2012 Springer-Verlag Berlin Heidelberg.

76 FR 3918 - National Institute of General Medical Sciences; Amended Notice of Meeting

Science.gov (United States)

2011-01-21

... General Medical Sciences; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Advisory General Medical Sciences Council, January 27, 2011, 8:30 a.m. to January 28... of Federal Advisory Committee Policy. [FR Doc. 2011-1198 Filed 1-20-11; 8:45 am] BILLING CODE 4140-01...

Medication use in children with asthma: not a child size problem.

Science.gov (United States)

Grover, Charu; Armour, Carol; Asperen, Peter Paul Van; Moles, Rebekah; Saini, Bandana

2011-12-01

The global burden of pediatric asthma is high. Governments and health-care systems are affected by the increasing costs of childhood asthma--in terms of direct health-care costs and indirect costs due to loss of parental productivity, missed school days, and hospitalizations. Despite the availability of effective treatment, the current use of medications in children with asthma is suboptimal. The purpose of this review is to scope the empirical literature to identify the problems associated with the use of pediatric asthma medications. The findings will help to design interventions aiming to improve the use of asthma medications among children. A literature search using electronic search engines (i.e., Medline, International Pharmaceutical Abstracts (IPA), PubMed, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature (CINAHL)) and the search terms "asthma," "children," and "medicines" (and derivatives of these keywords) was conducted. The search terms were expanded to include emergent themes arising out of search findings. Content themes relating to parents, children themselves, health-care professionals, organizational systems, and specific medications and devices were found. Within these themes, key issues included a lack of parental knowledge about asthma and asthma medications, lack of information provided to parents, parental beliefs and fears, parental behavioral problems, the high costs of medications and devices, the child's self-image, the need for more child responsibility, physician nonadherence to prescribing guidelines, "off-label" prescribing, poor understanding of teachers, lack of access to educational resources, and specific medications. These key issues should be taken into account when modifying the development of educational tools. These tools should focus on targeting the children themselves, the parent/carers, the health-care professionals, and various organizational systems.

Teaching Biochemistry at a Medical Faculty with a Problem-Based Learning System.

Science.gov (United States)

Rosing, Jan

1997-01-01

Highlights the differences between classical teaching methods and problem-based learning. Describes the curriculum and problem-based approach of the Faculty of Medicine at the Maastricht University and gives an overview of the implementation of biochemistry in the medical curriculum. Discusses the procedure for student assessment and presents…

Level of satisfaction of older persons with their general practitioner and practice: role of complexity of health problems.

Directory of Open Access Journals (Sweden)

Antonius J Poot

Full Text Available BACKGROUND: Satisfaction is widely used to evaluate and direct delivery of medical care; a complicated relationship exists between patient satisfaction, morbidity and age. This study investigates the relationships between complexity of health problems and level of patient satisfaction of older persons with their general practitioner (GP and practice. METHODS AND FINDINGS: This study is embedded in the ISCOPE (Integrated Systematic Care for Older Persons study. Enlisted patients aged ≥75 years from 59 practices received a written questionnaire to screen for complex health problems (somatic, functional, psychological and social. For 2664 randomly chosen respondents (median age 82 years; 68% female information was collected on level of satisfaction (satisfied, neutral, dissatisfied with their GP and general practice, and demographic and clinical characteristics including complexity of health problems. Of all participants, 4% was dissatisfied with their GP care, 59% neutral and 37% satisfied. Between these three categories no differences were observed in age, gender, country of birth or education level. The percentage of participants dissatisfied with their GP care increased from 0.4% in those with 0 problem domains to 8% in those with 4 domains, i.e. having complex health problems (p<0.001. Per additional health domain with problems, the risk of being dissatisfied increased 1.7 times (95% CI 1.4-2.14; p<0.001. This was independent of age, gender, and demographic and clinical parameters (adjusted OR 1.4, 95% CI 1.1-1.8; p = 0.021. CONCLUSION: In older persons, dissatisfaction with general practice is strongly correlated with rising complexity of health problems, independent of age, demographic and clinical parameters. It remains unclear whether complexity of health problems is a patient characteristic influencing the perception of care, or whether the care is unable to handle the demands of these patients. Prospective studies are needed to

Jacobi-Davidson methods for generalized MHD-eigenvalue problems

NARCIS (Netherlands)

J.G.L. Booten; D.R. Fokkema; G.L.G. Sleijpen; H.A. van der Vorst (Henk)

1995-01-01

textabstractA Jacobi-Davidson algorithm for computing selected eigenvalues and associated eigenvectors of the generalized eigenvalue problem $Ax = lambda Bx$ is presented. In this paper the emphasis is put on the case where one of the matrices, say the B-matrix, is Hermitian positive definite. The

Dialog about Psychosocial Issues in Problem-Based Learning Sessions in Medical Education

Science.gov (United States)

Adams, Nancy E.

2016-01-01

The purpose of this qualitative case study was two-fold: to investigate the dialog about psychosocial aspects of health care in problem based learning (PBL) groups in a single medical school; and to describe the factors that learners and PBL facilitators identify as influencing dialog about these issues in PBL groups. Medical education is a…

A Projection free method for Generalized Eigenvalue Problem with a nonsmooth Regularizer.

Science.gov (United States)

Hwang, Seong Jae; Collins, Maxwell D; Ravi, Sathya N; Ithapu, Vamsi K; Adluru, Nagesh; Johnson, Sterling C; Singh, Vikas

2015-12-01

Eigenvalue problems are ubiquitous in computer vision, covering a very broad spectrum of applications ranging from estimation problems in multi-view geometry to image segmentation. Few other linear algebra problems have a more mature set of numerical routines available and many computer vision libraries leverage such tools extensively. However, the ability to call the underlying solver only as a "black box" can often become restrictive. Many 'human in the loop' settings in vision frequently exploit supervision from an expert, to the extent that the user can be considered a subroutine in the overall system. In other cases, there is additional domain knowledge, side or even partial information that one may want to incorporate within the formulation. In general, regularizing a (generalized) eigenvalue problem with such side information remains difficult. Motivated by these needs, this paper presents an optimization scheme to solve generalized eigenvalue problems (GEP) involving a (nonsmooth) regularizer. We start from an alternative formulation of GEP where the feasibility set of the model involves the Stiefel manifold. The core of this paper presents an end to end stochastic optimization scheme for the resultant problem. We show how this general algorithm enables improved statistical analysis of brain imaging data where the regularizer is derived from other 'views' of the disease pathology, involving clinical measurements and other image-derived representations.

Medication management and practices in prison for people with mental health problems: a qualitative study

OpenAIRE

Bowen, Robert A; Rogers, Anne; Shaw, Jennifer

2009-01-01

Abstract Background Common mental health problems are prevalent in prison and the quality of prison health care provision for prisoners with mental health problems has been a focus of critical scrutiny. Currently, health policy aims to align and integrate prison health services and practices with those of the National Health Service (NHS). Medication management is a key aspect of treatment for patients with a mental health problem. The medication practices of patients and staff are therefore ...

PTSD and Use of Outpatient General Medical Services Among Veterans of the Vietnam War.

Science.gov (United States)

Schlenger, William E; Mulvaney-Day, Norah; Williams, Christianna S; Kulka, Richard A; Corry, Nida H; Mauch, Danna; Nagler, Caryn F; Ho, Chia-Lin; Marmar, Charles R

2016-05-01

The primary goal of this analysis was to assess whether recent use of outpatient services for general medical concerns by Vietnam veterans varies according to level of posttraumatic stress disorder (PTSD) symptomatology over time. Another goal was to determine whether PTSD symptomatology was associated with veterans' reports of discussing behavioral health issues as part of a general medical visit. Self-reported service use data and measures of PTSD were from a nationally representative sample of 848 male and female Vietnam theater veterans (individuals who were deployed to the Vietnam theater of operations) who participated in the National Vietnam Veterans Longitudinal Study, a 25-year follow-up of a cohort of veterans originally interviewed from 1984-1988 as part of the National Vietnam Veterans Readjustment Study. Four categories of PTSD symptomatology course over 25 years were defined, and logistic regression models were used to assess their relationship with recent use of outpatient general medical services. Male and female theater veterans with high or increasing PTSD symptomatology over the period were more likely than those with low symptomatology to report recent VA outpatient visits. Males in the increasing and high categories were also more likely to discuss behavioral health issues at general medical visits. Vietnam veterans with high and increasing PTSD symptomatology over time were likely to use VA outpatient general health services. Attention to stressors of the aging process and to persistence of PTSD symptoms is important for Vietnam veterans, as is addressing PTSD with other psychiatric and medical comorbidities within the context of outpatient general medical care.

General pathologist-helper: The new medical app about general pathology

Directory of Open Access Journals (Sweden)

Iván Fernandez-Vega

2015-01-01

Full Text Available Introduction: Smartphone applications (apps have become increasingly prevalent in medicine. Due to most pathologists, pathology trainees, technicians, and medical students use smartphones; apps can be a different way for general pathology education. “General pathologist-helper (GP-HELPER” is a novel app developed as a reference tool in general pathology and especially for general pathologists, developed for Android and iOS platforms. Materials and Methods: “GP-HELPER,” was created using Mobincube website platform. This tool also integrates “FORUM GP-HELPER,” an external website created using Miarroba website (http://forum-gp-helper.mboards.com and “COMMUNITY GP-HELPER” a multichannel chat created using Chatango website platform. Results: The application was released in July 2015, and it is been periodically updated since then. The app has permanent information (offline data about different pathology protocols (TNM latest edition, protocols regarding management of tumors of unknown primary origin, and flowcharts for some of the most difficult tumors to diagnose and a database with more than 5000 immunohistochemistry results from different tumors. Online data have links to more than 1100 reference pathology video lectures, 250 antibodies information, more than 70 pathology association websites, 46 pathology providers, and 78 outstanding pathology journal websites. Besides this information, the app has two interactive places such as “FORUM GP-HELPER” and “COMMUNITY GP-HELPER” that let users to stay in touch everywhere and every time. Expert consult section is also available. Conclusions: “GP-HELPER” pretends to integrate offline and online data about pathology with two interactive external places in order to represent a reference tool for general pathologists and associate members.

A general approach to posterior contraction in nonparametric inverse problems

NARCIS (Netherlands)

Knapik, Bartek; Salomond, Jean Bernard

In this paper, we propose a general method to derive an upper bound for the contraction rate of the posterior distribution for nonparametric inverse problems. We present a general theorem that allows us to derive contraction rates for the parameter of interest from contraction rates of the related

Characteristics of Orthopedic Publications in High-Impact General Medical Journals.

Science.gov (United States)

Nwachukwu, Benedict U; Kahlenberg, Cynthia A; Lehman, Jason D; Lyman, Stephen; Marx, Robert G

2017-05-01

Orthopedic studies are occasionally published in high-impact general medical journals; these studies are often given high visibility and have significant potential to impact health care policy and inform clinical decision-making. The purpose of this review was to investigate the characteristics of operative orthopedic studies published in high-impact medical journals. The number of orthopedic studies published in high-impact medical journals is relatively low; however, these studies demonstrate methodological characteristics that may bias toward nonoperative treatment. Careful analysis and interpretation of orthopedic studies published in these journals is warranted. [Orthopedics. 2017; 40(3):e405-e412.]. Copyright 2017, SLACK Incorporated.

PowerPlay: Training an Increasingly General Problem Solver by Continually Searching for the Simplest Still Unsolvable Problem.

Science.gov (United States)

Schmidhuber, Jürgen

2013-01-01

Most of computer science focuses on automatically solving given computational problems. I focus on automatically inventing or discovering problems in a way inspired by the playful behavior of animals and humans, to train a more and more general problem solver from scratch in an unsupervised fashion. Consider the infinite set of all computable descriptions of tasks with possibly computable solutions. Given a general problem-solving architecture, at any given time, the novel algorithmic framework PowerPlay (Schmidhuber, 2011) searches the space of possible pairs of new tasks and modifications of the current problem solver, until it finds a more powerful problem solver that provably solves all previously learned tasks plus the new one, while the unmodified predecessor does not. Newly invented tasks may require to achieve a wow-effect by making previously learned skills more efficient such that they require less time and space. New skills may (partially) re-use previously learned skills. The greedy search of typical PowerPlay variants uses time-optimal program search to order candidate pairs of tasks and solver modifications by their conditional computational (time and space) complexity, given the stored experience so far. The new task and its corresponding task-solving skill are those first found and validated. This biases the search toward pairs that can be described compactly and validated quickly. The computational costs of validating new tasks need not grow with task repertoire size. Standard problem solver architectures of personal computers or neural networks tend to generalize by solving numerous tasks outside the self-invented training set; PowerPlay's ongoing search for novelty keeps breaking the generalization abilities of its present solver. This is related to Gödel's sequence of increasingly powerful formal theories based on adding formerly unprovable statements to the axioms without affecting previously provable theorems. The continually increasing

Problem-Based Learning in a General Psychology Course.

Science.gov (United States)

Willis, Sandra A.

2002-01-01

Describes the adoption of problem-based learning (PBL) techniques in a general psychology course. States that the instructor used a combination of techniques, including think-pair-share, lecture/discussion, and PBL. Notes means and standard deviations for graded components of PBL format versus lecture/discussion format. (Contains 18 references.)…

A General Solution Framework for Component-Commonality Problems

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Nils Boysen

2009-05-01

Full Text Available Component commonality - the use of the same version of a component across multiple products - is being increasingly considered as a promising way to offer high external variety while retaining low internal variety in operations. However, increasing commonality has both positive and negative cost effects, so that optimization approaches are required to identify an optimal commonality level. As components influence to a greater or lesser extent nearly every process step along the supply chain, it is not surprising that a multitude of diverging commonality problems is being investigated in literature, each of which are developing a specific algorithm designed for the respective commonality problem being considered. The paper on hand aims at a general framework which is flexible and efficient enough to be applied to a wide range of commonality problems. Such a procedure based on a two-stage graph approach is presented and tested. Finally, flexibility of the procedure is shown by customizing the framework to account for different types of commonality problems.

A survey on acquaintance, orientation and behavior of general medical practitioners toward periodontal diseases

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Supreet Kaur

2015-01-01

Full Text Available Background: An association between oral conditions such as periodontal diseases and systemic conditions is noted. As such, periodontal disease is associated with an increased risk of systemic illnesses such as cardiovascular disease, diabetes, adverse pregnancy outcome, atherosclerosis, stroke and hospital acquired pneumonia. The concept of diagnosing and treating a potential patient to minimize the deleterious effects of this chronic infectious and inflammatory condition on systemic conditions represents both an unprecedented challenge and opportunity to our profession. Keeping this in view, the present survey was designed to evaluate the acquaintance, orientation and behavior of general medical practitioners; concerning the effects of periodontal disease on systemic health. Materials and Methods: A typed questionnaire carrying four sets of questions was distributed among general medical practitioners of seven different government and private medical colleges and hospitals. Questionnaire was developed to assess the acquaintance, orientation and behavior of general medical practitioners toward periodontal disease. Results: Most of the respondents have knowledge regarding the signs and symptoms of periodontal disease and its association with cardiovascular disease. However, majority of them do not know about the potential effect of periodontal disease on other organ systems. Conclusion: General medical practitioners have inadequate knowledge regarding periodontal diseases. Hence, oral health related training should be an integral part of the medical curriculum.

A survey on acquaintance, orientation and behavior of general medical practitioners toward periodontal diseases.

Science.gov (United States)

Kaur, Supreet; Khurana, Pankaj; Kaur, Harjit

2015-01-01

An association between oral conditions such as periodontal diseases and systemic conditions is noted. As such, periodontal disease is associated with an increased risk of systemic illnesses such as cardiovascular disease, diabetes, adverse pregnancy outcome, atherosclerosis, stroke and hospital acquired pneumonia. The concept of diagnosing and treating a potential patient to minimize the deleterious effects of this chronic infectious and inflammatory condition on systemic conditions represents both an unprecedented challenge and opportunity to our profession. Keeping this in view, the present survey was designed to evaluate the acquaintance, orientation and behavior of general medical practitioners; concerning the effects of periodontal disease on systemic health. A typed questionnaire carrying four sets of questions was distributed among general medical practitioners of seven different government and private medical colleges and hospitals. Questionnaire was developed to assess the acquaintance, orientation and behavior of general medical practitioners toward periodontal disease. Most of the respondents have knowledge regarding the signs and symptoms of periodontal disease and its association with cardiovascular disease. However, majority of them do not know about the potential effect of periodontal disease on other organ systems. General medical practitioners have inadequate knowledge regarding periodontal diseases. Hence, oral health related training should be an integral part of the medical curriculum.

Primary non-adherence to prescribed medication in general practice

DEFF Research Database (Denmark)

Linnet, Kristján; Halldórsson, Matthías; Thengilsdóttir, Gudrún

2013-01-01

Primary non-adherence refers to the patient not redeeming a prescribed medication at some point during drug therapy. Research has mainly focused on secondary non-adherence. Prior to this study, the overall rate of primary non-adherence in general practice in Iceland was not known....

Medical support of children’s sports: Topical problems

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L. A. Balykova

2017-01-01

Full Text Available The paper discusses the most topical issues of medical support of children and adolescents engaged in physical exercises and sports. Much attention is paid to different views on the etiology, pathogenesis, diagnosis, and principles of therapy of pathological transformation of the heart in child athletes. The problem of sudden cardiac death in sports and the possibility of a relationship between connective tissue dysplasia and its development are touched upon. Electrocardiographic and morphological criteria for cardiac maladaptation in athletes are discussed. The problem of early and accessible diagnosis and Russia’s tactics for the diagnosis of health changes in athletes and approaches to their prevention and treatment are covered. Different ways to prevent the pathological transformation of the cardiovascular system in athletes and sudden cardiac death as its extreme manifestation are discussed.

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

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Stefanadis Christodoulos

2007-06-01

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

Computational Complexity of Some Problems on Generalized Cellular Automations

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P. G. Klyucharev

2012-03-01

Full Text Available We prove that the preimage problem of a generalized cellular automation is NP-hard. The results of this work are important for supporting the security of the ciphers based on the cellular automations.

Consumers' willingness to use a medication management service: the effect of medication-related worry and the social influence of the general practitioner.

Science.gov (United States)

Carter, Stephen R; Moles, Rebekah J; White, Lesley; Chen, Timothy F

2013-01-01

Some consumers at risk of experiencing medication-related problems have chosen not to use pharmacist-provided medication management services. Previous research has shown that consumers' willingness to use the Australian Home Medicines Review (HMR) service depends on the extent to which they believe that they will receive medication information to assist them with self-management. The aim of this study was to develop and test a model of willingness to use HMR among consumers who were eligible to receive the service but have not yet experienced it. Specifically, this study aimed to determine the effects of consumers' medication-related worry and the social influence of the consumer's general practitioner (GP) over willingness. A cross-sectional postal survey was conducted among 1600 members of Council on the Ageing (NSW, Australia). Respondents were included in the study if they had not experienced an HMR and were taking more than 5 medicines daily or more than 12 doses daily. Measurement scales were developed or were based on previous research. Confirmatory factor analysis was used to test the reliability and validity of the multi-item scales. Multiple regression analysis and structural equation modeling (SEM) were used to test the model. Surveys received from 390 respondents (24.3%) were analyzed. Respondents held overall low-to-neutral positive outcome expectancy (POE). The SEM analysis revealed that worry had a direct effect on POE (β=0.35, Psocial influence over willingness to use this medication management service. Copyright © 2013 Elsevier Inc. All rights reserved.

An interactive problem-solving approach to teach traumatology for medical students.

Science.gov (United States)

Abu-Zidan, Fikri M; Elzubeir, Margaret A

2010-08-13

We aimed to evaluate an interactive problem-solving approach for teaching traumatology from perspectives of students and consider its implications on Faculty development. A two hour problem-solving, interactive tutorial on traumatology was structured to cover main topics in trauma management. The tutorial was based on real cases covering specific topics and objectives. Seven tutorials (5-9 students in each) were given by the same tutor with the same format for fourth and fifth year medical students in Auckland and UAE Universities (n = 50). A 16 item questionnaire, on a 7 point Likert-type scale, focusing on educational tools, tutor-based skills, and student-centered skills were answered by the students followed by open ended comments. The tutorials were highly ranked by the students. The mean values of educational tools was the highest followed by tutor-centered skills and finally student-centered skills. There was a significant increase of the rating of studied attributes over time (F = 3.9, p = 0.004, ANOVA). Students' open ended comments were highly supportive of the interactive problem-solving approach for teaching traumatology. The interactive problem-solving approach for tutorials can be an effective enjoyable alternative or supplement to traditional instruction for teaching traumatology to medical students. Training for this approach should be encouraged for Faculty development.

Mental health law: compulsory treatment in a general medical setting.

Science.gov (United States)

Linford, Steven

2005-10-01

Compulsory treatment of severe mental disorder can seem complicated even to psychiatrists. This article attempts to explain the current legal framework as it applies in common clinical situations in a general medical context.

The agency problem and medical acting: an example of applying economic theory to medical ethics.

Science.gov (United States)

Langer, Andreas; Schröder-Bäck, Peter; Brink, Alexander; Eurich, Johannes

2009-03-01

In this article, the authors attempt to build a bridge between economic theory and medical ethics to offer a new perspective to tackle ethical challenges in the physician-patient encounter. They apply elements of new institutional economics to the ethically relevant dimensions of the physician-patient relationship in a descriptive heuristic sense. The principal-agent theory can be used to analytically grasp existing action problems in the physician-patient relationship and as a basis for shaping recommendations at the institutional level. Furthermore, the patients' increased self-determination and modern opportunities for the medical laity to inform themselves lead to a less asymmetrical distribution of information between physician and patient and therefore require new interaction models. Based on the analysis presented here, the authors recommend that, apart from the physician's necessary individual ethics, greater consideration should be given to approaches of institutional ethics and hence to incentive systems within medical ethics.

Algebraic structures in generalized Clifford analysis and applications to boundary value problems

Directory of Open Access Journals (Sweden)

José Játem

2015-12-01

Full Text Available The present article has a threefold purpose: First it is a survey of the algebraic structures of generalized Clifford-type algebras and shows the main results of the corresponding Clifford-type analysis and its application to boundary value problems known so far. Second it is aimed to implement algorithms to provide the fast and accurate computation of boundary value problems for inhomogeneous equations in the framework of the generalized Clifford analysis. Finally it is also aimed to encourage the development of a generalized discrete Clifford analysis.

[Insufficient medication compliance in Parkinson's disease

NARCIS (Netherlands)

Aerts, M.B.; Eijk, M. van der; Kramers, C.; Bloem, B.R.

2011-01-01

Medication compliance is generally suboptimal, particularly in patients with complex polypharmacy. This generic treatment problem is described here for Parkinson's disease (PD). We would expect patients with PD to have good medication compliance, since missed doses immediately result in worsening of

Identification of general characteristics, motivation, and satisfaction of internet-based medical consultation service users in Croatia.

Science.gov (United States)

Klinar, Ivana; Balazin, Ana; Barsić, Bruno; Tiljak, Hrvoje

2011-08-15

To identify users' reasons to look for physician consultation on the internet instead of visiting a physician and to explore their general characteristics, motivation, and satisfaction with internet medical consultation service 'Your Questions.' Users of a free internet medical consultation service 'Your Questions' (www.plivazdravlje.hr) were invited to participate in a web-based survey designed to explore their general characteristics (age, sex, etc), reasons for using the service, the nature of their health problem or question, and their satisfaction with the service. Respondents were divided into two groups: users who consulted an internet physician only (Group I) and users who used internet consulting before or after visiting a physician (Group II). The response rate was 38% (1036/2747), with 79% female respondents. A fifth of the respondents (21%) consulted an internet physician only (Group I). Multivariate analysis revealed that the respondents in Group I were younger (median 24 vs 28 years in Group II), more interested into questions about pregnancy (odds ratio [OR], 1.984; 95% confidence interval [CI], 1.203-3.272), more often embarrassed to talk to a physician in person (OR, 1.828; 95% CI, 1.119-2.989), and more motivated to protect their privacy (OR, 1.727; 95% CI, 1.252-2.380). They also had greater satisfaction with the service (77% vs 60%, Pinternet-based medical consultation services were younger age, need for privacy protection, avoidance of embarrassment at the physician's office, and having a question related to pregnancy. This reveals the internet medical consultation service as a useful health promotion supplement that is particularly applicable for the population of young adults.

Prevalence and correlates of sleep-related problems in adults receiving medical cannabis for chronic pain.

Science.gov (United States)

Cranford, James A; Arnedt, J Todd; Conroy, Deirdre A; Bohnert, Kipling M; Bourque, Carrie; Blow, Frederic C; Ilgen, Mark

2017-11-01

To examine the prevalence and correlates of sleep problems in a sample of medical cannabis patients. Adults ages 21 and older (N=801,M age=45.8) who were seeking medical cannabis certification (either for the first time or as a renewal) for chronic pain at medical cannabis clinics in southern Michigan completed baseline measures of cannabis use, sleep, pain, and other related constructs. Over half of the sample (59%) met criteria for past 1-month sleep disturbance, defined as at least one sleep problem occurring on 15 or more nights in the past month. Most participants (86%) reported that sleep problems were due to their current pain. Approximately 80% of participants reported using cannabis in the past 6 months to improve sleep and, among these participants, cannabis was rated as helpful for improving sleep. Sleep-related cannabis side effects were rare (35%), but sleep-related cannabis withdrawal symptoms were relatively common (65%). Statistically significant correlates of past 1-month sleep disturbance included a) being female, b) being white, c) being on disability, d) not having a medical cannabis card, and e) frequency of using cannabis to help sleep. Sleep problems are highly prevalent and frequent in medical cannabis patients and are closely tied to pain. Sleep-related cannabis withdrawal symptoms are relatively common but their clinical relevance is unknown. The association between frequency of cannabis use to help sleep with higher odds of sleep problems will need to be clarified by longitudinal studies. Copyright © 2017 Elsevier B.V. All rights reserved.

The problem of general Radon representation for an arbitrary Hausdorff space

Science.gov (United States)

Zakharov, V. K.; Mikhalev, A. V.

1999-10-01

After the fundamental work of Riesz, Radon and Hausdorff in the period 1909-1914, the following problem of general Radon representation emerged: for any Hausdorff space find the space of linear functionals that are integrally representable by Radon measures. In the early 1950s, a partial solution of this problem (the bijective version) for locally compact spaces was obtained by Halmos, Hewitt, Edwards, Bourbaki and others. For bounded Radon measures on a Tychonoff space, the problem of isomorphic Radon representation was solved in 1956 by Prokhorov. In this paper we give a possible solution of the problem of general Radon representation. To do this, we use the family of metasemicontinuous functions with compact support and the class of thin functionals. We present bijective and isomorphic versions of the solution (Theorems 1 and 2 of §2.5). To get the isomorphic version, we introduce the family of Radon bimeasures.

The problem of general Radon representation for an arbitrary Hausdorff space

Energy Technology Data Exchange (ETDEWEB)

Zakharov, V K [St Petersburg State University of Technology and Design (Russian Federation); Mikhalev, A V [M.V. Lomonosov Moscow State University, Moscow (Russian Federation)

1999-10-31

After the fundamental work of Riesz, Radon and Hausdorff in the period 1909-1914, the following problem of general Radon representation emerged: for any Hausdorff space find the space of linear functionals that are integrally representable by Radon measures. In the early 1950s, a partial solution of this problem (the bijective version) for locally compact spaces was obtained by Halmos, Hewitt, Edwards, Bourbaki and others. For bounded Radon measures on a Tychonoff space, the problem of isomorphic Radon representation was solved in 1956 by Prokhorov. In this paper we give a possible solution of the problem of general Radon representation. To do this, we use the family of metasemicontinuous functions with compact support and the class of thin functionals. We present bijective and isomorphic versions of the solution (Theorems 1 and 2 of paragraph 2.5). To get the isomorphic version, we introduce the family of Radon bimeasures.

The problem of general Radon representation for an arbitrary Hausdorff space

International Nuclear Information System (INIS)

Zakharov, V K; Mikhalev, A V

1999-01-01

After the fundamental work of Riesz, Radon and Hausdorff in the period 1909-1914, the following problem of general Radon representation emerged: for any Hausdorff space find the space of linear functionals that are integrally representable by Radon measures. In the early 1950s, a partial solution of this problem (the bijective version) for locally compact spaces was obtained by Halmos, Hewitt, Edwards, Bourbaki and others. For bounded Radon measures on a Tychonoff space, the problem of isomorphic Radon representation was solved in 1956 by Prokhorov. In this paper we give a possible solution of the problem of general Radon representation. To do this, we use the family of metasemicontinuous functions with compact support and the class of thin functionals. We present bijective and isomorphic versions of the solution (Theorems 1 and 2 of paragraph 2.5). To get the isomorphic version, we introduce the family of Radon bimeasures

Radiographic quality and radiation protection in general medical practice and small hospitals

International Nuclear Information System (INIS)

Williamson, B.D.P.; Le Heron, J.C.

1988-01-01

Radiation protection and image quality were assessed in a survey of 22 general medical practices (GP) and the 24 smallest hospitals with x-ray facilities. Limited radiography, usually of extremities for trauma, was being performed in these facilities since access to regular radiology services was restricted, mainly for geographic reasons. An anthropomorphic phantom foot and ankle with two simulated fractures of the lateral and medical malleoli was presented at each facility for radiography, and the resulting films assessed for radiographic technique and basic diagnostic usefulness. The x-ray equipment was adequate for the range of procedures performed. While the standard of radiographic techniques was lower than in regular x-ray departments, most films of the phantom ankle were still diagnostically useful and only four were rejected entirely. The principal deficiency in general practice x-ray was in darkrooms and x-ray film processing. Consultation in this regard with registered medical radiation technologists is recommended. Generally, the x-ray equipment and working procedures complied with the National Radiation Laboratory Code of Safe Practice for the Use of X-rays in Diagnosis (Medical). Radiation doses to the phantom ankle ranged widely for effectively the same procedure, although none was excessive. Improved x-ray film processing, and tighter x-ray beam collimation, would result in a narrower range of doses to patients. Personnel exposures to radiation were satisfactorily low and special shieldings are not required in general practice. (author). 7 refs., 4 figs., 2 tabs

An analysis of medical students’ reflective essays in problem-based learning

Directory of Open Access Journals (Sweden)

Jihyun Si

2018-03-01

Full Text Available Purpose This study aimed to explore students’ learning experience in problem-based learning (PBL particularly in terms of what they learned and how they learned in one Korean medical school by analyzing their reflective essays with qualitative research methods. Methods This study included 44 first-year medical students. They took three consecutive PBL courses and wrote reflective essays 3 times anonymously on the last day of each course. Their reflective essays were analyzed using an inductive content analysis method. Results The coding process yielded 16 sub-categories and these categories were grouped into six categories according to the distinctive characteristics of PBL learning experience: integrated knowledge base, clinical problem solving, collaboration, intrinsic motivation, self-directed learning, and professional attitude. Among these categories, integrated knowledge base (34.68% and professional attitude (2.31% were the categories mentioned most and least frequently. Conclusion The findings of this study provide an overall understanding of the learning experience of Korean medical students during PBL in terms of what they learned and how they learned with rich descriptive commentaries from their perspectives as well as several thoughtful insights to help develop instructional strategies to enhance the effectiveness of PBL.

The effects of problem-based learning during medical school on physician competency: a systematic review.

Science.gov (United States)

Koh, Gerald Choon-Huat; Khoo, Hoon Eng; Wong, Mee Lian; Koh, David

2008-01-01

Systematic reviews on the effects of problem-based learning have been limited to knowledge competency either during medical school or postgraduate training. We conducted a systematic review of evidence of the effects that problem-based learning during medical school had on physician competencies after graduation. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Databases, and the tables of contents of 5 major medical education journals from earliest available date through Oct. 31, 2006. We included studies in our review if they met the following criteria: problem-based learning was a teaching method in medical school, physician competencies were assessed after graduation and a control group of graduates of traditional curricula was used. We developed a scoring system to assess the quality of the studies, categorized competencies into 8 thematic dimensions and used a second system to determine the level of evidence for each competency assessed. Our search yielded 102 articles, of which 15 met inclusion criteria after full text review. Only 13 studies entered final systematic analysis because 2 studies reported their findings in 2 articles. According to self-assessments, 8 of 37 competencies had strong evidence in support of problem-based learning. Observed assessments had 7 competencies with strong evidence. In both groups, most of these competencies were in the social and cognitive dimensions. Only 4 competencies had moderate to strong levels of evidence in support of problem-based learning for both self-and observed assessments: coping with uncertainty (strong), appreciation of legal and ethical aspects of health care (strong), communication skills (moderate and strong respectively) and self-directed continuing learning (moderate). Problem-based learning during medical school has positive effects on physician competency after graduation, mainly in social and cognitive dimensions.

42 CFR 412.87 - Additional payment for new medical services and technologies: General provisions.

Science.gov (United States)

2010-10-01

... payment for new medical services and technologies: General provisions. (a) Basis. Sections 412.87 and 412... establish a mechanism to recognize the costs of new medical services and technologies under the hospital... that are new medical services and technologies, if the following conditions are met: (1) A new medical...

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

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Nin-Chieh Hsu

2014-08-01

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

A Generalized Ant Colony Algorithm for Job一shop Scheduling Problem

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ZHANG Hong-Guo

2017-02-01

Full Text Available Aiming at the problem of ant colony algorithm for solving Job一shop scheduling problem. Considering the complexity of the algorithm that uses disjunctive graph to describe the relationship between workpiece processing. To solve the problem of optimal solution，a generalized ant colony algorithm is proposed. Under the premise of considering constrained relationship between equipment and process，the pheromone update mechanism is applied to solve Job-shop scheduling problem，so as to improve the quality of the solution. In order to improve the search efficiency，according to the state transition rules of ant colony algorithm，this paper makes a detailed study on the selection and improvement of the parameters in the algorithm，and designs the pheromone update strategy. Experimental results show that a generalized ant colony algorithm is more feasible and more effective. Compared with other algorithms in the literature，the results prove that the algorithm improves in computing the optimal solution and convergence speed.

Active teaching-learning methodologies: medical students' views of problem-based learning

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José Roberto Bittencourt Costa

Full Text Available The prevailing undergraduate medical training process still favors disconnection and professional distancing from social needs. The Brazilian Ministries of Education and Health, through the National Curriculum Guidelines, the Incentives Program for Changes in the Medical Curriculum (PROMED, and the National Program for Reorientation of Professional Training in Health (PRO-SAÚDE, promoted the stimulus for an effective connection between medical institutions and the Unified National Health System (SUS. In accordance to the new paradigm for medical training, the Centro Universitário Serra dos Órgãos (UNIFESO established a teaching plan in 2005 using active methodologies, specifically problem-based learning (PBL. Research was conducted through semi-structured interviews with third-year undergraduate students at the UNIFESO Medical School. The results were categorized as proposed by Bardin's thematic analysis, with the purpose of verifying the students' impressions of the new curriculum. Active methodologies proved to be well-accepted by students, who defined them as exciting and inclusive of theory and practice in medical education.

A snapshot of residents in medical oncology in Turkey: A Nationwide survey on profile and key problems

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Erdinc Nayir

2016-04-01

Conclusion: Recognition of the subspecialty residents who are the future of medical oncology, and determination of their needs, and problems will contribute to the development of recommendations for their solution. In our country their main problems are medical conscription, inadequate education, and burnout.

Modified and fuzzified general problem solver for the 'monkey and banana' problem, 1

International Nuclear Information System (INIS)

Sano, Norihide; Takahashi, Ryoichi.

1991-01-01

The master-and-slave control system should be extensively implemented for the in-service inspection of operating nuclear power stations or the decommission of retired plants. The performance of this system depends on the intelligent slave. In this paper the degree of intelligence is approximated by the given amount of prior knowledge or suggestions. This paper aims at improving the general problem solver (GPS) by incorporating the learning process in order to solve the puzzle of the 'monkey and banana'. The monkey in this puzzle may be a reasonable alternative to represent the intelligent slave. Also, this paper deals with fuzzified problem solving since the master's command is not always crisp to the slave. (author)

On a covariant 2+2 formulation of the initial value problem in general relativity

International Nuclear Information System (INIS)

Smallwood, J.

1980-03-01

The initial value problems in general relativity are considered from a geometrical standpoint with especial reference to the development of a covariant 2+2 formalism in which space-time is foliated by space-like 2-surfaces under the headings; the Cauchy problem in general relativity, the covariant 3+1 formulation of the Cauchy problem, characteristic and mixed initial value problems, on locally imbedding a family of null hypersurfaces, the 2+2 formalism, the 2+2 formulation of the Cauchy problem, the 2+2 formulation of the characteristic and mixed initial value problems, and a covariant Lagrangian 2+2 formulation. (U.K.)

Benefits and problems in implementation for integrated medical information system

International Nuclear Information System (INIS)

Park, Chang Seo; Kim, Kee Deog; Park, Hyok; Jeong, Ho Gul

2005-01-01

Once the decision has been made to adopt an integrated medical information system (IMIS), there are a number of tissues to overcome. Users need to be aware of the impact the change will make on end users and be prepared to address issues that arise before they become problems. The purpose of this study is to investigate the benefits and unexpected problems encountered in the implementation of IMIS and to determine a useful framework for IMIS. The Yonsei University Dental Hospital is steadily constructing an IMIS. The vendor's PACS software, Piview STAR, supports transactions between workstations that are approved to integrating the health care enterprise (IHE) with security function. It is necessary to develop an excellent framework that is good for the patient, health care provider and information system vendors, in an expert, efficient, and cost-effective manner. The problems encountered with IMIS implementation were high initial investments, delay of EMR enforcement, underdevelopment of digital radiographic appliances and software and insufficient educational training for users. The clinical environments of dental IMIS is some different from the medical situation. The best way to overcome these differences is to establish a gold standard of dental IMIS integration, which estimates the cost payback. The IHE and its technical framework are good for the patient, the health care provider and all information systems vendors.

Psychosocial problems of pre-clinical students in the University of Ibadan Medical School.

Science.gov (United States)

Omokhodion, F O

2003-06-01

Recent changes in the psychosocial environment of the university campus such as the steep rise in student numbers, the high cost of living standards and the increase in violence and cult activities has prompted the need to assess the impact of these changes on the students. A cross sectional study was carried out among pre-clinical medical students to identify their psychosocial problems. A self-administered questionnaire was used to collect information about socio-demographic variables including age, sex, sources of financial support, type of accommodation, smoking and drinking habits and use of recreational facilities. Causes of insecurity and depression among students were also recorded. The General Health Questionnaire GHQ-12 was used to assess their mental health status. One hundred and seventy-six students responded to the enquiry, 94 males (53%) and 80 females (45%). One hundred and thirty-seven (79%) live on the campus while 37 (21%) live off campus. Only 9 of the students (5%) were smokers and 28 (16%) were drinkers. Monthly pocket money ranged from Naira 1,000 to Naira 25,000. Forty-one (23%) thought their pocket money was adequate, 92 (52%) thought it was fair and 39 (22%) thought it was inadequate. Causes of insecurity on the campus were cultism 34 (19%), lack of money 27 (15%), lack of textbooks 13 (7%) and stealing 10 (6%). Causes of depression include fear of failure of examinations, 62 (35%), lack of money, 48 (27%) and family problems 17 (10%). Mental health scores ranged from 1 to 10. Using a cut off point of 3 to delineate those with traits of poor mental health, 35 (21%) fell into the category 15 boys and 20 girls. Mean mental health score were higher for females, those living on campus, smokers and drinkers but this was not statistically significant. Fear of failure of examinations, cultism and lack of money are major concerns among medical students on the main university campus. Counselling services should be provided to assist students with

Medical emergencies facing general practitioners: Drugs for the doctor's bag

OpenAIRE

Janković Slobodan

2014-01-01

General practitioners are frequently facing medical emergencies. In order to react properly and administer therapy on time, a general practitioner needs to prepare and keep with himself the appropriate set of drugs which could be effectively used for treatment of the emergencies. The following drugs should find their place in the doctor's bag: acetaminophen (for mild and moderate pain, and for fever), morphine (for severe pain), naloxone (for heroin poisoning), ceftriaxone (for meningococcal ...

Feasibility of a self-administered survey to identify primary care patients at risk of medication-related problems

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Makowsky MJ

2014-02-01

Full Text Available Mark J Makowsky,1 Andrew J Cave,2 Scot H Simpson1 1Faculty of Pharmacy and Pharmaceutical Sciences, 2Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada Background and objectives: Pharmacists working in primary care clinics are well positioned to help optimize medication management of community-dwelling patients who are at high risk of experiencing medication-related problems. However, it is often difficult to identify these patients. Our objective was to test the feasibility of a self-administered patient survey, to facilitate identification of patients at high risk of medication-related problems in a family medicine clinic. Methods: We conducted a cross-sectional, paper-based survey at the University of Alberta Hospital Family Medicine Clinic in Edmonton, Alberta, which serves approximately 7,000 patients, with 25,000 consultations per year. Adult patients attending the clinic were invited to complete a ten-item questionnaire, adapted from previously validated surveys, while waiting to be seen by the physician. Outcomes of interest included: time to complete the questionnaire, staff feedback regarding impact on workflow, and the proportion of patients who reported three or more risk factors for medication-related problems. Results: The questionnaire took less than 5 minutes to complete, according to the patient's report on the last page of the questionnaire. The median age (and interquartile range of respondents was 57 (45–69 years; 59% were women; 47% reported being in very good or excellent health; 43 respondents of 100 had three or more risk factors, and met the definition for being at high risk of a medication-related problem. Conclusions: Distribution of a self-administered questionnaire did not disrupt patients, or the clinic workflow, and identified an important proportion of patients at high risk of medication-related problems. Keywords: screening tool, pharmacists, primary

Selecting, training and assessing new general practice community teachers in UK medical schools.

Science.gov (United States)

Hydes, Ciaran; Ajjawi, Rola

2015-09-01

Standards for undergraduate medical education in the UK, published in Tomorrow's Doctors, include the criterion 'everyone involved in educating medical students will be appropriately selected, trained, supported and appraised'. To establish how new general practice (GP) community teachers of medical students are selected, initially trained and assessed by UK medical schools and establish the extent to which Tomorrow's Doctors standards are being met. A mixed-methods study with questionnaire data collected from 24 lead GPs at UK medical schools, 23 new GP teachers from two medical schools plus a semi-structured telephone interview with two GP leads. Quantitative data were analysed descriptively and qualitative data were analysed informed by framework analysis. GP teachers' selection is non-standardised. One hundred per cent of GP leads provide initial training courses for new GP teachers; 50% are mandatory. The content and length of courses varies. All GP leads use student feedback to assess teaching, but other required methods (peer review and patient feedback) are not universally used. To meet General Medical Council standards, medical schools need to include equality and diversity in initial training and use more than one method to assess new GP teachers. Wider debate about the selection, training and assessment of new GP teachers is needed to agree minimum standards.

Striking trends in the incidence of health problems in The Netherlands (2002-05). Findings from a new strategy for surveillance in general practice.

Science.gov (United States)

Biermans, Marion C J; Spreeuwenberg, Peter; Verheij, Robert A; de Bakker, Dinny H; de Vries Robbé, Pieter F; Zielhuis, Gerhard A

2009-06-01

This study aimed to detect striking trends based on a new strategy for monitoring public health. We used data over 4 years from electronic medical records of a large, nationally representative network of general practices. Episodes were either directly recorded by general practitioners (GPs) or were constructed using a new record linkage method (EPICON). The episodes were used to estimate raw morbidity rates for all codes of the International Classification of Primary Care (ICPC). Multilevel Poisson regression models were used to analyse the trend over time for 15 health problems that showed an obvious change over time. Based on these models, we calculated adjusted incidence rates corrected for clustering, sex and age. During 2002-05, both men and women increasingly consulted the GP because of concern about a drug reaction, a change in faeces/bowel movements and urination problems. Men showed an increase in consultations for prostate problems and venereal diseases. The incidence of chronic internal knee derangement decreased for both sexes. Women consulted their GP less frequently about sterilization and fear of being pregnant. The strategy developed proved to be useful to detect trends across a short period of time. Changes in the health care market, such as the increasing availability of over-the-counter drugs and various large advertising campaigns for medications may explain some of the findings. The increasing incidence of health problems in the urogenital area deserves attention as it could reflect increases in the incidence of sexually transmitted diseases (STDs) and urinary tract infections.

Solving the generalized symmetric eigenvalue problem using tile algorithms on multicore architectures

KAUST Repository

Ltaief, Hatem; Luszczek, Piotr R.; Haidar, Azzam; Dongarra, Jack

2012-01-01

This paper proposes an efficient implementation of the generalized symmetric eigenvalue problem on multicore architecture. Based on a four-stage approach and tile algorithms, the original problem is first transformed into a standard symmetric

Sonography and hypotension: a change to critical problem solving in undergraduate medical education

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Amini R

2016-01-01

Full Text Available Richard Amini, Lori A Stolz, Nicholas C Hernandez, Kevin Gaskin, Nicola Baker, Arthur Barry Sanders, Srikar AdhikariDepartment of Emergency Medicine, University of Arizona Medical Center, College of Medicine, University of Arizona, Tucson, AZ, USAStudy objectives: Multiple curricula have been designed to teach medical students the basics of ultrasound; however, few focus on critical problem-solving. The objective of this study is to determine whether a theme-based ultrasound teaching session, dedicated to the use of ultrasound in the management of the hypotensive patient, can impact medical students’ ultrasound education and provide critical problem-solving exercises.Methods: This was a cross-sectional study using an innovative approach to train 3rd year medical students during a 1-day ultrasound training session. The students received a 1-hour didactic session on basic ultrasound physics and knobology and were also provided with YouTube hyperlinks, and links to smart phone educational applications, which demonstrated a variety of bedside ultrasound techniques. In small group sessions, students learned how to evaluate patients for pathology associated with hypotension. A knowledge assessment questionnaire was administered at the end of the session and again 3 months later. Student knowledge was also assessed using different clinical scenarios with multiple-choice questions.Results: One hundred and three 3rd year medical students participated in this study. Appropriate type of ultrasound was selected and accurate diagnosis was made in different hypotension clinical scenarios: pulmonary embolism, 81% (95% CI, 73%–89%; abdominal aortic aneurysm, 100%; and pneumothorax, 89% (95% CI, 82%–95%. The average confidence level in performing ultrasound-guided central line placement was 7/10, focused assessment with sonography for trauma was 8/10, inferior vena cava assessment was 8/10, evaluation for abdominal aortic aneurysm was 8/10, assessment for

A survey of general surgery clerkships in Australian and New Zealand medical schools.

Science.gov (United States)

Yu, Tzu-Chieh; Wheeler, Benjamin Robert Logan; Hill, Andrew Graham

2010-12-01

Surgical clerkships facilitate development of knowledge and competency, but their structure and content vary. Establishment of new medical schools and raising student numbers are new challenges to the provision of standardized surgical teaching across Australasian medical schools. A survey was conducted to investigate how Australian and New Zealand medical schools structure their general surgery clerkships. Between April and August 2009, a 30-item web-based survey was electronically sent to academic and administrative staff members of 22 Australian and New Zealand medical schools. Eighteen surveys were returned by 16 medical schools, summarizing 20 clerkships. Ten schools utilize five or more different clinical teaching sites for general surgery clerkships and these include urban and rural hospitals from both public and private health sectors. Student teaching and assessment methods are similar between clerkships and standardized across clinical sites during 10 and 16 of the clerkships, respectively. Only eight of the surveyed clerkships use centralized assessments to evaluate student learning outcomes across different clinical sites. Four clerkships do not routinely use direct observational student assessments. Australian and New Zealand medical schools commonly assign students to multiple diverse clinical sites during general surgery clerkships and they vary in their approaches to standardizing curriculum delivery and student assessment across these sites. Differences in student learning are likely to exist and deficiencies in clinical ability may go undetected. This should be a focus for future improvement. © 2010 The Authors. ANZ Journal of Surgery © 2010 Royal Australasian College of Surgeons.

Gambling Problems in the General Danish Population

DEFF Research Database (Denmark)

Harrison, Glenn W.; Jessen, Lasse J.; Lau, Morten

We compare several popular survey instruments for measuring gambling behavior and gambling propensity to assess if they differ in their classification of individuals in the general adult Danish population. We also examine correlations with standard survey instruments for alcohol use, anxiety......, depression and impulsivity. A feature of our design is that nobody was excluded on the basis of their response to a “trigger,” “gateway” or “diagnostic item” question about previous gambling history. Our sample consists of 8,405 adult Danes. We administered the Focal Adult Gambling Screen to all subjects...... and estimate prevalence of gambling problems using sample weights and controlling for sample selection. We find that 95.4% of the population has no detectable risk, 2.9% has an early risk, 0.8% has an intermediate risk, 0.7% has an advanced risk, and 0.2% can be classified as problem gamblers...

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 ...

Investigation of Free Particle Propagator with Generalized Uncertainty Problem

International Nuclear Information System (INIS)

Hassanabadi, H.; Ghobakhloo, F.

2016-01-01

We consider the Schrödinger equation with a generalized uncertainty principle for a free particle. We then transform the problem into a second-order ordinary differential equation and thereby obtain the corresponding propagator. The result of ordinary quantum mechanics is recovered for vanishing minimal length parameter.

Energy-momentum distribution: A crucial problem in general relativity

NARCIS (Netherlands)

Sharif, M.; Fatima, T.

2005-01-01

This paper is aimed to elaborate the problem of energy–momentum in general relativity. In this connection, we use the prescriptions of Einstein, Landau–Lifshitz, Papapetrou and Möller to compute the energy–momentum densities for two exact solutions of Einstein field equations. The space–times under

Sources of Stress and Coping Strategies among Undergraduate Medical Students Enrolled in a Problem-Based Learning Curriculum

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Samira S. Bamuhair

2015-01-01

Full Text Available Background. Medical education is rated as one of the most difficult trainings to endure. Throughout their undergraduate years, medical students face numerous stressors. Coping with these stressors requires access to a variety of resources, varying from personal strengths to social support. We aimed to explore the perceived stress, stressors, and coping strategies employed by medical students studying in a problem-based learning curriculum. Methodology. This is a cross-sectional study of randomly selected medical students that explored demographics, perceived stress scale, sources of stress, and coping strategies. Results. Of the 378 medical students that participated in the study, males were 59.3% and females 40.7%. Nearly 53% of the students often felt stressed, and a third felt that they could not cope with stress. Over 82% found studying stressful and 64.3% were not sleeping well. Half of the students reported low self-esteem. Perceived stress scores were statistically significantly high for specific stressors of studying in general, worrying about future, interpersonal conflict, and having low self-esteem. Coping strategies that were statistically significantly applied more often were blaming oneself and being self-critical, seeking advice and help from others, and finding comfort in religion. Female students were more stressed than males but they employ more coping strategies as well. Conclusions. Stress is very common among medical students. Most of the stressors are from coursework and interpersonal relationships. Low self-esteem coupled with self-blame and self-criticism is quite common.

Numerical solution of pipe flow problems for generalized Newtonian fluids

International Nuclear Information System (INIS)

Samuelsson, K.

1993-01-01

In this work we study the stationary laminar flow of incompressible generalized Newtonian fluids in a pipe with constant arbitrary cross-section. The resulting nonlinear boundary value problems can be written in a variational formulation and solved using finite elements and the augmented Lagrangian method. The solution of the boundary value problem is obtained by finding a saddle point of the augmented Lagrangian. In the algorithm the nonlinear part of the equations is treated locally and the solution is obtained by iteration between this nonlinear problem and a global linear problem. For the solution of the linear problem we use the SSOR preconditioned conjugate gradient method. The approximating problem is solved on a sequence of adaptively refined grids. A scheme for adjusting the value of the crucial penalization parameter of the augmented Lagrangian is proposed. Applications to pipe flow and a problem from the theory of capacities are given. (author) (34 refs.)

General practice-based clinical trials in Germany - a problem analysis

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Hummers-Pradier Eva

2012-11-01

Full Text Available Abstract Background In Germany, clinical trials and comparative effectiveness studies in primary care are still very rare, while their usefulness has been recognised in many other countries. A network of researchers from German academic general practice has explored the reasons for this discrepancy. Methods Based on a comprehensive literature review and expert group discussions, problem analyses as well as structural and procedural prerequisites for a better implementation of clinical trials in German primary care are presented. Results In Germany, basic biomedical science and technology is more reputed than clinical or health services research. Clinical trials are funded by industry or a single national programme, which is highly competitive, specialist-dominated, exclusive of pilot studies, and usually favours innovation rather than comparative effectiveness studies. Academic general practice is still not fully implemented, and existing departments are small. Most general practitioners (GPs work in a market-based, competitive setting of small private practices, with a high case load. They have no protected time or funding for research, and mostly no research training or experience. Good Clinical Practice (GCP training is compulsory for participation in clinical trials. The group defined three work packages to be addressed regarding clinical trials in German general practice: (1 problem analysis, and definition of (2 structural prerequisites and (3 procedural prerequisites. Structural prerequisites comprise specific support facilities for general practice-based research networks that could provide practices with a point of contact. Procedural prerequisites consist, for example, of a summary of specific relevant key measures, for example on a web platform. The platform should contain standard operating procedures (SOPs, templates, checklists and other supporting materials for researchers. Conclusion All in all, our problem analyses revealed that

Knowledge of and attitudes toward electroconvulsive therapy among medical students, psychology students, and the general public.

Science.gov (United States)

Aki, Ozlem Erden; Ak, Sertac; Sonmez, Yunus Emre; Demir, Basaran

2013-03-01

Electroconvulsive therapy (ECT) is safe and effective for the treatment of various psychiatric disorders. Despite being a well-known treatment method among health care professionals, lay people generally have a negative opinion of ECT. The present study aimed to examine knowledge of and attitudes toward ECT among medical students, psychology students, and the general public. Psychology students were included because they are among the important groups in mental health care in Turkey. A Likert-type questionnaire was administered to fifth-year medical students (n = 28), master of science and doctor of philosophy clinical psychology students (n = 35), and a sample of the general public (n = 26). The questionnaire included questions about the general principles of and indications for ECT, and sources of knowledge of and attitudes toward ECT. The medical students were the most knowledgeable about ECT, as expected. The medical students also had a more positive attitude toward ECT than the other 2 groups. More psychology students had negative attitudes on some aspects than general public sample, despite being more knowledgeable. Medical school theoretical and practical training in ECT played an important role in increasing the level of knowledge of and decreasing the prevalence of negative attitudes toward ECT among the medical students; similar training for psychology students is required to achieve similar results.

Multistep Hybrid Iterations for Systems of Generalized Equilibria with Constraints of Several Problems

Directory of Open Access Journals (Sweden)

Lu-Chuan Ceng

2014-01-01

Full Text Available We first introduce and analyze one multistep iterative algorithm by hybrid shrinking projection method for finding a solution of the system of generalized equilibria with constraints of several problems: the generalized mixed equilibrium problem, finitely many variational inclusions, the minimization problem for a convex and continuously Fréchet differentiable functional, and the fixed-point problem of an asymptotically strict pseudocontractive mapping in the intermediate sense in a real Hilbert space. We prove strong convergence theorem for the iterative algorithm under suitable conditions. On the other hand, we also propose another multistep iterative algorithm involving no shrinking projection method and derive its weak convergence under mild assumptions.

Tracks to a Medical Diagnosis: Expertise Differences in Visual Problem Solving

NARCIS (Netherlands)

Jaarsma, Thomas; Boshuizen, Els; Jarodzka, Halszka; Nap, Marius; Verboon, Peter; Van Merriënboer, Jeroen

2018-01-01

This study focuses on the visual problem-solving process of clinical pathologists. Its aim is to find expertise-related differences in the temporal arrangement of this process, with a special focus on the orientation phase. A theoretical model of the visual diagnostic process of medical specialists

Medication management and practices in prison for people with mental health problems: a qualitative study.

Science.gov (United States)

Bowen, Robert A; Rogers, Anne; Shaw, Jennifer

2009-10-20

Common mental health problems are prevalent in prison and the quality of prison health care provision for prisoners with mental health problems has been a focus of critical scrutiny. Currently, health policy aims to align and integrate prison health services and practices with those of the National Health Service (NHS). Medication management is a key aspect of treatment for patients with a mental health problem. The medication practices of patients and staff are therefore a key marker of the extent to which the health practices in prison settings equate with those of the NHS. The research reported here considers the influences on medication management during the early stages of custody and the impact it has on prisoners. The study employed a qualitative design incorporating semi-structured interviews with 39 prisoners and 71 staff at 4 prisons. Participant observation was carried out in key internal prison locations relevant to the management of vulnerable prisoners to support and inform the interview process. Thematic analysis of the interview data and interpretation of the observational field-notes were undertaken manually. Emergent themes included the impact that delays, changes to or the removal of medication have on prisoners on entry to prison, and the reasons that such events take place. Inmates accounts suggested that psychotropic medication was found a key and valued form of support for people with mental health problems entering custody. Existing regimes of medication and the autonomy to self-medicate established in the community are disrupted and curtailed by the dominant practices and prison routines for the taking of prescribed medication. The continuity of mental health care is undermined by the removal or alteration of existing medication practice and changes on entry to prison which exacerbate prisoners' anxiety and sense of helplessness. Prisoners with a dual diagnosis are likely to be doubly vulnerable because of inconsistencies in substance

A Generalized Cauchy Distribution Framework for Problems Requiring Robust Behavior

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Carrillo RafaelE

2010-01-01

Full Text Available Statistical modeling is at the heart of many engineering problems. The importance of statistical modeling emanates not only from the desire to accurately characterize stochastic events, but also from the fact that distributions are the central models utilized to derive sample processing theories and methods. The generalized Cauchy distribution (GCD family has a closed-form pdf expression across the whole family as well as algebraic tails, which makes it suitable for modeling many real-life impulsive processes. This paper develops a GCD theory-based approach that allows challenging problems to be formulated in a robust fashion. Notably, the proposed framework subsumes generalized Gaussian distribution (GGD family-based developments, thereby guaranteeing performance improvements over traditional GCD-based problem formulation techniques. This robust framework can be adapted to a variety of applications in signal processing. As examples, we formulate four practical applications under this framework: (1 filtering for power line communications, (2 estimation in sensor networks with noisy channels, (3 reconstruction methods for compressed sensing, and (4 fuzzy clustering.

The quality of life of medical students studying in New Zealand: a comparison with nonmedical students and a general population reference group.

Science.gov (United States)

Henning, Marcus A; Krägeloh, Christian U; Hawken, Susan J; Zhao, Yipin; Doherty, Iain

2012-01-01

Quality of life is an essential component of learning and has strong links with the practice and study of medicine. There is burgeoning evidence in the research literature to suggest that medical students are experiencing health-related problems such as anxiety, depression, and burnout. The aim of the study was to investigate medical students' perceptions concerning their quality of life. Two hundred seventy-four medical students studying in their early clinical years (response rate = 80%) participated in the present study. Medical students were asked to fill in the abbreviated version of the World Health Organization Quality of Life questionnaire to elicit information about their quality of life perceptions in relation to their physical health, psychological health, social relationships, and environment. Subsequently, their responses were compared with two nonmedical students groups studying at a different university in the same city and an Australian general population norm. The findings were compared using independent group's t tests, confidence intervals, and Cohen's d. The main finding of the study indicated that medical students had similar quality of life perceptions to nonmedical students except in relation to the environment domain. Furthermore, the medical student group scored lower than the general population reference group on the physical health, psychological health, and environment quality of life domains. The results suggest that all university students are expressing concerns related to quality of life, and thus their health might be at risk. The findings in this study provided no evidence to support the notion that medical students experience lower levels of quality of life compared to other university students. When compared to the general population, all student groups examined in this study appeared to be experiencing lower levels of quality of life. This has implications for pastoral support, educationalists, student support personnel, and the

Documenting clinical performance problems among medical students: feedback for learner remediation and curriculum enhancement

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Brian E. Mavis

2013-07-01

Full Text Available Introduction: We operationalized the taxonomy developed by Hauer and colleagues describing common clinical performance problems. Faculty raters pilot tested the resulting worksheet by observing recordings of problematic simulated clinical encounters involving third-year medical students. This approach provided a framework for structured feedback to guide learner improvement and curricular enhancement. Methods: Eighty-two problematic clinical encounters from M3 students who failed their clinical competency examination were independently rated by paired clinical faculty members to identify common problems related to the medical interview, physical examination, and professionalism. Results: Eleven out of 26 target performance problems were present in 25% or more encounters. Overall, 37% had unsatisfactory medical interviews, with ‘inadequate history to rule out other diagnoses’ most prevalent (60%. Seventy percent failed because of physical examination deficiencies, with missing elements (69% and inadequate data gathering (69% most common. One-third of the students did not introduce themselves to their patients. Among students failing based on standardized patient (SP ratings, 93% also failed to demonstrate competency based on the faculty ratings. Conclusions: Our review form allowed clinical faculty to validate pass/fail decisions based on standardized patient ratings. Detailed information about performance problems contributes to learner feedback and curricular enhancement to guide remediation planning and faculty development.

Spatial variation in general medical services income in dublin general practitioners.

Science.gov (United States)

Teljeur, Conor; Kelly, Alan; O'Dowd, Tom

2011-01-01

The general medical services (GMS) scheme provides care free at the point of use for the 30% most economically deprived section of the population and the elderly. Almost all people of over-70-year olds are eligible for the GMS scheme potentially directing resources away from those most in need. The aim of this study is to analyse the relationship between practice GMS income and deprivation amongst Dublin-based general practitioners (GPs). The practice GMS income in Dublin was analysed in relation to practice characteristics including the number of GPs, catchment area population, proportion of over-70-year olds in the catchment area, catchment deprivation, number of GMS GPs within 2 km, and average GMS practice income within 2 km. Practice GMS income was highest in deprived areas but is also a valuable source of income in the least deprived areas. The capitation rate for over-70-year olds provides an incentive for GPs to locate in affluent areas and potentially directs resources away from those in greater need.

Problem based learning in medical education: theory, rationale, process and implications for pakistan.

Science.gov (United States)

Baig, Lubna A

2006-09-01

Historically, lectures were the medium to transfer cognitive information to the learners in medical education. Apprenticeship training, labs, bedside teaching, tutorials etc. were used to impart psychomotor and affective skills. It was assumed that the learner will assimilate all this knowledge and will be competent to apply this learning in practical life. Problem-based learning (PBL) emerged due to problems in building the appropriate competencies in the medical graduates and is a relatively newer mode of transfer of knowledge. This paper will deal with problem-based learning which took the world with storm in the 80's and most institutions in the world started using different variants of PBL. This paper attempts to define and explore the theoretical basis and historical background of PBL. The paper will systematically review literature and argue about the advantages and disadvantages of PBL and the implications of its implementation in Pakistan.

Review of existing issues, ethics and practices in general medical research and in radiation protection research

International Nuclear Information System (INIS)

Schreiner-Karoussou, A.

2008-01-01

A literature review was carried out in relation to general medical research and radiation protection research. A large number of documents were found concerning the subject of ethics in general medical research. For radiation protection research, the number of documents and the information available is very limited. A review of practices in 13 European countries concerning general medical research and radiation protection research was carried out by sending a questionnaire to each country. It was found that all countries reviewed were well regulated for general medical research. For research that involves ionising radiation, the UK and Ireland are by far the most regulated countries. For other countries, there does not seem to be much information available. From the literature review and the review of practices, a number of existing ethical issues were identified and exposed, and a number of conclusions were drawn. (authors)

Pharmacotherapeutic Problems and Pharmacist Interventions in a Medical Intensive Care Unit

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Tae Yun Park

2015-05-01

Full Text Available Background: Interest in pharmacist participation in the multidisciplinary intensive care team is increasing. However, studies examining pharmacist interventions in the medical intensive care unit (MICU are limited in Korea. The aim of this study was to describe the current status of pharmacist interventions and to identify common pharmacologic problems requiring pharmacist intervention in the MICU. Methods: Between September 2013 and August 2014, a retrospective, observational study was conducted in the 22-bed MICU at a university hospital. Data were obtained from two trained pharmacists who participated in MICU rounds three times a week. In addition to patient characteristics, data on the cause, type, related drug, and acceptance rate of interventions were collected. Results: In 340 patients, a total of 1211 pharmacologic interventions were performed. The majority of pharmacologic interventions were suggested by pharmacists at multidisciplinary rounds in the MICU. The most common pharmacologic interventions were adjustment of dosage and administration (n = 328, 26.0%, followed by parenteral/enteral nutritional support (n = 228, 18.1%, the provision of drug information (n = 228, 18.1%, and advice regarding pharmacokinetics (n = 118, 9.3%. Antimicrobial agents (n = 516, 42.6% were the most frequent type of drug associated with pharmacist interventions. The acceptance rate of interventions was 84.1% with most accepted by physicians within 24 hours (n = 602, 92.8%. Conclusions: Medication and nutritional problems are frequently encountered pharmacotherapeutic problems in the MICU. Pharmacist interventions play an important role in the management of these problems.

Teaching medical students to discern ethical problems in human clinical research studies.

Science.gov (United States)

Roberts, Laura Weiss; Warner, Teddy D; Green Hammond, Katherine A; Brody, Janet L; Kaminsky, Alexis; Roberts, Brian B

2005-10-01

Investigators and institutional review boards are entrusted with ensuring the conduct of ethically sound human studies. Assessing ethical aspects of research protocols is a key skill in fulfilling this duty, yet no empirically validated method exists for preparing professionals to attain this skill. The authors performed a randomized controlled educational intervention, comparing a criteria-based learning method, a clinical-research- and experience-based learning method, and a control group. All 300 medical students enrolled at the University of New Mexico School of Medicine in 2001 were invited to participate. After a single half-hour educational session, a written posttest of ability to detect ethical problems in hypothetical protocol vignettes was administered. The authors analyzed responses to ten protocol vignettes that had been evaluated independently by experts. For each vignette, a global assessment of the perceived significance of ethical problems and the identification of specific ethical problems were evaluated. Eighty-three medical students (27%) volunteered: 50 (60%) were women and 55 (66%) were first- and second-year students. On global assessments, the criteria-focused group perceived ethical problems as more significant than did the other two groups (p evaluation skills. This work supports the potential value of empirically derived methods for preparing professionals to discern ethical aspects of human studies.

The General Medical Council: frame of reference or arbiter of morals?

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Hill, D

1977-01-01

Many members of the public think of the General Medical Council (GMC) as the body which tries doctors: the doctors' law courts, as it were. And, except in the more sober of newspapers and news reports, the 'offences ' which receive the most publicity are those concerning alleged improper relations between doctors and patients. Professor Sir Denis Hill, in the following paper, which he read in the spring of this year to the annual conference of the London Medical Group devoted to a discussion of human sexuality, chose to examine the whole function of the General Medical Council as a frame of moral reference for doctors. Judging allegations of professional misconduct by doctors is the function of the Council's Disciplinary Committee. Judging sexual misconduct forms only a small part of their work. The GMC's responsibility covers the whole notion of morals and morality as it concerns doctors in their professional work. Sir Denis Hill stresses the modern thinking that morality must be learned and that attitudes are always shifting as society alters its norms of what is moral conduct. That is not to say that all that was previously considered not to be moral has now become acceptable but rather that other concepts have entered the field of moral debate. Therefore the GMC must constantly review the frame of reference it offers to doctors and the public may be surprised to learn that that process is never static. Sir Denis Hill in this paper is speaking personally and not as a member of the General Medical Council or of any of that body's special committees. PMID:926129

A Study of Some General Problems of Dieudonné-Rashevski Type

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Ariana Pitea

2012-01-01

Full Text Available We use a method of investigation based on employing adequate variational calculus techniques in the study of some generalized Dieudonné-Rashevski problems. This approach allows us to state and prove optimality conditions for such kind of vector multitime variational problems, with mixed isoperimetric constraints. We state and prove efficiency conditions and develop a duality theory.

Protection of Bulgarian population in medical radiation diagnostic science after 1950. Some basic problems

International Nuclear Information System (INIS)

Ingilizova, Kr.

2000-01-01

The report presents summarized data on frequency and structure of X-ray and nuclear medical examinations carried out in Bulgaria during the period 1950-1995. The effective and the collective effective dose are calculated. Some on the basic problems concerning the protection of Bulgarian population during medical exposure are outlined

EFFECTIVENESS OF PROBLEM BASED LEARNING AS A STRATEGY TO FOSTER PROBLEM SOLVING AND CRITICAL REASONING SKILLS AMONG MEDICAL STUDENTS.

Science.gov (United States)

Asad, Munazza; Iqbal, Khadija; Sabir, Mohammad

2015-01-01

Problem based learning (PBL) is an instructional approach that utilizes problems or cases as a context for students to acquire problem solving skills. It promotes communication skills, active learning, and critical thinking skills. It encourages peer teaching and active participation in a group. It was a cross-sectional study conducted at Al Nafees Medical College, Isra University, Islamabad, in one month duration. This study was conducted on 193 students of both 1st and 2nd year MBBS. Each PBL consists of three sessions, spaced by 2-3 days. In the first session students were provided a PBL case developed by both basic and clinical science faculty. In Session 2 (group discussion), they share, integrate their knowledge with the group and Wrap up (third session), was concluded at the end. A questionnaire based survey was conducted to find out overall effectiveness of PBL sessions. Teaching through PBLs greatly improved the problem solving and critical reasoning skills with 60% students of first year and 71% of 2nd year agreeing that the acquisition of knowledge and its application in solving multiple choice questions (MCQs) was greatly improved by these sessions. They observed that their self-directed learning, intrinsic motivation and skills to relate basic concepts with clinical reasoning which involves higher order thinking have greatly enhanced. Students found PBLs as an effective strategy to promote teamwork and critical thinking skills. PBL is an effective method to improve critical thinking and problem solving skills among medical students.

Brazilian medical students’ perceptions of expert versus non-expert facilitators in a (non problem-based learning environment

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Lucélio B. Couto

2015-04-01

Full Text Available Background: In problem-based learning (PBL, the facilitator plays an important role in guiding the student learning process. However, although content expertise is generally regarded as a useful but non-essential prerequisite for effective PBL facilitation, the perceived importance of content knowledge may be subject to cultural, contextual, and/or experiential influences. Aim: We sought to examine medical students’ perceptions of subject-matter expertise among PBL facilitators in a region of the world (Brazil where such active learning pedagogies are not widely used in university or pre-university settings. Results: Of the 252 Brazilian medical students surveyed, significantly (p≤0.001 greater proportions viewed content expert facilitators to be more effective than their non-expert counterparts at building knowledge (95% vs. 6%, guiding the learning process (93% vs. 7%, achieving cognitive learning (92% vs. 18%, generating learning goals (87% vs. 15%, and motivating self-study (80% vs. 15%. Discussion/conclusion: According to Brazilian medical students, subject-matter expertise among PBL facilitators is essential to the learning process. We believe this widespread perception is due, in large part, to the relative lack of prior educational exposure to such pedagogies.

Are medical educators following General Medical Council guidelines on obesity education: if not why not?

Science.gov (United States)

2013-01-01

Background Although the United Kingdom’s (UK’s) General Medical Council (GMC) recommends that graduating medical students are competent to discuss obesity and behaviour change with patients, it is difficult to integrate this education into existing curricula, and clinicians report being unprepared to support patients needing obesity management in practice. We therefore aimed to identify factors influencing the integration of obesity management education within medical schools. Methods Twenty-seven UK and Irish medical school educators participated in semi-structured interviews. Grounded theory principles informed data collection and analysis. Themes emerging directly from the dataset illustrated key challenges for educators and informed several suggested solutions. Results Factors influencing obesity management education included: 1) Diverse and opportunistic learning and teaching, 2) Variable support for including obesity education within undergraduate medical programmes, and 3) Student engagement in obesity management education. Findings suggest several practical solutions to identified challenges including clarifying recommended educational agendas; improving access to content-specific guidelines; and implementing student engagement strategies. Conclusions Students’ educational experiences differ due to diverse interpretations of GMC guidelines, educators’ perceptions of available support for, and student interest in obesity management education. Findings inform the development of potential solutions to these challenges which may be tested further empirically. PMID:23578257

The efficacy and usefulness of problem based learning in undergraduate medical school education of radiation oncology

International Nuclear Information System (INIS)

Uchino, Minako; Itazawa, Tomoko; Someya, Masanori; Nakamura, Satoaki

2007-01-01

The Japanese Association for Therapeutic Radiation Oncology (JASTRO) holds a seminar for medical students every summer, which has developed into a joint program with a session addressing radiation treatment planning. To clarify this topic for medical students, we have incorporated Problem Based Learning skills into the session. Not only has the students' comprehension improved but the instructors have also found this teaching experience valuable and productive in advancing their own clinical skills. Our experience suggests that the application of this Problem Based Learning session for radiation treatment planning in undergraduate medical school education has proven to be effective. (author)

A generalization of the finiteness problem in local cohomology ...

Indian Academy of Sciences (India)

(Math. Sci.) Vol. 119, No. 2, April 2009, pp. 159–164. © Printed in India. A generalization of the finiteness problem in local cohomology modules. AMIR MAFI. Department of Mathematics, University of Kurdistan, P.O. Box 416, Sanandaj, Iran. Institute for Studies in Theoretical Physics and Mathematics, P.O. Box 19395-5746,.

A New Inexact Inverse Subspace Iteration for Generalized Eigenvalue Problems

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Fatemeh Mohammad

2014-05-01

Full Text Available In this paper‎, ‎we represent an inexact inverse‎ ‎subspace iteration method for computing a few eigenpairs of the‎ ‎generalized eigenvalue problem $Ax = \\lambda Bx$[Q.~Ye and P.~Zhang‎, ‎Inexact inverse subspace iteration for generalized eigenvalue‎ ‎problems‎, ‎Linear Algebra and its Application‎, ‎434 (2011 1697-1715‎‎]‎. ‎In particular‎, ‎the linear convergence property of the inverse‎ ‎subspace iteration is preserved‎.

MEDICAL DIAGNOSTICS BY MICROSTRUCTURAL ANALYSIS OF BIOLOGICAL LIQUID DRIED PATTERNS AS A PROBLEM OF BIOINFORMATICS

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Petr Vladimirovich Lebedev-Stepanov, Dr.

2018-02-01

Full Text Available Motivation: It is important to develop the high-precision computerized methods for medical rapid diagnostic which is generalizing the unique clinical experience obtained in the past decade as specialized solutions for diagnostic problems of control of specific diseases and, potentially, for a wide health monitoring of virtually healthy population, identify the reserves of human health and take the actions to prevent of these reserves depletion. In this work we present one of the new directions in bioinformatics, i.e. medical diagnostics by automated expert system on basis of morphology analysis of digital image of biological liquid dried pattern. Results: Proposed method is combination of bioinformatics and biochemistry approaches for obtaining diagnostic information from a morphological analysis of standardized dried patterns of biological liquid sessile drop. We have carried out own research in collaboration with medical diagnostic centers and formed the electronic database for recognition the following types of diseases: candidiasis; neoplasms; diabetes mellitus; diseases of the circulatory system; cerebrovascular disease; diseases of the digestive system; diseases of the genitourinary system; infectious diseases; factors relevant to the work; factors associated with environmental pollution; factors related to lifestyle. The laboratory setup for diagnostics of the human body in pathology states is developed. The diagnostic results are considered. Availability: Access to testing the software can be obtained on request to the contact email below.

A Rule-Based Local Search Algorithm for General Shift Design Problems in Airport Ground Handling

DEFF Research Database (Denmark)

Clausen, Tommy

We consider a generalized version of the shift design problem where shifts are created to cover a multiskilled demand and fit the parameters of the workforce. We present a collection of constraints and objectives for the generalized shift design problem. A local search solution framework with mul......We consider a generalized version of the shift design problem where shifts are created to cover a multiskilled demand and fit the parameters of the workforce. We present a collection of constraints and objectives for the generalized shift design problem. A local search solution framework...... with multiple neighborhoods and a loosely coupled rule engine based on simulated annealing is presented. Computational experiments on real-life data from various airport ground handling organization show the performance and flexibility of the proposed algorithm....

Generalized double-humped logistic map-based medical image encryption

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Samar M. Ismail

2018-03-01

Full Text Available This paper presents the design of the generalized Double Humped (DH logistic map, used for pseudo-random number key generation (PRNG. The generalized parameter added to the map provides more control on the map chaotic range. A new special map with a zooming effect of the bifurcation diagram is obtained by manipulating the generalization parameter value. The dynamic behavior of the generalized map is analyzed, including the study of the fixed points and stability ranges, Lyapunov exponent, and the complete bifurcation diagram. The option of designing any specific map is made possible through changing the general parameter increasing the randomness and controllability of the map. An image encryption algorithm is introduced based on pseudo-random sequence generation using the proposed generalized DH map offering secure communication transfer of medical MRI and X-ray images. Security analyses are carried out to consolidate system efficiency including: key sensitivity and key-space analyses, histogram analysis, correlation coefficients, MAE, NPCR and UACI calculations. System robustness against noise attacks has been proved along with the NIST test ensuring the system efficiency. A comparison between the proposed system with respect to previous works is presented.

Doctors' attitudes and confidence towards providing nutrition care in practice: Comparison of New Zealand medical students, general practice registrars and general practitioners.

Science.gov (United States)

Crowley, Jennifer; Ball, Lauren; Han, Dug Yeo; McGill, Anne-Thea; Arroll, Bruce; Leveritt, Michael; Wall, Clare

2015-09-01

Improvements in individuals' nutrition behaviour can improve risk factors and outcomes associated with lifestyle-related chronic diseases. This study describes and compares New Zealand medical students, general practice registrars and general practitioners' (GPs') attitudes towards incorporating nutrition care into practice, and self-perceived skills in providing nutrition care. A total of 183 New Zealand medical students, 51 general practice registrars and 57 GPs completed a 60-item questionnaire investigating attitudes towards incorporating nutrition care into practice and self-perceived skills in providing nutrition care. Items were scored using a 5-point Likert scale. Factor analysis was conducted to group questionnaire items and a generalised linear model compared differences between medical students, general practice registrars and GPs. All groups indicated that incorporating nutrition care into practice is important. GPs displayed more positive attitudes than students towards incorporating nutrition in routine care (ppractice registrars were more positive than students towards performing nutrition recommendations (p=0.004), specified practices (p=0.037), and eliciting behaviour change (p=0.024). All groups displayed moderate confidence towards providing nutrition care. GPs were more confident than students in areas relating to wellness and disease (pmedical students, general practice registrars and GPs have positive attitudes and moderate confidence towards incorporating nutrition care into practice. It is possible that GPs' experience providing nutrition care contributes to greater confidence. Strategies to facilitate medical students developing confidence in providing nutrition care are warranted.

A branch-and-cut-and-price algorithm for the mixed capacitated general routing problem

DEFF Research Database (Denmark)

Bach, Lukas; Wøhlk, Sanne; Lysgaard, Jens

2016-01-01

In this paper, we consider the Mixed Capacitated General Routing Problem which is a combination of the Capacitated Vehicle Routing Problem and the Capacitated Arc Routing Problem. The problem is also known as the Node, Edge, and Arc Routing Problem. We propose a Branch-and-Cut-and-Price algorithm...

Seeking Medical Information Using Mobile Apps and the Internet: Are Family Caregivers Different from the General Public?

Science.gov (United States)

Kim, Hyunmin; Paige Powell, M; Bhuyan, Soumitra S; Bhuyan, Soumitra Sudip

2017-03-01

Family caregivers play an important role to care cancer patients since they exchange medical information with health care providers. However, relatively little is known about how family caregivers seek medical information using mobile apps and the Internet. We examined factors associated with medical information seeking by using mobile apps and the Internet among family caregivers and the general public using data from the 2014 Health Information National Trends Survey 4 Cycle 1. The study sample consisted of 2425 family caregivers and 1252 non-family caregivers (the general public). Guided by Comprehensive Model of Information Seeking (CMIS), we examined related factors' impact on two outcome variables for medical information seeking: mobile apps use and Internet use with multivariate logistic regression analyses. We found that online medical information seeking is different between family caregivers and the general public. Overall, the use of the Internet for medical information seeking is more common among family caregivers, while the use of mobile apps is less common among family caregivers compared with the general public. Married family caregivers were less likely to use mobile apps, while family caregivers who would trust cancer information were more likely to use the Internet for medical information seeking as compared to the general public. Medical information seeking behavior among family caregivers can be an important predictor of both their health and the health of their cancer patients. Future research should explore the low usage of mobile health applications among family caregiver population.

The documentation of health problems in relation to prescribed medication in people with profound intellectual and multiple disabilities

NARCIS (Netherlands)

van der Heide, D. C.; van der Putten, A. A. J.; van den Berg, P. B.; Taxis, K.; Vlaskamp, C.

Persons with profound intellectual and multiple disabilities (PIMD) suffer from a wide range of health problems and use a wide range of different drugs. This study investigated for frequently used medication whether there was a health problem documented in the medical notes for the drug prescribed.

Examination of Turkish Junior High-School Students' Perceptions of the General Problem-Solving Process

Science.gov (United States)

Ekici, Didem Inel

2016-01-01

This study aimed to determine Turkish junior high-school students' perceptions of the general problem-solving process. The Turkish junior high-school students' perceptions of the general problem-solving process were examined in relation to their gender, grade level, age and their grade point with regards to the science course identified in the…

Medication management and practices in prison for people with mental health problems: a qualitative study

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Rogers Anne

2009-10-01

Full Text Available Abstract Background Common mental health problems are prevalent in prison and the quality of prison health care provision for prisoners with mental health problems has been a focus of critical scrutiny. Currently, health policy aims to align and integrate prison health services and practices with those of the National Health Service (NHS. Medication management is a key aspect of treatment for patients with a mental health problem. The medication practices of patients and staff are therefore a key marker of the extent to which the health practices in prison settings equate with those of the NHS. The research reported here considers the influences on medication management during the early stages of custody and the impact it has on prisoners. Methods The study employed a qualitative design incorporating semi-structured interviews with 39 prisoners and 71 staff at 4 prisons. Participant observation was carried out in key internal prison locations relevant to the management of vulnerable prisoners to support and inform the interview process. Thematic analysis of the interview data and interpretation of the observational field-notes were undertaken manually. Emergent themes included the impact that delays, changes to or the removal of medication have on prisoners on entry to prison, and the reasons that such events take place. Results and Discussion Inmates accounts suggested that psychotropic medication was found a key and valued form of support for people with mental health problems entering custody. Existing regimes of medication and the autonomy to self-medicate established in the community are disrupted and curtailed by the dominant practices and prison routines for the taking of prescribed medication. The continuity of mental health care is undermined by the removal or alteration of existing medication practice and changes on entry to prison which exacerbate prisoners' anxiety and sense of helplessness. Prisoners with a dual diagnosis are likely

POWERPLAY: Training an Increasingly General Problem Solver by Continually Searching for the Simplest Still Unsolvable Problem

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Jürgen eSchmidhuber

2013-06-01

Full Text Available Most of computer science focuses on automatically solving given computational problems. I focus on automatically inventing or discovering problems in a way inspired by the playful behavior of animals and humans, to train a more and more general problem solver from scratch in an unsupervised fashion. Consider the infinite set of all computable descriptions of tasks with possibly computable solutions. The novel algorithmic framework POWERPLAY (2011 continually searches the space of possible pairs of new tasks and modifications of the current problem solver, until it finds a more powerful problem solver that provably solves all previously learned tasks plus the new one, while the unmodified predecessor does not. Wow-effects are achieved by continually making previously learned skills more efficient such that they require less time and space. New skills may (partially re-use previously learned skills. POWERPLAY's search orders candidate pairs of tasks and solver modifications by their conditional computational (time & space complexity, given the stored experience so far. The new task and its corresponding task-solving skill are those first found and validated. The computational costs of validating new tasks need not grow with task repertoire size. POWERPLAY's ongoing search for novelty keeps breaking the generalization abilities of its present solver. This is related to Goedel's sequence of increasingly powerful formal theories based on adding formerly unprovable statements to the axioms without affecting previously provable theorems. The continually increasing repertoire of problem solving procedures can be exploited by a parallel search for solutions to additional externally posed tasks. POWERPLAY may be viewed as a greedy but practical implementation of basic principles of creativity. A first experimental analysis can be found in separate papers [58, 56, 57].

75 FR 61507 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Amendment of...

Science.gov (United States)

2010-10-05

...] General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Amendment of Notice... announcing an amendment to the notice of meeting of the General and Plastic Surgery Devices Panel of the..., FDA announced that a meeting of the General and Plastic Surgery Devices Panel of the Medical Devices...

Medical emergencies facing general practitioners: Drugs for the doctor's bag

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Janković Slobodan

2014-01-01

Full Text Available General practitioners are frequently facing medical emergencies. In order to react properly and administer therapy on time, a general practitioner needs to prepare and keep with himself the appropriate set of drugs which could be effectively used for treatment of the emergencies. The following drugs should find their place in the doctor's bag: acetaminophen (for mild and moderate pain, and for fever, morphine (for severe pain, naloxone (for heroin poisoning, ceftriaxone (for meningococcal meningitis, albuterol (for bronchial asthma attack, hydrocortisone (for bronchial asthma attack, glucagon (for severe hypoglycemia, dextrose (for mild to moderate hypoglycemia, diazepam (for febrile convulsions or epileptic status, epinephrine (for anaphylaxis and cardiac arrest, atropine (for symptomatic bradicardia, chloropyramine (for acute allergy, aspirin (for acute myocardial infarction, nitroglycerine (for acute coronary syndrome, metoclopramide (for nausea and vomiting, haloperidol (for delirium, methylergometrine (for control of bleeding after delivery or abortion, furosemide (for acute pulmonary edema and flumazenil (for benzodiazepine poisoning. For each of the listed drugs a physician should well know the recommended doses, indications, contraindications and warnings. All of the listed drugs are either registered in Serbia or available through special import, so general practitioners may fill their bags with all necessary drugs and effectively and safely treat medical emergencies.

Municipal solid waste management problems: an applied general equilibrium analysis

NARCIS (Netherlands)

Bartelings, H.

2003-01-01

Keywords: Environmental policy; General equilibrium modeling; Negishi format; Waste management policies; Market distortions.

About 40% of the entire budget spent on environmental problems in the

General practitioners' views on (long-term) prescription and use of problematic and potentially inappropriate medication for oldest-old patients-A qualitative interview study with GPs (CIM-TRIAD study).

Science.gov (United States)

Pohontsch, Nadine Janis; Heser, Kathrin; Löffler, Antje; Haenisch, Britta; Parker, Debora; Luck, Tobias; Riedel-Heller, Steffi G; Maier, Wolfgang; Jessen, Frank; Scherer, Martin

2017-02-17

Potentially inappropriate medication (PIM) is defined as medication with uncertain therapeutic effects and/or potential adverse drug reactions outweighing the clinical benefits. The prescription rate of PIM for oldest-old patients is high despite the existence of lists of PIM (e.g. the PRISCUS list) and efforts to raise awareness. This study aims at identifying general practitioners' views on PIM and aspects affecting the (long-term) use of PIM. As part of the CIM-TRIAD study, we conducted semi-structured, qualitative interviews with 47 general practitioners, discussing 25 patients with and 22 without PIM (according to the PRISCUS list). The interview guideline included generic and patient-specific questions. Interviews were digitally recorded and transcribed verbatim. We content analyzed the interviews using deductive and inductive category development. The majority of the general practitioners were not aware of the PRISCUS list. Agents deemed potentially inappropriate from the general practitioners' point of view and the PRISCUS list are not completely superimposable. General practitioners named their criteria to identify appropriate medication for elderly patients (e.g. renal function, cognitive state) and emphasized the importance of monitoring. We identified prescription- (e.g. benzodiazepines on alternative private prescription), medication- (e.g. subjective perception that PIM has no alternative), general practitioner- (e.g. general practitioner relies on specialists), patient- (e.g. "demanding high-user", positive subjective benefit-risk-ratio) and system-related aspects (e.g. specialists lacking holistic view, interface problems) related to the (long term) use of PIM. While the PRISCUS list does not seem to play a decisive role in general practice, general practitioners are well aware of risks associated with PIM. Our study identifies some starting points for a safer handling of PIM, e.g. stronger dissemination of the PRISCUS list, better compensation of

Vertical Integration in Teaching And Learning (VITAL): an approach to medical education in general practice.

Science.gov (United States)

Dick, Marie-Louise B; King, David B; Mitchell, Geoffrey K; Kelly, Glynn D; Buckley, John F; Garside, Susan J

2007-07-16

There is increasing demand to provide clinical and teaching experiences in the general practice setting. Vertical integration in teaching and learning, whereby teaching and learning roles are shared across all learner stages, has the potential to decrease time demands and stress on general practitioners, to provide teaching skills and experience to GP registrars, and to improve the learning experience for medical students, and may also help meet the increased demand for teaching in general practice. We consider potential advantages and barriers to vertical integration of teaching in general practice, and provide results of focus group discussions with general practice principals and registrars about vertical integration. We recommend further research into the feasibility of using vertical integration to enhance the capacity to teach medical students in general practice.

Effect of training problem-solving skill on decision-making and critical thinking of personnel at medical emergencies

Science.gov (United States)

Heidari, Mohammad; Shahbazi, Sara

2016-01-01

Background: The aim of this study was to determine the effect of problem-solving training on decision-making skill and critical thinking in emergency medical personnel. Materials and Methods: This study is an experimental study that performed in 95 emergency medical personnel in two groups of control (48) and experimental (47). Then, a short problem-solving course based on 8 sessions of 2 h during the term, was performed for the experimental group. Of data gathering was used demographic and researcher made decision-making and California critical thinking skills questionnaires. Data were analyzed using SPSS software. Results: The finding revealed that decision-making and critical thinking score in emergency medical personnel are low and problem-solving course, positively affected the personnel’ decision-making skill and critical thinking after the educational program (P problem-solving in various emergency medicine domains such as education, research, and management, is recommended. PMID:28149823

Mental health care use in medically unexplained and explained physical symptoms: findings from a general population study

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van Eck van der Sluijs JF

2016-08-01

Full Text Available Jonna F van Eck van der Sluijs,1,2 Margreet ten Have,3 Cees A Rijnders,4 Harm WJ van Marwijk,5,6 Ron de Graaf,3 Christina M van der Feltz-Cornelis1,2 1Clinical Centre of Excellence for Body, Mind and Health, GGz Breburg, 2Tranzo Department, Tilburg University, Tilburg, 3Netherlands Institute of Mental Health and Addiction, Utrecht, 4Department of Residency training, GGz Breburg, Tilburg, the Netherlands; 5Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, UK; 6Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands Objective: The aim of this study was to explore mental health care utilization patterns in primary and specialized mental health care of people with unexplained or explained physical symptoms. Methods: Data were derived from the first wave of the Netherlands Mental Health Survey and Incidence Study-2, a nationally representative face-to-face cohort study among the general population aged 18–64 years. We selected subjects with medically unexplained symptoms (MUS only (MUSonly; n=177, explained physical symptoms only (PHYonly, n=1,952, combined MUS and explained physical symptoms (MUS + PHY, n=209, and controls without physical symptoms (NONE, n=4,168. We studied entry into mental health care and the number of treatment contacts for mental problems, in both primary care and specialized mental health care. Analyses were adjusted for sociodemographic characteristics and presence of any 12-month mental disorder assessed with the Composite International Diagnostic Interview 3.0. Results: At the primary care level, all three groups of subjects with physical symptoms showed entry into care for mental health problems significantly more often than controls. The adjusted odds ratios were 2.29 (1.33, 3.95 for MUSonly, 1.55 (1.13, 2.12 for PHYonly, and 2.25 (1.41, 3.57 for MUS + PHY. At the

Evaluating the Quantity and Quality of Continuing medical education Programs from the Viewpoint of General Medical Practitioners, Ilam Province

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Mohsen Fatahi

2015-07-01

Full Text Available Background and purpose: The purpose of this research was to evaluate the quantity and quality of continuing medical education programs from the viewpoint of general medical practitioners in Ilam province.Methods: The research method was descriptive survey and the statistic sample was a group of 61 general medical practitioners who have been working in Ilam during 2010-2011 and were chosen by simple random sampling method. The data collection tool was a questionnaire with 50 items and reliability coefficient obtained using Cronbach's alpha which was 88%.Results: The findings showed that there is a meaningful/significant relationship between CME (Continuing Medical Education/retraining programs and improving GPs (General Practitioner clinical skills with reliability of 99% and this relationship is direct and positive (r=0.502. It means that increasing the quality and quantity of these programs has positive effect on improving general practitioners’ clinical skills. There was no meaningful/significant relationship between the method of teaching and GPs satisfaction (r=0.160. It means most of these practitioners were not satisfied with using training equipment, teaching methods, teachers' knowledge and manners. Also, there was no meaningful/significant relationship between teaching times and educational materials and GPs satisfaction (r=0.73 .It shows that the rate of GPs satisfaction from teaching times and educational materials is very low and there is little coherence between them. But there was a meaningful/significant relationship between GPs job requirements and educational materials with reliability of 95% (r=0.326. It means presenting suitable teaching materials and content related to GPs jobs requirements led to increase GPs desire to attend educational classes .There was no meaningful/significant relationship between time dedicated to each topic and improving GPs skills (r=0.096. So, findings indicate that there is no coincidence between

Mental health problem in HIV/AIDS patients

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Camellia, V.

2018-03-01

People with HIV positive have risk increased mental health problem than the general population. It associated with psychosocial factors, direct neurological effects of the HIV infection and medication. Overall it can make increased morbidity and mortality in HIV positive patients. The more common mental problem in HIV/AIDS people is dementia, delirium, depression, and mania, suicide, psychotic, sleep problem. Both psychopharmacologic and psychotherapeutic treatment strategies often indicate.

An Enhanced Genetic Algorithm for the Generalized Traveling Salesman Problem

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H. Jafarzadeh

2017-12-01

Full Text Available The generalized traveling salesman problem (GTSP deals with finding the minimum-cost tour in a clustered set of cities. In this problem, the traveler is interested in finding the best path that goes through all clusters. As this problem is NP-hard, implementing a metaheuristic algorithm to solve the large scale problems is inevitable. The performance of these algorithms can be intensively promoted by other heuristic algorithms. In this study, a search method is developed that improves the quality of the solutions and competition time considerably in comparison with Genetic Algorithm. In the proposed algorithm, the genetic algorithms with the Nearest Neighbor Search (NNS are combined and a heuristic mutation operator is applied. According to the experimental results on a set of standard test problems with symmetric distances, the proposed algorithm finds the best solutions in most cases with the least computational time. The proposed algorithm is highly competitive with the published until now algorithms in both solution quality and running time.

[Child-pedestrian injuries inflicted in the road traffic accidents as a forensic medical problem].

Science.gov (United States)

Savenkova, E N; Efimov, A A

The road traffic accidents are known to make the greatest contribution to the overall structure of pediatric traumatism with the fatal outcome. The problem of pediatric traumatism remains on top of its relevancy despite numerous administrative, legal, technical, and financial measures taken at the government level in an attempt to reduce the mortality rate associated with the child-pedestrian injuries inflicted in the road traffic accidents. The objective of the present study was to summarize and interpret the results published in the scientific literature concerning child-pedestrian injuries inflicted in the road traffic accidents with special reference to the age of the victims and the type of the injury. The analysis of the publications of the domestic and foreign authors has demonstrated that the available data of interest remain to be systematized and that the forensic medical aspects of the problem in question are poorly represented in these materials. It was shown that forensic medical expertises of child-pedestrian injuries inflicted in the road traffic accidents are frequently carried out without taking into consideration the peculiar anatomical and physiological features of the child's organism. The available data concerning the mechanisms and evaluation of severe injuries inflicted to the children in the road traffic accidents are insufficient for the development of the algorithms for the relevant adequate forensic medical expertise. In the light of these findings, the problem of the child-pedestrian injuries inflicted in the road traffic accidents takes on new significance when considered in the context of pediatric traumatism. There is evidently the growing necessity to formulate the universal database containing systematized objective information for the development of new methods of forensic medical expertise for the elucidation of the mechanisms of road traffic injuries inflicted to the children of different age groups depending on the type of the

An efficient method for generalized linear multiplicative programming problem with multiplicative constraints.

Science.gov (United States)

Zhao, Yingfeng; Liu, Sanyang

2016-01-01

We present a practical branch and bound algorithm for globally solving generalized linear multiplicative programming problem with multiplicative constraints. To solve the problem, a relaxation programming problem which is equivalent to a linear programming is proposed by utilizing a new two-phase relaxation technique. In the algorithm, lower and upper bounds are simultaneously obtained by solving some linear relaxation programming problems. Global convergence has been proved and results of some sample examples and a small random experiment show that the proposed algorithm is feasible and efficient.

Generalized multiscale finite element methods for problems in perforated heterogeneous domains

KAUST Repository

Chung, Eric T.

2015-06-08

Complex processes in perforated domains occur in many real-world applications. These problems are typically characterized by physical processes in domains with multiple scales. Moreover, these problems are intrinsically multiscale and their discretizations can yield very large linear or nonlinear systems. In this paper, we investigate multiscale approaches that attempt to solve such problems on a coarse grid by constructing multiscale basis functions in each coarse grid, where the coarse grid can contain many perforations. In particular, we are interested in cases when there is no scale separation and the perforations can have different sizes. In this regard, we mention some earlier pioneering works, where the authors develop multiscale finite element methods. In our paper, we follow Generalized Multiscale Finite Element Method (GMsFEM) and develop a multiscale procedure where we identify multiscale basis functions in each coarse block using snapshot space and local spectral problems. We show that with a few basis functions in each coarse block, one can approximate the solution, where each coarse block can contain many small inclusions. We apply our general concept to (1) Laplace equation in perforated domains; (2) elasticity equation in perforated domains; and (3) Stokes equations in perforated domains. Numerical results are presented for these problems using two types of heterogeneous perforated domains. The analysis of the proposed methods will be presented elsewhere. © 2015 Taylor & Francis

Surgery or general medicine: a study of the reasons underlying the choice of medical specialty

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Patrícia Lacerda Bellodi

Full Text Available CONTEXT: The reality of medical services in Brazil points towards expansion and diversification of medical knowledge. However, there are few Brazilian studies on choosing a medical specialty. OBJECTIVE: To investigate and characterize the process of choosing the medical specialty among Brazilian resident doctors, with a comparison of the choice between general medicine and surgery. TYPE OF STUDY: Stratified survey. SETTING: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HC-FMUSP. METHODS: A randomized sample of resident doctors in general medicine (30 and surgery (30 was interviewed. Data on sociodemographic characteristics and the moment, stability and reasons for the choice of specialty were obtained. RESULTS: The moment of choice between the two specialties differed. Surgeons (30% choose the specialty earlier, while general doctors decided progressively, mainly during the internship (43%. Most residents in both fields (73% general medicine, 70% surgery said they had considered another specialty before the current choice. The main reasons for general doctors' choice were contact with patients (50%, intellectual activities (30% and knowledge of the field (27%. For surgeons the main reasons were practical intervention (43%, manual activities (43% and the results obtained (40%. Personality was important in the choice for 20% of general doctors and for 27% of surgeons. DISCUSSION: The reasons found for the choice between general medicine and surgery were consistent with the literature. The concepts of wanting to be a general doctor or a surgeon are similar throughout the world. Personality characteristics were an important influencing factor for all residents, without statistical difference between the specialties, as was lifestyle. Remuneration did not appear as a determinant. CONCLUSION: The results from this group of Brazilian resident doctors corroborated data on choosing a medical specialty from other countries

Benefit of Problem-Based Learning for Psychosocial Medicine: first experiences at the medical faculty of berne

OpenAIRE

Laederach-Hofmann, Kurt; Stadelmann, Barbara; Isenschmid, Bettina

2005-01-01

Aim: Presentation of skills and knowledge of medical students in psychiatry or psychosocial medicine in basic study (year 1 to 3) after the introduction of a problem oriented learning curriculum at the Medical Faculty of Berne.Method: Description of the curriculum with the different teaching units, and the evaluation by means of formative tools used by students and tutors.Results: With reference to qualitative comparison students of the problem based learning track showed a better preparation...

Investigation of medical board reports of disability due to mental health problems

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Mesut Yildiz

2016-06-01

Conclusion: We think that this report might be helpful for regulations related to disabled people, and might guide adult psychiatric services for patients who present to medical boards for disability due to mental health problems. [Cukurova Med J 2016; 41(2.000: 253-258

Bringing science to medicine: an interview with Larry Weed, inventor of the problem-oriented medical record.

Science.gov (United States)

Wright, Adam; Sittig, Dean F; McGowan, Julie; Ash, Joan S; Weed, Lawrence L

2014-01-01

Larry Weed, MD is widely known as the father of the problem-oriented medical record and inventor of the now-ubiquitous SOAP (subjective/objective/assessment/plan) note, for developing an electronic health record system (Problem-Oriented Medical Information System, PROMIS), and for founding a company (since acquired), which developed problem-knowledge couplers. However, Dr Weed's vision for medicine goes far beyond software--over the course of his storied career, he has relentlessly sought to bring the scientific method to medical practice and, where necessary, to point out shortcomings in the system and advocate for change. In this oral history, Dr Weed describes, in his own words, the arcs of his long career and the work that remains to be done. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Nurses who work in general medical practices: a Victorian survey.

Science.gov (United States)

Bonawit, V; Watson, L

1996-01-01

A questionnaire survey of 452 general medical practices in Victoria attracted responses from 277 practices, many of which did not employ nurses. The 93 respondents from 85 practices who were nurses reported that they enjoyed flexible working hours and stable employment. While their main reason for working in GPs' rooms was convenience, the most important aspect of their work was interaction with patients and fellow workers. Sixtyseven percent of nurses thought continuing education in specific skills was necessary for their work, 43% thought a post-registration qualification in community health nursing would be desirable and 47% thought a special interest group of nurses working in medical practices would be useful.

Generalization of the geometric optical series approach for nonadiabatic scattering problems

International Nuclear Information System (INIS)

Herman, M.F.

1982-01-01

The geometric optical series approach of Bremmer is generalized for multisurface nonadiabatic scattering problems. This method yields the formal solution of the Schroedinger equation as an infinite series of multiple integrals. The zeroth order term corresponds to WKB propagation on a single adiabatic surface, while the general Nth order term involves N reflections and/or transitions between surfaces accompanied by ''free,'' single surface semiclassical propagation between the points of reflection and transition. Each term is integrated over all possible transition and reflection points. The adiabatic and diabatic limits of this expression are discussed. Numerical results, in which all reflections are ignored, are presented for curve crossing and noncrossing problems. These results are compared to exact quantum results and are shown to be highly accurate

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

Science.gov (United States)

Pal, Ranabir; Kumar, Raman

2017-01-01

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

The characteristics of general practice and the attractiveness of working as a GP: medical students' views.

Science.gov (United States)

Landstrom, Bjorn; Mattsson, Bengt; Nordin, Per; Rudebeck, Carl E

2014-03-15

The aim of the study was to investigate medical students' views on general practice based on their experiences in training, and to find out whether there were certain views associated with the intention to become a GP. A questionnaire, based on our earlier studies about GP working behaviour, was handed out to medical students in terms 1, 3, 5, 7, 10 and 11 of undergraduate studies in Gothenburg, Sweden. The analysis comprised statistical descriptions and comparisons. The students regarded general practice positively. They found the work environment good, the GP's awareness of patients' living conditions necessary, and that GP work requires medical breadth. The status of the GP in the medical profession was not considered high. One-fourth of the students strongly agreed with the possibility of a future as a GP. This attitude was statistically associated with support to the statements that general practice offers a good work environment and should be a major component in undergraduate training. Students with a negative attitude to working as GPs were also negative to having a major component of general practice in undergraduate training. Medical students with a positive stated attitude towards becoming GPs support changes in undergraduate training to include more general practice. The risk of increasing a negative attitude should be considered when changes are discussed.

Resolving embarrassing medical conditions with online health information.

Science.gov (United States)

Redston, Sarah; de Botte, Sharon; Smith, Carl

2018-06-01

Reliance on online health information is proliferating and the Internet has the potential to revolutionize the provision of public health information. The anonymity of online health information may be particularly appealing to people seeking advice on 'embarrassing' health problems. The purpose of this study was to investigate (1) whether data generated by the embarrassingproblems.com health information site showed any temporal patterns in problem resolution, and (2) whether successful resolution of a medical problem using online information varied with the type of medical problem. We analyzed the responses of visitors to the embarrassingproblems.com website on the resolution of their problems. The dataset comprised 100,561 responses to information provided on 77 different embarrassing problems grouped into 9 classes of medical problem over an 82-month period. Data were analyzed with a Bernoulli Generalized Linear Model using Bayesian inference. We detected a statistically important interaction between embarrassing problem type and the time period in which data were collected, with an improvement in problem resolution over time for all of the classes of medical problem on the website but with a lower rate of increase in resolution for urinary health problems and medical problems associated with the mouth and face. As far as we are aware, this is the first analysis of data of this nature. Findings support the growing recognition that online health information can contribute to the resolution of embarrassing medical problems, but demonstrate that outcomes may vary with medical problem type. The results indicate that building data collection into online information provision can help to refine and focus health information for online users. Copyright © 2018 Elsevier B.V. All rights reserved.

Medical Information Management System (MIMS): A generalized interactive information system

Science.gov (United States)

Alterescu, S.; Friedman, C. A.; Hipkins, K. R.

1975-01-01

An interactive information system is described. It is a general purpose, free format system which offers immediate assistance where manipulation of large data bases is required. The medical area is a prime area of application. Examples of the system's operation, commentary on the examples, and a complete listing of the system program are included.

Are survivors who report cancer-related financial problems more likely to forgo or delay medical care?

Science.gov (United States)

Kent, Erin E; Forsythe, Laura P; Yabroff, K Robin; Weaver, Kathryn E; de Moor, Janet S; Rodriguez, Juan L; Rowland, Julia H

2013-10-15

Financial problems caused by cancer and its treatment can substantially affect survivors and their families and create barriers to seeking health care. The authors identified cancer survivors diagnosed as adults (n=1556) from the nationally representative 2010 National Health Interview Survey. Using multivariable logistic regression analyses, the authors report sociodemographic, clinical, and treatment-related factors associated with perceived cancer-related financial problems and the association between financial problems and forgoing or delaying health care because of cost. Adjusted percentages using the predictive marginals method are presented. Cancer-related financial problems were reported by 31.8% (95% confidence interval, 29.3%-34.5%) of survivors. Factors found to be significantly associated with cancer-related financial problems in survivors included younger age at diagnosis, minority race/ethnicity, history of chemotherapy or radiation treatment, recurrence or multiple cancers, and shorter time from diagnosis. After adjustment for covariates, respondents who reported financial problems were more likely to report delaying (18.3% vs 7.4%) or forgoing overall medical care (13.8% vs 5.0%), prescription medications (14.2% vs 7.6%), dental care (19.8% vs 8.3%), eyeglasses (13.9% vs 5.8%), and mental health care (3.9% vs 1.6%) than their counterparts without financial problems (all Pfinancial problems are not only disproportionately represented in survivors who are younger, members of a minority group, and have a higher treatment burden, but may also contribute to survivors forgoing or delaying medical care after cancer. Copyright © 2013 American Cancer Society.

Are Survivors Who Report Cancer-Related Financial Problems More Likely to Forgo or Delay Medical Care?

Science.gov (United States)

Kent, Erin E.; Forsythe, Laura P.; Yabroff, K. Robin; Weaver, Kathryn E.; de Moor, Janet S.; Rodriguez, Juan L.; Rowland, Julia H.

2015-01-01

BACKGROUND Financial problems caused by cancer and its treatment can substantially affect survivors and their families and create barriers to seeking health care. METHODS The authors identified cancer survivors diagnosed as adults (n = 1556) from the nationally representative 2010 National Health Interview Survey. Using multivariable logistic regression analyses, the authors report sociodemographic, clinical, and treatment-related factors associated with perceived cancer-related financial problems and the association between financial problems and forgoing or delaying health care because of cost. Adjusted percentages using the predictive marginals method are presented. RESULTS Cancer-related financial problems were reported by 31.8% (95% confidence interval, 29.3%–34.5%) of survivors. Factors found to be significantly associated with cancer-related financial problems in survivors included younger age at diagnosis, minority race/ethnicity, history of chemotherapy or radiation treatment, recurrence or multiple cancers, and shorter time from diagnosis. After adjustment for covariates, respondents who reported financial problems were more likely to report delaying (18.3% vs 7.4%) or forgoing overall medical care (13.8% vs 5.0%), prescription medications (14.2% vs 7.6%), dental care (19.8% vs 8.3%), eyeglasses (13.9% vs 5.8%), and mental health care (3.9% vs 1.6%) than their counterparts without financial problems (all Pfinancial problems are not only disproportionately represented in survivors who are younger, members of a minority group, and have a higher treatment burden, but may also contribute to survivors forgoing or delaying medical care after cancer. PMID:23907958

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

DEFF Research Database (Denmark)

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

2014-01-01

BACKGROUND: Practical descriptions of procedures used for pharmacists' medication reviews are sparse. OBJECTIVE: To describe a model for medication review by pharmacists tailored to a general practice setting. METHODS: A stepwise model is described. The model is based on data from the medical chart...... no indication (n=47, 23%). Most interventions were aimed at cardiovascular drugs. CONCLUSION: We have provided a detailed description of a practical approach to pharmacists' medication review in a GP setting. The model was tested and found to be usable, and to deliver a medication review with high acceptance...

Problems of overcoming medical consequences of nuclear tests at the former Semipalatinsk test site (STS)

International Nuclear Information System (INIS)

Devyatko, V.N.

1997-01-01

Tests conducted for many years resulted in large radioactive contamination of Semipalatinsk, East Kazakhstan, Pavlodar and Karaganda regions. About 1,5 million people underwent multiple acute and chronic influence of small ionizing radiation doses basically.In this connection Ministry of Heals Protection and Social Protection Organizations are worried about the problem of recovering and rehabilitating the population of the above regions. to solve these problems Ministry of Health Protection Republic of Kazakhstan established Scientific Research Institutes of Medicine and Ecology in Semipalatinsk and regional Medical and Diagnostic Center in Kurchatov. With the help of regional Administrations there were created medical centers: diagnostic, children's, recovering, ophthalmological, of motherhood and childhood protection. Work on creating State National Medical Registration for people who underwent influence of ionizing radiation is being performed

General Practitioner Education Reform in China: Most Undergraduate Medical Students do not Choose General Practitioner as a Career Under the 5+3 Model

Directory of Open Access Journals (Sweden)

Shuang Wang

2018-06-01

Full Text Available Purpose: In order to train more high-level general practitioners (GPs to work in primary care institutions, China launched the 5+3 model in 2015 as a way to educate GPs nationwide. In this study, we investigated the awareness of the 5+3 model, career choices after graduation, and influences on GP career choice of undergraduate medical students from Zhengzhou University. Methods: The study population consisted of 288 undergraduate medical students from Zhengzhou University. We explored the students׳ awareness of the 5+3 model, career choices after graduation, influences on general practitioner career choice and mental status by using a self-report questionnaire and the Chinese version of the 21-item Depression Anxiety Stress Scale. Results: We found 34.2% of students did not understand the new policy. Only 23.2% of students would choose to work as a GP after graduation, and those tended to be female, to have a monthly family income less than 4000 ¥, or to be from rural areas. Only 10% of undergraduate medical students expressed a preference to work at primary care institutions. The participants showed higher anxiety and stress scores than did a previously published group of Chinese college students, and those who chose to pursue higher education had more anxiety and stress than those who decided to become general practitioners. Discussion: More efforts should be made to popularize the 5+3 model and mental intervention among medical students. More efforts should be tried to increase the income/welfare benefits and strengthen the infrastructure of primary care institutions to attract more medical students. Keywords: 5+3 model, General practitioner, Health care reform, Hierarchical medical system

The Implementation of Physics Problem Solving Strategy Combined with Concept Map in General Physics Course

Science.gov (United States)

Hidayati, H.; Ramli, R.

2018-04-01

This paper aims to provide a description of the implementation of Physic Problem Solving strategy combined with concept maps in General Physics learning at Department of Physics, Universitas Negeri Padang. Action research has been conducted in two cycles where each end of the cycle is reflected and improved for the next cycle. Implementation of Physics Problem Solving strategy combined with concept map can increase student activity in solving general physics problem with an average increase of 15% and can improve student learning outcomes from 42,7 in the cycle I become 62,7 in cycle II in general physics at the Universitas Negeri Padang. In the future, the implementation of Physic Problem Solving strategy combined with concept maps will need to be considered in Physics courses.

Collaboration with general practitioners : preferences of medical specialists - a qualitative study

NARCIS (Netherlands)

Berendsen, Annette J.; Benneker, Wim H. G. M.; Schuling, Jan; Rijkers-Koorn, Nienke; Slaets, Joris P. J.; Meyboom-de Jong, Betty

2006-01-01

Background: Collaboration between general practitioners (GPs) and specialists has been the focus of many collaborative care projects during the past decade. Unfortunately, quite a number of these projects failed. This raises the question of what motivates medical specialists to initiate and continue

The frequency of smoking and problem drinking among general hospital inpatients in Brazil - using the AUDIT and Fagerström questionnaires

Directory of Open Access Journals (Sweden)

Neliana Buzi Figlie

2000-09-01

Full Text Available CONTEXT: Although the CAGE questionnaire is one of the most widely used alcohol screening instruments, it has been criticized for not identifying people who are drinking heavily or who have alcohol related problems but do not as yet show symptoms of alcohol dependence. The AUDIT (Alcohol Use Disorder Identification Test questionnaire was developed by WHO as a screening instrument specifically designed to identify problem drinkers, as well as those who were already dependent on alcohol. OBJECTIVE: The aim of this study was to use the AUDIT and Fagerström questionnaires in a general hospital inpatient population to measure the frequency of problem drinking and nicotine dependence, and to see if levels varied between medical speciality. DESIGN: Retrospective cross-sectional study. SETTING: Federally funded public teaching hospital. SAMPLE: 275 inpatients from both genders. MAIN MEASUREMENTS: Socio-demographic data, AUDIT (Alcohol Use Disorders Identification Test and Fagerström Test for Nicotine Dependence. RESULTS: We interviewed 275 inpatients, 49% of whom were men and 51% women. Thirty-four patients were identified as "cases" by the Audit questionnaire; 22% of the male patients and 3% of the females. Just over 21% of inpatients were current smokers. The gastroenterology (26% and general medicine (16% inpatient units had the largest number of individual cases. CONCLUSIONS: Only by knowing the prevalence of alcohol abuse/dependence and nicotine dependence in a general hospital can we evaluate the need for a specialized liaison service to identify and treat these patients.

Sonography and hypotension: a change to critical problem solving in undergraduate medical education.

Science.gov (United States)

Amini, Richard; Stolz, Lori A; Hernandez, Nicholas C; Gaskin, Kevin; Baker, Nicola; Sanders, Arthur Barry; Adhikari, Srikar

2016-01-01

Multiple curricula have been designed to teach medical students the basics of ultrasound; however, few focus on critical problem-solving. The objective of this study is to determine whether a theme-based ultrasound teaching session, dedicated to the use of ultrasound in the management of the hypotensive patient, can impact medical students' ultrasound education and provide critical problem-solving exercises. This was a cross-sectional study using an innovative approach to train 3rd year medical students during a 1-day ultrasound training session. The students received a 1-hour didactic session on basic ultrasound physics and knobology and were also provided with YouTube hyperlinks, and links to smart phone educational applications, which demonstrated a variety of bedside ultrasound techniques. In small group sessions, students learned how to evaluate patients for pathology associated with hypotension. A knowledge assessment questionnaire was administered at the end of the session and again 3 months later. Student knowledge was also assessed using different clinical scenarios with multiple-choice questions. One hundred and three 3rd year medical students participated in this study. Appropriate type of ultrasound was selected and accurate diagnosis was made in different hypotension clinical scenarios: pulmonary embolism, 81% (95% CI, 73%-89%); abdominal aortic aneurysm, 100%; and pneumothorax, 89% (95% CI, 82%-95%). The average confidence level in performing ultrasound-guided central line placement was 7/10, focused assessment with sonography for trauma was 8/10, inferior vena cava assessment was 8/10, evaluation for abdominal aortic aneurysm was 8/10, assessment for deep vein thrombus was 8/10, and cardiac ultrasound for contractility and overall function was 7/10. Student performance in the knowledge assessment portion of the questionnaire was an average of 74% (SD =11%) at the end of workshop and 74% (SD =12%) 3 months later (P=0.00). At our institution, we

Lecturing skills as predictors of tutoring skills in a problem-based medical curriculum

OpenAIRE

Kassab, Salah; Hassan,Nahla; Abu-Hijleh,Marwan; P Sequeira,Reginald

2016-01-01

Salah Eldin Kassab,1 Nahla Hassan,1 Marwan F Abu-Hijleh,2 Reginald P Sequeira3 1Department of Medical Education, Faculty of Medicine, Suez Canal University, Ismailia, Egypt; 2College of Medicine, Qatar University, Doha, Qatar; 3College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain Purpose: Recruitment of tutors to work in problem-based learning (PBL) programs is challenging, especially in that most of them are graduated from discipline-based programs. ...

Dealing with sickness certification – a survey of problems and strategies among general practitioners and orthopaedic surgeons

Directory of Open Access Journals (Sweden)

Nilsson Gunnar

2007-10-01

Full Text Available Abstract Background In order to get sickness benefit a sick-listed person need a medical certificate issued by a physician; in Sweden after one week of self-certification. Physicians experience sick-listing tasks as problematic and conflicts may arise when patients regard themselves unable to work due to complaints that are hard to objectively verify for the physician. Most GPs and orthopaedic surgeons (OS deal regularly with sick-listing issues in their daily practice. The aim of this study was to explore perceived problems and coping strategies related to tasks of sickness certification among general practitioners (GP and orthopaedic surgeons (OS. Methods A cross-sectional study about sickness certification in two Swedish counties, with 673 participating GPs and 149 OSs, who answered a comprehensive questionnaire. Frequencies together with crude and adjusted (gender and working years Odds ratios were calculated. Results A majority of the GPs and OSs experienced problems in sickness certification every week. To assess the patient's work ability, to handle situations when they and the patient had different opinions about the need for sickness absence, and to issue prolongation certificates when the previous was issued by another physician were reported as problematic by a majority in both groups. Both GPs and OSs prolonged sickness certifications due to waiting times in health care or at Social Insurance Office (SIO. To handle experienced problems they used different strategies; OSs issued sickness certificates without personal appointment more often than the GPs, who on the other hand reported having contact with SIO more often than the OSs. A higher rate of GPs experienced support from management and had a common strategy for handling sickness certification at the clinic than the OSs. Conclusion Most GPs and OSs handled sickness certification weekly and reported a variety of problems in relation to this task, generally GPs to a higher extent

The Association between Sleep Problems, Sleep Medication Use, and Falls in Community-Dwelling Older Adults: Results from the Health and Retirement Study 2010

Science.gov (United States)

2016-01-01

Background. Very few studies have assessed the impact of poor sleep and sleep medication use on the risk of falls among community-dwelling older adults. The objective of this study was to evaluate the association between sleep problems, sleep medication use, and falls in community-dwelling older adults. Methods. The study population comprised a nationally representative sample of noninstitutionalized older adults participating in the 2010 Health and Retirement Study. Proportion of adults reporting sleep problems, sleep medication use, and fall was calculated. Multiple logistic regression models were constructed to examine the impact of sleep problems and sleep medication use on the risk of falls after controlling for covariates. Results. Among 9,843 community-dwelling older adults, 35.8% had reported a fall and 40.8% had reported sleep problems in the past two years. Sleep medication use was reported by 20.9% of the participants. Older adults who do have sleep problems and take sleep medications had a significant high risk of falls, compared to older adults who do not have sleep problems and do not take sleep medications. The other two groups also had significantly greater risk for falls. Conclusion. Sleep problems added to sleep medication use increase the risk of falls. Further prospective studies are needed to confirm these observed findings. PMID:27547452

Loyalty conflicts in medical practice. A comparative study of general practitioners', paediatricians' and gynaecologists' assessments of three cases.

Science.gov (United States)

Lynöe, N; Mattsson, B

1998-09-01

To shed light on attitudes towards loyalty conflicts among general practitioners (GPs) compared with related specialists such as gynaecologists and paediatricians. A postal questionnaire containing three case histories with arguments for and against different ways of acting in loyalty conflicts. The medical problems of the clinical cases varied, but the ethical ones were in principle similar. A random sample of all Swedish GPs, gynaecologists, and paediatricians. GPs (n = 313), paediatricians (n = 197), and gynaecologists (n = 236). On average 71% of the doctors replied. The gynaecologists differed from the other groups by being markedly loyal to the individual patient especially in one case. The paediatricians tended to reply most consistently and they seemed to favour the family perspective, compared with the other doctors. The GPs' response pattern fell in between the other two groups. The study indicates that ethical reasoning depends on the doctors' different medical background with regard to specialty. This study should be followed by others in order to give further explanation of the findings.

Higher clinical performance during a surgical clerkship is independently associated with matriculation of medical students into general surgery.

Science.gov (United States)

Daly, Shaun C; Deal, Rebecca A; Rinewalt, Daniel E; Francescatti, Amanda B; Luu, Minh B; Millikan, Keith W; Anderson, Mary C; Myers, Jonathan A

2014-04-01

The purpose of our study was to determine the predictive impact of individual academic measures for the matriculation of senior medical students into a general surgery residency. Academic records were evaluated for third-year medical students (n = 781) at a single institution between 2004 and 2011. Cohorts were defined by student matriculation into either a general surgery residency program (n = 58) or a non-general surgery residency program (n = 723). Multivariate logistic regression was performed to evaluate independently significant academic measures. Clinical evaluation raw scores were predictive of general surgery matriculation (P = .014). In addition, multivariate modeling showed lower United States Medical Licensing Examination Step 1 scores to be independently associated with matriculation into general surgery (P = .007). Superior clinical aptitude is independently associated with general surgical matriculation. This is in contrast to the negative correlation United States Medical Licensing Examination Step 1 scores have on general surgery matriculation. Recognizing this, surgical clerkship directors can offer opportunities for continued surgical education to students showing high clinical aptitude, increasing their likelihood of surgical matriculation. Copyright © 2014 Elsevier Inc. All rights reserved.

Psychological and social problems in primary care patients - general practitioners' assessment and classification.

Science.gov (United States)

Rosendal, Marianne; Vedsted, Peter; Christensen, Kaj Sparle; Moth, Grete

2013-03-01

To estimate the frequency of psychological and social classification codes employed by general practitioners (GPs) and to explore the extent to which GPs ascribed health problems to biomedical, psychological, or social factors. A cross-sectional survey based on questionnaire data from GPs. Setting. Danish primary care. 387 GPs and their face-to-face contacts with 5543 patients. GPs registered consecutive patients on registration forms including reason for encounter, diagnostic classification of main problem, and a GP assessment of biomedical, psychological, and social factors' influence on the contact. The GP-stated reasons for encounter largely overlapped with their classification of the managed problem. Using the International Classification of Primary Care (ICPC-2-R), GPs classified 600 (11%) patients with psychological problems and 30 (0.5%) with social problems. Both codes for problems/complaints and specific disorders were used as the GP's diagnostic classification of the main problem. Two problems (depression and acute stress reaction/adjustment disorder) accounted for 51% of all psychological classifications made. GPs generally emphasized biomedical aspects of the contacts. Psychological aspects were given greater importance in follow-up consultations than in first-episode consultations, whereas social factors were rarely seen as essential to the consultation. Psychological problems are frequently seen and managed in primary care and most are classified within a few diagnostic categories. Social matters are rarely considered or classified.

75 FR 47606 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of...

Science.gov (United States)

2010-08-06

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0001] General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of... General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee scheduled for August...

The association between childhood autistic traits and adolescent psychotic experiences is explained by general neuropsychiatric problems.

Science.gov (United States)

Cederlöf, Martin; Pettersson, Erik; Sariaslan, Amir; Larsson, Henrik; Östberg, Per; Kelleher, Ian; Långström, Niklas; Gumpert, Clara Hellner; Lundström, Sebastian; Lichtenstein, Paul

2016-03-01

Studies suggest associations between childhood autistic traits and adolescent psychotic experiences. However, recent research suggests that a general neuropsychiatric problems factor predicts adverse outcomes better than specific diagnostic entities. To examine if the alleged association between autistic traits and psychotic experiences could rather be explained by a general neuropsychiatric problems factor comprising symptoms of ADHD, tic disorder, developmental coordination disorder, and learning disorder, we conducted a prospective cohort study based on the Child and Adolescent Twin Study in Sweden. In addition, we examined the genetic and environmental influences on the associations. A total of 9,282 twins with data on childhood autistic traits and other neuropsychiatric problems, and follow-up data on psychotic experiences at ages 15 and/or 18 years were included. First, psychotic experiences were regressed on autistic traits and second, the general neuropsychiatric problems factor was added to the model. Auditory hallucinations were analyzed separately from the other psychotic experiences. Finally, twin analyses were employed to disentangle genetic from environmental influences in the observed associations. Replicating prior research, significant associations were found between autistic traits in childhood and auditory hallucinations at ages 15 and 18. However, after controlling for the general neuropsychiatric problems factor, the associations between autistic traits and auditory hallucinations disappeared, whereas the association between the general neuropsychiatric problems factor and auditory hallucinations persisted after controlling for autistic traits. Twin analyses revealed that the association between the general neuropsychiatric problems factor and auditory hallucinations was driven by shared genetic influences. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

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

OpenAIRE

Leila Roshangar; Fariba Salek Ranjbarzadeh; Reza Piri; Mahdi Karimi Shoar; Leila Rasi Marzabadi

2014-01-01

Introduction: The basic medical sciences section requires 2.5 years in the medical education curriculum. Practical courses complement theoretical knowledge in this period to improve their appreciation. Despite spending lots of disbursement and time, this period’s efficacy is not clearly known. Methods: One hundred thirty-three General Practitioner (GP) students have been included in this descriptive cross-sectional study and were asked by questionnaire about the positive impact of practical c...

High blood pressure, antihypertensive medication and lung function in a general adult population

Science.gov (United States)

2011-01-01

Background Several studies showed that blood pressure and lung function are associated. Additionally, a potential effect of antihypertensive medication, especially beta-blockers, on lung function has been discussed. However, side effects of beta-blockers have been investigated mainly in patients with already reduced lung function. Thus, aim of this analysis is to determine whether hypertension and antihypertensive medication have an adverse effect on lung function in a general adult population. Methods Within the population-based KORA F4 study 1319 adults aged 40-65 years performed lung function tests and blood pressure measurements. Additionally, information on anthropometric measurements, medical history and use of antihypertensive medication was available. Multivariable regression models were applied to study the association between blood pressure, antihypertensive medication and lung function. Results High blood pressure as well as antihypertensive medication were associated with lower forced expiratory volume in one second (p = 0.02 respectively p = 0.05; R2: 0.65) and forced vital capacity values (p = 0.01 respectively p = 0.05, R2: 0.73). Furthermore, a detailed analysis of antihypertensive medication pointed out that only the use of beta-blockers was associated with reduced lung function, whereas other antihypertensive medication had no effect on lung function. The adverse effect of beta-blockers was significant for forced vital capacity (p = 0.04; R2: 0.65), while the association with forced expiratory volume in one second showed a trend toward significance (p = 0.07; R2: 0.73). In the same model high blood pressure was associated with reduced forced vital capacity (p = 0.01) and forced expiratory volume in one second (p = 0.03) values, too. Conclusion Our analysis indicates that both high blood pressure and the use of beta-blockers, but not the use of other antihypertensive medication, are associated with reduced lung function in a general adult

Patients with persistent medically unexplained physical symptoms: a descriptive study from Norwegian general practice.

Science.gov (United States)

Aamland, Aase; Malterud, Kirsti; Werner, Erik L

2014-05-29

Further research on effective interventions for patients with peristent Medically Unexplained Physical Symptoms (MUPS) in general practice is needed. Prevalence estimates of such patients are conflicting, and other descriptive knowledge is needed for development and evaluation of effective future interventions. In this study, we aimed to estimate the consultation prevalence of patients with persistent MUPS in general practice, including patients' characteristics and symptom pattern, employment status and use of social benefits, and the general practitioners' (GPs) management strategy. During a four-week period the participating Norwegian GPs (n=84) registered all consultations with patients who met a strict definition of MUPS (>3 months duration and function loss), using a questionnaire with simple tick-off questions. Analyses were performed with descriptive statistics for all variables and split analysis on gender and age. The GPs registered 526 patients among their total of 17 688 consultations, giving a consultation prevalence of persistent MUPS of 3%. The mean age of patients was 46 years, and 399 (76%) were women. The most frequent group of symptoms was musculoskeletal problems, followed by asthenia/fatigue. There was no significant gender difference in symptom pattern. Almost half of the patients were currently working (45%), significantly more men. The major GP management strategy was supportive counseling. A consultation prevalence rate of 3% implies that patients with persistent MUPS are common in general practice. Our study disclosed heterogeneity among the patients such as differences in employment status, which emphasizes the importance of personalized focus rather than unsubstantiated stereotyping of "MUPS patients" as a group.

General practitioners' decisions about discontinuation of medication: an explorative study.

Science.gov (United States)

Nixon, Michael Simon; Vendelø, Morten Thanning

2016-06-20

Purpose - The purpose of this paper is to investigate how general practitioners' (GPs) decisions about discontinuation of medication are influenced by their institutional context. Design/methodology/approach - In total, 24 GPs were interviewed, three practices were observed and documents were collected. The Gioia methodology was used to analyse data, drawing on a theoretical framework that integrate the sensemaking perspective and institutional theory. Findings - Most GPs, who actively consider discontinuation, are reluctant to discontinue medication, because the safest course of action for GPs is to continue prescriptions, rather than discontinue them. The authors conclude that this is in part due to the ambiguity about the appropriateness of discontinuing medication, experienced by the GPs, and in part because the clinical guidelines do not encourage discontinuation of medication, as they offer GPs a weak frame for discontinuation. Three reasons for this are identified: the guidelines provide dominating triggers for prescribing, they provide weak priming for discontinuation as an option, and they underscore a cognitive constraint against discontinuation. Originality/value - The analysis offers new insights about decision making when discontinuing medication. It also offers one of the first examinations of how the institutional context embedding GPs influences their decisions about discontinuation. For policymakers interested in the discontinuation of medication, the findings suggest that de-stigmatising discontinuation on an institutional level may be beneficial, allowing GPs to better justify discontinuation in light of the ambiguity they experience.

And that is Where the Fun Ends - General Practitioners' Conceptualisation of the Line Between Recreational and Problem Gambling

Directory of Open Access Journals (Sweden)

Dieter Egerer Michael

2015-03-01

Full Text Available AIMS - Problem gambling is normally identified by fixed criteria of harm adapted from those of substance abuse and by focusing on the individual gambler. However, rigid definitions neglect institutional variations of gambling practices within different legislative configurations. This study proposes analysing the line between recreational and problem gambling by focusing on gambling behaviour and looking at the corruption of the defining factors of play (Cail-lois, 1958 in three different institutional contexts. DESIGN - A stimulated focus-group method (Reception Analytical Group Interview was applied to seven groups of Finnish and French general practitioners each and three groups of German ones to study the variations of conceptualising the defining factors of play as introduced by Caillois. RESULTS - Corruption of play was distinguished by participants from all three countries as the dividing line between recreational and problem gambling, but cultural variations were found: the French and German GPs emphasised the loss of the exceptionality of gambling, whereas the Finnish GPs highlighted the invasion of the home by online gambling. Furthermore, the Finnish and German participants were more concerned about the use of gambling as an emotional regulator, while French GPs echoed the French medical model in discussing the adrenaline rush of problem gamblers. CONCLUSIONS - Caillois' defining factors of play can be used to distinguish recreational from problem gambling and to offer a more encompassing definition of problem gambling. The perception of the line between recreational and problem gambling also seems to depend on the institutional and cultural context.

Funding medical education: should we follow a different model to general higher education?

Directory of Open Access Journals (Sweden)

Kieran Walsh

2015-09-01

Full Text Available ISSUE. There has been much recent discussion on the funding of medical education. There has also been much discussion about the funding of higher education more generally. EVIDENCE. The topics of discussion have included the rising costs of education; who should pay; the various potential models of funding; and how best to ensure maximum returns from investment. IMPLICATIONS. Medical education has largely followed the emerging models of funding for higher education. However there are important reasons why the funding models for higher education may not suit medical education. These reasons include the fact that medical education is as important to the public as it is to the learner; the range of funding sources available to medical schools; the strict regulation of medical education; and the fact that the privatisation and commercialisation of higher education may not been in keeping with the social goals of medical schools and the agenda of diversification within the medical student population.

Spatial Transformation of Equality – Generalized Travelling Salesman Problem to Travelling Salesman Problem

Directory of Open Access Journals (Sweden)

Mohammed Zia

2018-03-01

Full Text Available The Equality-Generalized Travelling Salesman Problem (E-GTSP, which is an extension of the Travelling Salesman Problem (TSP, is stated as follows: given groups of points within a city, like banks, supermarkets, etc., find a minimum cost Hamiltonian cycle that visits each group exactly once. It can model many real-life combinatorial optimization scenarios more efficiently than TSP. This study presents five spatially driven search-algorithms for possible transformation of E-GTSP to TSP by considering the spatial spread of points in a given urban city. Presented algorithms are tested over 15 different cities, classified by their street-network’s fractal-dimension. Obtained results denote that the R-Search algorithm, which selects the points from each group based on their radial separation with respect to the start–end point, is the best search criterion for any E-GTSP to TSP conversion modelled for a city street network. An 8.8% length error has been reported for this algorithm.

Cybersecurity vulnerabilities in medical devices: a complex environment and multifaceted problem

Directory of Open Access Journals (Sweden)

Williams PAH

2015-07-01

Full Text Available Patricia AH Williams, Andrew J Woodward eHealth Research Group and Security Research Institute, Edith Cowan University, Perth, WA, Australia Abstract: The increased connectivity to existing computer networks has exposed medical devices to cybersecurity vulnerabilities from which they were previously shielded. For the prevention of cybersecurity incidents, it is important to recognize the complexity of the operational environment as well as to catalog the technical vulnerabilities. Cybersecurity protection is not just a technical issue; it is a richer and more intricate problem to solve. A review of the factors that contribute to such a potentially insecure environment, together with the identification of the vulnerabilities, is important for understanding why these vulnerabilities persist and what the solution space should look like. This multifaceted problem must be viewed from a systemic perspective if adequate protection is to be put in place and patient safety concerns addressed. This requires technical controls, governance, resilience measures, consolidated reporting, context expertise, regulation, and standards. It is evident that a coordinated, proactive approach to address this complex challenge is essential. In the interim, patient safety is under threat. Keywords: cybersecurity, security, safety, wireless, risk, medical devices

Vol. 1: Physics of Elementary Particles and Quantum Field Theory. General Problems

International Nuclear Information System (INIS)

Sitenko, A.

1993-01-01

Problems of modern physics and the situation with physical research in Ukraine are considered. Programme of the conference includes scientific and general problems. Its proceedings are published in 6 volumes. The papers presented in this volume refer to elementary particle physics and quantum field theory. The main attention is paid to the following problems: - development of science in Ukraine and its role in the state structures; - modern state of scientific research in Ukraine; - education and training of specialists; - history of Ukrainian physics and contribution of Ukrainian scientists in the world science; - problems of the Ukrainian scientific terminology

Generalization of the Fourier Convergence Analysis in the Neutron Diffusion Eigenvalue Problem

International Nuclear Information System (INIS)

Lee, Hyun Chul; Noh, Jae Man; Joo, Hyung Kook

2005-01-01

Fourier error analysis has been a standard technique for the stability and convergence analysis of linear and nonlinear iterative methods. Lee et al proposed new 2- D/1-D coupling methods and demonstrated several advantages of the new methods by performing a Fourier convergence analysis of the methods as well as two existing methods for a fixed source problem. We demonstrated the Fourier convergence analysis of one of the 2-D/1-D coupling methods applied to a neutron diffusion eigenvalue problem. However, the technique cannot be used directly to analyze the convergence of the other 2-D/1-D coupling methods since some algorithm-specific features were used in our previous study. In this paper we generalized the Fourier convergence analysis technique proposed and analyzed the convergence of the 2-D/1-D coupling methods applied to a neutron diffusion Eigenvalue problem using the generalized technique

[No increase in medical consumption in general practice after induced abortion

NARCIS (Netherlands)

Kooistra, P.A.; Vastbinder, M.B.; Lagro-Janssen, A.L.M.

2007-01-01

OBJECTIVE: To compare medical consumption in general practice between women who underwent an induced abortion and women who did not. DESIGN: Historical cohort study. METHOD: We selected 19o women who underwent an induced abortion in the period 1975-2004 and 145 control patients. Women were selected

Effort--reward imbalance and medically certified absence for mental health problems: a prospective study of white-collar workers.

Science.gov (United States)

Ndjaboué, R; Brisson, C; Vézina, M; Blanchette, C; Bourbonnais, R

2014-01-01

Little is known about the effects of psychosocial work factors on objectively assessed mental health problems leading to medically certified absence. Only one study has evaluated the prospective effects of effort-reward imbalance (ERI) at work with regards to this outcome. The present study aimed to evaluate the effects of ERI on the incidence of medically certified absence for mental health problems. The study included 2086 white-collar workers (63.3% women) employed in public organisations in Quebec city. Participants were followed over a 9-year period. Medical absences from work were collected from employers' files and psychosocial factors were measured using the ERI questionnaire. Cox regression models were used to estimate the incidence of certified sickness absence due to mental health problems that lasted 5 workdays or more, while controlling for confounders. Workers exposed to ERI had a higher risk of a first spell of medically certified absence for mental health problems (HR=1.38, 95% CI 1.08 to 1.76) compared with unexposed workers. Low reward was significantly associated with a high risk among men (HR=2.80, 95% CI 1.34 to 5.89) but not in women. (HR=1.24, 95% CI 0.90 to 1.73). Effort at work had no effect on certified absence. All these effects were adjusted for potential confounders. ERI and low reward at work were prospectively associated with medically certified absence for mental health problems. These effects seem to differ by gender. Primary prevention that is aimed at reducing these stressors should be considered to help reduce the incidence of such severe mental health problems.

Generalized Artificial Life Structure for Time-dependent Problems

Institute of Scientific and Technical Information of China (English)

TSAU Minhe; KAO Weiwen; CHANG Albert

2009-01-01

In recent years, more attention has been paid on artificial life researches. Artificial life(AL) is a research on regulating gene parameters of digital organisms under complicated problematic environments through natural selections and evolutions to achieve the final emergence of intelligence. Most recent studies focused on solving certain real problems by artificial life methods, yet without much address on the AL life basic mechanism. The real problems are often very complicated, and the proposed methods sometimes seem too simple to handle those problems. This study proposed a new approach in AL research, named "generalized artificial life structure(GALS)", in which the traditional "gene bits" in genetic algorithms is first replaced by "gene parameters", which could appear anywhere in GALS. A modeling procedure is taken to normalize the input data, and AL "tissue" is innovated to make AL more complex. GALS is anticipated to contribute significantly to the fitness of AL evolution. The formation of"tissue" begins with some different AL basic cells, and then tissue is produced by the casual selections of one or several of these cells. As a result, the gene parameters, represented by "tissues", could become highly diversified. This diversification should have obvious effects on improving gene fitness. This study took the innovative method of GALS in a stock forecasting problem under a carefully designed manipulating platform. And the researching results verify that the GALS is successful in improving the gene evolution fitness.

Generalized ladder operators for the Dirac-Coulomb problem via SUSY QM

International Nuclear Information System (INIS)

Rodrigues, R. de Lima; Universidade Federal de Campina Grande, PB

2003-12-01

The supersymmetry in quantum mechanics and shape invariance condition are applied as an algebraic method to solving the Dirac-Coulomb problem. The ground state and the excited states are investigated via new generalized ladder operators. (author)

General Satisfaction Among Healthcare Workers: Differences Between Employees in Medical and Mental Health Sector

Science.gov (United States)

Papathanasiou, Ioanna V.; Kleisiaris, Christos F.; Tsaras, Konstantinos; Fradelos, Evangelos C.; Kourkouta, Lambrini

2015-01-01

Background: General satisfaction is a personal experience and sources of satisfaction or dissatisfaction vary between professional groups. General satisfaction is usually related with work settings, work performance and mental health status. Aim: The purpose of this research study was to investigate the level of general satisfaction of health care workers and to examine whether there were any differences among employees of medical and mental health sector. Methods: The sample consisted of employees from the medical and mental health sector, who were all randomly selected. A two-part questionnaire was used to collect data. The first section involved demographic information and the second part was a General Satisfaction Questionnaire (GSQ). The statistical analysis of data was performed using the software package 19.0 for Windows. Descriptive statistics were initially generated for sample characteristics. All data exhibited normal distributions and thus the parametric t-test was used to compare mean scores between the two health sectors. P values satisfaction for the employees in medical sector was 4.5 (5=very satisfied) and for the employees in mental health sector is 4.8. T-test showed that these results are statistical different (t=4.55, psatisfaction. Conclusions: Mental health employees appear to experience higher levels of general satisfaction and mainly they experience higher satisfaction from family roles, life and sexual life, emotional state and relations with patients. PMID:26543410

General Satisfaction Among Healthcare Workers: Differences Between Employees in Medical and Mental Health Sector.

Science.gov (United States)

Papathanasiou, Ioanna V; Kleisiaris, Christos F; Tsaras, Konstantinos; Fradelos, Evangelos C; Kourkouta, Lambrini

2015-08-01

General satisfaction is a personal experience and sources of satisfaction or dissatisfaction vary between professional groups. General satisfaction is usually related with work settings, work performance and mental health status. The purpose of this research study was to investigate the level of general satisfaction of health care workers and to examine whether there were any differences among employees of medical and mental health sector. The sample consisted of employees from the medical and mental health sector, who were all randomly selected. A two-part questionnaire was used to collect data. The first section involved demographic information and the second part was a General Satisfaction Questionnaire (GSQ). The statistical analysis of data was performed using the software package 19.0 for Windows. Descriptive statistics were initially generated for sample characteristics. All data exhibited normal distributions and thus the parametric t-test was used to compare mean scores between the two health sectors. P values satisfaction for the employees in medical sector was 4.5 (5=very satisfied) and for the employees in mental health sector is 4.8. T-test showed that these results are statistical different (t=4.55, psatisfaction. Mental health employees appear to experience higher levels of general satisfaction and mainly they experience higher satisfaction from family roles, life and sexual life, emotional state and relations with patients.

78 FR 16684 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of...

Science.gov (United States)

2013-03-18

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0001] General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting... the public. Name of Committee: General and Plastic Surgery Devices Panel of the Medical Devices...

77 FR 20642 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of...

Science.gov (United States)

2012-04-05

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-N-0001] General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting... the public. Name of Committee: General and Plastic Surgery Devices Panel of the Medical Devices...

76 FR 14415 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of...

Science.gov (United States)

2011-03-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0002] General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting... the public. Name of Committee: General and Plastic Surgery Devices Panel of the Medical Devices...

76 FR 65200 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee: Notice of...

Science.gov (United States)

2011-10-20

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0002] General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee: Notice of... Administration (FDA) is postponing the meeting of the General and Plastic Surgery Devices Panel of the Medical...

76 FR 62419 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of...

Science.gov (United States)

2011-10-07

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0002] General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting... the public. Name of Committee: General and Plastic Surgery Devices Panel of the Medical Devices...

75 FR 49940 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of...

Science.gov (United States)

2010-08-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0001] General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting... the public. Name of Committee: General and Plastic Surgery Devices Panel of the Medical Devices...

78 FR 30928 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of...

Science.gov (United States)

2013-05-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0001] General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting... the public. Name of Committee: General and Plastic Surgery Devices Panel of the Medical Devices...

76 FR 39882 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of...

Science.gov (United States)

2011-07-07

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0478] General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting... the public. Name of Committee: General and Plastic Surgery Devices Panel of the Medical Devices...

Attitude and perception of undergraduate medical students toward the problem-based learning in Chitwan Medical College, Nepal

Directory of Open Access Journals (Sweden)

Yadav RL

2018-05-01

Full Text Available Ram Lochan Yadav,1 Rano Mal Piryani,2 Gopendra Prasad Deo,3 Dev Kumar Shah,1 Laxmi Kumari Yadav,4 Md Nazrul Islam1 1Department of Physiology, Chitwan Medical College, Bharatpur, Nepal; 2Department of Internal Medicine and Health Professional Educational Research Center (HPERC, Chitwan Medical College, Bharatpur, Nepal; 3Department of Anaesthesiology and Critical Care, Chitwan Medical College, Bharatpur, Nepal; 4Department of Microbiology, Chitwan Medical College, Bharatpur, Nepal Background: Problem-based learning (PBL was introduced into Basic Medical Sciences early in the 1980s at Tribhuvan University (TU, Nepal, followed by other universities where didactic lecture method was still followed as the main teaching strategy. Despite gaining its popularity worldwide as integrated teaching learning method, PBL is not given importance in Nepal. This study aimed to assess the attitude and perceptions of undergraduate medical students regarding learning outcomes of PBL and to know their views about role and qualities of effective tutors for its successful implementation.Methods: This descriptive study was based on a self-administered questionnaire. The first part of the questionnaire measured students’ perception and attitude toward benefits of PBL and the second part measured students’ perception about role of PBL tutor. Bachelor of Medicine and Bachelor of Surgery (MBBS first year (2014/2015 academic year students at Chitwan Medical College, TU, were asked to express their opinions about the importance of learning outcomes by rating each statement on a five-point Likert scale and the responses were combined into three categorical variables: “agree” (strongly agree plus agree, “neutral”, and “disagree” (strongly disagree plus disagree. Data were analyzed using SPSS version 21.0.Results: Approximately 85.5% participants agreed that PBL is an interesting method of teaching learning. Most of them (86.7% accepted that PBL is an

Organising medication discontinuation: a qualitative study exploring the views of general practitioners toward discontinuing statins.

Science.gov (United States)

Nixon, Michael; Kousgaard, Marius Brostrøm

2016-07-07

Discontinuing medications is a complex decision making process and an important medical practice. It is a tool in reducing polypharmacy, reducing health system expenditure and improving patient quality of life. Few studies have looked at how general practitioners (GPs) discontinue a medication, in agreement with the patients, from a professional perspective. Three research questions were examined in this study: when does medication discontinuation occur in general practice, how is discontinuing medication handled in the GP's practice and how do GPs make decisions about discontinuing medication? Twenty four GPs were interviewed using a maximum variation sample strategy. Participant observations were done in three general practices, for one day each, totalling approximately 30 consultations. The results show that different discontinuation cues (related to the type of consultation, medical records and the patient) create situations of dissonance that can lead to the GP considering the option of discontinuation. We also show that there is a lot of ambiguity in situations of discontinuing and that some GPs trialled discontinuing as means of generating more information that could be used to deal with the ambiguity. We conclude that the practice of discontinuation should be conceptualised as a continually evaluative process and one that requires sustained reflection through a culture of systematically scheduled check-ups, routinely eliciting the patient's experience of taking drugs and trialling discontinuation. Some policy recommendations are offered including supporting GPs with lists or handbooks that directly address discontinuation and by developing more person centred clinical guidelines that discuss discontinuation more explicitly.

Non-integrability of the generalized spring-pendulum problem

International Nuclear Information System (INIS)

Maciejewski, Andrzej J; Przybylska, Maria; Weil, Jacques-Arthur

2004-01-01

We investigate a generalization of the three-dimensional spring-pendulum system. The problem depends on two real parameters (k, a), where k is the Young modulus of the spring and a describes the nonlinearity of elastic forces. We show that this system is not integrable when k ≠ -a. We carefully investigated the case k = -a when the necessary condition for integrability given by the Morales-Ruiz-Ramis theory is satisfied. We discuss an application of the higher order variational equations for proving the non-integrability in this case

78 FR 66947 - National Institute of General Medical Sciences; Notice of Closed Meeting

Science.gov (United States)

2013-11-07

... Person: Robert Horowits, Ph.D., Senior Investigator, National Institute of General Medical Sciences..., Pharmacology, Physiology, and Biological Chemistry Research; 93.862, Genetics and Developmental Biology...

General versus executive cognitive ability in pupils with ADHD and with milder attention problems

Directory of Open Access Journals (Sweden)

Ek U

2013-01-01

Full Text Available Ulla Ek,1 Joakim Westerlund,2 Elisabeth Fernell31Department of Special Education, 2Department of Psychology, Stockholm University, Stockholm, 3Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg and the Research and Development Centre, Skaraborg Hospital Skövde, SwedenBackground: The aim of this study was to analyze two main types of cognitive domains in school children with different types and severities of attention-related problems. The cognitive domains examined were general cognitive ability and executive abilities.Methods: Three different clinical samples of pupils with school problems were analyzed to assess their cognitive Wechsler Intelligence Scale for Children profiles. In particular, the general cognitive ability index and the executive markers (ie, verbal memory index and processing speed index were of interest. Of the total sample (n = 198, two main groups were contrasted; one met the full criteria for attention deficit hyperactivity disorder (ADHD/subthreshold ADHD, and one was comprised of those with milder attention problems, insufficient to meet the criteria for ADHD/subthreshold ADHD.Results: It could be demonstrated that both groups had a significantly higher score on the general cognitive ability index than on measures of working memory and processing speed. This difference was more pronounced for boys.Conclusion: These types of cognitive differences need to be considered in children with different kinds of learning, behavior, and attention problems; this is also true for children presenting with an average general intelligence quotient and with milder attention problems. Current educational expectations are demanding for children with mild difficulties, and such cognitive information will add to the understanding of the child's learning problems, hopefully leading to a better adapted education than that conventionally available.Keywords: working memory, processing speed, children, learning and

Perceptions of general environmental problems, willingness to expend federal funds on these problems, and concerns regarding the Los Alamos national laboratory: Hispanics are more concerned than Whites

International Nuclear Information System (INIS)

Burger, Joanna; Myers, O.; Boring, C.S.; Dixon, C.; Lord, C.; Ramos, R.; Shukla, S.; Gochfeld, Michael

2004-01-01

Perceptions about general environmental problems, governmental spending for these problems, and major concerns about the US Department of Energy's Los Alamos National Laboratory (LANL) were examined by interviewing 356 people attending a gun show in Albuquerque, New Mexico. The hypothesis that there are differences in these three areas as a function of ethnicity was examined. We predicted that if differences existed, they would exist for all three evaluations (general environmental problems, government spending, and environmental concerns about LANL). However, this was not the case; there were fewer ethnic differences concerning LANL. Hispanics rated most general environmental problems higher than Whites and rated their willingness to expend federal funds higher than Whites, although all groups gave a lower score on willingness than on concern. Further, the congruence between these two types of ratings was higher for Hispanics than for others. In general, the concerns expressed by subjects about LANL showed few ethnic differences, and everyone was most concerned about contamination. These data indicate that Hispanics attending a gun show are equally or more concerned than others about environmental problems generally but are not more concerned about LANL. The data can be useful for developing future research and stewardship plans and for understanding general environmental problems and their relationship to concerns about LANL. More generally, they indicate that the attitudes and perceptions of Hispanics deserve increased study in a general population

What language is your doctor speaking? Facing the problems of translating medical documents into English

Directory of Open Access Journals (Sweden)

Mićović Dragoslava

2013-01-01

Full Text Available What is translation - a craft, an art, a profession or a job? Although one of the oldest human activities, translation has not still been fully defined, and it is still young in terms of an academic discipline. The paper defines the difference between translation and interpreting and then attempts to find the answer to the question what characteristics, knowledge and skills a translator must have, particularly the one involved in court translation, and where his/her place in the communication process (both written and oral communication is. When translating medical documentation, a translator is set within a medical language environment as an intermediary between two doctors (in other words, two professionals in the process of communication which would be impossible without him, since it is conducted in two different languages. The paper also gives an insight into types of medical documentation and who they are intended for. It gives practical examples of the problems faced in the course of translation of certain types of medical documentation (hospital discharge papers, diagnoses, case reports,.... Is it possible to make this kind of communication between professionals (doctors standardized, which would subsequently make their translation easier? Although great efforts are made in Serbia regarding medical language and medical terminology, the conclusion is that specific problems encountered by translators can hardly be overcome using only dictionaries and translation manuals.

Audit and feedback by medical students to improve the preventive care practices of general practice supervisors.

Science.gov (United States)

Gilkes, Lucy A; Liira, Helena; Emery, Jon

Medical students benefit from their contact with clinicians and patients in the clinical setting. However, little is known about whether patients and clinicians also benefit from medical students. We developed an audit and feedback intervention activity to be delivered by medical students to their general practice supervisors. We tested whether the repeated cycle of audit had an effect on the preventive care practices of general practitioners (GPs). The students performed an audit on topics of preventive medicine and gave feedback to their supervisors. Each supervisor in the study had more than one student performing the audit over the academic year. After repetitive cycles of audit and feedback, the recording of social history items by GPs improved. For example, recording alcohol history increased from 24% to 36%. This study shows that medical students can be effective auditors, and their repeated audits may improve their general practice supervisors' recording of some aspects of social history.

Medical psychology services in dutch general hospitals: state of the art developments and recommendations for the future.

Science.gov (United States)

Soons, Paul; Denollet, Johan

2009-06-01

In this article an overview is presented of the emergence of medical psychology in the care of somatically ill patients. The situation in the Netherlands can be considered as prototypical. For 60 years, clinical psychologists have been working in general, teaching and academic hospitals. Nowadays, they are an integrated non-medical specialism working in the medical setting of hospitals in the Netherlands, and are a full-member of the medical board. This paper discusses several topics: the position of the general hospital in the health care system in the Netherlands, the emergence of medical psychology in Dutch hospitals, the role of the professional association of medical psychologists, and the characteristics of patients seen by clinical psychologists. Following the discussion about the situation of medical psychology in other countries, recommendations are formulated for the further development of medical psychology in the Netherlands as well as in other countries.

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

Science.gov (United States)

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

2011-05-09

In Germany, there is a shortage of young physicians in several specialties, the situation of general practitioners (GP) being especially precarious. The factors influencing the career choice of German medical students are poorly understood. This study aims to identify factors influencing medical students' specialty choice laying a special focus on general practice. The study was designed as a cross-sectional survey. In 2010, students at the five medical schools in the federal state of Baden-Wuerttemberg (Germany) filled out an online-questionnaire. On 27 items with 5-point Likert scales, the students rated the importance of specified individual and occupational aspects. Furthermore, students were asked to assign their intended medical specialty. 1,299 students participated in the survey. Thereof, 1,114 students stated a current choice for a specialty, with 708 students choosing a career in one of the following 6 specialties: internal medicine, surgery, gynaecology and obstetrics, paediatrics, anaesthetics and general practice. Overall, individual aspects ('Personal ambition', 'Future perspective', 'Work-life balance') were rated as more important than occupational aspects (i.e. 'Variety in job', 'Job-related ambition') for career choice. For students favouring a career as a GP individual aspects and the factor 'Patient orientation' among the occupational aspects were significantly more important and 'Job-related ambition' less important compared to students with other specialty choices. This study confirms that future GPs differ from students intending to choose other specialties particularly in terms of patient-orientation and individual aspects such as personal ambition, future perspective and work-life balance. Improving job-conditions in terms of family compatibility and work-life balance could help to increase the attractiveness of general practice. Due to the shortage of GPs those factors should be made explicit at an early stage at medical school to increase

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

Directory of Open Access Journals (Sweden)

Loh Andreas

2011-05-01

Full Text Available Abstract Background In Germany, there is a shortage of young physicians in several specialties, the situation of general practitioners (GP being especially precarious. The factors influencing the career choice of German medical students are poorly understood. This study aims to identify factors influencing medical students' specialty choice laying a special focus on general practice. Methods The study was designed as a cross-sectional survey. In 2010, students at the five medical schools in the federal state of Baden-Wuerttemberg (Germany filled out an online-questionnaire. On 27 items with 5-point Likert scales, the students rated the importance of specified individual and occupational aspects. Furthermore, students were asked to assign their intended medical specialty. Results 1,299 students participated in the survey. Thereof, 1,114 students stated a current choice for a specialty, with 708 students choosing a career in one of the following 6 specialties: internal medicine, surgery, gynaecology and obstetrics, paediatrics, anaesthetics and general practice. Overall, individual aspects ('Personal ambition', 'Future perspective', 'Work-life balance' were rated as more important than occupational aspects (i.e. 'Variety in job', 'Job-related ambition' for career choice. For students favouring a career as a GP individual aspects and the factor 'Patient orientation' among the occupational aspects were significantly more important and 'Job-related ambition' less important compared to students with other specialty choices. Conclusions This study confirms that future GPs differ from students intending to choose other specialties particularly in terms of patient-orientation and individual aspects such as personal ambition, future perspective and work-life balance. Improving job-conditions in terms of family compatibility and work-life balance could help to increase the attractiveness of general practice. Due to the shortage of GPs those factors should

General physicians: born or made? The use of a tracking database to answer medical workforce questions.

Science.gov (United States)

Poole, P; McHardy, K; Janssen, A

2009-07-01

The aim of the study was to use a tracking database to investigate the perceived influence of various factors on career choices of New Zealand medical graduates and to examine specifically whether experiences at medical school may have an effect on a decision to become a general physician. Questionnaires were distributed to medical students in the current University of Auckland programme at entry and exit points. The surveys have been completed by two entry cohorts and an exit one since 2006. The response rates were 70 and 88% in the entry and exit groups, respectively. More than 75% of exiting students reported an interest in pursuing a career in general internal medicine. In 42%, this is a 'strong interest' in general medicine compared with 23% in the entry cohort (P Auckland medical students. Only 11% of study respondents reported that student loan burden has a significant influence on career decisions. Quality experiences on attachments seem essential for undergraduates to promote interest in general medicine. There is potential for curriculum design and clinical experiences to be formulated to promote the 'making' of these doctors. Tracking databases will assist in answering some of these questions.

Consumer-Involved Participatory Research to Address General Medical Health and Wellness in a Community Mental Health Setting.

Science.gov (United States)

Iyer, Sharat P; Pancake, Laura S; Dandino, Elizabeth S; Wells, Kenneth B

2015-12-01

Barriers to sustainably implementing general medical interventions in community mental health (CMH) settings include role uncertainty, consumer engagement, workforce limitations, and sustainable reimbursement. To address these barriers, this project used a community-partnered participatory research framework to create a stakeholder-based general medical and wellness intervention in a large CMH organization, with consumers involved in all decision-making processes. Consumers faced practical barriers to participating in organizational decision making, but their narratives were critical in establishing priorities and ensuring sustainability. Addressing baseline knowledge and readiness of stakeholders and functional challenges to consumer involvement can aid stakeholder-based approaches to implementing general medical interventions in CMH settings.

The role of the national general medical journal: surveys of which journals UK clinicians read to inform their clinical practice.

Science.gov (United States)

Jones, Teresa H; Hanney, Stephen; Buxton, Martin J

2008-12-01

For biomedical research findings to contribute toward health gains they must reach clinicians. Academic journals have historically been considered important information sources. Birken and Parkin found seven journals to most consistently contain the best pediatric evidence and, of these seven, four were general medical journals. We surveyed clinicians in three UK medical specialties (psychiatry, surgery and pediatrics), asking which journals they read and which they considered important to inform their clinical practice. The readership of general medical journals, in comparison to specialty and sub-specialty journals, is widespread across the three UK medical specialties, although the importance of general medical journals varies widely. The BMJ is the most prominent general medical journal in terms of readership and importance but a dominant specialty or sub-specialty journal was usually more important for most groups. The Lancet is less widely read and less important, although more academics than non-academics consider it important. Overall, key general medical journals play an important role. Journal availability and cost, particularly in relation to membership for UK clinicians, and the position of academics and non-academics have to be considered in any analysis. Three of the four general medical journals containing the best pediatric evidence were found to be widely read by UK pediatricians and two UK-based general medical journals, the BMJ and The Lancet, were also considered important in our survey. Further investigation of the reasons for the importance of a journal and studies that would allow international comparisons would provide greater input to the discussion.

Medical identity theft: prevention and reconciliation initiatives at Massachusetts General Hospital.

Science.gov (United States)

Judson, Timothy; Haas, Mark; Lagu, Tara

2014-07-01

Medical identity theft refers to the misuse of another individual's identifying medical information to receive medical care. Beyond the financial burden on patients, hospitals, health insurance companies, and government insurance programs, undetected cases pose major patient safety challenges. Inaccuracies in the medical record may persist even after the theft has been identified because of restrictions imposed by patient privacy laws. Massachusetts General Hospital (MGH; Boston) has conducted initiatives to prevent medical identity theft and to better identify and respond to cases when they occur. Since 2007, MGH has used a notification tree to standardize reporting of red flag incidents (warning signs of identity theft, such as suspicious personal identifiers or account activity). A Data Integrity Dashboard allows for tracking and reviewing of all potential incidents of medical identity theft to detect trends and targets for mitigation. An identity-checking policy, VERI-(Verify Everyone's Identity) Safe Patient Care, requires photo identification at every visit and follow-up if it is not provided. Data from MGH suggest that an estimated 120 duplicate medical records are created each month, 25 patient encounters are likely tied to identity theft or fraud each quarter, and 14 patients are treated under the wrong medical record number each year. As of December 2013, 80%-85% of patients were showing photo identification at appointments. Although an organization's policy changes and educational campaigns can improve detection and reconciliation of medical identity theft cases, national policies should be implemented to streamline the process of correcting errors in medical records, reduce the financial disincentive for hospitals to detect and report cases, and create a single point of entry to reduce the burden on individuals and providers to reconcile cases.

General conditions guaranteeing the solvability of the Cauchy problem for functional differential equations

Czech Academy of Sciences Publication Activity Database

Dilna, N.; Rontó, András

2008-01-01

Roč. 133, č. 4 (2008), s. 435-445 ISSN 0862-7959 R&D Projects: GA ČR(CZ) GA201/06/0254 Institutional research plan: CEZ:AV0Z10190503 Keywords : functional differential equation * Cauchy problem * initial value problem * differential inequality Subject RIV: BA - General Mathematics

Forensic evaluation of medical liability cases in general surgery.

Science.gov (United States)

Moreira, H; Magalhães, T; Dinis-Oliveira, Rj; Taveira-Gomes, A

2014-10-01

Although medical liability (disciplinary, civil and criminal) is increasingly becoming an issue, few studies exist, particularly from the perspective of forensic science, which demonstrate the extent to which medical malpractice occurs, or when it does, the reasons for it. Our aims were to evaluate the current situation concerning medical liability in general surgery (GS) in Portugal, the reasons for claims, and the forensic evaluations and conclusions, as well as the association between these issues and the judicial outcomes. We analysed the Medico-Legal Council (CML) reports of the National Institute of Legal Medicine and Forensic Sciences of Portugal related to GS during 2001-2010. The judicial outcomes of each case were requested from the Public Prosecutor Office (PPO) and the court. Alleged cases of medical liability in GS represented 11.2% of the total cases analysed by the CML. We estimated that in Portugal, 4:100,000 surgeries are subject to litigation. The majority of complaints were due to the patient's death (75.4%), with laparoscopic cholecystectomy surgeries representing 55.2% of cases. In 76.1% of the cases, the CML believed that there was no violation of legesartis and in 55.2% of cases, no causal nexus was found between the medical practice and the alleged harm. The PPO prosecuted physicians in 6.4% of the cases and resulted in one conviction. Finally, the importance of the CML reports as a relevant technical-scientific tool for judicial decision was evident because these reports significantly (p < 0.05) influenced the prosecutor's decision, whether to prosecute or not. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Sexual dysfunction and the underlying medical problems in post-menopausal women

Directory of Open Access Journals (Sweden)

Soheila Nazarpour

2016-02-01

Full Text Available Background: Sexual dysfunction could be under the influence of some underlying medical problems. The purpose of this study is to examine the relationship between medical problems and sexual function in post-menopausal women. Methods: This is a community-based, descriptive-correlation study of 405 post-menopausal women residing in Chalus and Nowshahr cities, North of Iran, aged 40 to 65 years old from October 2013 to May 2014. A multistage, randomized sampling was conducted. The data was acquired through interviews using the Female Sexual Function Index (FSFI questionnaire and a researcher-made questionnaire, and was analyzed using descriptive and analytical tests such as multiple linear regression and logistic regression models. Results: 51.4% of the subjects had medical conditions. Cardiovascular disorders were the most common diseases among the subjects. 61% of the women were suffering from female sexual dysfunction (FSD. Sexual dysfunction in patients with medical conditions was significantly higher (P= 0.037. Scores of arousal (P= 0.000, orgasm (P= 0.018, and satisfaction (P= 0.026, as well as the FSFI total score (P= 0.005, were significantly lower in subjects with cardiovascular disorders. Scores of desire (P= 0.001, arousal (P= 0.006, lubrication (P= 0.010, orgasm (P= 0.004, and satisfaction (P= 0.022, as well as the FSFI total score (P= 0.017, were significantly lower in subjects with diabetes. Scores of pain were significantly lower in subjects with musculoskeletal disorders (P= 0.041, they experienced more pain during intercourse. In domains of arousal (P= 0.030, satisfaction (P= 0.040, and pain (P= 0.044, the scores of those taking antihypertensive medications were significantly lower than the scores of the rest of the subjects. Scores of desire (P= 0.001, arousal (P= 0.006, orgasm (P= 0.006, and satisfaction (P= 0.048, as well as the FSFI total score (P= 0.006, were significantly lower in those taking antidiabetic drugs. And lastly

An analysis of radiological research publications in high impact general medical journals between 1996 and 2010

International Nuclear Information System (INIS)

Ku, You Jin; Yoon, Dae Young; Yun, Eun Joo; Baek, Sora; Lim, Kyoung Ja; Seo, Young Lan; Choi, Chul Soon; Bae, Sang Hoon

2013-01-01

Highlights: ► Radiologists published only 0.2% of articles in five general medical journals. ► Most original articles from radiologists were funded and were prospective studies. ► Radiology researchers from only 11 countries published at least one original article. -- Abstract: Objective: To evaluate scientific papers published by radiologists in high impact general medical journals between 1996 and 2010. Methods: A MEDLINE search was performed in five high impact general medical journals (AIM, BMJ, JAMA, Lancet, and NEJM) for all articles of which a radiologist was the first author between 1996 and 2010. The following information was abstracted from the original articles: radiological subspecialty, imaging technique used, type of research, sample size, study design, statistical analysis, study outcome, declared funding, number of authors, collaboration, and country of the first author. Results: Of 216 (0.19%) articles were published by radiologists in five general medical journals between 1996 and 2010, 83 were original articles. Fifteen (18.1%) original articles were concerned with the field of vascular/interventional radiology, 24 (28.9%) used combined imaging techniques, 76 (91.6%) were clinical research, 63 (75.9%) had a sample size of >50, 65 (78.3%) were prospective, 78 (94.0%) performed statistical analysis, 83 (100%) showed positive study outcomes, 57 (68.7%) were funded, 49 (59.0%) had from four to seven authors, and 79 (95.2%) were collaborative studies. Conclusions: A very small number (0.19%) in five high impact general medical journals was published by radiologists between 1996 and 2010

Frequent attenders in general practice: problem solving treatment provided by nurses [ISRCTN51021015

Directory of Open Access Journals (Sweden)

van Oppen P

2005-10-01

Full Text Available Abstract Background There is a need for assistance from primary care mental health workers in general practice in the Netherlands. General practitioners (GPs experience an overload of frequent attenders suffering from psychological problems. Problem Solving Treatment (PST is a brief psychological treatment tailored for use in a primary care setting. PST is provided by nurses, and earlier research has shown that it is a treatment at least as effective as usual care. However, research outcomes are not totally satisfying. This protocol describes a randomized clinical trial on the effectiveness of PST provided by nurses for patients in general practice. The results of this study, which currently being carried out, will be presented as soon as they are available. Methods/design This study protocol describes the design of a randomized controlled trial to investigate the effectiveness and cost-effectiveness of PST and usual care compared to usual care only. Patients, 18 years and older, who present psychological problems and are frequent attenders in general practice are recruited by the research assistant. The participants receive questionnaires at baseline, after the intervention, and again after 3 months and 9 months. Primary outcome is the reduction of symptoms, and other outcomes measured are improvement in problem solving skills, psychological and physical well being, daily functioning, social support, coping styles, problem evaluation and health care utilization. Discussion Our results may either confirm that PST in primary care is an effective way of dealing with emotional disorders and a promising addition to the primary care in the UK and USA, or may question this assumption. This trial will allow an evaluation of the effects of PST in practical circumstances and in a rather heterogeneous group of primary care patients. This study delivers scientific support for this use and therefore indications for optimal treatment and referral.

Support for medical students with mental health problems: a conceptual model.

Science.gov (United States)

Grant, Andrew; Rix, Andrew; Winter, Peter; Mattick, Karen; Jones, Debbie

2015-02-01

Medical students experience higher prevalence of mental illness than age-matched controls and are less likely to access appropriate help when this happens. The aim of this study was to determine the range of strategies deployed by medical schools to support medical students with mental health concerns and to use this to identify distinct categories. Websites and documents relating to all 32 UK medical schools were looked at, as were reports for quality assurance visits carried out by the General Medical Council (UK). A structured telephone interview was carried out with medical schools. Support services were examined by tracing the path that might be taken by a hypothetical student with mental health concerns of varying severity, seeing what was required and what was available at each stage. A range of support strategies is available to most medical students both from their medical school and from generic services in the university. Medical students will usually first contact a personal tutor or a senior member of faculty or be contacted by them as a result of concerns raised either via performance issues or by another student. While individual support interventions are mostly based on evidence of effectiveness, there is no unifying theory in terms of what constitutes effective support. To enable analysis of support interventions and comparison across providers, a six-stage conceptual model of prevention was developed. The six stages are the following: prevention, identification, referral, escalation, treatment, and reintegration. The staged model, derived from analysis of existing interventions, provides a framework for evaluation of current provision and comparison of different methods of delivery. Moreover, it provides a framework for future research.

The Survey of Correlation between Internet Addiction and General Health Status among the Students of Qom University of Medical Sciences in 2010-2011, Qom, Iran

Directory of Open Access Journals (Sweden)

Jafary Nodoushan M.A

2012-09-01

Full Text Available Background and Objectives: Nowadays, internet addiction is known as a psychological disorder in medical science and psychology. Comparing with average users, addicted users' public health are in great danger. This study aims to determine the relationship between internet addiction and students' public health in Qom University of Medical Sciences in 2010 to 2011(1389-1390 academic year. Methods: This descriptive study assessed 250 students of Qom university of medical sciences by means of two questionnaires: the General Health Questionnaire (GHQ-28 and addiction internet (IAT. The obtained data were analyzed by using statistical chi-square tests, ANOVA and T test and p<0.05 was considered as the significant level. Results: In this study, 90% were mild addicted users to internet , 9.6% medium addicted users to internet and 4% of users had severe addiction to internet. The most desirable level of general health was observed in mild addicted users (p<0.05. Significant relationship between internet addiction and general health was not observed.Conclusion: Based on this study, it is necessary to consider internet addiction phenomenon as a serious problem to young generation's health and university officials who are responsible for their health should make a plan in educating and culture of using internet.

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.

A comparison between the effectiveness of PBL and LBL on improving problem-solving abilities of medical students using questioning

DEFF Research Database (Denmark)

He, Yunfeng; Du, Xiangyun; Toft, Egon

2018-01-01

of problem-based learning (PBL) and lecture-based learning in improving the questioning abilities of medical students (N = 104) was assessed by a modified 20-question task. In this task, the participants were asked to identify target pictures by asking questions, the problem-solving process of which......In daily patient-history taking and diagnosis practice, doctors ask questions to gather information from patients and narrow down diagnostic hypotheses. Training medical students to be efficient problem solvers through the use of questioning is therefore important. In this study, the effectiveness....... This finding suggests that PBL curricula may help improve the questioning strategies of medical students and help them diagnose more efficiently in future diagnosis practice....

Decisions about Confidentiality in Medical Student Mental Health Settings.

Science.gov (United States)

Lindenthal, Jacob Jay; And Others

1984-01-01

Examined responses of psychologists and psychiatrists in medical schools (N=59) to vignettes representing student problems. Results suggested practitioners were generally unwilling to break confidentiality in response to problems involving suicidal tendencies, sexual coercion/seduction, social transgressions, or falsifying data. Only suggestions…

Educational Level, Underachievement, and General Mental Health Problems in 10,866 Adolescents.

Science.gov (United States)

Tempelaar, Wanda M; de Vos, Nelleke; Plevier, Carolien M; van Gastel, Willemijn A; Termorshuizen, Fabian; MacCabe, James H; Boks, Marco P M

2017-08-01

Previous research suggests that cognitive functioning is associated with the risk of several adult psychiatric disorders. In this study we investigated whether adolescents who perform worse than expected at secondary school are at a higher risk for general mental health problems. In a cross-sectional survey comprising 10,866 Dutch adolescents aged 13 to 16 years, underachievement at secondary school was defined as the discrepancy between predicted school grade and actual grade 1 or 3 years later. Mental health problems were assessed using the Strengths and Difficulties Questionnaire. We investigated the association of underachievement with mental health problems using logistic regression, adjusting for potential confounders. Underachievement was associated with general psychopathology in pupils aged 13 to 14 years (odds ratio [OR], 1.86; 95% confidence interval [CI], 1.47-2.37) and in pupils aged 15 to 16 years (OR, 2.05; 95% CI, 1.67-2.52) in a multivariate analysis including sociodemographic factors. The association between underachievement and mental health problems was attenuated when school factors such as teacher advice and interaction between underachievement and teacher advice were added, but underachievement remained significantly associated with mental health problems in adolescents in the higher educational tracks (pupils aged 13-14 years: OR, 2.22; 95% CI, 1.07-4.60 and OR, 2.41; 95% CI, 1.10-5.30, age 15-16 years: OR, 2.63; 95% CI, 1.38-5.03). In the multivariate analysis including the interaction between underachievement and teacher advice, a significant interaction effect occurs between underachievement and teacher advice in the higher tracks. Values of OR and CI are given for each significant interaction term. In the younger age group (pupils aged 13-14 years) this results in 2 sets of OR and CI. This association was most pronounced for the hyperactivity subscale of the Strengths and Difficulties Questionnaire. Underachievement at secondary school

Randomized controlled trial of the effect of medical audit on AIDS prevention in general practice

DEFF Research Database (Denmark)

Sandbæk, Annelli

1999-01-01

OBJECTIVE: We aimed to evaluate the effect of a medical audit on AIDS prevention in general practice. METHODS: We conducted a prospective randomized controlled study performed as 'lagged intervention'. At the time of comparison, the intervention group had completed 6 months of audit including a p...... of such consultations initiated by the GPs. CONCLUSIONS: Medical audit had no observed effect on AIDS prevention in general practice. Udgivelsesdato: 1999-Oct......OBJECTIVE: We aimed to evaluate the effect of a medical audit on AIDS prevention in general practice. METHODS: We conducted a prospective randomized controlled study performed as 'lagged intervention'. At the time of comparison, the intervention group had completed 6 months of audit including....... One hundred and thirty-three GPs completed the project. The main outcome measures were the number of consultations involving AIDS prevention and the number of talks about AIDS initiated by the GP, and some elements of the content were registered on a chart. RESULTS: No statistically significant...

Consultations for mental problems in general practices with and without mental health nurses.

NARCIS (Netherlands)

Magnée, T.; Beurs, D. de; Verhaak, P.

2016-01-01

Background & Aim: It seems cost-effective to provide mental health care to patient with mild mental problems in general practices instead of in specialized care, but general practitioners (GPs) often lack time or expertise. Since 2008, Dutch GPs have been collaborating with nurses with mental health

Markov chains with exponentially small transition probabilities: First exit problem from a general domain. II. The general case

International Nuclear Information System (INIS)

Olivieri, E.; Scoppola, E.

1996-01-01

In this paper we consider aperiodic ergodic Markov chains with transition probabilities exponentially small in a large parameter β. We extend to the general, not necessarily reversible case the analysis, started in part I of this work, of the first exit problem from a general domain Q containing many stable equilibria (attracting equilibrium points for the β = ∞ dynamics). In particular we describe the tube of typical trajectories during the first excursion outside Q

Constructivist, Problem-Based Learning Does Work: A Meta-Analysis of Curricular Comparisons Involving a Single Medical School

Science.gov (United States)

Schmidt, Henk G.; van der Molen, Henk T.; te Winkel, Wilco W. R.; Wijnen, Wynand H. F. W.

2009-01-01

Effects of problem-based learning as reported in curricular comparison studies have been shown to be inconsistent over different medical schools. Therefore, we decided to summarize effects of a single well-established problem-based curriculum rather than to add up sometimes-conflicting findings from different problem-based curricula. Effect sizes…

Evaluating learning among undergraduate medical students in schools with traditional and problem-based curricula.

Science.gov (United States)

Meo, Sultan Ayoub

2013-09-01

This study aimed to assess knowledge and skills in a respiratory physiology course in traditional versus problem-based learning (PBL) groups in two different medical schools. Two different undergraduate medical schools were selected for this study. The first medical school followed the traditional [lecture-based learning (LBL)] curriculum, and the second medical school followed the PBL curriculum. Sixty first-year male medical students (30 students from each medical school) volunteered; they were apparently healthy and of the same age, sex, nationality, and regional and cultural background. Students were taught respiratory physiology according to their curriculum for a period of 2 wk. At the completion of the study period, knowledge was measured based on a single best multiple-choice question examination, and skill was measured based on the objective structured practical examination in the lung function laboratory (respiratory physiology). A Student's t-test was applied for the analysis of the data, and the level of significance was set at P schools.

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

DEFF Research Database (Denmark)

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

2012-01-01

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

Comparison of the Perceived Quality of Life between Medical and Veterinary Students in Tehran.

Science.gov (United States)

Labbafinejad, Yasser; Danesh, Hossein; Imanizade, Zahra

2016-01-01

Medical and veterinary professional programs are demanding and may have an impact on a student's quality of life (QOL). The aim of this study was to compare the perceived QOL of these two groups. In this study, we used the SF-36 questionnaire in which higher scores mean a better perceived QOL. Only the students in the internship phase of their program were selected so that we could compare the two groups in a similar way. In total, 308 valid questionnaires were gathered. Apart from age and body mass index (BMI), the two groups were demographically similar. The scores of five domains (physical activity limitation due to health problems, usual role limitation due to emotional problems, vitality, general mental health, and general health perception) and also the total score were statistically higher in medical students. Only the score of one domain (social activity limitation due to physical or emotional problems) was statistically higher in veterinary students. BMI, physical activity limitation due to health problems, and vitality lost their significance after binomial logistic regression. We found that, in general, veterinary students have lower scores for the perceived QOL with social function being the only exception. It can be assumed that in medical students, interaction with human patients may have a negative impact in the score of this domain. Even though medical students have shown lower perceived QOL than the general population in previous studies, veterinary students appear to have slightly lower perceived QOL than medical students.

What determines medical students' career preference for general practice residency training?: a multicenter survey in Japan.

Science.gov (United States)

Ie, Kenya; Murata, Akiko; Tahara, Masao; Komiyama, Manabu; Ichikawa, Shuhei; Takemura, Yousuke C; Onishi, Hirotaka

2018-01-01

Few studies have systematically explored factors affecting medical students' general practice career choice. We conducted a nationwide multicenter survey (Japan MEdical Career of Students: JMECS) to examine factors associated with students' general practice career aspirations in Japan, where it has been decided that general practice will be officially acknowledged as a new discipline. From April to December 2015, we distributed a 21-item questionnaire to final year medical students in 17 medical schools. The survey asked students about their top three career preferences from 19 specialty fields, their demographics and their career priorities. Multivariable logistic regression was used to determine the effect of each item. A total of 1264 responses were included in the analyses. The top three specialty choice were internal medicine: 833 (65.9%), general practice: 408 (32.3%), and pediatrics: 372 (29.4%). Among demographic factors, "plan to inherit other's practice" positively associated with choosing general practice, whereas "having physician parent" had negative correlation. After controlling for potential confounders, students who ranked the following items as highly important were more likely to choose general practice: "clinical diagnostic reasoning (adjusted odds ratio (aOR): 1.65, 95% CI 1.40-1.94)", "community-oriented practice (aOR: 1.33, 95% CI 1.13-1.57)", and" involvement in preventive medicine (aOR: 1.18, 95% CI 1.01-1.38)". On the contrary, "acute care rather than chronic care", "mastering advanced procedures", and "depth rather than breadth of practice" were less likely to be associated with general practice aspiration. Our nationwide multicenter survey found several features associated with general practice career aspirations: clinical diagnostic reasoning; community-oriented practice; and preventive medicine. These results can be fundamental to future research and the development of recruitment strategies.

[Problems in integrative postgraduate medical training of physicians at anthroposophic hospitals in Germany and Switzerland].

Science.gov (United States)

Heusser, Peter; Eberhard, Sabine; Weinzirl, Johannes; Orlow, Pascale; Berger, Bettina

2014-01-01

Anthroposophic hospitals provide integrative medical care by complementing conventional (CON) with anthroposophic medicine (AM). They teach integrative medicine in postgraduate medical training (PGMT). In a first evaluation of PGMT quality in AM, we analyzed the problems of this training from the perspectives of trainers and trainees. We conducted an anonymous cross-sectional full survey of all trainee and trainer physicians at the 15 AM hospitals in Germany (DE) and Switzerland (CH) with questionnaires of the Swiss Institute of Technology (ETH) Zürich, complemented by a module for AM. We also conducted descriptive statistics for questions with answering scales as well as calculations of group differences (two-tailed Mann-Whitney U test) and a qualitative content analysis (Mayring) of free text answers related to the problem analysis. The response rate in DE embraced 89 out of 215 (41.39%) surveyed trainees and 78 out of 184 (42.39%) trainers; in CH, the response rate comprised 19 out of 25 (76%) trainees and 22 out of 30 (73.33%) trainers. Free text answers related to problem analysis in DE and CH were given by 16 out of 108 (14.8%) trainees and by 20 out of 100 (20%) trainers, overall. Perceived main problems include work overload; shortcomings in work organization; delimitation of competences; interprofessional cooperation; financial resources (trainers); wages (trainees DE); practical relevance of AM (trainees and trainers in DE); professional or didactic competence of trainers; lack of interest in AM (trainees); problems with learning and practicing AM; no curriculum for postgraduate medical training in AM; tensions between AM and CON. Explanations for the differences between DE and CH include larger departments and the DRG system in DE, but also better structural conditions for AM PGMT in CH. Main problems of PGMT in AM include not only non-specific and systemic aspects, but also AM-specific issues. In order to develop a basis for concrete problem solving

Contraception in women with medical problems

Science.gov (United States)

Dhanjal, Mandish K

2008-01-01

Women with medical disease have a higher incidence of maternal mortality compared with healthy women, with cardiac disease now being the most common cause of maternal death in the UK. A handful of medical conditions exist where pregnancy is not recommended due to mortality rates approaching 50%. It is imperative that such women have the most reliable methods of contraception available. Contraceptive agents may themselves affect medical disease, or may interact with medications used by such women. There may be a range of contraceptive agents suitable for each medical condition. The contraceptive selected should be tailored to suit the individual. The following points should be considered when deciding on the most appropriate contraceptive agent: efficacy, thrombotic risk (oestrogen containing contraceptives), arterial risks (oestrogen containing contraceptives), infective risk (e.g. insertion of intrauterine device [IUD]), vagal stimulation (e.g. insertion of IUD, ESSURE®), bleeding risks with patients on anticoagulants, interaction with concomitant drugs, effects of anaesthesia and ease of use. This review aims to cover the different contraceptive agents available and the best ones to use for certain medical illnesses. PMID:27582790

Randomized controlled trial of the effect of medical audit on AIDS prevention in general practice

DEFF Research Database (Denmark)

Sandbæk, Annelli

1999-01-01

OBJECTIVE: We aimed to evaluate the effect of a medical audit on AIDS prevention in general practice. METHODS: We conducted a prospective randomized controlled study performed as 'lagged intervention'. At the time of comparison, the intervention group had completed 6 months of audit including...... of such consultations initiated by the GPs. CONCLUSIONS: Medical audit had no observed effect on AIDS prevention in general practice. Udgivelsesdato: 1999-Oct...... a primary activity registration, feedback of own data and a meeting with colleagues and experts, and had received brief summaries of the meetings and reminders about the project (a full 'audit circle'). The participants were from general practices in Copenhagen and the Counties of Funen and Vejle, Denmark...

An analysis of radiological research publications in high impact general medical journals between 1996 and 2010.

Science.gov (United States)

Ku, You Jin; Yoon, Dae Young; Yun, Eun Joo; Baek, Sora; Lim, Kyoung Ja; Seo, Young Lan; Choi, Chul Soon; Bae, Sang Hoon

2013-06-01

To evaluate scientific papers published by radiologists in high impact general medical journals between 1996 and 2010. A MEDLINE search was performed in five high impact general medical journals (AIM, BMJ, JAMA, Lancet, and NEJM) for all articles of which a radiologist was the first author between 1996 and 2010. The following information was abstracted from the original articles: radiological subspecialty, imaging technique used, type of research, sample size, study design, statistical analysis, study outcome, declared funding, number of authors, collaboration, and country of the first author. Of 216 (0.19%) articles were published by radiologists in five general medical journals between 1996 and 2010, 83 were original articles. Fifteen (18.1%) original articles were concerned with the field of vascular/interventional radiology, 24 (28.9%) used combined imaging techniques, 76 (91.6%) were clinical research, 63 (75.9%) had a sample size of >50, 65 (78.3%) were prospective, 78 (94.0%) performed statistical analysis, 83 (100%) showed positive study outcomes, 57 (68.7%) were funded, 49 (59.0%) had from four to seven authors, and 79 (95.2%) were collaborative studies. A very small number (0.19%) in five high impact general medical journals was published by radiologists between 1996 and 2010. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

The Clinical Assessment Study of the Hand (CAS-HA: a prospective study of musculoskeletal hand problems in the general population

Directory of Open Access Journals (Sweden)

Marshall Michelle

2007-08-01

Full Text Available Abstract Background Pain in the hand affects an estimated 12–21% of the population, and at older ages the hand is one of the most common sites of pain and osteoarthritis. The association between symptomatic hand osteoarthritis and disability in everyday life has not been studied in detail, although there is evidence that older people with hand problems suffer significant pain and disability. Despite the high prevalence of hand problems and the limitations they cause in older adults, little attention has been paid to the hand by health planners and policy makers. We plan to conduct a prospective, population-based, observational cohort study designed in parallel with our previously reported cohort study of knee pain, to describe the course of musculoskeletal hand problems in older adults and investigate the relative merits of different approaches to classification and defining prognosis. Methods/Design All adults aged 50 years and over registered with two general practices in North Staffordshire will be invited to take part in a two-stage postal survey. Respondents to the survey who indicate that they have experienced hand pain or problems within the previous 12 months will be invited to attend a research clinic for a detailed assessment. This will consist of clinical interview, hand assessment, screening test of lower limb function, digital photography, plain x-rays, anthropometric measurement and brief self-complete questionnaire. All consenting clinic attenders will be followed up by (i general practice medical record review, (ii repeat postal questionnaire at 18-months, and (iii repeat postal questionnaire at 3 years. Discussion This paper describes the protocol for the Clinical Assessment Study of the Hand (CAS-HA, a prospective, population-based, observational cohort study of community-dwelling older adults with hand pain and hand problems based in North Staffordshire.

Melanoma and medical education: knowledge and sun safety practices amongst medical students

Directory of Open Access Journals (Sweden)

Nicolina Smith

2018-02-01

Full Text Available Introduction: Melanoma has become a public health problem; however, with proper education and the use of sun safety techniques, most cases can be prevented. The purpose of this study is to determine if medical students have safer sun practices than the general population. Material and Methods: An online survey was sent to all students enrolled in the three medical schools in the Kansas City metropolitan area. Surveys were sent to 1200 medical students with a 39.25% response rate (n=471. Results: Most of the student population (n=436; 92.6% indicated that over the past year they had used one or more forms of sun protection. Of the respondents, 60.7% (n=286 indicated they had, to this point in their medical training, been educated counseling patients about the risk factors for prevention of skin cancer. Respondents who indicated that they had been educated on the steps/procedures of a complete skin exam were significantly more likely to indicate they had used sun protective equipment in the past year (P=.024. Conclusions: The general population is in need of dermatologic education on the basic risk factors of skin cancer as well as ways to prevent skin cancer. As education increases in the general population one would anticipate that these individuals would engage in safe sun practices as seen in the medical student community.

General Disinfection in Medical and Dental Hospitals, Selection of Disinfectant Type and Problems Encountered

OpenAIRE

Akça, Gülin

2015-01-01

Hospitals are the places where, either the patients or other health workers can encounter with dangerous problem of several bacterial, fungal, viral, parasitic infectious agents, especially the emerging and life threatening ones such as, methicillin-resistant Staphylococcus aureus (MRSA), vancomycin resistant Enterococcus faecalis (VRE), Stenotrophomonas sp., and multi drug resistant Acinetobacter sp., Pseudomonas sp.. The reasons of these resistant microorganisms that can threaten the life o...

Detectability of T1a lung cancer on digital chest radiographs: an observer-performance comparison among 2-megapixel general-purpose, 2-megapixel medical-purpose, and 3-megapixel medical-purpose liquid-crystal display (LCD) monitors.

Science.gov (United States)

Yabuuchi, Hidetake; Matsuo, Yoshio; Kamitani, Takeshi; Jinnnouchi, Mikako; Yonezawa, Masato; Yamasaki, Yuzo; Nagao, Michinobu; Kawanami, Satoshi; Okamoto, Tatsuro; Sasaki, Masayuki; Honda, Hiroshi

2015-08-01

There has been no comparison of detectability of small lung cancer between general and medical LCD monitors or no comparison of detectability of small lung cancer between solid and part-solid nodules. To compare the detectabilities of T1a lung cancer on chest radiographs on three LCD monitor types: 2-megapixel (MP) for general purpose (General), 2-MP for medical purpose (Medical), and 3-MP-Medical. Radiographs from forty patients with T1aN0M0 primary lung cancer (27 solid nodules, 13 part-solid nodules) and 60 patients with no abnormalities on both chest X-ray and computed tomography (CT) were consecutively collected. Five readers assessed 100 cases for each monitor. The observations were analyzed using receiver operating characteristic (ROC) analysis. A jackknife method was used for statistical analysis. A P value of General, 2-MP-Medical, and 3-MP-Medical LCD monitors were 0.86, 0.89, and 0.89, respectively; there were no significant differences among them. The average AUC for part-solid nodule detection using a 2-MP-General, 2-MP-Medical, and 3-MP-Medical LCD monitors were 0.77, 0.86, and 0.89, respectively. There were significant differences between the 2-MP-General and 2-MP-Medical LCD monitors (P = 0.043) and between the 2-MP-General and 3-MP-Medical LCD monitors (P = 0.027). There was no significant difference between the 2-MP-Medical and 3-MP-Medical LCD monitors. The average AUC for solid nodule detection using a 2-MP-General, 2-MP-Medical, and 3-MP-Medical LCD monitors were 0.90, 0.90, and 0.88, respectively; there were no significant differences among them. The mean AUC values for all and part-solid nodules of the low-experienced readers were significantly lower than those of the high-experienced readers with the 2 M-GP color LCD monitor (P general-purpose LCD monitor was significantly lower than those using medical-purpose LCD monitors. © The Foundation Acta Radiologica 2014.

The workload of general practitioners does not affect their awareness of patients' psychological problems.

NARCIS (Netherlands)

Zantinge, E.M.; Verhaak, P.F.M.; Bakker, D.H. de; Kerssens, J.J.; Meer, K. van der; Bensing, J.M.

2007-01-01

OBJECTIVE: To investigate if general practitioners (GPs) with a higher workload are less inclined to encourage their patients to disclose psychological problems, and are less aware of their patients' psychological problems. METHODS: Data from 2095 videotaped consultations from a representative

[The medical education and the extended general practice: results of a Brazilian experiment].

Science.gov (United States)

Hafner, Maria de Lourdes Marmorato Botta; Moraes, Magali Aparecida Alves de; Marvulo, Marilda Marques Luciano; Braccialli, Luzmarina Aparecida Doretto; Carvalho, Maria Helena Ribeiro de; Gomes, Romeu

2010-06-01

This is a qualitative study that is part of an evaluation research of a medicine course with the use of active teaching-learning methodologies based on the triangulation of methods. The aim is to evaluate the results related to the extended general practice concept. The sources of information used in the study include 17 semi-structured interviews with ex-prisoners and a situation that simulated the medical practice, of which seven ex-prisoners and a simulated patient participated. The analysis of the information and the production of the data were based on the method of interpretation of senses, according to the referential hermeneutic-dialectic system. The results point to aspects that justify the extended general practice, evidenced in two themes: the doctor-patient relationship and the patient approach. In conclusion, it is observed that the evaluated medical course brings together the education of the general, humanist, critical and reflexive doctor that may intervene in the different levels of health attention as well as in the individual and collective approach. It is also concluded that there are limits in operating an extended general practice in diverse health situations.

A BEME systematic review of UK undergraduate medical education in the general practice setting: BEME Guide No. 32.

Science.gov (United States)

Park, Sophie; Khan, Nada F; Hampshire, Mandy; Knox, Richard; Malpass, Alice; Thomas, James; Anagnostelis, Betsy; Newman, Mark; Bower, Peter; Rosenthal, Joe; Murray, Elizabeth; Iliffe, Steve; Heneghan, Carl; Band, Amanda; Georgieva, Zoya

2015-05-06

General practice is increasingly used as a learning environment in undergraduate medical education in the UK. The aim of this project was to identify, summarise and synthesise research about undergraduate medical education in general practice in the UK. We systematically identified studies of undergraduate medical education within a general practice setting in the UK from 1990 onwards. All papers were summarised in a descriptive report and categorised into two in-depth syntheses: a quantitative and a qualitative in-depth review. 169 papers were identified, representing research from 26 UK medical schools. The in-depth review of quantitative papers (n = 7) showed that medical students learned clinical skills as well or better in general practice settings. Students receive more teaching, and clerk and examine more patients in the general practice setting than in hospital. Patient satisfaction and enablement are similar whether a student is present or not in a consultation, however, patients experience lower relational empathy. Two main thematic groups emerged from the qualitative in-depth review (n = 10): the interpersonal interactions within the teaching consultation and the socio-cultural spaces of learning which shape these interactions. The GP has a role as a broker of the interactions between patients and students. General practice is a socio-cultural and developmental learning space for students, who need to negotiate the competing cultures between hospital and general practice. Lastly, patients are transient members of the learning community, and their role requires careful facilitation. General practice is as good, if not better, than hospital delivery of teaching of clinical skills. Our meta-ethnography has produced rich understandings of the complex relationships shaping possibilities for student and patient active participation in learning.

Funding medical education: should we follow a different model to general higher education? Commentary.

Science.gov (United States)

Walsh, Kieran

2015-01-01

There has been much recent discussion on the funding of medical education. There has also been much discussion about the funding of higher education more generally. The topics of discussion have included the rising costs of education; who should pay; the various potential models of funding; and how best to ensure maximum returns from investment. Medical education has largely followed the emerging models of funding for higher education. However there are important reasons why the funding models for higher education may not suit medical education. These reasons include the fact that medical education is as important to the public as it is to the learner; the range of funding sources available to medical schools; the strict regulation of medical education; and the fact that the privatisation and commercialisation of higher education may not been in keeping with the social goals of medical schools and the agenda of diversification within the medical student population.

Utilization and perceived problems of online medical resources and search tools among different groups of European physicians.

Science.gov (United States)

Kritz, Marlene; Gschwandtner, Manfred; Stefanov, Veronika; Hanbury, Allan; Samwald, Matthias

2013-06-26

There is a large body of research suggesting that medical professionals have unmet information needs during their daily routines. To investigate which online resources and tools different groups of European physicians use to gather medical information and to identify barriers that prevent the successful retrieval of medical information from the Internet. A detailed Web-based questionnaire was sent out to approximately 15,000 physicians across Europe and disseminated through partner websites. 500 European physicians of different levels of academic qualification and medical specialization were included in the analysis. Self-reported frequency of use of different types of online resources, perceived importance of search tools, and perceived search barriers were measured. Comparisons were made across different levels of qualification (qualified physicians vs physicians in training, medical specialists without professorships vs medical professors) and specialization (general practitioners vs specialists). Most participants were Internet-savvy, came from Austria (43%, 190/440) and Switzerland (31%, 137/440), were above 50 years old (56%, 239/430), stated high levels of medical work experience, had regular patient contact and were employed in nonacademic health care settings (41%, 177/432). All groups reported frequent use of general search engines and cited "restricted accessibility to good quality information" as a dominant barrier to finding medical information on the Internet. Physicians in training reported the most frequent use of Wikipedia (56%, 31/55). Specialists were more likely than general practitioners to use medical research databases (68%, 185/274 vs 27%, 24/88; χ²₂=44.905, Presources on the Internet and frequent reliance on general search engines and social media among physicians require further attention. Possible solutions may be increased governmental support for the development and popularization of user-tailored medical search tools and open

Pediatric patients on ketogenic diet undergoing general anesthesia-a medical record review.

Science.gov (United States)

Soysal, Elif; Gries, Heike; Wray, Carter

2016-12-01

To identify guidelines for anesthesia management and determine whether general anesthesia is safe for pediatric patients on ketogenic diet (KD). Retrospective medical record review. Postoperative recovery area. All pediatric patients who underwent general anesthesia while on KD between 2009 and 2014 were reviewed. We identified 24 patients who underwent a total of 33 procedures. All children were on KD due to intractable epilepsy. The age of patients ranged from 1 to 15 years. General anesthesia for the scheduled procedures. Patients' demographics, seizure history, type of procedure; perioperative blood chemistry, medications including the anesthesia administered, and postoperative complications. Twenty-four patients underwent a total of 33 procedures. The duration of KD treatment at the time of general anesthesia ranged from 4 days to 8 years. Among the 33 procedures, 3 patients had complications that could be attributable to KD and general anesthesia. A 9-year-old patient experienced increased seizures on postoperative day 0. An 8-year-old patient with hydropcephalus developed metabolic acidosis on postoperative day 1, and a 7-year-old patient's procedure was complicated by respiratory distress and increased seizure activity in the postanesthesia care unit. This study showed that it is relatively safe for children on KD to undergo general anesthesia. The 3 complications attributable to general anesthesia were mild, and the increased seizure frequencies in 2 patients returned back to baseline in 24 hours. Although normal saline is considered more beneficial than lactated Ringer's solution in patients on KD, normal saline should also be administered carefully because of the risk of exacerbating patients' metabolic acidosis. One should be aware of the potential change of the ketogenic status due to drugs given intraoperatively. Copyright © 2016 Elsevier Inc. All rights reserved.

Structuring group medical practices: tax planning aspects.

Science.gov (United States)

Gassman, A S; Conetta, T F

1992-01-01

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

[Insufficient medication compliance in Parkinson's disease].

Science.gov (United States)

Aerts, Marjolein B; van der Eijk, Martijn; Kramers, Kees; Bloem, Bastiaan R

2011-01-01

Medication compliance is generally suboptimal, particularly in patients with complex polypharmacy. This generic treatment problem is described here for Parkinson's disease (PD). We would expect patients with PD to have good medication compliance, since missed doses immediately result in worsening of symptoms. However, recent research has revealed that PD patients demonstrate poor medication compliance. Poor medication compliance is particularly undesirable for patients with PD because regular intake of medication is required for optimal treatment effect. Possible ways of improving medication compliance are pharmacotherapeutic measures and behavioural interventions. Modern methods of communication (text message reminders) and 'smart' pill dispensers may be beneficial, but the advantages of such interventions have not yet been scientifically studied.

Case-based medical informatics

Directory of Open Access Journals (Sweden)

Arocha José F

2004-11-01

Full Text Available Abstract Background The "applied" nature distinguishes applied sciences from theoretical sciences. To emphasize this distinction, we begin with a general, meta-level overview of the scientific endeavor. We introduce the knowledge spectrum and four interconnected modalities of knowledge. In addition to the traditional differentiation between implicit and explicit knowledge we outline the concepts of general and individual knowledge. We connect general knowledge with the "frame problem," a fundamental issue of artificial intelligence, and individual knowledge with another important paradigm of artificial intelligence, case-based reasoning, a method of individual knowledge processing that aims at solving new problems based on the solutions to similar past problems. We outline the fundamental differences between Medical Informatics and theoretical sciences and propose that Medical Informatics research should advance individual knowledge processing (case-based reasoning and that natural language processing research is an important step towards this goal that may have ethical implications for patient-centered health medicine. Discussion We focus on fundamental aspects of decision-making, which connect human expertise with individual knowledge processing. We continue with a knowledge spectrum perspective on biomedical knowledge and conclude that case-based reasoning is the paradigm that can advance towards personalized healthcare and that can enable the education of patients and providers. We center the discussion on formal methods of knowledge representation around the frame problem. We propose a context-dependent view on the notion of "meaning" and advocate the need for case-based reasoning research and natural language processing. In the context of memory based knowledge processing, pattern recognition, comparison and analogy-making, we conclude that while humans seem to naturally support the case-based reasoning paradigm (memory of past experiences

Do longer consultations improve the management of psychological problems in general practice? A systematic literature review

Directory of Open Access Journals (Sweden)

Hutton Catherine

2007-05-01

Full Text Available Abstract Background Psychological problems present a huge burden of illness in our community and GPs are the main providers of care. There is evidence that longer consultations in general practice are associated with improved quality of care; but this needs to be balanced against the fact that doctor time is a limited resource and longer consultations may lead to reduced access to health care. The aim of this research was to conduct a systematic literature review to determine whether management of psychological problems in general practice is associated with an increased consultation length and to explore whether longer consultations are associated with better health outcomes for patients with psychological problems. Methods A search was conducted on Medline (Ovid databases up to7 June 2006. The following search terms, were used: general practice or primary health care (free text or family practice (MeSH AND consultation length or duration (free text or time factors (MeSH AND depression or psychological problems or depressed (free text. A similar search was done in Web of Science, Pubmed, Google Scholar, and Cochrane Library and no other papers were found. Studies were included if they contained data comparing consultation length and management or detection of psychological problems in a general practice or primary health care setting. The studies were read and categories developed to enable systematic data extraction and synthesis. Results 29 papers met the inclusion criteria. Consultations with a recorded diagnosis of a psychological problem were reported to be longer than those with no recorded psychological diagnosis. It is not clear if this is related to the extra time or the consultation style. GPs reported that time pressure is a major barrier to treating depression. There was some evidence that increased consultation length is associated with more accurate diagnosis of psychological problems. Conclusion Further research is needed to

Update on Research and Application of Problem-Based Learning in Medical Science Education

Science.gov (United States)

Fan, Chuifeng; Jiang, Biying; Shi, Xiuying; Wang, Enhua; Li, Qingchang

2018-01-01

Problem-based learning (PBL) is a unique form of pedagogy dedicated to developing students' self-learning and clinical practice skills. After several decades of development, although applications vary, PBL has been recognized all over the world and implemented by many medical schools. This review summarizes and updates the application and study of…

Multi-choice stochastic transportation problem involving general form of distributions.

Science.gov (United States)

Quddoos, Abdul; Ull Hasan, Md Gulzar; Khalid, Mohammad Masood

2014-01-01

Many authors have presented studies of multi-choice stochastic transportation problem (MCSTP) where availability and demand parameters follow a particular probability distribution (such as exponential, weibull, cauchy or extreme value). In this paper an MCSTP is considered where availability and demand parameters follow general form of distribution and a generalized equivalent deterministic model (GMCSTP) of MCSTP is obtained. It is also shown that all previous models obtained by different authors can be deduced with the help of GMCSTP. MCSTP with pareto, power function or burr-XII distributions are also considered and equivalent deterministic models are obtained. To illustrate the proposed model two numerical examples are presented and solved using LINGO 13.0 software package.

21 CFR 862.2050 - General purpose laboratory equipment labeled or promoted for a specific medical use.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false General purpose laboratory equipment labeled or... TOXICOLOGY DEVICES Clinical Laboratory Instruments § 862.2050 General purpose laboratory equipment labeled or promoted for a specific medical use. (a) Identification. General purpose laboratory equipment labeled or...

Consultation for and identification of child and adolescent psychological problems in Dutch general practice.

NARCIS (Netherlands)

Zwaanswijk, M.; Verhaak, P.F.M.; Ende, J. van der; Bensing, J.M.; Verhulst, F.C.

2005-01-01

BACKGROUND: Child and adolescent psychological problems are rarely brought to the attention of GPs. Children and adolescents with psychological problems who do visit their GP are seldom identified as such by GPs. OBJECTIVE: To investigate in a general population sample of 2,449 Dutch children and

A composite screening tool for medication reviews of outpatients: general issues with specific examples.

NARCIS (Netherlands)

Smet, P.A.G.M. de; Denneboom, W.; Kramers, C.; Grol, R.P.T.M.

2007-01-01

Regular performance of medication reviews is prominent among methods that have been advocated to reduce the extent and seriousness of drug-related problems, such as adverse drug reactions, drug-disease interactions, drug-drug interactions, drug ineffectiveness and cost ineffectiveness. Several

Experience of Problem-Based Learning in Nursing Education at Kaohsiung Medical University

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Fan-Hao Chou

2009-05-01

Full Text Available Nursing education must keep up with the rapidly changing medical landscape to support the competences of nurses in the areas of critical thinking, problem solving, and creativity. Problem-based learning (PBL provides an appropriate strategy for nursing education innovation. Nursing curricula based on PBL remain in the growing stage in Taiwan. Kaohsiung Medical University introduced PBL into nursing education in 2002. The critical events in the process included: (1 nurturing key tutors; (2 using PBL teaching methods in an elective course—Oncology Nursing, and designing a new elective course—Symposiums Regarding Clinical Cases; (3 holding conferences inside and outside the school to promote PBL teaching methods; (4 linking e-learning and PBL teaching methods; (5 conducting PBL research; (6 establishing a committee of PBL, objective structured clinical examination, and teaching material review for the College of Nursing; and (7 setting up a required course—Nursing Ethics. We now have 12 key tutors in the College of Nursing. We have also completed two studies to evaluate the ability of students and to explore the experience of tutors. From our studies, we know that PBL can increase learner abilities in self-directed learning, critical thinking, and PBL performance. The approach helps students to cope with the changing medical landscape. Furthermore, tutors and teachers develop adequate PBL teaching skills. Based on the experience above, we believe that we are on the right path in terms of continuing tutor development, gradually increasing the number of PBL courses, and undertaking further research to promote PBL methods in Taiwan.

General Medical Terminology for Vocational Rehabilitation Counselors. "A Guide for the Rehabilitation Practitioner." Final Report.

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Phelps, William R.

This training guide is prepared primarily for the Vocational Rehabilitation practitioner, although academicians may also find it of value. Sixteen specific areas are covered, including common abbreviations, prefixes and suffixes, root words, general terms, operative terminology, special senses and body systems, general medical examination, medical…

Compliance with referrals to medical specialist care: patient and general practice determinants: a cross-sectional study.

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van Dijk, Christel E; de Jong, Judith D; Verheij, Robert A; Jansen, Tessa; Korevaar, Joke C; de Bakker, Dinny H

2016-02-01

In a gatekeeper system, primary care physicians and patients jointly decide whether or not medical specialist care is needed. However, it is the patient who decides to actually use the referral. Referral non-compliance could delay diagnosis and treatment. The objective of this study was to assess patient compliance with a referral to medical specialist care and identify patient and practice characteristics that are associated with it. Observational study using data on 48,784 referrals to medical specialist care derived from electronic medical records of 58 general practices for the period 2008-2010. Referral compliance was based on claims data of medical specialist care. Logistic multilevel regression analyses were conducted to determine associations between patient and general practice characteristics and referral compliance. In 86.6% of the referrals, patients complied. Patient and not practice characteristics were significantly associated with compliance. Patients from deprived urban areas and patients aged 18-44 years were less likely to comply, whereas patients aged 65 years and older were more likely to comply. About 1 in 8 patients do not use their referral. These patients may not receive adequate care. Demographic and socio-economic factors appear to affect compliance. The results of this study may be used to make general practitioners more aware that some patients are more likely to be noncompliant with referrals.

Consumption of psychiatric drugs by patients of medical and surgical clinics in a general hospital

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Shirama,Flavio Hiroshi; Miasso,Adriana Inocenti

2013-01-01

PURPOSES: to identify the prevalence of the use of psychiatric drugs among patients admitted to medical and surgical clinics of a general hospital, and also the factors related to the consumption of this type of medication. METHOD: this is a transversal, descriptive, correlational study with quantitative analysis. For the collection of data, there was use of structured interviews and also reference to medical files. RESULTS: there was confirmation of a high prevalence of users of psy...

Learning styles, academic achievement, and mental health problems among medical students in Thailand.

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Paiboonsithiwong, Salilthip; Kunanitthaworn, Natchaya; Songtrijuck, Natchaphon; Wongpakaran, Nahathai; Wongpakaran, Tinakon

2016-01-01

This study aimed to investigate the prevalence of various learning styles among medical students and their correlations with academic achievement and mental health problems in these students. This study was conducted among 140 first-year medical students of Chiang Mai University, Thailand in 2014. The participants completed the visual-aural-read/write-kinesthetic (VARK) questionnaire, the results of which can be categorized into 4 modes, corresponding to how many of the 4 types are preferred by a respondent. The 10-item Perceived Stress Scale (PSS-10) and the 21-item Outcome Inventory (OI-21) were also used. The participants' demographic data, grade point average (GPA), and scores of all measurements are presented using simple statistics. Correlation and regression analysis were employed to analyze differences in the scores and to determine the associations among them. Sixty percent of the participants were female. The mean age was 18.86±0.74 years old. Quadmodal was found to be the most preferred VARK mode (43.6%). Unimodal, bimodal, and trimodal modes were preferred by 35%, 12.9%, and 18.6% of the participants, respectively. Among the strong unimodal learners, visual, aural, read/write, and kinesthetic preferences were reported by 4.3%, 7.1%, 11.4%, and 12.1% of participants, respectively. No difference was observed in the PSS-10, OI-anxiety, OI-depression, and OI-somatization scores according to the VARK modes, although a significant effect was found for OI-interpersonal (F=2.788, P=0.043). Moreover, neither VARK modes nor VARK types were correlated with GPA. The most preferred VARK learning style among medical students was quadmodal. Learning styles were not associated with GPA or mental health problems, except for interpersonal problems.

Learning styles, academic achievement, and mental health problems among medical students in Thailand

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Salilthip Paiboonsithiwong

2016-10-01

Full Text Available Purpose This study aimed to investigate the prevalence of various learning styles among medical students and their correlations with academic achievement and mental health problems in these students. Methods This study was conducted among 140 first-year medical students of Chiang Mai University, Thailand in 2014. The participants completed the visual-aural-read/write-kinesthetic (VARK questionnaire, the results of which can be categorized into 4 modes, corresponding to how many of the 4 types are preferred by a respondent. The 10-item Perceived Stress Scale (PSS-10 and the 21-item Outcome Inventory (OI-21 were also used. The participants’ demographic data, grade point average (GPA, and scores of all measurements are presented using simple statistics. Correlation and regression analysis were employed to analyze differences in the scores and to determine the associations among them. Results Sixty percent of the participants were female. The mean age was 18.86±0.74 years old. Quadmodal was found to be the most preferred VARK mode (43.6%. Unimodal, bimodal, and trimodal modes were preferred by 35%, 12.9%, and 18.6% of the participants, respectively. Among the strong unimodal learners, visual, aural, read/write, and kinesthetic preferences were reported by 4.3%, 7.1%, 11.4%, and 12.1% of participants, respectively. No difference was observed in the PSS-10, OI-anxiety, OI-depression, and OI-somatization scores according to the VARK modes, although a significant effect was found for OI-interpersonal (F=2.788, P=0.043. Moreover, neither VARK modes nor VARK types were correlated with GPA. Conclusion The most preferred VARK learning style among medical students was quadmodal. Learning styles were not associated with GPA or mental health problems, except for interpersonal problems.

Medicalizing versus psychologizing mental illness: what are the implications for help seeking and stigma? A general population study.

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Pattyn, E; Verhaeghe, M; Sercu, C; Bracke, P

2013-10-01

This study contrasts the medicalized conceptualization of mental illness with psychologizing mental illness and examines what the consequences are of adhering to one model versus the other for help seeking and stigma. The survey "Stigma in a Global Context-Belgian Mental Health Study" (2009) conducted face-to-face interviews among a representative sample of the general Belgian population using the vignette technique to depict schizophrenia (N = 381). Causal attributions, labeling processes, and the disease view are addressed. Help seeking refers to open-ended help-seeking suggestions (general practitioner, psychiatrist, psychologist, family, friends, and self-care options). Stigma refers to social exclusion after treatment. The data are analyzed by means of logistic and linear regression models in SPSS Statistics 19. People who adhere to the biopsychosocial (versus psychosocial) model are more likely to recommend general medical care and people who apply the disease view are more likely to recommend specialized medical care. Regarding informal help, those who prefer the biopsychosocial model are less likely to recommend consulting friends than those who adhere to the psychosocial model. Respondents who apply a medical compared to a non-medical label are less inclined to recommend self-care. As concerns treatment stigma, respondents who apply a medical instead of a non-medical label are more likely to socially exclude someone who has been in psychiatric treatment. Medicalizing mental illness involves a package deal: biopsychosocial causal attributions and applying the disease view facilitate medical treatment recommendations, while labeling seems to trigger stigmatizing attitudes.

Recruitment and retention of general practitioners in the UK: what are the problems and solutions?

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Young, R; Leese, B

1999-10-01

Recruitment and retention of general practitioners (GPs) has become an issue of major concern in recent years. However, much of the evidence is anecdotal and some commentators continue to question the scale of workforce problems. Hence, there is a need to establish a clear picture of those instabilities (i.e. imbalances between demand and supply) that do exist in the GP labour market in the UK. Based on a review of the published literature, we identify problems that stem from: (i) the changing social composition of the workforce and the fact that a large proportion of qualified GPs are significantly underutilized within traditional career structures; and (ii) the considerable differences in the ability of local areas to match labour demand and supply. We argue that one way to address these problems would be to encourage greater flexibility in a number of areas highlighted in the literature: (i) time commitment across the working day and week; (ii) long-term career paths; (iii) training and education; and (iv) remuneration and contract conditions. Overall, although the evidence suggests that the predicted 'crisis' has not yet occurred in the GP labour market as a whole, there is no room for lack of imagination in planning terms. Workforce planners continue to emphasize national changes to the medical school intake as the means to balance labour demand and supply between the specialities; however, better retention and deployment of existing GP labour would arguably produce more effective supply-side solutions. In this context, current policy and practice developments (e.g. Primary Care Groups and Primary Care Act Pilot Sites) offer a unique learning base upon which to move forward.

A descriptive study of medical educators' views of problem-based learning

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