Regional variation in medication-taking behaviour of new users of oral anti-hyperglycaemic therapy in Ireland

LENUS (Irish Health Repository)

O’Shea, M. P.

2014-05-01

Few studies have investigated regional variation in medication-taking behaviour. The purpose of this study was to investigate whether there are regional differences in non-persistence and non-adherence to oral anti-hyperglycaemic agents in patients initiating therapy and examine if any association exists between different types of comorbidity in terms of medication-taking behaviour.\\r\

Regional training course on medical response on radiological emergencies. Annex

International Nuclear Information System (INIS)

2000-01-01

This short information is an annex of the documentation distributed to the participants to the International Atomic Energy Agency (IAEA) Regional Training Course on Medical Response on Radiological Emergencies, organised by the IAEA in co-operation with the Government of Argentina thought the Nuclear Regulatory Authority, held in Buenos Aires, Argentina, 16-20 October 2000. The course was intended to people from IAEA Member State in the Latin American and Caribbean region, and to professionals and workers on medicine related with the radiation protection. This annex present information about: Radioactive materials transport; Internal and external contamination; Radiation accidents; Physical dosimetry

Diversity of United States medical students by region compared to US census data

Directory of Open Access Journals (Sweden)

Smith MM

2015-05-01

Full Text Available Mark M Smith,1 Steven H Rose,1 Darrell R Schroeder,2 Timothy R Long1 1Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, MN, USA; 2Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, Rochester, MN, USA Purpose: Increasing the diversity of the United States (US physician workforce to better represent the general population has received considerable attention. The purpose of this study was to compare medical student race data to that of the US general population. We hypothesized that race demographics of medical school matriculants would reflect that of the general population. Patients and methods: Published race data from the United States Census Bureau (USCB 2010 census and the 2011 Association of American Medical Colleges (AAMC allopathic medical school application and enrollment by race and ethnicity survey were analyzed and compared. Race data of enrolled medical students was compared to race data of the general population within geographic regions and subregions. Additionally, race data of medical school applicants and matriculants were compared to race data of the overall general population. Results: Race distribution within US medical schools was significantly different than race distribution for the overall, regional, and subregional populations of the US (P<0.001. Additionally, the overall race distribution of medical school applicants differed significantly to the race distribution of the general population (P<0.001. Conclusion: This study demonstrated that race demographics of US medical school applicants and matriculants are significantly different from that of the general population, and may be resultant of societal quandaries present early in formal education. Initiatives targeting underrepresented minorities at an early stage to enhance health care career interest and provide academic support and mentorship will be required to address the racial disparity that exists in US

iMAGE cloud: medical image processing as a service for regional healthcare in a hybrid cloud environment.

Science.gov (United States)

Liu, Li; Chen, Weiping; Nie, Min; Zhang, Fengjuan; Wang, Yu; He, Ailing; Wang, Xiaonan; Yan, Gen

2016-11-01

To handle the emergence of the regional healthcare ecosystem, physicians and surgeons in various departments and healthcare institutions must process medical images securely, conveniently, and efficiently, and must integrate them with electronic medical records (EMRs). In this manuscript, we propose a software as a service (SaaS) cloud called the iMAGE cloud. A three-layer hybrid cloud was created to provide medical image processing services in the smart city of Wuxi, China, in April 2015. In the first step, medical images and EMR data were received and integrated via the hybrid regional healthcare network. Then, traditional and advanced image processing functions were proposed and computed in a unified manner in the high-performance cloud units. Finally, the image processing results were delivered to regional users using the virtual desktop infrastructure (VDI) technology. Security infrastructure was also taken into consideration. Integrated information query and many advanced medical image processing functions-such as coronary extraction, pulmonary reconstruction, vascular extraction, intelligent detection of pulmonary nodules, image fusion, and 3D printing-were available to local physicians and surgeons in various departments and healthcare institutions. Implementation results indicate that the iMAGE cloud can provide convenient, efficient, compatible, and secure medical image processing services in regional healthcare networks. The iMAGE cloud has been proven to be valuable in applications in the regional healthcare system, and it could have a promising future in the healthcare system worldwide.

Standardization and Implementation of a Standard Emergency Code Call System within Estern Region Medical Command

Science.gov (United States)

2009-03-01

ACHs) exist the same way that Kaiser has established different levels of services within a geographical region ( Hawaii : Hilo , Kona, Honolulu, Maui...California, Hawaii , etc., the Army MHS is divided into regions. Within these regions, Army Medical Centers (MEDCENSs) and Army Community Hospitals

Medical physics aspects of cancer care in the Asia Pacific region: 2011 survey results

Science.gov (United States)

Kron, T; Azhari, HA; Voon, EO; Cheung, KY; Ravindran, P; Soejoko, D; Inamura, K; Han, Y; Ung, NM; Bold, L; Win, UM; Srivastava, R; Meyer, J; Farrukh, S; Rodriguez, L; Kuo, M; Lee, JCL; Kumara, A; Lee, CC; Krisanachinda, A; Nguyen, XC; Ng, KH

2012-01-01

Background: Medical physicists are essential members of the radiation oncology team. Given the increasing complexity of radiotherapy delivery, it is important to ensure adequate training and staffing. The aim of the present study was to update a similar survey from 2008 and assess the situation of medical physicists in the large and diverse Asia Pacific region. Methods: Between March and July 2011, a survey on profession and practice of radiation oncology medical physicists (ROMPs) in the Asia Pacific region was performed. The survey was sent to senior physicists in 22 countries. Replies were received from countries that collectively represent more than half of the world’s population. The survey questions explored five areas: education, staffing, work patterns including research and teaching, resources available, and job satisfaction. Results and discussion: Compared to a data from a similar survey conducted three years ago, the number of medical physicists in participating countries increased by 29% on average. This increase is similar to the increase in the number of linear accelerators, showing that previously identified staff shortages have yet to be substantially addressed. This is also highlighted by the fact that most ROMPs are expected to work overtime often and without adequate compensation. While job satisfaction has stayed similar compared to the previous survey, expectations for education and training have increased somewhat. This is in line with a trend towards certification of ROMPs. Conclusion: As organisations such as the International Labour Organization (ILO) start to recognise medical physics as a profession, it is evident that despite some encouraging signs there is still a lot of work required towards establishing an adequately trained and resourced medical physics workforce in the Asia Pacific region. PMID:22970066

The truth lies somewhere in the middle: Swinging between globalization and regionalization of medical education in Japan.

Science.gov (United States)

Saiki, Takuya; Imafuku, Rintaro; Suzuki, Yasuyuki; Ban, Nobutaro

2017-10-01

Japan is well known as a super-aging society, with a low birth rate, and has been ranked as one of the countries having the highest quality of healthcare system. Japan's society is currently approaching a major turning point with regard to societal and healthcare reforms, which are influenced by international trends and regional needs. Development of Japanese healthcare human resources, including medical students, is now expected to ride the wave of globalization, while resolving regional problems in the training and delivery of healthcare. Terms and global trends in medical education, such as outcome-based education, community-based education, reflective learning, international accreditation of medical education, and professionalization of educators are well translated into the Japanese language and embraced positively among the Japanese medical educators. However, these trends occasionally sit uncomfortably with cultural variations that are often a common approach in Japan; notably, "hansei" (introspection) and "kaizen" (change for the better). In the world facing a new era where people are unsettled between globalism and regionalism, Japan's future mission is to steer a balanced route that recognizes both global and regional influences and produce global health professionals educators.

Medical schools can cooperate: a new joint venture to provide medical education in the Northern Rivers region of New South Wales.

Science.gov (United States)

Page, Sue L; Birden, Hudson H; Hudson, J Nicky; Thistlethwaite, Jill E; Roberts, Chris; Wilson, Ian; Bushnell, John; Hogg, John; Freedman, S Ben; Yeomans, Neville

2008-02-04

The medical schools at the University of Western Sydney, University of Wollongong and University of Sydney have developed a joint program for training medical students through placements of up to 40 weeks on the New South Wales North Coast. The new partnership agency - the North Coast Medical Education Collaboration - builds on the experience of regional doctors and their academic partners. A steering committee has identified the availability and support requirements of local practitioners to provide training, and has undertaken a comparative mapping of learning objectives and assessments from the courses of the three universities. The goals of the program include preparing doctors who can perform effectively in rural settings and multidisciplinary health care teams, and to advance research in medical education.

Corrigendum to: It's more than money: policy options to secure medical specialist workforce for regional centres.

Science.gov (United States)

May, Jennifer; Walker, Judi; McGrail, Mathew; Rolley, Fran

2017-12-01

Objectives Regional centres and their rural hinterlands support significant populations of non-metropolitan Australians. Despite their importance in the settlement hierarchy and the key medical services provided from these centres, little research has focused on their issues of workforce supply and long-term service requirements. In addition, they are a critical component of the recent growth of 'regional' hub-and-spoke specialist models of service delivery. Methods The present study interviewed 62 resident specialists in four regional centres, seeking to explore recruitment and retention factors important to their location decision making. The findings were used to develop a framework of possible evidence-informed policies. Results This article identifies key professional, social and locational factors, several of which are modifiable and amenable to policy redesign, including work variety, workplace culture, sense of community and spousal employment; these factors that can be targeted through initiatives in selection, training and incentives. Conclusions Commonwealth, state and local governments in collaboration with communities and specialist colleges can work synergistically, with a multiplicity of interdigitating strategies, to ensure a positive approach to the maintenance of a critical mass of long-term rural specialists. What is known about the topic? Rural origin increases likelihood of long-term retention to rural locations, with rural clinical school training associated with increased rural intent. Recruitment and retention policy has been directed at general practitioners in rural communities, with little focus on regional centres or medical specialists. What does this study add? Rural origin is associated with regional centre recruitment. Professional, social and locational factors are all moderately important in both recruitment and retention. Specialist medical training for regional centres ideally requires both generalist and subspecialist skills

New Region-Scalable Discriminant and Fitting Energy Functional for Driving Geometric Active Contours in Medical Image Segmentation

Directory of Open Access Journals (Sweden)

Xuchu Wang

2014-01-01

that uses region-scalable discriminant and fitting energy functional for handling the intensity inhomogeneity and weak boundary problems in medical image segmentation. The region-scalable discriminant and fitting energy functional is defined to capture the image intensity characteristics in local and global regions for driving the evolution of active contour. The discriminant term in the model aims at separating background and foreground in scalable regions while the fitting term tends to fit the intensity in these regions. This model is then transformed into a variational level set formulation with a level set regularization term for accurate computation. The new model utilizes intensity information in the local and global regions as much as possible; so it not only handles better intensity inhomogeneity, but also allows more robustness to noise and more flexible initialization in comparison to the original global region and regional-scalable based models. Experimental results for synthetic and real medical image segmentation show the advantages of the proposed method in terms of accuracy and robustness.

An insight into the emerging role of regional medical advisor in the pharmaceutical industry

Directory of Open Access Journals (Sweden)

Sandeep Kumar Gupta

2013-01-01

Full Text Available The position of regional medical advisor (RMA is relatively new in the pharmaceutical industry and its roles and responsibility are still evolving. The RMA is a field based position whose main mission is to foster collaborative relationships with the key opinion leaders (KOLs and to facilitate the exchange of unbiased scientific information between the medical community and the company. Field-based medical liaison teams are expanding world-wide as part of the pharmaceutical industry′s increased focus on global operations including emerging markets. Now, the position of the RMA has evolved into comprehensive, complex, highly interactive, targeted, highly strategic, innovative, and independent role since its inception by the Upjohn Company in 1967. The major objective of the RMA is to develop the professional relationships with the health-care community, particularly KOLs, through peer-to-peer contact. The RMA can facilitate investigator-initiated clinical research proposals from approval until completion, presentation, and publication. It is possible for a RMA to have valuable access to KOLs through his expertise in the clinical research. The RMA can assist in the development, review, and follow-up of the clinical studies initiated within the relevant therapeutic area at the regional/local level. The RMA can lead regional/local clinical projects to ensure that all clinical trials are conducted in compliance with the International Conference of Harmonisation Good Clinical Practice (ICH GCP guidelines.

Decreasing medication turnaround time with digital scanning technology in a canadian health region.

Science.gov (United States)

Neville, Heather; Nodwell, Lisa; Alsharif, Sahar

2014-11-01

Reducing medication turnaround time can improve efficiency, patient safety, and quality of care in the hospital setting. Digital scanning technology (DST) can be used to electronically transmit scanned prescriber orders to a pharmacy computer queue for verification and processing, which may help to improve medication turnaround time. To evaluate medication turnaround time before and after implementation of DST for all medications and for antibiotics only. Medication turnaround times were evaluated retrospectively for periods before (June 6-10, 2011) and after (September 26-30, 2011) implementation of DST at 2 hospital sites in 1 health region. Medication turnaround time was defined as the time from composition of a medication order by the prescriber to its verification by the pharmacy (phase 1) and the time from prescriber composition to administration to the patient by a nurse (total). Median turnaround times were analyzed with SPSS software using the Mann-Whitney U test. In total, 304 and 244 medication orders were audited before and after DST implementation, respectively. Median phase 1 turnaround time for all medications declined significantly, from 2 h 23 min before DST implementation to 1 h 33 min after DST implementation (p < 0.001). Antibiotics were also processed significantly faster (1 h 51 min versus 1 h 9 min, p = 0.015). However, total turnaround time for all medications did not differ significantly (5 h 15 min versus 5 h 0 min, p = 0.42). Implementation of DST was associated with a 50-min decrease in medication turnaround time for the period from when an order was prescribed to the time it was processed by the pharmacy. Regular evaluation of medication turnaround times is recommended to compare with benchmarks, to ensure that hospital standards are being met, and to measure the effects of policy changes and implementation of new technology on medication-use processes.

Caffeine Consumption among Medical Interns and Association with GPA in Makkah Region

Directory of Open Access Journals (Sweden)

Alsharif Mohammed H

2016-12-01

Full Text Available The Vagarious amount of caffeine may become harmful in frequent use, it increased among medical interns in Makkah region. The caffeine becomes a daily routine for medical interns without attention for their side harmful effect. The purpose of our study was to evaluate the educational level of awareness of the harmful effect of caffeine consumption. This was a cross-sectional study from August to October 2016. A total number 437 of participants with GPA groups, Group I (GPA 1.5-2, Group II (GPA 2.1- 3 and Group III (GPA 3.1- 3.5. The higher percentages were the group II and female consumed caffeine frequently more than male.

Ministry of Health and regional health agency measures for medical imaging

International Nuclear Information System (INIS)

Podeur, Annie

2011-01-01

The issues in imaging are the appropriate use of equipment and optimising the organisation of imaging facilities, through a pooling of medical resources. The Ministry responsible for health has confirmed its desire to increase the number of MRI devices in order to better address patient needs in compliance with best practices, especially in dealing with strokes and cancers. The primary need is to reinforce radiation protection, essentially with regard to children. The steps taken are designed to speed up the replacement of irradiating techniques. According to the SROS-PRS (regional health care organisation scheme - regional health care project), the ARS (regional health agencies) are required to mobilize all resources in order to meet the national objectives for improving access to imaging and reducing disparities in access and efficiency. It is up to the ARS to define the territorial distribution of supply, with appropriate gradation of imaging facilities, in particular to ensure a permanent supply of care. (author)

Regional coordination in medical emergencies and major incidents; plan, execute and teach

Directory of Open Access Journals (Sweden)

Hedelin Annika

2009-07-01

Full Text Available Abstract Background Although disasters and major incidents are difficult to predict, the results can be mitigated through planning, training and coordinated management of available resources. Following a fire in a disco in Gothenburg, causing 63 deaths and over 200 casualties, a medical disaster response centre was created. The center was given the task to coordinate risk assessments, disaster planning and training of staff within the region and on an executive level, to be the point of contact (POC with authority to act as "gold control," i.e. to take immediate strategic command over all medical resources within the region if needed. The aim of this study was to find out if the centre had achieved its tasks by analyzing its activities. Methods All details concerning alerts of the regional POC was entered a web-based log by the duty officer. The data registered in this database was analyzed during a 3-year period. Results There was an increase in number of alerts between 2006 and 2008, which resulted in 6293 activities including risk assessments and 4473 contacts with major institutions or key persons to coordinate or initiate actions. Eighty five percent of the missions were completed within 24 h. Twenty eight exercises were performed of which 4 lasted more than 24 h. The centre also offered 145 courses in disaster and emergency medicine and crisis communication. Conclusion The data presented in this study indicates that the center had achieved its primary tasks. Such regional organization with executive, planning, teaching and training responsibilities offers possibilities for planning, teaching and training disaster medicine by giving immediate feed-back based on real incidents.

Positive implications from socially accountable, community-engaged medical education across two Philippines regions.

Science.gov (United States)

Woolley, Torres; Cristobal, Fortunato; Siega-Sur, Jusie; Ross, Simone; Neusy, Andre-Jacques; Halili, Servando; Reeve, Carole

2018-02-01

Hundreds of millions of people worldwide lack access to quality health services, largely because of geographic and socioeconomic maldistribution of qualified practitioners. This study describes differences between the practice locations of Philippines medical graduates from two 'socially accountable, community-engaged' health professional education (SAHPE) schools and the practice locations of graduates from two 'conventionally trained' medical schools located in the same respective geographic regions. Licensed medical graduates were currently practising in the Philippines and had been practising for at least 6 months. Graduates were from two Philippines SAHPE schools (Ateneo de Zamboanga University-School of Medicine (ADZU-SOM) on the Zamboanga Peninsula (n=212) and the University of the Philippines Manila-School of Health Sciences (SHS-Palo) in Eastern Visayas (n=71), and from two 'conventional' medical schools Methods: Current graduate practice locations in municipalities or cities were linked with their respective population size and socioeconomic income class, and geocoded using Geographical Information System software onto a geospatial map of the Philippines. Bivariate analysis compared the population size and socioeconomic class of communities where the SAHPE medical graduates practised to communities where 'conventional' medical school graduates practised. Thirty-one percent of ADZU-SOM medical graduates practised in communities play a significant role in graduates choosing to practice in rural and/or economically disadvantaged communities. Governments experiencing medical workforce maldistributions similar to those in the Philippines should consider SAHPE as a potentially cost-effective strategy in recruiting and retaining health graduates to underserved areas.

The impact of work-related stress on medication errors in Eastern Region Saudi Arabia.

Science.gov (United States)

Salam, Abdul; Segal, David M; Abu-Helalah, Munir Ahmad; Gutierrez, Mary Lou; Joosub, Imran; Ahmed, Wasim; Bibi, Rubina; Clarke, Elizabeth; Qarni, Ali Ahmed Al

2018-05-07

To examine the relationship between overall level and source-specific work-related stressors on medication errors rate. A cross-sectional study examined the relationship between overall levels of stress, 25 source-specific work-related stressors and medication error rate based on documented incident reports in Saudi Arabia (SA) hospital, using secondary databases. King Abdulaziz Hospital in Al-Ahsa, Eastern Region, SA. Two hundred and sixty-nine healthcare professionals (HCPs). The odds ratio (OR) and corresponding 95% confidence interval (CI) for HCPs documented incident report medication errors and self-reported sources of Job Stress Survey. Multiple logistic regression analysis identified source-specific work-related stress as significantly associated with HCPs who made at least one medication error per month (P stress were two times more likely to make at least one medication error per month than non-stressed HCPs (OR: 1.95, P = 0.081). This is the first study to use documented incident reports for medication errors rather than self-report to evaluate the level of stress-related medication errors in SA HCPs. Job demands, such as social stressors (home life disruption, difficulties with colleagues), time pressures, structural determinants (compulsory night/weekend call duties) and higher income, were significantly associated with medication errors whereas overall stress revealed a 2-fold higher trend.

Quality of Liver and Kidney Function Tests among Public Medical Laboratories in Western Region of Amhara National Regional State of Ethiopia.

Science.gov (United States)

Teka, Abaynesh; Kibatu, Girma

2012-03-01

Medical laboratories play essential roles in measurements of substances in body fluids for the purpose of diagnosis, treatment, prevention, and for greater understanding of the disease process. Thus, data generated from have to be reliable for which strict quality control, management and assurance are maintained. The aim of this study is to assess the accuracy and precision of clinical chemistry laboratories in western region of Amhara national regional state of Ethiopia in testing liver and kidney functions. Eight laboratories in hospitals and a Regional Health Research Laboratory Center participated in this study from February to March, 2011. Each participant was requested to measure six specimens for six chemistry tests from two control samples. Three hundred twenty four test results to be reported from all participant laboratories, if all measurements can be made, were designed to be collected and statistically evaluated. None of the study subject laboratories could deliver all the six tests for estimation of both liver and renal functions simultaneously during the study period. Only 213 values from the expected 324 values were reported and about 65 % of the 213 values reported fell outside of the allowable limits of errors for the chemistry tests of the control specimen used. This study finding showed that there were lack of accuracy and precision in chemistry measurements. A regular survey on medical laboratories should be conducted questioning the accuracy and precision of their analyses in order to sustain improvements in the quality of services provided by participating laboratories for the benefit of patients. Laboratory Quality Management Systems appreciate the need for regular quality control and quality assessment schemes in medical laboratories.

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

Science.gov (United States)

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

2008-10-15

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

Impact of a regional distributed medical education program on an underserved community: perceptions of community leaders.

Science.gov (United States)

Toomey, Patricia; Lovato, Chris Y; Hanlon, Neil; Poole, Gary; Bates, Joanna

2013-06-01

To describe community leaders' perceptions regarding the impact of a fully distributed undergraduate medical education program on a small, medically underserved host community. The authors conducted semistructured interviews in 2007 with 23 community leaders representing, collectively, the education, health, economic, media, and political sectors. They reinterviewed six participants from a pilot study (2005) and recruited new participants using purposeful and snowball sampling. The authors employed analytic induction to organize content thematically, using the sectors as a framework, and they used open coding to identify new themes. The authors reanalyzed transcripts to identify program outcomes (e.g., increased research capacity) and construct a list of quantifiable indicators (e.g., number of grants and publications). Participants reported their perspectives on the current and anticipated impact of the program on education, health services, the economy, media, and politics. Perceptions of impact were overwhelmingly positive (e.g., increased physician recruitment), though some were negative (e.g., strains on health resources). The authors identified new outcomes and confirmed outcomes described in 2005. They identified 16 quantifiable indicators of impact, which they judged to be plausible and measureable. Participants perceive that the regional undergraduate medical education program in their community has broad, local impacts. Findings suggest that early observed outcomes have been maintained and may be expanding. Results may be applicable to medical education programs with distributed or regional sites in similar rural, remote, and/or underserved regions. The areas of impact, outcomes, and quantifiable indicators identified will be of interest to future researchers and evaluators.

[Regional analysis of drug treatment prevalence and medication of diabetes mellitus in Germany].

Science.gov (United States)

Willert, T; Walker, J; Schramm, W

2012-11-01

Diabetes mellitus is a widespread chronic disease. Diabetes prevalence was already analyzed in multiple complex studies. The goal of this analysis was the determination of the regional drug treatment prevalence and medication of diabetes mellitus in Germany. Simultaneously, we examined and validated the applicability of prescription data of the German statutory health insurance (SHI) as the basis for reliable and comparable prevalence estimations. For the analysis, we used anonymized data from a prescription database as well as the member statistics of the German federal Ministry of Health. By using defined prescription profiles with anti-diabetic medication, we determined the diabetic patients and treatment schemes per Association of SHI Physicians. Subsequently, we calculated and described the drug treatment prevalence and medication. A differentiation between type 1 and type 2 diabetes was not possible. The total prevalence of drug-treated patients in Germany was 7.77%. The regional values ranged from 6.40% in Schleswig-Holstein until 11.37% in Saxony-Anhalt. The highest numbers of drug treatment prevalence were found in the East of Germany. Insulin treatment was frequent in Hamburg, but rare in Bavaria. Insulin combined with oral anti-diabetic medication was mainly dispensed in Saxony-Anhalt and Brandenburg, least in Hamburg. A treatment with one or more oral anti-diabetics was most common in Bavaria and Bremen, lowest in Rhineland-Palatinate and Mecklenburg-West Pomerania. We developed an easy to use evaluation algorithm for prescription data to estimate the drug treatment prevalence of a chronic disease. The estimated prevalence confirms the increasing trend reported from other studies and appears to be plausible in comparison. More research is required to validate and enhance the method. © Georg Thieme Verlag KG Stuttgart · New York.

Smartphone and medical related App use among medical students and junior doctors in the United Kingdom (UK: a regional survey

Directory of Open Access Journals (Sweden)

Payne Karl Frederick

2012-10-01

Full Text Available Abstract Background Smartphone usage has spread to many settings including that of healthcare with numerous potential and realised benefits. The ability to download custom-built software applications (apps has created a new wealth of clinical resources available to healthcare staff, providing evidence-based decisional tools to reduce medical errors. Previous literature has examined how smartphones can be utilised by both medical student and doctor populations, to enhance educational and workplace activities, with the potential to improve overall patient care. However, this literature has not examined smartphone acceptance and patterns of medical app usage within the student and junior doctor populations. Methods An online survey of medical student and foundation level junior doctor cohorts was undertaken within one United Kingdom healthcare region. Participants were asked whether they owned a Smartphone and if they used apps on their Smartphones to support their education and practice activities. Frequency of use and type of app used was also investigated. Open response questions explored participants’ views on apps that were desired or recommended and the characteristics of apps that were useful. Results 257 medical students and 131 junior doctors responded, equating to a response rate of 15.0% and 21.8% respectively. 79.0% (n=203/257 of medical students and 74.8% (n=98/131 of junior doctors owned a smartphone, with 56.6% (n=115/203 of students and 68.4% (n=67/98 of doctors owning an iPhone. The majority of students and doctors owned 1–5 medical related applications, with very few owning more than 10, and iPhone owners significantly more likely to own apps (Chi sq, p Conclusions This study found a high level of smartphone ownership and usage among medical students and junior doctors. Both groups endorse the development of more apps to support their education and clinical practice.

A quasi-experimental design based on regional variations: discussion of a method for evaluating outcomes of medical practice

DEFF Research Database (Denmark)

Loft, A; Andersen, T F; Madsen, Mette

1989-01-01

A large proportion of common medical practices are subject to substantial regional variation resulting in numerous natural experiments. Opportunities are thereby provided for outcome evaluation through quasi-experimental design. If patients treated in different regions were comparable a natural...... experiment involving alternative treatments could be regarded as 'pseudo randomised', but empirical investigations are needed to verify this prerequisite. This paper discusses the role of quasi-experimental designs in assessment of medical care with evaluation of outcomes after hysterectomy in Denmark...... groups are elicited from administrative data. We conclude that it is possible to establish a quasi-experimental design based on regional variations and that the comparability of the groups included may be assessed through registry data. The importance of technology diffusion for the prospects...

Implementing a Swedish regionalized medical program supported by digital technologies: possibilities and challenges from a management perspective.

Science.gov (United States)

Pettersson, Fanny L M

2013-01-01

In 2011, Umeå University in Sweden was facing its first attempt to transform the existing medical program into a regionalized medical program (RMP), supported by the use of digital technologies. The Swedish RMP means that students are distributed in geographically separated groups while doing their five clinical clerkship semesters. To provide medical students with ways of undertaking their theoretical studies when geographically distributed, digital technologies are used for educational and administrative purposes. In this article, the Swedish RMP will be described and related to previous international research on educating medical students in rural settings. The aim of this article was, from a management perspective, to understand if and how contradictions arise during the implementation process of the Swedish RMP, supported by digital technologies. Based on this analysis, a further aim was to discuss, from a management perspective, the possibilities and challenges for improvement of this medical educational practice, as well as to provide implications for other similar changes in medical programs internationally. To identify possible contradictions during the implementation process, ethnographically inspired observations were made during management work meetings, before and during the first regionalized semester. In addition, in-depth follow-up interviews were held in May and June 2011 with six management executives of the Swedish RMP, concerning their expectations and experiences of the implementation process. The qualitative and activity theory (AT)-inspired analysis resulted in the emergence of two main themes and seven sub-themes. The analysis suggests that a number of contradictions arose during the implementation process of the Swedish RMP. For instance, a contradiction constituted as a conflict between the university management and some teachers concerning how digital technologies and technology enhanced learning (TEL) could and should be used when

Regional Master on Medical Physics

International Nuclear Information System (INIS)

Gutt, F.

2001-01-01

It points out: the master project; the master objective; the medical physicist profile and tasks; the requirements to be a master student; the master programmatic contents and the investigation priorities [es

[The expert characteristic of the forensic medical documentation for the purpose of investigations of the injuries to the maxillofacial region].

Science.gov (United States)

Popov, V L; Yagmurov, M O; Troshin, E L

2018-01-01

The injuries to the maxillofacial region (MFR) are among the most frequently occurring problems encountered if the forensic medical practice. The objective of the present study was the analysis of the quality of the medical record documentation of the victims of the injuries to the maxillofacial region for obtaining the information necessary for forensic medical experts to make the well-founded conclusions. We undertook the in-depth analysis of random samples from the materials stored in the archive of living subjects at the Saint-Petersburg Bureau of forensic medical expertise for the period from 2010 to 2014. The results of a total of 438 forensic medical examinations were available for the analysis. The study has demonstrated the generally low forensic medical value of the expert conclusions that frequently fail to conform to the requirements of the departmental instructions on the description of MFR injuries. In all the cases, neurologists and radiologists were counselled. The results of analysis of the drawbacks of forensic medical examinations give evidence that they originate first and foremost from subjective circumstances which opens up the promising prospects for the improvement of expertise quality based on the enhancement of the professional responsibility of the forensic medical experts.

Active Contour Driven by Local Region Statistics and Maximum A Posteriori Probability for Medical Image Segmentation

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Xiaoliang Jiang

2014-01-01

Full Text Available This paper presents a novel active contour model in a variational level set formulation for simultaneous segmentation and bias field estimation of medical images. An energy function is formulated based on improved Kullback-Leibler distance (KLD with likelihood ratio. According to the additive model of images with intensity inhomogeneity, we characterize the statistics of image intensities belonging to each different object in local regions as Gaussian distributions with different means and variances. Then, we use the Gaussian distribution with bias field as a local region descriptor in level set formulation for segmentation and bias field correction of the images with inhomogeneous intensities. Therefore, image segmentation and bias field estimation are simultaneously achieved by minimizing the level set formulation. Experimental results demonstrate desirable performance of the proposed method for different medical images with weak boundaries and noise.

Iraqi health system in kurdistan region: medical professionals' perspectives on challenges and priorities for improvement.

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Shabila, Nazar P; Al-Tawil, Namir G; Tahir, Rebaz; Shwani, Falah H; Saleh, Abubakir M; Al-Hadithi, Tariq S

2010-11-30

The views of medical professionals on efficiency of health system and needs for any changes are very critical and constitute a cornerstone for any health system improvement. This is particularly relevant to Iraqi Kurdistan case as the events of the last few decades have significantly devastated the national Iraqi health system while the necessity for adopting a new health care system is increasingly recognized since 2004. This study aims to examine the regional health system in Iraqi Kurdistan from medical professionals' perspectives and try to define its problems and priorities for improvement. A survey questionnaire was developed and administered to a convenience sample of 250 medical professionals in Erbil governorate. The questionnaire included four items; rating of the quality of services and availability of resources in the health institutions, view on different aspects of the health system, the perceived priority needs for health system improvement and gender and professional characteristics of the respondents. The response rate to the survey was 83.6%. A high proportion of respondents rated the different aspects of services and resources in the health institutions as weak or very weak including the availability of the required quantity and quality of medicines (68.7%), the availability of sufficient medical equipment and investigation tools (68.7%), and the quality of offered services (65.3%). Around 72% of respondents had a rather negative view on the overall health system. The weak role of medical research, the weak role of professional associations in controlling the system and the inefficient health education were identified as important problems in the current health system (87.9%, 87.1% and 84.9%, respectively). The priority needs of health system improvement included adoption of social insurance for medical care of the poor (82%), enhancing the role of family medicine (77.2%), adopting health insurance system (76.1%) and periodic scientific

Job stress and burnout in hospital employees: comparisons of different medical professions in a regional hospital in Taiwan

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Chou, Li-Ping; Li, Chung-Yi; Hu, Susan C

2014-01-01

Objectives To explore the prevalence and associated factors of burnout among five different medical professions in a regional teaching hospital. Design Cross-sectional study. Setting Hospital-based survey. Participants A total of 1329 medical professionals were recruited in a regional hospital with a response rate of 89%. These voluntary participants included 101 physicians, 68 physician assistants, 570 nurses, 216 medical technicians and 374 administrative staff. Primary and secondary outcome measures Demographic data included gender, age, level of education and marital status, and work situations, such as position, work hours and work shifts, were obtained from an electronic questionnaire. Job strain and burnout were measured by two validated questionnaires, the Chinese version of the Job Content Questionnaire and the Copenhagen Burnout Inventory. Results Among the five medical professions, the prevalence of high work-related burnout from highest to lowest was nurses (66%), physician assistants (61.8%), physicians (38.6%), administrative staff (36.1%) and medical technicians (31.9%), respectively. Hierarchical regression analysis indicated that job strain, overcommitment and low social support explained the most variance (32.6%) of burnout. Conclusions Physician assistant is an emerging high burnout group; its severity is similar to that of nurses and far more than that of physicians, administrative staff and medical technicians. These findings may contribute to the development of feasible strategies to reduce the stress which results in the burnout currently plaguing most hospitals in Taiwan. PMID:24568961

Implementing telehealth to support medical practice in rural/remote regions: what are the conditions for success?

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Gagnon, Marie-Pierre; Duplantie, Julie; Fortin, Jean-Paul; Landry, Réjean

2006-08-24

Telehealth, as other information and communication technologies (ICTs) introduced to support the delivery of health care services, is considered as a means to answer many of the imperatives currently challenging health care systems. In Canada, many telehealth projects are taking place, mostly targeting rural, remote or isolated populations. So far, various telehealth applications have been implemented and have shown promising outcomes. However, telehealth utilisation remains limited in many settings, despite increased availability of technology and telecommunication infrastructure. A qualitative field study was conducted in four remote regions of Quebec (Canada) to explore perceptions of physicians and managers regarding the impact of telehealth on clinical practice and the organisation of health care services, as well as the conditions for improving telehealth implementation. A total of 54 respondents were interviewed either individually or in small groups. Content analysis of interviews was performed and identified several effects of telehealth on remote medical practice as well as key conditions to ensure the success of telehealth implementation. According to physicians and managers, telehealth benefits include better access to specialised services in remote regions, improved continuity of care, and increased availability of information. Telehealth also improves physicians' practice by facilitating continuing medical education, contacts with peers, and access to a second opinion. At the hospital and health region levels, telehealth has the potential to support the development of regional reference centres, favour retention of local expertise, and save costs. Conditions for successful implementation of telehealth networks include the participation of clinicians in decision-making, the availability of dedicated human and material resources, and a planned diffusion strategy. Interviews with physicians and managers also highlighted the importance of considering

Implementing telehealth to support medical practice in rural/remote regions: what are the conditions for success?

Directory of Open Access Journals (Sweden)

Duplantie Julie

2006-08-01

Full Text Available Abstract Background Telehealth, as other information and communication technologies (ICTs introduced to support the delivery of health care services, is considered as a means to answer many of the imperatives currently challenging health care systems. In Canada, many telehealth projects are taking place, mostly targeting rural, remote or isolated populations. So far, various telehealth applications have been implemented and have shown promising outcomes. However, telehealth utilisation remains limited in many settings, despite increased availability of technology and telecommunication infrastructure. Methods A qualitative field study was conducted in four remote regions of Quebec (Canada to explore perceptions of physicians and managers regarding the impact of telehealth on clinical practice and the organisation of health care services, as well as the conditions for improving telehealth implementation. A total of 54 respondents were interviewed either individually or in small groups. Content analysis of interviews was performed and identified several effects of telehealth on remote medical practice as well as key conditions to ensure the success of telehealth implementation. Results According to physicians and managers, telehealth benefits include better access to specialised services in remote regions, improved continuity of care, and increased availability of information. Telehealth also improves physicians' practice by facilitating continuing medical education, contacts with peers, and access to a second opinion. At the hospital and health region levels, telehealth has the potential to support the development of regional reference centres, favour retention of local expertise, and save costs. Conditions for successful implementation of telehealth networks include the participation of clinicians in decision-making, the availability of dedicated human and material resources, and a planned diffusion strategy. Interviews with physicians and

Nonattendance to medical specialists’ appointments and its relation to regional environmental and socioeconomic indicators in the Chilean public health system

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Elizabeth Angélica Salinas Rebolledo

2014-10-01

Full Text Available INTRODUCTION Medical care provided by medical specialists is one of the scarcest resources in the public system. It is costly and difficult to access for the general population. Availability and accessibility of specialized care is related to economic, social and cultural aspects that vary among geographical areas. An aggravating factor for this situation is patients’ failure to appear on the date of their appointment, which is defined as the nonattendance of patients to medical specialist appointments without notice. OBJECTIVES To measure and analyze the phenomenon of nonattendance of patients to medical appointments with specialists in the public healthcare system of Chile and its relationship with environmental and socioeconomic regional indicators. METHODS Ecological design study, using medical care records in the public system and environmental and socioeconomic regional indicators potentially related to the absence of patients, between the years 2005-2010. Poisson regression models with random components were used for assessing associations. RESULTS There is 16.5% of nonattendance of patients, with a range between regions from 8.8 to 20.2%. Nonattendance is higher in the specialties of dermatology, geriatrics and nutrition (20.0%, in children (3.1% more than in adults, in areas with highest indigenous population (RR=1.3, in areas with low diversity of specialties (RR=1.1 and in the months of February, July, November and December (RR>1.1. CONCLUSIONS In Chile, socioeconomic factors and the management of healthcare resources have greater influence on the nonattendance of patients to medical specialists’ appointments than environmental factors; therefore, this phenomenon may be avoidable.

[The regional cooperation of medical services and a nutritional support team].

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Maruyama, Michio

2006-12-01

"Community NST" is a new concept, which means a cooperation system with the hospital NST and a regional medical service. "Community NST" provides home nutritional care for the patients with nutritional problems. The function of the hospital NST for inpatients has been established in recent years. Now the patients need a continuous nutritional care not only in the hospital but at home. Percutaneous endoscopic gastrostomy (PEG) has been performed on the base of cooperation with the hospital and home care. This PEG system is one of the functions of "Community NST". The author showed several measures of "Community NST", which have been tried in the hospital.

Semiquantitative regional cerebral blood flow evaluation by the sup 123 I-IMP SPECT before and during medication of bifemelane hydrochloride in patients with cerebrovascular diseases

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Tsuda, Yoshiyasu; Ayada, Yoshihide; Kitadai, Masaya; Tanabe, Masatada; Matsuo, Hirohide (Kagawa Medical School, Miki (Japan))

1992-04-01

Regional cerebral blood flow (rCBF) by {sup 123}I-IMP SPECT was measured before and 2.8, 10.3 months during medication of bifemelane hydrochloride in 10 patients with cerebrovascular diseases and compared with 5 control patients without medication. Semiquantitative rCBF indices of asymmetry and redistribution (AI, RI) were calculated from mean regional counts/pixel of each region of interest (ROI) in the early and delayed images of IMP SPECT. Before medication, no significant differences of RI and AI were observed between patients with and without medication of bifemelane hydrochloride. Significantly higher RI was observed in the second measurement 2.8 months in mean during medication of bifemelane hydrochloride, while AI was less in patients medicated with bifemelane hydrochloride. In the third measurement 10.3 months in mean during medication of bifemelane hydrochloride, RI was kept to be higher than that in the second measurement of the control patients without medication. The ratio of the number of ROI, where the redistribution being observed, was significantly higher in patients medicated than in control patients. From the results, medication of bifemelane hydrochloride might keep the redistribution phenomenon, which may indicate reversible cerebral ischemia, more persistently and intensively in patients with cerebrovascular diseases. (author).

A Study on Strategic Planning and Procurement of Medicals in Uganda's Regional Referral Hospitals.

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Masembe, Ishak Kamaradi

2016-12-31

This study was an analysis of the effect of strategic planning on procurement of medicals in Uganda's regional referral hospitals (RRH's). Medicals were defined as essential medicines, medical devices and medical equipment. The Ministry of Health (MOH) has been carrying out strategic planning for the last 15 years via the Health Sector Strategic Plans. Their assumption was that strategic planning would translate to strategic procurement and consequently, availability of medicals in the RRH's. However, despite the existence of these plans, there have been many complaints about expired drugs and shortages in RRH's. For this purpose, a third variable was important because it served the role of mediation. A questionnaire was used to obtain information on perceptions of 206 respondents who were selected using simple random sampling. 8 key informant interviews were held, 2 in each RRH. 4 Focus Group Discussions were held, 1 for each RRH, and between 5 and 8 staff took part as discussants for approximately three hours. The findings suggested that strategic planning was affected by funding to approximately 34% while the relationship between funding and procurement was 35%. The direct relationship between strategic planning and procurement was 18%. However when the total causal effect was computed it turned out that strategic planning and the related variable of funding contributed 77% to procurement of medicals under the current hierarchical model where MOH is charged with development of strategic plans for the entire health sector. Since even with this contribution there were complaints, the study proposed a new model called CALF which according to a simulation, if adopted by MOH, strategic planning would contribute 87% to effectiveness in procurement of medicals.

Exploring the effects of telehealth on medical human resources supply: a qualitative case study in remote regions

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Duplantie Julie

2007-01-01

Full Text Available Abstract Background The availability of medical human resource supply is a growing concern for rural and remote communities in many countries. In the last decade, various telehealth experiences in Canada have highlighted the potential impact of this technology on professional practice. The purpose of this study was to explore physicians' and managers' perceptions regarding the potential of telehealth to support recruitment and retention of physicians in remote and rural regions. Methods A case study in Eastern Quebec was performed to explore this complex phenomenon. The analytical framework was based on two literature reviews and a Delphi study. Data were collected from semi-structured interviews with 41 physicians and 22 managers. Transcripts were produced and interview content was coded independently by two judges and validated by an expert panel. Results Interviews have highlighted the potential impact of telehealth on several factors influencing the recruitment and retention of physicians in rural and remote regions. The potential effects of telehealth on physicians' choice of practice location could be seen at the professional, organizational, educational and individual levels. For instance, telehealth could improve work satisfaction by allowing a regional on-call duty system and a better follow-up of patients. However, there are also certain limits related to telehealth, such as the fear that it would eventually replace all continuing medical education activities and onsite specialists in remoteregions. Conclusion Telehealth is likely to have an impact on several factors related to medical workforce supply in remote and rural regions. However, the expected benefits will materialize if and only if this technology is properly integrated into organizations as a support to professional practice.

[Supply and demand of medical specialists in the health facilities of the Ministry of Health: national, regional and by type of specialty gaps].

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Zevallos, Leslie; Pastor, Reyna; Moscoso, Betsy

2011-06-01

To characterize the supply, demand and the gap of medical specialists in facilities of the Ministry of Health of Peru (MINSA) at the national, regional and specialty type levels. Observational, descriptive study through which we calculated the supply of medical specialists using secondary sources of MINSA. The analysis of the demand for medical specialists was based on two methodologies: the need for specialists according to the guidelines of classification of the health facilities and according to the epidemiological and demographic profile. The arithmetic difference between the estimated demand and the supply was the procedure used to calculate the gap of medical specialists. The Ministry of Health has a total supply at the national level of 6,074 medical specialists of which 61.5% belong to the clinical specialties, 33.2% to the surgical specialties, 4.9% specialities related to aid to diagnosis and treatment and 0.4% to public health specialties. According to the categorization guideline there is a total demand of 11,176 medical specialists and according to the epidemiological and demographic profile of 11,738. The national estimated gaps found are similar in both methods, although they differ widely across regions and by type of specialty. At the regional level, the gaps are greater in Loreto, Piura, Puno and Madre de Dios when estimating the defficit in relation to the supply. Regarding the speciality, the gap is greater in the four basic specialties: gynecology and obstetrics, pediatrics, internal medicine and general surgery. There is a waid gap between supply and demand of medical specialists at the national and regional levels, as a whole representing approximately 45% of the current offer, regardless of the estimation method.

Demonstrating the use of high-volume electronic medical claims data to monitor local and regional influenza activity in the US.

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Cécile Viboud

Full Text Available Fine-grained influenza surveillance data are lacking in the US, hampering our ability to monitor disease spread at a local scale. Here we evaluate the performances of high-volume electronic medical claims data to assess local and regional influenza activity.We used electronic medical claims data compiled by IMS Health in 480 US locations to create weekly regional influenza-like-illness (ILI time series during 2003-2010. IMS Health captured 62% of US outpatient visits in 2009. We studied the performances of IMS-ILI indicators against reference influenza surveillance datasets, including CDC-ILI outpatient and laboratory-confirmed influenza data. We estimated correlation in weekly incidences, peak timing and seasonal intensity across datasets, stratified by 10 regions and four age groups (<5, 5-29, 30-59, and 60+ years. To test IMS-Health performances at the city level, we compared IMS-ILI indicators to syndromic surveillance data for New York City. We also used control data on laboratory-confirmed Respiratory Syncytial Virus (RSV activity to test the specificity of IMS-ILI for influenza surveillance.Regional IMS-ILI indicators were highly synchronous with CDC's reference influenza surveillance data (Pearson correlation coefficients rho≥0.89; range across regions, 0.80-0.97, P<0.001. Seasonal intensity estimates were weakly correlated across datasets in all age data (rho≤0.52, moderately correlated among adults (rho≥0.64 and uncorrelated among school-age children. IMS-ILI indicators were more correlated with reference influenza data than control RSV indicators (rho = 0.93 with influenza v. rho = 0.33 with RSV, P<0.05. City-level IMS-ILI indicators were highly consistent with reference syndromic data (rho≥0.86.Medical claims-based ILI indicators accurately capture weekly fluctuations in influenza activity in all US regions during inter-pandemic and pandemic seasons, and can be broken down by age groups and fine geographical areas

Utilization of a Marketing Strategy at Naval Regional Medical Center Great Lakes, Great Lakes, Illinois

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1983-06-01

22 Analysis of the Mare.....................22 Development of the Marketing Mix .. .......... 29 A Marketing Mix --Recommendations...problem. Marketing strategy, marketing mix and ultimately the marketing orientation will allow hospitals to persevere and possibly thrive in a somewhat...market are currently being met at Naval Regional Medical Center Great Lakes. The fourth objective is to demonstrate an appropriate marketing mix for

HEALTH & FINANCE

African Journals Online (AJOL)

HEALTH & FINANCE. Patrick Thokwa Masobe. Patrick Thokwa Masobe completed his undergraduate studies at Grinnel/. University in the USA, and a Master. Degreefrom the University of London in. 1995. He is wrrently employed by the national Department of Health, where he led the task team charged with making.

Positive impacts on rural and regional workforce from the first seven cohorts of James Cook University medical graduates.

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Sen Gupta, T; Woolley, T; Murray, R; Hays, R; McCloskey, T

2014-01-01

The regionally-based James Cook University (JCU) School of Medicine aims to meet its mission to address the health needs of the region by combining selection and curriculum strategies shown to increase rural career recruitment outcomes. The School has graduated 536 students in its first seven cohorts from 2005 to 2011. This paper presents the early career practice locations and the specialty training undertaken by these cohorts, and describes the association between later practice location with both hometown at application and internship location. Hometown at application' data for JCU Bachelor of Medicine, Bachelor of Surgery (MBBS) graduates was retrieved from administrative databases held by the university, while postgraduate location and career data were obtained either from personal contact via email, telephone, Facebook or electronically from the Australian Health Practitioner Regulation Authority website. Practice location was described across Australian Standard Geographical Classification Remoteness Area (RA) categories. Data for the primary practice location of 536 JCU MBBS graduates across postgraduate years (PGY) 1 to 7 is 99% complete. A total of 65% of JCU graduates undertook their internship in non-metropolitan locations including 20% in RA 2 and 44% in RA 3-5, a pattern of practice different to that of other Australian clinicians. For the internship year, 'non-metropolitan-origin' JCU MBBS graduates predominantly worked in RA 2-5 locations, while 'metropolitan origin' graduates were more likely to work in major cities. However, by PGY 7, the distribution of 'rural' and 'metropolitan' origin JCU graduates across RA categories was similar. The RA category of internship location - either 'metropolitan (RA 1) or 'non-metropolitan' (RA 2-5) - was associated with the location of subsequent practice across PGY 2-7. This comprehensive data set provides the first real evidence from one of Australia's new medical schools on actual postgraduate practice

Social Adversity and Regional Differences in Prescribing of ADHD Medication for School-Age Children

DEFF Research Database (Denmark)

Kildemoes, Helle Wallach; Skovgaard, Anne Mette; Thielen, Karsten

2015-01-01

Objectives: To explore whether regional variations in the initiation of attention-deficit hyperactivity disorder (ADHD) medication among school-age children are explained by differences in sociodemographic composition and/or ADHD prescribing practice, especially in children who face social...... adversity (low parental education and single parenthood). Methods: A cohort of Danish school-age children (ages 5–17) without previous psychiatric conditions (N = 813,416) was followed during 2010–2011 for incident ADHD prescribing in the individual-level Danish registers. Register information was retrieved...... for both children and their parents. Regional differences were decomposed into contributions from differences in sociodemographic composition and in prescribing practices. Incidence rate ratios (IRR) with 95% confidence interval (CI) of ADHD prescribing were calculated using demographically standardized...

Chronic disease, medications and lifestyle: perceptions from a regional Victorian Aboriginal community

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Deacon-Crouch M

2016-09-01

Full Text Available Background: Poor medication management may contribute to the increased morbidity and mortality of Aboriginal people in Australia. Yet while there is extensive literature about the perceptions of healthcare providers on this issue, there is limited information on the perceptions of Aboriginal people themselves. Objectives: To investigate the perceptions of a group of Aboriginal people attending a Victorian regional Aboriginal Health Service (AHS with diagnosed medical conditions requiring medications, of their lifestyle, disease management and medication usage. Methods: Data was collected through one to one in depth interviews using a semi-structured ‘yarning’ process. Twenty patients were invited to participate in the study and were interviewed by Aboriginal Health Workers in a culturally appropriate manner. The interviews were recorded and transcribed verbatim. The data were analysed using descriptive statistics. Results: Our results show that the majority of participants perceived that changes in lifestyle factors such as diet, exercise, and smoking cessation would help improve their health. Most patients reported having been counselled on their medicines, and while the majority reported adherence and acknowledgement of the efficacy of their medicines, there was a lack of clarity regarding long term maintenance on regimens. Finally, while the majority reported taking over the counter products, some did not see the need to inform their doctor about this, or chose not to. Conclusion: Chronic illness was perceived as common in families and community. Patients relied mostly on their health care professionals as sources for their drug information. Patients may have benefited from further counselling in the area of complementary and other over the counter medicines, as well as on the necessity of maintenance of regimes for chronic disease management. Finally, lifestyle changes such as dietary improvements and smoking cessation were identified as

A Study on Strategic Planning and Procurement of Medicals in Uganda’s Regional Referral Hospitals

Science.gov (United States)

2016-01-01

This study was an analysis of the effect of strategic planning on procurement of medicals in Uganda’s regional referral hospitals (RRH’s). Medicals were defined as essential medicines, medical devices and medical equipment. The Ministry of Health (MOH) has been carrying out strategic planning for the last 15 years via the Health Sector Strategic Plans. Their assumption was that strategic planning would translate to strategic procurement and consequently, availability of medicals in the RRH’s. However, despite the existence of these plans, there have been many complaints about expired drugs and shortages in RRH’s. For this purpose, a third variable was important because it served the role of mediation. A questionnaire was used to obtain information on perceptions of 206 respondents who were selected using simple random sampling. 8 key informant interviews were held, 2 in each RRH. 4 Focus Group Discussions were held, 1 for each RRH, and between 5 and 8 staff took part as discussants for approximately three hours. The findings suggested that strategic planning was affected by funding to approximately 34% while the relationship between funding and procurement was 35%. The direct relationship between strategic planning and procurement was 18%. However when the total causal effect was computed it turned out that strategic planning and the related variable of funding contributed 77% to procurement of medicals under the current hierarchical model where MOH is charged with development of strategic plans for the entire health sector. Since even with this contribution there were complaints, the study proposed a new model called CALF which according to a simulation, if adopted by MOH, strategic planning would contribute 87% to effectiveness in procurement of medicals. PMID:28299158

[(Inter)national and regional health goals in academic social-medical education conception for teaching medical students at the Eberhard Karls University Tuebingen].

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Simoes, E; Hildenbrand, S; Rieger, M A

2012-07-01

Social medicine deals with the specific interactions between medicine and society within a constantly changing social environment. The Institute of Occupational and Social Medicine, University Hospital Tuebingen, focuses on this relationship within the academic teaching of the Medical Faculty. Many of the issues thus directly affect the national health objectives and especially the health targets of the state of Baden-Württemberg, summarised in the Health Strategy Baden-Wuerttemberg. In addition to the recommendations of the German Society for Social Medicine and Prevention (DGSMP) for the social medicine curriculum and the specific definition of the content by the Tuebingen medical faculty, national and regional health-care goals are also taken into account in the teaching conception. Classes are increasingly offered as training courses in small groups (seminars, group work with practical training), instead of classic lectures. These teaching methods allow the students to take part more actively in social medicine issues and to think and act within a comprehensive understanding of health management based on societal goals and the needs of a good health system. The concept is supported by the curriculum design element "log-book skills" of the Medical Faculty of Tuebingen. Feedback elements for teachers and students shape the further development of the concept. In dealing with real system data, practical experience on site and case vignettes, the students experience the links between societal influences, political objectives and medical action as well as the importance of accessibility of medical services for equity in health chances. The fact that advice and expertise play a crucial role in accessibility is a component to which too little attention is paid and calls for emphasis in the teaching concept. This teaching approach will deepen the understanding of the influence of psychosocial context factors and the conditions of the structural framework on the medical

Asthma medication prescribing before, during and after pregnancy: a study in seven European regions.

Science.gov (United States)

Charlton, Rachel A; Pierini, Anna; Klungsøyr, Kari; Neville, Amanda J; Jordan, Susan; de Jong-van den Berg, Lolkje T W; Thayer, Daniel; Bos, H Jens; Puccini, Aurora; Hansen, Anne V; Gini, Rosa; Engeland, Anders; Nybo Andersen, Anne-Marie; Dolk, Helen; Garne, Ester

2016-01-19

To explore utilisation patterns of asthma medication before, during and after pregnancy as recorded in seven European population-based databases. A descriptive drug utilisation study. 7 electronic healthcare databases in Denmark, Norway, the Netherlands, Italy (Emilia Romagna and Tuscany), Wales, and the Clinical Practice Research Datalink representing the rest of the UK. All women with a pregnancy ending in a delivery that started and ended between 2004 and 2010, who had been present in the database for the year before, throughout and the year following pregnancy. The percentage of deliveries where the woman received an asthma medicine prescription, based on prescriptions issued (UK) or dispensed (non-UK), during the year before, throughout or during the year following pregnancy. Asthma medicine prescribing patterns were described for 3-month time periods and the choice of asthma medicine and changes in prescribing over the study period were evaluated in each database. In total, 1,165,435 deliveries were identified. The prevalence of asthma medication prescribing during pregnancy was highest in the UK and Wales databases (9.4% (CI95 9.3% to 9.6%) and 9.4% (CI95 9.1% to 9.6%), respectively) and lowest in the Norwegian database (3.7% (CI95 3.7% to 3.8%)). In the year before pregnancy, the prevalence of asthma medication prescribing remained constant in all regions. Prescribing levels peaked during the second trimester of pregnancy and were at their lowest during the 3-month period following delivery. A decline was observed, in all regions except the UK, in the prescribing of long-acting β-2-agonists during pregnancy. During the 7-year study period, there were only small changes in prescribing patterns. Differences were found in the prevalence of prescribing of asthma medications during and surrounding pregnancy in Europe. Inhaled β-2 agonists and inhaled corticosteroids were, however, the most popular therapeutic regimens in all databases. Published by the BMJ

A Cultural Resource Inventory of Portions of Lake Oahe, Corson County, South Dakota. Volume 1.

Science.gov (United States)

1987-07-01

Dakota Twilight. Exposition Press, Hicksville, New York. Moran, S. R., M. Arndt, J. P. Bluemle, M. Camara, L. Clayton, M. M. Fenton , K. L. Harris, H. C...89 35 116 89 *Piscellaneous, a - smoking material. b - gum, c - sap. d - ceremonial or play. a - cosmetic . References: 6 - Gilmore 1919. 6 - Grinnell

77 FR 63874 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

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2012-10-17

..., Color Rochester, NY April 11, 2011. Paper Testing Lab. 81,517 Lane Furniture Industries, Tupelo, MS... Motivation, Inc. 81,540A Rock Creek Athletics, Inc., Grinnell, IA April 24, 2011. 727 6th Avenue West, Neff Motivation, Inc. The following certifications have been issued. The requirements of Section 222(c) (supplier...

Unregulated usage of labour-inducing medication in a region of Pakistan with poor drug regulatory control: characteristics and risk patterns.

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Shah, Safieh; Van den Bergh, Rafael; Prinsloo, Jeanne Rene; Rehman, Gulalai; Bibi, Amna; Shaeen, Neelam; Auat, Rosa; Daudi, Sabina Mutindi; Njenga, Joyce Wanjiru; Khilji, Tahir Bashir-Ud-Din; Maïkéré, Jacob; De Plecker, Eva; Caluwaerts, Séverine; Zachariah, Rony; Van Overloop, Catherine

2016-03-01

In developing countries such as Pakistan, poor training of mid-level cadres of health providers, combined with unregulated availability of labour-inducing medication can carry considerable risk for mother and child during labour. Here, we describe the exposure to labour-inducing medication and its possible risks in a vulnerable population in a conflict-affected region of Pakistan. A retrospective cohort study using programme data, compared the outcomes of obstetric risk groups of women treated with unregulated oxytocin, with those of women with regulated treatment. Of the 6379 women included in the study, 607 (9.5%) received labour-inducing medication prior to reaching the hospital; of these, 528 (87.0%) received unregulated medication. Out of 528 labour-inducing medication administrators, 197 (37.3%) traditional birth attendants (also known as dai) and 157 (29.7%) lady health workers provided unregulated treatment most frequently. Women given unregulated medication who were diagnosed with obstructed/prolonged labour were at risk for uterine rupture (RR 4.1, 95% CI: 1.7-9.9) and severe birth asphyxia (RR 3.9, 95% CI: 2.5-6.1), and those with antepartum haemorrhage were at risk for stillbirth (RR 1.8, 95% CI: 1.0-3.1). In a conflict-affected region of Pakistan, exposure to unregulated treatment with labour-inducing medication is common, and carries great risk for mother and child. Tighter regulatory control of labour-inducing drugs is needed, and enhanced training of the mid-level cadres of healthcare workers is required. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

[The regional model of three-level system of of medical social monitoring of children and adolescents: the pilot project in the Republic of Tatarstan].

Science.gov (United States)

Al'bitskii, V Iu; Ustinova, N V; Farrakhov, A Z; Shavaliev, R F; Kulikov O V; Plaksina, L V

2014-01-01

The absence of system of medical social monitoring of children being in difficult life situations is one of main causes of preventable losses of health and life of children and adolescents. The plan of activities of the working group No3 under the Coordination council under the President of the Russian Federation of the national strategy realization of actions in interest of children for 2012-2017 includes a point: "The development and implementation of standard model of medical social monitoring of children and adolescents in the subjects of the Russian Federation". The implementation of this task is assigned to the Department of social pediatrics of The research center of children health of Moscow and the Ministry of Health of the Republic of Tatarstan. The research methods included analysis and generalization of advanced experience of medical social monitoring of children population; expertise technique; modeling. The regional model of three-level system of medical social monitoring of children population is developed and implemented. The model includes level I (consulting rooms of medical social care of children polyclinics, feldsher obstetric stations, first-aid centers), level II--inter-municipal (departments of medical social monitoring in central district hospitals, medical institutions, clinical diagnostic centers) and level III--regional (the Republican center of medical social monitoring of children and adolescents). The immediate tasks necessary for effective functioning of system of medical social monitoring were determined. Within the framework of implementation of the pilot project the legal and normative legislative acts were developed to regulate functioning of regional model of three-level system of medical social care. The other documents necessary for effective functioning of this system were elaborated. The practical significance of this system is in the implementation of effective three-level model of medical social monitoring of children and

Medical e-commerce for regional Australia.

Science.gov (United States)

Kumar, D K; Mikelaitis, P

2001-12-01

The residents of rural and regional Australia have less access to health care services than in capital cities. There is a reluctance of General Practitioners to practice in the country. New information technology and government initiatives are now addressing this problem. High bandwidth videoconferencing is now being routinely used to provide psychiatric consultations to areas without this service. But this (like many other implementations of telecommunication technologies to health) has resulted in loss of revenue to regional Australia while benefiting capital cities. Thus, the current implementation of telecommunication technology to health has resulted in loss of revenue of the regions while increasing the bias towards the cities. Further, the system is not economically viable and requires the Government to inject funds for the smooth operation of the system. This paper proposes the use of telecommunication technology for enabling the communities of regional Australia to access health facilities via physical and virtual clinics. The proposed technique is self supporting and is based in the country with the intent to prevent the drain of resources from regional Australia. The technique attempts to eradicate the problem at the root level by providing a business opportunity that is based in and to cater for the needs of the remote communities. The proposed system would provide health services by physical and virtual clinics and while serving the communities would be profit centres- and thus attracting doctors and other resources to the remote communities.

[How to make regional medicine revive from the medical crisis or collapse due to the severe paucity of medical doctors: a plan with "the magnet hospital"].

Science.gov (United States)

Itoh, Tsunetoshi

2009-01-01

In 2002-2003, the practice of doctors lending their names to appear as "staff" of hospitals became known. Problems regarding funds from public hospitals were also revealed. Tohoku University asked regional societies how to improve the medical situation, and redefined its responsibilities. The Educational Development Center for Local Medicine and Department of Local Medical Service System were set up (2005-2008). A severe shortage of medical doctors prevails in Japan: the number of doctors per population is at the 4th lowest among OECD countries, and the number per hospital bed is the lowest. We have no nursing homes whose beds are not counted as hospital beds. The number of faculty staff in Japanese medical schools is 1/3 to those of Western countries. The reported number of doctors working in hospitals and offices surpasses that by census for medical doctors by >40,000. Japanese doctors work for >60 hours per week. I propose essential plans to improve Japanese situation for medical service: 1. Immediately increase the number of doctors by at least 50%. Based on our calculation, we need 450,000 doctors. 2. When the shortage of doctors is severe, establish a magnet hospital with c.a. 500 beds for every 200,000 population, capable of treating highly emergency patients and attracting doctors who need medical training. Hospitals should not belong to each city or town. 3. Establish a comprehensive organization to nurture doctors on a long-term basis. It should consist of a medical school, hospitals, and the prefectural government. It should help doctors to move between hospitals, and be responsible both for designing doctors' career paths and for allocating them appropriately.

A Lab-Based, Lecture-Free General Physics Course

Science.gov (United States)

Schneider, Mark B.

1997-04-01

The past four years have seen the development of a discovery style, lecture-free, lab-based General Physics course at Grinnell College. Similar in spirit to Priscilla Laws' Workshop Physics (P. Laws, Physics Today, Dec. 1991, p. 24.), this course is a calculus- based, two-semester sequence, which is offered in parallel with more conventional lecture sections, allowing students choice of pedagogical styles. This new course is taught without a text, allowing a somewhat atypical ordering of topics and the early inclusion of a modern introduction to quantum and statistical mechanics. A complete set of laboratory materials was developed at Grinnell for this course, with activities considerably different in most cases than Laws' activities. A quick overview of the pedagogical style and topics covered will be given, and then several specific activities will be described in greater detail. The course has been shown to be a popular and viable alternative to the more conventional sections for majors and non-majors; ongoing efforts to assess the course will be described, especially those that make comparisons between this course and more conventional sections.

Medical tourism.

Science.gov (United States)

Leggat, Peter

2015-01-01

Medical tourism is a burgeoning industry in our region. It involves patients travelling outside of their home country for medical treatment. This article provides an outline of the current research around medical tourism, especially its impact on Australians. Patients are increasingly seeking a variety of medical treatments abroad, particularly those involving cosmetic surgery and dental treatment, often in countries in South-East Asia. Adverse events may occur during medical treatment abroad, which raises medico-legal and insurance issues, as well as concerns regarding follow-up of patients. General practitioners need to be prepared to offer advice, including travel health advice, to patients seeking medical treatment abroad.

A Study to Develop the Optimal Military Inter-Institutional Patient Referral Systems Model for DoD (Department of Defense) Military Medical Region III

Science.gov (United States)

1988-05-01

I rerr syttemn an do wlon t P ontimal military inter-instittiuonal patient referral systems model for DOD Military Medical Region III. A convenience...Dactin- on the Armed Services Medical Regulating Office and Patient Airlift "lc rcsusl.s of :his study indicated that the single largest breakdown...and the requirement to regulate to the closest medical facility with capability to care for the patient . L! / I Ii I i A STUDY TO DEVELOP THE OPTIMAL

Public Use of Mobile Medical Applications: A Case Study on Cloud-Based Medical Service of Taiwan.

Science.gov (United States)

Lu, Chen-Luan; Yan, Yu-Hua

2016-01-01

The use of smart mobile devices has been getting increasingly popular. The focus of this study is an attempt to explore the development of mobile medical App by medical centers and regional hospitals of Taiwan and the function of the App for comparison. The results show indicated that many hospitals developed Apps for the public for mobile medical service, of which 26 medical centers (100%) and 72 regional hospitals (84.7%) availed appointment making service via Apps. The result indicated variance at significant level (p < 0.01). There are 23 medical centers (88.5%) and 74 regional hospitals (87.1%) availed Apps for checking service progress. The result indicated insignificant variance level (p > 0.01). We can see that mobile medical service is gradually emerging as a vital issue. Yet, this is a new domain in medical service. With the mushrooming of medical applications in smart mobile devices, the medical service system is expected to be installed in these devices to enhance interactive mode of operation and inquiry services, such as medication and inquiries into physical examination results. By then, people can learn the status of their health with this system.

Fulltext PDF

Indian Academy of Sciences (India)

After nearly a year of organic chemistry lecture and lab, this mini-project pulls together many skills your instructors have been trying to teach: how to think, write, and apply organic reactions. We have been doing this mini-synthesis project for two years at Grinnell College with success, and many students say this it is the best ...

Regionalizing healthcare: a vision for transforming Lebanon into a regional academic hub

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Akl Elie A

2010-06-01

Full Text Available Abstract Background Lebanon suffers from a large scale emigration of physicians coupled with an oversaturation of the physician job market. Lebanon is currently witnessing an expansion of its medical education capacity with the establishment of new private medical schools, raising the fears of a worsening market oversaturation. Discussion The neighboring Arabian Gulf countries are suffering from a serious shortage of clinicians and academicians. In spite of their enormous investments in educational, clinical and research collaborative initiatives with some of the most renowned North American medical schools and institutions, their ability to recruit and retain highly qualified clinicians and academicians remains a major challenge. Lebanese universities have the opportunity to establish triangular collaborations with the Gulf regional medical centers and their North American partners. They could achieve this goal by tapping into the globalized and high quality Lebanese physician workforce and consequently regionalize healthcare delivery in the Middle East. Summary By recruiting its globalized and high quality physician workforce to establish collaborations with the Gulf regional, Lebanon could become a regional "academic hub".

Regionalizing healthcare: a vision for transforming Lebanon into a regional academic hub.

Science.gov (United States)

Badr, Kamal F; Akl, Elie A

2010-06-16

Lebanon suffers from a large scale emigration of physicians coupled with an oversaturation of the physician job market. Lebanon is currently witnessing an expansion of its medical education capacity with the establishment of new private medical schools, raising the fears of a worsening market oversaturation. The neighboring Arabian Gulf countries are suffering from a serious shortage of clinicians and academicians. In spite of their enormous investments in educational, clinical and research collaborative initiatives with some of the most renowned North American medical schools and institutions, their ability to recruit and retain highly qualified clinicians and academicians remains a major challenge. Lebanese universities have the opportunity to establish triangular collaborations with the Gulf regional medical centers and their North American partners. They could achieve this goal by tapping into the globalized and high quality Lebanese physician workforce and consequently regionalize healthcare delivery in the Middle East. By recruiting its globalized and high quality physician workforce to establish collaborations with the Gulf regional, Lebanon could become a regional "academic hub".

World medical schools: The sum also rises.

Science.gov (United States)

Rigby, Perry G; Gururaja, Ramnarayan P

2017-06-01

There is a worldwide shortage of doctors, which is true in most countries and on most continents. To enumerate the number of medical schools in the world at two different times, showing the trends and relating this to population is a beginning. The number is actually going up and has done so for some time; this has increased the supply of physicians and broadened healthcare delivery. The number to count for geographic and regional information about the medical schools relates directly to the supply of doctors. Regions were chosen from WHO and Foundation for the Advancement of International Medical Education and Research data to illustrate geographic distributions, physicians per patient and kinetics. The number of medical schools has consistently been rising around the world. However, world order is reverting to disorder, considering wars, disease and beleaguered stand-offs. None. Eight countries contain 40% of medical schools; however, several locations are rising faster than the rest. Some regions are stable, but sub-Saharan Africa, the Caribbean, South Asia and South America have increased the most in percentage recently, but not uniformly. Medical schools are related not only by geography, political boundaries and population but are concentrated in some regions. Graduate Medical Education positions appear to be short on a worldwide basis, as well as in some regions and countries. The number of medical schools is increasing worldwide and the identification of rapidly rising geographic areas is useful in exploring, planning and comparing regions. Controversy continues in a variety of locations, especially concerning Graduate Medical Education. In addition to funding, faculty candidates and accreditation, new schools are confronting a variety of choices in standards and quality, sizing and regional concerns.

Using Tools of Strategic Management in Medical Facilities of Lublin Region

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Jaworzynska Magdalena

2017-06-01

Full Text Available The purpose of this article is to evaluate the use of tools of strategic management in hospitals in Lublin region. The study was conducted among 14 medical entities from the area of Lublin Voivodeship. The survey was addressed to economic directors or chief accountants of health care facilities and sent by post. The questionnaire was also helpful in conducting an in-depth interview as it provided a required structure. As part of the interviews with managers of health care facilities, information beyond the questionnaire was acquired, e.g. about the mission. According to studies, most health care facilities develop strategic plans (71.4%. For 21.4% of the studied facilities, the strategic plan is known mainly to management. In contrast, 28.6% of entities do not have a strategic plan. The presented results of the research can increase the effectiveness of activities in each area of the health care facility, continuous process improvement and rapid response to changes in the environment.

The use of shared medication record as part of medication reconciliation at hospital admission is feasible

DEFF Research Database (Denmark)

Munck, Lars K; Hansen, Karina R; Mølbak, Anne Grethe

2014-01-01

INTRODUCTION: Medication reconciliation improves congruence in cross sectional patient courses. Our regional electronic medical record (EMR) integrates the shared medication record (SMR) which provides full access to current medication and medication prescriptions for all citizens in Denmark. We...

Selection and construction of nuclear and radiation emergency medical center in a region

International Nuclear Information System (INIS)

Wang Guojun; He Xu; Liao Li; Gao Dong

2014-01-01

Three level of first-class comprehensive hospital is an important force of nuclear and radiation accident rescue, has a very rich experience in response to nuclear and radiation accidents and deal with large quantities of the sick and wounded. With the foundation and the ability of the construction and operation of medical emergency rescue center. This paper according to the median model location theory of emergency center, combined with the specific situation of the nuclear and radiation accident in Hunan Province, reference location, rescue experience, emergency allocation of resources, teaching and research capacity, establish regional medical emergency center of nuclear and radiation accidents based on three level of first-class comprehensive hospital, break the traditional concept that the center must be provincial capital,form a multi-level, three-dimensional, network of emergency hospital rescue system. The main duties of the center are accident emergency response, on-site treatment and technical guidance of accident, psychological grooming. The author propose building measures according to the duties of the center: increase national and provincial financial investment, carry out training, drills and first aid knowledge missionaries regularly, innovative materials management, speed up the construction of information platform, establish and improve the hospital rescue system, improve organization institution and system of plans, reengineering rescue process. (authors)

More than medical tourism: lessons from Indonesia and Malaysia on South–South intra-regional medical travel

NARCIS (Netherlands)

Ormond, M.E.; Sulianti, D.

2017-01-01

While scholars increasingly acknowledge that most contemporary international medical travel comprises South–South flows, these have gone curiously unexamined. Rather, policy, scholarly and media attention focuses predominantly on North–South flows of ‘medical tourists’. However, this focus diverts

Medical Image Tamper Detection Based on Passive Image Authentication.

Science.gov (United States)

Ulutas, Guzin; Ustubioglu, Arda; Ustubioglu, Beste; V Nabiyev, Vasif; Ulutas, Mustafa

2017-12-01

Telemedicine has gained popularity in recent years. Medical images can be transferred over the Internet to enable the telediagnosis between medical staffs and to make the patient's history accessible to medical staff from anywhere. Therefore, integrity protection of the medical image is a serious concern due to the broadcast nature of the Internet. Some watermarking techniques are proposed to control the integrity of medical images. However, they require embedding of extra information (watermark) into image before transmission. It decreases visual quality of the medical image and can cause false diagnosis. The proposed method uses passive image authentication mechanism to detect the tampered regions on medical images. Structural texture information is obtained from the medical image by using local binary pattern rotation invariant (LBPROT) to make the keypoint extraction techniques more successful. Keypoints on the texture image are obtained with scale invariant feature transform (SIFT). Tampered regions are detected by the method by matching the keypoints. The method improves the keypoint-based passive image authentication mechanism (they do not detect tampering when the smooth region is used for covering an object) by using LBPROT before keypoint extraction because smooth regions also have texture information. Experimental results show that the method detects tampered regions on the medical images even if the forged image has undergone some attacks (Gaussian blurring/additive white Gaussian noise) or the forged regions are scaled/rotated before pasting.

Domestic Travel and Regional Migration for Parathyroid Surgery Among Patients Receiving Care at Academic Medical Centers in the United States, 2012-2014.

Science.gov (United States)

Hinson, Andrew M; Hohmann, Samuel F; Stack, Brendan C

2016-07-01

To improve outcomes after parathyroidectomy, several organizations advocate for selective referral of patients to high-volume academic medical centers with dedicated endocrine surgery programs. The major factors that influence whether patients travel away from their local community and support system for perceived better care remain elusive. To assess how race/ethnicity and insurance status influence domestic travel patterns and selection of high- vs low-volume hospitals in different regions of the United States for parathyroid surgery. A retrospective study was conducted of 36 750 inpatients and outpatients discharged after undergoing parathyroidectomy identified in the University HealthSystem Consortium database from January 1, 2012, to December 31, 2014 (12 quarters total). Each US region (Northeast, Mid-Atlantic, Great Lakes, Central Plains, Southeast, Gulf Coast, and West) contained 20 or more low-volume hospitals (1-49 cases annually), 5 or more mid-volume hospitals (50-99 cases annually), and multiple high-volume hospitals (≥100 cases annually). Domestic medical travelers were defined as patients who underwent parathyroidectomy at a hospital in a different US region from which they resided and traveled more than 150 miles to the hospital. Distance traveled, regional destination, and relative use of high- vs low-volume hospitals. A total of 23 268 of the 36 750 patients (63.3%) had parathyroidectomy performed at high-volume hospitals. The mean (SD) age of the study cohort was 71.5 (16.2) years (95% CI, 71.4-71.7 years). The female to male ratio was 3:1. Throughout the study period, mean (SD) distance traveled was directly proportional to hospital volume (high-volume hospitals, 208.4 [455.1] miles; medium-volume hospitals, 50.5 [168.4] miles; low-volume hospitals, 27.7 [89.5] miles; P < .001). From 2012 to 2014, the annual volume of domestic medical travelers increased by 15.0% (from 961 to 1105), while overall volume increased by 4.9% (from 11�

The Influence of Quality Assurance and Supportive Supervision on the Quality of Medical Care in Children’s Hospitals of the Municipal Level of the Rostov Region

Directory of Open Access Journals (Sweden)

Tatiana V. Kulichenko

2017-01-01

Full Text Available Background. Improving the quality of medical care is the absolute priority of the World Health Organization and all socially-oriented ministries and departments around the world.Objective. Our aim was to evaluate the effectiveness of quality  assurance and supportive supervision in municipal hospitals to improve the quality of medical care for children (by the example of the Rostov region.Methods. The open observational study included 10 second-level hospitals in the Rostov Region. At the start of the project, the quality of inpatient care for children in the region was audited based on recommendations and tools of the World Health Organization, and training of medical personnel was organized. Monitoring visits to hospitals were carried out by experts every 3 months (supportive supervision. Reaudit of the quality of care was conducted a year later.Results. As a result of regular quality assurance and supportive supervision of hospitals during the first year of operation, such indicators of the quality of medical care as the availability of medical equipment for emergency care for children, the infrastructure of children’s departments, the triage and provision of emergency care in children’s departments, managing patients with various acute conditions (fever, diarrhea, respiratory diseases, supporting care, internal quality assurance, accessibility to standards of care and clinical guidelines for the diagnosis and treatment of various diseases, respect for children’s rights were significantly (p < 0.05 improved.Conclusion. Supportive supervision and regular external quality assurances of hospitals contribute to a rapid increase in the quality of medical care for children.

Factors influencing medical students' choice of future specialization in medical sciences: a cross-sectional questionnaire survey from medical schools in china, malaysia and regions of South asian association for regional cooperation.

Science.gov (United States)

Kumar, Arun; Mitra, Kasturi; Nagarajan, Sangeetha; Poudel, Bibek

2014-03-01

In future, increase in the number of healthcare professionals is dependent on the career interest among present undergraduate medical students. Based on their interest to pursue their specialty, the availability of medical doctors in each specialty could be done. This study was to find out future career interest and factors that influence undergraduate medical students to choose their future specialization. The study was carried out among first-year medical students from five countries. The students were asked to complete an 8-item questionnaire. Two thousand one hundred fifty three participants were enrolled in the study. Data were analyzed in Microsoft-Excel and Statistical Package for the Social Sciences. Of the 2153 participants, only 1470 responded. Among the 1470 participants, 169 participants were excluded due to the ambiguity in responses, finally making it to 1301participants. Among them, Anatomy (49.3%) followed by Biochemistry (26.7%) and Physiology (24%) were the most preferred subjects. Anatomy was the most preferred basic science subject among the other subjects and the students were interested to pursuing surgery in future. Furthermore, the most preferred future specialties were surgery, internal medicine and pediatrics with gender variations; males preferring surgery and females in obstetrics and gynecology.

The text of the Agreement establishing the Asian Regional Co-operative Project on Medical and Biological Applications of Nuclear Techniques

International Nuclear Information System (INIS)

1987-04-01

The full text of the Agreement establishing the Asian Regional Co-operative Project on Medical and Biological Applications of Nuclear Techniques between the Agency and Member States is reproduced. The Agreement entered into force on 20 May 1986 after the Governments of Japan, Bangladesh and the Philippines had notified the Agency of their acceptance of the Agreement

Local-regional anesthesia in the management of stingray stings: Experience of the Bouffard medical-surgical hospital in Djibouti.

Science.gov (United States)

Vanoye, C; Lacroix, G; Le Gonidec, E; Couret, A; Benois, A; Peigne, V

2017-02-01

Stingray injuries are very painful. Systemic analgesics are ineffective, and the use of local-regional anesthesia has been reported. This retrospective descriptive study reviewed all cases of stingray injuries seen at the emergency department of the Bouffard Hospital (Djbouti, Africa) between 2011 and 2014. The study included 35 patients. Most of the injuries (n= 31, 89%) concerned the lower limbs. Median pain intensity was 6 [5-8] on a visual analog scale of 0 (no pain) to 10. The following systemic medications were administered: acetaminophen to 13 (27%) patients, morphine to 8 (23%), and tramadol to 6 (17%). In all, 25 (71%) patients received local-regional anesthesia, 15 (60%) by injections at the ankle. All procedures were successful, and no adverse event was reported. This study reports clinical data about stingray injuries in the Red Sea area and highlights the interest of local-regional anesthesia in their management. Most of the procedures were distal and could be performed by trained emergency physicians.

Steps towards optimization of medical exposures

International Nuclear Information System (INIS)

Araujo, A.M.C.; Drexler, G.; Oliveira, S.M.V.

1992-01-01

Data about ionizing radiation sources used in medical applications and obtained through and IRD/CNEN National Programme together with Brazilian health authorities are discussed. The data presentation follows, as close as possible, suggestions given by the United Nations Scientific Committee on effects of Atomic Radiation (UNSCEAR). This study uses the geographic country division into five regions. The results have been also analyzed for each region. Due to many demographic, social and economic differences among these regions, some modifications are proposed to the UNSCEAR collection data model, to be used in developing countries with similar situations. This programme has two main aims : (1) to investigate radiation source and radiation protection status in Brazil, in order to give assistance to Brazilian health authorities to plan regional radiation control programmes and training for medical staffs : (2) to implement the system of protection in medical exposures, following the 1990 ICRP recommendations. This includes the justification of a practice in medical exposures, the optimization protection and the possible application of dose constraints. (author)

Research-oriented medical education for graduate medical students.

Science.gov (United States)

Deo, Madhav G

2013-01-01

In most parts of the world, medical education is predominantly geared to create service personnel for medical and health services. Training in research is ignored, which is a major handicap for students who are motivated to do research. The main objective of this study was to develop, for such students, a cost-effective 'in-study' research training module that could be adopted even by medical colleges, which have a modest research infrastructure, in different regions of India. Short-duration workshops on the clinical and laboratory medicine research methods including clinical protocol development were held in different parts of India to facilitate participation of students from various regions. Nine workshops covering the entire country were conducted between July 2010 and December 2011. Participation was voluntary and by invitation only to the recipients of the Indian Council of Medical Research-Short-term Studentship programme (ICMR- STS), which was taken as an index of students' research motivation. Faculty was drawn from the medical institutions in the region. All expenses on students, including their travel, and that of the faculty were borne by the academy. Impact of the workshop was judged by the performance of the participants in pre- and post-workshop tests with multiple-choice questions (MCQs) containing the same set of questions. There was no negative marking. Anonymous student feedback was obtained using a questionnaire. Forty-one per cent of the 1009 invited students attended the workshops. These workshops had a positive impact on the participants. Only 20% students could pass and just 2.3% scored >80% marks in the pre-workshop test. There was a three-fold increase in the pass percentage and over 20% of the participants scored >80% marks (A grade) in the post-workshop test. The difference between the pre- and post- workshop performance was statistically significant at all the centres. In the feedback from participants, the workshop received an average

A Three-Year Experience of Medical Thoracoscopy at A Tertiary Care Center of Himalayan Region

Directory of Open Access Journals (Sweden)

Rakhee Sodhi

2016-03-01

Full Text Available Introduction: Medical thoracoscopy is a minimally invasive procedure for diagnosing and treating pleural diseases. Despite its proven role in diagnostic and therapeutic purposes, it is infrequently used, which could be because of cost of equipment and lack of training. We analyzed our initial 3 years record of thoracoscopy at Himalayan Institute of Medical Sciences, a tertiary care center in Himalayan region of north India. Materials and Methods: This cross-sectional study was to analyze our experience of medical thoracoscopy which was started in Jan 2011 at our center. All patients who underwent thoracoscopy during the period between Jan 2011 to Dec 2013 were included in the study. Thoracoscopy was performed for diagnosis of undiagnosed pleural effusions. Clinical, radiological, cytological & histopathological data of the patients were collected prospectively and analysed. Results: The diagnostic yield for a pleuroscopic pleural biopsy in our study was 87.23% (41/47. Malignancy was diagnosed histopathologically in 70.2% (33/47 patients (both primary & metastatic pleural carcinoma and tuberculosis in 10.6% (5/47. There was no mortality related to procedure. Only three patients had minor complications like subcutaneous emphysema which was mild and resolved by second post-procedure day. Pain at intercostal drain site was observed in some patients. Conclusion: Thoracoscopy is an easy outpatient procedure and an excellent diagnostic tool for pleural effusion of uncertain etiology. It has low complication rate even in settings where the procedure is just started. It should be included in the armamentarium of tools for management of pleural effusion.

Use of a medication quantification scale for comparison of pain medication usage in patients with complex regional pain syndrome (CRPS).

Science.gov (United States)

Gallizzi, Michael A; Khazai, Ravand S; Gagnon, Christine M; Bruehl, Stephen; Harden, R Norman

2015-03-01

To correlate the amount and types of pain medications prescribed to CRPS patients, using the Medication Quantification Scale, and patients' subjective pain levels. An international, multisite, retrospective review. University medical centers in the United States, Israel, Germany, and the Netherlands. A total of 89 subjects were enrolled from four different countries: 27 from the United States, 20 Germany, 18 Netherlands, and 24 Israel. The main outcome measures used were the Medication Quantification Scale III and numerical analog pain scale. There was no statistically significant correlation noted between the medication quantification scale and the visual analog scale for any site except for a moderate positive correlation at German sites. The medication quantification scale mean differences between the United States and Germany, the Netherlands, and Israel were 9.793 (P CRPS patients and would be useful in further prospective studies of pain medication prescription practices in the CRPS population worldwide. Wiley Periodicals, Inc.

Medical response for radiological accidents from Regional cooperation : Latin-American radiopathology networks

International Nuclear Information System (INIS)

Valverde, Nelson; Cardenas, Juan; Perez, Maria del Rosario; Trano, Jose Luiz Di; Gisone, Pablo

2001-01-01

The objective of this program is to have a system, in order to assure an appropriate medical response in the case of radiological accidents and to offer medical advice in aspects related to the biological effects of ionizing radiations in risk assessment of radiation workers, medical exposures, potential effects of prenatal irradiation

Variability in United States Allopathic Medical School Tuition.

Science.gov (United States)

Gil, Joseph A; Park, Sarah H; Daniels, Alan H

2015-11-01

Over the course of the last generation, the cost of medical school attendance and medical student debt has increased drastically. Medical student debt has been reported as high as $350,000, and the Association of American Medical Colleges (AAMC) reports that medical school tuition continues to increase annually. The increasing cost of medical education and associated financial burden is now beginning to deter potential applicants from pursuing a career in medicine. In this study we aimed to assess medical school tuition across the US. We hypothesized that the cost of medical school attendance is variable across all regions of the US, and as a result, the financial burden on medical students is inconsistent. All 123 allopathic medical schools accredited by the AAMC were assessed in this investigation. In-state and out-of-state tuitions for the year 2016 were obtained from U.S. News and World Report. Additionally, medical school size was collected. Regions were defined according to the US Census Bureau definition, with the US being divided into 4 regions: Northeast, Midwest, South, and West. There was no difference in average medical school size among the 4 regions (P > .05). Average in-state tuition was $38,291.56 ± $9801.38 (95% confidence interval [CI], $34,658.07-$41,513.46) in the Midwest, $45,923.04 ± $9178.87 (95% CI, $42,566.28-$49,216.78) in the Northeast, $32,287.78 ± $12,277.53 (95% CI, $28,581.90-$35,378.68) in the South, and $37,745.40 ± $11,414.37 (95% CI, $30,063.28-$40,458.99) in the West. In-state tuition in the South was significantly lower than in the Northeast, West, and Midwest (P tuition in the Northeast was significantly higher than in the South, West, and Midwest (P tuition is $54,104.04 ± $8227.65 (95% CI, $51,207.6-$57,000.39) in the Midwest, $53,180.10 ± $3963.71 (95% CI, $51,761.71-$54,598.50) in the Northeast, $48,191.86 ± $12,578.13 (95% CI, $44,595.84-$51,787.89) in the South, and $52,920.47 ± $7400.83 (95% CI, $49

Medical tourism

OpenAIRE

Abbas Ghanbari; Khadijeh Zirak Moradlu; Morteza Ramazani

2014-01-01

Medical tourism is considered as one of the tourism dimensions and it can contribute to the stabilized and dynamic development of a country's economy. Since it is cost-effective industry, most developing countries have focused on this industry and they are planning to develop this industry. Not only does Zanjan province, as the central region in medicine services, enjoy different kinds of variety and acceptable medical specialties but also it has historical, natural, and religious tourism pot...

The Arabian Gulf University College of Medicine and Medical Sciences: a successful model of a multinational medical school.

Science.gov (United States)

Hamdy, Hossam; Anderson, M Brownell

2006-12-01

In the late 1970s, leaders of the Arabian [corrected] Gulf countries proposed a novel idea of a joint educational and cultural venture: establishing a new regional university based in the Kingdom of Bahrain that would be managed as a multinational consortium of Gulf countries including Saudi Arabia, United Arab Emirates, Kuwait, Oman, Qatar, and Bahrain. It was intended to promote higher education and research in the Gulf region; to serve the development needs of the region; to reflect the unique economic, social, and cultural attributes of the Gulf communities and their environments; and to respond to the health care needs of the member countries. Since its inception in 1982, the College of Medicine and Medical Sciences (CMMS) at Arabian Gulf University (AGU) has adopted the educational philosophy of problem-based learning (PBL) and self-directed, student-centered education. The curriculum is integrated, with early introduction of education to foster clinical skills and professional competencies. The strategic alliance with the health care systems in Bahrain and other Gulf regions has created a successful model of efficient and effective initialization of health care resources in the community. The experience that has accumulated at the AGU-CMMS from introducing innovative medical education has allowed it to take a leadership position in medical education in the Gulf region. The original goals of this unique experiment have been realized along with unanticipated outcomes of spearheading changes in medical education in the Gulf region. Old and new medical schools have adopted several characteristics of the AGU educational program. Several elements contributed to its success: a clear vision of providing quality medical education and realizing and sustaining this vision by a supportive leadership at the university and college levels; an alliance with the regional health care systems; a dedicated faculty who have been able to work as a team while continually

assessment of emergency medical services in the ashanti region

African Journals Online (AJOL)

2015-09-01

Sep 1, 2015 ... Background: We aimed to assess the structure, func- tion and performance of ... operated Facility-Based Ambulance Service (FBAS).4 ... National Disaster Management Organisation (Kumasi, .... Equipment and Medication. ✓.

[Development of a microbiology data warehouse (Akita-ReNICS) for networking hospitals in a medical region].

Science.gov (United States)

Ueki, Shigeharu; Kayaba, Hiroyuki; Tomita, Noriko; Kobayashi, Noriko; Takahashi, Tomoe; Obara, Toshikage; Takeda, Masahide; Moritoki, Yuki; Itoga, Masamichi; Ito, Wataru; Ohsaga, Atsushi; Kondoh, Katsuyuki; Chihara, Junichi

2011-04-01

The active involvement of hospital laboratory in surveillance is crucial to the success of nosocomial infection control. The recent dramatic increase of antimicrobial-resistant organisms and their spread into the community suggest that the infection control strategy of independent medical institutions is insufficient. To share the clinical data and surveillance in our local medical region, we developed a microbiology data warehouse for networking hospital laboratories in Akita prefecture. This system, named Akita-ReNICS, is an easy-to-use information management system designed to compare, track, and report the occurrence of antimicrobial-resistant organisms. Participating laboratories routinely transfer their coded and formatted microbiology data to ReNICS server located at Akita University Hospital from their health care system's clinical computer applications over the internet. We established the system to automate the statistical processes, so that the participants can access the server to monitor graphical data in the manner they prefer, using their own computer's browser. Furthermore, our system also provides the documents server, microbiology and antimicrobiotic database, and space for long-term storage of microbiological samples. Akita-ReNICS could be a next generation network for quality improvement of infection control.

Medical tourism

Directory of Open Access Journals (Sweden)

Abbas Ghanbari

2014-08-01

Full Text Available Medical tourism is considered as one of the tourism dimensions and it can contribute to the stabilized and dynamic development of a country's economy. Since it is cost-effective industry, most developing countries have focused on this industry and they are planning to develop this industry. Not only does Zanjan province, as the central region in medicine services, enjoy different kinds of variety and acceptable medical specialties but also it has historical, natural, and religious tourism potentials. In this survey, the researcher investigated the existing potentials of Zanjan province based on descriptive - analytical tourism in offering and providing medical services and accommodation. The survey reports that offered services in tourism were not acceptable and satisfactory.

Faculty development programs for medical teachers in India

Directory of Open Access Journals (Sweden)

SANJAY ZODPEY

2016-04-01

Full Text Available Introduction: India has the highest number of medical colleges in the world and subsequently the higher number of medical teachers. There is a dire need of adopting a systematic approach to faculty development to enhance quality education to meet health challenges for 21st Century. This manuscript provides a landscape of faculty development programs in India, identifying gaps and opportunities for reforms in faculty development. Methods: Conventionally, FDPs are organized by medical colleges and universities through Basic Courses and Advanced Courses focusing on pedagogy. Medical Council of India is facilitating FDPs through 18 selected regional centers to enable medical teachers to avail modern education technology for teaching from July 2009. Foundation for Advancement of International Medical Education and Research has three Regional Institutes in India. Results: Recommendations include the need for formulating a national strategy for faculty development to not only enhance the quantity of medical teachers but also the quality of medical education; providing support for Departments of Medical Education/Regional Centers in terms of finance and staffing and incorporation of teaching skills in postgraduate training. Conclusion: Distance learning courses focusing on educational leadership and pedagogy for medical teachers can be an option to reach a wider audience. FDPs can be an asset in recruiting and retaining teachers as they offer valued professional development opportunities.

Delinquent Medical Service Accounts at Landstuhl Regional Medical Center Need Additional Management Oversight

Science.gov (United States)

2016-04-28

Treasury for collection when the debts are delinquent more than 120 days.9 Further, UBOs can transfer debt to the Defense Finance and Accounting ...Comptroller); • Defense Finance and Accounting Service; • MEDCOM; • RHCE; and • LRMC. During the site visits to LRMC and MEDCOM, we observed daily...Uniform Business Office Manual,” November 2006; and • MEDCOM Finance and Accounting Division Standard Operating Procedures Medical Services Account

The development of medical networks through ICT in Japan

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Tsutomu Nakamura

2016-09-01

Full Text Available This paper examines how medical networks using Information and Communications Technology (ICT have been constructed, and what kind of spatial impact they have on the existing medical care provision system. The results are reported below. In Japan, each prefecture implements its own regional health care program for the appropriate allocation of medical resources. However, regional disparities in such allocation have not yet been resolved. ICT applied to two cases (the Wakashio Medical Network in Chiba Prefecture and the Haniwa Health and Welfare Network in Miyazaki Prefecture has promoted functional division and cooperation among medical institutions as well as the efficient use of resources on medical networks. Factors contributing to the construction of these networks and their continued utilization include strong leadership of central hospitals in the regions, and the fact that they have managed to solve problems related to system development and operation costs. However, differences in medical network awareness between doctors and patients, as well as the constraints of network maintenance costs, force participating doctors in ICT field. In this way, medical networks become a way to complement existing medical delivery systems.

The Distribution and Status of Bats at Fort Irwin National Training Center

Science.gov (United States)

2012-12-01

the Avawatz Mountains (Table 9) in the vicinity of Goat Mountain are more human accessible due to their close proximity to roads. Troops are currently...altitudinally, (Grinnell 1918, Krutzsch 1948, Cryan 2003) and are often the species most frequently killed at wind farms . For southern California...As noted in the results section, the current level of bat use was similar at the Desert King Mine and the Avawatz mines near Goat Mountain as was

World Federation for Medical Education Policy on international recognition of medical schools' programme.

Science.gov (United States)

Karle, Hans

2008-12-01

The increasing globalisation of medicine, as manifested in the migration rate of medical doctors and in the growth of cross-border education providers, has inflicted a wave of quality assurance efforts in medical education, and underlined the need for definition of standards and for introduction of effective and transparent accreditation systems. In 2004, reflecting the importance of the interface between medical education and the healthcare delivery sector, a World Health Organization (WHO)/World Federation for Medical Education (WFME) Strategic Partnership to improve medical education was formed. In 2005, the partnership published Guidelines for Accreditation of Basic Medical Education. The WHO/WFME Guidelines recommend the establishment of proper accreditation systems that are effective, independent, transparent and based on medical education-specific criteria. An important prerequisite for this development was the WFME Global Standards programme, initiated in 1997 and widely endorsed. The standards are now being used in all 6 WHO/WFME regions as a basis for quality improvement of medical education throughout its continuum and as a template for national and regional accreditation standards. Promotion of national accreditation systems will have a pivotal influence on future international appraisal of medical education. Information about accreditation status - the agencies involved and the criteria and procedure used - will be an essential component of new Global Directories of Health Professions Educational Institutions. According to an agreement between the WHO and the University of Copenhagen (UC), these Directories (the Avicenna Directories) will be developed and published by the UC with the assistance of the WFME, starting with renewal of the WHO World Directory of Medical Schools, and sequentially expanding to cover educational institutions for other health professions. The Directories will be a foundation for international meta-recognition ("accrediting the

[The Evaluation of Medical Demographic and Economic Losses of the Region Conditioned by Mortality of Lung Cancer].

Science.gov (United States)

Zukov, R A; Modestov, A A; Safontsev, I P; Slepov, E V; Narkevich, A N

2017-11-01

The article presents evaluation of medical demographic and economic losses of population of the Krasnoyarskii kraii conditioned by mortality of lung cancer in 2010-2014 using DALY technology. In the Krasnoyarskii kraii, during 2010-2014 64,712 individuals died because of lung cancer. The mortality of male population surpasses corresponding indices of mortality of females up to 3.9 times. In the region, the standardized indicator mortality of lung cancer among males annually surpasses the same indicator among females at maximum up to 8.1 times. The DALY maximal absolute losses of among males were registered in 2010 and 2013 and fell on age group of 55-59 years and among females on the age group of 60-64 years in 2014. The maximal (up to 5.2 times) difference in values of DALY indicator was established in 2010 between male and female population. the maximal gap in in DALY indices between male and female population was established in the age of 55-59 years. Almost half of DALY losses among males was established in 2013 and among females in 2014. The total losses of gross regional product in the region because of mortality conditioned by lung cancer made up to 29.8 billions of rubles in 2010-2014.

Predictors for total medical costs for acute hemorrhagic stroke patients transferred to the rehabilitation ward at a regional hospital in Taiwan.

Science.gov (United States)

Chen, Chien-Min; Ke, Yen-Liang

2016-02-01

One-third of the acute stroke patients in Taiwan receive rehabilitation. It is imperative for clinicians who care for acute stroke patients undergoing inpatient rehabilitation to identify which medical factors could be the predictors of the total medical costs. The aim of this study was to identify the most important predictors of the total medical costs for first-time hemorrhagic stroke patients transferred to inpatient rehabilitation using a retrospective design. All data were retrospectively collected from July 2002 to June 2012 from a regional hospital in Taiwan. A stepwise multivariate linear regression analysis was used to identify the most important predictors for the total medical costs. The medical records of 237 patients (137 males and 100 females) were reviewed. The mean total medical cost per patient was United States dollar (USD) 5939.5 ± 3578.5.The following were the significant predictors for the total medical costs: impaired consciousness [coefficient (B), 1075.7; 95% confidence interval (CI) = 138.5-2012.9], dysphagia [coefficient (B), 1025.8; 95% CI = 193.9-1857.8], number of surgeries [coefficient (B), 796.4; 95% CI = 316.0-1276.7], pneumonia in the neurosurgery ward [coefficient (B), 2330.1; 95% CI = 1339.5-3320.7], symptomatic urinary tract infection (UTI) in the rehabilitation ward [coefficient (B), 1138.7; 95% CI = 221.6-2055.7], and rehabilitation ward stay [coefficient (B), 64.9; 95% CI = 31.2-98.7] (R(2) = 0.387). Our findings could help clinicians to understand that cost reduction may be achieved by minimizing complications (pneumonia and UTI) in these patients.

Medical irradiation risk assessment based on the data of radiation-hygienic passportization in the regions of the Russian Federation

Directory of Open Access Journals (Sweden)

V. Ju. Golikov

2015-01-01

Full Text Available This article is aimed at methodology development for collective risk assessment of medical irradiation, basing on results of radiation-hygienic passportization in the Russian Federation regions, i.e. using values of collective effective doses for big groups of medical technologies: photoroentgenography, roentgenography, roentgenoscopy, and computer tomography. Use of the effective dose concept for medical irradiation risk definition involves a number of essential restrictions. Age and sex of the employees and of general population (effective dose concept has been developed for these groups of people may essentially differ from those in patients. Lifelong risk of stochastic effects occurrence in children is 2-3 times higher than the rating values used in effective dose concept, while for elderly people (about 60 years at irradiation time it’s 4-5 times lower. The article suggests the algorithm of effective doses values correcting factors assessment for consideration of dependence of radiogenic cancer risk factors on age and sex. This enables to assess more correctly collective risk of radiology and nuclear medicine imaging. Since patients tend to be elderly and their risk factor is below the rating used in the effective dose concept, the values of these correcting factors for most radiology and nuclear medicine imaging are below one. Thus, in most cases, the effective dose concept leads to conservative assessment of medical irradiation collective risk.

Evaluation of Self Medication Amongst Nursing Students of Bastar Region: A Questionnaire Based Study

Directory of Open Access Journals (Sweden)

Syed Sajid Ali

2015-07-01

Full Text Available  Self-medication provides low cost alternative for expensive medical management but inappropriate use can cause problems. For Nursing undergraduates such practice has special significance since they have medical knowledge but very superficial and also its application is limited.  Hence the present study was planned to evaluate the status of students studying in different years of B.Sc. Nursing.To determine the prevalence, attitude and knowledge of self medication amongst the students of Government Nursing College, Jagdalpur(ChhatisgarhThis questionnaire based study was performed on 142 Nursing students of 1st, 2nd and 3rd year aged between17-24 years. Mean age was found to be 20.5 years (±2.5years. A prevalidated questionnaire was distributed amongst the participants after explaining the purpose of the study and taking informed consent. The results obtained from this study showed that out of 142 students 120 (84.50 % students used self medicationCommonest source of information for self medication were seniors and colleagues 40(33.33%, and the most common indication for self medication was common cold 41(34.16 %.D’cold Total 49(40.83% was the most common medication used as self medication .Only 16 (13.33% students were having the knowledge about content, dose, duration of therapy and adverse drug reaction of the medication that they used. The most common source to obtain medicines for self medication was pharmaceutical store 80 (66.67 %.The findings from this study highlights the striking prevalence of self medication among nursing students, the lack of knowledge and the risks associated with them. We recommend that a global approach must be taken to prevent this problem from escalating which would involve awareness and education regarding the implications of self medication, strategies to prevent the supply of medicines without prescription by pharmacies and strict rules regarding pharmaceutical advertising.

Evaluation of a medication order writing standards policy in a regional health authority

Science.gov (United States)

Raymond, Colette B.; Coates, Jan; Woloschuk, Donna M. M.

2013-01-01

Background: The Winnipeg Regional Health Authority (WRHA) implemented a medication order writing standards (MOWS) policy (including banned abbreviations) to improve patient safety. Widespread educational campaigns and direct prescriber feedback were implemented. Methods: We audited orders within the WRHA from 2005 to 2009 and surveyed all WRHA staff in 2011 about the policy and suggestions for improving education and compliance. Results: Overall, orders containing banned abbreviations, acronyms or symbols numbered 2261/8565 (26.4%) preimplementation. After WRHA-wide didactic education, the proportion declined to 1358/5461 (24.9%) (p = 0.043) and then, with targeted prescriber feedback, to 1186/6198 (19.1%) (p < 0.0001). A survey of 723 employees showed frequent violations of the MOWS, despite widespread knowledge of the policy. Respondents supported ongoing efforts to enforce the policy within the WRHA. Nonprescribers were significantly more likely than prescribers to agree with statements regarding enhancing compliance by defining prescriber/transcriber responsibilities and placing sanctions on noncompliant prescribers. Discussion: Education, raising general awareness and targeted feedback to prescribers alone are insufficient to ensure compliance with MOWS policies. WRHA staff supported ongoing communication, improved tools such as compliant preprinted orders and reporting and feedback about medication incidents. A surprising number of respondents supported placing sanctions on noncompliant prescribers. Conclusion: Serial audits and targeted interventions such as direct prescriber feedback improve prescription quality in inpatient hospital settings. Education plus direct prescriber feedback had a greater impact than education alone on improving compliance with a MOWS policy. Future efforts at the WRHA to improve compliance will require an expanded focus on incentives, resources and development of action plans that involve all affected staff, not just prescribers

Singapore's proposed graduate medical school--an expensive medical tutorial college or an opportunity for transforming Singapore medicine?

Science.gov (United States)

Soo, K C

2005-07-01

The proposed Graduate Medical School at the Outram Campus will open in 2007. The main value of this medical school is the transformation of the medical institutions in the campus and SingHealth into Academic Medical Centres. Such centres will train and host quality physicians and physician-scientists. It will help push the development of translational research, complementing the country's investment in Biopolis. It will also underpin Singapore's push into regional medical tourism and its development as an educational hub in the biomedical sciences.

A New Approach to Identify High Burnout Medical Staffs by Kernel K-Means Cluster Analysis in a Regional Teaching Hospital in Taiwan.

Science.gov (United States)

Lee, Yii-Ching; Huang, Shian-Chang; Huang, Chih-Hsuan; Wu, Hsin-Hung

2016-01-01

This study uses kernel k-means cluster analysis to identify medical staffs with high burnout. The data collected in October to November 2014 are from the emotional exhaustion dimension of the Chinese version of Safety Attitudes Questionnaire in a regional teaching hospital in Taiwan. The number of effective questionnaires including the entire staffs such as physicians, nurses, technicians, pharmacists, medical administrators, and respiratory therapists is 680. The results show that 8 clusters are generated by kernel k-means method. Employees in clusters 1, 4, and 5 are relatively in good conditions, whereas employees in clusters 2, 3, 6, 7, and 8 need to be closely monitored from time to time because they have relatively higher degree of burnout. When employees with higher degree of burnout are identified, the hospital management can take actions to improve the resilience, reduce the potential medical errors, and, eventually, enhance the patient safety. This study also suggests that the hospital management needs to keep track of medical staffs' fatigue conditions and provide timely assistance for burnout recovery through employee assistance programs, mindfulness-based stress reduction programs, positivity currency buildup, and forming appreciative inquiry groups. © The Author(s) 2016.

A New Approach to Identify High Burnout Medical Staffs by Kernel K-Means Cluster Analysis in a Regional Teaching Hospital in Taiwan

Directory of Open Access Journals (Sweden)

Yii-Ching Lee PhD

2016-11-01

Full Text Available This study uses kernel k-means cluster analysis to identify medical staffs with high burnout. The data collected in October to November 2014 are from the emotional exhaustion dimension of the Chinese version of Safety Attitudes Questionnaire in a regional teaching hospital in Taiwan. The number of effective questionnaires including the entire staffs such as physicians, nurses, technicians, pharmacists, medical administrators, and respiratory therapists is 680. The results show that 8 clusters are generated by kernel k-means method. Employees in clusters 1, 4, and 5 are relatively in good conditions, whereas employees in clusters 2, 3, 6, 7, and 8 need to be closely monitored from time to time because they have relatively higher degree of burnout. When employees with higher degree of burnout are identified, the hospital management can take actions to improve the resilience, reduce the potential medical errors, and, eventually, enhance the patient safety. This study also suggests that the hospital management needs to keep track of medical staffs’ fatigue conditions and provide timely assistance for burnout recovery through employee assistance programs, mindfulness-based stress reduction programs, positivity currency buildup, and forming appreciative inquiry groups.

Medical technology advances from space research

Science.gov (United States)

Pool, S. L.

1972-01-01

Details of medical research and development programs, particularly an integrated medical laboratory, as derived from space technology are given. The program covers digital biotelemetry systems, automatic visual field mapping equipment, sponge electrode caps for clinical electroencephalograms, and advanced respiratory analysis equipment. The possibility of using the medical laboratory in ground based remote areas and regional health care facilities, as well as long duration space missions is discussed.

assessment of emergency medical services in the ashanti region of ...

African Journals Online (AJOL)

2015-09-01

Sep 1, 2015 ... trauma and burn care, and various medical and surgical sub-specialties. The mission ..... equipment (bag valve mask, face mask, nasal cannu- lae), an .... which legally empowered the publicly-operated Na- tional Ambulance ...

Clinical Training of Medical Physicists Specializing in Nuclear Medicine

International Nuclear Information System (INIS)

2011-01-01

The application of radiation in human health, for both diagnosis and treatment of disease, is an important component of the work of the IAEA. The responsibility for the increasingly technical aspects of this work is undertaken by the medical physicist. To ensure good practice in this vital area, structured clinical training programmes are required to complement academic learning. This publication is intended to be a guide to the practical implementation of such a programme for nuclear medicine. There is a general and growing awareness that radiation medicine is increasingly dependent on well trained medical physicists who are based in a clinical setting. However an analysis of the availability of medical physicists indicates a large shortfall of qualified and capable professionals. This is particularly evident in developing countries. While strategies to increase educational opportunities are critical to such countries, the need for guidance on structured clinical training was recognized by the members of the Regional Cooperative Agreement for Research, Development and Training related to Nuclear Science and Technology (RCA) for the Asia-Pacific region. Consequently, a technical cooperation regional project (RAS6038) under the RCA programme was formulated to address this need in this region by developing suitable material and establishing its viability. Development of a clinical training guide for medical physicists specialising in nuclear medicine was started in 2009 with the appointment of a core drafting committee of regional and international experts. The publication drew on the experience of clinical training in Australia, Croatia and Sweden and was moderated by physicists working in the Asian region. The present publication follows the approach of earlier IAEA publications in the Training Course Series, specifically Nos 37 and 47, Clinical Training of Medical Physicists Specializing in Radiation Oncology and Clinical Training of Medical Physicists

Radiation emergency medical preparedness and assistance network in Korea

International Nuclear Information System (INIS)

Kim, E. S.; Kong, H. J.; Noh, J. H.; Lim, Y. K.; Kim, C. S.

2003-01-01

Nationwide Medical Preparedness for Nuclear Accidents as an integral part of nuclear safety system has been discussed for several years and Radiation Health Research Institute (RHRI) of Korea Hydro and Nuclear Power Co. was established on July, 1999. The National Radiation Emergency Medical Center (NREMC) of Korea Cancer Center Hospital was also founded on September, 2002. Two organizations have established Radiation Emergency Medical Preparedness and Assistance Network in Korea to cope with accidental situations in nuclear power plants and also in handling sites of radionuclides. In order to construct an effective Nationwide Emergency Medical Network System they maintain good cooperation among regional hospitals. RHRI is going to make three types of medical groups, that is to say, the collaboration of the regional (primary appointed) hospital group around the nuclear power plants, the regional core (secondary appointed) hospital group and the central core hospital (RHRI). NREMC is also playing a central role in collaboration with 10 regional hospitals. Two cores are working key role for the maintenance of the network. Firstly, They maintain a radiological emergency response team consisting of physicians, nurses, health physicists, coordinators, and necessary support personnel to provide first-line responders with consultative or direct medical and radiological assistance at their facility or at the accident site. Secondly, they serves educational programs for the emergency personnel of collaborating hospitals not only as a treatment facility but also as a central training and demonstration unit. Regularly scheduled courses for the physician and nurse, and health/medical physicists are conducted. Therefore, to activate Nationwide Emergency Medical Network System and to maintain it for a long time, well-trained specialists and budgetary supports are indispensable

FORMATION OF THE EQUILIBRIUM AND BALANCED SYSTEM OF GRANTING OF MEDICAL SERVICES IN REGION (ON THE EXAMPLE OF TREATMENT OF NEFROLETIAZE

Directory of Open Access Journals (Sweden)

V.S. Bochko

2007-12-01

Full Text Available The problem of formation of equilibrium on solvent demand and balanced in the organizational attitude the system of granting of medical services is put in clause. It is shown, that the decision of a problem in conditions of widely spreading of requirement payment for them is possible on the basis of use of a principle of the social responsibility of the state. The medico-economic party of the decision of questions is revealed on an example of treatment of nefroletiaze. Inseparability of system "doctor-equipment" for effective treatment of patients is noted. In this connection the idea of prime saturation of public health services by hi-tech medical techniques is put forward. It is offered to realize within the limits of national project "Health" in Sverdlovsk region the pilot project on creation of chambers of remote treatment of patients.

Medical physics and challenges faced in Africa

International Nuclear Information System (INIS)

Nakatudde, R.

2010-01-01

, Uganda and Ghana. A questionnaire was used to collect data inline with the objectives. The data collected was analysed to identify the correlation between the challenges identified and the objectives of FAMPO. Results and discussions Challenges faced by medical physicists in African countries There is shortage of qualified skilled medical physicists to man all the activities the three areas of Radiotherapy, Radiology and Nuclear Medicine. 5 The cost involved to obtain clinical training from the recognized training centres is high and there no local training centres. Training of qualified medical physicists has been done by the International Atomic Energy Agency (IAEA) as little or no support is given to training medical physicists by individual governments. Lack of recognized bodies governing medical physicists, hence lack of coordination among medical physicists in a particular country and between countries in Africa. The law governing the use ionizing radiation is still weak in some African countries. Ignorance about the role of a medical physicist from the hospital managers and health ministries, hence limitation of their participation in research and publication. Lack of equipment has inhibited execution of their duties especially in areas of dosimetry, dose assessment and radiation monitoring. Hospitals have no budget for continuous education to fund conferences or congress attendance. Most of these conferences are commonly supported by international organizations like IAEA, WHO. Aims and Functions of FAMPO To promote improved quality service to patients and the community in the region. To promote the co-operation and communication between medical physics organization in the region, and where such organizations do not exist between individual medical physicists. To promote the profession and practice of medical physics and related activities in the region. To promote the advancement in status and standard of practice of medical physics profession. To promote and

Medical assistance in case of nuclear accident

International Nuclear Information System (INIS)

Dodig, D.; Tezak, S.; Kasal, B.; Huic, D.; Medvedec, M.; Loncaric, S.; Grosev, D.; Rozman, B.; Popovic, S.

1996-01-01

Medical service is a prerequisite for work license of nuclear installation. Every nuclear installation incorporate in their safety procedure also medical emergency plan. Usually the medical emergency plan consists of several degrees of action: 1. First aid, 2. First medical treatment, 3. Treatment in regional hospital, 4. Treatment in special institution (centre for radiation medicine). This paper discusses organization and activities of Centre for Radiation Medicine and Protection - Clinical Hospital Centre Zagreb

Referral to massage therapy in primary health care: a survey of medical general practitioners in rural and regional New South Wales, Australia.

Science.gov (United States)

Wardle, Jon L; Sibbritt, David W; Adams, Jon

2013-01-01

Massage therapists are an important part of the health care setting in rural and regional Australia and are the largest complementary and alternative medicine (CAM) profession based on both practitioner numbers and use. The purpose of this study was to survey medical general practitioners (GPs) in rural and regional New South Wales, Australia, to identify their knowledge, attitudes, relationships, and patterns of referral to massage therapy in primary health care. A 27-item questionnaire was sent to all 1486 GPs currently practicing in rural and regional Divisions of General Practice in New South Wales, Australia. The survey had 5 general areas: the GP's personal use and knowledge of massage, the GP's professional relationships with massage practice and massage practitioners, the GP's specific opinions on massage, the GP's information-seeking behavior in relation to massage, and the GP's assumptions on massage use by patients in their local areas. A total of 585 questionnaires were returned completed, with 49 survey questionnaires returned as "no longer at this address" (response rate of 40.7%). More than three-quarters of GPs (76.6%) referred to massage therapy at least a few times per year, with 12.5% of GPs referring at least once per week. The GP being in a nonremote location (odds ratio [OR], 14.28; 95% confidence interval [CI], 3.7-50.0), graduating from an Australian medical school (OR, 2.03; 95% CI, 1.09-3.70), perceiving a lack of other treatment options (OR, 2.64; 95% CI, 1.15-6.01), perceiving good patient access to a wide variety of medical specialists (OR, 11.1; 95% CI, 1.7-50.0), believing in the efficacy of massage therapy (OR, 2.75; 95% CI, 1.58-4.78), experiencing positive results from patients using massage therapy previously (OR, 13.95; 95% CI, 5.96-32.64), or having prescribed any CAM previously (OR, 1.83; 95% CI, 1.03-3.27) were all independently predictive of increased referral to massage therapy among the GPs in this study. There appears to

Beyond "medical tourism": Canadian companies marketing medical travel.

Science.gov (United States)

Turner, Leigh

2012-06-15

Despite having access to medically necessary care available through publicly funded provincial health care systems, some Canadians travel for treatment provided at international medical facilities as well as for-profit clinics found in several Canadian provinces. Canadians travel abroad for orthopaedic surgery, bariatric surgery, ophthalmologic surgery, stem cell injections, "Liberation therapy" for multiple sclerosis, and additional interventions. Both responding to public interest in medical travel and playing an important part in promoting the notion of a global marketplace for health services, many Canadian companies market medical travel. Research began with the goal of locating all medical tourism companies based in Canada. Various strategies were used to find such businesses. During the search process it became apparent that many Canadian business promoting medical travel are not medical tourism companies. To the contrary, numerous types of businesses promote medical travel. Once businesses promoting medical travel were identified, content analysis was used to extract information from company websites. Company websites were analyzed to establish: 1) where in Canada these businesses are located; 2) the destination countries and health care facilities that they market; 3) the medical procedures they promote; 4) core marketing messages; and 5) whether businesses market air travel, hotel accommodations, and holiday tours in addition to medical procedures. Searches conducted from 2006 to 2011 resulted in identification of thirty-five Canadian businesses currently marketing various kinds of medical travel. The research project began with what seemed to be the straightforward goal of establishing how many medical tourism companies are based in Canada. Refinement of categories resulted in the identification of eighteen businesses fitting the category of what most researchers would identify as medical tourism companies. Seven other businesses market regional, cross

Medical Tourism within the Czech Republic

OpenAIRE

Němečková, Eva

2016-01-01

The thesis analyses factors influencing medical tourism within the Czech Re- public where districts ("okresy") and regions ("kraje") are considered as the units where the patient can travel to receive health care. The dataset was pro- vided by the Czech general health insurance (VZP). The research covers the period 2011-2014 and reveals the differences between "medical tourism" for hospitalizations and for medical treatments and between travelling into other districts ("okresy") and travellin...

Medical tourism in the Caribbean region: a call to consider environmental health equity.

Science.gov (United States)

Johnston, R; Crooks, V A

2013-03-01

Medical tourism, which is the intentional travel by private-paying patients across international borders for medical treatment, is a sector that has been targeted for growth in many Caribbean countries. The international development of this industry has raised a core set of proposed health equity benefits and drawbacks for host countries. These benefits centre on the potential investment in health infrastructure and opportunities for health labour force development while drawbacks focus on the potential for reduced access to healthcare for locals and inefficient use of limited public resources to support the growth of the medical tourism industry. The development of the medical tourism sector in Caribbean countries raises additional health equity questions that have received little attention in existing international debates, specifically in regard to environmental health equity. In this viewpoint, we introduce questions of environmental health equity that clearly emerge in relation to the developing Caribbean medical tourism sector These questions acknowledge that the growth of this sector will have impacts on the social and physical environments, resources, and waste management infrastructure in countries. We contend that in addition to addressing the wider health equity concerns that have been consistently raised in existing debates surrounding the growth of medical tourism, planning for growth in this sector in the Caribbean must take environmental health equity into account in order to ensure that local populations, environments, and ecosystems are not harmed by facilities catering to international patients.

Physicians’ circularity in health regions in Brazil

Directory of Open Access Journals (Sweden)

Paulo Henrique Seixas

Full Text Available Abstract Objectives: to characterize the medical circularity in Brazil and to discuss the case in the North and South Barretos regions, São Paulo. Methods: a cross-sectional study using secondary data from the national registrations and a case study of physician’s sample in the North-Barretos and South-Barretos regions. Results: in the health regions in Brazil, on an average, 45% of the physicians in activities circulate in more than one region. The Capitals of the States have more stable physicians while more than 50% of the medical workforce work in other regions. The professionals with the greatest tendency to move from one work place to another are those who work in surgical specialties in services to uphold the diagnostic and therapy. Conclusions: there is a high circulation of physicians among the regions, with distinct characteristics between geographical and health regions. In case of Barretos area, the professionals move from one workplace to another according to their professional association and specialized practice.

Geology of Glacier National Park and the Flathead Region, Northwestern Montana

Science.gov (United States)

Ross, Clyde P.

1959-01-01

introduces complexities into stratigraphic correlation and should be remembered wherever the series is studied. The stromatolites, or fossil algae, in the Belt series, although still imperfectly understood, give clues with respect to problems of ecology and stratigraphy. The subdivisions of the Belt series within the areas covered by the present report are, in ascending order, Altyn limestone, Appekunny argillite, Grinnell argillite, Siyeh limestone, and Missoula group. Local subdivisions of the Missoula group are possible in certain areas, and all the units just named are expected to be subdivided when detailed studies are undertaken. In the Glacier National Park and Flathead regions together, it is probable that between 25,000 and 30,000 feet of beds belonging to the Belt series, possibly more, are present. These consist largely of quartzitic argillite, quartzite, and carbonate rocks, mostly dolomitic. Small gabbroic and diabasic intrusive bodies and, at one horizon, basaltic lava are associated with the Belt series. Above the Belt series is a thick sequence of Cambrian, Devonian, and Carboniferous strata, in which limestone is dominant, followed by strata of Jurassic and Cretaceous age, largely limestone and shale and partly of terrestrial origin. Slightly consolidated gravel, sand, and silt of Tertiary age are preserved in some valleys and as erosional remnants on the plains close to the mountain border. Pleistocene and Recent glacial and fluviatile deposits are plentiful in mountain valleys and on the plains east of the mountains. Sufficient crustal movements took place during the latter part of Belt time to produce tension cracks that permitted some intrusion and related extrusion to occur. Broad crustal warping probably took place at intervals during the Paleozoic era, but these successive movements left little record other than the absence of sedimentary rock units that might otherwise have been deposited. The same can be said of much of the Me

Forskning på regionshospitaler i Region Midtjylland og Region Nordjylland

DEFF Research Database (Denmark)

Lauszus, Finn Friis; Nielsen, Gunnar Lauge; Petersen, Lars Jelstrup

2013-01-01

The quantity of interest, experience, and barriers to research in non-university hospitals in Denmark is undocumented. Therefore, a questionnaire was distributed to all employees at non-university hospitals in two Danish regions. The results showed that a substantial number of medical doctors were...

Contribution of the Medical Radiology Research Center, Russian Academy of Medical Sciences, to liquidation of radionuclide contamination aftereffects in the Kaluga Region that resulted from the Chernobyl power plant accident

International Nuclear Information System (INIS)

Matveenko, E.G.; Berdov, B.A.; Gorobets, V.F.; Tsyplyakovskaya, L.M.; Ivanov, V.K.; Stepanenko, V.F.; Pitkevich, V.A.; Omel'chenko, V.N.; Borovikova, M.P.

1992-01-01

Specialists from the Medical Radiology Research Center, have been participating in liquidation of the Chernobyl power plant accident aftereffects since May-June, 1986. The basic trends of their work are mass dosimetric studies of the population of the contaminated areas, annual prophylactic check-ups of children and adolescents, pregnant and nursing women and other adults of high-risk groups (agricultural workers, patients with chronic diseases), development of recommendations for health and prophylactic measures in the districts under observation, treatment of patients from these regions, who are in need of a specialized care, at the clinic of the Center

The structure of long tubular bones fractures of lower extremity by the data of the regional bureau of forensic-medical examination

Directory of Open Access Journals (Sweden)

Savka I.H.

2013-10-01

Full Text Available The main purpose of the research is carrying out forensic-medical analysis of cases from expert’s practice with fractures of the long bones based on the findings of the Regional Bureau of Forensic-Medical Examination over 2009-2012 years period. The research has been carried out using methods of statistical and comparative analysis. Their distribution by gender, age, localization, character and type of external influence, the conditions of their occurrence and participation of other persons has been outlined. Fractures of lower extremity bones make up from 15,8 to 22,5% of all the cases of mechanical trauma with lethal outcomes. Therewith male persons suffer more often from injury of the left extremity at different day time and season. The principal mechanism of their origin is injury resulting from road accidents in the countryside with the participation of other persons.

Beyond "medical tourism": Canadian companies marketing medical travel

Science.gov (United States)

2012-01-01

businesses market regional, cross-border health services available in the United States and intranational travel to clinics in Canada. In contrast to medical tourism companies, they do not market holiday tours in addition to medical care. Two companies occupy a narrow market niche and promote testing for CCSVI and “Liberation therapy” for multiple sclerosis. Three additional companies offer bariatric surgery and cosmetic surgery at facilities in Mexico. Four businesses offer health insurance products intended to cover the cost of obtaining privately financed health care in the U.S. These businesses also help their clients arrange treatment beyond Canada’s borders. Finally, one medical travel company based in Canada markets health services primarily to U.S. citizens. Conclusions This article uses content analysis of websites of Canadian companies marketing medical travel to provide insight into Canada’s medical travel industry. The article reveals a complex marketplace with different types of companies taking distinct approaches to marketing medical travel. PMID:22703873

Social accountability of medical education

DEFF Research Database (Denmark)

Lindgren, Stefan; Karle, Hans

2011-01-01

accountability of medical education must be included in all accreditation processes at all levels. The global standards programme by World Federation for Medical Education (WFME) provides tools for national or regional accreditation but also guidance for reforms and quality improvement. The standards are used......Medical doctors constitute a profession which embraces trust from and accountability to society. This responsibility extends to all medical educational institutions. Social accountability of medical education means a willingness and ability to adjust to the needs of patients and health care systems...... both nationally and globally. But it also implies a responsibility to contribute to the development of medicine and society through fostering competence for research and improvement. Accreditation is a process by which a statutory body evaluates and recognises an educational institution and/or its...

[Design and application of implantable medical device information management system].

Science.gov (United States)

Cao, Shaoping; Yin, Chunguang; Zhao, Zhenying

2013-03-01

Through the establishment of implantable medical device information management system, with the aid of the regional joint sharing of resources, we further enhance the implantable medical device traceability management level, strengthen quality management, control of medical risk.

Complex Regional Pain Syndrome and Treatment Approaches

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Neslihan Gokcen

2013-08-01

Full Text Available Complex Regional Pain Syndrome is a symptom complex including severe pain which is disproportioned by the initiating event. Formerly, it was known as reflex sympathetic dystropy, Sudeck’s atrophy and algoneurodystrophy. There are two types of complex regional pain syndrome (CPRS. CRPS type 1 (Reflex sympathetic dystropy occurs after a minor trauma of the extremities, CRPS type 2 (Causalgia occurs following peripheral nevre injury. Diagnosis is made according to the history, symptoms and physical findings of the patients. Patient education, physical therapy and medical treatment are the most common treatment approaches of complex regional pain syndrome. The aim of this review is to revise the treatment options ofcomplex regional pain syndrome, as well as to overview the new treatment approaches and options for the refractory complex regional pain syndrome cases. [Archives Medical Review Journal 2013; 22(4.000: 514-531

Distributed medical services within the ATM-based Berlin regional test bed

Science.gov (United States)

Thiel, Andreas; Bernarding, Johannes; Krauss, Manfred; Schulz, Sandra; Tolxdorff, Thomas

1996-05-01

The ATM-based Metropolitan Area Network (MAN) of Berlin connects two university hospitals (Benjamin Franklin University Hospital and Charite) with the computer resources of the Technical University of Berlin (TUB). Distributed new medical services have been implemented and will be evaluated within the highspeed MAN of Berlin. The network with its data transmission rates of up to 155 Mbit/s renders these medical services externally available to practicing physicians. Resource and application sharing is demonstrated by the use of two software systems. The first software system is an interactive 3D reconstruction tool (3D- Medbild), based on a client-server mechanism. This structure allows the use of high- performance computers at the TUB from the low-level workstations in the hospitals. A second software system, RAMSES, utilizes a tissue database of Magnetic Resonance Images. For the remote control of the software, the developed applications use standards such as DICOM 3.0 and features of the World Wide Web. Data security concepts are being tested and integrated for the needs of the sensitive medical data. The highspeed network is the necessary prerequisite for the clinical evaluation of data in a joint teleconference. The transmission of digitized real-time sequences such as video and ultrasound and the interactive manipulation of data are made possible by Multi Media tools.

Business continuity after catastrophic medical events: the Joplin medical business continuity report.

Science.gov (United States)

Carlton, Paul K; Bringle, Dottie

2012-01-01

On May 22, 2011, The St Johns Mercy Medical Center in Joplin, MO, was destroyed by an F-5 tornado. There were 183 patients in the building at that time in this 367-bed Medical Center. The preparation and response were superbly done and resulted in many lives saved. This report is focused on the reconstitution phase of this disaster response, which includes how to restore business continuity. As 95 percent of our medical capacity resides in the private sector in the United States, we must have a proper plan for how to restore business continuity or face the reality of the medical business failing and not providing critical medical services to the community. A tornado in 2007 destroyed a medical center in Sumter County, GA, and it took more than 365 days to restore business continuity at a cost of $18M. The plan executed by the Mercy Medical System after the disaster in Joplin restored business continuity in 88 days and cost a total of $6.6M, with all assets being reusable. The recommendation from these lessons learned is that every county, state, and Federal Emergency Management Agency region has a plan on the shelf to restore business continuity and the means to be able to do so. The hard work that the State of Missouri and the Mercy Medical System did after this disaster can serve as a model for the nation in how to quickly recover from any loss of medical capability.

Commentary: discovering a different model of medical student education.

Science.gov (United States)

Watson, Robert T

2012-12-01

Traditional medical schools in modern academic health centers make discoveries, create new knowledge and technology, provide innovative care to the sickest patients, and educate future academic and practicing physicians. Unfortunately, the growth of the research and clinical care missions has sometimes resulted in a loss of emphasis on the general professional education of medical students. The author concludes that it may not be practical for many established medical schools to functionally return to the reason they were created: for the education of medical students.He had the opportunity to discover a different model of medical student education at the first new MD-granting medical school created in the United States in 25 years (in 2000), the Florida State University College of Medicine. He was initially skeptical about how its distributed regional campuses model, using practicing primary care physicians to help medical students learn in mainly ambulatory settings, could be effective. But his experience as a faculty member at the school convinced him that the model works very well.He proposes a better alignment of form and function for many established medical schools and an extension of the regional community-based model to the formation of community-based primary care graduate medical education programs determined by physician workforce needs and available resources.

Comparative Analysis of the Main Indicators of Population Health and Staffing for Diabetes Care in the Kyiv Region in the Conditions of Implementation of Medical and Technological Documents (2010–2012 and 2012–2014

Directory of Open Access Journals (Sweden)

V.I. Tkachenko

2015-08-01

Full Text Available Analysis of the results of medical and technological documents implementation remains an urgent problem in different countries of the world. The objective — to carry out a comparative analysis of the main indicators of population health and staffing for diabetes care in 2010–2012 and 2012–2014 in the conditions of implementation of unified clinical protocol of medical care to the patients with diabetes mellitus (DM type 2 (Order of the Ministry of Healthcare of Ukraine dated December 21, 2012 № 1118 in the Kyiv region and Ukraine. Materials and methods. Analysis of data from statistical reports of medical institutions, by reporting forms in accordance with the law. Statistical analysis was performed using Excel 2007, SPSS. Results. Availability of endocrinologists per 10,000 adult population in the Kyiv region for 2012–2014 has changed statistically insignificantly (by 7.5 % from 0.40 to 0.43 per 10,000 adult population, while the total number of general practitioners — family physicians significantly increased by 140.57 % from 1.06 to 2.55 0/000 (p < 0.01. Prevalence of DM in general increased significantly, but in 2012–2014 in the Kyiv region growth rate of morbidity has stabilized (in 2012 — 27.39 0/000; in 2014 — 27.06 0/000, growth of –1.2 %, reaching the level of all-Ukrainian index. When analyzing the incidence rate of DM complications in the Kyiv region, there was its probable decrease by 5.02 % over 2012–2014 (from 9.17 to 8.71 0/000, p < 0.01, as well as in Ukraine — by 12.09 % (from 8.6 to 7.56 0/000, p < 0.01. The percentage of hospitalized patients with DM in the Kyiv region for the 2012–2014 significantly decreased (p < 0.01, primary disability tended to decrease, mortality significantly decreased by 8.33 % (p < 0.01. Conclusion. Implementation of medical and technological documents on providing medical care to the patients with DM type 2 had a positive effect.

Level set segmentation of medical images based on local region statistics and maximum a posteriori probability.

Science.gov (United States)

Cui, Wenchao; Wang, Yi; Lei, Tao; Fan, Yangyu; Feng, Yan

2013-01-01

This paper presents a variational level set method for simultaneous segmentation and bias field estimation of medical images with intensity inhomogeneity. In our model, the statistics of image intensities belonging to each different tissue in local regions are characterized by Gaussian distributions with different means and variances. According to maximum a posteriori probability (MAP) and Bayes' rule, we first derive a local objective function for image intensities in a neighborhood around each pixel. Then this local objective function is integrated with respect to the neighborhood center over the entire image domain to give a global criterion. In level set framework, this global criterion defines an energy in terms of the level set functions that represent a partition of the image domain and a bias field that accounts for the intensity inhomogeneity of the image. Therefore, image segmentation and bias field estimation are simultaneously achieved via a level set evolution process. Experimental results for synthetic and real images show desirable performances of our method.

Developing a bioethics curriculum for medical students from divergent geo-political regions.

Science.gov (United States)

Greenberg, Rebecca A; Kim, Celine; Stolte, Helen; Hellmann, Jonathan; Shaul, Randi Zlotnik; Valani, Rahim; Scolnik, Dennis

2016-07-27

The World Health Organization calls for stronger cross-cultural emphasis in medical training. Bioethics education can build such competencies as it involves the conscious exploration and application of values and principles. The International Pediatric Emergency Medicine Elective (IPEME), a novel global health elective, brings together 12 medical students from Canada and the Middle East for a 4-week, living and studying experience. It is based at a Canadian children's hospital and, since its creation in 2004, ethics has informally been part of its curriculum. Our study sought to determine the content and format of an ideal bioethics curriculum for a culturally diverse group of medical students. We conducted semi-structured interviews with students and focus groups with faculty to examine the cultural context and ethical issues of the elective. Three areas were explored: 1) Needs Analysis - students' current understanding of bioethics, prior bioethics education and desire for a formal ethics curriculum, 2) Teaching formats - students' and faculty's preferred teaching formats, and 3) Curriculum Content - students' and faculty's preferred subjects for a curriculum. While only some students had received formal ethics training prior to this program, all understood that it was a necessary and desirable subject for formal training. Interactive teaching formats were the most preferred and truth-telling was considered the most important subject. This study helps inform good practices for ethics education. Although undertaken with a specific cohort of students engaging in a health-for-peace elective, it may be applicable to many medical education settings since diversity of student bodies is increasing world-wide.

Medical Requirements During a Natural Disaster: A Case Study on WhatsApp Chats Among Medical Personnel During the 2015 Nepal Earthquake.

Science.gov (United States)

Basu, Moumita; Ghosh, Saptarshi; Jana, Arnab; Bandyopadhyay, Somprakash; Singh, Ravikant

2017-12-01

The objective of this study was to explore a log of WhatsApp messages exchanged among members of the health care group Doctors For You (DFY) while they were providing medical relief in the aftermath of the Nepal earthquake in April 2015. Our motivation was to identify medical resource requirements during a disaster in order to help government agencies and other responding organizations to be better prepared in any upcoming disaster. A large set of WhatsApp (WhatsApp Inc, Mountain View, CA) messages exchanged among DFY members during the Nepal earthquake was collected and analyzed to identify the medical resource requirements during different phases of relief operations. The study revealed detailed phase-wise requirements for various types of medical resources, including medicines, medical equipment, and medical personnel. The data also reflected some of the problems faced by the medical relief workers in the earthquake-affected region. The insights from this study may help not only the Nepalese government, but also authorities in other earthquake-prone regions of the world to better prepare for similar disasters in the future. Moreover, real-time analysis of such online data during a disaster would aid decision-makers in dynamically formulating resource-mapping strategies. (Disaster Med Public Health Preparedness. 2017;11:652-655).

Clinical Training of Medical Physicists Specializing in Nuclear Medicine (Spanish Edition)

International Nuclear Information System (INIS)

2013-01-01

The application of radiation in human health, for both diagnosis and treatment of disease, is an important component of the work of the IAEA. The responsibility for the increasingly technical aspects of this work is undertaken by the medical physicist. To ensure good practice in this vital area, structured clinical training programmes are required to complement academic learning. This publication is intended to be a guide to the practical implementation of such a programme for nuclear medicine. There is a general and growing awareness that radiation medicine is increasingly dependent on well trained medical physicists who are based in a clinical setting. However an analysis of the availability of medical physicists indicates a large shortfall of qualified and capable professionals. This is particularly evident in developing countries. While strategies to increase educational opportunities are critical to such countries, the need for guidance on structured clinical training was recognized by the members of the Regional Cooperative Agreement for Research, Development and Training related to Nuclear Science and Technology (RCA) for the Asia-Pacific region. Consequently, a technical cooperation regional project (RAS6038) under the RCA programme was formulated to address this need in this region by developing suitable material and establishing its viability. Development of a clinical training guide for medical physicists specialising in nuclear medicine was started in 2009 with the appointment of a core drafting committee of regional and international experts. The publication drew on the experience of clinical training in Australia, Croatia and Sweden and was moderated by physicists working in the Asian region. The present publication follows the approach of earlier IAEA publications in the Training Course Series, specifically Nos 37 and 47, Clinical Training of Medical Physicists Specializing in Radiation Oncology and Clinical Training of Medical Physicists

Clinical Training of Medical Physicists Specializing in Nuclear Medicine (French Edition)

International Nuclear Information System (INIS)

2012-01-01

The application of radiation in human health, for both diagnosis and treatment of disease, is an important component of the work of the IAEA. The responsibility for the increasingly technical aspects of this work is undertaken by the medical physicist. To ensure good practice in this vital area, structured clinical training programmes are required to complement academic learning. This publication is intended to be a guide to the practical implementation of such a programme for nuclear medicine. There is a general and growing awareness that radiation medicine is increasingly dependent on well trained medical physicists who are based in a clinical setting. However an analysis of the availability of medical physicists indicates a large shortfall of qualified and capable professionals. This is particularly evident in developing countries. While strategies to increase educational opportunities are critical to such countries, the need for guidance on structured clinical training was recognized by the members of the Regional Cooperative Agreement for Research, Development and Training related to Nuclear Science and Technology (RCA) for the Asia-Pacific region. Consequently, a technical cooperation regional project (RAS6038) under the RCA programme was formulated to address this need in this region by developing suitable material and establishing its viability. Development of a clinical training guide for medical physicists specialising in nuclear medicine was started in 2009 with the appointment of a core drafting committee of regional and international experts. The publication drew on the experience of clinical training in Australia, Croatia and Sweden and was moderated by physicists working in the Asian region. The present publication follows the approach of earlier IAEA publications in the Training Course Series, specifically Nos 37 and 47, Clinical Training of Medical Physicists Specializing in Radiation Oncology and Clinical Training of Medical Physicists

The Chinese community patient’s life satisfaction, assessment of community medical service, and trust in community health delivery system

Science.gov (United States)

2013-01-01

Background Although the Chinese government put a lot of effort into promoting the community patient’s life satisfaction, there still lacked the holistic and systematic approaches to promote the community patient’s life satisfaction in various regions of China. On the basis of the literature, it was found that both the community patient’s assessment of community medical service and trust in community health delivery system were important considerations when the community patient comprehensively evaluated community medical service to generate life satisfaction. So this study was set up to test whether and to what extent the community patient’s assessments of various major aspects of community medical service/various major aspects of the community patient’s trust in community health delivery system influenced life satisfaction in whole China/in various regions of China. Methods In order to explore the situation of China’s community health delivery system before 2009 and provide a reference for China’s community health delivery system reform, the data that could comprehensively and accurately reflect the community patient’s life satisfaction, assessment of community medical service, and trust in community health delivery system in various regions of China was needed, so this study collaborated with the National Bureau of Statistics of China to carry out a large-scale 2008 national community resident household survey (N = 3,306) for the first time in China. And the specified ordered probit models were established to analyze the dataset from this household survey. Results Among major aspects of community medical service, the medical cost (particularly in developed regions), the doctor-patient communication (particularly in developed regions), the medical facility and hospital environment (particularly in developed regions), and the medical treatment process (particularly in underdeveloped regions) were all key considerations (ppatient’s life

SOFTWARE FOR REGIONS OF INTEREST RETRIEVAL ON MEDICAL 3D IMAGES

Directory of Open Access Journals (Sweden)

G. G. Stromov

2014-01-01

Full Text Available Background. Implementation of software for areas of interest retrieval in 3D medical images is described in this article. It has been tested against large volume of model MRIs.Material and methods. We tested software against normal and pathological (severe multiple sclerosis model MRIs from tge BrainWeb resource. Technological stack is based on open-source cross-platform solutions. We implemented storage system on Maria DB (an open-sourced fork of MySQL with P/SQL extensions. Python 2.7 scripting was used for automatization of extract-transform-load operations. The computational core is written on Java 7 with Spring framework 3. MongoDB was used as a cache in the cluster of workstations. Maven 3 was chosen as a dependency manager and build system, the project is hosted at Github.Results. As testing on SSMU's LAN has showed, software has been developed is quite efficiently retrieves ROIs are matching for the morphological substratum on pathological MRIs.Conclusion. Automation of a diagnostic process using medical imaging allows to level down the subjective component in decision making and increase the availability of hi-tech medicine. Software has shown in the article is a complex solution for ROI retrieving and segmentation process on model medical images in full-automated mode.We would like to thank Robert Vincent for great help with consulting of usage the BrainWeb resource.

Medical Image Segmentation for Mobile Electronic Patient Charts Using Numerical Modeling of IoT

Directory of Open Access Journals (Sweden)

Seung-Hoon Chae

2014-01-01

Full Text Available Internet of Things (IoT brings telemedicine a new chance. This enables the specialist to consult the patient’s condition despite the fact that they are in different places. Medical image segmentation is needed for analysis, storage, and protection of medical image in telemedicine. Therefore, a variety of methods have been researched for fast and accurate medical image segmentation. Performing segmentation in various organs, the accurate judgment of the region is needed in medical image. However, the removal of region occurs by the lack of information to determine the region in a small region. In this paper, we researched how to reconstruct segmentation region in a small region in order to improve the segmentation results. We generated predicted segmentation of slices using volume data with linear equation and proposed improvement method for small regions using the predicted segmentation. In order to verify the performance of the proposed method, lung region by chest CT images was segmented. As a result of experiments, volume data segmentation accuracy rose from 0.978 to 0.981 and from 0.281 to 0.187 with a standard deviation improvement confirmed.

Framing medical tourism: an examination of appeal, risk, convalescence, accreditation, and interactivity in medical tourism web sites.

Science.gov (United States)

Mason, Alicia; Wright, Kevin B

2011-02-01

This exploratory study analyzed the content of medical tourism Web sites in an attempt to examine how they convey information about benefits and risks of medical procedures, how they frame credibility, and the degree to which these Web sites include interactive features for consumers. Drawing upon framing theory, the researchers content analyzed a sample of 66 medical tourism Web sites throughout the world. The results indicated that medical tourism Web sites largely promote the benefits of medical procedures while downplaying the risks, and relatively little information regarding the credibility of these services appears. In addition, the presentation of benefits/risks, credibility, and Web site interactivity were found to differ by region and type of facility. The authors discuss the implications of these findings concerning the framing of medical tourism Web site content, future directions for research, and limitations.

Vertical integration of medical education: Riverland experience, South Australia.

Science.gov (United States)

Rosenthal, D R; Worley, P S; Mugford, B; Stagg, P

2004-01-01

Vertical integration of medical education is currently a prominent international topic, resulting from recent strategic initiatives to improve medical education and service delivery in areas of poorly met medical need. In this article, vertical integration of medical education is defined as 'a grouping of curricular content and delivery mechanisms, traversing the traditional boundaries of undergraduate, postgraduate and continuing medical education, with the intent of enhancing the transfer of knowledge and skills between those involved in the learning-teaching process'. Educators closely involved with vertically integrated teaching in the Riverland of South Australia present an analytical description of the educational dynamics of this system. From this analysis, five elements are identified which underpin the process of successful vertical integration: (1) raised educational stakes; (2) local ownership; (3) broad university role; (4) longer attachments; and (5) shared workforce vision. Given the benefits to the Riverland medical education programs described in this paper, it is not surprising that vertical integration of medical education is a popular goal in many rural regions throughout the world. Although different contexts will result in different functional arrangements, it could be argued that the five principles outlined in this article can be applied in any region.

Clinical Training of Medical Physicists Specializing in Diagnostic Radiology

International Nuclear Information System (INIS)

2010-01-01

The application of radiation in human health, for both diagnosis and treatment of disease, is an important component of the work of the IAEA. The responsibility for the increasing technical aspects of this work is undertaken by the medical physicist. To ensure good practice in this vital area, structured clinical training programmes are required to complement academic learning. This publication is intended to be a guide to the practical implementation of such a programme for diagnostic radiology. There is a general and growing awareness that radiation medicine is increasingly dependent on well trained medical physicists based in the clinical setting. However, an analysis of the availability of medical physicists indicates a large shortfall of qualified and capable professionals. This is particularly evident in developing countries. While strategies to increase academic educational opportunities are critical to such countries, the need for guidance on structured clinical training was recognized by the members of the Regional Cooperative Agreement (RCA) for Research, Development and Training related to Nuclear Sciences for Asia and the Pacific. Consequently, a technical cooperation regional project (RAS6038) under the RCA programme was formulated to address this need in the Asia-Pacific region by developing suitable material and establishing its viability. Development of a clinical training guide for medical physicists specializing in diagnostic radiology started in 2007 with the appointment of a core drafting committee of regional and international experts. The publication drew on the experiences of clinical training programmes in Australia and New Zealand, the UK and the USA, and was moderated by physicists working in the Asian region. This publication follows the approach of the IAEA publication Training Course Series No. 37, Clinical Training of Medical Physicists specializing in Radiation Oncology. This approach to clinical training has been successfully tested

[Analysis of Xin'an imperial medical officials in the Ming and Qing Dynasties].

Science.gov (United States)

Wan, S M; Liu, B S; Lu, X

2017-01-28

Xin'an imperial medical officials of the Ming and Qing Dynasties was a special group of Xin'an doctors. It had exerted a positive and active impact on the development of traditional Chinese medicine. Rooted in the Xin'an region, with higher literacy and noble medical ethics and medical knowhow, through the imperial enlistment, examination, and other ways to enter the palace as imperial medical officials. During their tenure, they wrote books and communicated and merged with the folk medicine actively. After retiring, they were still involved actively in folk medicine activities, thus promoting and influencing the development of local medicine. The formation of Xin'an community of imperial medical officials in the Ming and Qing Dynasties was closely related to the prosperity of regional culture and commerce, and the development of medicine in Xin'an region.

A comparative study on medical image segmentation methods

Directory of Open Access Journals (Sweden)

Praylin Selva Blessy SELVARAJ ASSLEY

2014-03-01

Full Text Available Image segmentation plays an important role in medical images. It has been a relevant research area in computer vision and image analysis. Many segmentation algorithms have been proposed for medical images. This paper makes a review on segmentation methods for medical images. In this survey, segmentation methods are divided into five categories: region based, boundary based, model based, hybrid based and atlas based. The five different categories with their principle ideas, advantages and disadvantages in segmenting different medical images are discussed.

OLTENIA NORTHERN MEDICAL TOURISM AND DEVELOPMENT IN TERMS OF THE POSSIBILITY OF REGIONAL SUSTAINABILITY

Directory of Open Access Journals (Sweden)

Constanta Enea

2013-06-01

Full Text Available Health tourism in Romania is at the beginning - it exists, develops in some areas, shy, we do not boast of many tourists who come to us for such services, however, the data provided by NATA, now a year or two there were over 60,000 people who came to our country for health tourism. Of course, data are incomplete because not all tourists coming to say. But it seems that 250 million would have entered this area. Potential exists, and curiosity and demand for Romania there. But there is enough interest for the development of such tourism. Medical tourism (also called medical travel, health tourism or global healthcare is a term initially coined by travel agencies and the media to rapidly growing phenomenon of crossing international borders to obtain health care services. The paper tries to highlight the chances for Romania, more specifically, Northern Oltenia become a specific area of medical tourism or medical tourism practiced in other countries, to local patient survival chance.

Medical women of the West.

Science.gov (United States)

Scully, A L

1988-01-01

The presence in the West of women physicians with degrees from regular medical schools spans a period of approximately 130 years. Women's Medical College of Pennsylvania graduated many of these early women physicians. The first woman medical graduate of a western school was Lucy M. Field Wanzer, who finished in 1876 at the Department of Medicine, University of California in San Francisco. Soon thereafter, schools that would become Stanford University and the Oregon Health Sciences University schools of medicine, as well as the newly founded University of Southern California, were contributing to the pool of women physicians. The University of Michigan Medical School, the first coeducational state medical school, also educated some of the western women physicians, who by 1910 numbered about 155. This regional account of the progress of women physicians as they strove to become an integral part of the profession emphasizes the familiar themes of altruism, ingenuity, and perseverance that characterized their efforts. Images PMID:3074578

Grid-supported Medical Digital Library.

Science.gov (United States)

Kosiedowski, Michal; Mazurek, Cezary; Stroinski, Maciej; Weglarz, Jan

2007-01-01

Secure, flexible and efficient storing and accessing digital medical data is one of the key elements for delivering successful telemedical systems. To this end grid technologies designed and developed over the recent years and grid infrastructures deployed with their use seem to provide an excellent opportunity for the creation of a powerful environment capable of delivering tools and services for medical data storage, access and processing. In this paper we present the early results of our work towards establishing a Medical Digital Library supported by grid technologies and discuss future directions of its development. These works are part of the "Telemedycyna Wielkopolska" project aiming to develop a telemedical system for the support of the regional healthcare.

A Method for Automatic Extracting Intracranial Region in MR Brain Image

Science.gov (United States)

Kurokawa, Keiji; Miura, Shin; Nishida, Makoto; Kageyama, Yoichi; Namura, Ikuro

It is well known that temporal lobe in MR brain image is in use for estimating the grade of Alzheimer-type dementia. It is difficult to use only region of temporal lobe for estimating the grade of Alzheimer-type dementia. From the standpoint for supporting the medical specialists, this paper proposes a data processing approach on the automatic extraction of the intracranial region from the MR brain image. The method is able to eliminate the cranium region with the laplacian histogram method and the brainstem with the feature points which are related to the observations given by a medical specialist. In order to examine the usefulness of the proposed approach, the percentage of the temporal lobe in the intracranial region was calculated. As a result, the percentage of temporal lobe in the intracranial region on the process of the grade was in agreement with the visual sense standards of temporal lobe atrophy given by the medical specialist. It became clear that intracranial region extracted by the proposed method was good for estimating the grade of Alzheimer-type dementia.

Advanced medical life support procedures in vitally compromised children by a helicopter emergency medical service

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Scheffer Gert J

2010-03-01

Full Text Available Abstract Background To determine the advanced life support procedures provided by an Emergency Medical Service (EMS and a Helicopter Emergency Medical Service (HEMS for vitally compromised children. Incidence and success rate of several procedures were studied, with a distinction made between procedures restricted to the HEMS-physician and procedures for which the HEMS is more experienced than the EMS. Methods Prospective study of a consecutive group of children examined and treated by the HEMS of the eastern region of the Netherlands. Data regarding type of emergency, physiological parameters, NACA scores, treatment, and 24-hour survival were collected and subsequently analysed. Results Of the 558 children examined and treated by the HEMS on scene, 79% had a NACA score of IV-VII. 65% of the children had one or more advanced life support procedures restricted to the HEMS and 78% of the children had one or more procedures for which the HEMS is more experienced than the EMS. The HEMS intubated 38% of all children, and 23% of the children intubated and ventilated by the EMS needed emergency correction because of potentially lethal complications. The HEMS provided the greater part of intraosseous access, as the EMS paramedics almost exclusively reserved this procedure for children in cardiopulmonary resuscitation. The EMS provided pain management only to children older than four years of age, but a larger group was in need of analgesia upon arrival of the HEMS, and was subsequently treated by the HEMS. Conclusions The Helicopter Emergency Medical Service of the eastern region of the Netherlands brings essential medical expertise in the field not provided by the emergency medical service. The Emergency Medical Service does not provide a significant quantity of procedures obviously needed by the paediatric patient.

Medical Diplomacy: A Tool for Enabling National Security Strategy Objectives

Science.gov (United States)

2012-04-06

USGs global health portfolio includes a diverse set of programs and investments in...cultural linguistic competency, expertise in regional medical initiatives, and knowledge of joint coordination in the ability foster medical goodwill...operates medical research units in Egypt and Peru . Additionally, the Navy has operated facilities in Indonesia and maintains research capabilities

Disbursement of $65 million to the State of Texas for construction of a Regional Medical Technology Center at the former Superconducting Super Collider Site, Waxahachie, Texas

International Nuclear Information System (INIS)

1995-05-01

As part of a settlement agreement between the US DOE and the State of Texas, DOE proposes to transfer $65 million of federal funds to the Texas National Research Laboratory Commission (TNLRC) for construction of the Regional Medical Technology Center (RMTC) to be located in Ellis County, Texas. The RMTC would be a state-of-the-art medical facility for proton cancer therapy, operated by the State of Texas in conjunction with the University of Texas Southwestern Medical Center. The RMTC would use the linear accelerator assets of the recently terminated DOE Superconducting Super Collider Project to accelerate protons to high energies for the treatment of cancer patients. The current design provides for treatment areas, examination rooms, support laboratories, diagnostic imaging equipment, and office space as well as the accelerators (linac and synchrotron) and beam steering and shaping components. The potential environmental consequences of the proposed action are expected to be minor

Impact on medication use and adherence of Australian pharmacists' diabetes care services.

Science.gov (United States)

Krass, Ines; Taylor, Susan J; Smith, Carlene; Armour, Carol L

2005-01-01

To assess the effect of a specialized service implemented in community pharmacies for patients with type 2 diabetes on medication use and medication-related problems. Parallel group, multisite, control versus intervention, repeated measures design, with three different regions in New South Wales, Australia, used as intervention regions, then matched with control regions as much as possible. After initial training, pharmacists followed a clinical protocol for more than 9 months, with patient contact approximately monthly. Each patient received an adherence assessment at the beginning and end of the study, adherence support, and a medication review as part of the intervention. Risk of nonadherence using Brief Medication Questionnaire (BMQ) scores and changes to medication regimen. Compared with 82 control patients, 106 intervention patients with similar demographic and clinical characteristics had significantly improved self-reported nonadherence as reflected in total BMQ scores after 9 months. The mean (+/-SD) number of medications prescribed at follow-up in intervention participants decreased significantly, from 8.2+/-3.0 to 7.7+/-2.7. No reduction was observed among the control patients (7.6+/-2.4 and 7.3+/-2.4). The overall prevalence of changes to the regimen was also significantly higher in the intervention group (51%) compared with controls (40%). Community pharmacists trained in medication review and using protocols in collaboration with providers improved adherence in patients with type 2 diabetes, reduced problems patients had in accessing their medications, and recommended medication regimen changes that improved outcomes.

Regional Healthcare Effectiveness

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Olga Vladimirovna Kudelina

2016-03-01

Full Text Available An evaluation of healthcare systems effectiveness of the regions of the Russian Federation (federal districts was conducted using the Minmax method based on the data available at the United Interdepartmental Statistical Information System. Four groups of components (i.e. availability of resources; use of resources; access to resources and medical effectiveness decomposed into 17 items were analyzed. The resource availability was measured by four indicators, including the provision of doctors, nurses, hospital beds; agencies providing health care to the population. Use of resources was measured by seven indicators: the average hospital stay, days; the average bed occupancy, days; the number of operations per 1 physician surgical; the cost per unit volume of medical care: in outpatient clinics, day hospitals, inpatient and emergency care. Access to the resources was measured by three indicators: the satisfaction of the population by medical care; the capacity of outpatient clinics; the average number of visits to health facility. The medical effectiveness was also measured by three indicators: incidence with the "first-ever diagnosis of malignancy"; life expectancy at birth, years; the number of days of temporary disability. The study of the dynamics of the components and indexes for 2008–2012 allows to indicate a multidirectional influence on the regional healthcare system. In some federal districts (e.g. North Caucasian, the effectiveness decreases due to resource availability, in others (South, North Caucasian — due to the use of resources, in others (Far Eastern, Ural — due to access to resources. It is found that the effectiveness of the healthcare systems of the federal districts differs significantly. In addition, the built matrix proves the variability the of effectiveness (comparison of expenditures and results of healthcare systems of the federal districts of the Russian Federation: the high results can be obtained at high costs

[Scientific information, medical education and health policies: the Pan-American Health Organization and the creation of the Regional Library of Medicine--Bireme].

Science.gov (United States)

Pires-Alves, Fernando

2008-01-01

This article examines the creation and the first years of functioning of the Regional Library of Medicine (Biblioteca Regional de Medicina--Bireme--PAHO), today Latin-American Center for Information in Health Sciences, during 1963-1982. In the course of this analysis, Bireme is being characterized as both an apparatus and an arena for negotiation present in the most general processes of development expressed in international cooperation, information in science and technology, health policies and in the movement for expansion and reform of medical teaching. The narrative has as initial landmark the conception of a regional library of medicine for Latin America according to a model proposed by the National Library of Medicine. The article qualifies the first years of Bireme's existence as the history of the reception of this model, a trajectory that reflected the criticism of that time against the way the health care services were organized and their human resources were educated. Finally, beginning in 1976, a new model resulted in a real modification of Bireme's programmatic agenda, implying in very distinct contributions for the functioning of the regime of information in health sciences in force in Brazil and Latin America.

Medical Tourism Abroad: A new challenge to Oman's health system - Al Dakhilya region experience.

Science.gov (United States)

Al-Hinai, Saleh S; Al-Busaidi, Ahmed S; Al-Busaidi, Ibrahim H

2011-11-01

This study aimed to understand why people seek medical advice abroad given the trouble and expense this entails. The types of medical problems for which treatment abroad was sought, preferred destinations and satisfaction with the treatment were explored. A secondary aim was to give feedback to stakeholders in the health care system on how to handle this issue and meet the needs of the community. 45 patients who had recently travelled abroad for treatment were asked to complete a questionnaire or were interviewed by telephone. 40 questionnaires were received. 68% of the respondents were male. Orthopaedic diseases were the most common conditions leading patients to seek treatment abroad. Thailand was the most popular destination followed by India (50% and 30% respectively). 85% of respondents went abroad for treatment only, 10% for treatment and tourism and 2.5% were healthy, but travelled abroad for a checkup. Interestingly, 15% of the participants went abroad without first seeking medical care locally. Out of those initially treated in Oman, 38.2% had no specific diagnosis and 38.2% had received treatment, but it was not effective. 73% of respondents obtained information on treatment abroad from a friend. The Internet and medical tourism offices were the least used sources of information. 15% of the patients experienced complications after their treatment abroad. Various facts about medical treatment abroad need to be disseminated to the public. This will necessitate greater effort in public health promotion and education.

Nuclear medical examinations

International Nuclear Information System (INIS)

Chiba, Kazuo; Yamada, Hideo

1983-01-01

Nuclear medical examinations for cerebral vascular diseases were outlined. These procedures developed associated with development of scanners, production of radionuclides and development of labelled compounds. Examination of cerebral circulation with 133 Xe and sup(87m)Kr was replaced by CT. Furthermore, emission CT developed. Each of brain scintiscan, measurement of regional cerebral blood flow, positron emission CT and single photon emission CT was reviewed. (Namekawa, K.)

Abstracts of the 2. Meeting on Medical Physics in the Northeastern Region

International Nuclear Information System (INIS)

Melo, H.C.

1985-01-01

Abstracts from experimental works on medical physics are presented, especially about: calibration and thermal behaviour of personnel monitoring dosemeters, radioactive sources appliers for the treatment of patological diseases. (C.L.B.) [pt

Zweigbibliothek Medizin der Universitäts- und Landesbibliothek Münster – vor Ort, online und mobil / Medical Branch Library of the University & Regional Library Münster – local, online, and mobile

Directory of Open Access Journals (Sweden)

Obst, Oliver

2009-09-01

Full Text Available The Medical Branch Library is a subject library of the University and Regional Library Münster, and was founded in 1993 as the central medical library in the grounds of the University Hospital. Second only to the German National Library in Cologne, it is the largest medical library in North Rhine-Westphalia. The budget of the library derives mainly from the Medical Faculty. The funding from the university and from tuition fees is used to acquire textbooks. The physical library is used almost exclusively as a place of learning (by students, while the online presence mainly by researchers and physicians. The library offers since 1997 e-journals, since 2003 e-books and media for Smart Computers/Phones. It is using innovative ways for supplying journal articles, such as a virtual library budget and serving Subito for free.

A PERSPECTIVE ON MILITARY MEDICAL SERVICE ROLE IN STABILIZATION OPERATIONS: EXPANSION OF AIR FORCE MEDICAL SERVICE CAPABILITIES INMEDICAL DIPLOMACY

Science.gov (United States)

2017-04-06

global and regional international organizations (IOs), US and foreign nongovernmental organizations ( NGOs ), and private-sector individuals and for-profit...iv Abstract This research paper advocates that the US military health workers will be more effective in medical diplomacy than their NGO ...organizations (IO), and non-governmental organizations ( NGO ), provided humanitarian assistance to bring social stability to affected regions. In

Clinical Training of Medical Physicists Specializing in Radiation Oncology

International Nuclear Information System (INIS)

2009-01-01

The application of radiation in human health, for both diagnosis and treatment of disease, is an important component of the work of the IAEA. The responsibility for the increasing technical aspects of this work is undertaken by the medical physicist. To ensure good practice in this vital area structured clinical training programmes are required to complement academic learning. This publication is intended to be a guide to the practical implementation of such a programme for radiation therapy. There is a general and growing awareness that radiation medicine is increasingly dependant on well trained medical physicists that are based in the clinical setting. However an analysis of the availability of medical physicists indicates a large shortfall of qualified and capable professionals. This is particularly evident in developing countries. While strategies to increase academic educational opportunities are critical to such countries, the need for guidance on structured clinical training was recognised by the members of the Regional Cooperative Agreement (RCA) for research, development and training related to nuclear sciences for Asia and the Pacific. Consequently a technical cooperation regional project (RAS6038) under the RCA programme was formulated to address this need in the Asia Pacific region by developing suitable material and establishing its viability. Development of a clinical training guide for medical physicists specialising in radiation therapy was started in 2005 with the appointment of a core drafting committee of regional and international experts. Since 2005 the IAEA has convened two additional consultant group meetings including additional experts to prepare the present publication. The publication drew heavily, particularly in the initial stages, from the experience and documents of the Clinical Training Programme for Radiation Oncology Medical Physicists as developed by the Australasian College of Physical Scientists and Engineers in Medicine. Their

Using an electronic prescribing system to ensure accurate medication lists in a large multidisciplinary medical group.

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Stock, Ron; Scott, Jim; Gurtel, Sharon

2009-05-01

Although medication safety has largely focused on reducing medication errors in hospitals, the scope of adverse drug events in the outpatient setting is immense. A fundamental problem occurs when a clinician lacks immediate access to an accurate list of the medications that a patient is taking. Since 2001, PeaceHealth Medical Group (PHMG), a multispecialty physician group, has been using an electronic prescribing system that includes medication-interaction warnings and allergy checks. Yet, most practitioners recognized the remaining potential for error, especially because there was no assurance regarding the accuracy of information on the electronic medical record (EMR)-generated medication list. PeaceHealth developed and implemented a standardized approach to (1) review and reconcile the medication list for every patient at each office visit and (2) report on the results obtained within the PHMG clinics. In 2005, PeaceHealth established the ambulatory medication reconciliation project to develop a reliable, efficient process for maintaining accurate patient medication lists. Each of PeaceHealth's five regions created a medication reconciliation task force to redesign its clinical practice, incorporating the systemwide aims and agreed-on key process components for every ambulatory visit. Implementation of the medication reconciliation process at the PHMG clinics resulted in a substantial increase in the number of accurate medication lists, with fewer discrepancies between what the patient is actually taking and what is recorded in the EMR. The PeaceHealth focus on patient safety, and particularly the reduction of medication errors, has involved a standardized approach for reviewing and reconciling medication lists for every patient visiting a physician office. The standardized processes can be replicated at other ambulatory clinics-whether or not electronic tools are available.

RESULTS OF THE SURVEY CONDUCTED AMONG OPHTHALMOLOGISTS ON THE ISSUE OF EQUIPMENT OF MEDICAL INSTITUTIONS WITH OPHTHALMOLOGY DEVICES

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S. V. Seraphimov

2017-01-01

Full Text Available Introduction. The problem of limited accessibility and quality of ophthalmic medical care remains one of the leading ones in the national healthcare. This article presents results of the survey conducted among ophthalmologists about the effect of large-scale equipment of all medical institutions in the Leningrad Region with modern ophthalmologic devices over the recent years.Objective is to determine the contribution of the health care modernization program to equipping the medical institutions of the Leningrad Region with modern ophthalmologic medical devices, and to identify the main areas for improving the ophthalmologic care for residents of the Leningrad region with cataracts.Materials and methods. According to a specially developed questionnaire, 105 ophthalmologists from the Leningrad Region were interviewed. The survey was conducted among physicians working both in out-patient medical facilities and in medical facilities with in-patient modalities.Results. The results of the study confirmed positive changes that occurred in recent years as a result of equipping medical institutions with modern medical devices. Almost two-thirds (59.9% of respondents noted that equipping with modern medical devices had a significant impact on the quality of the medical and diagnostic measures carried out in healthcare facilities of the region.Conclusions. The equipment had a significant impact on the diagnosis and treatment of all kinds of diseases of the eye and its appendages, especially such eye disease which is so common among the population of the Leningrad Region as cataracts (75.0 per 100 ophthalmologists surveyed. At the same time, in spite of these efforts, the standard for equipping ophthalmologic departments in individual medical institutions has not been fully provided. Only every fifth (20.9% ophthalmologist noted during the survey that the list of available ophthalmic devices was sufficient, and that they all worked properly.

Value of systematic intervention for chronic obstructive pulmonary disease in a regional Japanese city based on case detection rate and medical cost

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Tawara Y

2015-08-01

Full Text Available Yuichi Tawara,1 Hideaki Senjyu,1 Kenichiro Tanaka,1 Takako Tanaka,1 Masaharu Asai,1 Ryo Kozu,2 Mitsuru Tabusadani,3 Sumihisa Honda,1 Terumitsu Sawai1 1Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; 2Department of Rehabilitation Medicine, Nagasaki University Hospital, Nagasaki, Japan; 3Center for Industry, University and Government Cooperation, Nagasaki University, Nagasaki, Japan Objective: We established a COPD taskforce for early detection, diagnosis, treatment, and intervention. We implemented a pilot intervention with a prospective and longitudinal design in a regional city. This study evaluates the usefulness of the COPD taskforce and intervention based on COPD case detection rate and per capita medical costs.Method: We distributed a questionnaire to all 8,878 inhabitants aged 50–89 years, resident in Matsuura, Nagasaki Prefecture in 2006. Potentially COPD-positive persons received a pulmonary function test and diagnosis. We implemented ongoing detection, examination, education, and treatment interventions, performed follow-up examinations or respiratory lessons yearly, and supported the health maintenance of each patient. We compared COPD medical costs in Matsuura and in the rest of Nagasaki Prefecture using data from 2004 to 2013 recorded by the association of Nagasaki National Health Insurance Organization, assessing 10-year means and annual change.Results: As of 2014, 256 people have received a definitive diagnosis of COPD; representing 31% of the estimated total number of COPD patients. Of the cases detected, 87.5% were mild or moderate in severity. COPD medical costs per patient in Matsuura were significantly lower than the rest of Nagasaki Prefecture, as was rate of increase in cost over time.Conclusion: The COPD program in Matsuura enabled early detection and treatment of COPD patients and helped to lower the associated burden of medical costs. The

Medication Use Patterns, Treatment Satisfaction, and Inadequate Control of Osteoporosis Study in the Asia-Pacific Region (MUSIC OS-AP): Design of a multinational, prospective, observational study examining the impact of gastrointestinal events on osteoporosis management in postmenopausal women.

Science.gov (United States)

Modi, Ankita; Ebeling, Peter R; Lee, Mel S; Min, Yong-Ki; Mithal, Ambrish; Yang, Xiaoqin; Sajjan, Shiva

2015-12-01

The burden of osteoporosis in the Asia-Pacific region is not well characterized. The Medication Use Patterns, Treatment Satisfaction, and Inadequate Control of Osteoporosis Study in the Asia-Pacific Region (MUSIC OS-AP) was designed to better understand the association of gastrointestinal events with patient-reported outcomes in postmenopausal women of this region. MUSIC OS-AP is a prospective, multinational, observational cohort study of postmenopausal women ≥ 50 years of age diagnosed with osteoporosis. The study was conducted in five Asia-Pacific countries: Australia, New Zealand, Taiwan, Korea, and India. MUSIC OS-AP has three components: a physician questionnaire, a retrospective chart review, and a prospective cohort study. The physician questionnaire investigated the role of gastrointestinal events in physicians' pharmacologic management of osteoporosis. The retrospective chart review, also completed by physicians, recorded rate of osteoporosis treatment and the types of osteoporosis medications prescribed to osteoporosis patients. The prospective cohort study investigated the associations between gastrointestinal events and patient-reported outcomes among patients taking oral medications for osteoporosis as well as reasons for non-treatment in patients who remained untreated. The prospective cohort study enrolled two groups of patients: untreated, and treated with oral osteoporosis medications. Untreated patients completed only the baseline surveys, providing information on gastrointestinal event rates, quality of life, health care resource use, and reasons for non-treatment. Treated patients, who were either new to osteoporosis medication or continuing an ongoing medication course, completed surveys at baseline and 3, 6, and 12 months post-baseline. The evaluations recorded patient characteristics, gastrointestinal events, health-related and osteoporosis-specific quality of life, health care resource use, medication adherence, and satisfaction with

A new day for CME/CPD in Canada: proceedings from the 1st Canada Regional Conference of the Global Alliance for Medical Education in Montreal, Canada

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Suzanne Murray

2015-11-01

Full Text Available The Global Alliance for Medical Education (GAME is a not-for-profit organization founded in 1995, with the aim of advancing innovation in medical education. The 1st GAME Canada regional conference was held in Montreal on May 22, 2015, under the leadership of Suzanne Murray, who acted as programme chair, and GAME president Lisa Sullivan. The conference brought together a broad array of speakers and panellists, including experts from academic centres, health systems, accreditors, private organizations, and industry. Thirty-one key stakeholders participated in the event, demonstrating a strong commitment towards the improvement of best practice in continuing medical education (CME/continuing professional development (CPD. The conference included diverse presentations providing opportunities for reflection and discussion throughout the day. The participants actively took part in stimulating discussions that covered a large range of topics, including the need for enhanced networking and opportunities to learn from others, the challenges of assessment and the potential solutions, interprofessional education and competencies, and, finally, the future of a Canadian CME/CPD organization.

A survey of Sub-Saharan African medical schools.

Science.gov (United States)

Chen, Candice; Buch, Eric; Wassermann, Travis; Frehywot, Seble; Mullan, Fitzhugh; Omaswa, Francis; Greysen, S Ryan; Kolars, Joseph C; Dovlo, Delanyo; El Gali Abu Bakr, Diaa Eldin; Haileamlak, Abraham; Koumare, Abdel Karim; Olapade-Olaopa, Emiola Oluwabunmi

2012-02-24

Sub-Saharan Africa suffers a disproportionate share of the world's burden of disease while having some of the world's greatest health care workforce shortages. Doctors are an important component of any high functioning health care system. However, efforts to strengthen the doctor workforce in the region have been limited by a small number of medical schools with limited enrolments, international migration of graduates, poor geographic distribution of doctors, and insufficient data on medical schools. The goal of the Sub-Saharan African Medical Schools Study (SAMSS) is to increase the level of understanding and expand the baseline data on medical schools in the region. The SAMSS survey is a descriptive survey study of Sub-Saharan African medical schools. The survey instrument included quantitative and qualitative questions focused on institutional characteristics, student profiles, curricula, post-graduate medical education, teaching staff, resources, barriers to capacity expansion, educational innovations, and external relationships with government and non-governmental organizations. Surveys were sent via e-mail to medical school deans or officials designated by the dean. Analysis is both descriptive and multivariable. Surveys were distributed to 146 medical schools in 40 of 48 Sub-Saharan African countries. One hundred and five responses were received (72% response rate). An additional 23 schools were identified after the close of the survey period. Fifty-eight respondents have been founded since 1990, including 22 private schools. Enrolments for medical schools range from 2 to 1800 and graduates range from 4 to 384. Seventy-three percent of respondents (n = 64) increased first year enrolments in the past five years. On average, 26% of respondents' graduates were reported to migrate out of the country within five years of graduation (n = 68). The most significant reported barriers to increasing the number of graduates, and improving quality, related to

A survey of Sub-Saharan African medical schools

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Chen Candice

2012-02-01

Full Text Available Abstract Background Sub-Saharan Africa suffers a disproportionate share of the world's burden of disease while having some of the world's greatest health care workforce shortages. Doctors are an important component of any high functioning health care system. However, efforts to strengthen the doctor workforce in the region have been limited by a small number of medical schools with limited enrolments, international migration of graduates, poor geographic distribution of doctors, and insufficient data on medical schools. The goal of the Sub-Saharan African Medical Schools Study (SAMSS is to increase the level of understanding and expand the baseline data on medical schools in the region. Methods The SAMSS survey is a descriptive survey study of Sub-Saharan African medical schools. The survey instrument included quantitative and qualitative questions focused on institutional characteristics, student profiles, curricula, post-graduate medical education, teaching staff, resources, barriers to capacity expansion, educational innovations, and external relationships with government and non-governmental organizations. Surveys were sent via e-mail to medical school deans or officials designated by the dean. Analysis is both descriptive and multivariable. Results Surveys were distributed to 146 medical schools in 40 of 48 Sub-Saharan African countries. One hundred and five responses were received (72% response rate. An additional 23 schools were identified after the close of the survey period. Fifty-eight respondents have been founded since 1990, including 22 private schools. Enrolments for medical schools range from 2 to 1800 and graduates range from 4 to 384. Seventy-three percent of respondents (n = 64 increased first year enrolments in the past five years. On average, 26% of respondents' graduates were reported to migrate out of the country within five years of graduation (n = 68. The most significant reported barriers to increasing the number of

A survey of Sub-Saharan African medical schools

Science.gov (United States)

2012-01-01

Background Sub-Saharan Africa suffers a disproportionate share of the world's burden of disease while having some of the world's greatest health care workforce shortages. Doctors are an important component of any high functioning health care system. However, efforts to strengthen the doctor workforce in the region have been limited by a small number of medical schools with limited enrolments, international migration of graduates, poor geographic distribution of doctors, and insufficient data on medical schools. The goal of the Sub-Saharan African Medical Schools Study (SAMSS) is to increase the level of understanding and expand the baseline data on medical schools in the region. Methods The SAMSS survey is a descriptive survey study of Sub-Saharan African medical schools. The survey instrument included quantitative and qualitative questions focused on institutional characteristics, student profiles, curricula, post-graduate medical education, teaching staff, resources, barriers to capacity expansion, educational innovations, and external relationships with government and non-governmental organizations. Surveys were sent via e-mail to medical school deans or officials designated by the dean. Analysis is both descriptive and multivariable. Results Surveys were distributed to 146 medical schools in 40 of 48 Sub-Saharan African countries. One hundred and five responses were received (72% response rate). An additional 23 schools were identified after the close of the survey period. Fifty-eight respondents have been founded since 1990, including 22 private schools. Enrolments for medical schools range from 2 to 1800 and graduates range from 4 to 384. Seventy-three percent of respondents (n = 64) increased first year enrolments in the past five years. On average, 26% of respondents' graduates were reported to migrate out of the country within five years of graduation (n = 68). The most significant reported barriers to increasing the number of graduates, and improving

Clinical Training of Medical Physicists Specializing in Diagnostic Radiology (French Edition)

International Nuclear Information System (INIS)

2012-01-01

The application of radiation in human health, for both diagnosis and treatment of disease, is an important component of the work of the IAEA. The responsibility for the increasing technical aspects of this work is undertaken by the medical physicist. To ensure good practice in this vital area, structured clinical training programmes are required to complement academic learning. This publication is intended to be a guide to the practical implementation of such a programme for diagnostic radiology. There is a general and growing awareness that radiation medicine is increasingly dependent on well trained medical physicists based in the clinical setting. However, an analysis of the availability of medical physicists indicates a large shortfall of qualified and capable professionals. This is particularly evident in developing countries. While strategies to increase academic educational opportunities are critical to such countries, the need for guidance on structured clinical training was recognized by the members of the Regional Cooperative Agreement (RCA) for Research, Development and Training related to Nuclear Sciences for Asia and the Pacific. Consequently, a technical cooperation regional project (RAS6038) under the RCA programme was formulated to address this need in the Asia-Pacific region by developing suitable material and establishing its viability. Development of a clinical training guide for medical physicists specializing in diagnostic radiology started in 2007 with the appointment of a core drafting committee of regional and international experts. The publication drew on the experiences of clinical training programmes in Australia and New Zealand, the UK and the USA, and was moderated by physicists working in the Asian region. This publication follows the approach of the IAEA publication Training Course Series No. 37, Clinical Training of Medical Physicists specializing in Radiation Oncology. This approach to clinical training has been successfully tested

Clinical Training of Medical Physicists Specializing in Diagnostic Radiology (Spanish Edition)

International Nuclear Information System (INIS)

2013-01-01

The application of radiation in human health, for both diagnosis and treatment of disease, is an important component of the work of the IAEA. The responsibility for the increasing technical aspects of this work is undertaken by the medical physicist. To ensure good practice in this vital area, structured clinical training programmes are required to complement academic learning. This publication is intended to be a guide to the practical implementation of such a programme for diagnostic radiology. There is a general and growing awareness that radiation medicine is increasingly dependent on well trained medical physicists based in the clinical setting. However, an analysis of the availability of medical physicists indicates a large shortfall of qualified and capable professionals. This is particularly evident in developing countries. While strategies to increase academic educational opportunities are critical to such countries, the need for guidance on structured clinical training was recognized by the members of the Regional Cooperative Agreement (RCA) for Research, Development and Training related to Nuclear Sciences for Asia and the Pacific. Consequently, a technical cooperation regional project (RAS6038) under the RCA programme was formulated to address this need in the Asia-Pacific region by developing suitable material and establishing its viability. Development of a clinical training guide for medical physicists specializing in diagnostic radiology started in 2007 with the appointment of a core drafting committee of regional and international experts. The publication drew on the experiences of clinical training programmes in Australia and New Zealand, the UK and the USA, and was moderated by physicists working in the Asian region. This publication follows the approach of the IAEA publication Training Course Series No. 37, Clinical Training of Medical Physicists specializing in Radiation Oncology. This approach to clinical training has been successfully tested

Characterizing customers at medical center farmers' markets.

Science.gov (United States)

Kraschnewski, Jennifer L; George, Daniel R; Rovniak, Liza S; Monroe, Diana L; Fiordalis, Elizabeth; Bates, Erica

2014-08-01

Approximately 100 farmers' markets operate on medical center campuses. Although these venues can uniquely serve community health needs, little is known about customer characteristics and outreach efforts. Intercept survey of markets and market customers between August 2010 and October 2011 at three medical centers in different geographic regions of the US (Duke University Medical Center, Cleveland Clinic, and Penn State Hershey Medical Center) were conducted. Markets reported serving 180-2,000 customers per week and conducting preventive medicine education sessions and community health programs. Customers (n = 585) across markets were similar in sociodemographic characteristics--most were middle-aged, white, and female, who were employees of their respective medical center. Health behaviors of customers were similar to national data. The surveyed medical center farmers' markets currently serve mostly employees; however, markets have significant potential for community outreach efforts in preventive medicine. If farmers' markets can broaden their reach to more diverse populations, they may play an important role in contributing to community health.

Oferta y demanda de médicos especialistas en los establecimientos de salud del Ministerio de Salud: brechas a nivel nacional, por regiones y tipo de especialidad Supply and demand of medical specialists in the health facilities of the Ministry of Health: national, regional and by type of specialty gaps

Directory of Open Access Journals (Sweden)

Leslie Zevallos

2011-06-01

medical specialists in facilities of the Ministry of Health of Peru (MINSA at the national, regional and specialty type levels. Materials and methods. Observational, descriptive study through which we calculated the supply of medical specialists using secondary sources of MINSA. The analysis of the demand for medical specialists was based on two methodologies: the need for specialists according to the guidelines of classification of the health facilities and according to the epidemiological and demographic profile. The arithmetic difference between the estimated demand and the supply was the procedure used to calculate the gap of medical specialists. Results. The Ministry of Health has a total supply at the national level of 6,074 medical specialists of which 61.5% belong to the clinical specialties, 33.2% to the surgical specialties, 4.9% specialities related to aid to diagnosis and treatment and 0.4% to public health specialties. According to the categorization guideline there is a total demand of 11,176 medical specialists and according to the epidemiological and demographic profile of 11,738. The national estimated gaps found are similar in both methods, although they differ widely across regions and by type of specialty. At the regional level, the gaps are greater in Loreto, Piura, Puno and Madre de Dios when estimating the defficit in relation to the supply. Regarding the speciality, the gap is greater in the four basic specialties: gynecology and obstetrics, pediatrics, internal medicine and general surgery. Conclusions. There is a waid gap between supply and demand of medical specialists at the national and regional levels, as a whole representing approximately 45% of the current offer, regardless of the estimation method.

[Complexity of care and organizational effectiveness: a survey among medical care units in nine Lombardy region hospitals].

Science.gov (United States)

Pasquali, Sara; Capitoni, Enrica; Tiraboschi, Giuseppina; Alborghetti, Adriana; De Luca, Giuseppe; Di Mauro, Stefania

2017-01-01

Eleven medical care units of nine Lombardy Region hospitals organized by levels of care model or by the traditional departmental model have been analyzed, in order to evaluate if methods for complexity of patient-care evaluation represent an index factor of nursing organizational effectiveness. Survey with nine Nurses in managerial position was conducted between Nov. 2013-Jan. 2014. The following factors have been described: context and nursing care model, staffing, complexity evaluation, patient satisfaction, staff well-being. Data were processed through Microsoft Excel. Among Units analysed ,all Units in levels of care and one organized by the departmental model systematically evaluate nursing complexity. Registered Nurses (RN) and Health Care Assistants (HCA) are on average numerically higher in Units that measure complexity (0.55/ 0.49 RN, 0.38/0.23 HCA - ratio per bed). Adopted measures in relation to changes in complexity are:rewarding systems, supporting interventions, such as moving personnel within different Units or additional required working hours; reduction in number of beds is adopted when no other solution is available. Patient satisfaction is evaluated through Customer Satisfaction questionnaires. Turnover, stress and rate of absenteeism data are not available in all Units. Complexity evaluation through appropriate methods is carried out in all hospitals organized in levels of care with personalized nursing care models, though complexity is detected with different methods. No significant differences in applied managerial strategies are present. Patient's satisfaction is evaluated everywhere. Data on staffing wellbeing is scarcely available. Coordinated regional actions are recommended in order to gather comparable data for research, improve decision making and effectiveness of Nursing care.

Deployment of field hospitals to disaster regions: Insights from ten medical relief operations spanning three decades.

Science.gov (United States)

Naor, Michael; Heyman, Samuel N; Bader, Tarif; Merin, Ofer

2017-01-01

The Israeli Defense Force (IDF) Medical Corps developed a model of airborne field hospital. This model was structured to deal with disaster settings, requiring self-sufficiency, innovation and flexible operative mode in the setup of large margins of uncertainty regarding the disaster environment. The current study is aimed to critically analyze the experience, gathered in ten such missions worldwide. Interviews with physicians who actively participated in the missions from 1988 until 2015 as chief medical officers combined with literature review of principal medical and auxiliary publications in order to assess and integrate information about the assembly of these missions. A body of knowledge was accumulated over the years by the IDF Medical Corps from deploying numerous relief missions to both natural (earthquake, typhoon, and tsunami), and man-made disasters, occurring in nine countries (Armenia, Rwanda, Kosovo, Turkey, India, Haiti, Japan, Philippines, and Nepal). This study shows an evolutionary pattern with improvements implemented from one mission to the other, with special adaptations (creativity and improvisation) to accommodate logistics barriers. The principals and operative function for deploying medical relief system, proposed over 20 years ago, were challenged and validated in the subsequent missions of IDF outlined in the current study. These principals, with the advantage of the military infrastructure and the expertise of drafted civilian medical professionals enable the rapid assembly and allocation of highly competent medical facilities in disaster settings. This structure model is to large extent self-sufficient with a substantial operative flexibility that permits early deployment upon request while the disaster assessment and definition of needs are preliminary.

Recognition of out-of-hospital cardiac arrest by medical dispatchers in emergency medical dispatch centres in two countries

DEFF Research Database (Denmark)

Møller, Thea Palsgaard; Andréll, Cecilia; Viereck, Søren

2016-01-01

in two steps; registry data were merged with electronically registered emergency call data from the emergency medical dispatch centres in the two regions. Cases with missing or non-OHCA dispatch codes were analysed further by auditing emergency call recordings using a uniform data collection template......INTRODUCTION: Survival after out-of-hospital cardiac arrest (OHCA) remains low. Early recognition by emergency medical dispatchers is essential for an effective chain of actions, leading to early cardiopulmonary resuscitation, use of an automated external defibrillator and rapid dispatching...... of the emergency medical services. AIM: To analyse and compare the accuracy of OHCA recognition by medical dispatchers in two countries. METHOD: An observational register-based study collecting data from national cardiac arrest registers in Denmark and Sweden during a six-month period in 2013. Data were analysed...

The geographical mobility of recently graduated medical doctors

DEFF Research Database (Denmark)

Drejer, Ina; Holm, Jacob Rubæk; Petersen, Karin Dam

specialize to become general practitioners (GPs). Access to medical services is included among the services important for ensuring the basics in a welfare society. The analysis is limited to general practitioners (GPs), although access to other types of medical professionals is also an important aspect......University graduates are not evenly distributed geographically, and attraction and retention of university graduates is high on the agenda in many regional development strategies. In this paper we study the geographical mobility of a particular type of university graduates: medical doctors who...... of local access to medical services. We have chosen GPs because they – except in cases of emergency – are the main entrance to medical services in Denmark. We study how different factors may influence where GPs choose to set up medical practice. We pay particular attention to the importance of local...

Meditate don't medicate: How medical imaging evidence supports the role of meditation in the treatment of depression

International Nuclear Information System (INIS)

Annells, S.; Kho, K.; Bridge, P.

2016-01-01

Introduction: Depression is a debilitating psychiatric disorder that affects a large proportion of the population. The current treatment for depression involves anti-depressant medication which is associated with side effects and a heightened risk of relapse. Methods: A systematic literature review was performed to determine the value of medical imaging studies in measuring the impact of meditation on depression. Results: Medical imaging studies have successfully demonstrated that meditation may counteract or prevent the physiological cause of depression by decreasing amygdala activity and increasing grey matter volume and activity of the hippocampus, prefrontal cortex and other brain regions associated with attention and emotional self-regulation. Recent advances in functional imaging have enabled visualisation of neural plasticity within the brain. This has shown that for meditators, practice-induced alterations could be due to micro-anatomical processes that may represent an increased functional capacity within the brain regions activated. These changes within brain physiology in association with the skills gained during meditation such as self-regulation, mental processing of negative information and relaxation techniques could potentially lead to a permanent cure for depression and thus prevent relapse. Conclusions: The results of this review suggest that medical imaging has a valuable role to play in evidencing the physiological changes within the brain caused by meditation that counteract those that cause depression. These studies indicate that meditation is a viable alternative to medication for clinical treatment of patients with depression. More rigorous longitudinal imaging studies are proposed to enhance understanding of the neural pathways and mechanisms of meditation. - Highlights: • Medical imaging demonstrates physiological changes that counteract those that cause depression. • Meditation is an alternative to medication for clinical treatment of

[The forensic medical aspects of the inappropriate medical care in the modern-day Ukraine].

Science.gov (United States)

Franchuk, V V

2018-01-01

Despite the fact that the ever growing relevance of the problem of the inappropriate medical care was long ago brought to the worldwide attention, it has not been practically addressed in the Ukraine since the country gained independence in 1991. The objective of the present study was to consider the specific features of expert examination of the cases of inappropriate medical care as exemplified by the materials of the legal actions and lawsuits instituted against healthcare specialists violating their occupational duties. The results of forensic medical examination by the local Bureaux of forensic medical expertise concerning the 350 so-called malpractice suits instituted in the Ternopol, Zhitomir, and Chernovtsy regions during the period from 207 to 2016 were available for the analysis. The facts of inadequate and inappropriate medical care were documented in 245 (72.0%) cases. The frequency of diagnostic and therapeutic errors amounted to 29.7% and 26.9% respectively while the improper formulation of the medical documentation was recorded in 21.3% of the cases. The cases of poor organization of the diagnostic and treatment process accounted for 14.6% of the total whereas the improper behaviour of the medical personnel was reported in 7.5% of all the known cases of provision of the healthcare services. It is concluded that in the majority of the cases, the citizens of the modern-day Ukraine receive the inappropriate (insufficient and untimely) medical care. Over 80% of the cases of the inappropriate medical care currently provided in the country can be accounted for by the objective reasons, with each fifths case being due to the violation of professional responsibilities by the healthcare providers.

Operations of the Biblioteca Regional de Medicina (BIREME).

Science.gov (United States)

Neghme, A

1975-04-01

The operations and accomplishments of the Biblioteca Regional de Medicina (BIREME), the regional medical library of the Pan American Health Organization, are summarized. Aspects of BIREME's program which are described include: strengthening biomedical collections in Latin America, network organization, international cooperation, document and information delivery, bibliographic services, and educational efforts.

The ASEAN economic community and medical qualification.

Science.gov (United States)

Kittrakulrat, Jathurong; Jongjatuporn, Witthawin; Jurjai, Ravipol; Jarupanich, Nicha; Pongpirul, Krit

2014-01-01

In the regional movement toward ASEAN Economic Community (AEC), medical professions including physicians can be qualified to practice medicine in another country. Ensuring comparable, excellent medical qualification systems is crucial but the availability and analysis of relevant information has been lacking. This study had the following aims: 1) to comparatively analyze information on Medical Licensing Examinations (MLE) across ASEAN countries and 2) to assess stakeholders' view on potential consequences of AEC on the medical profession from a Thai perspective. To search for relevant information on MLE, we started with each country's national body as the primary data source. In case of lack of available data, secondary data sources including official websites of medical universities, colleagues in international and national medical student organizations, and some other appropriate Internet sources were used. Feasibility and concerns about validity and reliability of these sources were discussed among investigators. Experts in the region invited through HealthSpace.Asia conducted the final data validation. For the second objective, in-depth interviews were conducted with 13 Thai stakeholders, purposely selected based on a maximum variation sampling technique to represent the points of view of the medical licensing authority, the medical profession, ethicists and economists. MLE systems exist in all ASEAN countries except Brunei, but vary greatly. Although the majority has a national MLE system, Singapore, Indonesia, and Vietnam accept results of MLE conducted at universities. Thailand adopted the USA's 3-step approach that aims to check pre-clinical knowledge, clinical knowledge, and clinical skills. Most countries, however, require only one step. A multiple choice question (MCQ) is the most commonly used method of assessment; a modified essay question (MEQ) is the next most common. Although both tests assess candidate's knowledge, the Objective Structured Clinical

Sanitary services in the perm region during the Great Patriotic war

Directory of Open Access Journals (Sweden)

V.A. Horoshavin

2015-06-01

Full Text Available The article is devoted to the history of the formation of the Medical Service of the (Molotov region during the war. We describe the problems encountered sanitary doctors in the war years, the direction of the main measures to address these problems. It is shown that the organizers of the health service – A.V. Kostina, V.A. Ryazanov, their colleagues have made every effort to prevent epidemics and save health of both local and evacuees. It is showed the role of volunteers, doctors of medical units at the plants, the Department of Health Medical Institute to improve the sanitary conditions in the region.

[New possibilities in emergency medical transportation and emergency services of Polish Medical Air Rescue].

Science.gov (United States)

Gałazkowski, Robert

2010-01-01

In Poland, two types of medical services are accomplished by the Medical Air Rescue (MAR) operating all over the country: emergency transport from the incident scene to hospital and inter-hospital transport. Helicopters or planes are used for this purpose. In 2009, helicopters performed 4359 flights to incidents and 1537 inter-hospital transports whereas planes performed 589 inter-hospital ambulance and 196 rescue flights. MAR operates from 17 bases of the Helicopter Emergency Medical Service (HEMS) and one airbase. Helicopters are mainly used when medical transport is emergent, within the operational region of a given base whereas planes when the distance between the present and target airports exceeds 250 km. In 2008, new modern aircraft were introduced to HEMS-helicopters EC 135. They fulfil all requirements of air transport regulations and are adjusted to visual (VFR) and instrumental (IFR) flights rules, at day and night. The medical cabin of EC 135 is ergonomic and functional considering the majority of rescue activities under life-saving circumstances. It is equipped with ventilator, defibrillator, infusion pumps etc. Defibrillators have 12-lead ECG, E(T)CO2, SpO2, NIBP, and IBP modules. Transport ventilators can work in a variety of ventilation modes including CMV, SIMV, SVV, BILEVEL, PCV, ASB, PPV and CPAP. The purchase of helicopters with modern avionic and medical configuration ensures high quality services of MAR for many years to come.

Integration of the Problem of Medical Ecology on the Level of the Highly Urbanized Region

Science.gov (United States)

Rozenberg, Gennadiy S.; Lazareva, Natalya V.; Simonov, Yury V.; Lifirenko, Natalya G.; Sarapultseva, Lilija A.

2016-01-01

The urgency of the analyzed issue is due to the study of the basic issues of medical ecology: the dynamics of demographic indicators, the correlation of somatic and reproductive public health, depending on the influence of physical factors of the urban environment on public health on the basis of medical and geographic mapping. The article aims at…

CHALLENGING ISSUES OF SPECIALIZED CARE DELIVERY TO VICTIMS OF BURNS IN THE KRASNODAR REGION

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V. A. Porkhanov

2016-01-01

Full Text Available BACKGROUND. The number of burn victims in Russia is growing annually. However, combustiology remains one of the few medical specialties in the country, which has no accepted procedure for the care delivery.MATERIAL AND METHODS. The article presents an analysis of high-tech medical assistance delivery to victims of burns in the Krasnodar Region. We also consider challenging issues on combustiology services organization in Russia and economic aspects for patients with burn injury under the compulsory medical insurance.RESULTS AND CONCLUSION. Up to 3,000 patients requiring hospital treatment are registered in the Krasnodar Region. Of 2,200 operations, 2,000 surgeries are performed in the regional burn center. Implementation of regional system of “early surgical treatment” allowed to reach some of the lowest mortality rates in Russia (in the Region: total 2.43%, adults 4.69%, children 0.16%.

Paediatric medical emergency calls to a Danish Emergency Medical Dispatch Centre: a retrospective, observational study.

Science.gov (United States)

Andersen, Kasper; Mikkelsen, Søren; Jørgensen, Gitte; Zwisler, Stine Thorhauge

2018-01-05

Little is known regarding paediatric medical emergency calls to Danish Emergency Medical Dispatch Centres (EMDC). This study aimed to investigate these calls, specifically the medical issues leading to them and the pre-hospital units dispatched to the paediatric emergencies. We performed a retrospective, observational study on paediatric medical emergency calls managed by the EMDC in the Region of Southern Denmark in February 2016. We reviewed audio recordings of emergency calls and ambulance records to identify calls concerning patients ≤ 15 years. We examined EMDC dispatch records to establish how the medical issues leading to these calls were classified and which pre-hospital units were dispatched to the paediatric emergencies. We analysed the data using descriptive statistics. Of a total of 7052 emergency calls in February 2016, 485 (6.9%) concerned patients ≤ 15 years. We excluded 19 and analysed the remaining 466. The reported medical issues were commonly classified as: "seizures" (22.1%), "sick child" (18.9%) and "unclear problem" (12.9%). The overall most common pre-hospital response was immediate dispatch of an ambulance with sirens and lights with a supporting physician-manned mobile emergency care unit (56.4%). The classification of medical issues and the dispatched pre-hospital units varied with patient age. We believe our results might help focus the paediatric training received by emergency medical dispatch staff on commonly encountered medical issues, such as the symptoms and conditions pertaining to the symptom categories "seizures" and "sick child". Furthermore, the results could prove useful in hypothesis generation for future studies examining paediatric medical emergency calls. Almost 7% of all calls concerned patients ≤ 15 years. Medical issues pertaining to the symptom categories "seizures", "sick child" and "unclear problem" were common and the calls commonly resulted in urgent pre-hospital responses.

Threats to bioethical principles in medical practice in Brazil: new medical ethics code period.

Science.gov (United States)

Gracindo, G C L; da Silva Gallo, J H; Nunes, R

2018-03-15

We aimed to outline the profile of medical professionals in Brazil who have violated the deontological norms set forth in the ethics code of the profession, and whose cases were judged by the higher tribunal for medical ethics between 2010 and 2016. This survey was conducted using a database formed from professional ethics cases extracted from the plenary of the medical ethics tribunal of the Federal Council of Medicine. These were disciplinary ethics cases that were judged at appeal level between 2010 and 2016. Most of these professionals were male (88.5%) and their mean age was 59.9 years (SD=11.62) on the date of judgment of their appeals, ranging from 28 to 95 years. Most of them were based in the southeastern region of Brazil (50.89%). Articles 1 and 18 of the medical ethics code were the rules most frequently violated. The sentence given most often was the cancellation of their professional license (37.6%) and the acts most often sentenced involved malpractice, imprudence, and negligence (18.49%). It is acknowledged that concern for the principles of bioethics was present in the appeal decisions made by the plenary of the medical ethics tribunal of the Federal Council of Medicine.

Threats to bioethical principles in medical practice in Brazil: new medical ethics code period

Directory of Open Access Journals (Sweden)

G.C.L. Gracindo

2018-03-01

Full Text Available We aimed to outline the profile of medical professionals in Brazil who have violated the deontological norms set forth in the ethics code of the profession, and whose cases were judged by the higher tribunal for medical ethics between 2010 and 2016. This survey was conducted using a database formed from professional ethics cases extracted from the plenary of the medical ethics tribunal of the Federal Council of Medicine. These were disciplinary ethics cases that were judged at appeal level between 2010 and 2016. Most of these professionals were male (88.5% and their mean age was 59.9 years (SD=11.62 on the date of judgment of their appeals, ranging from 28 to 95 years. Most of them were based in the southeastern region of Brazil (50.89%. Articles 1 and 18 of the medical ethics code were the rules most frequently violated. The sentence given most often was the cancellation of their professional license (37.6% and the acts most often sentenced involved malpractice, imprudence, and negligence (18.49%. It is acknowledged that concern for the principles of bioethics was present in the appeal decisions made by the plenary of the medical ethics tribunal of the Federal Council of Medicine.

Potential drug-drug interactions on in-patient medication ...

African Journals Online (AJOL)

Potential drug-drug interactions on in-patient medication prescriptions at Mbarara Regional Referral Hospital (MRRH) in western Uganda: prevalence, clinical importance and associated factors. SJ Lubinga, E Uwiduhaye ...

Acceptability of medical male circumcision among traidtionally non ...

African Journals Online (AJOL)

IMTU Medical Journal ... Background: Male circumcision (MC) can reduce men's risk of contracting Sexually Transmitted Infections (STIs) ... non-circumcising males accessing health care in Makambako Hospital, Njombe Region, Tanzania.

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

Health region development from the perspective of system theory - an empirical cross-regional case study.

Science.gov (United States)

Volgger, Michael; Mainil, Tomas; Pechlaner, Harald; Mitas, Ondrej

2015-01-01

Governments are increasingly establishing health regions to deal with current challenges of public health service. These regions are seen as instruments to balance public and private stakeholders, and offer health care to regional citizens as well as to medical/health tourists. However, it is still unclear how the development of such health regions as well as their governance may be conceptualized. We apply Luhmann's system theory approach in the context of a cross-regional case study that compares health region developments in the Autonomous Province of Bolzano-South Tyrol (Italy) with particular regard to the Eastern Dolomites and in the province of Zeeland (the Netherlands). We suggest that Luhmann's system theory provides a useful set of criteria to evaluate and judge health region development. Fully developed health regions can be understood as auto-poietic systems. By emphasizing programs, personnel, and communication channels, these case studies illustrate the suitability of the system theory toolset to analyze the governance and spatial embeddedness of health regions. Additionally, the study contributes to literature by indicating that health regions are closely related to identity issues and to decision making in regions. Copyright © 2014 Elsevier Ltd. All rights reserved.

Use of medications of questionable benefit in advanced dementia.

Science.gov (United States)

Tjia, Jennifer; Briesacher, Becky A; Peterson, Daniel; Liu, Qin; Andrade, Susan E; Mitchell, Susan L

2014-11-01

Advanced dementia is characterized by severe cognitive impairment and complete functional dependence. Patients' goals of care should guide the prescribing of medication during such terminal illness. Medications that do not promote the primary goal of care should be minimized. To estimate the prevalence of medications with questionable benefit used by nursing home residents with advanced dementia, identify resident- and facility-level characteristics associated with such use, and estimate associated medication expenditures. Cross-sectional study of medication use by nursing home residents with advanced dementia using a nationwide long-term care pharmacy database linked to the Minimum Data Set (460 facilities) between October 1, 2009, and September 30, 2010. Use of medication deemed of questionable benefit in advanced dementia based on previously published criteria and mean 90-day expenditures attributable to these medications per resident. Generalized estimating equations using the logit link function were used to identify resident- and facility-related factors independently associated with the likelihood of receiving medications of questionable benefit after accounting for clustering within nursing homes. Of 5406 nursing home residents with advanced dementia, 2911 (53.9%) received at least 1 medication with questionable benefit (range, 44.7% in the Mid-Atlantic census region to 65.0% in the West South Central census region). Cholinesterase inhibitors (36.4%), memantine hydrochloride (25.2%), and lipid-lowering agents (22.4%) were the most commonly prescribed. In adjusted analyses, having eating problems (adjusted odds ratio [AOR], 0.68; 95% CI, 0.59-0.78), a feeding tube (AOR, 0.58; 95% CI, 0.48-0.70), or a do-not-resuscitate order (AOR, 0.65; 95% CI, 0.57-0.75), and enrolling in hospice (AOR, 0.69; 95% CI, 0.58-0.82) lowered the likelihood of receiving these medications. High facility-level use of feeding tubes increased the likelihood of receiving these

Measures against radiation disaster/terrorism and radiation emergency medical assistance team

International Nuclear Information System (INIS)

Tominaga, Takako; Akashi, Makoto

2016-01-01

The probability of occurrence of radiological terrorism and disaster in Japan is not low. For this reason, preparations for coping with the occurrence of radiological terrorism should be an urgent issue. This paper describes the radiation medical system and the threat of radiological terrorism and disaster in Japan, and introduces the Radiation Emergency Medical Assistance Team (REMAT), one of the radiation accident/disaster response organizations at the National Institute of Radiological Sciences. Radiation exposure medical systems in Japan are constructed only in the location of nuclear facilities and adjacent prefectures. These medical systems have been developed only for the purpose of medical correspondence at the time of nuclear disaster, but preparations are not made by assuming measures against radiological terrorism. REMAT of the National Institute of Radiological Sciences is obligated to dispatch persons to the requesting prefecture to support radiation medical care in case of nuclear disaster or radiation accident. The designation of nuclear disaster orientated hospitals in each region, and the training of nuclear disaster medical staffing team were also started, but preparations are not enough. In addition to enhancing and strengthening experts, specialized agencies, and special forces dealing with radiological terrorism, it is essential to improve regional disaster management capacity and terrorism handling capacity. (A.O.)

ATTITUDES OF RURAL POPULATION WITH OCCUPATIONAL DISEASES TO MEDICAL SERVICE: EXPERTS VIEW

Directory of Open Access Journals (Sweden)

Inna Yurievna Yurova

2015-12-01

Full Text Available The article presents the analysis of factors that may influence the attitudes of rural population with occupational diseases to medical service. The analysis is based on the results of the survey that has been conducted in Saratov region in 2013-2014. Ten experts, doctors involved in treating rural population with occupational diseases in Saratov region, formed the sample.It was revealed that refusal from pre-arranged treatment and hospitalization as well as execution of documents on disability is often determined by financial factor, i.e. unwillingness of rural population to lose their job, the only source of income. According to the experts the main factors that may influence the incidence of in- and out-patient visits in rural regions are low accessibility to medical institutions due to isolated location of many rural territories, insufficiency of professional staff able to cope with occupational pathologies in central regional hospitals, lack of medical equipment and facilities. The factors preventing health-saving behavior are as follows: life style and educational level.

The academic medical centre and nongovernmental organisation partnership following a natural disaster.

Science.gov (United States)

Sarani, Babak; Mehta, Samir; Ashburn, Michael; Nakashima, Koji; Gupta, Rajan; Dombroski, Derek; Schwab, C William

2012-10-01

The global response to the 12 January 2010 earthquake in Haiti revealed the ability to mobilise medical teams quickly and effectively when academic medical centres partner non-governmental organisations (NGO) that already have a presence in a zone of devastation. Most established NGOs based in a certain region are accustomed to managing the medical conditions that are common to that area and will need additional and specialised support to treat the flux of myriad injured persons. Furthermore, an NGO with an established presence in a region prior to a disaster appears better positioned to provide sustained recovery and rehabilitation relief. Academic medical centres can supply these essential specialised resources for a prolonged time. This relationship between NGOs and academic medical centres should be further developed prior to another disaster response. This model has great potential with regard to the rapid preparation and worldwide deployment of skilled medical and surgical teams when needed following a disaster, as well as to the subsequent critical recovery phase. © 2012 The Author(s). Journal compilation © Overseas Development Institute, 2012.

Voluntary medical male circumcision: matching demand and supply with quality and efficiency in a high-volume campaign in Iringa Region, Tanzania.

Science.gov (United States)

Mahler, Hally R; Kileo, Baldwin; Curran, Kelly; Plotkin, Marya; Adamu, Tigistu; Hellar, Augustino; Koshuma, Sifuni; Nyabenda, Simeon; Machaku, Michael; Lukobo-Durrell, Mainza; Castor, Delivette; Njeuhmeli, Emmanuel; Fimbo, Bennett

2011-11-01

The government of Tanzania has adopted voluntary medical male circumcision (VMMC) as an important component of its national HIV prevention strategy and is scaling up VMMC in eight regions nationwide, with the goal of reaching 2.8 million uncircumcised men by 2015. In a 2010 campaign lasting six weeks, five health facilities in Tanzania's Iringa Region performed 10,352 VMMCs, which exceeded the campaign's target by 72%, with an adverse event (AE) rate of 1%. HIV testing was almost universal during the campaign. Through the adoption of approaches designed to improve clinical efficiency-including the use of the forceps-guided surgical method, the use of multiple beds in an assembly line by surgical teams, and task shifting and task sharing-the campaign matched the supply of VMMC services with demand. Community mobilization and bringing client preparation tasks (such as counseling, testing, and client scheduling) out of the facility and into the community helped to generate demand. This case study suggests that a campaign approach can be used to provide high-volume quality VMMC services without compromising client safety, and provides a model for matching supply and demand for VMMC services in other settings.

An analysis of the awareness and performance of radiation workers' radiation/radioactivity protection in medical institutions : Focused on Busan regional medical institutions

International Nuclear Information System (INIS)

Park, Cheol Koo; Hwang, Chul Hwan; Kim, Dong Hyun

2017-01-01

The purpose of this study was to investigate safety management awareness and behavioral investigation of radiation/radioactivity performance defenses of radiation workers' in medical institutions. Data collection consisted of 267 radiation workers working in medical institutions using structured questionnaires. As a result, it was analyzed that radiation safety management awareness and performance were high in 40s, 50s group and higher education group. The analysis according to the radiation safety management knowledge was analyzed that the 'Know very well' group had higher scores on awareness and performance scores. The analysis according to the degree of safety management effort showed the high awareness scale and the performance scale in the group 'Receiving various education or studying the safety management contents through book'. The correlations between the sub-factors showed the highest positive correlation between perceived practician and personal perspective and perceived by patient and patient's caretaker perspective. Therefore, radiation safety management for workers, patients, and patient's caretaker should be conducted through continuous education of radiation safety management through various routes of radiation workers working at medical institutions

Medical education research in GCC countries.

Science.gov (United States)

Meo, Sultan Ayoub; Hassan, Asim; Aqil, Mansoor; Usmani, Adnan Mahmood

2015-02-01

Medical education is an essential domain to produce physicians with high standards of medical knowledge, skills and professionalism in medical practice. This study aimed to investigate the research progress and prospects of GCC countries in medical education during the period 1996-2013. In this study, the research papers published in various global scientific journals during the period 1996-2013 were accessed. We recorded the total number of research documents having an affiliation with GCC Countries including Saudi Arabia, Bahrain, Kuwait, Qatar, United Arab Emirates and Oman. The main source for information was Institute of Scientific Information (ISI) Web of Science, Thomson Reuters. In ISI-Web of Science, Saudi Arabia contributed 40797 research papers, Kuwait 1666, United Arab Emirates 3045, Qatar 4265, Bahrain 1666 and Oman 4848 research papers. However, in Medical Education only Saudi Arabia contributed 323 (0.79%) research papers, Kuwait 52 (0.03%), United Arab Emirates 41(0.01%), Qatar 37(0.008%), Bahrain 28 (0.06%) and Oman 22 (0.45%) research papers in in ISI indexed journals. In medical education the Hirsch index (h-index) of Saudi Arabia is 14, United Arab Emirates 14, Kuwait 11, Qatar 8, Bahrain 8 and Oman 5. GCC countries produced very little research in medical education during the period 1996-2013. They must improve their research outcomes in medical education to produce better physicians to enhance the standards in medical practice in the region.

Psychiatric consultations and the management of associated comorbid medical conditions in a regional referral hospital

Directory of Open Access Journals (Sweden)

Nkokone S Z Tema

2015-05-01

Full Text Available Background. Psychiatrists are often called upon to evaluate patients with a medical condition and psychiatric symptoms, either as a complication thereof or initial presenting symptoms. There are often grey areas with regard to neuropsychiatric disorders in which psychiatrists and specialists from other clinical disciplines would need to co-manage or share ideas on the comprehensive treatment of a presenting patient. Objectives. This study was undertaken to provide a demographic and clinical profile of all patients consulted by the consultation-liaison psychiatry (CLP service at the Helen Joseph Hospital (HJH in Johannesburg, and to describe the clinical management of patients admitted with a diagnosis of a mental disorder associated with a comorbid medical condition, including delirium, dementia and a mood or psychotic disorder due to a general medical condition. Methods. A retrospective record review of all patients referred to the HJH CLP team over a 6-month period. Results. A total of 884 routine and emergency consultations were done for 662 patients (males n=305; females n=357 between the ages of 13 and 90 years who were referred from various other clinical departments. The most common documented reason for referral was a request for assessment (n=182; 27.5%, which consisted of mental state assessment, reconsultation and assessing capacity. A total of 63 patients (10.0% of cases consulted were admitted to either the medical or psychiatric wards with a confirmed diagnosis of delirium, dementia and/or a mood or psychotic disorder due to a general medical condition (although admission wards were identified in 55 files only. The medical wards admitted the majority (n=37; 67.3% mostly for delirium (n=28; 50.9%. HIV was identified as the most common systemic aetiological factor (n=23; 67.7%. Conclusion. In this study, a female patient between 31 and 45 years of age was slightly more likely to be referred to the HJH CLP service for assessment, and

New regulations regarding Postgraduate Medical Training in Spain: perception of the tutor's role in the Murcia Region

Directory of Open Access Journals (Sweden)

Saura-Llamas José

2010-06-01

Full Text Available Abstract Background Recently introduced regulatory changes have expanded the Tutor role to include their primary responsibility for Postgraduate Medical Training (PMT. However, accreditation and recognition of that role has been devolved to the autonomic regions. The opinions of the RT may be relevant to future decisions; Methods A comprehensive questionnaire, including demographic characteristics, academic and research achievement and personal views about their role, was sent to 201 RTs in the Murcia Region of Spain. The responses are described using median and interquartile ranges (IQR; Results There were 147 replies (response rate 73%, 69% male, mean age 45 ± 7 yrs. RTs perception of the residents' initial knowledge and commitment throughout the program was 5 (IQR 4-6 and 7 (IQR 5-8, respectively. As regards their impact on the PMT program, RTs considered that their own contribution was similar to that of senior residents. RTs perception of how their role was recognised was 5 (IQR 3-6. Only 16% did not encounter difficulties in accessing specific RT training programs. Regarding the RTs view of their various duties, supervision of patient care was accorded the greatest importance (64% while the satisfactory completion of the PMT program and supervision of day-to-day activities were also considered important (61% and 59% respectively. The main RT requirements were: a greater professional recognition (97%, protected time (95%, specific RT training programs (95% and financial recognition (86%; Conclusions This comprehensive study, reflecting the feelings of our RTs, provides a useful insight into the reality of their work and the findings ought to be taken into consideration in the imminent definitive regulatory document on PMT.

A new inequality? Privatisation, urban bias, migration and medical tourism.

Science.gov (United States)

Connell, John

2011-01-01

Access to health care in developing countries, the main destinations of medical tourists, is notoriously uneven, and often becoming more so. Medical tourism, urban bias and privatisation have combined to exacerbate this trend. This is exemplified in both Thailand and India, where regional areas have been disadvantaged by the migration of health-care workers to hospitals focusing on medical tourism, neo-liberal national financial provision for medical tourism (and related tourism campaigns) and evidence of trickle-down gains is lacking. Medical tourism challenges rather than complements local health care providers, distorts national health care systems, and raises critical national economic, ethical and social questions.

Virtue in Medical Practice: An Exploratory Study.

Science.gov (United States)

Kotzee, Ben; Ignatowicz, Agnieszka; Thomas, Hywel

2017-03-01

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

Court decisions on medical malpractice.

Science.gov (United States)

Knaak, Jan-Paul; Parzeller, Markus

2014-11-01

Recent studies on court cases dealing with medical malpractice are few and far between. This retrospective study, therefore, undertakes an analysis of medical malpractice lawsuits brought before regional courts in two judicial districts of the federal state of Hesse. Over a 5-year period (2006-2010), 232 court decisions on medical malpractice taken by the regional courts (Landgericht) of Kassel and Marburg were evaluated according to medical discipline, diagnosis, therapy, relevant level of care, charge of neglect of duty by the claimant party, outcome of the lawsuit, and further criteria. With certain overlaps, the disciplines most frequently confronted with claims of medical malpractice were accident surgery and orthopedics (30.2%; n = 70), dentistry (16.4%; n = 38), surgery (12.1%; n = 28), and gynecology and obstetrics (7.8%; n = 18), followed by the remaining medical disciplines (38.8%; n = 90). Malpractice allegations were brought against the practice-based sector in 35.8 % (n = 83) of cases, the hospital-based sector in 63.3% (n = 147) of cases, and other sectors in 0.9% (n = 2) of cases. The allegation grounds included false administration of treatment (67.2%; n = 156), false indication of treatment (37.1%; n = 86), false diagnosis (31.5%; n = 73), and/or organizational negligence (13.8%; n = 32). A breach of duty to inform was given as grounds for the claim in 38.8% (n = 90) of cases. A significant majority of 65.6% (n = 152) of cases ended in a court settlement. Of the cases, 18.9% (n = 44) were concluded by claim withdrawal, 11.2% (n = 26) by claim dismissal and 2.6% (n = 6) by criminal sentence. Of the cases, 1.7% (n = 4) were for purposes of securing evidence. Although there was no conclusive evidence of malpractice, two thirds of the cases ended in a court settlement. On the one hand, this outcome reduces the burden on the courts, but on the other, it can in the long term give

the effect of air medical transport on survival after trauma

African Journals Online (AJOL)

region in the latter part of 1999. This empirical research assessed death rate data to ascertain if the air medical transport (AMT) of patients results in lower death rates than occur with road transportation of patients. Wits Business School ... the South African medical environment, patients were evaluated at the trauma units of ...

Problem-based learning in regional anatomy education at Peking University.

Science.gov (United States)

Wang, Jun; Zhang, Weiguang; Qin, Lihua; Zhao, Jing; Zhang, Shuyong; Gu, Jin; Zhou, Changman

2010-01-01

Problem-based learning (PBL) has been introduced to medical schools around the world and has increasingly become a popular pedagogical technique in Asian countries since 1990. Gross anatomy is a fundamental basic science course in virtually all medical training programs, and the methods used to teach it are under frequent scrutiny and revision. Students often struggle with the vast collection of new terms and complex relationships between structures that they must learn. To help students with this process, our department teaches separate systemic and regional anatomy courses, the latter in a PBL format. After three years of using PBL in our regional anatomy course, we have worked out a set of effective instructions that we would like to share with other medical schools. We report here evidence that our clinical PBL approach stimulates students' interest in learning and enhances anatomy education in a way that can foster better practices in our future medical work force. (c) 2010 American Association of Anatomists.

Sexual and gender minority identity disclosure during undergraduate medical education: "in the closet" in medical school.

Science.gov (United States)

Mansh, Matthew; White, William; Gee-Tong, Lea; Lunn, Mitchell R; Obedin-Maliver, Juno; Stewart, Leslie; Goldsmith, Elizabeth; Brenman, Stephanie; Tran, Eric; Wells, Maggie; Fetterman, David; Garcia, Gabriel

2015-05-01

To assess identity disclosure among sexual and gender minority (SGM) students pursuing undergraduate medical training in the United States and Canada. From 2009 to 2010, a survey was made available to all medical students enrolled in the 176 MD- and DO-granting medical schools in the United States and Canada. Respondents were asked about their sexual and gender identity, whether they were "out" (i.e., had publicly disclosed their identity), and, if they were not, their reasons for concealing their identity. The authors used a mixed-methods approach and analyzed quantitative and qualitative survey data. Of 5,812 completed responses (of 101,473 eligible respondents; response rate 5.7%), 920 (15.8%) students from 152 (of 176; 86.4%) institutions identified as SGMs. Of the 912 sexual minorities, 269 (29.5%) concealed their sexual identity in medical school. Factors associated with sexual identity concealment included sexual minority identity other than lesbian or gay, male gender, East Asian race, and medical school enrollment in the South or Central regions of North America. The most common reasons for concealing one's sexual identity were "nobody's business" (165/269; 61.3%), fear of discrimination in medical school (117/269; 43.5%), and social or cultural norms (110/269; 40.9%). Of the 35 gender minorities, 21 (60.0%) concealed their gender identity, citing fear of discrimination in medical school (9/21; 42.9%) and lack of support (9/21; 42.9%). SGM students continue to conceal their identity during undergraduate medical training. Medical institutions should adopt targeted policies and programs to better support these individuals.

Medical Image Compression Based on Region of Interest, With Application to Colon CT Images

National Research Council Canada - National Science Library

Gokturk, Salih

2001-01-01

...., in diagnostically important regions. This paper discusses a hybrid model of lossless compression in the region of interest, with high-rate, motion-compensated, lossy compression in other regions...

Characterizing customers at medical center farmers’ markets1

Science.gov (United States)

Kraschnewski, Jennifer L.; George, Daniel R.; Rovniak, Liza S.; Monroe, Diana L.; Fiordalis, Elizabeth; Bates, Erica

2014-01-01

Approximately 100 farmers’ markets operate on medical center campuses. Although these venues can uniquely serve community health needs, little is known about customer characteristics and outreach efforts. Intercept survey of markets and market customers between August 2010-October 2011 at three medical centers in different geographic regions of the US: Duke University Medical Center, Cleveland Clinic, and Penn State Hershey Medical Center were conducted. Markets reported serving 180–2000 customers per week and conducting preventive medicine education sessions and community health programs. Customers (n=585) across markets were similar in sociodemographic characteristics – most were middle-aged, white, and female, who were employees of their respective medical center. Health behaviors of customers were similar to national data. The surveyed medical center farmers’ markets currently serve mostly employees; however, markets have significant potential for community outreach efforts in preventive medicine. If farmers’ markets can broaden their reach to more diverse populations, they may play an important role in contributing to community health. PMID:24421001

MEDICAL MANUFACTURING INNOVATIONS

Directory of Open Access Journals (Sweden)

Cosma Sorin Cosmin

2015-02-01

Full Text Available The purpose of these studies was to improve the design and manufacturing process by selective laser melting, of new medical implants. After manufacturing process, the implants were measured, microscopically and mechanical analyzed. Implants manufactured by AM can be an attractive option for surface coatings to improve the osseointegration process. The main advantages of customized implants made by AM process are: the precise adaptation to the region of implantation, better cosmesis, reduced surgical times and better performance over their generic counterparts. These medical manufacturing changes the way that the surgeons are planning surgeries and engineers are designing custom implant. AM process has eliminated the constraints of shape, size, internal structure and mechanical properties making it possible for fabrication of implants that conform to the physical and mechanical requirements of implantation according to CT images. This article will review some custom implants fabricated in DME using biocompatible titanium.

The Impact of a Patient Safety Program on Medical Error Reporting

Science.gov (United States)

2005-05-01

307 The Impact of a Patient Safety Program on Medical Error Reporting Donald R. Woolever Abstract Background: In response to the occurrence of...a sentinel event—a medical error with serious consequences—Eglin U.S. Air Force (USAF) Regional Hospital developed and implemented a patient safety...communication, teamwork, and reporting. Objective: To determine the impact of a patient safety program on patterns of medical error reporting. Methods: This

Generic Procedures for Medical Response During a Nuclear or Radiological Emergency

International Nuclear Information System (INIS)

2009-01-01

The aim of this manual is to provide the medical community with practical guidance for medical emergency preparedness and response, describing the tasks and actions of different members of the national, regional or local medical infrastructure in accordance with international standards. This document provides generic response procedures for medical personnel responding to different types of radiation emergencies and at the different stages of the emergency response (at the scene of the emergency, pre-hospital, hospital), and during the early post-emergency stage (about 1-2 months afterwards).

Empathy in Medical Students: Exploring the Impact of a Longitudinal Integrated Clerkship Model

Science.gov (United States)

Bergstresser, Kara

2017-01-01

Empathy is considered a significant factor in the physician-patient relationship. The current study examined the impact of a Longitudinal Integrated Clerkship (LIC) model on empathy and patient-centered attitude in medical students. Archival data were examined from 186 medical students at a medical college in the mid-Atlantic region of the United…

Motion and deformation estimation from medical imagery by modeling sub-structure interaction and constraints

KAUST Repository

Sundaramoorthi, Ganesh

2012-09-13

This paper presents a novel medical image registration algorithm that explicitly models the physical constraints imposed by objects or sub-structures of objects that have differing material composition and border each other, which is the case in most medical registration applications. Typical medical image registration algorithms ignore these constraints and therefore are not physically viable, and to incorporate these constraints would require prior segmentation of the image into regions of differing material composition, which is a difficult problem in itself. We present a mathematical model and algorithm for incorporating these physical constraints into registration / motion and deformation estimation that does not require a segmentation of different material regions. Our algorithm is a joint estimation of different material regions and the motion/deformation within these regions. Therefore, the segmentation of different material regions is automatically provided in addition to the image registration satisfying the physical constraints. The algorithm identifies differing material regions (sub-structures or objects) as regions where the deformation has different characteristics. We demonstrate the effectiveness of our method on the analysis of cardiac MRI which includes the detection of the left ventricle boundary and its deformation. The experimental results indicate the potential of the algorithm as an assistant tool for the quantitative analysis of cardiac functions in the diagnosis of heart disease.

Clinical Training of Medical Physicists Specializing in Radiation Oncology (French Ed.)

International Nuclear Information System (INIS)

2012-01-01

The application of radiation in human health, for both diagnosis and treatment of disease, is an important component of the work of the IAEA. The responsibility for the increasing technical aspects of this work is undertaken by the medical physicist. To ensure good practice in this vital area structured clinical training programmes are required to complement academic learning. This publication is intended to be a guide to the practical implementation of such a programme for radiation therapy. There is a general and growing awareness that radiation medicine is increasingly dependant on well trained medical physicists that are based in the clinical setting. However an analysis of the availability of medical physicists indicates a large shortfall of qualified and capable professionals. This is particularly evident in developing countries. While strategies to increase academic educational opportunities are critical to such countries, the need for guidance on structured clinical training was recognised by the members of the Regional Cooperative Agreement (RCA) for research, development and training related to nuclear sciences for Asia and the Pacific. Consequently a technical cooperation regional project (RAS6038) under the RCA programme was formulated to address this need in the Asia Pacific region by developing suitable material and establishing its viability. Development of a clinical training guide for medical physicists specialising in radiation therapy was started in 2005 with the appointment of a core drafting committee of regional and international experts. Since 2005 the IAEA has convened two additional consultant group meetings including additional experts to prepare the present publication. The publication drew heavily, particularly in the initial stages, from the experience and documents of the Clinical Training Programme for Radiation Oncology Medical Physicists as developed by the Australasian College of Physical Scientists and Engineers in Medicine. Their

Clinical Training of Medical Physicists Specializing in Radiation Oncology (Spanish Ed.)

International Nuclear Information System (INIS)

2012-01-01

The application of radiation in human health, for both diagnosis and treatment of disease, is an important component of the work of the IAEA. The responsibility for the increasing technical aspects of this work is undertaken by the medical physicist. To ensure good practice in this vital area structured clinical training programmes are required to complement academic learning. This publication is intended to be a guide to the practical implementation of such a programme for radiation therapy. There is a general and growing awareness that radiation medicine is increasingly dependant on well trained medical physicists that are based in the clinical setting. However an analysis of the availability of medical physicists indicates a large shortfall of qualified and capable professionals. This is particularly evident in developing countries. While strategies to increase academic educational opportunities are critical to such countries, the need for guidance on structured clinical training was recognised by the members of the Regional Cooperative Agreement (RCA) for research, development and training related to nuclear sciences for Asia and the Pacific. Consequently a technical cooperation regional project (RAS6038) under the RCA programme was formulated to address this need in the Asia Pacific region by developing suitable material and establishing its viability. Development of a clinical training guide for medical physicists specialising in radiation therapy was started in 2005 with the appointment of a core drafting committee of regional and international experts. Since 2005 the IAEA has convened two additional consultant group meetings including additional experts to prepare the present publication. The publication drew heavily, particularly in the initial stages, from the experience and documents of the Clinical Training Programme for Radiation Oncology Medical Physicists as developed by the Australasian College of Physical Scientists and Engineers in Medicine. Their

Regional tourist industry in context of principles of regional socioeconomic systems self-regulation

Directory of Open Access Journals (Sweden)

Andrey Gennadyevich Shelomentsev

2011-03-01

Full Text Available This paper deals with basic principles of self-regulation of tourist complexes as regional socio-economic systems on the example of Sverdlovsk region. These include the principles of goal setting and the necessary diversity of economic entropy: in this case, these are important for the tourism industry and the human and natural resource and ecological potential. Is it shown how a tourist complex influences the socio-economic development of regional economic systems. In particular, tourism influences some of migration processes. Tourism development strategy in the Russian Federation at the tourist center level is analyzed. The need to develop such a strategy is due to the transition to market relations and, as a consequence, complexity of governmental regulation. It is substantiated that Sverdlovsk region is a subject to following strategy and might be successful in various sectors of tourism: business and congress and exhibition, urban entertainment, family and shopping tourism, sports, medical and recreational tourism.

Supervised variational model with statistical inference and its application in medical image segmentation.

Science.gov (United States)

Li, Changyang; Wang, Xiuying; Eberl, Stefan; Fulham, Michael; Yin, Yong; Dagan Feng, David

2015-01-01

Automated and general medical image segmentation can be challenging because the foreground and the background may have complicated and overlapping density distributions in medical imaging. Conventional region-based level set algorithms often assume piecewise constant or piecewise smooth for segments, which are implausible for general medical image segmentation. Furthermore, low contrast and noise make identification of the boundaries between foreground and background difficult for edge-based level set algorithms. Thus, to address these problems, we suggest a supervised variational level set segmentation model to harness the statistical region energy functional with a weighted probability approximation. Our approach models the region density distributions by using the mixture-of-mixtures Gaussian model to better approximate real intensity distributions and distinguish statistical intensity differences between foreground and background. The region-based statistical model in our algorithm can intuitively provide better performance on noisy images. We constructed a weighted probability map on graphs to incorporate spatial indications from user input with a contextual constraint based on the minimization of contextual graphs energy functional. We measured the performance of our approach on ten noisy synthetic images and 58 medical datasets with heterogeneous intensities and ill-defined boundaries and compared our technique to the Chan-Vese region-based level set model, the geodesic active contour model with distance regularization, and the random walker model. Our method consistently achieved the highest Dice similarity coefficient when compared to the other methods.

Medical physics practice and training in Ghana.

Science.gov (United States)

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

2016-06-01

Medical physics has been an indispensable and strategic stakeholder in the delivery of radiological services to the healthcare system of Ghana. The practice has immensely supported radiation oncology and medical imaging facilities over the years, while the locally established training programme continues to produce human resource to feed these facilities. The training programme has grown to receive students from other African countries in addition to local students. Ghana has been recognised by the International Atomic Energy Agency as Regional Designated Centre for Academic Training of Medical Physicists in Africa. The Ghana Society for Medical Physics collaborates with the School of Nuclear and Allied Sciences of the University of Ghana to ensure that training offered to medical physicists meet international standards, making them clinically qualified. The Society has also worked together with other bodies for the passage of the Health Profession's Regulatory Bodies Act, giving legal backing to the practice of medical physics and other allied health professions in Ghana. The country has participated in a number of International Atomic Energy Agency's projects on medical physics and has benefited from its training courses, fellowships and workshops, as well as those of other agencies such as International Organization for Medical Physics. This has placed Ghana's medical physicists in good position to practice competently and improve healthcare. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Assessing accuracy of an electronic provincial medication repository

Directory of Open Access Journals (Sweden)

Price Morgan

2012-05-01

Full Text Available Abstract Background Jurisdictional drug information systems are being implemented in many regions around the world. British Columbia, Canada has had a provincial medication dispensing record, PharmaNet, system since 1995. Little is known about how accurately PharmaNet reflects actual medication usage. Methods This prospective, multi-centre study compared pharmacist collected Best Possible Medication Histories (BPMH to PharmaNet profiles to assess accuracy of the PharmaNet profiles for patients receiving a BPMH as part of clinical care. A review panel examined the anonymized BPMHs and discrepancies to estimate clinical significance of discrepancies. Results 16% of medication profiles were accurate, with 48% of the discrepant profiles considered potentially clinically significant by the clinical review panel. Cardiac medications tended to be more accurate (e.g. ramipril was accurate >90% of the time, while insulin, warfarin, salbutamol and pain relief medications were often inaccurate (80–85% of the time. 1215 sequential BPMHs were collected and reviewed for this study. Conclusions The PharmaNet medication repository has a low accuracy and should be used in conjunction with other sources for medication histories for clinical or research purposes. This finding is consistent with other, smaller medication repository accuracy studies in other jurisdictions. Our study highlights specific medications that tend to be lower in accuracy.

[Integration of district psychiatric hospitals into the development of regional community psychiatry networks--the actual state. Results of a survey among medical directors of Bavarian district hospitals].

Science.gov (United States)

Welschehold, Michael; Kraus, Eva

2004-11-01

In this study, the medical directors of all Bavarian district psychiatric hospitals evaluated certain aspects of the integration of their hospitals into the development of regional community psychiatry networks ("Gemeindepsychiatrische Verbunde" - GPVs). They were asked to rate the actual quantity of cooperation between their hospitals and diverse community based services and to express their requests concerning the quality of cooperation. An estimation of possible advantages of the hospitals' integration in GPVs and expectations to future perspectives of GPV development were also investigated. The data were collected by a written questionnaire. The results of the survey indicate that a high relevance is attached to GPV: inspite of current heterogenous developments and inspite of existing skepticism concerning the feasibility of a complete GPV structure, medical directors strongly approve of seeing their hospitals actively engaged in the further development of community psychiatry networks.

Implementing standards for the interoperability among healthcare providers in the public regionalized Healthcare Information System of the Lombardy Region.

Science.gov (United States)

Barbarito, Fulvio; Pinciroli, Francesco; Mason, John; Marceglia, Sara; Mazzola, Luca; Bonacina, Stefano

2012-08-01

Information technologies (ITs) have now entered the everyday workflow in a variety of healthcare providers with a certain degree of independence. This independence may be the cause of difficulty in interoperability between information systems and it can be overcome through the implementation and adoption of standards. Here we present the case of the Lombardy Region, in Italy, that has been able, in the last 10 years, to set up the Regional Social and Healthcare Information System, connecting all the healthcare providers within the region, and providing full access to clinical and health-related documents independently from the healthcare organization that generated the document itself. This goal, in a region with almost 10 millions citizens, was achieved through a twofold approach: first, the political and operative push towards the adoption of the Health Level 7 (HL7) standard within single hospitals and, second, providing a technological infrastructure for data sharing based on interoperability specifications recognized at the regional level for messages transmitted from healthcare providers to the central domain. The adoption of such regional interoperability specifications enabled the communication among heterogeneous systems placed in different hospitals in Lombardy. Integrating the Healthcare Enterprise (IHE) integration profiles which refer to HL7 standards are adopted within hospitals for message exchange and for the definition of integration scenarios. The IHE patient administration management (PAM) profile with its different workflows is adopted for patient management, whereas the Scheduled Workflow (SWF), the Laboratory Testing Workflow (LTW), and the Ambulatory Testing Workflow (ATW) are adopted for order management. At present, the system manages 4,700,000 pharmacological e-prescriptions, and 1,700,000 e-prescriptions for laboratory exams per month. It produces, monthly, 490,000 laboratory medical reports, 180,000 radiology medical reports, 180

[Medication adherence and use of health services in patients with psychosis in the region of Osona (Catalonia, Spain)].

Science.gov (United States)

Palmarola-Ginesta, Joan; Chirveches-Pérez, Emilia; Puigoriol-Juvanteny, Emma; Bleda-García, Francesc; Villa-Ribas, Ester; Arrufat-Nebot, Francesc Xavier

2014-04-01

To describe and analyze sociodemographic and clinical characteristics, medication adherence and use of health resources by country of birth of psychosis diagnosed patients treated with long-term antipsychotic injectable drugs in the region of Osona (Catalonia, Spain). Descriptive observational study in psychosis diagnosed patients over 18 years old, receiving long-term antipsychotic injectable treatment and treated at a Mental Health Center for adults in Vic (Catalonia, Spain). 185 patients were included, of them: 163 (88.1%) were born in Spain and 22 (17.9%) abroad. The sample was gender homogeneous with differences in age, employment status, family situation and diagnosis (p Spain-born patients and 9.1% of abroad-born patients received the injectable treatment at Primary Care Center (p Spain and 6 (27.3%) abroad (p = 0.012). All patients diagnosed with psychosis, either born or not in Spain, describe good adherence to long-term antipsychotic injectable treatment, with similar use of health resources from a quantitative point of view and some differences in the type of visits.

Medical ethics, bioethics and research ethics education perspectives in South East Europe in graduate medical education.

Science.gov (United States)

Mijaljica, Goran

2014-03-01

Ethics has an established place within the medical curriculum. However notable differences exist in the programme characteristics of different schools of medicine. This paper addresses the main differences in the curricula of medical schools in South East Europe regarding education in medical ethics and bioethics, with a special emphasis on research ethics, and proposes a model curriculum which incorporates significant topics in all three fields. Teaching curricula of Medical Schools in Bulgaria, Bosnia and Herzegovina, Croatia, Serbia, Macedonia and Montenegro were acquired and a total of 14 were analyzed. Teaching hours for medical ethics and/or bioethics and year of study in which the course is taught were also analyzed. The average number of teaching hours in medical ethics and bioethics is 27.1 h per year. The highest national average number of teaching hours was in Croatia (47.5 h per year), and the lowest was in Serbia (14.8). In the countries of the European Union the mean number of hours given to ethics teaching throughout the complete curriculum was 44. In South East Europe, the maximum number of teaching hours is 60, while the minimum number is 10 teaching hours. Research ethics topics also show a considerable variance within the regional medical schools. Approaches to teaching research ethics vary, even within the same country. The proposed model for education in this area is based on the United Nations Educational, Scientific and Cultural Organization Bioethics Core Curriculum. The model curriculum consists of topics in medical ethics, bioethics and research ethics, as a single course, over 30 teaching hours.

Factors Influencing Electronic Clinical Information Exchange in Small Medical Group Practices

Science.gov (United States)

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

2012-01-01

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

Undergraduate medical education in the Gulf Cooperation Council: a multi-countries study (Part 1).

Science.gov (United States)

Hamdy, H; Telmesani, A W; Al Wardy, N; Abdel-Khalek, N; Carruthers, G; Hassan, F; Kassab, S; Abu-Hijleh, M; Al-Roomi, K; O'malley, K; El Din Ahmed, M G; Raj, G A; Rao, G M; Sheikh, K

2010-01-01

The Gulf Cooperation Council (GCC) countries have witnessed over the last 40 years a rapid and major social, cultural, and economic transformation. The development of medical education in the region is relatively new, dating from the late 1960s. An important goal among the medical colleges in the region is to graduate national physicians who can populate the healthcare service of each country. The aim of this study is to provide understanding of undergraduate medical education in each of the six GCC countries and the challenges that each face. This is a descriptive cross-sectional study. Fourteen senior medical faculty were requested to submit information about undergraduate medical education in their own countries, focusing on its historical background, student selection, curriculum, faculty, and challenges. The information provided was about 27 medical colleges: 16 from the Kingdom of Saudi Arabia (KSA), five from the United Arab Emirates (UAE), two from the Kingdom of Bahrain, two from Sultanate of Oman, one from Kuwait, and one from the State of Qatar. It was found that older colleges are reviewing their curriculum while new colleges are developing their programs following current trends in medical education, particularly problem-based learning and integrated curricula. The programs as described 'on paper' look good but what needs to be evaluated is the curriculum 'in action'. Faculty development in medical education is taking place in most of the region's medical colleges. The challenges reported were mainly related to shortages of faculty, availability of clinical training facilities and the need to more integration with the National Health Care services. Attention to quality, standards, and accreditation is considered essential by all colleges.

Undergraduate medical education in the Gulf Cooperation Council: a multi-countries study (Part 2).

Science.gov (United States)

Hamdy, H; Telmesani, A W; Wardy, N Al; Abdel-Khalek, N; Carruthers, G; Hassan, F; Kassab, S; Abu-Hijleh, M; Al-Roomi, K; O'Malley, K; El Din Ahmed, M G; Raj, G A; Rao, G M; Sheikh, J

2010-01-01

The Gulf Cooperation Council (GCC) countries have witnessed over the last 40 years a rapid and major social, cultural, and economic transformation. The development of medical education in the region is relatively new, dating from the late 1960s. An important goal among the medical colleges in the region is to graduate national physicians who can populate the healthcare service of each country. The aim of this study is to provide understanding of undergraduate medical education in each of the six GCC countries and the challenges that each face. This is a descriptive cross-sectional study. Fourteen senior medical faculty were requested to submit information about undergraduate medical education in their own countries, focusing on its historical background, student selection, curriculum, faculty, and challenges. The information provided was about 27 medical colleges: 16 from the Kingdom of Saudi Arabia (KSA), five from the United Arab Emirates, two from the Kingdom of Bahrain, two from Sultanate of Oman, one from Kuwait and one from the State of Qatar. It was found that older colleges are reviewing their curriculum while new colleges are developing their programs following current trends in medical education particularly problem-based learning and integrated curricula. The programs as described 'on paper' look good but what needs to be evaluated is the curriculum 'in action'. Faculty development in medical education is taking place in most of the region's medical colleges. The challenges reported were mainly related to shortages of faculty, availability of clinical training facilities, and the need to more integration with the National Health Care services. Attention to quality, standards, and accreditation is considered essential by all colleges.

Concurrent alcohol and medication poisoning hospital admissions among older rural and urban residents.

Science.gov (United States)

Zanjani, Faika; Smith, Rachel; Slavova, Svetla; Charnigo, Richard; Schoenberg, Nancy; Martin, Catherine; Clayton, Richard

2016-07-01

Alcohol and medication interactions are projected to increase due to the growth of older adults that are unsafely consuming alcohol and medications. Plus, aging adults who reside in rural areas are at the highest risk of experiencing medication interactions. Estimate concurrent alcohol and medication (alcohol/medication) hospitalizations in adults 50+ years, comparing age groups and rural/urban regions. Kentucky nonfederal, acute care inpatient hospital discharge electronic records for individuals aged 50+ years from 2001 to 2012 were examined. Rate differences were estimated across age and regional strata. Differences in the underlying principal diagnosis, intent, and medications were also examined. There were 2168 concurrent alcohol/medication hospitalizations among 50+ year olds identified. There was a 187% increase in alcohol/medication hospitalizations from 2001 (n = 104) to 2012 (n = 299). The per capita alcohol/medication hospitalization rate increased from 8.91 (per 100,000) in 2001 to 19.98 (per 100,000) in 2012, a 124% increase. The characteristics of the hospitalizations included 75% principal diagnosis as medication poisoning, self-harm as the primary intent (55%) in 50-64-year olds, and unintentional intent (41%) in 65+ adults. Benzodiazepines were most often involved in the poisonings (36.5%). Concurrent alcohol/medication hospitalizations in Kentucky are increasing among aging adults. Greater increases in rural areas and the 65+ aged adults were seen, although there were also higher alcohol/medication hospitalizations in urban and 50-64 aged adults. These findings indicate the need for public-health prevention and clinical intervention to better educate and manage alcohol consuming older adults on safe medication and alcohol practices.

Musculoskeletal disorder costs and medical claim filing in the US retail trade sector.

Science.gov (United States)

Bhattacharya, Anasua; Leigh, J Paul

2011-01-01

The average costs of Musculoskeletal Disorder (MSD) and odds ratios for filing medical claims related to MSD were examined. The medical claims were identified by ICD 9 codes for four US Census regions within retail trade. Large private firms' medical claims data from Thomson Reuters Inc. MarketScan databases for the years 2003 through 2006 were used. Average costs were highest for claims related to lumbar region (ICD 9 Code: 724.02) and number of claims were largest for low back syndrome (ICD 9 Code: 724.2). Whereas the odds of filing an MSD claim did not vary greatly over time, average costs declined over time. The odds of filing claims rose with age and were higher for females and southerners than men and non-southerners. Total estimated national medical costs for MSDs within retail trade were $389 million (2007 USD).

Medication use in pregnancy: a cross-sectional, multinational web-based study.

Science.gov (United States)

Lupattelli, A; Spigset, O; Twigg, M J; Zagorodnikova, K; Mårdby, A C; Moretti, M E; Drozd, M; Panchaud, A; Hämeen-Anttila, K; Rieutord, A; Gjergja Juraski, R; Odalovic, M; Kennedy, D; Rudolf, G; Juch, H; Passier, A; Björnsdóttir, I; Nordeng, H

2014-02-17

Intercountry comparability between studies on medication use in pregnancy is difficult due to dissimilarities in study design and methodology. This study aimed to examine patterns and factors associated with medications use in pregnancy from a multinational perspective, with emphasis on type of medication utilised and indication for use. Cross-sectional, web-based study performed within the period from 1 October 2011 to 29 February 2012. Uniform collection of drug utilisation data was performed via an anonymous online questionnaire. Multinational study in Europe (Western, Northern and Eastern), North and South America and Australia. Pregnant women and new mothers with children less than 1 year of age. Prevalence of and factors associated with medication use for acute/short-term illnesses, chronic/long-term disorders and over-the-counter (OTC) medication use. The study population included 9459 women, of which 81.2% reported use of at least one medication (prescribed or OTC) during pregnancy. Overall, OTC medication use occurred in 66.9% of the pregnancies, whereas 68.4% and 17% of women reported use of at least one medication for treatment of acute/short-term illnesses and chronic/long-term disorders, respectively. The extent of self-reported medicated illnesses and types of medication used by indication varied across regions, especially in relation to urinary tract infections, depression or OTC nasal sprays. Women with higher age or lower educational level, housewives or women with an unplanned pregnancy were those most often reporting use of medication for chronic/long-term disorders. Immigrant women in Western (adjusted OR (aOR): 0.55, 95% CI 0.34 to 0.87) and Northern Europe (aOR: 0.50, 95% CI 0.31 to 0.83) were less likely to report use of medication for chronic/long-term disorders during pregnancy than non-immigrants. In this study, the majority of women in Europe, North America, South America and Australia used at least one medication during pregnancy. There

The new innovative medical education system in Ethiopia ...

African Journals Online (AJOL)

User

Background: A New Innovative Medical Education Initiative (NIMEI) had been launched in Ethiopia in February ... development as well as for the overall health system of the country. .... A national survey was conducted in all regions of Ethiopia.

Regional cerebral blood flow in schizophrenia

International Nuclear Information System (INIS)

Mathew, R.J.; Duncan, G.C.; Weinman, M.L.; Barr, D.L.

1982-01-01

Regional cerebral blood flow (rCBF) was measured via xenon133 inhalation technique in 23 patients with schizophrenia and 18 age- and sex-matched controls. The mean blood flow to both hemispheres was found to be lower for the patients. The patients and their controls did not differ on interhemispheric differences in blood flow. There were no differences in rCBF between medicated and unmedicated, subchronic and chronic, and paranoid and nonparanoid patients. Hallucinations were associated with reduced blood flow to several postcentral regions

Regional cerebral blood flow in schizophrenia

Energy Technology Data Exchange (ETDEWEB)

Mathew, R.J.; Duncan, G.C.; Weinman, M.L.; Barr, D.L.

1982-10-01

Regional cerebral blood flow (rCBF) was measured via xenon133 inhalation technique in 23 patients with schizophrenia and 18 age- and sex-matched controls. The mean blood flow to both hemispheres was found to be lower for the patients. The patients and their controls did not differ on interhemispheric differences in blood flow. There were no differences in rCBF between medicated and unmedicated, subchronic and chronic, and paranoid and nonparanoid patients. Hallucinations were associated with reduced blood flow to several postcentral regions.

Does a global budget superimposed on fee-for-service payments mitigate hospitals' medical claims in Taiwan?

Science.gov (United States)

Hsu, Pi-Fem

2014-12-01

Taiwan's global budgeting for hospital health care, in comparison to other countries, assigns a regional budget cap for hospitals' medical benefits claimed on the basis of fee-for-service (FFS) payments. This study uses a stays-hospitals-years database comprising acute myocardial infarction inpatients to examine whether the reimbursement policy mitigates the medical benefits claimed to a third-payer party during 2000-2008. The estimated results of a nested random-effects model showed that hospitals attempted to increase their medical benefit claims under the influence of initial implementation of global budgeting. The magnitudes of hospitals' responses to global budgeting were significantly attributed to hospital ownership, accreditation status, and market competitiveness of a region. The results imply that the regional budget cap superimposed on FFS payments provides only blunt incentive to the hospitals to cooperate to contain medical resource utilization, unless a monitoring mechanism attached with the payment system.

Impact of Online Learning Modules on Medical Student Microbiology Examination Scores

OpenAIRE

Johnson, Mary T.

2008-01-01

Medical students have a limited amount of time in which to acquire working knowledge of an enormous amount of information, and this is especially relevant for microbiology. One large midwestern medical school is unique in having medical microbiology taught at nine regional campuses using a single core curriculum. A committee of statewide course directors writes a licensure board-style final examination that is referenced to the core and used at all campuses. To prepare for the final examinati...

[New business model for medical specialists].

Science.gov (United States)

Houwen, L G H J Louis

2013-01-01

The reforms in the field of medical specialist care have important implications for the professional practice of medical specialists and their working relationship with the hospital. This leads to a considerable amount of pressure placed upon the way physicians have traditionally practiced their liberal professions, which is by forming partnerships and practicing from within the hospitals based on an admission agreement. As of 2015, the tax benefits for entrepreneurs will be abolished and the formation of regional partnerships will be discouraged. These developments not only pose threats but also offer opportunities for both the entrepreneurial medical specialist and the innovative hospital. In this article, the prospect of a future business model for specialist medical care will be outlined and explored by proposing three new organizational forms. The central vision of this model is that physicians who wish to retain their status of liberal professional practitioners in the twenty-first century should be more involved in the ownership structure of hospitals. The social importance of responsible patient care remains paramount.

Medical cyclotron: why, where, how

International Nuclear Information System (INIS)

Scheer, Kurt; Comar, Dominique; Kellershohn, Claude

1976-01-01

Cyclotrons for medical purposes are particularly useful for the production of radioactive isotopes of elements normally constituting organic matter ( 15 O, 13 N, 11 C). The short half-life and positron emission of those elements are of great interest in medical diagnosis. Many others carrier-free radioisotopes can be produced by cyclotrons. Three categories of cyclotrons are mentioned. Desk top cyclotron only adapted to the production of short-lived radioisotopes in a hospital; low energy and average energy cyclotrons which require well-entrained personnel for their operation and are best adapted to the production of radioelements on a regional or even national scale. Examples relative to the interest of short-lived radioisotopes in lung and brain investigations and tumor detection are given

The Culture of General Palliative Nursing Care in Medical Departments

DEFF Research Database (Denmark)

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

2015-01-01

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

[Regulatory Program for Medical Devices in Cuba: experiences and current challenges].

Science.gov (United States)

Pereira, Dulce María Martínez; Rodríguez, Yadira Álvarez; Valdés, Yamila Cedeño; Ribas, Silvia Delgado

2016-05-01

Regulatory control of medical devices in Cuba is conducted through a system based on the Regulatory Program for Medical Devices as a way to ensure the safety, efficacy, and effectiveness of these technologies, which are in use by the National Health System. This program was launched in 1992, when the Regulations for State Evaluation and Registration of Medical Devices were approved. Its successive stages and the merging of regulatory activities for drugs and medical equipment have meant progress toward stronger, more transparent strategies and greater control of industry and the National Health System. Throughout its course the Cuban program has met with challenges and difficulties that it has addressed by drawing on its own experiences. During the new period, the greatest challenges revolve around ensuring that regulatory systems incorporate scientific evaluation, risk levels, maximum rigor through the use of technical standards, and the implementation of international recommendations, together with the application of the ISO 13485 certification scheme, enhanced market monitoring, and classification of medical devices in accordance with their relevance to the country's national health policies. From the regional standpoint, the greatest challenge lies in working toward regulatory convergence. The Collaborating Centre for the Regulation of Health Technologies will support the proposed regulatory strategy and established regional priorities, in particular in connection with the implementation of actions involving medical devices.

Proceedings of the 1st Ibero-Latin American and Caribbean Congress on Medical Physics. Mexico 98

International Nuclear Information System (INIS)

Gaona, E.; Huitron, B.G.

1998-01-01

This book composes the works received for the 1st Ibero-Latin American and the Caribbean Congress on Medical Physics. There are 68 works which represent a sample of the recent advances of the medical physics which are indicators about the level of development of the speciality in these regions of the world. Thus, the Congress represents the greatest event of medical physics of Ibero-Latin America and the Caribbean besides its consolidation and regional organization. The book also contains useful counsels for the education, yours researches and the daily hospitable practice. (Author)

[Forecast of physician workforce in the 22 French regions (1998-2013)].

Science.gov (United States)

Coste, Emmanuel; Doan, Bui Dang Ha

2003-01-01

The first chapter provides detailed information on the methodology and data used. As were the other projections carried out in the past by the Centre de sociologie et de démographie médicales, the present work is basically a demographic projection. Whereas a projection of national workforce uses the total number of annual new graduates as inflow, a regional projection has to collect other types of data, as new graduates move freely from one region to another. This fundamental difference implies the use of more complex models for predicting the flows of newcomers at regional level. As concerns the outflow, a single table covering retirement and death is used for all regions. The medical profession is a homogeneous group and such a decision is not irrelevant. The second chapter presents briefly the results of the work as concerns one region. In the high variant, the regional number of physicians will continue to increase from 1998 to 2007 or 2008, then it will decrease. In the low variant, the growth will end in 2004 or 2005, followed by a stronger decreasing process. The decrease is caused by the "graduate boom" cohorts (doctors graduated during the 70's and 80's) reaching retirement age. Given the duration of medical training, the decrease will take place even if the numerous clausus (at the start of medical training) rises steadily right now. The decrease in the number of physicians will be accompanied by an aging process: the proportion of senior active doctors will raise and that of junior doctors will diminish. The third chapter evidences the diversity of the various regional trends.

An analysis of the awareness and performance of radiation workers' radiation/radioactivity protection in medical institutions : Focused on Busan regional medical institutions

Energy Technology Data Exchange (ETDEWEB)

Park, Cheol Koo [Dept. of Radiological Science, Graduate School of Catholic University of Pusan, Busan (Korea, Republic of); Hwang, Chul Hwan [Dept. of Radiation Oncology, Pusan National University Hospital, Busan (Korea, Republic of); Kim, Dong Hyun [Dept. of Radiological Science, College of Health Sciences, Catholic University of Pusan, Busan (Korea, Republic of)

2017-03-15

The purpose of this study was to investigate safety management awareness and behavioral investigation of radiation/radioactivity performance defenses of radiation workers' in medical institutions. Data collection consisted of 267 radiation workers working in medical institutions using structured questionnaires. As a result, it was analyzed that radiation safety management awareness and performance were high in 40s, 50s group and higher education group. The analysis according to the radiation safety management knowledge was analyzed that the 'Know very well' group had higher scores on awareness and performance scores. The analysis according to the degree of safety management effort showed the high awareness scale and the performance scale in the group 'Receiving various education or studying the safety management contents through book'. The correlations between the sub-factors showed the highest positive correlation between perceived practician and personal perspective and perceived by patient and patient's caretaker perspective. Therefore, radiation safety management for workers, patients, and patient's caretaker should be conducted through continuous education of radiation safety management through various routes of radiation workers working at medical institutions.

[Medical technology and medical education].

Science.gov (United States)

von Mallek, D; Biersack, H-J; Mull, R; Wilhelm, K; Heinz, B; Mellert, F

2010-08-01

The education of medical professionals is divided into medical studies, postgraduate training leading to the qualification as a specialist, and continuing professional development. During education, all scientific knowledge and practical skills are to be acquired, which enable the physician to practice responsibly in a specialized medical area. In the present article, relevant curricula are analyzed regarding the consideration of medical device-related topics, as the clinical application of medical technology has reached a central position in modern patient care. Due to the enormous scientific and technical progress, this area has become as important as pharmacotherapy. Our evaluation shows that medical device-related topics are currently underrepresented in the course of medical education and training and should be given greater consideration in all areas of medical education. Possible solutions are presented.

Medical physics in Europe following recommendations of the International Atomic Energy Agency

International Nuclear Information System (INIS)

Casar, Bozidar; Lopes, Maria do Carmo; Drljević, Advan; Gershkevitsh, Eduard; Pesznyak, Csilla

2016-01-01

Medical physics is a health profession where principles of applied physics are mostly directed towards the application of ionizing radiation in medicine. The key role of the medical physics expert in safe and effective use of ionizing radiation in medicine was widely recognized in recent European reference documents like the European Union Council Directive 2013/59/EURATOM (2014), and European Commission Radiation Protection No. 174, European Guidelines on Medical Physics Expert (2014). Also the International Atomic Energy Agency (IAEA) has been outspoken in supporting and fostering the status of medical physics in radiation medicine through multiple initiatives as technical and cooperation projects and important documents like IAEA Human Health Series No. 25, Roles and Responsibilities, and Education and Training Requirements for Clinically Qualified Medical Physicists (2013) and the International Basic Safety Standards, General Safety Requirements Part 3 (2014). The significance of these documents and the recognition of the present insufficient fulfilment of the requirements and recommendations in many European countries have led the IAEA to organize in 2015 the Regional Meeting on Medical Physics in Europe, where major issues in medical physics in Europe were discussed. Most important outcomes of the meeting were the recommendations addressed to European member states and the survey on medical physics status in Europe conducted by the IAEA and European Federation of Organizations for Medical Physics. Published recommendations of IAEA Regional Meeting on Medical Physics in Europe shall be followed and enforced in all European states. Appropriate qualification framework including education, clinical specialization, certification and registration of medical physicists shall be established and international recommendation regarding staffing levels in the field of medical physics shall be fulfilled in particular. European states have clear legal and moral

Medical physics in Europe following recommendations of the International Atomic Energy Agency.

Science.gov (United States)

Casar, Bozidar; Lopes, Maria do Carmo; Drljević, Advan; Gershkevitsh, Eduard; Pesznyak, Csilla

2016-03-01

Medical physics is a health profession where principles of applied physics are mostly directed towards the application of ionizing radiation in medicine. The key role of the medical physics expert in safe and effective use of ionizing radiation in medicine was widely recognized in recent European reference documents like the European Union Council Directive 2013/59/EURATOM (2014), and European Commission Radiation Protection No. 174, European Guidelines on Medical Physics Expert (2014). Also the International Atomic Energy Agency (IAEA) has been outspoken in supporting and fostering the status of medical physics in radiation medicine through multiple initiatives as technical and cooperation projects and important documents like IAEA Human Health Series No. 25, Roles and Responsibilities, and Education and Training Requirements for Clinically Qualified Medical Physicists (2013) and the International Basic Safety Standards, General Safety Requirements Part 3 (2014). The significance of these documents and the recognition of the present insufficient fulfilment of the requirements and recommendations in many European countries have led the IAEA to organize in 2015 the Regional Meeting on Medical Physics in Europe, where major issues in medical physics in Europe were discussed. Most important outcomes of the meeting were the recommendations addressed to European member states and the survey on medical physics status in Europe conducted by the IAEA and European Federation of Organizations for Medical Physics. Published recommendations of IAEA Regional Meeting on Medical Physics in Europe shall be followed and enforced in all European states. Appropriate qualification framework including education, clinical specialization, certification and registration of medical physicists shall be established and international recommendation regarding staffing levels in the field of medical physics shall be fulfilled in particular. European states have clear legal and moral

Medical physics in Europe following recommendations of the International Atomic Energy Agency

Science.gov (United States)

Lopes, Maria do Carmo; Drljević, Advan; Gershkevitsh, Eduard; Pesznyak, Csilla

2016-01-01

Background Medical physics is a health profession where principles of applied physics are mostly directed towards the application of ionizing radiation in medicine. The key role of the medical physics expert in safe and effective use of ionizing radiation in medicine was widely recognized in recent European reference documents like the European Union Council Directive 2013/59/EURATOM (2014), and European Commission Radiation Protection No. 174, European Guidelines on Medical Physics Expert (2014). Also the International Atomic Energy Agency (IAEA) has been outspoken in supporting and fostering the status of medical physics in radiation medicine through multiple initiatives as technical and cooperation projects and important documents like IAEA Human Health Series No. 25, Roles and Responsibilities, and Education and Training Requirements for Clinically Qualified Medical Physicists (2013) and the International Basic Safety Standards, General Safety Requirements Part 3 (2014). The significance of these documents and the recognition of the present insufficient fulfilment of the requirements and recommendations in many European countries have led the IAEA to organize in 2015 the Regional Meeting on Medical Physics in Europe, where major issues in medical physics in Europe were discussed. Most important outcomes of the meeting were the recommendations addressed to European member states and the survey on medical physics status in Europe conducted by the IAEA and European Federation of Organizations for Medical Physics. Conclusions Published recommendations of IAEA Regional Meeting on Medical Physics in Europe shall be followed and enforced in all European states. Appropriate qualification framework including education, clinical specialization, certification and registration of medical physicists shall be established and international recommendation regarding staffing levels in the field of medical physics shall be fulfilled in particular. European states have clear

Regional socioeconomic disparities in outcomes for workers with low back pain in the United States.

Science.gov (United States)

Shraim, Mujahed; Cifuentes, Manuel; Willetts, Joanna L; Marucci-Wellman, Helen R; Pransky, Glenn

2017-05-01

Although regional socioeconomic (SE) factors have been associated with worse health outcomes, prior studies have not addressed important confounders or work disability. A national sample of 59 360 workers' compensation (WC) cases to evaluate impact of regional SE factors on medical costs and length of disability (LOD) in occupational low back pain (LBP). Lower neighborhood median household incomes (MHI) and higher state unemployment rates were associated with longer LOD. Medical costs were lower in states with more workers receiving Social Security Disability, and in areas with lower MHI, but this varied in magnitude and direction among neighborhoods. Medical costs were higher in more urban, more racially diverse, and lower education neighborhoods. Regional SE disparities in medical costs and LOD occur even when health insurance, health care availability, and indemnity benefits are similar. Results suggest opportunities to improve care and disability outcomes through targeted health care and disability interventions. © 2017 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.

Assessment of Data Management Services at New England Region Resource Libraries

Directory of Open Access Journals (Sweden)

Julie Goldman

2015-07-01

Full Text Available Objective: To understand how New England medical libraries are addressing scientific research data management and providing services to their communities. Setting: The National Network of Libraries of Medicine, New England Region (NN/LM NER contains 17 Resource Libraries. The University of Massachusetts Medical School serves as the New England Regional Medical Library (RML. Sixteen of the NER Resource Libraries completed this survey. Methods: A 40-question online survey assessed libraries’ services and programs for providing research data management education and support. Libraries shared their current plans and institutional challenges associated with developing data services. Results: This study shows few NER Resource Libraries currently integrate scientific research data management into their services and programs, and highlights the region’s use of resources provided by the NN/LM NER RML at the University of Massachusetts Medical School. Conclusions: Understanding the types of data services being delivered at NER libraries helps to inform the NN/LM NER about the eScience learning needs of New England medical librarians and helps in the planning of professional development programs that foster effective biomedical research data services.

Proceedings of the seventh Northern region paediatric colloquium.

Science.gov (United States)

Barkla, Xanthe; Kaplan, Carole

2014-01-01

Ethical and legal dilemmas frequently arise in paediatric practice. Given the nature of the speciality, these issues are relevant to both the medical and legal professions. To this end, senior figures from the medical and legal professions in the Northern region have met on a regular basis in order to discuss anonymised case material. We report on the proceedings of the seventh such meeting. Six cases are described and key points arising from the subsequent discussion are presented.

Medical School Outcomes, Primary Care Specialty Choice, and Practice in Medically Underserved Areas by Physician Alumni of MEDPREP, a Postbaccalaureate Premedical Program for Underrepresented and Disadvantaged Students.

Science.gov (United States)

Metz, Anneke M

2017-01-01

Minorities continue to be underrepresented as physicians in medicine, and the United States currently has a number of medically underserved communities. MEDPREP, a postbaccalaureate medical school preparatory program for socioeconomically disadvantaged or underrepresented in medicine students, has a stated mission to increase the numbers of physicians from minority or disadvantaged backgrounds and physicians working with underserved populations. This study aims to determine how MEDPREP enhances U.S. physician diversity and practice within underserved communities. MEDPREP recruits disadvantaged and underrepresented in medicine students to complete a 2-year academic enhancement program that includes science coursework, standardized test preparation, study/time management training, and emphasis on professional development. Five hundred twenty-five disadvantaged or underrepresented students over 15 years completed MEDPREP and were tracked through entry into medical practice. MEDPREP accepts up to 36 students per year, with two thirds coming from the Midwest region and another 20% from nearby states in the South. Students complete science, test preparation, academic enhancement, and professionalism coursework taught predominantly by MEDPREP faculty on the Southern Illinois University Carbondale campus. Students apply broadly to medical schools in the region and nation but are also offered direct entry into our School of Medicine upon meeting articulation program requirements. Seventy-nine percent of students completing MEDPREP became practicing physicians. Fifty-eight percent attended public medical schools, and 62% attended medical schools in the Midwest. Fifty-three percent of program alumni chose primary care specialties compared to 34% of U.S. physicians, and MEDPREP alumni were 2.7 times more likely to work in medically underserved areas than physicians nationally. MEDPREP increases the number of disadvantaged and underrepresented students entering and graduating

Exercise CAPITAL SHIELD Towards Medical Response Integration in the National Capital Region

Science.gov (United States)

2011-01-24

provided JTF the authority to develop Interagency partnerships  CY09/10: JTF CapMed executed (12) DSCA missions with Fed/State/Local partners...incident site at Lorton Youth Detention Center, VA – admin medical support 4-5 days  FY10, JTF CapMed inserted two-day MASCAL training (onsite only...Use exercise as test-bed for structure/tools: – Joint Critical Care ATLS Team: Modification of ATLS Team w/ attached triage and evac sections

Chernobylsk NPP accident and its medical effects

International Nuclear Information System (INIS)

Gus'kova, A.K.

2000-01-01

Medical effects of the Chernobyl accident for various groups of people engaged in liquidation of the accident aftereffects and residents of the regions affected are assessed. Specific medical and social recommendations for each of the five groups of patients are made. Special attention is paid to the health of children who were exposed to external radiation in combination with intake of iodine isotopes. Extremely unfavourable influence of the mass media on the health of people involved in the Chernobyl accident is painted out. The necessity of adequate rehabilitation measures for various categories of patients involved in a large-scale accident is emphasized [ru

Nonresearch Industry Payments to Radiologists: Characteristics and Associations With Regional Medical Imaging Utilization.

Science.gov (United States)

Kokabi, Nima; Junn, Jacqueline C; Xing, Minzhi; Hemingway, Jennifer; Hughes, Danny R; Duszak, Richard

2017-03-01

To evaluate characteristics of nonresearch industry payments to radiologists and associations with regional diagnostic imaging utilization. Using 2014 CMS Open Payment data, all disclosed nonresearch-related industry payments to radiologists were identified. Health Resources and Services Administration Area Health Resources Files were used to identify actual and population-weighted numbers of radiologists by state. Utilizing the 5% random beneficiary sample CMS Research Identifiable Files from 2014, average Medicare imaging spending per beneficiary in each state was calculated. Average frequency and dollar amounts of nonresearch nonroyalty payments to radiologists were calculated at the state level. Using the Pearson correlation coefficient, the relationship between frequency and amounts of nonresearch payments to radiologists versus per-beneficiary Medicare imaging spending was evaluated at the state level. Overall, 2,008 radiologists (1,670 diagnostic, 338 interventional) received nonresearch nonroyalty payments from industry, representing 5.2% of all 38,857 radiologists nationwide. A total of 4,975 individual transfers translated to 2.5 ± 1.3 discrete payments per receiving radiologist with a mean of $432 ± $1,976 (median $26; range $1-$34,050). Food and beverage expenses constituted the vast majority of disclosed transfers (4,111; 83%), followed by travel and lodging (444; 9%), consulting fees (279; 6%), and educational expenses (51; 1%). Considerable geographic variation in payments was observed, ranging from 0% of radiologists in Vermont to 12.9% in the District of Columbia. No correlation was identified between average per-beneficiary Medicare imaging spending and the proportion of nonresearch-funded radiologists in each state (r = 0.06). Similarly, no correlation was identified between average per-beneficiary Medicare imaging spending and the average nonresearch transfer amount to radiologists in each state (r = -0.08). In 2014, only a small minority of

An Approach to Medical Tourism on Mexico's Northern Border

OpenAIRE

Contreras, Tomás Cuevas

2016-01-01

This article discusses the opportunities to develop the northern region of Mexico as a medical destination. Global competitiveness is emerging in health care while advances in science and technology allow almost any patient to travel abroad for treatment. Today, more and more individuals from developed countries, with the financial capacity to cover all expenses, consider overseas travel to developing countries for health care. The aim of this study is to examine what kind of medical services...

Gender issues in medical and public health education.

Science.gov (United States)

Wong, Y L

2000-01-01

There is no doubt that gender bias has been inherent in medical and public health education, research, and clinical practice. This paper discusses the central question for medical and public health educators viz. whether women's health concerns and needs could be best addressed by the conventional biomedical approach to medical and public health education, research, and practice. Gender inequalities in health and gender bias in medical and public health education are revealed. It is found that in most public health and prevention issues related to women's health, the core issue is male-female power relations, and not merely the lack of public health services, medical technology, or information. There is, thus, an urgent need to gender-sensitize public health and medical education. The paper proposes a gender analysis of health to distinguish between biological causes and social explanations for the health differentials between men and women. It also assessed some of the gender approaches to public health and medical education currently adopted in the Asia-Pacific region. It poses the pressing question of how medical and public health educators integrate the gender perspective into medical and public health education. The paper exhorts all medical and public health practitioners to explore new directions and identify innovative strategies to formulate a gender-sensitive curriculum towards the best practices in medicine and public health that will meet the health needs of women and men in the 21st century.

Utilisation of a Helicopter Emergency Medical Service (HEMS) for equestrian accidents in a regional major trauma network in the United Kingdom.

Science.gov (United States)

McQueen, Carl; Crombie, Nick; Cormack, Stef; George, Arun; Wheaton, Steve

2015-05-01

The utilisation of Helicopter Emergency Medical Services (HEMS) in response to equestrian accidents has been an integral part of operations for many years throughout the UK. The recent establishment of major trauma networks in the UK has placed great emphasis on the appropriate tasking of HEMS units to cases where added benefit can be provided and the incidence of time critical injury in cases of equestrian accidents has been shown to be low. This study assesses the impact made on the utilisation of the different HEMS resources for cases of equestrian accidents within the West Midlands following the launch of the regional trauma network. We present a retrospective analysis of all equestrian accidents attended by Midlands Air Ambulance (MAA) between 1 April 2012 and 1 April 2013. Data were abstracted from the MAA operational database relating to mission activations/scene attendances; team configuration (physician led and Critical Care Paramedic (CCP) led); on-scene interventions; mission timings and patient conveyance by helicopter. A total of 114 activations involved equestrian accidents (6% of overall workload). The contribution of equestrian accidents to overall workload was similar for physician led and CCP-led (69/1069) platforms (5% vs. 6%, p=0.50). Only three patients (3%) required pre-hospital RSI during the period analysed and there were no recorded cases of ketamine administration for analgesia/conscious sedation. In approximately half of all scene attendances patients did not require any medication to be administered by the HEMS team. The vast majority of incidents occurred in rural locations with over 80% of patients conveyed to hospital by helicopter. The average mission time for scene attendances resulting in conveyance by helicopter was in excess of 90 min on both types of platform. There is a clear requirement for the design and implementation of informed and intelligent tasking models to respond to the need for assistance in equestrian accidents

Organization and startup of The Gambia's new community-based medical programme.

Science.gov (United States)

Chávez, José A; Suárez, Lázaro V; Del Rosario, Odalis; Hechavarría, Suiberto; Quiñones, Judith

2012-01-01

The shortage of health professionals in developing countries and especially in their poorest regions imperils the vision of health for all. New training policies and strategies are needed urgently to address these shortages. The Gambia's new Community-Based Medical Programme is one such strategy. KEYWORDS Medical education, access to health care, healthcare disparities, health manpower, rural health, developing countries, The Gambia.

Planning of emergency medical treatment in nuclear power plant

International Nuclear Information System (INIS)

Kusama, Tomoko

1989-01-01

Medical staffs and health physicists have shown deep concerning at the emergency plans of nuclear power plants after the TMI nuclear accident. The most important and basic countermeasure for accidents was preparing appropriate and concrete organization and plans for treatment. We have planed emergency medical treatment for radiation workers in a nuclear power plant institute. The emergency medical treatment at institute consisted of two stages, that is on-site emergency treatment at facility medical service. In first step of planning in each stage, we selected and treatment at facility medical service. In first step of planning in each stage, we selected and analyzed all possible accidents in the institute and discussed on practical treatments for some possible accidents. The manuals of concrete procedure of emergency treatment for some accidents were prepared following discussion and facilities and equipment for medical treatment and decontamination were provided. All workers in the institute had periodical training and drilling of on-site emergency treatment and mastered technique of first aid. Decontamination and operation rooms were provided in the facillity medical service. The main functions at the facility medical service have been carried out by industrial nurses. Industrial nurses have been in close co-operation with radiation safety officers and medical doctors in regional hospital. (author)

Treating Hypotension in Preterm Neonates With Vasoactive Medications

Directory of Open Access Journals (Sweden)

Chloe Joynt

2018-04-01

Full Text Available Preterm neonates often have hypotension which may be due to various etiologies. While it is controversial to define hypotension in preterm neonates, various vasoactive medications are commonly used to provide the cardiovascular support to improve the blood pressure, cardiac output, or to treat shock. However, the literature on the systemic and regional hemodynamic effects of these antihypotensive medications in neonates is deficient and incomplete, and cautious translation of findings from other clinical populations and animal studies is required. Based on a literature search on published reports, meta-analytic reviews, and selected abstracts, this review discusses the current available information on pharmacologic actions, clinical effects, and side effects of commonly used antihypotensive medications including dopamine, dobutamine, epinephrine, norepinephrine, vasopressin, and milrinone in preterm neonates.

Medical activities at nuclear disaster. Experience in the accident of Fukushima nuclear power plant

International Nuclear Information System (INIS)

Hasegawa, Arifumi

2013-01-01

The Great East Japan Earthquake brought multiple disaster resulting nuclear accident at Fukushima. Existing medical system for emergency radiation exposure did not work well. Present medical system for the nuclear disaster is maintained temporary with supports by teams from regions other than Fukushima Pref. The radiation protection action must be both for the public and the medical persons. Medical activities for nuclear disaster are still in progress now. Medical system for radiation exposure should be maintained in future for works of decommissioning of reactors. Problems, however, may exist in economy and education of medical personnel. (K.Y.)

[Cologne Statement for Medical Care of Refugees].

Science.gov (United States)

Wiesmüller, G A; Dötsch, J; Weiß, M; Wiater, A; Fätkenheuer, G; Nitschke, H; Bunte, A

2016-04-01

The Cologne statement resulted from both regional and nationwide controversial discussions about meaning and purpose of an initial examination for infectious diseases of refugees with respect to limited time, personnel and financial resources. Refugees per se are no increased infection risk factors for the general population as well as aiders, when the aiders comply with general hygiene rules and are vaccinated according to the recommendations of the German Standing Committee on Vaccination (STIKO). This is supported by our own data. Based on individual medical history, refugees need medical care, which is offered purposeful, economic, humanitarian and ethical. In addition to medical confidentiality, the reporting obligation according § 34 Infection Protection Act (IPA) and the examination concerning infectious pulmonary tuberculosis according to § 36 (4) IPA must be considered. © Georg Thieme Verlag KG Stuttgart · New York.

South-South medical tourism and the quest for health in Southern Africa.

Science.gov (United States)

Crush, Jonathan; Chikanda, Abel

2015-01-01

Intra-regional South-South medical tourism is a vastly understudied subject despite its significance in many parts of the Global South. This paper takes issue with the conventional notion of South Africa purely as a high-end "surgeon and safari" destination for medical tourists from the Global North. It argues that South-South movement to South Africa for medical treatment is far more significant, numerically and financially, than North-South movement. The general lack of access to medical diagnosis and treatment in SADC countries has led to a growing temporary movement of people across borders to seek help at South African institutions in border towns and in the major cities. These movements are both formal (institutional) and informal (individual) in nature. In some cases, patients go to South Africa for procedures that are not offered in their own countries. In others, patients are referred by doctors and hospitals to South African facilities. But the majority of the movement is motivated by lack of access to basic healthcare at home. The high demand and large informal flow of patients from countries neighbouring South Africa has prompted the South African government to try and formalise arrangements for medical travel to its public hospitals and clinics through inter-country agreements in order to recover the cost of treating non-residents. The danger, for 'disenfranchised' medical tourists who fall outside these agreements, is that medical xenophobia in South Africa may lead to increasing exclusion and denial of treatment. Medical tourism in this region and South-South medical tourism in general are areas that require much additional research. Copyright © 2014. Published by Elsevier Ltd.

From magic to science: a journey throughout Latin American medical mycology.

Science.gov (United States)

San-Blas, G

2000-01-01

The start of Latin America's love story with fungi may be placed in pre-Hispanic times when the use of fungi in both ritual ceremonies and daily life were common to the native civilizations. But the medical mycology discipline in Latin America started at the end of the 19th Century. At that time, scholars such as A. Posadas, R. Seeber, A. Lutz and P. Almeida, discovered agents of fungal diseases, the study of which has influenced the regional research ever since. Heirs to them are the researchers that today thrive in regional Universities and Research Institutes. Two current initiatives improve cooperation among Latin American medical mycologists. First, the periodical organization of International Paracoccidioidomycosis Meetings (seven so far, from 1979 to 1999); second, the creation of the Latin American Association for Mycology in 1991 (three Congresses, from 1993 to 1999). Latin American publications have increased in international specialized journals such as that from our Society (ISHAM) (from 8% in 1967 to 19% in 1999), and the Iberoamerican Journal of Mycology (Revista Iberoamericana de Micologia; > 40% from 1997 to 1999). In addition, Latin American participation at ISHAM International Congresses has risen from 6.9% in 1975 to 21.3% in 1997, and 43.2% at the 14th ISHAM Congress, held for the first time in a Latin American country, Argentina. A significant contribution of women to the scientific establishment of Latin American medical mycology (e.g., 45% of Latin American papers vs. 18% of other regions published in Journal of Medical and Veterinary Mycology in 1987, had women as authors or coauthors) suggests a better academic consideration of Latin American women against their counterparts in the developed world. Taken together, all these figures reflect the enthusiasm of our Latin American colleagues in the field, despite the difficulties that afflict our region, and affect our work.

Medical expenditure for liver cancer in urban China: A 10-year multicenter retrospective survey (2002-2011).

Science.gov (United States)

Qiu, Wu-Qi; Shi, Ju-Fang; Guo, Lan-Wei; Mao, A-Yan; Huang, Hui-Yao; Hu, Guang-Yu; Dong, Pei; Bai, Fang-Zhou; Yan, Xiao-Ling; Liao, Xian-Zhen; Liu, Guo-Xiang; Bai, Ya-Na; Ren, Jian-Song; Sun, Xiao-Jie; Zhu, Xin-Yu; Zhou, Jin-Yi; Gong, Ji-Yong; Zhu, Lin; Mai, Ling; Du, Ling-Bing; Zhou, Qi; Xing, Xiao-Jing; Song, Bing-Bing; Liu, Yu-Qin; Lou, Pei-An; Sun, Xiao-Hua; Wu, Shou-Ling; Cao, Rong; Qi, Xiao; Lan, Li; Ren, Ying; Zhang, Kai; He, Jie; Qu, Chunfeng; Dai, Min

2018-01-01

This study aims to understand the medical expenditure for liver cancer during 2002-2011 in urban areas of China. This is a retrospective study. Based on a stratified cluster sampling method, a medical expenditure survey collected basic personal information from related medical records. Two-tailed independent sample t-test, variance analysis, and Student-Newman-Keuls Tests were used in cost analysis for the corresponding data types. A total of 12,342 liver cancer patients were included in the analysis. Overall average medical expenditure per case for liver cancer diagnosis and treatment in China has increased from ¥21, 950 to ¥40, 386 over the study period. For each liver cancer patient diagnosed between 2009 and 2011, the average expenditures were 29,332 CNY for stage I, 35,754 CNY for stage II, 34,288 CNY for stage III, and 30,275 CNY for stage IV diseases (P medical expenditure and it rose from 48.01% to 52.96% during these ten years, and the share of nursing fee expenses was the lowest (around 1%). Over the entire 10-year data period, the per capita expenditure of the east region (32,983 CNY) was higher than that of the west region (26,219 CNY) and slightly higher than the central region (31,018 CNY, P medical expenditure is heavy for families. Early diagnosis and treatment for liver cancer will save medical expenditure. The economic burden of liver cancer is high in China and related medical expenditure has increased.

‘Livings Labs’ for New Health Concepts and Medical Technology in Cluster Development

NARCIS (Netherlands)

Guldemond, N.A.; Van Geenhuizen, M.S.

2012-01-01

The development of medical clusters is high on the agenda of many policymakers in the European Union. Constructing medical clusters may draw on the presence of living labs of different kinds in the regions involved. Living labs are practical environments for innovation aiming at a better mix and

Medical devices and the Middle East: market, regulation, and reimbursement in Gulf Cooperation Council states

Directory of Open Access Journals (Sweden)

Howard JJ

2014-11-01

Full Text Available Jason J Howard Division of Paediatric Orthopaedics, Department of Surgery, Sidra Medical and Research Center, Doha, Qatar Abstract: With some of the richest economies in the world, the Gulf Cooperation Council (GCC is undergoing rapid growth not only in its population but also in health care expenditure. Despite the GCC's abundance of hydrocarbon-based wealth, the drivers of the medical device industry in the GCC are still in flux, with gains yet to be made in areas of infrastructure, regulation, and reimbursement. However, the regional disease burden, expanding health insurance penetration, increasing privatization, and a desire to attract skilled expatriate health care providers have led to favorable conditions for the medical device market in the GCC. The purpose of this article is to investigate the current state of the GCC medical device industry, with respect to market, regulation, and reimbursement, paying special attention to the three largest medical device markets: Saudi Arabia, the United Arab Emirates, and Qatar. The GCC would seem to represent fertile ground for the development of medical technologies, especially those in line with the regional health priorities of the respective member states. Keywords: medical devices, regulation, reimbursement, Middle East 

Cloud solution for histopathological image analysis using region of interest based compression.

Science.gov (United States)

Kanakatte, Aparna; Subramanya, Rakshith; Delampady, Ashik; Nayak, Rajarama; Purushothaman, Balamuralidhar; Gubbi, Jayavardhana

2017-07-01

Recent technological gains have led to the adoption of innovative cloud based solutions in medical imaging field. Once the medical image is acquired, it can be viewed, modified, annotated and shared on many devices. This advancement is mainly due to the introduction of Cloud computing in medical domain. Tissue pathology images are complex and are normally collected at different focal lengths using a microscope. The single whole slide image contains many multi resolution images stored in a pyramidal structure with the highest resolution image at the base and the smallest thumbnail image at the top of the pyramid. Highest resolution image will be used for tissue pathology diagnosis and analysis. Transferring and storing such huge images is a big challenge. Compression is a very useful and effective technique to reduce the size of these images. As pathology images are used for diagnosis, no information can be lost during compression (lossless compression). A novel method of extracting the tissue region and applying lossless compression on this region and lossy compression on the empty regions has been proposed in this paper. The resulting compression ratio along with lossless compression on tissue region is in acceptable range allowing efficient storage and transmission to and from the Cloud.

Medical consultations and the sharing of medical images involving spinal injury over mobile phone networks.

Science.gov (United States)

Filip, Michal; Linzer, Petr; Šámal, Filip; Tesař, Jiří; Herzig, Roman; Školoudík, David

2012-07-01

The transmission of medical images and other data over mobile phone networks may facilitate remote medical consultations between neurosurgeons and regional hospitals treating spinal injury patients. The aim of this study was to compare the efficacy of mobile phone consultations with standard hospital workstation consultations in spinal injury patients. The images were exported over the Internet from surrounding local hospitals through the Picture Archiving and Communication System, in DICOM III format, to the central hospital server. The xVision browser was used to view the acquired images on a standard workstation. The data were also exported to the secured hospital Web server IIS60 and converted to JPEG format to enable remote physician access and consultation. The remote consulting physician connected to this server by mobile phone using the phone's Internet browser. A second physician, blind to the mobile phone results, evaluated the same images at a workstation in the hospital. The results of the mobile phone consultations were compared with the results from standard workstation consultations. There was no difference in the quality of spinal computed tomographic/magnetic resonance images viewed on the phone screen compared with on the workstation. More importantly, the final diagnoses made by mobile phone did not differ from those made by workstation consultations. A transfer to the department of neurosurgery was required after consultation in 11 patients. Mobile phone consultations for patients with spinal injuries was as effective as workstation consultations. Mobile phone consultations can increase the expertise available to regional hospitals, which are often the first responders to medical emergencies. Copyright © 2012 Elsevier Inc. All rights reserved.

An interactive medical image segmentation framework using iterative refinement.

Science.gov (United States)

Kalshetti, Pratik; Bundele, Manas; Rahangdale, Parag; Jangra, Dinesh; Chattopadhyay, Chiranjoy; Harit, Gaurav; Elhence, Abhay

2017-04-01

Segmentation is often performed on medical images for identifying diseases in clinical evaluation. Hence it has become one of the major research areas. Conventional image segmentation techniques are unable to provide satisfactory segmentation results for medical images as they contain irregularities. They need to be pre-processed before segmentation. In order to obtain the most suitable method for medical image segmentation, we propose MIST (Medical Image Segmentation Tool), a two stage algorithm. The first stage automatically generates a binary marker image of the region of interest using mathematical morphology. This marker serves as the mask image for the second stage which uses GrabCut to yield an efficient segmented result. The obtained result can be further refined by user interaction, which can be done using the proposed Graphical User Interface (GUI). Experimental results show that the proposed method is accurate and provides satisfactory segmentation results with minimum user interaction on medical as well as natural images. Copyright © 2017 Elsevier Ltd. All rights reserved.

Trends in Regionalization of Care for ST-Segment Elevation Myocardial Infarction

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Renee Y. Hsia

2017-09-01

Full Text Available Introduction: California has led successful regionalized efforts for several time-critical medical conditions, including ST-segment elevation myocardial infarction (STEMI, but no specific mandated protocols exist to define regionalization of care. We aimed to study the trends in regionalization of care for STEMI patients in the state of California and to examine the differences in patient demographic, hospital, and county trends. Methods: Using survey responses collected from all California emergency medical services (EMS agencies, we developed four categories – no, partial, substantial, and complete regionalization – to capture prehospital and inter-hospital components of regionalization in each EMS agency’s jurisdiction between 2005–2014. We linked the survey responses to 2006 California non-public hospital discharge data to study the patient distribution at baseline. Results: STEMI regionalization-of-care networks steadily developed across California. Only 14% of counties were regionalized in 2006, accounting for 42% of California’s STEMI patient population, but over half of these counties, representing 86% of California’s STEMI patient population, reached complete regionalization in 2014. We did not find any dramatic differences in underlying patient characteristics based on regionalization status; however, differences in hospital characteristics were relatively substantial. Conclusion: Potential barriers to achieving regionalization included competition, hospital ownership, population density, and financial challenges. Minimal differences in patient characteristics can establish that patient differences unlikely played any role in influencing earlier or later regionalization and can provide a framework for future analyses evaluating the impact of regionalization on patient outcomes.

Curb your premium! evaluating state intervention in medical malpractice insurance

OpenAIRE

Sofia, AmaralGarcia; Veronica, Grembi

2011-01-01

Using data of Italian public healthcare providers over years 2001 through 2008, we evaluate the impact of two policies adopted by Italian Regions (i.e., States) to cope with increasing medical malpractice costs using a Difference-in-Difference specification. We assess the impact of the policies on premiums paid and legal expenditures. The first policy consisted in collecting information and monitoring both compensation requests and any legal action related to a medical malpractice claim again...

75 FR 27917 - Emergency Medical Services Week, 2010

Science.gov (United States)

2010-05-18

... enhancing our country's preparedness and resilience. During Emergency Medical Services Week, we recommit to... physicians. From rural regions of our Nation to our busiest urban centers, EMS teams provide access to... to arrive at the scene of a crisis. These heroic professionals, volunteers, and citizens form a...

THE MAIN TRENDS OF INTERACTION BETWEEN THE ADMINISTRATION OF ROSPOTREBNADZOR IN THE LENINGRAD REGION AND THE GOVERNMENT OF LENINGRAD REGION IN THE FIELD OF POPULATION RADIATION PROTECTION

Directory of Open Access Journals (Sweden)

S. A. Gorbanev

2008-01-01

Full Text Available The article gives the main interaction trends of the Administration of Rospotrebnadzor in the Leningrad Region and the Government of Leningrad Region regarding issues of regional radiation protection. It reports on comprehensive measures devoted to the limitation of the population exposure from natural irradiation sources, monitoring of territories which suffered from Chernobyl NPP accident and monitoring of the environmental impact of unauthorized dumps and solid municipal waste sites in the Leningrad Region. It presents the basic issues of medical exposure limitation in the Leningrad Region and measures for their solving.

Medical tourism in Thailand: a cross-sectional study.

Science.gov (United States)

Noree, Thinakorn; Hanefeld, Johanna; Smith, Richard

2016-01-01

To investigate the magnitude and characteristics of medical tourism in Thailand and the impact of such tourism on the Thai health system and economy. In 2010, we checked the records of all visits to five private hospitals that are estimated to cover 63% of all foreign patients. We reviewed hospital records of foreign patients and obtained data on their countries of origin, diagnoses and interventions. We surveyed 293 medical tourists to collect demographic characteristics and information on their expenditure and travelling companions. To help understand the impact of medical tourism on the Thai health system, we also interviewed 15 hospital executives and 28 service providers from the private hospitals. We obtained 911,913 records of hospital visits, of which 324,906 came from 104,830 medical tourists. We estimated that there were 167,000 medical tourists in Thailand in 2010. Of the medical tourists who attended our study hospitals, 67,987 (64.8%) came from the eastern Mediterranean region or Asia and 109,509 (34%) of them were treated for simple and uncomplicated conditions - i.e. general check-ups and medical consultations. The mean self-reported non-medical expenditure was 2750 United States dollars. According to the hospital staff interviewed, medical tourism in 2010 brought benefits to - and apparently had no negative impacts on - the Thai health system and economy. We estimate that the total number of medical tourists visiting Thailand is about 10% of previous national government estimates of 1.2 million. Such tourists appear to bring economic benefits to Thailand and to have negligible effects on the health system.

Patients' view on medical students in dermatology practice

Directory of Open Access Journals (Sweden)

Seval Doğruk Kaçar

2014-12-01

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

CERN crystals used in medical imaging

CERN Multimedia

Maximilien Brice

2004-01-01

This crystal is a type of material known as a scintillator. When a high energy charged particle or photon passes through a scintillator it glows. These materials are widely used in particle physics for particle detection, but their uses are being realized in further fields, such as Positron Emission Tomography (PET), an area of medical imaging that monitors the regions of energy use in the body.

Identification of Bodies by Unique Serial Numbers on Implanted Medical Devices.

Science.gov (United States)

Blessing, Melissa M; Lin, Peter T

2018-05-01

Visual identification is the most common identification method used by medical examiners but is not always possible. Alternative methods include X-ray, fingerprint, or DNA comparison, but these methods require additional resources. Comparison of serial numbers on implanted medical devices is a rapid and definitive method of identification. To assess the practicality of using this method, we reviewed 608 consecutive forensic autopsies performed at a regional medical examiner office. Of these, 56 cases required an alternative method of identification due to decomposition (n = 35), gunshot wound (n = 9), blunt trauma (n = 6), or charring (n = 6). Of these 56 cases, eight (14.3%) were known to have an implanted medical device. Of these eight cases, five (63%) could be positively identified by comparing serial numbers. If an implanted medical device is known to be present, and medical records are available, identification by medical device serial number should be a first-line method. © 2017 American Academy of Forensic Sciences.

Monitoring and documentation of side effects from depot antipsychotic medication: an interdisciplinary audit of practice in a regional mental health service.

LENUS (Irish Health Repository)

Cleary, A

2012-01-01

The aim of this audit was to review current practice within a rural mental health service area on the monitoring and documentation of side effects of antipsychotic depot medication. Following a review of the literature on best practice internationally, an evidence based audit tool was adapted. A sample of 60 case files, care plans and prescriptions were audited between January and May 2010. This represented 31% of the total number of service users receiving depot injections in the mental health service region (n=181). The audit results revealed that most service users had an annual documented medical review and a documented prescription. However, only 5 (8%) case notes examined had documentation recorded describing the condition of the injection site and alternation of the injection site was recorded in only 28 (47%) case notes. No case notes examined had written consent to commence treatment recorded, and only 3 (5%) of case notes had documented that information on the depot injection and side effects was given. In 57 (95%) of case notes no documentation of recorded information on the depot and on side effects was given. Documentation of physical observations and tests revealed that 58% of cases had full blood count, liver function tests, thyroid function tests and fasting lipids recorded. All other tests (i.e. temperature, pulse, respirations, blood pressure, ECG) were recorded in less than 50% of cases. Prolactin levels were not recorded in any case. The lack of written consent was partly attributed to lack of recording of consent. The failure to monitor and record some\\r\

Educating Physicians for Rural America: Validating Successes and Identifying Remaining Challenges With the Rural Medical Scholars Program.

Science.gov (United States)

Wheat, John R; Leeper, James D; Murphy, Shannon; Brandon, John E; Jackson, James R

2018-02-01

To evaluate the Rural Medical Scholars (RMS) Program's effectiveness to produce rural physicians for Alabama. A nonrandomized intervention study compared RMS (1997-2002) with control groups in usual medical education (1991-2002) at the University of Alabama School of Medicine's main and regional campuses. Participants were RMS and others admitted to regular medical education, and the intervention was the RMS Program. Measures assessed the percentage of graduates practicing in rural areas. Odds ratios compared effectiveness of producing rural Alabama physicians. The RMS Program (N = 54), regional campuses (N = 182), and main campus (N = 649) produced 48.1% (odds ratio 6.4, P rural physicians, respectively. The RMS Program, contrasted to other local programs of medical education, was effective in producing rural physicians. These results were comparable to benchmark programs in the Northeast and Midwest USA on which the RMS Program was modeled, justifying the assumption that model programs can be replicated in different regions. However, this positive effect was not shared by a disparate rural minority population, suggesting that models for rural medical education must be adjusted to meet the challenge of such communities for physicians. © 2017 National Rural Health Association.

Machine Learning for Medical Imaging.

Science.gov (United States)

Erickson, Bradley J; Korfiatis, Panagiotis; Akkus, Zeynettin; Kline, Timothy L

2017-01-01

Machine learning is a technique for recognizing patterns that can be applied to medical images. Although it is a powerful tool that can help in rendering medical diagnoses, it can be misapplied. Machine learning typically begins with the machine learning algorithm system computing the image features that are believed to be of importance in making the prediction or diagnosis of interest. The machine learning algorithm system then identifies the best combination of these image features for classifying the image or computing some metric for the given image region. There are several methods that can be used, each with different strengths and weaknesses. There are open-source versions of most of these machine learning methods that make them easy to try and apply to images. Several metrics for measuring the performance of an algorithm exist; however, one must be aware of the possible associated pitfalls that can result in misleading metrics. More recently, deep learning has started to be used; this method has the benefit that it does not require image feature identification and calculation as a first step; rather, features are identified as part of the learning process. Machine learning has been used in medical imaging and will have a greater influence in the future. Those working in medical imaging must be aware of how machine learning works. © RSNA, 2017.

Medical exposure to ionising radiation and the risk of brain tumours

DEFF Research Database (Denmark)

Blettner, Maria; Schlehofer, Brigitte; Samkange-Zeeb, Florence

2007-01-01

BACKGROUND: The role of exposure to low doses of ionising radiation in the aetiology of brain tumours has yet to be clarified. The objective of this study was to investigate the association between medically or occupationally related exposure to ionising radiation and brain tumours. METHODS: We...... used self-reported medical and occupational data collected during the German part of a multinational case-control study on mobile phone use and the risk of brain tumours (Interphone study) for the analyses. RESULTS: For any exposure to medical ionising radiation we found odds ratios (ORs) of 0.63 (95...... regions. CONCLUSION: We did not find any significant increased risk of brain tumours for exposure to medical ionising radiation....

Medical humanities in the undergraduate medical curriculum.

Science.gov (United States)

Supe, Avinash

2012-01-01

The medical humanities have been introduced in medical curricula over the past 30 years in the western world. Having medical humanities in a medical school curriculum can nurture positive attitudes in the regular work of a clinician and contribute equally to personality development. Though substantial evidence in favour of a medical humanities curriculum may be lacking, the feedback is positive. It is recommended that medical humanities be introduced into the curriculum of every medical school with the purpose of improving the quality of healthcare, and the attitudes of medical graduates.

Hospital-Based Coalition to Improve Regional Surge Capacity

Directory of Open Access Journals (Sweden)

James M. Learning

2012-12-01

Full Text Available Introduction: Surge capacity for optimization of access to hospital beds is a limiting factor in response to catastrophic events. Medical facilities, communication tools, manpower, and resource reserves exist to respond to these events. However, these factors may not be optimally functioning to generate an effective and efficient surge response. The objective was to improve the function of these factors.Methods: Regional healthcare facilities and supporting local emergency response agencies developed a coalition (the Healthcare Facilities Partnership of South Central Pennsylvania; HCFP¬SCPA to increase regional surge capacity and emergency preparedness for healthcare facilities. The coalition focused on 6 objectives: (1 increase awareness of capabilities and assets, (2 develop and pilot test advanced planning and exercising of plans in the region, (3 augment written medical mutual aid agreements, (4 develop and strengthen partnership relationships, (5 ensure National Incident Management System compliance, and (6 develop and test a plan for effective utilization of volunteer healthcare professionals.Results: In comparison to baseline measurements, the coalition improved existing areas covered under all 6 objectives documented during a 24-month evaluation period. Enhanced communications between the hospital coalition, and real-time exercises, were used to provide evidence of improved preparedness for putative mass casualty incidents.Conclusion: The HCFP-SCPA successfully increased preparedness and surge capacity through a partnership of regional healthcare facilities and emergency response agencies.

Comparison of the outcomes of hepatocellular carcinoma after hepatectomy between two regional medical centers in China and Japan.

Science.gov (United States)

Wang, Kai; Eguchi, Susumu; Hidaka, Masaaki; Jin, Tao; Soyama, Akihiko; Kuroki, Tamotsu; Huang, Mingwen; Wu, Linquan; Zou, Shubing; Shao, Jianghua

2017-09-01

Hepatocellular carcinoma (HCC) is a common malignant disease of the liver in China and Japan. The purpose of this study was to compare the outcomes of HCC patients after hepatectomy between two regional medical centers in China and Japan. Data on HCC after hepatectomy were collected from January 2005 to December 2014 from Nagasaki University Hospital in Nagasaki, Japan and the Second Affiliated Hospital of Nanchang University in Nanchang, China. The patient and tumor characteristics, HCC etiology, and overall survival rates after hepatectomy were investigated. Two hundred patients in the Nagasaki group and 238 patients in the Nanchang group were diagnosed with HCC and underwent hepatectomy. The major underlying liver diseases were hepatitis C infection (32%, 64/200) and nonalcoholic steatohepatitis (NASH) (34.5%, 69/200) in the Nagasaki group, while in the Nanchang group, hepatitis B infection (79.4%, 189/238) was the dominant etiology. Large tumors (> 5 cm), the presence of a tumor capsule and a high alpha-fetoprotein value (≥ 400 U/L) were more frequently observed in the Nanchang group as compared with the Nagasaki group (p Japan and China. These differences may impact the eligibility for potentially curative therapy and the prognosis of patients with HCC. Copyright © 2016. Published by Elsevier Taiwan.

Biological risks of medical irradiations: Medical physics monograph 5

International Nuclear Information System (INIS)

Fullerton, G.D.; Kopp, D.T.; Waggener, R.G.; Webster, E.W.

1980-01-01

This book is the fifth in a series of monographs by the American Association of Physicists in Medicine (AAPM) and is a compendium of papers presented at an AAPM regional symposium conducted in San Antonio in July 1980. The book is divided into three sections: (1) biological fundamentals of ionizing radiation, (2) risk evaluation and reduction in three principle radiologic subspecialties (diagnostic radiology, nuclear medicine and radiation therapy), and (3) medical-legal implications. The first section includes a historical review of radiation biology, including a discussion of somatic and genetic effects and statistical approaches to risk estimates. The section on risk evaluation and reduction includes a good review of the units of exposure and activity including the international (SI) system employing the gray, becquerel, and seivert that respectively replace the rad, Curie, and rem. The unavoidable problem of legal responsibility and liability is the subject of the third, and last, section of the monograph. A chapter summarizing the legal history of medical irradiation also includes a glossary of pertinent legal terms. Recent court decisions that impact upon the clinical use of radiation are presented and discussed as well as proposed changes in federal guidelines that could have a large impact on the practice of medicine in general and radiology in particular

Region of interest and windowing-based progressive medical image delivery using JPEG2000

Science.gov (United States)

Nagaraj, Nithin; Mukhopadhyay, Sudipta; Wheeler, Frederick W.; Avila, Ricardo S.

2003-05-01

An important telemedicine application is the perusal of CT scans (digital format) from a central server housed in a healthcare enterprise across a bandwidth constrained network by radiologists situated at remote locations for medical diagnostic purposes. It is generally expected that a viewing station respond to an image request by displaying the image within 1-2 seconds. Owing to limited bandwidth, it may not be possible to deliver the complete image in such a short period of time with traditional techniques. In this paper, we investigate progressive image delivery solutions by using JPEG 2000. An estimate of the time taken in different network bandwidths is performed to compare their relative merits. We further make use of the fact that most medical images are 12-16 bits, but would ultimately be converted to an 8-bit image via windowing for display on the monitor. We propose a windowing progressive RoI technique to exploit this and investigate JPEG 2000 RoI based compression after applying a favorite or a default window setting on the original image. Subsequent requests for different RoIs and window settings would then be processed at the server. For the windowing progressive RoI mode, we report a 50% reduction in transmission time.

Does Pukawakawa (the regional-rural programme at the University of Auckland) influence workforce choice?

Science.gov (United States)

Matthews, Christina; Bagg, Warwick; Yielder, Jill; Mogol, Vernon; Poole, Phillippa

2015-02-20

Relative shortages of rural doctors persist. In 2008 the University of Auckland medical programme introduced a Year 5 regional and rural immersion programme, Pukawakawa, based in Northland, New Zealand (NZ). This study evaluates the early workforce outcomes of graduates of this programme. During 2013 we surveyed Auckland medical graduates who were in the 2008-2011 Pukawakawa cohorts. Questions were asked regarding recent and current place of work, future intentions for place of work, and career preference with reasons why. Qualitative analysis was undertaken to analyse free text responses about experiences of Pukawakawa on this choice. Of the 72 Pukawakawa participants, 45 completed the survey, for a response rate of 63%. In 2013, 62% were working in rural or regional areas, with 31% in the Northland DHB. The great majority intend to work rurally or regionally, with 35.6% intending to return to Northland DHB. Of the respondents, 68% listed general practice in their top three future career intentions. In the early postgraduate years, medical graduates who participated in Pukawakawa are very likely to be working in rural and regional areas. These graduates also show an intention to work in general practice and rural medicine.

P. Prithvi Raj, MD, FFARCS: regional anesthesia pioneer.

Science.gov (United States)

Nair, Lakshmi; Giesecke, Adolph

2010-04-01

At a time when regional anesthesia was a curious alternative, Dr. Raj developed techniques to improve the success of the blocks and make regional analgesia more acceptable to the average anesthesiologist. His abundant research and numerous articles, books, lectures and demonstrations on regional anesthesia and pain management have established him as a world leader in the field. He has described new blocks and new techniques of doing old blocks. He has described the mechanism of action of intravenous regional analgesia. He has improved education and training by opening pain centers across the country, each of which has offered pain fellowship opportunities. He has founded societies dedicated to research and education in regional analgesia and pain management. Regional anesthesia and pain management will forever be linked with the name of Dr. Prithvi Raj. University of Texas Southwestern Medical Center is proud to have been a part of his early development.

COMPLEX REGIONAL PAIN SYNDROME – CLINIC, DIAGNOSTICS, TREATMENT

Directory of Open Access Journals (Sweden)

N. A. Shostak

2014-07-01

Full Text Available The problem of pain today remains one of the fundamental issues of medical care. It is known that the pain is the leading cause of treatmentto the doctor. Among pain syndromes, a special place belongs to the complex regional pain syndromes. They are distinguished by the multidisciplinary problem, the presence of explicit nature of the pain, difficulty of diagnosis and nature of the treatment. The article presentsmodern data on the diagnosis and treatment of the complex regional pain syndromes.

COMPLEX REGIONAL PAIN SYNDROME – CLINIC, DIAGNOSTICS, TREATMENT

Directory of Open Access Journals (Sweden)

N. A. Shostak

2013-01-01

Full Text Available The problem of pain today remains one of the fundamental issues of medical care. It is known that the pain is the leading cause of treatmentto the doctor. Among pain syndromes, a special place belongs to the complex regional pain syndromes. They are distinguished by the multidisciplinary problem, the presence of explicit nature of the pain, difficulty of diagnosis and nature of the treatment. The article presentsmodern data on the diagnosis and treatment of the complex regional pain syndromes.

Build-up forces at Military Institute of Medical Radiology and Oncology for emergency medical response to some eventualities of radiological accidents - some suggestions

International Nuclear Information System (INIS)

Ho Van Cu; Nguyen Huu Nghia

2011-01-01

Nowadays, the use of various nuclear sources in some fields of the life has brought many practical advantages in general; especially in the next several years, our country will begin construction of the first nuclear plant. However, if there were user carelessness or objective disadvantageous factors (earthquake, tsunami, etc.), that disadvantages could lead to a radiation accident or nuclear accident which causes damages not only for economy but also for public health. Therefore, the emergency response to radiation accident, especially the emergency medical response that has a great important position. To satisfy this real demand, in 1996, Vietnam Ministry of Defence made the decision to establish Center for Nuclear Medicine and Radiation Protecting (now becomes Military Institute of Medical Radiology and Oncology) with the main missions are research, applying radiation protecting methods and organizing treatments to radiation injured victims. To fulfill above main missions, with the help of Vietnam Atomic Energy Institute (VAEI), Vietnam Agency for Radiation and Nuclear Safety (VARANS), the doctors and staffs of our Institute have been participated in the international training courses and workshops that organized in Vietnam or in regional countries about emergency medical response to radiation accidents, they get valuable information, knowledge and documents from these courses and workshops. Depending on the principles of radiation emergency medical response to nuclear/ radiation accidents that International Atomic Energy Agency (IAEA) guided, and with the experience learned from other countries in Asia region, our Institute have been gradually improving on organization and curing processes for the radiation victims and also setting the preparedness for emergency medical response to radiation accidents if maybe they could occur. (author)

Optical polymers for laser medical applications

Science.gov (United States)

Sultanova, Nina G.; Kasarova, Stefka N.; Nikolov, Ivan D.

2016-01-01

In medicine, optical polymers are used not only in ophthalmology but in many laser surgical, diagnostic and therapeutic systems. The application in lens design is determined by their refractive and dispersive properties in the considered spectral region. We have used different measuring techniques to obtain precise refractometric data in the visible and near-infrared spectral regions. Dispersive, thermal and other important optical characteristics of polymers have been studied. Design of a plastic achromatic objective, used in a surgical stereo-microscope at 1064 nm laser wavelength, is accomplished. Geometrical and wavefront aberrations are calculated. Another example of application of polymers is the designed all-mirror apochromatic micro-lens, intended for superluminescent diode fiber coupling in medical systems.

Medical tourism in Thailand: a cross-sectional study

Science.gov (United States)

Noree, Thinakorn; Hanefeld, Johanna; Smith, Richard

2016-01-01

Abstract Objective To investigate the magnitude and characteristics of medical tourism in Thailand and the impact of such tourism on the Thai health system and economy. Methods In 2010, we checked the records of all visits to five private hospitals that are estimated to cover 63% of all foreign patients. We reviewed hospital records of foreign patients and obtained data on their countries of origin, diagnoses and interventions. We surveyed 293 medical tourists to collect demographic characteristics and information on their expenditure and travelling companions. To help understand the impact of medical tourism on the Thai health system, we also interviewed 15 hospital executives and 28 service providers from the private hospitals. Findings We obtained 911 913 records of hospital visits, of which 324 906 came from 104 830 medical tourists. We estimated that there were 167 000 medical tourists in Thailand in 2010. Of the medical tourists who attended our study hospitals, 67 987 (64.8%) came from the eastern Mediterranean region or Asia and 109 509 (34%) of them were treated for simple and uncomplicated conditions – i.e. general check-ups and medical consultations. The mean self-reported non-medical expenditure was 2750 United States dollars. According to the hospital staff interviewed, medical tourism in 2010 brought benefits to – and apparently had no negative impacts on – the Thai health system and economy. Conclusion We estimate that the total number of medical tourists visiting Thailand is about 10% of previous national government estimates of 1.2 million. Such tourists appear to bring economic benefits to Thailand and to have negligible effects on the health system. PMID:26769994

[The use of medical journals by medical students. Which medical journals are read?].

Science.gov (United States)

Algra, Annemijn M; Dekker, Friedo W

2015-01-01

To investigate the role of scientific medical journals in Dutch medical curricula. Descriptive questionnaire study. In 2013, medical students (from year 3 onwards) at the Leiden University Medical Centre (LUMC), were invited to respond to an online questionnaire. They were presented with 28 multiple-choice questions and 11 statements about the use of scientific medical journals in the medical curriculum. We calculated the frequencies of the answers per question and analysed differences between medical students using two-by-two tables. The questionnaire was completed by 680 (53.0%) of 1277 invited medical students enrolled at the LUMC. Most of the respondents were those doing clinical rotations (56.6%) and 60.1% had research experience. More than half of the students read at least one scientific journal a few times per month; this percentage was 38.8% among third-year students, 49.3% among fourth-year students, 60.0% among those on clinical rotation, and was higher among students with research experience (63.3%) than among those without research experience (44.1%). Nearly 90% of students agreed with the statement that the development of academic and scientific education should take place in the bachelor's phase of medical school. Medical students start to read scientific medical journals at an early phase in the medical curriculum and this increases further when students start to undertake research projects or go on clinical rotation. Medical curricula should be constructed in such a way that medical students learn to select and interpret research findings adequately for themselves before they turn to articles from scientific medical journals.

Posterior Approach to Kidney Dissection: An Old Surgical Approach for Integrated Medical Curricula

Science.gov (United States)

Daly, Frank J.; Bolender, David L.; Jain, Deepali; Uyeda, Sheryl; Hoagland, Todd M.

2015-01-01

Integrated medical curricular changes are altering the historical regional anatomy approach to abdominal dissection. The renal system is linked physiologically and biochemically to the cardiovascular and respiratory systems; yet, anatomists often approach the urinary system as part of the abdomen and pelvic regions. As part of an integrated…

[Professional drivers and psychoactive substances consumption: results from medical surveillance at the workplace in Piedmont region].

Science.gov (United States)

Rosso, G L; Feola, M; Rubinetto, Maria Paola; Petti, N; Rubinetto, L

2011-01-01

The use of psychoactive substances has been shown to be a risk factor for accidents in professional drivers. According to an approved Italian law, in order to detect dependency at the workplace the occupational health physician is called to assess the use of illicit drugs among professional drivers. The main purpose of this study was to investigate the use of psychoactive substances among professional drivers. From July to December 2008, rapid urine screening test was carried out on 198 professional drivers. All positive results from the screening stage were verified by specialized laboratories. We found 4 workers with a positive rapid urine screening test (7.1%), one of which was positive only for benzodiazepines and another positive test was not confirmed by specialized laboratory. By only considering illegal substances detected, 6.1% of the drivers tested positive. In this study, the high number of consumers among professional drivers ranged from 31 to 35 years old. Cannabis (THC) was the most frequently detected substance (seen in 10 over 12 cases,), after that was methadone (2/12 cases) and cocaine (1/12 case). We only had one case where more than one substance was found in the same subject (THC and cocaine). Five (41.7%) were former drug-addicts and public Pathological Addiction Services (Ser.T.) had previously followed them. Our results highlight the problem of drug consumption among professional drivers in Piedmont region. Health education and medical surveillance in workplace drug-testing may improve worker and third parties safety.

Medical devices and the Middle East: market, regulation, and reimbursement in Gulf Cooperation Council states.

Science.gov (United States)

Howard, Jason J

2014-01-01

With some of the richest economies in the world, the Gulf Cooperation Council (GCC) is undergoing rapid growth not only in its population but also in health care expenditure. Despite the GCC's abundance of hydrocarbon-based wealth, the drivers of the medical device industry in the GCC are still in flux, with gains yet to be made in areas of infrastructure, regulation, and reimbursement. However, the regional disease burden, expanding health insurance penetration, increasing privatization, and a desire to attract skilled expatriate health care providers have led to favorable conditions for the medical device market in the GCC. The purpose of this article is to investigate the current state of the GCC medical device industry, with respect to market, regulation, and reimbursement, paying special attention to the three largest medical device markets: Saudi Arabia, the United Arab Emirates, and Qatar. The GCC would seem to represent fertile ground for the development of medical technologies, especially those in line with the regional health priorities of the respective member states.

Examining Burnout, Depression, and Attitudes Regarding Drug Use Among Lebanese Medical Students During the 4 Years of Medical School.

Science.gov (United States)

Talih, Farid; Daher, Michel; Daou, Dayane; Ajaltouni, Jean

2018-04-01

This study aims to evaluate the prevalence of burnout, depressive symptoms, and anxiety symptoms and attitudes toward substance use in medical students as well as their evolution during the 4 years of medical school. A cross-sectional study was carried out at the American University of Beirut Medical Center (AUBMC) between September and December 2016. In total, 176 out of 412 eligible medical students responded. The survey was anonymous and administered via e-mail link to an electronic form. The study included general socio-demographic questions and standardized validated tools to measure depressive symptomatology (PHQ-9), burnout (Burnout Measure), anxiety (GAD-7), alcohol use (AUDIT), and substance abuse (DAST-10) as well as questions pertaining to attitudes toward recreational substance use. Overall, 23.8% of medical students reported depressive symptomatology, with 14.5% having suicidal ideations. Forty-three percent were found to have burnout. Those who screened positive for burnout were more likely to be males, to be living away from their parents, and to have experienced a stressful life event during the last year. With the exception of burnout, there was no significant difference in the prevalence of depression or anxiety among the 4 years of medical school. There was a significant difference in alcohol use, illicit substance use, and marijuana use during the four medical school years. The results of this study show high rates of depression, burnout, and suicidal ideation among medical students from the Middle East region. Increased rates of substance use were detected as well as a more tolerant attitude toward substance use in general, specifically cannabis. It is crucial that medical educators and policymakers keep tackling the complex multifactorial mental health issues affecting medical students and design effective solutions and support systems.

[More than a decade improving medical and judicial certification in mortality statistics of death causes].

Science.gov (United States)

Cirera, Lluís; Salmerón, Diego; Martínez, Consuelo; Bañón, Rafael María; Navarro, Carmen

2018-06-06

After the return of Spain to democracy and the regional assumption of government powers, actions were initiated to improve the mortality statistics of death causes. The objective of this work was to describe the evolution of the quality activities improvements into the statistics of death causes on Murcia's region during 1989 to 2011. Descriptive epidemiological study of all death documents processed by the Murcia mortality registry. Use of indicators related to the quality of the completion of death in medical and judicial notification; recovery of information on the causes and circumstances of death; and impact on the statistics of ill-defined, unspecific and less specific causes. During the study period, the medical notification without a temporary sequence on the death certificate (DC) has decreased from 46% initial to 21% final (p less than 0.001). Information retrieval from sources was successful in 93% of the cases in 2001 compared to 38%, at the beginning of the period (p less than 0.001). Regional rates of ill-defined and unspecific causes fell more than national ones, and they were in the last year with a differential of 10.3 (p less than 0.001) and 2.8 points (p=0.001), respectively. The medical death certification improved in form and suitability. Regulated recovery of the causes of death and circumstances corrected medical and judicial information. The Murcia's region presented lower rates in less specified causes and ill-defined entities than national averages.

Equity and efficiency of medical service systems at the provincial level of China's mainland: a comparative study from 2009 to 2014.

Science.gov (United States)

Ding, Jingmei; Hu, Xuejun; Zhang, Xianzhi; Shang, Lei; Yu, Min; Chen, Huoliang

2018-02-05

The astonishing economic achievements of China in the past few decades have remarkably increased not only the quantity and quality of medical services but also the inequalities in health resources allocation across regions and inefficiency of the medical service delivery. A descriptive analysis was used to compare the inequities in inputs and outputs of the provincial medical service systems, a non-radial super-efficiency data envelopment analysis model was then used to estimate the efficiency, and a regression analysis of the panel data was used to explore the determinants. The inputs and outputs of most provincial medical service systems increased gradually from 2009 to 2014. Overall, the eastern region allocated more human and capital resources than the other two regions, and produced more than 50% of the total outpatient and emergency room visits, whereas the western region produced more inpatient services (about 30% of the total volume of inpatient services) according to the distribution of the population. The average efficiency scores of the provincial medical systems in China's mainland were 0.895, 0.927, 0.929, 0.963, 0.977 and 0.968 from 2009 to 2014, with a slight average improvement of 1.60%. The efficiency score of each provincial medical service system varied greatly from one another: Tibet (1.475 ± 0.057) performed extremely well, whereas several others including Heilongjiang (0.579 ± 0.001) performed poorly. Furthermore, the proportion of high-class medical facilities was negatively associated with efficiency, whereas the proportion of the vulnerable population, the per capita Gross Domestic Product, the proportion of the illiterate population and the improvement of primary health care had positive effects on efficiency. Inequity in health resources allocation and service provision existed across the regions, but not all the gaps have begun to narrow since 2009. The difference of efficiency was great among provincial medical service systems

Clinical Training of Medical Physicists Specializing in Nuclear Medicine (Spanish Edition); Capacitacion clinica de fisicos medicos especialistas en medicina nuclear

Energy Technology Data Exchange (ETDEWEB)

NONE

2013-07-15

The application of radiation in human health, for both diagnosis and treatment of disease, is an important component of the work of the IAEA. The responsibility for the increasingly technical aspects of this work is undertaken by the medical physicist. To ensure good practice in this vital area, structured clinical training programmes are required to complement academic learning. This publication is intended to be a guide to the practical implementation of such a programme for nuclear medicine. There is a general and growing awareness that radiation medicine is increasingly dependent on well trained medical physicists who are based in a clinical setting. However an analysis of the availability of medical physicists indicates a large shortfall of qualified and capable professionals. This is particularly evident in developing countries. While strategies to increase educational opportunities are critical to such countries, the need for guidance on structured clinical training was recognized by the members of the Regional Cooperative Agreement for Research, Development and Training related to Nuclear Science and Technology (RCA) for the Asia-Pacific region. Consequently, a technical cooperation regional project (RAS6038) under the RCA programme was formulated to address this need in this region by developing suitable material and establishing its viability. Development of a clinical training guide for medical physicists specialising in nuclear medicine was started in 2009 with the appointment of a core drafting committee of regional and international experts. The publication drew on the experience of clinical training in Australia, Croatia and Sweden and was moderated by physicists working in the Asian region. The present publication follows the approach of earlier IAEA publications in the Training Course Series, specifically Nos 37 and 47, Clinical Training of Medical Physicists Specializing in Radiation Oncology and Clinical Training of Medical Physicists

Expatriate clinics and medical evacuation companies are a growth industry worldwide.

Science.gov (United States)

Wilde, Henry; Roselieb, Marcus; Hanvesakul, Rekha; Phaosavasdi, Sukhit; Pruksapong, Chumsak

2003-01-01

Globalization and the growth of tourism, which now includes "adventure" visits to very remote regions, has created new employment but also new problems. For example, elderly tourists break their hips where there is no competent orthopedic surgeon, a traveler gets bitten by a cobra in rural Cambodia where there is not even an "Ambu" bag to keep him oxygenated, and a tour guide develops high-altitude cerebral edema on a remote Nepalese mountain. What would we do without organizations that are capable of removing such victims rapidly and safely to a place able to provide appropriate medical care? Fortunately, several well-staffed and well-equipped air ambulance companies stand ready almost worldwide to help 24 hours a day. Medical assistance firms, which sell their own travel insurance and/or act as agents of large insurance companies, are also at hand and have offices in major cities worldwide. They have 24-hour telephone numbers and are prepared to advise a sick or injured traveler where he or she should go to obtain competent medical care. Most of these firms have regional medical advisors in strategic locations who maintain a network of contacts. They can ensure that an ill traveler is receiving appropriate care and will act as quality controllers. They are also able to advise whether medical evacuation to a higher level of care is needed and where the traveler should be evacuated to.

Feature Detector and Descriptor for Medical Images

Science.gov (United States)

Sargent, Dusty; Chen, Chao-I.; Tsai, Chang-Ming; Wang, Yuan-Fang; Koppel, Daniel

2009-02-01

The ability to detect and match features across multiple views of a scene is a crucial first step in many computer vision algorithms for dynamic scene analysis. State-of-the-art methods such as SIFT and SURF perform successfully when applied to typical images taken by a digital camera or camcorder. However, these methods often fail to generate an acceptable number of features when applied to medical images, because such images usually contain large homogeneous regions with little color and intensity variation. As a result, tasks like image registration and 3D structure recovery become difficult or impossible in the medical domain. This paper presents a scale, rotation and color/illumination invariant feature detector and descriptor for medical applications. The method incorporates elements of SIFT and SURF while optimizing their performance on medical data. Based on experiments with various types of medical images, we combined, adjusted, and built on methods and parameter settings employed in both algorithms. An approximate Hessian based detector is used to locate scale invariant keypoints and a dominant orientation is assigned to each keypoint using a gradient orientation histogram, providing rotation invariance. Finally, keypoints are described with an orientation-normalized distribution of gradient responses at the assigned scale, and the feature vector is normalized for contrast invariance. Experiments show that the algorithm detects and matches far more features than SIFT and SURF on medical images, with similar error levels.

NUMBER AND STRUCTURE OF MEDICAL STAFF IN THE SIBERIAN CITIES IN THE GREAT PATRIOTIC WAR OF 1941-1945

Directory of Open Access Journals (Sweden)

Yuliya A. Davidova

2013-01-01

Full Text Available A dynamics of the number of medical personnel Siberian cities in the Great Patriotic war is analyzed in the article. The author studies quantity and structure of senior and low-grade medical personnel of healthcare institutions, shows its impact on medical and sanitarian anti-epidemic work, as well as considers methods of decision of personnel problem in the region. The study is based on analysis of documents of the State Archive of the Russian Federation, the Russian State Archive of Socio-Political History, the Russian State Archive of Economy and the Regional Archives of the Siberian cities.

The influence of Iranian scientific journals in disseminating medical information.

Science.gov (United States)

Aminpour, Farzaneh

2012-02-01

Scientific journals are the most credible and updated information resources for valid information in the various fields of science and technology. The present study investigates the status of Iranian scientific journals in disseminating medical information to the world of science. Total 163 Iranian medical journals accredited by national medical journals commission of Iranian ministry of health and medical education were evaluated through a cross-sectional study. The results were represented in descriptive statistics in the form of table and chart. The study showed that 89.6% of Iranian medical journals were covered by regional information databases. Web of Science database indexed 22 (13.5%) Iranian journals in the field of medical science. Only six (6.7%) journals were indexed by Medline. Fifty-eight (35.6%) journals were in English, 102 (62.6%) in Persian, and three (1.8%) were bilingual which published their articles both in Persian and English languages. The highest Impact factor belonged to Iranian Journal of Allergy Asthma and Immunology. Improving scientific credibility of Iranian scholarly journals and their influence in disseminating medical information calls for a precise scientific and executive administration in publishing standards and also in the quality of content.

Medical Evacuation from Vietnam of an Elderly with Tuberculosis Spondylitis

Directory of Open Access Journals (Sweden)

Ying-Hua Shieh

2007-09-01

Full Text Available Despite the growth in economy in Vietnam, the infrastructure of dependable medical care is still lacking. Therefore, aeromedical evacuation of patients to other countries for further medical interventions has become an important medical service in the region. We report a case where an elderly man who was aeromedically evacuated from Ho Chi Minh City, Vietnam to Taipei Medical University–Municipal Wan Fang Hospital in Taipei, Taiwan. The patient developed a sudden onset of quadriplegia because of an epidural abscess at the cervical spine C6–C7. Antituberculous medication was prescribed for suspected tuberculous spondylitis, because his cerebral spinal fluid showed elevated white blood cells with a predominance of lymphocytes, and mildly elevated total protein. However, whole body tumor scan (67Ga mCi and whole body bone scan (99mTc methylene diphosphonate, 25 mCi did not reveal any specific results. Surgical intervention was arranged because of cervical spine instability and the need for a diagnostic biopsy. Adenocarcinoma of the prostate was found incidentally and was treated with bilateral orchiectomy and radiation therapy. This was the first medical evacuation by the Family Medical Practice group in Ho Chi Minh City, Vietnam to Taiwan.

Clinical anatomy of the periocular region.

Science.gov (United States)

Shams, Pari N; Ortiz-Pérez, Santiago; Joshi, Naresh

2013-08-01

The aims of this article are twofold: (1) to provide the facial plastic surgeon with a comprehensive and up-to-date overview of periocular anatomy including the brow, midface, and temporal region and (2) to highlight important anatomical relationships that must be appreciated in order to achieve the best possible functional and aesthetic surgical outcomes. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Medical devices for the anesthetist: current perspectives

Directory of Open Access Journals (Sweden)

Ingrande J

2014-03-01

Full Text Available Jerry Ingrande, Hendrikus JM LemmensDepartment of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USAAbstract: Anesthesiologists are unique among most physicians in that they routinely use technology and medical devices to carry out their daily activities. Recently, there have been significant advances in medical technology. These advances have increased the number and utility of medical devices available to the anesthesiologist. There is little doubt that these new tools have improved the practice of anesthesia. Monitoring has become more comprehensive and less invasive, airway management has become easier, and placement of central venous catheters and regional nerve blockade has become faster and safer. This review focuses on key medical devices such as cardiovascular monitors, airway equipment, neuromonitoring tools, ultrasound, and target controlled drug delivery software and hardware. This review demonstrates how advances in these areas have improved the safety and efficacy of anesthesia and facilitate its administration. When applicable, indications and contraindications to the use of these novel devices will be explored as well as the controversies surrounding their use.Keywords: catheters, echocardiography, ultrasound, fiberoptic bronchoscope, laryngeal mask airway, closed-loop anesthesia

Lossless medical image compression using geometry-adaptive partitioning and least square-based prediction.

Science.gov (United States)

Song, Xiaoying; Huang, Qijun; Chang, Sheng; He, Jin; Wang, Hao

2018-06-01

To improve the compression rates for lossless compression of medical images, an efficient algorithm, based on irregular segmentation and region-based prediction, is proposed in this paper. Considering that the first step of a region-based compression algorithm is segmentation, this paper proposes a hybrid method by combining geometry-adaptive partitioning and quadtree partitioning to achieve adaptive irregular segmentation for medical images. Then, least square (LS)-based predictors are adaptively designed for each region (regular subblock or irregular subregion). The proposed adaptive algorithm not only exploits spatial correlation between pixels but it utilizes local structure similarity, resulting in efficient compression performance. Experimental results show that the average compression performance of the proposed algorithm is 10.48, 4.86, 3.58, and 0.10% better than that of JPEG 2000, CALIC, EDP, and JPEG-LS, respectively. Graphical abstract ᅟ.

Safety of antimalarial medications for use while scuba diving in malaria Endemic Regions.

Science.gov (United States)

Petersen, Kyle; Regis, David P

2016-01-01

Recreational diving occurs annually in areas of the world where malaria is endemic. The safety and efficacy of antimalarials for travelers in a hyperbaric environment is unknown. Of particular concern would be medications with adverse effects that could either mimic diving related illnesses such as barotrauma, decompression sickness (DCS) and gas toxicities, or increase the risk for such illnesses. We conducted a review of PubMed and Cochrane databases to determine rates of neurologic adverse effects or other effects from antimalarials that may be a problem in the diving environment. One case report was found on diving and mefloquine. Multiple case reports and clinical trials were found describing neurologic adverse effects of the major chemoprophylactic medications atovaquone/proguanil, chloroquine, doxycycline, mefloquine, and primaquine. Of the available literature, atovaquone/proguanil and doxycycline are most likely the safest agents and should be preferred; atovaquone/proguanil is superior due to reduced rates of sunburn in the marine environment. Primaquine also appears to be safe, but has reduced efficacy against P. falciparum ; mefloquine possesses the highest rate of neurologic side effects and therefore these agents should be limited to extreme cases of patients intolerant to other agents. Chloroquine appears unsafe in the hyperbaric environment and should be avoided. More studies are required to include database reviews of returned divers traveling to malaria endemic areas and randomized controlled trials in the hyperbaric environments.

Therapeutic landscapes and postcolonial theory: a theoretical approach to medical tourism.

Science.gov (United States)

Buzinde, Christine N; Yarnal, Careen

2012-03-01

This paper draws on two conceptual frameworks, therapeutic landscapes and postcolonial theory, to discuss aspects of medical tourism not addressed in extant literature. Building on the intersection between postcolonial and therapeutic landscapes scholarship, it highlights inequalities related to the production of national therapeutic landscapes located in postcolonial regions as well as their discursive (re)positioning as medical tourism destinations. As a framework, therapeutic landscapes can facilitate an understanding of medical tourism sites as curative spaces which combine modern and alternative forms of medicine with travel and leisure. Postcolonial theory critiques the economic, moral and cultural tensions emerging from the intersection between corporations that provide cheaper and more attractive medical services, and the nations on the periphery struggling to offer high medical standards that may not be accessible to their own local populations. In an effort to enhance scholarship on medical tourism, these conceptual frameworks are offered as points of departure, rather than sites of arrival, through which critical dialog on medical tourism can be sustained and broadened. Copyright © 2012 Elsevier Ltd. All rights reserved.

Heat Stroke: A Medical Emergency Appearing in New Regions

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Sofie Søndergaard Mørch

2017-01-01

Full Text Available Heat stroke is an acute, life-threatening emergency characterized clinically by elevated body temperature and central nervous system dysfunction. Early recognition and treatment including aggressive cooling and management of life-threatening systemic complications are essential to reduce morbidity and mortality. This case report describes two Danish patients diagnosed with heat stroke syndrome during a heat wave in the summer of 2014. Both patients were morbidly obese and had several predisposing illnesses. However since heat stroke is a rare condition in areas with temperate climate, they were not diagnosed until several days after admittance; hence treatment with cooling was delayed. Both patients were admitted to the intensive care unit, where they were treated with an external cooling device and received treatment for complications. Both cases ended fatally. As global warming continues, more heat waves will occur in previously cooler regions. Therefore it is important to raise awareness of heat stroke since outcome depends on early recognition and rapid cooling.

Embedding the shapes of regions of interest into a Clinical Document Architecture document.

Science.gov (United States)

Minh, Nguyen Hai; Yi, Byoung-Kee; Kim, Il Kon; Song, Joon Hyun; Binh, Pham Viet

2015-03-01

Sharing a medical image visually annotated by a region of interest with a remotely located specialist for consultation is a good practice. It may, however, require a special-purpose (and most likely expensive) system to send and view them, which is an unfeasible solution in developing countries such as Vietnam. In this study, we design and implement interoperable methods based on the HL7 Clinical Document Architecture and the eXtensible Markup Language Stylesheet Language for Transformation standards to seamlessly exchange and visually present the shapes of regions of interest using web browsers. We also propose a new integration architecture for a Clinical Document Architecture generator that enables embedding of regions of interest and simultaneous auto-generation of corresponding style sheets. Using the Clinical Document Architecture document and style sheet, a sender can transmit clinical documents and medical images together with coordinate values of regions of interest to recipients. Recipients can easily view the documents and display embedded regions of interest by rendering them in their web browser of choice. © The Author(s) 2014.

Sharing and selling of prescription medications in a college student sample

Science.gov (United States)

Garnier, Laura M.; Arria, Amelia M.; Caldeira, Kimberly M.; Vincent, Kathryn B.; O’Grady, Kevin E.; Wish, Eric D.

2009-01-01

Objectives To estimate the prevalence of prescription medication diversion among college students; to compare classes of medications with respect to the likelihood of diversion; to document the most common methods of diversion; and to examine the characteristics of students who diverted medications. Method A cross-sectional analysis of personal interview data collected between August 2006 and August 2007 as part of an ongoing longitudinal study. The cohort of students, who were between the ages 17 and 19 at study onset, attended a large public university in the mid-Atlantic region. Information was gathered regarding a wide variety of variables, including demographics, diversion of medically prescribed drugs, illicit drug use, and childhood conduct problems. Results Among 483 students prescribed a medication, 35.8% diverted a medication at least once in their lifetime. The most commonly diverted medication classes were prescription ADHD medication, with a 61.7% diversion rate, and prescription analgesics (35.1% diversion rate). Sharing was the most common method of diversion, with 33.6% of students sharing their medication(s) and 9.3% selling in their lifetime. Comparative analyses revealed that prescription medication diverters had used more illicit drugs in the past year and had more childhood conduct problems than non-diverters. Conclusions If confirmed, these findings have important clinical implications for improved physician-patient communication and vigilance regarding prescribing analgesic and stimulant medications for young adults. PMID:20331930

Referral Regions for Time-Sensitive Acute Care Conditions in the United States.

Science.gov (United States)

Wallace, David J; Mohan, Deepika; Angus, Derek C; Driessen, Julia R; Seymour, Christopher M; Yealy, Donald M; Roberts, Mark M; Kurland, Kristen S; Kahn, Jeremy M

2018-03-24

Regional, coordinated care for time-sensitive and high-risk medical conditions is a priority in the United States. A necessary precursor to coordinated regional care is regions that are actionable from clinical and policy standpoints. The Dartmouth Atlas of Health Care, the major health care referral construct in the United States, uses regions that cross state and county boundaries, limiting fiscal or political ownership by key governmental stakeholders in positions to create incentive and regulate regional care coordination. Our objective is to develop and evaluate referral regions that define care patterns for patients with acute myocardial infraction, acute stroke, or trauma, yet also preserve essential political boundaries. We developed a novel set of acute care referral regions using Medicare data in the United States from 2011. For acute myocardial infraction, acute stroke, or trauma, we iteratively aggregated counties according to patient home location and treating hospital address, using a spatial algorithm. We evaluated referral political boundary preservation and spatial accuracy for each set of referral regions. The new set of referral regions, the Pittsburgh Atlas, had 326 distinct regions. These referral regions did not cross any county or state borders, whereas 43.1% and 98.1% of all Dartmouth Atlas hospital referral regions crossed county and state borders. The Pittsburgh Atlas was comparable to the Dartmouth Atlas in measures of spatial accuracy and identified larger at-risk populations for all 3 conditions. A novel and straightforward spatial algorithm generated referral regions that were politically actionable and accountable for time-sensitive medical emergencies. Copyright © 2018 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Duration and setting of rural immersion during the medical degree relates to rural work outcomes.

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O'Sullivan, Belinda; McGrail, Matthew; Russell, Deborah; Walker, Judi; Chambers, Helen; Major, Laura; Langham, Robyn

2018-04-19

Providing year-long rural immersion as part of the medical degree is commonly used to increase the number of doctors with an interest in rural practice. However, the optimal duration and setting of immersion has not been fully established. This paper explores associations between various durations and settings of rural immersion during the medical degree and whether doctors work in rural areas after graduation. Eligible participants were medical graduates of Monash University between 2008 and 2016 in postgraduate years 1-9, whose characteristics, rural immersion information and work location had been prospectively collected. Separate multiple logistic regression and multinomial logit regression models tested associations between the duration and setting of any rural immersion they did during the medical degree and (i) working in a rural area and (ii) working in large or smaller rural towns, in 2017. The adjusted odds of working in a rural area were significantly increased if students were immersed for one full year (odds ratio [OR], 1.79; 95% confidence interval [CI], 1.15-2.79), for between 1 and 2 years (OR, 2.26; 95% CI, 1.54-3.32) and for 2 or more years (OR, 4.43; 95% CI, 3.03-6.47) relative to no rural immersion. The strongest association was for immersion in a mix of both regional hospitals and rural general practice (OR, 3.26; 95% CI, 2.31-4.61), followed by immersion in regional hospitals only (OR, 1.94; 95% CI, 1.39-2.70) and rural general practice only (OR, 1.91; 95% CI, 1.06-3.45). More than 1 year's immersion in a mix of regional hospitals and rural general practices was associated with working in smaller regional or rural towns (immersion programmes. Longer rural immersion and immersion in both regional hospitals and rural general practices are likely to increase rural work and rural distribution of early career doctors. © 2018 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

IOMP - Challenges for advancing medical physic globally

International Nuclear Information System (INIS)

Nusslin, F.

2010-01-01

IOMP stands for International Organization for Medical Physics. The determinants of health care include; science, research, academia, education, technology, engineering, industry, politics, economic, society, ethics, culture and medicine. However, physics and engineering are the driving forces of progress in health care. Medical Physics is a branch of Applied Physics, pursued by medical physicists, which uses physics principles, methods and techniques in practice and research for the prevention, diagnosis and treatment of human diseases with a specific goal of improving human health and well-being. How can we achieve Health Care improvement through Medical Physics globally? By forming international alliances in the Medical Physics community to develop and implement coherent concepts of • Appropriate University / Hospital Structures • Education & Training and Certification Schemes • Research & Development Platforms • Professional Career Development • International Cooperation within the Science Community IOMP represents ca. 18.000 medical physicists worldwide, it is affiliated to 80 national member organizations, six regional organizations as Members plus Corporate Members. The mission of IOMP is to advance medical physics practice worldwide by disseminating scientific and technical information, fostering the educational and professional development of medical physics and promoting the highest quality medical services for patients. 6 Medical physicists are professionals with education and specialist training in the concepts and techniques of applying physics in medicine. They work in clinical, academic or research institutions. Challenges, Efforts and Achievements of the International Organization for Medical Physics Recognition of the Medical Physics profession by the National Health Authorities. Medical Physicists are essential to ensure adequate and safe use of radiation equipment, Radiation Protection of patients, workers and public in a clinical

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

Medical Science and Research in Iran.

Science.gov (United States)

Akhondzadeh, Shahin; Ebadifar, Asghar; Baradaran Eftekhari, Monir; Falahat, Katayoun

2017-11-01

During the last 3 decades, Iran has experienced a rapid population growth and at the same time the health of Iranian people has improved greatly. This achievement was mainly due to training and availability of health manpower, well organized public health network and medical science and research improvement. In this article, we aimed to report the relevant data about the medical science and research situation in Iran and compare them with other countries. In this study, after reviewing science development and research indicators in medical sciences with participation of key stakeholders, we selected 3 main hybrid indexes consisting of "Research and Development (R&D) expenditures," "Personnel in Science and Technology sector" and "knowledge generation" for evaluation of medical science and research situation. Data was extracted from reliable databases. Over the past decade, Iran has achieved significant success in medical sciences and for the first time in 2015 based on Scopus index, Iran ranked first in the number of published scientific papers and number of citations in the region and among all Islamic countries. Also, 2% of the world's publications belong to Iran. Regarding innovation, the number of Iranian patents submitted to the United States Patent and Trademark Office (USPTO) was 3 and 43 in 2008 and 2013, respectively. In these years, the number of personnel in science and technology sectors including post graduate students, researchers and academic members in universities of medical sciences (UMSs) have increased. The female students in medical sciences field account for about twothirds of all students. Also, women comprise about one-third of faculty members. Since 5 years ago, Iran has had growth in science and technology parks. These achievements were attained in spite of the fact that research spending in Iran was still very low (0.5% of gross domestic product [GDP]) due to economic hardships and sanctions. Medical science and research development has

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

Directory of Open Access Journals (Sweden)

Mira MOON

2017-08-01

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

Regional cost differences of hospital supply in Germany

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Lauterbach, Karl W.

2005-04-01

Full Text Available The intended adoption of a global reimbursement system for inpatient care in Germany envisions identical payments for identical treatments at different hospitals. This may lead to losses in some hospitals and may cause problems for the supply with health care facilities in the long run if there a important regional cost differences. Cost and performance data of 1112 hospitals in Germany have been analysed for regional differences in 2001: As regional categorizations we used official classification schemes based on centrality. The investigation does not support the postulation of additional payments for selected regions in Germany accounting for level cost-differences between hospitals. Confounding influence factors like ownership and hospital size seem to be more important. We recommend further investigations to evaluate regional cost-differences on the level of medical wards and using more risk-adjusted data. The examination of the individual case is necessary.

THE ANALYSIS OF CANCER INCIDENCE AND MORTALITY AMONG THE POPULATION OF THE MOSCOW REGION IN 2014

Directory of Open Access Journals (Sweden)

A. N. Gurov

2015-01-01

Full Text Available Rationale: Analysis of the cancer incidence and mortality in the population is of major importance for planning of measures aimed at improvement of organization of medical care to cancer patients, ensuring high quality and availability of this type of medical care.Aim: To evaluate cancer-related incidence and mortality rates and structure among the population of the Moscow Region depending on patient gender and tumor localization.Materials and methods: The estimation and analysis of incidence and mortality rates was performed based on the Reporting Form of the Federal Statistic Surveillance #7 “Information on disorders related to malignant tumors” in the Moscow Region in 2014. For mortality analysis, including that among pediatric patients, we used data from the State Statistics Service of the Moscow Region.Results: In 2014, there were 25 600 new cases of malignancies diagnosed in the Moscow Region, that corresponded to the incidence rate of 363.2 per 100,000 of the population. The leading types of newly diagnosed tumors in men were prostate cancer, as well as tracheal, bronchial and lung cancers (54.2 and 47.0 per 100,000 of male population, respectively. In women, the highest incidence rates were found for breast and skin cancers (86.0 and 58.9 per 100,000 of female population, respectively. According to the data from Rosstat, in 2014, the overall cancer mortality rate in the Moscow Region was 228.1 per 100,000 of the population. Among the causes of cancer mortality in men, the leading one was tracheal, bronchial and lung cancer (22.2%, followed by stomach cancer (13.3% and prostate cancer (8.1%. In women, the leading cause of cancer mortality was breast cancer (16.6%, followed by ovarian, uterine and cervical cancers (14.1% and stomach cancer (11.4%.Conclusion: Based on the results of medical and statistical analysis of cancer incidence and mortality rates, the main direction of improvement of medical care to cancer patients and the ways

[Ways of improving medical services for schoolchildren].

Science.gov (United States)

Korenev, N M; Novikova, V N; Gaĭdaĭ, V Ia; Bulaga, L P; Komlik, P V

1990-01-01

The protection and promotion of schoolchildren's health might be ensured by means of differential approach to the use of different forms of organization of medical provision and its further improvement with due regard for regional conditions. The development of All-union programme "Schoolchildren" is needed which would provide for a scientific base for improving organizational and health-promoting activities at general education schools and boarding schools.

[The significance of the experience in organizing medical support for the troops during the war years for the development of the modern military medical infrastructure].

Science.gov (United States)

Pogodin, Iu I; Gurov, A N

1995-05-01

In the present period when combat activities are being carried out at the territory of Russia, namely in Chechnya, it is very important to solve the problem of the improvement of the infrastructure of medical service as a basis of territorial system of medical support of troops. That's why we are looking at the experience of medical support of troops in the period of the Great Patriotic war in order to determine the basic characteristic features of military medical infrastructure (MMI) of that time. Using the experience of medical support in the period of the Great Patriotic war it is necessary to draw the main attention on studying the medico-geographical aspects of the Armed Forces deployment over the whole territory of the country, state of health service system (taking into account its reformation), influence of natural, socio-economic and ecological factors of different regions upon the health of servicemen, organization of medical support of troops, proliferation of infectious and parasitic diseases, local resources and availability of medication materials, medical supplies, equipment and technique, as well as other indices which must be taken into consideration in routine situations or during disaster relief. All this information is very valuable for the process of the formation of an adequate MMF in the zone of responsibility of medical support of troops.

[Network Analyses in Regional Health Care Research: Example of Dermatological Care in the Metropolitan Region of Hamburg].

Science.gov (United States)

Augustin, J; Austermann, J; Erasmi, S

2016-10-18

Background: One of the overall objectives of the legislator is to ensure an overall "homogeneous", and easily accessible medical care for the population. The physician-patient ratio can be used to describe the regional health care situation. But this method does not provide information concerning the availability of, for instance, the nearest doctor. Therefore, further parameters such as accessibility must be taken into consideration. For this purpose, network analyses are an appropriate method. The objective of this study is to present methodological tools to evaluate the healthcare situation in the metropolitan region of Hamburg, primarily focusing on accessibility using dermatologists as an example. Methods: Analyzing data of 20 counties, the geographical distribution of N=357 dermatologists and the physician-patient ratio were calculated. In a second step, a network analysis regarding accessibility was performed. In order to calculate accessibility, address data (physicians) were transformed into coordinates, consisting of defined places (N=303) and restrictions (e. g. speed, turn restrictions) of the network. The calculation of population-based accessibility is based on grid cells for the population density. Results: Despite adequacy of the overall medical situation, differences in the availability of the nearest dermatologists in the metropolitan region are remarkable, particularly when use of public transport is taken into consideration. In some counties, over 60% of the population require at least one hour to get to the nearest dermatologist using public transportation. In rural regions within the metropolitan area are particularly affected. Conclusion: The network analysis has shown that the choice and availability of transportation in combination with the location (rural/urban) is essential for health care access. Especially elderly people in rural areas with restricted mobility are at a disadvantage. Therefore, modern health care approaches (e

A some aspects of medical demographical situation in the regions, confidant to Semipalatinsk former test site

International Nuclear Information System (INIS)

Slazhneva, T.I.; Korchevskij, A.A.; Tret'yakova, S.N.; Pozdnyakova, A.P.

1993-01-01

It had been analysed the data of mortality index and average future life span (AFLS).The data was devided in sex and age groups of Pavlodar region (Kazakstan) for the period of 1970, 1979, 1989 and given in comparison with Semipalatinsk region (Kazakstan) and Former Soviet Union. It was discovered peculiarities of demographic index dynamics for last decades: downfall of average life span of population from 1970 to 1979 with further increasing in 1989. In Semipalatinsk region the AFLS of men was decreasing to 2,19 year, women - to 1,24 year; in Pavlodar region the AFLS of men was decreasing to 3,87 year, women - to 4,3 year. Relative compensation of this effect was being marked to 1989 year: from 1979 to 1989 the AFLS index of Pavlodar region men increased to 2,93 year, women - to 1,83 year. Similar oscillations were being followed up for all age groups. Special attention is drawing to the infants mortality dynamic in the regions, confidant to Semipalatinsk test site. Radical ascent of the infants mortality in 1970-1983 period leaded to shaping of excluding unfavourable indexes (71,9 % for 1000 burned in 1975). Analysis confirmed the information of demographic indexes, as integral characteristics of population health levels and ecological equilibrium rate in the regions

The influences of patient's satisfaction with medical service delivery, assessment of medical service, and trust in health delivery system on patient's life satisfaction in China.

Science.gov (United States)

Tang, Liyang

2012-09-14

Patient's satisfaction with medical service delivery/assessment of medical service/trust in health delivery system may have significant influence on patient's life satisfaction in China's health delivery system/in various kinds of hospitals.The aim of this study was to test whether and to what extent patient's satisfaction with medical service delivery/patient's assessments of various major aspects of medical service/various major aspects of patient's trust in health delivery system influenced patient's life satisfaction in China's health delivery system/in various kinds of hospitals. This study collaborated with National Bureau of Statistics of China to carry out a 2008 national urban resident household survey in 17 provinces, autonomous regions, and municipalities directly under the central government (N = 3,386), and specified ordered probit models were established to analyze dataset from this household survey. The key considerations in generating patient's life satisfaction involved patient's overall satisfaction with medical service delivery, assessment of doctor-patient communication, assessment of medical cost, assessment of medical treatment process, assessment of medical facility and hospital environment, assessment of waiting time for medical service, trust in prescription, trust in doctor, and trust in recommended medical examination. But the major considerations in generating patient's life satisfaction were different among low level public hospital, high level public hospital, and private hospital. The promotion of patient's overall satisfaction with medical service delivery, the improvement of doctor-patient communication, the reduction of medical cost, the improvement of medical treatment process, the promotion of medical facility and hospital environment, the reduction of waiting time for medical service, the promotion of patient's trust in prescription, the promotion of patient's trust in doctor, and the promotion of patient's trust in

The medical physicist: Criteria and recommendations for their academic training, clinical training and certification in Latin America

International Nuclear Information System (INIS)

2010-01-01

During the last decade, the International Atomic Energy Agency (IAEA) has promoted a considerable number of technical cooperation activities and regular program linked to the establishment of educational programs in radiophysical medicine in Latin America. Despite these efforts, the amount of medical physicists in the various areas of radiological medicine (radiotherapy, nuclear medicine, radiodiagnosis) remains insufficient. In addition, many medical physicists currently associated with hospitals have inadequate training, and professional conditions (situation, salary, etc.) are very far from those of their colleagues in industrialized countries. This will result in the profession of clinical medical physicist not sufficiently attractive in Latin America. The medium-term projections indicate that the continuous evolution toward a medical care based increasingly on high technology will require even more well-trained medical physicists, thereby exacerbating the current situation. In response to the problems exposed, and considering the keen interest of the Member States of the IAEA to find a consensus solution, and an effective cooperation that would enable them to solve this problem, the ARCAL project LXXXIII was launched in 2005, strengthening the performance of medical physicists in Latin America. As part of its activities is a group of experts with the task of evaluating the problem of medical physics in the region and to develop recommendations, which are contained in this document, for harmonizing training and professional recognition of medical physicists. For the Pan American Health Organization (PAHO), medical physics is an area of special attention. For many years it has been promoting safe and effective use of radiation in health and giving technical advice to the ministries of health of Latin America and Caribbean region, in this field. Taking, therefore, on account the common interest of the IAEA and PAHO by tackling this problem, the historic and

SADC establishes a regional action plan.

Science.gov (United States)

Klouda, T

1997-02-01

The regional meeting held on AIDS strategy in Lilongwe, Malawi, in December, 1996, made important advances. The 12 countries of the SADC (Southern Africa Development Community) joined the European Union to institute a regional action plan for the reduction of susceptibility of people to HIV because of social, cultural, and environmental factors; the vulnerability of people with HIV infection to social and other difficulties; and the vulnerability of institutions because of the foregoing impacts. At the conference the issues explored were employment, mining, medical drugs, education, and tourism. An employment charter was seen as crucial for the success of AIDS and workplace activities. Facilitation of travel across borders was important for the reduction of susceptibility to HIV infection. Enhancement of regional policies for essential drugs was vital for drugs for the treatment of AIDS. The clarification of the regional role was critical for regional support of national action (strengthening technical and institutional capacities) and for regional joint action such as studies on research, harmonization of data collection on HIV/AIDS; organization of training; development of information and education on HIV/AIDS; facilitation of manufacturing of drugs and condoms; and the development of a regional information and education program about HIV/AIDS. The conference also clarified HIV/AIDS programs in relation to other health and socioeconomic problems.

Using an International Clinical Registry of Regional Anesthesia to Identify Targets for Quality Improvement

Science.gov (United States)

Sites, Brian D.; Barrington, Michael J.; Davis, Matthew

2014-01-01

Background Despite the widespread use of regional anesthesia, limited information on clinical performance exists. Institutions, therefore, have little knowledge of how they are performing in regards to both safety and effectiveness. In this study, we demonstrate how a medical institution (or physician/physician group) may use data from a multi-center clinical registry of regional anesthesia to inform quality improvement strategies. Methods We analyzed data from the International Registry of Regional Anesthesia that includes prospective data on peripheral regional anesthesia procedures from 19 centers located around the world. Using data from the clinical registry, we present summary statistics of the overall safety and effectiveness of regional anesthesia. Furthermore, we demonstrate, using a variety of performance measures, how these data can be used by hospitals to identify areas for quality improvement. To do so, we compare the performance of one member institution (a United States medical center in New Hampshire) to that of the other 18 member institutions of the clinical registry. Results The clinical registry contained information on 23,271 blocks that were performed between June 1, 2011, and May 1, 2014, on 16,725 patients. The overall success rate was 96.7%, immediate complication rate was 2.2%, and the all-cause 60-day rate of neurological sequelae was 8.3 (95% CI, 7.2–9.7) per 10,000. Registry wide major hospital events included 7 wrong site blocks, 3 seizures, 1 complete heart block, 1 retroperitoneal hematoma, and 3 pneumothoraces. For our reference medical center, we identified areas meriting quality improvement. Specifically, after accounting for differences in the age, sex, and health status of patient populations, the reference medical center appeared to rely more heavily on opioids for post procedure management, had higher patient pain scores, and experienced delayed discharge when compared with other member institutions. Conclusions To our

Self-medication practice in Ethiopia: a systematic review

Directory of Open Access Journals (Sweden)

Ayalew MB

2017-03-01

/relatives.Conclusion: Self-medication practice is prevalent in Ethiopia and varies in different populations and regions of the country. Some of the self-medication practices are harmful and need prompt action. Special attention should be given to educating the public and health care providers on the types of illnesses that can be self-diagnosed and self-treated and the types of drugs to be used for self-medication. Keywords: self-medication, self-care, OTC drug, Ethiopia

Learning strategies of first year nursing and medical students: a comparative study.

Science.gov (United States)

Salamonson, Yenna; Everett, Bronwyn; Koch, Jane; Wilson, Ian; Davidson, Patricia M

2009-12-01

Interprofessional education (IPE), where two or more professions learn with, from, and about each other to improve collaboration and the quality of care, has been proposed as a curriculum strategy to promote mutual understanding between professions, thus helping to prepare health professionals to work in challenging contemporary health systems. Although there is support for IPE initiatives within health professional education, differences in student motivation and learning strategies are likely to contribute to the success of these initiatives. To explore self-regulated learning strategies used by first year medical and nursing students, and to determine if these strategies were different among nursing students who were high achievers. A comparative survey design. Nursing and medical nursing schools in a large university in the western region of Sydney, Australia. Six hundred and sixty-five first year nursing (n=565) and medical (n=100) students in a large university in the western region of Sydney were surveyed to assess motivational and learning strategies using The Motivated Strategies for Learning Questionnaire (MSLQ). Data relating to sociodemographic characteristics and academic performance were also collected. Nursing students were significantly older than medical students (mean age: 24.4 years versus 19.4 years; plearning strategies measured: peer learning (p=0.003), help seeking (p=0.008), critical thinking (p=0.058), and time and study environment management (plearning strategies between nursing and medical students that may impact on the success of interprofessional programs.

Perspective: Medical education in medical ethics and humanities as the foundation for developing medical professionalism.

Science.gov (United States)

Doukas, David J; McCullough, Laurence B; Wear, Stephen

2012-03-01

Medical education accreditation organizations require medical ethics and humanities education to develop professionalism in medical learners, yet there has never been a comprehensive critical appraisal of medical education in ethics and humanities. The Project to Rebalance and Integrate Medical Education (PRIME) I Workshop, convened in May 2010, undertook the first critical appraisal of the definitions, goals, and objectives of medical ethics and humanities teaching. The authors describe assembling a national expert panel of educators representing the disciplines of ethics, history, literature, and the visual arts. This panel was tasked with describing the major pedagogical goals of art, ethics, history, and literature in medical education, how these disciplines should be integrated with one another in medical education, and how they could be best integrated into undergraduate and graduate medical education. The authors present the recommendations resulting from the PRIME I discussion, centered on three main themes. The major goal of medical education in ethics and humanities is to promote humanistic skills and professional conduct in physicians. Patient-centered skills enable learners to become medical professionals, whereas critical thinking skills assist learners to critically appraise the concept and implementation of medical professionalism. Implementation of a comprehensive medical ethics and humanities curriculum in medical school and residency requires clear direction and academic support and should be based on clear goals and objectives that can be reliably assessed. The PRIME expert panel concurred that medical ethics and humanities education is essential for professional development in medicine.

Computers, the Internet and medical education in Africa.

Science.gov (United States)

Williams, Christopher D; Pitchforth, Emma L; O'Callaghan, Christopher

2010-05-01

OBJECTIVES This study aimed to explore the use of information and communications technology (ICT) in undergraduate medical education in developing countries. METHODS Educators (deans and heads of medical education) in English-speaking countries across Africa were sent a questionnaire to establish the current state of ICT at medical schools. Non-respondents were contacted firstly by e-mail, subsequently by two postal mailings at 3-month intervals, and finally by telephone. Main outcome measures included cross-sectional data about the availability of computers, specifications, Internet connection speeds, use of ICT by students, and teaching of ICT and computerised research skills, presented by country or region. RESULTS The mean computer : student ratio was 0.123. Internet speeds were rated as 'slow' or 'very slow' on a 5-point Likert scale by 25.0% of respondents overall, but by 58.3% in East Africa and 33.3% in West Africa (including Cameroon). Mean estimates showed that campus computers more commonly supported CD-ROM (91.4%) and sound (87.3%) than DVD-ROM (48.1%) and Internet (72.5%). The teaching of ICT and computerised research skills, and the use of computers by medical students for research, assignments and personal projects were common. CONCLUSIONS It is clear that ICT infrastructure in Africa lags behind that in other regions. Poor download speeds limit the potential of Internet resources (especially videos, sound and other large downloads) to benefit students, particularly in East and West (including Cameroon) Africa. CD-ROM capability is more widely available, but has not yet gained momentum as a means of distributing materials. Despite infrastructure limitations, ICT is already being used and there is enthusiasm for developing this further. Priority should be given to developing partnerships to improve ICT infrastructure and maximise the potential of existing technology.

Egyptian Journal of Medical Human Genetics - Vol 13, No 2 (2012)

African Journals Online (AJOL)

Egyptian Journal of Medical Human Genetics - Vol 13, No 2 (2012) ... as independent indicators for B-CLL: Correlation to response to treatment and disease ... Profile of disorders of sexual differentiation in the Northeast region of Cairo, Egypt ...

Medical emergency planning in case of severe nuclear power plant accidents

International Nuclear Information System (INIS)

Ohlenschlaeger, L.

1980-01-01

This paper is an attempt to discuss a three-step-plan on medical emergency planning in case of severe accidents at nuclear power plants on the basis of own experiences in the regional area as well as on the basis of recommendations of the Federal Minister of the Interior. The medical considerations take account of the severity and extension of an accident whereby the current definitions used in nuclear engineering for accident situations are taken as basis. A comparison between obligatory and actual state is made on the possibilities of medical emergency planning, taking all capacities of staff, facilities, and equipment available in the Federal Republic of Germany into account. To assure a useful and quick utilization of the existing infra-structure as well as nation-wide uniform training of physicians and medical assistants in the field of medical emergency in case of a nuclear catastrophe, a federal law for health protection is regarded urgently necessary. (orig.) [de

A longitudinal study of the characteristics and performances of medical students and graduates from the Arab countries.

Science.gov (United States)

Tekian, Ara; Boulet, John

2015-11-05

While international physician migration has been studied extensively, more focused and regional explorations are not commonplace. In many Arab countries, medical education is conducted in English and students/graduates seek postgraduate opportunities in other countries such as the United States (US). Eligibility for residency training in the US requires certification by the Educational Commission for Foreign Medical Graduates (ECFMG). This study investigates ECFMG application trends, examination performance, and US physician practice data to quantify the abilities and examine the career pathways of Arab-trained physicians. Medical students and graduates from 15 Arab countries where English is the language of medical school instruction were studied. The performances (1(st) attempt pass rates) of individuals on the United States Medical Licensing Examination Step 1, Step 2CK (clinical knowledge), and and a combination of Step 2CS (clinical skills) and ECFMG CSA (clinical skills assessment) were tallied and contrasted by country. Based on physician practice data, the contribution of Arab-trained physicians to the US healthcare workforce was explored. Descriptive statistics (means, frequencies) were used to summarize the collected data. Between 1998 and 2012, there has been an increase in the number of Arab trained students/graduates seeking ECFMG certification. Examination performance varied considerably across countries, suggesting differences in the quality of medical education programs in the Eastern Mediterranean Region. Based on current US practice data, physicians from some Arab countries who seek postgraduate opportunities in the US are less likely to stay in the US following specialty training. Countries, or regions, with concerns about physician migration, physican performance, or the pedagogical quality of their training programs should conduct longitudinal research studies to help inform medical education policies.

Regional enteritis and gluten-free diet. A clinical study

NARCIS (Netherlands)

Merwe, Christiaan Frederik van der

1974-01-01

The purpose of this clinical study was to determine whether the use of a gluten-free diet influenced the course and prognosis of regional enteritis. Following a few clinical communications in the Dutch medical literature reporting favourable results obtained with the gluten-free diet in the

An evaluation of training of teachers in medical education in four medical schools of Nepal.

Science.gov (United States)

Baral, Nirmal; Paudel, Bishnu Hari; Das, Binod Kumar Lal; Aryal, Madhukar; Das, Balbhadra Prasad; Jha, Nilambar; Lamsal, Madhab

2007-09-01

Effective teaching is a concern of all teachers. Therefore, regular teachers' training is emphasized globally. B. P. Koirala Institute of Health Sciences (BPKIHS), a health science deemed university situated in eastern region of Nepal has an established Medical Education unit which attempts to improve teaching-learning skills by training faculty members through organizing regular medical education training programs. The aim of the present study was to assess the effectiveness of 3-day training workshop on "Teaching-learning methodology and Evaluation" held in four different medical colleges of Nepal. The workshop was targeted at middle and entry level of health profession teachers who had not been previously exposed to any teacher's training program. The various components, such as teaching-learning principles, writing educational objectives, organizing and sequencing education materials, teaching-learning methods, microteaching and assessment techniques, were incorporated in the workshop. A team of resource persons from BPKIHS were involved in all the four medical institutions. The collection data had two categories of responses: (1) a questionnaire survey of participants at the beginning and end of the workshop to determine their gain in knowledge and (2) a semi-structured questionnaire survey of participants at the end of workshop to evaluate their perception on usefulness of the workshop. The later category had items with three-point likert scale (very useful, useful and not useful) and responses to open-ended questions/ statements to document participants general views. The response was entered into a spreadsheet and analyzed using SPSS. The result showed that all participants (n = 92) improved their scores after attending the workshop (p teaching-learning methods, media, microteaching and evaluation techniques were useful in teaching-learning. The workshop was perceived as an acceptable way of acquiring teaching-learning skills but 39.4% participants

Zika Virus: Medical Countermeasure Development Challenges.

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Robert W Malone

2016-03-01

Full Text Available Reports of high rates of primary microcephaly and Guillain-Barré syndrome associated with Zika virus infection in French Polynesia and Brazil have raised concerns that the virus circulating in these regions is a rapidly developing neuropathic, teratogenic, emerging infectious public health threat. There are no licensed medical countermeasures (vaccines, therapies or preventive drugs available for Zika virus infection and disease. The Pan American Health Organization (PAHO predicts that Zika virus will continue to spread and eventually reach all countries and territories in the Americas with endemic Aedes mosquitoes. This paper reviews the status of the Zika virus outbreak, including medical countermeasure options, with a focus on how the epidemiology, insect vectors, neuropathology, virology and immunology inform options and strategies available for medical countermeasure development and deployment.Multiple information sources were employed to support the review. These included publically available literature, patents, official communications, English and Lusophone lay press. Online surveys were distributed to physicians in the US, Mexico and Argentina and responses analyzed. Computational epitope analysis as well as infectious disease outbreak modeling and forecasting were implemented. Field observations in Brazil were compiled and interviews conducted with public health officials.

Zika Virus: Medical Countermeasure Development Challenges

Science.gov (United States)

Malone, Robert W.; Homan, Jane; Callahan, Michael V.; Glasspool-Malone, Jill; Damodaran, Lambodhar; Schneider, Adriano De Bernardi; Zimler, Rebecca; Talton, James; Cobb, Ronald R.; Ruzic, Ivan; Smith-Gagen, Julie; Janies, Daniel; Wilson, James

2016-01-01

Introduction Reports of high rates of primary microcephaly and Guillain–Barré syndrome associated with Zika virus infection in French Polynesia and Brazil have raised concerns that the virus circulating in these regions is a rapidly developing neuropathic, teratogenic, emerging infectious public health threat. There are no licensed medical countermeasures (vaccines, therapies or preventive drugs) available for Zika virus infection and disease. The Pan American Health Organization (PAHO) predicts that Zika virus will continue to spread and eventually reach all countries and territories in the Americas with endemic Aedes mosquitoes. This paper reviews the status of the Zika virus outbreak, including medical countermeasure options, with a focus on how the epidemiology, insect vectors, neuropathology, virology and immunology inform options and strategies available for medical countermeasure development and deployment. Methods Multiple information sources were employed to support the review. These included publically available literature, patents, official communications, English and Lusophone lay press. Online surveys were distributed to physicians in the US, Mexico and Argentina and responses analyzed. Computational epitope analysis as well as infectious disease outbreak modeling and forecasting were implemented. Field observations in Brazil were compiled and interviews conducted with public health officials. PMID:26934531

Attitudes of Saudi medical students toward the disclosure of information on cancer in eastern Saudi Arabia

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Ali M Al-Amri

2011-01-01

Full Text Available Objective: To assess the attitude of future physicians regarding the disclosure of diagnosis, prognosis, benefits, and adverse effects of therapeutic intervention if they happen to have cancer. It also examined the differences if any between regions or gender. Materials and Methods: A total of 332 medical students from University of Dammam, in the Eastern Province of the Kingdom of Saudi Arabia were surveyed using a self-administered questionnaire. The questionnaire consisted of nine questions on the attitudes to disclosure of information on cancer. This self-administered questionnaire was completed by the students in the presence of an investigator. Results: The vast majority of Saudi medical students stated that they would like to know about diagnosis of cancer (92.8% and only 7.2% wanted information withheld from them. Further, 67% of the males and 74.1% of the females wanted family members to know (P = 0.01, but one-third (33% did not want their family to know. Only 24.1% of the male and 21.1% of female students wanted their friends to know. In addition, -97% of the males and 98.8% of the females wanted to know the diagnosis, and 97% and 95.8% of females and males, respectively, would like to know the side effects of the therapy. Almost 95% of male and 93.4% of female students wanted to know the prognosis. Also, 98% of medical students from the Eastern Region would want the diagnosis of cancer to be disclosed compared to 73.6% of those from other regions (P = 0.01. There is no difference between the genders in attitudes toward the disclosure of the diagnosis, 94.6% and 92.2% (P = 0.38. Conclusions: There was a consensus among Saudi medical students on the knowledge of the benefits of treatment, adverse effects of therapy, and prognosis. Female students significantly more than males would like their families to be informed. Significantly more medical students from the Eastern Region than those from other regions would like the diagnosis of

James Cook University's rurally orientated medical school selection process: quality graduates and positive workforce outcomes.

Science.gov (United States)

Ray, Robin A; Woolley, Torres; Sen Gupta, Tarun

2015-01-01

The regionally based James Cook University (JCU) College of Medicine and Dentistry aims to meet its mission to address the health needs of the region by using a selection policy favouring rural origin applicants and providing students with early and repeated exposure to rural experiences during training. This study seeks to determine if the JCU medical school's policy of preferentially selecting rural and remote background students is associated with differing patterns of undergraduate performance or graduate practice location. Data at application to medical school and during the undergraduate years was retrieved from administrative databases held by the university and the medical school. Postgraduate location data were obtained either from personal contact via email, telephone or Facebook or electronically from the Australian Health Practitioner Regulation Authority website. Practice location was described across Australian Standard Geographical Classification Remoteness Area (ASGC-RA) categories, with 1 being a major city and 5 being a very remote location. The 856 Australian-based students accepted into the JCU medical program between 2000 and 2008 came from all geographical regions across Australia: 20% metropolitan (ASGC-RA 1), 20% inner regional (ASGC-RA 2), 56% outer regional (ASGC-RA 3), and 5% from remote or very remote locations (ASGC-RA 4 and 5). Having a rural or remote hometown at application (ASGC-RA 3-5) was significantly associated with a lower tertiary entrance score (pacademic achievement across years 1 to 3 (p=0.002, p=0.005 and p=0.025, respectively). Graduates having either a rural or a remote home town at application were more likely to practise in rural (RA 3-5) towns than graduates from metropolitan/inner regional centre across all postgraduate years. For example, the prevalence odds ratios (POR) for graduates practising in a rural town at postgraduate year 1 (PGY 1) having either a rural or remote hometown were 2.6 and 1.8, respectively

Educational technology infrastructure and services in North American medical schools.

Science.gov (United States)

Kamin, Carol; Souza, Kevin H; Heestand, Diane; Moses, Anna; O'Sullivan, Patricia

2006-07-01

To describe the current educational technology infrastructure and services provided by North American allopathic medical schools that are members of the Association of American Medical Colleges (AAMC), to present information needed for institutional benchmarking. A Web-based survey instrument was developed and administered in the fall of 2004 by the authors, sent to representatives of 137 medical schools and completed by representatives of 88, a response rate of 64%. Schools were given scores for infrastructure and services provided. Data were analyzed with one-way analyses of variance, chi-square, and correlation coefficients. There was no difference in the number of infrastructure features or services offered based on region of the country, public versus private schools, or size of graduating class. Schools implemented 3.0 (SD = 1.5) of 6 infrastructure items and offered 11.6 (SD = 4.1) of 22 services. Over 90% of schools had wireless access (97%), used online course materials for undergraduate medical education (97%), course management system for graduate medical education (95%) and online teaching evaluations (90%). Use of services differed across the undergraduate, graduate, and continuing medical education continuum. Outside of e-portfolios for undergraduates, the least-offered services were for services to graduate and continuing medical education. The results of this survey provide a benchmark for the level of services and infrastructure currently supporting educational technology by AAMC-member allopathic medical schools.

Emphasizing humanities in medical education: Promoting the integration of medical scientific spirit and medical humanistic spirit.

Science.gov (United States)

Song, Peipei; Tang, Wei

2017-05-23

In the era of the biological-psychological-social medicine model, an ideal of modern medicine is to enhance the humanities in medical education, to foster medical talents with humanistic spirit, and to promote the integration of scientific spirit and humanistic spirit in medicine. Throughout the United States (US), United Kingdom (UK), other Western countries, and some Asian countries like Japan, many medical universities have already integrated the learning of medical humanities in their curricula and recognized their value. While in China, although medical education reform over the past decade has emphasized the topic of medical humanities to increase the professionalism of future physicians, the integration of medical humanity courses in medical universities has lagged behind the pace in Western countries. In addition, current courses in medical humanities were arbitrarily established due to a lack of organizational independence. For various reasons like a shortage of instructors, medical universities have failed to pay sufficient attention to medical humanities education given the urgent needs of society. The medical problems in contemporary Chinese society are not solely the purview of biomedical technology; what matters more is enhancing the humanities in medical education and fostering medical talents with humanistic spirit. Emphasizing the humanities in medical education and promoting the integration of medical scientific spirit and medical humanistic spirit have become one of the most pressing issues China must address. Greater attention should be paid to reasonable integration of humanities into the medical curriculum, creation of medical courses related to humanities and optimization of the curriculum, and actively allocating abundant teaching resources and exploring better methods of instruction.

Experimental medical mycological research in Latin America - a 2000-2009 overview.

Science.gov (United States)

San-Blas, Gioconda; Burger, Eva

2011-01-01

An overview of current trends in Latin American Experimental Medical Mycological research since the beginning of the 21(st) century is done (search from January 2000 to December 2009). Using the PubMed and LILACS databases, the authors have chosen publications on medically important fungi which, according to our opinion, are the most relevant because of their novelty, interest, and international impact, based on research made entirely in the Latin American region or as part of collaborative efforts with laboratories elsewhere. In this way, the following areas are discussed: 1) molecular identification of fungal pathogens; 2) molecular and clinical epidemiology on fungal pathogens of prevalence in the region; 3) cell biology; 4) transcriptome, genome, molecular taxonomy and phylogeny; 5) immunology; 6) vaccines; 7) new and experimental antifungals. Copyright © 2010 Revista Iberoamericana de Micología. Published by Elsevier Espana. All rights reserved.

Measles outbreak in a poorly vaccinated region in Cameroon: a ...

African Journals Online (AJOL)

preventable deaths in Africa; especially in unvaccinated populations. We reviewed the medical reports of the measles outbreak that occurred in Misaje, in the North west region of Cameroon from 11/03/2015 to 14/05/2015. Six measles cases ...

Medical physics in Europe

International Nuclear Information System (INIS)

Walstam, Rune

1995-01-01

Radiotherapy was in the early days empirically developed and thought to be applicable only in dermatology. The x-ray equipment was rather primitive and dosimetry very rudimentary. Radium, radon and mesothorium was introduced for brachytherapy and dosage could be expressed in mgh Ra or in mCd. Radiation protection became of great concern in view of the injuries noted among staff members. The need for physical support became apparent and in certain places physicists were appointed. Their main duties were in the planning of new departments, basic and clinical dosimetry, design, maintenance and performance checking of equipment and instruments, development of new treatment techniques, physical treatment planning, radiation protection e.t.c. ICRU and ICRP were set up in London in 1925 and in Stockholm in 1928 respectively by the first and second International Congress of Radiology. Physicists have throughout the years been leading scientists in these well reputed commissions. With increasing responsibilities and the growth of the profession separate departments have been established in hospitals, medical schools and at universities. Education and training programs have been introduced with the aim of ensuring competence for all categories engaged in the realization of the procedures. Quality Assurance (QA) is the modern term for procedures which have always been the main aim with medical radiation physics. National and international organizations for hospital- or medical physics have been very influential. Handbooks, codes of practice and journals published by leading associations are widely accepted and through workshops, conferences and regional meetings the knowledge is conveyed. In this respect the cooperation with such organizations as the IAEA and WHO is very important. Through work in IEC committees setting standards for medical equipment valuable contributions can be made by physicists

Developing Soft Power Using Afloat Medical Capability

Science.gov (United States)

2009-03-02

engagement with the nations in the Asia -Pacific region contributed to considerable progress across a broad range of security issues. Southeast Asia remains...Forces and the U.S. military has been positive and valuable in the War on Terror and humanitarian assistance.20 The poor economies, overpopulation , weak...Public Health Services combined to conduct a medical and dental civil-assistance program (MEDCAP/DENCAP) visit throughout Southeast Asia and Oceania.42

Novel Variants of a Histogram Shift-Based Reversible Watermarking Technique for Medical Images to Improve Hiding Capacity

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Vishakha Kelkar

2017-01-01

Full Text Available In telemedicine systems, critical medical data is shared on a public communication channel. This increases the risk of unauthorised access to patient’s information. This underlines the importance of secrecy and authentication for the medical data. This paper presents two innovative variations of classical histogram shift methods to increase the hiding capacity. The first technique divides the image into nonoverlapping blocks and embeds the watermark individually using the histogram method. The second method separates the region of interest and embeds the watermark only in the region of noninterest. This approach preserves the medical information intact. This method finds its use in critical medical cases. The high PSNR (above 45 dB obtained for both techniques indicates imperceptibility of the approaches. Experimental results illustrate superiority of the proposed approaches when compared with other methods based on histogram shifting techniques. These techniques improve embedding capacity by 5–15% depending on the image type, without affecting the quality of the watermarked image. Both techniques also enable lossless reconstruction of the watermark and the host medical image. A higher embedding capacity makes the proposed approaches attractive for medical image watermarking applications without compromising the quality of the image.

Novel Variants of a Histogram Shift-Based Reversible Watermarking Technique for Medical Images to Improve Hiding Capacity

Science.gov (United States)

Tuckley, Kushal

2017-01-01

In telemedicine systems, critical medical data is shared on a public communication channel. This increases the risk of unauthorised access to patient's information. This underlines the importance of secrecy and authentication for the medical data. This paper presents two innovative variations of classical histogram shift methods to increase the hiding capacity. The first technique divides the image into nonoverlapping blocks and embeds the watermark individually using the histogram method. The second method separates the region of interest and embeds the watermark only in the region of noninterest. This approach preserves the medical information intact. This method finds its use in critical medical cases. The high PSNR (above 45 dB) obtained for both techniques indicates imperceptibility of the approaches. Experimental results illustrate superiority of the proposed approaches when compared with other methods based on histogram shifting techniques. These techniques improve embedding capacity by 5–15% depending on the image type, without affecting the quality of the watermarked image. Both techniques also enable lossless reconstruction of the watermark and the host medical image. A higher embedding capacity makes the proposed approaches attractive for medical image watermarking applications without compromising the quality of the image. PMID:29104744

Watershed-based Image Segmentation with Region Merging and Edge Detection

Institute of Scientific and Technical Information of China (English)

无

2003-01-01

The clustering technique is used to examine each pixel in the image which assigned to one of the clusters depending on the minimum distance to obtain primary classified image into different intensity regions. A watershed transformation technique is then employes. This includes: gradient of the classified image, dividing the image into markers, checking the Marker Image to see if it has zero points (watershed lines). The watershed lines are then deleted in the Marker Image created by watershed algorithm. A Region Adjacency Graph (RAG) and Region Adjacency Boundary (RAB) are created between two regions from Marker Image. Finally region merging is done according to region average intensity and two edge strengths (T1, T2). The approach of the authors is tested on remote sensing and brain MR medical images. The final segmentation result is one closed boundary per actual region in the image.

[Andrologic disease detected during army medical visit].

Science.gov (United States)

Campodonico, Fabio; Michelazzi, Alberto; Capurro, Anna; Carmignani, Giorgio

2003-12-01

Aim of this study is to investigate the prevalence of andrologic diseases in young men (age 18 years) recruited for conscription in a north-western Italian region. A random sample of 1993 young men was evaluated at the Army Medical Visit Center of the Military District of Genoa. The visits were performed by the same doctor. An examination of external genitalia and secondary sex characters was made and the medical history of each conscript was recorded. Investigation procedures were standardized according to the guidelines of the WHO for the diagnosis and management of the infertile male. Andrologic disorders were found in 547 subjects (27.5%) and first diagnosed in 412 (20.7%). Specific acquired or congenital disorders are discussed. Some patients with most significant diseases were referred to the Urologic Department for second level diagnostic exams. This study underlines the role of the army medical visit as a tool for andrologic screening in young males. The military health service may be a relevant institution for postpuberal control and it could be useful to prevent future sexual and fertility problems in adult males.

Medical Waste Management in Community Health Centers.

Science.gov (United States)

Tabrizi, Jafar Sadegh; Rezapour, Ramin; Saadati, Mohammad; Seifi, Samira; Amini, Behnam; Varmazyar, Farahnaz

2018-02-01

Non-standard management of medical waste leads to irreparable side effects. This issue is of double importance in health care centers in a city which are the most extensive system for providing Primary Health Care (PHC) across Iran cities. This study investigated the medical waste management standards observation in Tabriz community health care centers, northwestern Iran. In this triangulated cross-sectional study (qualitative-quantitative), data collecting tool was a valid checklist of waste management process developed based on Iranian medical waste management standards. The data were collected in 2015 through process observation and interviews with the health center's staff. The average rate of waste management standards observance in Tabriz community health centers, Tabriz, Iran was 29.8%. This case was 22.8% in dimension of management and training, 27.3% in separating and collecting, 31.2% in transport and temporary storage, and 42.9% in sterilization and disposal. Lack of principal separation of wastes, inappropriate collecting and disposal cycle of waste and disregarding safety tips (fertilizer device performance monitoring, microbial cultures and so on) were among the observed defects in health care centers supported by quantitative data. Medical waste management was not in a desirable situation in Tabriz community health centers. The expansion of community health centers in different regions and non-observance of standards could predispose to incidence the risks resulted from medical wastes. So it is necessary to adopt appropriate policies to promote waste management situation.

Status of medical liability claims in Saudi Arabia

International Nuclear Information System (INIS)

Samarkandi, A.

2006-01-01

With the evolution of health services in Saudi Arabia, there has been increase in the number of medical practice litigations. The author analyzed the medical malpractice litigation that was referred to the National Medico-Legal Committee (MLC) in order to evaluate the magnitude and underlying factors of the problem in Saudi Arabia. A retrospective analysis of the official records of Medico-Legal malpractice over the period 1420H-1424H (199-2003) was performed. The incidence among different medical specialties, location, and final resolution of each claim were identified. Data analysis revealed an increasing trend in the total number of claims over the study period, with a sharp increase in the transition between 1422H and 1423H (2001-200). The distribution of claims over different medical specialties showed that obstetrical practice took the lead with 27%, followed by general surgery and subspecialties, represented by 17% each, internal medicine 13%, while pediatrics contributed 10% of claims: the fewest claims were in dentistry with 2.5%. The majority of claims were referred to the Ministry of Health and private sectors medical facilities. Most claims were from the Riyadh region over the period between 1420H to 1422H (1999-2001), while thereafter, during 1423 and 1424H (2002 and 2003), the Holy Capital had the highest number of claims referred to the MLC. Adherence to standards of medical practice is by far the best approach to avoid or reduce the incidence of litigation. (author)

Self‐medication patterns among medical students in South India

Directory of Open Access Journals (Sweden)

Nitasha Bhat

2012-04-01

Full Text Available BackgroundSelf-medication results in wastage of resources, increases resistance of pathogens and generally causes serious health hazards such as adverse drug reactions, prolonged suffering and drug dependence. This study was undertaken to determine the reasons for self-medication and the pattern of self-medication among medical students.MethodThis cross-sectional descriptive study was conducted at the K.S. Hegde Medical Academy, Mangalore. The participants were medical students from first to final year. Medical students were selected through convenience sampling. The data was collected using a pre-tested semi-structured questionnaire. The data was analysed using SPSS version 16 and the results expressed as proportions.ResultsA total of 200 students, 121 (60.5% female and 79 (39.5% male, were included in the study. Of the medical students surveyed, self-medication was reported among 92%. The respondents who used self-medication found it to be time-saving in providing relief from minor ailments. The most common ailments for which self-medication were used were: the common cold (69%, fever (63% and headache (60%. The students consulted their textbooks (39% and seniors or classmates (38% for the medications. Antipyretics (71%, analgesics (65%, antihistamines (37% and antibiotics (34% were the most common self-medicated drugs. Of the respondents, 33% were unaware of the adverse effects of the medication and 5% had experienced adverse reactions. The majority (64% of students advised medications to others, more often to family and friends.ConclusionThe prevalence of self-medication among medical students is high, facilitated by the easy availability of drugs and information from textbooks or seniors. A significant number of students are unaware of the adverse effects of the medication that they themselves take and suggest to others. Therefore, potential problems of self-medication should be emphasised to the students.

[Missed lessons, missed opportunities: a role for public health services in medical absenteeism in young people].

Science.gov (United States)

Vanneste, Y T M; van de Goor, L A M; Feron, F J M

2016-01-01

Young people who often miss school for health reasons are not only missing education, but also the daily routine of school, and social intercourse with their classmates. Medical absenteeism among students merits greater attention. For a number of years, in various regions in the Netherlands, students with extensive medical absenteeism have been invited to see a youth healthcare specialist. The MASS intervention (Medical Advice of Students reported Sick; in Dutch: Medische Advisering van de Ziekgemelde Leerling, abbreviated as M@ZL) has been developed by the West Brabant Regional Public Health Service together with secondary schools to address school absenteeism due to reporting sick. In this paper we discuss the MASS intervention and explain why attention should be paid by public health services to the problem of school absenteeism, especially absenteeism on health grounds.

Canadian medical tourism companies that have exited the marketplace: Content analysis of websites used to market transnational medical travel

Science.gov (United States)

2011-01-01

Background Medical tourism companies play an important role in promoting transnational medical travel for elective, out-of-pocket medical procedures. Though researchers are paying increasing attention to the global phenomenon of medical tourism, to date websites of medical tourism companies have received limited scrutiny. This article analyzes websites of Canadian medical tourism companies that advertised international healthcare but ultimately exited the marketplace. Using content analysis of company websites as an investigative tool, the article provides a detailed account of medical tourism companies that were based in Canada but no longer send clients to international health care facilities. Methods Internet searches, Google Alerts, searches on Google News Canada and ProQuest Newsstand, and searches of an Industry Canada database were used to locate medical tourism companies located in Canada. Once medical tourism companies were identified, the social science research method of content analysis was used to extract relevant information from company websites. Company websites were analyzed to determine: 1) where these businesses were based; 2) the destination countries and medical facilities that they promoted; 3) the health services they advertised; 4) core marketing messages; and 5) whether businesses marketed air travel, hotel accommodations, and holiday excursions in addition to medical procedures. Results In total, 25 medical tourism companies that were based in Canada are now defunct. Given that an estimated 18 medical tourism companies and 7 regional, cross-border medical travel facilitators now operate in Canada, it appears that approximately half of all identifiable medical tourism companies in Canada are no longer in business. 13 of the previously operational companies were based in Ontario, 7 were located in British Columbia, 4 were situated in Quebec, and 1 was based in Alberta. 14 companies marketed medical procedures within a single country, 9

Canadian medical tourism companies that have exited the marketplace: Content analysis of websites used to market transnational medical travel.

Science.gov (United States)

Turner, Leigh

2011-10-14

Medical tourism companies play an important role in promoting transnational medical travel for elective, out-of-pocket medical procedures. Though researchers are paying increasing attention to the global phenomenon of medical tourism, to date websites of medical tourism companies have received limited scrutiny. This article analyzes websites of Canadian medical tourism companies that advertised international healthcare but ultimately exited the marketplace. Using content analysis of company websites as an investigative tool, the article provides a detailed account of medical tourism companies that were based in Canada but no longer send clients to international health care facilities. Internet searches, Google Alerts, searches on Google News Canada and ProQuest Newsstand, and searches of an Industry Canada database were used to locate medical tourism companies located in Canada. Once medical tourism companies were identified, the social science research method of content analysis was used to extract relevant information from company websites. Company websites were analyzed to determine: 1) where these businesses were based; 2) the destination countries and medical facilities that they promoted; 3) the health services they advertised; 4) core marketing messages; and 5) whether businesses marketed air travel, hotel accommodations, and holiday excursions in addition to medical procedures. In total, 25 medical tourism companies that were based in Canada are now defunct. Given that an estimated 18 medical tourism companies and 7 regional, cross-border medical travel facilitators now operate in Canada, it appears that approximately half of all identifiable medical tourism companies in Canada are no longer in business. 13 of the previously operational companies were based in Ontario, 7 were located in British Columbia, 4 were situated in Quebec, and 1 was based in Alberta. 14 companies marketed medical procedures within a single country, 9 businesses marketed health care

Canadian medical tourism companies that have exited the marketplace: Content analysis of websites used to market transnational medical travel

Directory of Open Access Journals (Sweden)

Turner Leigh

2011-10-01

Full Text Available Abstract Background Medical tourism companies play an important role in promoting transnational medical travel for elective, out-of-pocket medical procedures. Though researchers are paying increasing attention to the global phenomenon of medical tourism, to date websites of medical tourism companies have received limited scrutiny. This article analyzes websites of Canadian medical tourism companies that advertised international healthcare but ultimately exited the marketplace. Using content analysis of company websites as an investigative tool, the article provides a detailed account of medical tourism companies that were based in Canada but no longer send clients to international health care facilities. Methods Internet searches, Google Alerts, searches on Google News Canada and ProQuest Newsstand, and searches of an Industry Canada database were used to locate medical tourism companies located in Canada. Once medical tourism companies were identified, the social science research method of content analysis was used to extract relevant information from company websites. Company websites were analyzed to determine: 1 where these businesses were based; 2 the destination countries and medical facilities that they promoted; 3 the health services they advertised; 4 core marketing messages; and 5 whether businesses marketed air travel, hotel accommodations, and holiday excursions in addition to medical procedures. Results In total, 25 medical tourism companies that were based in Canada are now defunct. Given that an estimated 18 medical tourism companies and 7 regional, cross-border medical travel facilitators now operate in Canada, it appears that approximately half of all identifiable medical tourism companies in Canada are no longer in business. 13 of the previously operational companies were based in Ontario, 7 were located in British Columbia, 4 were situated in Quebec, and 1 was based in Alberta. 14 companies marketed medical procedures within a

MANAGEMENT OF INNOVATION IN HEALTH CARE AT THE REGIONAL LEVEL

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Ye. G. Totskaya

2014-01-01

Full Text Available The paper reviews topical issues of organization and management of innovative activity in the regional health care system.Objective. Development and scientific substantiation of a conceptual model of managing innovation in the regional health care system, introduction of institutional mechanisms for its implementation, and evaluation of their efficacy in using diagnosis and treatment technologies. Objectives of the study included reviewing the organization status and problems hampering the development, identification of prospects, and justification for appropriate changes in innovation in healthcare system and medical science at the regional level.Material and methods. To conduct a comprehensive assessment of the status and meet challenges of innovation promotion, a methodology for social-hygienic research was worked out including bibliographic and analytical methods, situational analysis, sociological and economic methods, expert assessment, methods for quality management system audit in accordance with ISO 19011:2002, IDEFO function modeling (RD IDEF0-2000, and organizational modeling. The study was based on the analysis of foreign and domestic literature, statistics, methods for managerial modeling, as well as management experience (including innovative methodological approaches gained by Novosibirsk Research Institute of Traumatology and Orthopedics named after Ya.L. Tsivyan which meets the requirements for a platform for research and innovative product reproduction, including research, clinical, organizational, and managerial aspects. Other facilities were considered in conjunction with the leading innovative platform.Results. The paper presents a scientifically based model of innovative medical environment with its elements as subjects, each with a set of functions. Conceptual model for management includes structuring (resource, processes, and quality management; application of international standards and strategic management mechanisms

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

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Monekosso, G L

2014-08-01

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

XIV Mediterranean Conference on Medical and Biological Engineering and Computing

CERN Document Server

Christofides, Stelios; Pattichis, Constantinos

2016-01-01

This volume presents the proceedings of Medicon 2016, held in Paphos, Cyprus. Medicon 2016 is the XIV in the series of regional meetings of the International Federation of Medical and Biological Engineering (IFMBE) in the Mediterranean. The goal of Medicon 2016 is to provide updated information on the state of the art on Medical and Biological Engineering and Computing under the main theme “Systems Medicine for the Delivery of Better Healthcare Services”. Medical and Biological Engineering and Computing cover complementary disciplines that hold great promise for the advancement of research and development in complex medical and biological systems. Research and development in these areas are impacting the science and technology by advancing fundamental concepts in translational medicine, by helping us understand human physiology and function at multiple levels, by improving tools and techniques for the detection, prevention and treatment of disease. Medicon 2016 provides a common platform for the cross fer...

Defining the medical imaging requirements for a rural health center

CERN Document Server

2017-01-01

This book establishes the criteria for the type of medical imaging services that should be made available to rural health centers, providing professional rural hospital managers with information that makes their work more effective and efficient. It also offers valuable insights into government, non-governmental and religious organizations involved in the planning, establishment and operation of medical facilities in rural areas. Rural health centers are established to prevent patients from being forced to travel to distant urban medical facilities. To manage patients properly, rural health centers should be part of regional and more complete systems of medical health care installations in the country on the basis of a referral and counter-referral program, and thus, they should have the infrastructure needed to transport patients to urban hospitals when they need more complex health care. The coordination of all the activities is only possible if rural health centers are led by strong and dedicated managers....

Regional surface geometry of the rat stomach based on three-dimensional curvature analysis

Energy Technology Data Exchange (ETDEWEB)

Liao Donghua [Center of Excellence in Visceral Biomechanics and Pain, Aalborg Hospital, DK-9100 Aalborg (Denmark); Zhao Jingbo [Center of Excellence in Visceral Biomechanics and Pain, Aalborg Hospital, DK-9100 Aalborg (Denmark); Gregersen, Hans [Center of Excellence in Visceral Biomechanics and Pain, Aalborg Hospital, DK-9100 Aalborg (Denmark)

2005-01-21

A better understanding of gastric accommodation and gastric perception requires knowledge of regional gastric geometry and local gastric tension throughout the stomach. An analytic method based on medical imaging data was developed in this study to describe the three-dimensional (3D) rat stomach geometry and tension distribution. The surface principal radii of curvatures were simulated and the surface tension was calculated in the glandular and non-glandular region of the stomach at pressures from 0 Pa to 800 Pa. The radii of curvature and tension distribution in the stomach were non-homogeneous. The radii of curvature in the glandular stomach were larger than those in the non-glandular region at pressures less than 100 Pa (P < 0.001). When the pressure increased to more than 200 Pa, the radii of curvature in the non-glandular stomach was larger than in the glandular stomach (P < 0.05). The curvature and tension distribution mapping using medical imaging technology and 3D models can be used to characterize and distinguish the physical behaviour in separate regions of the stomach.

Regional surface geometry of the rat stomach based on three-dimensional curvature analysis

International Nuclear Information System (INIS)

Liao Donghua; Zhao Jingbo; Gregersen, Hans

2005-01-01

A better understanding of gastric accommodation and gastric perception requires knowledge of regional gastric geometry and local gastric tension throughout the stomach. An analytic method based on medical imaging data was developed in this study to describe the three-dimensional (3D) rat stomach geometry and tension distribution. The surface principal radii of curvatures were simulated and the surface tension was calculated in the glandular and non-glandular region of the stomach at pressures from 0 Pa to 800 Pa. The radii of curvature and tension distribution in the stomach were non-homogeneous. The radii of curvature in the glandular stomach were larger than those in the non-glandular region at pressures less than 100 Pa (P < 0.001). When the pressure increased to more than 200 Pa, the radii of curvature in the non-glandular stomach was larger than in the glandular stomach (P < 0.05). The curvature and tension distribution mapping using medical imaging technology and 3D models can be used to characterize and distinguish the physical behaviour in separate regions of the stomach

"Yes, and …" Exploring the Future of Learning Analytics in Medical Education.

Science.gov (United States)

Cirigliano, Matt M; Guthrie, Charlie; Pusic, Martin V; Cianciolo, Anna T; Lim-Dunham, Jennifer E; Spickard, Anderson; Terry, Valerie

2017-01-01

This Conversations Starter article presents a selected research abstract from the 2017 Association of American Medical Colleges Northeastern Region Group on Educational Affairs annual spring meeting. The abstract is paired with the integrative commentary of three experts who shared their thoughts stimulated by the study. Commentators brainstormed "what's next" with learning analytics in medical education, including advancements in interaction metrics and the use of interactivity analysis to deepen understanding of perceptual, cognitive, and social learning and transfer processes.

Etiology of Pancytopenia: An observation from a referral medical institution of Eastern Region of India

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Senjuti Dasgupta

2015-01-01

Conclusion: Aplastic anemia was found to be the most common cause of pancytopenia in this study, which is in contrast to studies conducted from other regions of India. Delineation of etiologies of pancytopenia in various regions can help in defining diagnostic and therapeutic strategies, which is expected to contribute toward the better management of such patients.

Geriatric teaching in Brazilian medical schools in 2013 and considerations regarding adjustment to demographic and epidemiological transition

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Ana Conceição Norbim Prado Cunha

2016-04-01

Full Text Available Summary Objective: This study aims to describe the profile of medical schools that introduced courses on Geriatrics and Elderly Health or Aging in their curriculum, and compare such information with the age distribution and health epidemiological data of the Brazilian population, using data until the year of 2013. Methods: 180 universities offering medical undergraduate courses and registered with the Ministry of Education and Culture of Brazil (MEC were found, as seen on the MEC website (www.emec.mec.gov.br in February 2013. Based on the list of institutions, the authors created a database. Results: Brazil's Southeast region is the one presenting most of the courses, both offered as core or elective subjects, in the area of Geriatrics. The Midwest region had the least offer of Geriatrics and Elderly Health and Care courses. The Southeast region presents the greater absolute number of institutions with elective subjects, followed by the South and Northeast regions, each with a single institution. The Southeast region was at the same time the one that presented the biggest absolute number of institutions offering core subjects in the area of Geriatrics, being followed by the Northeast, South, North, and Midwest regions. Conclusion: By analyzing the availability of courses that emphasize aging and Geriatrics in brazilian medical schools, the present study reveals that specialized training should be encouraged with respect to the specificities of health care given to the elderly population, which has a higher frequency of chronic and degenerative diseases.

On a turbulent wall model to predict hemolysis numerically in medical devices

Science.gov (United States)

Lee, Seunghun; Chang, Minwook; Kang, Seongwon; Hur, Nahmkeon; Kim, Wonjung

2017-11-01

Analyzing degradation of red blood cells is very important for medical devices with blood flows. The blood shear stress has been recognized as the most dominant factor for hemolysis in medical devices. Compared to laminar flows, turbulent flows have higher shear stress values in the regions near the wall. In case of predicting hemolysis numerically, this phenomenon can require a very fine mesh and large computational resources. In order to resolve this issue, the purpose of this study is to develop a turbulent wall model to predict the hemolysis more efficiently. In order to decrease the numerical error of hemolysis prediction in a coarse grid resolution, we divided the computational domain into two regions and applied different approaches to each region. In the near-wall region with a steep velocity gradient, an analytic approach using modeled velocity profile is applied to reduce a numerical error to allow a coarse grid resolution. We adopt the Van Driest law as a model for the mean velocity profile. In a region far from the wall, a regular numerical discretization is applied. The proposed turbulent wall model is evaluated for a few turbulent flows inside a cannula and centrifugal pumps. The results present that the proposed turbulent wall model for hemolysis improves the computational efficiency significantly for engineering applications. Corresponding author.

The multiple mini-interview for selecting medical residents: first experience in the Middle East region.

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Ahmed, Ashraf; Qayed, Khalil Ibrahim; Abdulrahman, Mahera; Tavares, Walter; Rosenfeld, Jack

2014-08-01

Numerous studies have shown that multiple mini-interviews (MMI) provides a standard, fair, and more reliable method for assessing applicants. This article presents the first MMI experience for selection of medical residents in the Middle East culture and an Arab country. In 2012, we started using the MMI in interviewing applicants to the residency program of Dubai Health Authority. This interview process consisted of eight, eight-minute structured interview scenarios. Applicants rotated through the stations, each with its own interviewer and scenario. They read the scenario and were requested to discuss the issues with the interviewers. Sociodemographic and station assessment data provided for each applicant were analyzed to determine whether the MMI was a reliable assessment of the non-clinical attributes in the present setting of an Arab country. One hundred and eighty-seven candidates from 27 different countries were interviewed for Dubai Residency Training Program using MMI. They were graduates of 5 medical universities within United Arab Emirates (UAE) and 60 different universities outside UAE. With this applicant's pool, a MMI with eight stations, produced absolute and relative reliability of 0.8 and 0.81, respectively. The person × station interaction contributed 63% of the variance components, the person contributed 34% of the variance components, and the station contributed 2% of the variance components. The MMI has been used in numerous universities in English speaking countries. The MMI evaluates non-clinical attributes and this study provides further evidence for its reliability but in a different country and culture. The MMI offers a fair and more reliable assessment of applicants to medical residency programs. The present data show that this assessment technique applied in a non-western country and Arab culture still produced reliable results.

WAYS TO DECREASE INFANT MORTALITY IN A LARGE AGRO INDUSTRIAL REGION IN RUSSIAN NORTH WEST BASED ON A PROGRAMMED GOAL ORIENTED APPROACH (MATERIALS FROM VOLOGDA REGION

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V.I. Orel

2007-01-01

Full Text Available The authors analyze infant mortality situation in a large agroindustrial region to the north west of Russia. Basing on a programmed goal oriented approach and the example of Vologda region, the authors suggest ways to reduce the sickness rate, perinatal, early neonatal and infant mortality, as well as the methods to improve medical aid to early children.Key words: infant mortality, maternity and infant health protection, sickness rate, organization of health services.

Attitudes Toward Medical Cannabis Legalization Among Serbian Medical Students.

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Vujcic, Isidora; Pavlovic, Aleksandar; Dubljanin, Eleonora; Maksimovic, Jadranka; Nikolic, Aleksandra; Sipetic-Grujicic, Sandra

2017-07-29

Currently, medical cannabis polices are experiencing rapid changes, and an increasing number of nations around the world legalize medical cannabis for certain groups of patients, including those in Serbia. To determine medical students' attitudes toward medical cannabis legalization and to examine the factors influencing their attitudes. Fourth-year medical students at the Faculty of Medicine, University of Belgrade, had participated in a cross-sectional study. Data were collected by an anonymous questionnaire. Overall, 63.4% students supported medical cannabis legalization, and only 20.8% supported its legalization for recreational use. Students who previously used marijuana (p medical cannabis legalization compared with students who never used them. Support for marijuana recreational use was also related to prior marijuana (p cancer (90.4%) and chronic pain (74.2%) were correctly reported approved medical indications by more than half the students. Students who supported medical cannabis legalization showed better knowledge about indications, in contrast to opponents for legalization who showed better knowledge about side effects. Beliefs that using medical cannabis is safe and has health benefits were correlated with support for legalization, and previous marijuana and alcohol use, while beliefs that medical cannabis poses health risks correlated most strongly with previous marijuana use. Conclusions/Importance: The medical students' attitudes toward medical cannabis legalization were significantly correlated with previous use of marijuana and alcohol, knowledge about medical indications and side effects, and their beliefs regarding medical cannabis health benefits and risks.

Evidence of educational inadequacies in region-specific musculoskeletal medicine.

Science.gov (United States)

Day, Charles S; Yeh, Albert C

2008-10-01

Recent studies suggest US medical schools are not effectively addressing musculoskeletal medicine in their curricula. We examined if there were specific areas of weakness by analyzing students' knowledge of and confidence in examining specific anatomic regions. A cross-sectional survey study of third- and fourth-year students at Harvard Medical School was conducted during the 2005 to 2006 academic year. One hundred sixty-two third-year students (88% response) and 87 fourth-year students (57% response) completed the Freedman and Bernstein cognitive mastery examination in musculoskeletal medicine and a survey eliciting their clinical confidence in examining the shoulder, elbow, hand, back, hip, knee, and foot on a one to five Likert scale. We specifically analyzed examination questions dealing with the upper extremity, lower extremity, back, and others, which included more systemic conditions such as arthritis, metabolic bone diseases, and cancer. Students failed to meet the established passing benchmark of 70% in all subgroups except for the others category. Confidence scores in performing a physical examination and in generating a differential diagnosis indicated students felt below adequate confidence (3.0 of 5) in five of the seven anatomic regions. Our study provides evidence that region-specific musculoskeletal medicine is a potential learning gap that may need to be addressed in the undergraduate musculoskeletal curriculum.

A STUDY OF TUMOURS OF THE SELLER REGION

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Rame

2016-03-01

Full Text Available BACKGROUND The tumours of the sellar region that are encountered according to literature are Craniopharyngioma [WHO grade I], Granular cell tumour of the neurohypophysis [WHO grade I], Pituicytoma [WHO grade I], Spindle cells oncocytoma of the adenohypophysis [WHO grade I]. The aim of the study is to study the tumours that are encountered in the Sellar Region. The incidence of the sellar region is very less in this region of Karnataka. METHOD The sample size included 100 cases of intra-cranial neoplasms that turned in the Department of Medicine in KVJ Medical College, Sullia and different local private hospitals of Sullia and Mangalore. RESULTS Only one case of craniopharyngioma was encountered in this study. It accounts for 1(1% of all intracranial tumours studied in this series. Tumour was located in the suprasellar region. This case was reported in a 52-year-old female patient. Presenting complaint was bilateral visual loss and loss of memory. Microscopically-Stratified squamous epithelium was seen lining a cyst and solid ameloblastomatous tissue, calcification ossification and inflammatory reaction were common features. CONCLUSION The incidence of the sellar region is very less in this region of Karnataka.

New study program: Interdisciplinary Postgraduate Specialist Study in Medical Informatics.

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Hercigonja-Szekeres, Mira; Simić, Diana; Božikov, Jadranka; Vondra, Petra

2014-01-01

Paper presents an overview of the EU funded Project of Curriculum Development for Interdisciplinary Postgraduate Specialist Study in Medical Informatics named MEDINFO to be introduced in Croatia. The target group for the program is formed by professionals in any of the areas of medicine, IT professionals working on applications of IT for health and researchers and teachers in medical informatics. In addition to Croatian students, the program will also provide opportunity for enrolling students from a wider region of Southeast Europe. Project partners are two faculties of the University of Zagreb - Faculty of Organization and Informatics from Varaždin and School of Medicine, Andrija Štampar School of Public Health from Zagreb with the Croatian Society for Medical Informatics, Croatian Chamber of Economy, and Ericsson Nikola Tesla Company as associates.

The Royal Naval Medical Services: delivering medical operational capability. the 'black art' of Medical Operational Planning.

Science.gov (United States)

Faye, M

2013-01-01

This article looks to dispel the mysteries of the 'black art' of Medical Operational Planning whilst giving an overview of activity within the Medical Operational Capability area of Medical Division (Med Div) within Navy Command Headquarters (NCHQ) during a period when the Royal Naval Medical Services (RNMS) have been preparing and reconfiguring medical capability for the future contingent battle spaces. The rolling exercise program has been used to illustrate the ongoing preparations taken by the Medical Operational Capability (Med Op Cap) and the Medical Force Elements to deliver medical capability in the littoral and maritime environments.

"That's enough patients for everyone!": Local stakeholders' views on attracting patients into Barbados and Guatemala's emerging medical tourism sectors.

Science.gov (United States)

Snyder, Jeremy; Crooks, Valorie A; Johnston, Rory; Cerón, Alejandro; Labonte, Ronald

2016-10-07

Medical tourism has attracted considerable interest within the Latin American and Caribbean (LAC) region. Governments in the region tout the economic potential of treating foreign patients while several new private hospitals primarily target international patients. This analysis explores the perspectives of a range of medical tourism sector stakeholders in two LAC countries, Guatemala and Barbados, which are beginning to develop their medical tourism sectors. These perspectives provide insights into how beliefs about international patients are shaping the expanding regional interest in medical tourism. Structured around the comparative case study methodology, semi-structured interviews were conducted with 50 medical tourism stakeholders in each of Guatemala and Barbados (n = 100). To capture a comprehensive range of perspectives, stakeholders were recruited to represent civil society (n = 5/country), health human resources (n = 15/country), public health care and tourism sectors (n = 15/country), and private health care and tourism sectors (n = 15/country). Interviews were transcribed verbatim, coded using a collaborative process of scheme development, and analyzed thematically following an iterative process of data review. Many Guatemalan stakeholders identified the Guatemalan-American diaspora as a significant source of existing international patients. Similarly, Barbadian participants identified their large recreational tourism sector as creating a ready source of foreign patients with existing ties to the country. While both Barbadian and Guatemalan medical tourism proponents share a common understanding that intra-regional patients are an existing supply of international patients that should be further developed, the dominant perception driving interest in medical tourism is the proximity of the American health care market. In the short term, this supplies a vision of a large number of Americans lacking adequate health insurance willing to

Clinical Training of Medical Physicists Specializing in Diagnostic Radiology (Spanish Edition); Capacitacion clinica de fisicos medicos especialistas en radiodiagnostico

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NONE

2013-01-15

The application of radiation in human health, for both diagnosis and treatment of disease, is an important component of the work of the IAEA. The responsibility for the increasing technical aspects of this work is undertaken by the medical physicist. To ensure good practice in this vital area, structured clinical training programmes are required to complement academic learning. This publication is intended to be a guide to the practical implementation of such a programme for diagnostic radiology. There is a general and growing awareness that radiation medicine is increasingly dependent on well trained medical physicists based in the clinical setting. However, an analysis of the availability of medical physicists indicates a large shortfall of qualified and capable professionals. This is particularly evident in developing countries. While strategies to increase academic educational opportunities are critical to such countries, the need for guidance on structured clinical training was recognized by the members of the Regional Cooperative Agreement (RCA) for Research, Development and Training related to Nuclear Sciences for Asia and the Pacific. Consequently, a technical cooperation regional project (RAS6038) under the RCA programme was formulated to address this need in the Asia-Pacific region by developing suitable material and establishing its viability. Development of a clinical training guide for medical physicists specializing in diagnostic radiology started in 2007 with the appointment of a core drafting committee of regional and international experts. The publication drew on the experiences of clinical training programmes in Australia and New Zealand, the UK and the USA, and was moderated by physicists working in the Asian region. This publication follows the approach of the IAEA publication Training Course Series No. 37, Clinical Training of Medical Physicists specializing in Radiation Oncology. This approach to clinical training has been successfully tested

Self-medication practice among undergraduate medical students in a tertiary care medical college, West Bengal.

Science.gov (United States)

Banerjee, I; Bhadury, T

2012-01-01

Self-medication is a widely prevalent practice in India. It assumes a special significance among medical students as they are the future medical practitioners. To assess the pattern of self-medication practice among undergraduate medical students. Tertiary care medical college in West Bengal, India. A cross-sectional questionnaire-based study was conducted among the undergraduate medical students. Out of 500 students of the institute, 482 consented for the study and filled in the supplied questionnaire. Fourteen incomplete questionnaires were excluded and the remaining 468 analyzed. It was found that 267 (57.05%) respondents practiced self-medication. The principal morbidities for seeking self-medication included cough and common cold as reported by 94 students (35.21%) followed by diarrhea (68 students) (25.47%), fever (42 students) (15.73%), headache (40 students) (14.98%) and pain abdomen due to heartburn/ peptic ulcer (23 students) (8.61%). Drugs/ drug groups commonly used for self-medication included antibiotics (31.09%) followed by analgesics (23.21%), antipyretics (17.98%), antiulcer agents (8.99%), cough suppressant (7.87%), multivitamins (6.37%) and antihelminthics (4.49%). Among reasons for seeking self-medication, 126 students (47.19%) felt that their illness was mild while 76 (28.46%) preferred as it is time-saving. About 42 students (15.73%) cited cost-effectiveness as the primary reason while 23 (8.62%) preferred because of urgency. Our study shows that self-medication is widely practiced among students of the institute. In this situation, faculties should create awareness and educate their students regarding advantages and disadvantages of self-medication.

Region-of-interest imaging in cone beam computerized tomography

International Nuclear Information System (INIS)

Tam, K.C.

1996-01-01

Imaging a sectional region within an object with a detector just big enough to cover the sectional region-of-interest is analyzed. We show that with some suitable choice of scanning configuration and with an innovative method of data combination, all the Radon data can be obtained accurately. The algorithm is mathematically exact, and requires no iterations and no additional measurements. The method can be applied to inspect portions of large industrial objects in industrial imaging, as well as to image portions of human bodies in medical diagnosis

Medical Students’ and Interns’ Attitudes toward Medical Ethics Education in a Thai Medical School

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Sakda Sathirareuangchai

2016-03-01

Full Text Available Background: Medical ethics has been accepted as part of every accredited medical curriculum for the past 40 years. Medical students’ attitudes have an important role for development and improvement of the curriculum. Faculty of Medicine Siriraj Hospital is the oldest and largest medical school in Thailand, and has been teaching medical ethics since 1907. Objective: To determine attitudes among medical students and interns toward medical ethics education and understand the factors influencing their attitudes. Methods: Mixed quantitative and qualitative research was conducted with early 6th year medical students and interns. A questionnaire was adapted from previous studies and included some original items. Results: Of the 550 questionnaires distributed, 386 were returned (70.2% response rate. Males (n=180 made up 46.63 % of the sample. Interns (n=219, 56.74 % tended to have more positive attitudes toward ethics learning than did medical students (n = 167, 43.26 %. Male participants tended to agree more with negative statements about ethics learning than did females. There was no statistically significant effect of hometown (Bangkok versus elsewhere or grade point average on attitudes. The main problem cited with medical ethics education was lack of engaging methods. Conclusion: Because clinical experience has an effect on learners’ attitudes towards ethics education, medical ethics should be taught at the appropriate time and with proper techniques, such as drawing explicit ties between ethical principles and real-life situations. Attention to the more detailed aspects of these data should also facilitate improvements to curriculum content, thereby ensuring better educational outcomes.

COMPLEX REGIONAL PAIN SYNDROME: AN UPDATE

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Patta

2015-10-01

Full Text Available Complex Regional Pain Syndrome or CRPS is a chronic disabling heterogenous pain disorder due to trauma, resulting in sensory changes, motor function impairment, psychological changes. Diagnosis is based on clinical features and investigations. The patho - physiology is not clearly known. There is no single drug therapy, only combinations work. Treatment is multidisplinary involving medical, psychological and rehabi li tation. Newer modes of spinal cord stimulations, neuraxial mode of analgesics and newe r drugs are promising

Perception of self-medication among university students in Saudi Arabia

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Mustafa S Saeed

2014-01-01

Full Text Available The aim of this study is to assess self-medication practice among university students in the Al-Qassim Province of Saudi Arabia. A cross-sectional community-based survey was conducted by distributing a self-administered 18-item questionnaire among university students in the Al-Qassim Province of Saudi Arabia in the period between October and December 2012. The participants were selected using a convenience sampling technique. Data were collected from the questionnaire and analyzed using SPSS version 19. A total of 354 male students with an average age of 21.95 (SD ± 3.43 participated in this study. Our study showed that self-medication among male students was high (86.6% compared to results shown in other studies in the same region. Headache (59.9%, cough/cold (41% and fever (24.6% were the most common symptoms associated with self-medication. Congruent with the medical conditions reported, the most widely used medications without prescriptions were paracetamol (34.7%, followed by antibiotics (31.4% and nonsteroidal anti-inflammatory drugs (28.7%. Our study shows that antibiotics were sometimes irrationally used for self-treatment of cough and fever. Self-medication was highly frequent among the students. Influence of TV advertisements, high accessibility of pharmacies and convenience stores, as well as good buying power were found to be leading factors for self-medication among male university students.

Prevalence of non-communicable diseases and access to health care and medications among Yazidis and other minority groups displaced by ISIS into the Kurdistan Region of Iraq.

Science.gov (United States)

Cetorelli, Valeria; Burnham, Gilbert; Shabila, Nazar

2017-01-01

The increasing caseload of non-communicable diseases (NCDs) in displaced populations poses new challenges for humanitarian agencies and host country governments in the provision of health care, diagnostics and medications. This study aimed to characterise the prevalence of NCDs and better understand issues related to accessing care among Yazidis and other minority groups displaced by ISIS and currently residing in camps in the Kurdistan Region of Iraq. The study covered 13 camps managed by the Kurdish Board of Relief and Humanitarian Affairs. A systematic random sample of 1300 households with a total of 8360 members were interviewed between November and December 2015. Respondents were asked whether any household members had been previously diagnosed by a health provider with one or more of four common NCDs: hypertension, diabetes, cardiovascular disease and musculoskeletal conditions. For each household member with an NCD diagnosis, access to health care and medications were queried. Nearly one-third of households had at least one member who had been previously diagnosed with one or more of the four NCDs included in this study. Hypertension had the highest prevalence (19.4%; CI: 17.0-22.0), followed by musculoskeletal conditions (13.5%; CI: 11.4-15.8), diabetes (9.7%; CI: 8.0-11.7) and cardiovascular disease (6.3%; CI: 4.8-8.1). Individual NCD prevalence and multimorbidity increased significantly with age. Of those with an NCD diagnosis, 92.9% (CI: 88.9-95.5) had seen a health provider for this condition in the 3 months preceding the survey. In the majority of cases, care was sought from private clinics or hospitals rather than from the camp primary health care clinics. Despite the frequent access to health providers, 40.0% (CI: 34.4-46.0) were not taking prescribed medications, costs being the primary reason cited. New strategies are needed to strengthen health care provision for displaced persons with NCDs and ensure access to affordable medications.

Medical Identity

DEFF Research Database (Denmark)

Musaeus, Peter

2015-01-01

Purpose: To examine philosophical stances underpinning medical identity and assess the conceptual relationship between physician, medical practice and culture. Argument: Medical identity is about the ideals and moral positions that physicians take when justifying themselves. Medical identity...... hedonistic versus sentimentalist approaches to medical identity. The sociocultural philosophical analysis of medical identity can shed light on what it means conceptually for a physician to harbor beliefs associated with him/her being taken to be an autonomous professional. It is important because it touches...... on the meaning of being a compassionate, good and skilled physician, making its relevance to person-centered medicine self-evident. Conclusion: Medical identity should be analyzed with reference to literature, philosophy and medical practice in order for the physician to exercise a reflective position...

A medical facility proposal to use the SSC linac

International Nuclear Information System (INIS)

Funk, L.W.

1994-01-01

A consortium organized by the Texas National Research Laboratory Commission under a Department of Energy grant proposes to build and operate a Regional Medical Technology Center to function as a combined medical radioisotope production complex and proton cancer therapy facility using the Linear Accelerator (Linac) assets of the Superconducting Super Collider (SSC). The radioisotope production complex will serve as a domestic source of radioisotopes critically needed by the U.S. pharmaceutical industry and nuclear medicine facilities throughout North America. Presently, more than 70 percent of radioisotopes used in U.S. nuclear medicine procedures are produced outside the country. The Center's state-of-the-art proton cancer therapy facility will serve the Central United States, providing advanced capabilities and augmenting facilities in California and Massachusetts. Long-term, it is anticipated that the RMTC also will stimulate nuclear medicine research, advance medical diagnostic technologies, and generate new industrial applications for linear accelerator technology

The South East Asian Federation of Organizations for Medical Physics (SEAFOMP): Its history and role in the ASEAN countries.

Science.gov (United States)

Ng, Kh; Wong, Jhd

2008-04-01

Informal discussion started in 1996 and the South East Asian Federation of Organizations for Medical Physics (SEAFOMP) was officially accepted as a regional chapter of the IOMP at the Chicago World Congress in 2000 with five member countries, namely Indonesia, Malaysia, Philippines, Singapore and Thailand. Professor Kwan-Hoong Ng served as the founding president until 2006. Brunei (2002) and Vietnam (2005) joined subsequently. We are very grateful to the founding members of SEAFOMP: Anchali Krisanachinda, Kwan-Hoong Ng, Agnette Peralta, Ratana Pirabul, Djarwani S Soejoko and Toh-Jui Wong.The objectives of SEAFOMP are to promote (i) co-operation and communication between medical physics organizations in the region; (ii) medical physics and related activities in the region; (iii) the advancement in status and standard of practice of the medical physics profession; (iv) to organize and/or sponsor international and regional conferences, meetings or courses; (v) to collaborate or affiliate with other scientific organizations.SEAFOMP has been organizing a series of congresses to promote scientific exchange and mutual support. The South East Asian Congress of Medical Physics (SEACOMP) series was held respectively in Kuala Lumpur (2001), Bangkok (2003), Kuala Lumpur (2004) and Jakarta (2006). The respective congress themes indicated the emphasis and status of development. The number of participants (countries in parentheses) was encouraging: 110 (17), 150 (16), 220 (23) and 126 (7).In honour of the late Professor John Cameron, an eponymous lecture was established. The inaugural John Cameron Lecture was delivered by Professor Willi Kalender in 2004. His lecture was titled "Recent Developments in Volume CT Scanning".

Medical Education in Japan and Introduction of Medical Education at Tokyo Women’s Medical University

Institute of Scientific and Technical Information of China (English)

Yumiko Okubo

2014-01-01

Medical education in Japan changed rapidly in the last decade of the 20th century with the introduction of new education methods and implementation of the core curriculum and common achievement testing such as CBT and OSCE.Recently, there have been other movements in medical education in Japan that have introduced 'outcome(competency) based education(OBE)' and created a system for accreditation of medical education programs. This report provides an overview of current medical education in Japan. Moreover, it introduces medical education at Tokyo Women’s Medical University.

Regionalism, Regionalization and Regional Development

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Liviu C. Andrei

2016-03-01

Full Text Available Sustained development is a concept associating other concepts, in its turn, in the EU practice, e.g. regionalism, regionalizing and afferent policies, here including structural policies. This below text, dedicated to integration concepts, will limit on the other hand to regionalizing, otherwise an aspect typical to Europe and to the EU. On the other hand, two aspects come up to strengthen this field of ideas, i.e. the region (al-regionalism-(regional development triplet has either its own history or precise individual outline of terms.

Self-medication practice among undergraduate medical students in a tertiary care medical college, West Bengal

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I Banerjee

2012-01-01

Full Text Available Background: Self-medication is a widely prevalent practice in India. It assumes a special significance among medical students as they are the future medical practitioners. Aim: To assess the pattern of self-medication practice among undergraduate medical students. Settings and Design: Tertiary care medical college in West Bengal, India. Material and Methods: A cross-sectional questionnaire-based study was conducted among the undergraduate medical students. Results: Out of 500 students of the institute, 482 consented for the study and filled in the supplied questionnaire. Fourteen incomplete questionnaires were excluded and the remaining 468 analyzed. It was found that 267 (57.05% respondents practiced self-medication. The principal morbidities for seeking self-medication included cough and common cold as reported by 94 students (35.21% followed by diarrhea (68 students (25.47%, fever (42 students (15.73%, headache (40 students (14.98% and pain abdomen due to heartburn/ peptic ulcer (23 students (8.61%. Drugs/ drug groups commonly used for self-medication included antibiotics (31.09% followed by analgesics (23.21%, antipyretics (17.98%, antiulcer agents (8.99%, cough suppressant (7.87%, multivitamins (6.37% and antihelminthics (4.49%. Among reasons for seeking self-medication, 126 students (47.19% felt that their illness was mild while 76 (28.46% preferred as it is time-saving. About 42 students (15.73% cited cost-effectiveness as the primary reason while 23 (8.62% preferred because of urgency. Conclusion: Our study shows that self-medication is widely practiced among students of the institute. In this situation, faculties should create awareness and educate their students regarding advantages and disadvantages of self-medication.

Pharmacy Malpractice: The rate and prevalence of dispensing high-risk prescription-only medications at community pharmacies in Saudi Arabia.

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Alshammari, Thamir M; Alhindi, Salman A; Alrashdi, Ahmed M; Benmerzouga, Imaan; Aljofan, Mohamad

2017-07-01

To assess the compliance of community pharmacies with the regulations that prohibit the dispensing of prescription-only medications in the absence of a physician prescription in Saudi Arabia. A cross-sectional study was conducted in the period between October 2014 and January 2015. A list of 10 prescription-only medications were selected to be studied. 150 community pharmacies were visited across 6 major regions in Saudi Arabia to assess the prevalence of non-compliance among community pharmacies. Pharmacies were selected in random and researchers (disguised as patients) requested to purchase prescription-only medications in the absence of a prescription. Not all medications were purchased at once. Data were recorded per pharmacy, where pharmacies that approved dispense of the selected drug were scored as non-compliant and the pharmacies that rejected dispense of the selected drug were scored as compliant. Compliance rate was calculated per region per drug. Pharmacies based in governmental hospitals were visited in parallel. A total of 20 were visited. Data and statistical analysis were performed using Statistical Analyses Software (SAS 9.3). A total of 150 pharmacies were visited over a period of 3 months. On average, the percent approved dispense of prescription-only drugs across 6 regions in Saudi Arabia is 63% and the percent rejected dispense is 37% representing a significant non-compliance rate regarding the selected list of medications in this study. The frequency of dispense per medication across 6 major regions in Saudi Arabia is as follows: Isosorbide dinitrate (86%), Enoxaparin (82%), nitroglycerin (74%), Propranolol (73%), Verapamil (70%), Warfarin (65%), Methyldopa (64%), Ciprofloxacin (57%) and Codeine (4%). Non-compliance of community pharmacies with the law of pharmaceutical practice is at an alarming rate in the Kingdom of Saudi Arabia and authoritative figures must intervene to impede and combat such activities .

Medical service plans in academic medical centers.

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Siegel, B

1978-10-01

Medical service plans are of major importance to academic medical centers and are becoming increasingly so each year as evidenced by growing dependence of medical schools on resulting funds. How these funds are generated and used varies among schools. The procedures may affect the governance of the institution, modifying the authority of the central administration or the clinical departments. Recent developments in federal legislation, such as health maintenance organizations and amendments (Section 227) to the Social Security Act, and the future development of national health insurance will certainly have an effect on how academic medical centers organize their clinical activities. How successfully various medical schools deal with the dynamic problem may well determine their future survival.

Ground and Helicopter Emergency Medical Services Time Tradeoffs Assessed with Geographic Information.

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Widener, Michael J; Ginsberg, Zac; Schleith, Daniel; Floccare, Douglas J; Hirshon, Jon Mark; Galvagno, Samuel

2015-07-01

We describe how geographic information systems (GIS) can be used to assess and compare estimated transport time for helicopter and ground emergency medical services. Recent research shows that while the odds of a trauma patient's survival increase with helicopter emergency medical services (HEMS), they may not increase to the extent necessary to make HEMS cost effective. This study offers an analytic tool to objectively quantify the patient travel time advantage that HEMS offers compared to ground emergency medical services (GEMS). Using helicopter dispatch data from the Maryland State Police from 2000-2011, we computed transport time estimates for HEMS and GEMS, compare these results to a reference transport time of 60 min, and use geospatial interpolation to extrapolate the total response times for each mode across the study region. Mapping the region's trauma incidents and modeling response times, our findings indicate the GIS framework for calculating transportation time tradeoffs is useful in identifying which areas can be better served by HEMS or GEMS. The use of GIS and the analytical methodology described in this study present a method to compare transportation by air and ground in the prehospital setting that accounts for how mode, distance, and road infrastructure impact total transport time. Whether used to generate regional maps in advance or applied real-time, the presented framework provides a tool to identify earlier incident locations that favor HEMS over GEMS transport modes.

Role of State Medical Boards in Continuing Medical Education

Science.gov (United States)

Johnson, David A.; Austin, Dale L.; Thompson, James N.

2005-01-01

The evaluation of physician competency prior to issuing an initial medical license has been a fundamental responsibility of medical boards. Growing public expectation holds that medical boards will ensure competency throughout a physician's career. The Federation of State Medical Boards (FSMB) strongly supports the right of state medical boards to…

Accounting for Medication Particularities: Designing for Everyday Medication Management

DEFF Research Database (Denmark)

Dalgaard, Lea Gulstav; Grönvall, Erik; Verdezoto, Nervo

2013-01-01

Several projects have shown that self-management of medication in private homes can be challenging. Many projects focused on specific illness-related approaches (e.g. diabetes) or practical issues such as how to handle medication while travelling. However, designing for everyday medication manage....... These medication particularities can enhance the individual’s medication overview and support the understanding of medication intake in everyday life. The study also presents five design principles for future design of PHMMS....

[Involvement of medical representatives in team medical care].

Science.gov (United States)

Hirotsu, Misaki; Sohma, Michiro; Takagi, Hidehiko

2009-04-01

In recent years, chemotherapies have been further advanced because of successive launch of new drugs, introduction of molecular targeting, etc., and the concept of so-called Team Medical Care ,the idea of sharing interdisciplinary expertise for collaborative treatment, has steadily penetrated in the Japanese medical society. Dr. Naoto Ueno is a medical oncologist at US MD Anderson Cancer Center, the birthplace of the Team Medical Care. He has advocated the concept of ABC of Team Oncology by positioning pharmaceutical companies as Team C. Under such team practice, we believe that medical representatives of a pharmaceutical company should also play a role as a member of the Team Medical Care by providing appropriate drug use information to healthcare professionals, supporting post-marketing surveillance of treated patients, facilitating drug information sharing among healthcare professionals at medical institutions, etc.

Medical decision making and medical education: challenges and opportunities.

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Schwartz, Alan

2011-01-01

The Flexner Report highlighted the importance of teaching medical students to reason about uncertainty. The science of medical decision making seeks to explain how medical judgments and decisions ought ideally to be made, how they are actually made in practice, and how they can be improved, given the constraints of medical practice. The field considers both clinical decisions by or for individual patients and societal decisions designed to benefit the public. Despite the relevance of decision making to medical practice, it currently receives little formal attention in the U.S. medical school curriculum. This article suggests three roles for medical decision making in medical education. First, basic decision science would be a valuable prerequisite to medical training. Second, several decision-related competencies would be important outcomes of medical education; these include the physician's own decision skills, the ability to guide patients in shared decisions, and knowledge of health policy decisions at the societal level. Finally, decision making could serve as a unifying principle in the design of the medical curriculum, integrating other curricular content around the need to create physicians who are competent and caring decision makers.

[Laboratory diagnosis of pandemic influenza at the Department of Medical Microbiology of the Regional Authority of Public Health based in Banská Bystrica in the season 2009-2010].

Science.gov (United States)

Kissová, R; Mad'arová, L; Klement, C

2011-02-01

The Department of Medical Microbiology of the Regional Authority of Public Health (RAPH) in Banská Bystrica serves as a catchment laboratory of virology for the Central Slovakia Region, and in the influenza season 2009/10, it also served as such for the East Slovakia Region. Specimens (nasopharyngeal swabs and post-mortem specimens) from patients with suspected influenza were obtained from both sentinel and non-sentinel physicians. The specimens were analyzed by a rapid test, followed by real-time PCR (RT-PCR) for influenza A or B diagnosis. RT-PCR subtyping for pandemic influenza A/H1N1 was performed. From May 2009 to June 2010, 2497 specimens were analyzed for the presence of influenza A and B viruses and in particular for the presence of pandemic influenza A/H1N1 virus. As many as 537 of 589 influenza A-positive specimens, i.e. 21.5% of all specimens analyzed and 91.2% of influenza A-positive specimens, were subtyped as pandemic influenza A/H1N1. In the influenza season 2009/10, the new pandemic influenza A/H1N1 clearly predominated in Central and Eastern Slovakia. PCR tests have played a key role in diagnosing patients with suspected pandemic influenza in the laboratory participating in the surveillance of influenza and influenza-like illness in the Slovak Republic.

Emergency Medical Service (EMS) Utilization by Syrian Refugees Residing in Ankara, Turkey.

Science.gov (United States)

Altıner, Ali Osman; Yeşil, Sıdıka Tekeli

2018-04-01

Introduction Many Syrians have left their country and migrated to other countries since March 2011, due to the civil war. As of March 2016, a total of 2,747,946 Syrian refugees had immigrated to Turkey. Some Syrian refugees have been living in camps, while 2,475,134 have been living in metropolitan areas, such as Ankara. Study Objective This study investigated Emergency Medical Service (EMS) utilization among Syrian refugees residing in Ankara. This study was a descriptive, cross-sectional database analysis using data obtained from the Department of EMS of the Ankara Provincial Health Directorate. Five stations in the Altındağ region of Ankara responded to 42% of all calls from Syrian refugees. Prehospital EMS in Ankara have been used mostly by Syrian refugees younger than 18-years-old. Study findings also suggest that medical staff in regions where Syrian refugees are likely to be treated should be supported and provided with the ability to overcome language barriers and cultural differences. Altıner AO , Tekeli Yeşil S . Emergency Medical Service (EMS) utilization by Syrian refugees residing in Ankara, Turkey. Prehosp Disaster Med. 2018;33(2):160-164.

Organization of a Regional Hemodialysis Center

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D. G. Dantsiger

2006-01-01

Full Text Available The paper presents a concept of formation and development of interregional, regional, and equated centers, interregional specialized units set up on the basis of therapeutic-and-prophylactic institutions on the basis of a multileveled multistage health care system. Large multidisciplinary clinical hospital One (Novokuznetsk was used as an example to consider the mechanism of integration of innovation technology of organizing a specialized medical aid. Analysis of the needs of the region’s population for dialysis care for patients with acute and chronic renal failure has revealed the barest necessity of setting up a regional hemodyalisis center under a multidisciplinary clinical hospital. The setting up of a hemodialysis center substantially has quantitatively and qualitatively improved health care delivered to patients with acute and chronic renal failure.

Medical genetic services in Latin America: report of a meeting of experts

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Penchaszadeh Víctor B

1998-01-01

Full Text Available During the Ninth International Congress of Human Genetics which was held in Rio de Janeiro, Brazil, from 16 to 18 August 1996, a group of experts under the coordination of the authors discussed at length the state of medical genetics in Latin America. The facts and ideas presented at the meeting, which was sponsored by the Human Genetics Program of the World Health Organization (WHO and the Maternal and Child Health Program of the Pan American Health Organization, are examined in this document under three broad headings. The first verses on the history and current status of medical genetics in selected Latin American countries. This is followed by a discussion of the general features of medical genetics in the Region and by a final section of recommendations for promoting medical genetics in Latin America.

Mapping telemedicine efforts: surveying regional initiatives in Denmark.

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Kierkegaard, Patrick

2015-05-01

The aim of this study is to survey telemedicine services currently in operation across Denmark. The study specifically seeks to answer the following questions: What initiatives are deployed within the different regions? What are the motivations behind the projects? What technologies are being utilized? What medical disciplines are being supported using telemedicine systems? All data were surveyed from the Telemedicinsk Landkort, a newly created database designed to provide a comprehensive and systematic overview of all telemedicine technologies in Denmark. The results of this study suggest that a growing numbers of telemedicine initiatives are currently in operation across Denmark but that considerable variations exist in terms of regional efforts as the number of operational telemedicine projects varied from region to region. The results of this study provide a timely picture of the factors that are shaping the telemedicine landscape of Denmark and suggest potential strategies to help policymakers increase and improve national telemedicine deployment.

Perspective: private schools of the Caribbean: outsourcing medical education.

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Eckhert, N Lynn

2010-04-01

Twenty-five percent of the U.S. physician workforce is made up of international medical graduates (IMGs), a growing proportion of whom (27% in 2005) are U.S. citizens. Most IMGs graduate from "offshore medical schools" (OMSs), for-profit institutions primarily located in the Caribbean region and established to train U.S. students who will return home to practice medicine. Following the recent call for a larger physician workforce, OMSs rapidly increased in number. Unlike U.S. schools, which must be accredited by the Liaison Committee on Medical Education, OMSs are recognized by their home countries and may not be subject to a rigorous accreditation process. Although gaps in specific data exist, a closer look at OMSs reveals that most enroll three groups of students per year, and many educate students initially at "offshore campuses" and later at clinical sites in the United States. Students from some OMSs are eligible for the U.S. Federal Family Education Loan Program. The lack of uniform data on OMSs is problematic for state medical boards, which struggle to assess the quality of the medical education offered at any one school and which, in some cases, disapprove a school. With the United States' continued reliance on IMGs to meet its health needs, the public and the profession will be best served by knowing more about medical education outside of the United States. Review of medical education in OMSs whose graduates will become part of U.S. health care delivery is timely as the United States reforms its health-care-delivery system.