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Sample records for group health medical

  1. Efficacy of a lay health worker led group antiretroviral medication ...

    African Journals Online (AJOL)

    Efficacy of a lay health worker led group antiretroviral medication adherence ... SAHARA-J: Journal of Social Aspects of HIV/AIDS ... of care, while adherence motivation and skills did not significantly change among the conditions over time.

  2. Focus group discussion: a tool for health and medical research.

    Science.gov (United States)

    Wong, L P

    2008-03-01

    Focus group discussion is a research methodology in which a small group of participants gather to discuss a specified topic or an issue to generate data. The main characteristic of a focus group is the interaction between the moderator and the group, as well as the interaction between group members. The objective is to give the researcher an understanding of the participants' perspective on the topic in discussion. Focus groups are rapidly gaining popularity in health and medical research. This paper presents a general introduction of the use of focus groups as a research tool within the context of health research, with the intention of promoting its use among researchers in healthcare. A detailed methodology for the conduct of focus groups and analysis of focus group data are discussed. The potentials and limitations of this qualitative research technique are also highlighted.

  3. Aerobics health as means of increasing somatic health of students of special medical group

    Directory of Open Access Journals (Sweden)

    Pivneva M.M.

    2013-08-01

    Full Text Available We prove the feasibility of employment by improving aerobic low intensity (LowImpact - heart rate in the range 128-140 beats / min, or 60-74% of HR max with students of special medical groups with disabilities cardiovascular system. The choice of three varieties of improving aerobics - classical, dance, tap dance - and with the help of laboratory experiment investigated the specificity of their effects on the physical health of students. According to the results of laboratory studies developed two versions of the author's method of application for improving aerobic physical education classes with students with disabilities but cardiac-vascular system, the main difference between them lies in the relationship and the manner of the classical sequence of exercises, dance, step aerobics. By comparing the results of educational experiments proved that both variants techniques contribute significantly improved key indicators of physical health subjects and thus are fairly equal in the nature of exposure.

  4. Perceptions and efficiency of short-term medical aid missions among key groups of health professionals.

    Science.gov (United States)

    Chiu, Ya-Wen; Weng, Yi-Hao; Chen, Chih-Fu; Yang, Chun-Yuh; Lee, Ming-Liang

    2014-09-01

    This study investigated the perceptions of short-term assignments of medical services among participating health care professionals dispatched from Taiwan to underdeveloped areas. Structured questionnaires were mailed to four groups of professionals (physicians, pharmacists, nurses, and public health personnel) who had participated in any of 88 medical missions dispatched to 24 allied nations. A total of 278 returns were valid for analysis. Among them, 222 respondents reported that they had participated in just one overseas medical mission (79.9%). The majority of physicians, pharmacists, and nurses listed humanitarianism as their foremost incentive for participation. In contrast, public health personnel most frequently reported that they had been assigned to the mission abroad. Pharmacists, nurses, and public health personnel most commonly stated that their top goal was health care; but physicians said that aiding Taiwan's diplomatic relations was their main motive. While all groups generally recognized language proficiency and cultural awareness as important for conducting successful short-term medical aid missions (STMMs), many members of groups did not rate their own capabilities in those area as sufficient, especially pharmacists (p help inform efforts to integrate evidence into the deployment of STMMs.

  5. Simulation Suggests that medical group mergers won't undermine the potential utility of health information exchanges.

    NARCIS (Netherlands)

    Rudin, R.S.; Schneider, E.C.; Volk, L.A.; Szolovits, P.; Salzberg, C.A.; Simon, S.R.; Bates, D.W.

    2012-01-01

    Federal and state agencies are investing substantial resources in the creation of community health information exchanges, which are consortia that enable independent health care organizations to exchange clinical data. However, under pressure to form accountable care organizations, medical groups ma

  6. Undergraduate Rural Medical Education Program Development: Focus Group Consultation with the NRHA Rural Medical Educators Group

    Science.gov (United States)

    Downey, Laura H.; Wheat, John R.; Leeper, James D.; Florence, Joseph A.; Boulger, James G.; Hunsaker, Matt L.

    2011-01-01

    Context: Over a decade ago, leaders in rural medical education established the Rural Medical Educators (RME) Group, an interest group within the National Rural Health Association, to support faculty in rural medical education programs. This group has convened an annual RME conclave since 2006. In 2008, this conclave convened 15 national leaders in…

  7. The Medicaid Medically Improved Group, Losing Disability...

    Data.gov (United States)

    U.S. Department of Health & Human Services — According to findings reported in, The Medicaid Medically Improved Group, Losing Disability Status and Growing Earnings, published in Volume 4, Issue 1 of the...

  8. The Medicaid Medically Improved Group, Losing Disability...

    Data.gov (United States)

    U.S. Department of Health & Human Services — According to findings reported in, The Medicaid Medically Improved Group, Losing Disability Status and Growing Earnings, published in Volume 4, Issue 1 of the...

  9. Effects of racial and ethnic group and health literacy on responses to genomic risk information in a medically underserved population.

    Science.gov (United States)

    Kaphingst, Kimberly A; Stafford, Jewel D; McGowan, Lucy D'Agostino; Seo, Joann; Lachance, Christina R; Goodman, Melody S

    2015-02-01

    Few studies have examined how individuals respond to genomic risk information for common, chronic diseases. This randomized study examined differences in responses by type of genomic information (genetic test/family history) and disease condition (diabetes/heart disease), and by race/ethnicity in a medically underserved population. 1,057 English-speaking adults completed a survey containing 1 of 4 vignettes (2-by-2 randomized design). Differences in dependent variables (i.e., interest in receiving genomic assessment, discussing with doctor or family, changing health habits) by experimental condition and race/ethnicity were examined using chi-squared tests and multivariable regression analysis. No significant differences were found in dependent variables by type of genomic information or disease condition. In multivariable models, Hispanics were more interested in receiving a genomic assessment than Whites (OR = 1.93; p literacy had greater interest than those with adequate health literacy. Blacks (OR = 1.78; p = .001) and Hispanics (OR = 1.85; p = .001) had greater interest in discussing information with family than Whites. Non-Hispanic Blacks (OR = 1.45; p = .04) had greater interest in discussing genomic information with a doctor than Whites. Blacks (β = -0.41; p literacy was negatively associated with number of health habits participants intended to change. Findings suggest that race/ethnicity may affect responses to genomic risk information. Additional research could examine how cognitive representations of this information differ across racial/ethnic groups. Health literacy is also critical to consider in developing approaches to communicating genomic information.

  10. Learning global health: a pilot study of an online collaborative intercultural peer group activity involving medical students in Australia and Indonesia.

    Science.gov (United States)

    Ambrose, Mark; Murray, Linda; Handoyo, Nicholas E; Tunggal, Deif; Cooling, Nick

    2017-01-13

    There is limited research to inform effective pedagogies for teaching global health to undergraduate medical students. Theoretically, using a combination of teaching pedagogies typically used in 'international classrooms' may prove to be an effective way of learning global health. This pilot study aimed to explore the experiences of medical students in Australia and Indonesia who participated in a reciprocal intercultural participatory peer e-learning activity (RIPPLE) in global health. Seventy-one third year medical students (49 from Australia and 22 from Indonesia) from the University of Tasmania (Australia) and the University of Nusa Cendana (Indonesia) participated in the RIPPLE activity. Participants were randomly distributed into 11 intercultural 'virtual' groups. The groups collaborated online over two weeks to study a global health topic of their choice, and each group produced a structured research abstract. Pre- and post-RIPPLE questionnaires were used to capture students' experiences of the activity. Descriptive quantitative data were analysed with Microsoft Excel and qualitative data were thematically analysed. Students' motivation to volunteer for this activity included: curiosity about the innovative approach to learning; wanting to expand knowledge of global health; hoping to build personal and professional relationships; and a desire to be part of an intercultural experience. Afer completing the RIPPLE program, participants reported on global health knowledge acquisition, the development of peer relationships, and insight into another culture. Barriers to achieving the learning outcomes associated with RIPPLE included problems with establishing consistent online communication, and effectively managing time to simultaneously complete RIPPLE and other curricula activities. Medical students from both countries found benefits in working together in small virtual groups to complement existing teaching in global health. However, our pilot study

  11. Experience in the use of social media in medical and health education. Contribution of the IMIA Social Media Working Group.

    Science.gov (United States)

    Paton, C; Bamidis, P D; Eysenbach, G; Hansen, M; Cabrer, M

    2011-01-01

    Social media are online tools that allow collaboration and community building. Succinctly, they can be described as applications where "users add value". This paper aims to show how five educators have used social media tools in medical and health education to attempt to add value to the education they provide. We conducted a review of the literature about the use of social media tools in medical and health education. Each of the authors reported on their use of social media in their educational projects and collaborated on a discussion of the advantages and disadvantages of this approach to delivering educational projects. We found little empirical evidence to support the use of social media tools in medical and health education. Social media are, however, a rapidly evolving range of tools, websites and online experiences and it is likely that the topic is too broad to draw definitive conclusions from any particular study. As practitioners in the use of social media, we have recognised how difficult it is to create evidence of effectiveness and have therefore presented only our anecdotal opinions based on our personal experiences of using social media in our educational projects. The authors feel confident in recommending that other educators use social media in their educational projects. Social media appear to have unique advantages over non-social educational tools. The learning experience appears to be enhanced by the ability of students to virtually build connections, make friends and find mentors. Creating a scientific analysis of why these connections enhance learning is difficult, but anecdotal and preliminary survey evidence appears to be positive and our experience reflects the hypothesis that learning is, at heart, a social activity.

  12. Building a Privacy, Ethics, and Data Access Framework for Real World Computerised Medical Record System Data: A Delphi Study. Contribution of the Primary Health Care Informatics Working Group.

    Science.gov (United States)

    Liyanage, H; Liaw, S-T; Di Iorio, C T; Kuziemsky, C; Schreiber, R; Terry, A L; de Lusignan, S

    2016-11-10

    Privacy, ethics, and data access issues pose significant challenges to the timely delivery of health research. Whilst the fundamental drivers to ensure that data access is ethical and satisfies privacy requirements are similar, they are often dealt with in varying ways by different approval processes. To achieve a consensus across an international panel of health care and informatics professionals on an integrated set of privacy and ethics principles that could accelerate health data access in data-driven health research projects. A three-round consensus development process was used. In round one, we developed a baseline framework for privacy, ethics, and data access based on a review of existing literature in the health, informatics, and policy domains. This was further developed using a two-round Delphi consensus building process involving 20 experts who were members of the International Medical Informatics Association (IMIA) and European Federation of Medical Informatics (EFMI) Primary Health Care Informatics Working Groups. To achieve consensus we required an extended Delphi process. The first round involved feedback on and development of the baseline framework. This consisted of four components: (1) ethical principles, (2) ethical guidance questions, (3) privacy and data access principles, and (4) privacy and data access guidance questions. Round two developed consensus in key areas of the revised framework, allowing the building of a newly, more detailed and descriptive framework. In the final round panel experts expressed their opinions, either as agreements or disagreements, on the ethics and privacy statements of the framework finding some of the previous round disagreements to be surprising in view of established ethical principles. This study develops a framework for an integrated approach to ethics and privacy. Privacy breech risk should not be considered in isolation but instead balanced by potential ethical benefit.

  13. Reaching the hard-to-reach: a systematic review of strategies for improving health and medical research with socially disadvantaged groups

    Science.gov (United States)

    2014-01-01

    Background This study aims to review the literature regarding the barriers to sampling, recruitment, participation, and retention of members of socioeconomically disadvantaged groups in health research and strategies for increasing the amount of health research conducted with socially disadvantaged groups. Methods A systematic review with narrative synthesis was conducted. Searches of electronic databases Medline, PsychInfo, EMBASE, Social Science Index via Web of Knowledge and CINHAL were conducted for English language articles published up to May 2013. Qualitative and quantitative studies as well as literature reviews were included. Articles were included if they reported attempts to increase disadvantaged group participation in research, or the barriers to research with disadvantaged groups. Groups of interest were those described as socially, culturally or financially disadvantaged compared to the majority of society. Eligible articles were categorised according to five phases of research: 1) sampling, 2) recruitment and gaining consent, 3) data collection and measurement, 4) intervention delivery and uptake, and 5) retention and attrition. Results In total, 116 papers from 115 studies met inclusion criteria and 31 previous literature reviews were included. A comprehensive summation of the major barriers to working with various disadvantaged groups is provided, along with proposed strategies for addressing each of the identified types of barriers. Most studies of strategies to address the barriers were of a descriptive nature and only nine studies reported the results of randomised trials. Conclusions To tackle the challenges of research with socially disadvantaged groups, and increase their representation in health and medical research, researchers and research institutions need to acknowledge extended timeframes, plan for higher resourcing costs and operate via community partnerships. PMID:24669751

  14. A Group of Asthma Patients\\\\\\' Treatment Related Thoughts Based on Health Belief Model and Perception of Medication Success

    Directory of Open Access Journals (Sweden)

    Mesut Cimen

    2012-02-01

    Full Text Available Purpose: This study is a descriptive study which aims to determine the attitude and perceptions of asthma patients about their health and their opinion regarding the success of treatment. Method: The study is carried out without any sampling. The participants are 74 patients who were admitted in a public pulmonary disease clinic between April and June 2010. A revised version of Health Belief Model scale for asthma treatment and another scale, which was developed to determine the opinion and observations of patients regarding the success of treatment, are used for data collection. In addition to descriptive statistics, regression analysis, Mann-Whitney U and Kruskal Wallis tests are used in the data analysis. Findings: The mean score of attitudes and perceptions of asthma patients, which is defined with the Health Belief Model and which can affect their responsiveness to treatment, is found out 3,37(±0,38 and the attitude and perceptions of patients are positive. The mean value for success treatment is 2,35(±0,49. Since the treatment is deemed to be more successful as it gets closer to 1 hence it can be said that the opinion of asthma patients regarding the success of treatment is positive. In the study, it is found out that the participants have a high admission rate to hospitals and that there is no significant difference for socio-demographic characteristics in the positive attitude development and in their belief in the efficiency of the treatment that they are receiving, of which both are components of health belief model concept. The findings from regression analysis indicate that the duration of the asthma sickness and the number of people living in the household not only affect the perceptions and attitudes of patients that are investigated by health belief model, but also the effectiveness of the treatment and the number of admissions to the Emergency Room in the last 6 months. Conclusion: In order to prevent long-term complications

  15. Mental Health Medications

    Science.gov (United States)

    ... The most common anti-anxiety medications are called benzodiazepines. Benzodiazepines can treat generalized anxiety disorder. In the case ... panic disorder or social phobia (social anxiety disorder), benzodiazepines are usually second-line treatments, behind SSRIs or ...

  16. [Piercing: health education or medicalization?].

    Science.gov (United States)

    Meningaud, J P; Moutel, G; Hervé, C

    2000-06-10

    In Europe, the piercing mode has naturally been associated with specific complications raising an important public health problem. The debate on the role physicians should play requires a careful analysis of the ethical issues involved. Specifically, should the piercing be done in a medical setting? This question is raised because, when performed under ideal conditions, the act of piercing requires a certain degree of medical competency: history taking, asepsia, technical procedure (hemostasis), anesthesia.... However, mandatory medicalization would not, in our opinion, appear to be desirable since we are dealing with a social rite which lies outside the domain of specific medical care. Nevertheless, although we do not advocate systematic medicalization, we do believe that medicine should play a role, in terms of public health, in this emerging practice. We discuss the modalities of a health education dialogue which could be established with professional practicing piercing.

  17. Medical and Health Services Managers

    Science.gov (United States)

    ... Contact & Help Economic Releases Latest Releases » Major Economic Indicators » Schedules for news Releases » By Month By News ... business-related courses with courses in medical terminology, hospital organization, ... often includes courses in health services management, accounting ...

  18. Contents and features of forming students' culture of health of special medical group in the process of theoretical preparation on physical education.

    Directory of Open Access Journals (Sweden)

    Gribok N.N.

    2010-12-01

    Full Text Available The problem of forming valued attitude is considered toward own health for students with the presence of diseases. New vision of maintenance of theoretical preparation is found on physical education of students at which rejections are marked in a state of health. An experimental on-line tutorial is offered, on the basis of analysis of the existent program, on physical education for the students of task medical force. It is set that the offered on-line tutorial is directed not only on liquidation of diseases but also on forming, strengthening and maintenance of own health in spiritual, psychical and physical aspects.

  19. Structuring group medical practices: tax planning aspects.

    Science.gov (United States)

    Gassman, A S; Conetta, T F

    1992-01-01

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

  20. Marketing the academic medical center group practice.

    Science.gov (United States)

    Eudes, J A; Divis, K L

    1992-01-01

    From a marketing perspective, there are many differences between private and academic medical center (AMC) group practices. Given the growing competition between the two, write John Eudes and Kathy Divis, it is important for the AMC group practice to understand and use these differences to develop a competitive market advantage.

  1. Medical group management: a marketing orientation.

    Science.gov (United States)

    Bopp, K D; Allcorn, S

    1986-09-01

    This article considers the pragmatic aspects of conducting a situation/marketing audit for group medical practices. This audit is a key component in the formulation of a competitive strategy and the development of a marketing program. Given are a series of questions that may be used by medical groups to guide assessment of the opportunities and threats present in the environment as well as the strengths and weaknesses of the organization in meeting the environmental challenges. Furthermore, the article provides a framework for thinking about strategy and the variables that should be considered and aligned to achieve effective implementation of strategy. Finally, the parameters are outlined for deciding on a marketing program: the mix of marketing tools (service design, distribution channels, pricing and promotion) that should be employed to offensively and/or defensively position the medical group in the competitive marketplace.

  2. Are medical residents a "core group" for future improvement of influenza vaccination coverage in health-care workers? A study among medical residents at the University Hospital of Palermo (Sicily).

    Science.gov (United States)

    Amodio, Emanuele; Tramuto, Fabio; Maringhini, Guido; Asciutto, Rosario; Firenze, Alberto; Vitale, Francesco; Costantino, Claudio; Calamusa, Giuseppe

    2011-10-19

    Despite international recommendations, vaccination coverage among European healthcare workers, including physicians, is widely recognized as unsatisfactory. In order to plan tailored vaccination campaigns and increase future coverage, we investigated reasons for refusing vaccination and determinants associated with influenza vaccine uptake among young health care workers. A survey was carried out during September and October 2010 on medical residents attending post-graduate Schools of the Medical Faculty at the University of Palermo (Italy). Each participant completed an anonymous web-based questionnaire including items on demographic and occupational characteristics, knowledge, attitudes and behaviours with regard to influenza and influenza vaccination, and main sources of information. A total of 202 (66.9%) out of 302 medical residents participated in the survey. During the 2009-2010 influenza vaccine campaign, 44 residents (21.8%) were vaccinated against seasonal influenza and 84 (41.6%) against pandemic influenza A (H1N1) 2009. For the impending 2010-2011 influenza season, 45 (22.3%) stated their intention to get vaccinated against seasonal influenza, 40 (19.8%) were uncertain and 117 (57.9%) were opposed. Considering themselves to be a high risk group for developing influenza was significantly associated with vaccination against both 2009-2010 seasonal (adj-OR=1.46; 95% CI=1.05-2.04) and pandemic A (H1N1) influenza (adj-OR 1.38; 95% CI=1.08-1.75). Intention to get vaccinated against 2010-2011 seasonal influenza was significantly more frequent in participants who had a high perception of efficacy/safety (adj-OR=1.49; 95% CI=1.05-2.12). After adjusting for confounding, vaccinations against seasonal 2009-2010 influenza, pandemic influenza A (H1N1) 2009 and seasonal 2010-2011 influenza were significantly more frequent in residents who were vaccinated against influenza at least once in the previous five influenza seasons. Influenza vaccination among medical

  3. Group Health Education in Inpatient Rehabilitation: Patients' Role Perceptions

    Science.gov (United States)

    Schöpf, Andrea C.; Ullrich, Antje; Nagl, Michaela; Farin, Erik

    2016-01-01

    Objective: Group health education is an important aspect of medical rehabilitation. While interaction and active involvement are important characteristics of group health education, little is known about patients' understanding of their role in this form of education. This study explored patients' understanding of their role in group health…

  4. Management by objectives in medical group practice.

    Science.gov (United States)

    Bozis, D E

    1986-01-01

    When the concept of management by objectives first emerged, it was heralded by many as the long-sought secret to employee motivation. The MBO technique, involving the three primary functions of objective setting, objective using, and employee involvement, is described here in terms of both theory and practice. Although it does have its pitfalls and is certainly not the "ultimate answer," MBO in medical group practice does have its merits when properly introduced. It is much more than a purely academic concept, and its major strength lies in its recognition of the importance of human resources in getting the job done.

  5. Medical liability and health care reform.

    Science.gov (United States)

    Nelson, Leonard J; Morrisey, Michael A; Becker, David J

    2011-01-01

    We examine the impact of the Affordable Care Act (ACA) on medical liability and the controversy over whether federal medical reform including a damages cap could make a useful contribution to health care reform. By providing guaranteed access to health care insurance at community rates, the ACA could reduce the problem of under-compensation resulting from damages caps. However, it may also exacerbate the problem of under-claiming in the malpractice system, thereby reducing incentives to invest in loss prevention activities. Shifting losses from liability insurers to health insurers could further undermine the already weak deterrent effect of the medical liability system. Republicans in Congress and physician groups both pushed for the adoption of a federal damages cap as part of health care reform. Physician support for damages caps could be explained by concerns about the insurance cycle and the consequent instability of the market. Our own study presented here suggests that there is greater insurance market stability in states with caps on non-economic damages. Republicans in Congress argued that the enactment of damages caps would reduce aggregate health care costs. The Congressional Budget Office included savings from reduced health care utilization in its estimates of cost savings that would result from the enactment of a federal damages cap. But notwithstanding recent opinions offered by the CBO, it is not clear that caps will significantly reduce health care costs or that any savings will be passed on to consumers. The ACA included funding for state level demonstration projects for promising reforms such as offer and disclosure and health courts, but at this time the benefits of these reforms are also uncertain. There is a need for further studies on these issues.

  6. Health Literacy Explains Racial Disparities in Diabetes Medication Adherence

    OpenAIRE

    Osborn, Chandra Y.; Cavanaugh, Kerri; Wallston, Kenneth A.; Kripalani, Sunil; White, Richard O.; Elasy, Tom A; Russell L Rothman

    2011-01-01

    While low health literacy and suboptimal medication adherence are more prevalent in racial/ethnic minority groups than Whites, little is known about the relationship between these factors in adults with diabetes, and whether health literacy or numeracy might explain racial/ethnic disparities in diabetes medication adherence. Previous work in HIV suggests health literacy mediates racial differences in adherence to anti-retroviral treatment, but no study to date has explored numeracy as a media...

  7. Medicalization of global health 4: the universal health coverage campaign and the medicalization of global health

    Directory of Open Access Journals (Sweden)

    Jocalyn Clark

    2014-05-01

    Full Text Available Universal health coverage (UHC has emerged as the leading and recommended overarching health goal on the post-2015 development agenda, and is promoted with fervour. UHC has the backing of major medical and health institutions, and is designed to provide patients with universal access to needed health services without financial hardship, but is also projected to have ‘a transformative effect on poverty, hunger, and disease’. Multiple reports and resolutions support UHC and few offer critical analyses; but among these are concerns with imprecise definitions and the ability to implement UHC at the country level. A medicalization lens enriches these early critiques and identifies concerns that the UHC campaign contributes to the medicalization of global health. UHC conflates health with health care, thus assigning undue importance to (biomedical health services and downgrading the social and structural determinants of health. There is poor evidence that UHC or health care alone improves population health outcomes, and in fact health care may worsen inequities. UHC is reductionistic because it focuses on preventative and curative actions delivered at the individual level, and ignores the social and political determinants of health and right to health that have been supported by decades of international work and commitments. UHC risks commodifying health care, which threatens the underlying principles of UHC of equity in access and of health care as a collective good.

  8. Medicalization of global health 4: The universal health coverage campaign and the medicalization of global health.

    Science.gov (United States)

    Clark, Jocalyn

    2014-01-01

    Universal health coverage (UHC) has emerged as the leading and recommended overarching health goal on the post-2015 development agenda, and is promoted with fervour. UHC has the backing of major medical and health institutions, and is designed to provide patients with universal access to needed health services without financial hardship, but is also projected to have 'a transformative effect on poverty, hunger, and disease'. Multiple reports and resolutions support UHC and few offer critical analyses; but among these are concerns with imprecise definitions and the ability to implement UHC at the country level. A medicalization lens enriches these early critiques and identifies concerns that the UHC campaign contributes to the medicalization of global health. UHC conflates health with health care, thus assigning undue importance to (biomedical) health services and downgrading the social and structural determinants of health. There is poor evidence that UHC or health care alone improves population health outcomes, and in fact health care may worsen inequities. UHC is reductionistic because it focuses on preventative and curative actions delivered at the individual level, and ignores the social and political determinants of health and right to health that have been supported by decades of international work and commitments. UHC risks commodifying health care, which threatens the underlying principles of UHC of equity in access and of health care as a collective good.

  9. Medical Records and Health Information Technicians

    Science.gov (United States)

    ... Projected Employment, 2024 Change, 2014-24 Employment by Industry Percent Numeric SOURCE: U.S. Bureau of Labor Statistics, Employment Projections program Medical records and health information ...

  10. Seeking health care through international medical tourism.

    Science.gov (United States)

    Eissler, Lee Ann; Casken, John

    2013-06-01

    The purpose of this study was the exploration of international travel experiences for the purpose of medical or dental care from the perspective of patients from Alaska and to develop insight and understanding of the essence of the phenomenon of medical tourism. The study is conceptually oriented within a model of health-seeking behavior. Using a qualitative design, 15 Alaska medical tourists were individually interviewed. The data were analyzed using a hermeneutic process of inquiry to uncover the meaning of the experience. Six themes reflecting the experiences of Alaska medical tourists emerged: "my motivation," "I did the research," "the medical care I need," "follow-up care," "the advice I give," and "in the future." Subthemes further categorized data for increased understanding of the phenomenon. The thematic analysis provides insight into the experience and reflects a modern approach to health-seeking behavior through international medical tourism. The results of this study provide increased understanding of the experience of obtaining health care internationally from the patient perspective. Improved understanding of medical tourism provides additional information about a contemporary approach to health-seeking behavior. Results of this study will aid nursing professionals in counseling regarding medical tourism options and providing follow-up health care after medical tourism. Nurses will be able to actively participate in global health policy discussions regarding medical tourism trends. © 2013 Sigma Theta Tau International.

  11. Hospital Contracts: Important Issues for Medical Groups.

    Science.gov (United States)

    Rosolio, Charles E

    2016-01-01

    Relationships with hospitals and outpatient medical facilities have always been an important part of the business model for private medical practices. As healthcare delivery to patients has evolved in the United States (much of it driven by the new government mandates, regulations, and the Affordable Care Act), the delivery of such services is becoming more and more centered on the hospital or institutional setting, thus making contractual relationships with hospitals even more important for medical practices. As a natural outgrowth of this relationship, attention to hospital contracts is becoming more important.

  12. Medical education and health care in Uganda.

    Science.gov (United States)

    Kiely, J M

    1980-10-01

    Health care and medical education in Uganda, once the best in Black Africa, have been adversely affected by the economic, political, and social upheavals in this developing country during the past decade. Crop failures, inadequate public health measures, shortage of medical equipment and essential drugs, and lack of sufficient medical school faculty have resulted in a major crisis. Substantial aid from the medical profession in developed countries will be necessary to help restore medical practice and education to the level present before the regime of Idi Amin.

  13. Health literacy explains racial disparities in diabetes medication adherence.

    Science.gov (United States)

    Osborn, Chandra Y; Cavanaugh, Kerri; Wallston, Kenneth A; Kripalani, Sunil; Elasy, Tom A; Rothman, Russell L; White, Richard O

    2011-01-01

    Although low health literacy and suboptimal medication adherence are more prevalent in racial/ethnic minority groups than Whites, little is known about the relationship between these factors in adults with diabetes, and whether health literacy or numeracy might explain racial/ethnic disparities in diabetes medication adherence. Previous work in HIV suggests health literacy mediates racial differences in adherence to antiretroviral treatment, but no study to date has explored numeracy as a mediator of the relationship between race/ethnicity and medication adherence. This study tested whether health literacy and/or numeracy were related to diabetes medication adherence, and whether either factor explained racial differences in adherence. Using path analytic models, we explored the predicted pathways between racial status, health literacy, diabetes-related numeracy, general numeracy, and adherence to diabetes medications. After adjustment for covariates, African American race was associated with poor medication adherence (r = -0.10, p literacy was associated with adherence (r = .12, p diabetes-related numeracy and general numeracy were not related to adherence. Furthermore, health literacy reduced the effect of race on adherence to nonsignificance, such that African American race was no longer directly associated with lower medication adherence (r = -0.09, p = .14). Diabetes medication adherence promotion interventions should address patient health literacy limitations.

  14. [Public health competencies and contents in Spanish undergraduate medical degrees].

    Science.gov (United States)

    Davó-Blanes, M Carmen; Vives-Cases, Carmen; Barrio-Fernández, José Luis; Porta, Miquel; Benavides, Fernando G; de Miguel, Ángel Gil

    2016-01-01

    To reach a consensus among public health faculty from various Spanish universities about the core public health competencies that should be integrated into undergraduate medical degrees. The 2nd Forum of University Teachers was held at the Rey Juan Carlos University (Madrid, 11-12 December 2014). Twenty-four university professors and lecturers from 19 Spanish universities imparting medical degrees participated in the forum. They were distributed in three working groups during three working sessions. In the first session, they were asked to identify and classify core public health competencies for medical degrees. In the second, they were asked to propose public health contents for the identified competencies. In the third session, the participants organized these contents in thematic blocks. The results were discussed in distinct plenary sessions. The highest number of core competencies was identified in the activities related to the public health functions «Assessment of the population's health needs» and «Developing health policies». The final programme included basic contents organised into five units: Concept of health, public health and its determinants; Epidemiology and health research; Determinants and health problems; Strategies, interventions and policies; and health systems, clinical and healthcare management. The public health core competencies and contents identified in this Forum may be considered as a starting point to improve and update public health training programmes for future medical professionals. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

  15. Evaluating the Efficacy of a Short Aging Simulation Workshop for an Interdisciplinary Group of Health-Care Employees at a Veterans Affairs Medical Center

    Science.gov (United States)

    Halpin, Sean N.

    2015-01-01

    Several interventions aimed at increasing positive attitudes towards older adults among health-care professionals have been introduced. These interventions tend to focus on a small subset of clinical employees, ignoring other clinical and nonclinical hospital staff. The objective of this study was to evaluate the efficacy of a short aging…

  16. Philosophy in medical education: a means of protecting mental health.

    Science.gov (United States)

    Keller, Eric J

    2014-08-01

    This study sought to identify and examine less commonly discussed challenges to positive mental health faced by medical students, residents, and physicians with hopes of improving current efforts to protect the mental health of these groups. Additionally, this work aimed to suggest an innovative means of preventing poor mental health during medical education. Literature on medical student, resident, and physician mental health was carefully reviewed and a number of psychiatrists who treat physician-patients were interviewed. The culture of medicine, medical training, common physician psychology and identity, and conflicting professional expectations all seem to contribute to poor mental health among medical students, residents, and physicians. Many current efforts may be more successful by better addressing the negative effects of these characteristics of modern medicine. Programs aimed at promoting healthy mental lifestyles during medical education should continue to be developed and supported to mitigate the deleterious effects of the challenging environment of modern medicine. To improve these efforts, educators may consider incorporating philosophical discussions on meaning and fulfillment in life between medical students and faculty. Through medical school faculty members sharing and living out their own healthy outlooks on life, students may emulate these habits and the culture of medicine may become less challenging for positive mental health.

  17. Integrating environmental health into medical education.

    Science.gov (United States)

    Gehle, Kimberly S; Crawford, Jewel L; Hatcher, Michael T

    2011-10-01

    Although environmental factors contribute to more than 25% of all global disease, and toxic agents ranked fifth in underlying causes of U.S. deaths in 2000, environmental medicine education is largely omitted in the continuum of U.S. medical education. The paucity of specialists trained in environmental medicine (i.e., occupational medicine and other preventive medicine specialties and subspecialties), coupled with the lack of adequate general medical education on how to prevent, diagnose, refer, or treat patients exposed to hazardous substances in the environment, contributes to lost opportunities for primary prevention or early intervention to mitigate or minimize environmentally related disease burden. Survey findings of graduating medical students over the past few years have identified environmental health as a medical school topic area that can be improved. This article reflects a panel presentation on the challenge of including environmental health in general medical education. It was given at the 2010 "Patients and Populations: Public Health in Medical Education" conference cosponsored by the CDC and the American Association of Medical Colleges. A variety of educational strategies, models, and educational resources are presented that illustrate how recommended competency-based environmental health content can be integrated into medical education to better prepare medical students and physicians without specialized expertise in environmental medicine to provide or facilitate environmental preventive or curative patient care.

  18. Mental health of dubai medical college students.

    Science.gov (United States)

    Ahmadi, Jamshid; Galal Ahmed, Mohammed; Ali Bayoumi, Fatehia; Abdul Moneenum, Abeer; Alshawa, Haya

    2012-01-01

    Considering the association between medical school dropout and psychiatric distress, we aimed to assess the prevalence of psychiatric distress among medical students at Dubai Medical College. One hundred and three medical students were chosen randomly and were assessed by the General Health Questionnaire (GHQ). The mean age for the students was 18.85 year (Minimum: 17, Maximum: 22), and 90.3% were between 18 and 20 years old. The mean of GHQ score was 16.46. Of the participants, 47 (45.6%) were found to be in normal range (GHQ mean College students reported a significant level of psychiatric distress, however, it should not be underestimated, and actions should be taken to encourage Dubai Medical College students to get help from for psychiatric services for their emotional problems. The risk factors as well as the protective factors must be identified in nation-wide studies to promote mental health of medical students.

  19. Enabling medication management through health information technology (Health IT).

    Science.gov (United States)

    McKibbon, K Ann; Lokker, Cynthia; Handler, Steve M; Dolovich, Lisa R; Holbrook, Anne M; O'Reilly, Daria; Tamblyn, Robyn; J Hemens, Brian; Basu, Runki; Troyan, Sue; Roshanov, Pavel S; Archer, Norman P; Raina, Parminder

    2011-04-01

    questions. Study quality varied according to phase of medication management. Substantially more studies, and studies with stronger comparative methods, evaluated prescribing and monitoring. Clinical decision support systems (CDSS) and computerized provider order entry (CPOE) systems were studied more than any other application of MMIT. Physicians were more often the subject of evaluation than other participants. Other health care professionals, patients, and families are important but not studied as thoroughly as physicians. These nonphysicians groups often value different aspects of MMIT, have diverse needs, and use systems differently. Hospitals and ambulatory clinics were well-represented in the literature with less emphasis placed on long-term care facilities, communities, homes, and nonhospital pharmacies. Most studies evaluated changes in process and outcomes of use, usability, and knowledge, skills, and attitudes. Most showed moderate to substantial improvement with implementation of MMIT. Economics studies and those with clinical outcomes were less frequently studied. Those articles that did address economics and clinical outcomes often showed equivocal findings on the effectiveness and cost-effectiveness of MMIT systems. Qualitative studies provided evidence of strong perceptions, both positive and negative, of the effects of MMIT and unintended consequences. We found little data on the effects of forms of medications, conformity, standards, and open source status. Much descriptive literature discusses implementation issues but little strong evidence exists. Interest is strong in MMIT and more groups and institutions will implement systems in the next decades, especially with the Federal Government's push toward more health IT to support better and more cost-effective health care. MMIT is well-studied, although on closer examination of the literature the evidence is not uniform across phases of medication management, groups of people involved, or types of MMIT

  20. [Medical care for Russian cosmonauts' health on the ISS].

    Science.gov (United States)

    Bogomolov, V V; Kozlovskaia, I B; Alferova, I V; Egorov, A D; Kovachevich, I V

    2008-01-01

    Established with the personal participation of O.G. Gazenko, the Russian system of medical care for cosmonauts' health has been largely preserved till this day. The system was fully functional on board the orbital complex MIR and, with appropriate modifications, has been adopted as a core of the medical care for Russian members of the ISS crews. In the period of 2000-2008, 22 cosmonauts were members of 17 ISS increments from 140 to 216 days in duration. The main functions of the medical care system were to control health, physical and mental performance, and to support implementation of space researches. The flow of readaptation to the normal gravity was, in most cases similar to what has been typical on return from the Russian orbital stations; some deviations are accounted for by application of the in-flight countermeasures. The paper familiarizes reader with some aspects of the theoretical work of academician O.G. Gazenko in the field of medical care in space flight. It outlines the principles of ISS medical management. The integrated medical support system combines medical equipment and items available on the Russian and US segments; the integrated medical group consists of flight surgeons, medical experts and biomedical engineers of the international partners and coordinates planning and implementation of medical operations. Also, challenges of health care on the phase of ISS utilization are defined.

  1. 76 FR 68198 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2011-11-03

    ... Administration Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage... designated as primary medical care, mental health, and dental health professional shortage areas (HPSAs) as... seven health professional types (primary medical care, dental, psychiatric, vision care,...

  2. Child Health and Access to Medical Care

    Science.gov (United States)

    Leininger, Lindsey; Levy, Helen

    2015-01-01

    It might seem strange to ask whether increasing access to medical care can improve children's health. Yet Lindsey Leininger and Helen Levy begin by pointing out that access to care plays a smaller role than we might think, and that many other factors, such as those discussed elsewhere in this issue, strongly influence children's health.…

  3. Stress and mental health among medical students

    Directory of Open Access Journals (Sweden)

    Backović Dušan V.

    2013-01-01

    Full Text Available Introduction. Medical studies bring many stressful activities to students. Prolonged stress can make adverse effects to mental health and lead to further professional burnout. Objective. The aim of this study was to assess the association of stress impact and adverse effects of medical studies with psychological distress among medical students. Methods. The cross sectional study was conducted on 367 fourth­year medical students of the Faculty of Medicine in Belgrade, by means of the anonymous questionnaire, containing: socio­demographic data, self­reported health status and stressful influences of studying activities. Mental health status was estimated by General Health Questionnaire (GHQ­12. Results. More than 50% of students perceive frequent feeling of psychic tension, and one third has problems with insomnia. Nearly one­half of students assessed their general stress level as moderate or high. Exams were estimated as high stressor in 63.1% of all students. Stressful effects of communication with teaching staff were reported by one quarter of the examinees. The scores of GHQ­12 were above the threshold in 55.6 % of all students. Mental health problems among students were most significantly associated with stressful experience during exams and contacts with teaching staff. Conclusion. Academic stress makes great influence on mental health of medical students. Reduction of stress effects should be directed to optimization of the examination process and improvement of communication skills. [Projekat Ministarstva nauke Republike Srbije, br. OI 175078

  4. Conceptualizing violence for health and medical geography.

    Science.gov (United States)

    DeVerteuil, Geoffrey

    2015-05-01

    Despite the fact that violence is a major threat to public health, the term itself is rarely considered as a phenomenon unto itself, and rarely figures explicitly in work by health and medical geographers. In response, I propose a definitionally and conceptually more robust approach to violence using a tripartite frame (interpersonal violence, structural violence, mass intentional violence) and suggest critical interventions through which to apply this more explicit and conceptually more robust approach: violence and embodiment via substance abuse in health geography, and structural violence via mental illness in medical geography.

  5. Views on group simulation in an integrated medical curriculum

    OpenAIRE

    Salaria M; Oyewole T; Shah S

    2017-01-01

    Mariam Salaria, Tobi Oyewole, Sundes ShahUniversity of Liverpool, School of Medicine, Liverpool, UKWe read with great interest the article by Ginzburg et al,1 regarding small group simulation with debrief, for first and second year medical students. Having completed four years at Liverpool Medical School, we agree that small group simulation assists in consolidating the knowledge of basic sciences. The article states that the majority of students agree that simulation followed by a debrief, i...

  6. Medical marijuana: a public health perspective

    Directory of Open Access Journals (Sweden)

    Ushang Desai

    2013-04-01

    Full Text Available Over the few years medical marijuana is growing in the United States. Because of the medical marijuana legislators able to legalized recreational marijuana in the two states in the US. Marijuana has several potential benefits that help in certain disease. The delivery of marijuana is also important because smoking marijuana has severe side effects. Physicians also play important role in medical marijuana, physicians also divided on the use of medical marijuana. Their attitude towards medical marijuana important for the treatment of disease is important for the community. Marijuana is the most commonly used illegal drug in the US and all over world, several risks associated with it. Major concern is medical marijuana increased the use of marijuana and will create the public health problem in the society. There are several medical benefits from the marijuana but require more research to establish the marijuana as a medicine. Control of medical marijuana is also major issue for the law enforcement agencies and challenge for policymakers also in the United States. [Int J Basic Clin Pharmacol 2013; 2(2.000: 136-143

  7. Occupational health and safety in medical museums.

    Science.gov (United States)

    Westhorpe, R N

    2008-07-01

    Medical museum collections provide challenges in occupational health and safety that do not become apparent in many other collections. During the recent development of the Geoffrey Kaye Museum of the Australian and New Zealand College of Anaesthetists, these challenges were addressed, following the guidelines of the Occupational Health and Safety Regulations of the State of Victoria. This paper details these regulations and their necessary application in this specialist museum.

  8. Academic Medical Centers as digital health catalysts.

    Science.gov (United States)

    DePasse, Jacqueline W; Chen, Connie E; Sawyer, Aenor; Jethwani, Kamal; Sim, Ida

    2014-09-01

    Emerging digital technologies offer enormous potential to improve quality, reduce cost, and increase patient-centeredness in healthcare. Academic Medical Centers (AMCs) play a key role in advancing medical care through cutting-edge medical research, yet traditional models for invention, validation and commercialization at AMCs have been designed around biomedical initiatives, and are less well suited for new digital health technologies. Recently, two large bi-coastal Academic Medical Centers, the University of California, San Francisco (UCSF) through the Center for Digital Health Innovation (CDHI) and Partners Healthcare through the Center for Connected Health (CCH) have launched centers focused on digital health innovation. These centers show great promise but are also subject to significant financial, organizational, and visionary challenges. We explore these AMC initiatives, which share the following characteristics: a focus on academic research methodology; integration of digital technology in educational programming; evolving models to support "clinician innovators"; strategic academic-industry collaboration and emergence of novel revenue models. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Population Health Implications of Medical Tourism.

    Science.gov (United States)

    Adabi, Kian; Stern, Carrie S; Weichman, Katie E; Garfein, Evan S; Pothula, Aravind; Draper, Lawrence; Tepper, Oren M

    2017-07-01

    Fifteen million U.S. patients each year seek medical care abroad; however, there are no data on outcomes and follow-up of these procedures. This study aims to identify, evaluate, and survey patients presenting with complications from aesthetic procedures abroad and estimate their cost to the U.S. health care system. A single-center retrospective review was conducted. A cohort of patients presenting with complications from aesthetic procedures performed abroad was generated. Demographic, complication, and cost data were compiled. Patients were surveyed to assess their overall experience. Over a 36-month period, 42 patients met inclusion criteria (one man and 41 women), with an average age of 35 ± 11.4 years (range, 20 to 60 years). Comorbidities included four active smokers, two patients with hypertension, and one patient with diabetes. Average body mass index was 29 ± 4.4 kg/m (range, 22 to 38 kg/m). Procedures performed abroad included abdominoplasty (n = 28), liposuction (n = 20), buttock augmentation (n = 10), and breast augmentation (n = 7), with several patients undergoing combined procedures. Eleven patients presented with abscesses and eight presented with wound dehiscence. Eight of the 18 patients who were surveyed were not pleased with their results and 11 would not go abroad again for subsequent procedures. Average cost of treating the complications was $18,211, with an estimated cost to the U.S. health care system of $1.33 billion. The main payer group was Medicaid. Complications from patients seeking aesthetic procedures abroad will continues to increase. Patients should be encouraged to undergo cosmetic surgery in the United States to improve patient outcomes and satisfaction and because it is economically advantageous. Therapeutic, IV.

  10. Financing and cash flow management for the medical group practice.

    Science.gov (United States)

    Bert, Andrew J

    2008-01-01

    The expansion of a medical group practice and the addition of ancillary services require a substantial cash outlay. Obtaining proper financing to complete a successful expansion is a process that takes time, and there are critical steps that must be followed. The group's business objectives must be presented properly by developing a business plan detailing the practice and goals associated with the desired expansion. This article discusses some of the key elements that are essential in creating an overall effective business plan for the group medical practice.

  11. Can eHealth Reduce Medical Expenditures of Chronic Diseases?

    Science.gov (United States)

    Tsuji, Masatsugu; Taher, Sheikh Abu; Kinai, Yusuke

    2015-01-01

    The objective of this research is to evaluate empirically the effectiveness of eHealth in Nishi-aizu Town, Fukushima Prefecture, based on a mail survey to the residents and their receipt data of National Health Insurance from November 2006 to February 2007. The residents were divided into two groups, users and non-users, and sent questionnaires to ask their characteristics or usage of the system. Their medical expenditures paid by National Health Insurance for five years from 2002 to 2006 are examined. The effects were analyzed by comparison of medical expenditures between users and non-users. The interests are focused on four chronic diseases namely heart diseases, high blood pressure, diabetes, and strokes. A regression analysis is employed to estimate the effect of eHealth to users who have these diseases and then calculate the monetary effect of eHealth on reduction of medical expenditures. The results are expected to be valid for establishment of evidence-based policy such as reimbursement from medical insurance to eHealth.

  12. Improving aquaaerobics as means of hydrorehabilitation of students of special medical groups.

    Directory of Open Access Journals (Sweden)

    Balamutova N.M.

    2011-02-01

    Full Text Available The questions which concern with estimate of implementation of aquaaerobics in an educational process of physical culture of students with weakened health were examined. In experiment took place 76 students of Law Academy. The data that were used in this research were taken from a questionnaire survey that was made among students, analysis of methodological literature and own practical experience. The experimental program of aquaaerobical studies with students of special medical group was developed .The analysis of students quantity of special medical groups which attended physical training studies showed that aquaaerobisc appeared no less attractive then medical swimming.

  13. Group processes in medical education: learning from social identity theory.

    Science.gov (United States)

    Burford, Bryan

    2012-02-01

    The clinical workplace in which doctors learn involves many social groups, including representatives of different professions, clinical specialties and workplace teams. This paper suggests that medical education research does not currently take full account of the effects of group membership, and describes a theoretical approach from social psychology, the social identity approach, which allows those effects to be explored. The social identity approach has a long history in social psychology and provides an integrated account of group processes, from the adoption of group identity through a process of self-categorisation, to the biases and conflicts between groups. This paper outlines key elements of this theoretical approach and illustrates their relevance to medical education. The relevance of the social identity approach is illustrated with reference to a number of areas of medical education. The paper shows how research questions in medical education may be usefully reframed in terms of social identity in ways that allow a deeper exploration of the psychological processes involved. Professional identity and professionalism may be viewed in terms of self-categorisation rather than simply attainment; the salience of different identities may be considered as influences on teamwork and interprofessional learning, and issues in communication and assessment may be considered in terms of intergroup biases. Social identity theory provides a powerful framework with which to consider many areas of medical education. It allows disparate influences on, and consequences of, group membership to be considered as part of an integrated system, and allows assumptions, such as about the nature of professional identity and interprofessional tensions, to be made explicit in the design of research studies. This power to question assumptions and develop deeper and more meaningful research questions may be increasingly relevant as the nature and role of the medical profession change

  14. Virtual health platform for medical tourism purposes.

    Science.gov (United States)

    Martinez, Debora; Ferriol, Pedro; Tous, Xisco; Cabrer, Miguel; Prats, Mercedes

    2008-01-01

    This paper introduces an overview of the Virtual Health Platform (VHP), an alternative approach to create a functional PHR system in a medical tourism environment. The proposed platform has been designed in order to be integrated with EHR infrastructures and in this way it expects to be useful and more advantageous to the patient or tourist. Use cases of the VHP and its potential benefits summarize the analysis.

  15. Constitutional rights to health, public health and medical care: the status of health protections in 191 countries.

    Science.gov (United States)

    Heymann, Jody; Cassola, Adèle; Raub, Amy; Mishra, Lipi

    2013-07-01

    United Nations (UN) member states have universally recognised the right to health in international agreements, but protection of this right at the national level remains incomplete. This article examines the level and scope of constitutional protection of specific rights to public health and medical care, as well as the broad right to health. We analysed health rights in the constitutions of 191 UN countries in 2007 and 2011. We examined how rights protections varied across the year of constitutional adoption; national income group and region; and for vulnerable groups within each country. A minority of the countries guaranteed the rights to public health (14%), medical care (38%) and overall health (36%) in their constitutions in 2011. Free medical care was constitutionally protected in 9% of the countries. Thirteen per cent of the constitutions guaranteed children's right to health or medical care, 6% did so for persons with disabilities and 5% for each of the elderly and the socio-economically disadvantaged. Valuable next steps include regular monitoring of the national protection of health rights recognised in international agreements, analyses of the impact of health rights on health outcomes and longitudinal multi-level studies to assess whether specific formulations of the rights have greater impact.

  16. Expanding Group Peer Review: A Proposal for Medical Education Scholarship.

    Science.gov (United States)

    Dumenco, Luba; Engle, Deborah L; Goodell, Kristen; Nagler, Alisa; Ovitsh, Robin K; Whicker, Shari A

    2017-02-01

    After participating in a group peer-review exercise at a workshop presented by Academic Medicine and MedEdPORTAL editors at the 2015 Association of American Medical Colleges Medical Education Meeting, the authors realized that the way their work group reviewed a manuscript was very different from the way by which they each would have reviewed the paper as an individual. Further, the group peer-review process yielded more robust feedback for the manuscript's authors than did the traditional individual peer-review process. This realization motivated the authors to reconvene and collaborate to write this Commentary to share their experience and propose the expanded use of group peer review in medical education scholarship.The authors consider the benefits of a peer-review process for reviewers, including learning how to improve their own manuscripts. They suggest that the benefits of a team review model may be similar to those of teamwork and team-based learning in medicine and medical education. They call for research to investigate this, to provide evidence to support group review, and to determine whether specific paper types would benefit most from team review (e.g., particularly complex manuscripts, those receiving widely disparate initial individual reviews). In addition, the authors propose ways in which a team-based approach to peer review could be expanded by journals and institutions. They believe that exploring the use of group peer review potentially could create a new methodology for skill development in research and scholarly writing and could enhance the quality of medical education scholarship.

  17. Views on group simulation in an integrated medical curriculum

    Directory of Open Access Journals (Sweden)

    Salaria M

    2017-03-01

    Full Text Available Mariam Salaria, Tobi Oyewole, Sundes ShahUniversity of Liverpool, School of Medicine, Liverpool, UKWe read with great interest the article by Ginzburg et al,1 regarding small group simulation with debrief, for first and second year medical students. Having completed four years at Liverpool Medical School, we agree that small group simulation assists in consolidating the knowledge of basic sciences. The article states that the majority of students agree that simulation followed by a debrief, illustrated the clinical relevance of basic sciences. What is more, students felt that these practices provided chances for direct application of scientific knowledge, as well as simulating real world experience. The development of clinical reasoning was also noted, and as medical students ourselves, we agree that this aspect is cemented by simulation scenarios.View the original paper by Ginzburg and colleagues.

  18. Health and medical care in Ethiopia.

    Science.gov (United States)

    Hodes, R M; Kloos, H

    1988-10-01

    Ethiopia is a country of 45 million people in northeast Africa. With a stagnant, agriculture-based economy and a per capita gross national product of $110 in 1984, it is one of the world's poorest nations. 70% of the children are mildly to severely malnourished, and 25.7% of children born alive die before the age of 5. Life expectancy is 41 years. The population is growing at the rate of 2.9%/year, but only 2% of the people use birth control. After the 1974 revolution, the socialist government nationalized land and created 20,000 peasant associations and kebeles (urban dwellers' associations), which are the units of local government. The government has set ambitious goals for development in all sectors, including health, but famine, near famine, forced resettlement programs, and civil war have prevented any real progress from being made. The government's approach to health care is based on an emphasis on primary health care and expansion of rural health services, but the Ministry of Health is allocated only 3.5% of the national budget. Ethiopia has 3 medical schools -- at Addis Ababa, Gondar, and the Jimma Institute of Health Sciences. Physicians are government employees but also engage in private practice. A major problem is that a large proportion of medical graduates emigrate. Ethiopia has 87 hospitals with 11,296 beds, which comes to 1 bed per 3734 people. There are 1949 health stations and 141 health centers, but many have no physician, and attrition among health workers is high due to lack of ministerial support. Health care is often dispensed legally or illegally by pharmacists. Overall, there is 1 physician for 57,876 people, but in the southwest and west central Ethiopia 1 physician serves between 200,000 and 300,000 people. In rural areas, where 90% of the population lives, 85% live at least 3 days by foot from a rural health unit. Immunization of 1-year olds against tuberculosis, diphtheria-pertussis-tetanus, poliomyelitis, and measles is 11, 6, 6, and

  19. Medical Student Perspectives of Active Learning: A Focus Group Study.

    Science.gov (United States)

    Walling, Anne; Istas, Kathryn; Bonaminio, Giulia A; Paolo, Anthony M; Fontes, Joseph D; Davis, Nancy; Berardo, Benito A

    2017-01-01

    Phenomenon: Medical student perspectives were sought about active learning, including concerns, challenges, perceived advantages and disadvantages, and appropriate role in the educational process. Focus groups were conducted with students from all years and campuses of a large U.S. state medical school. Students had considerable experience with active learning prior to medical school and conveyed accurate understanding of the concept and its major strategies. They appreciated the potential of active learning to deepen and broaden learning and its value for long-term professional development but had significant concerns about the efficiency of the process, the clarity of expectations provided, and the importance of receiving preparatory materials. Most significantly, active learning experiences were perceived as disconnected from grading and even as impeding preparation for school and national examinations. Insights: Medical students understand the concepts of active learning and have considerable experience in several formats prior to medical school. They are generally supportive of active learning concepts but frustrated by perceived inefficiencies and lack of contribution to the urgencies of achieving optimal grades and passing United States Medical Licensing Examinations, especially Step 1.

  20. Group counseling for medical students with drop-out experiences.

    Science.gov (United States)

    Kim, Eun Kyung; Baek, Sunyong; Woo, Jae Seok; Im, Sun Ju; Lee, Sun Hee; Kam, Beesung; Lee, Sang Yeoup; Yun, So Jung

    2013-03-01

    The purpose of this research was to describe our group counseling methods for medical students with drop-out experiences. Group counseling was offered to 11 medical students with drop-out experiences in their previous second semester. All subjects provided written informed consent before participating and completed a 2-day group counseling program using the Gestalt approach. The self-assertiveness training group counseling program consisted of 6 sessions, each of which lasted 90 minutes. Experience reports by participants after the program and data from semi-structured qualitative interviews were qualitatively analyzed. Program participants reported that they were moderately satisfied with the program regarding its usefulness and helpfulness on self-awareness, understanding, and reminding them of attempts to change behavior. Most students showed heightened levels of sincerity perceptions and positive attitudes in every session. The results demonstrated significant changes in experience in self-esteem, self-recognition, and interpersonal relationships. A group counseling program using the Gestalt approach could help medical students with drop-out experiences to adjust with 1 year their juniors, enhance their self-esteem, contribute to their psychological well-being, and prevent student re-failure through effective stress management and improved interpersonal relationships.

  1. A suicide prevention advisory group at an academic medical center.

    Science.gov (United States)

    Hough, David; Lewis, Philip

    2010-05-01

    During a 15-month period, there were seven suicides among patients who were in active treatment or who had been seen recently by providers in the Department of Psychiatry of Tripler Army Medical Center, Honolulu, Hawaii. As a result, a Suicide Prevention Advisory Group (SPAG) was formed to identify possible causes and make recommendations aimed at improving the identification and treatment of suicidal patients. The group made 11 specific recommendations. No known suicides occurred during the 22 months after the implementation of the Suicide Prevention Advisory Group's recommendations.

  2. Medical Students' Perceptions and Preferences for Sexual Health Education

    Science.gov (United States)

    Zamboni, Brian; Bezek, Katelyn

    2017-01-01

    Sexual health topics are not well-covered in US medical schools. Research has not typically asked medical students what sexual health topics they would like addressed and their preferred methods of sexual health education. This study attempted to address this deficit via an online survey of medical students at an institution where little sexual…

  3. Medical and Para-Medical Personnel’ Perspectives on Home Health Care Technology

    Directory of Open Access Journals (Sweden)

    Vera Stara

    2017-06-01

    Full Text Available User-based research is strongly recommended in design for older adults. The aim of this paper is to focus the attention on the poorly explored role of medical and para-medical personnel’s perspective on home health care technologies using data that have been gained during the “Active Ageing At Home” (AA@H project. A focus group was organized at the National Institute of Health & Science on Ageing (INRCA in Italy. Results demonstrate that several challenges deserve a stronger effort by the whole research sector on ageing and technology: (1 a leading role of the participatory design process; (2 the assessment of the added value of health technologies through robust methods; (3 the definition of an unique identity and well established practices among disciplines; (4 the creation of favorable prerequisites and conditions to the technology uptake.

  4. A psychodrama group for health workers.

    Science.gov (United States)

    Costa, J; Walsh, S

    Although much has been written about psychodrama as a therapeutic and educational method with patients, there is little evidence of its effectiveness as an activity for professional clinicians. The authors describe how the basic elements, phases and techniques of psychodrama have been used with groups of health workers to improve their clinical performance and personal life. The therapy has important applications in helping staff come to terms with the emotional stresses of their work with patients.

  5. The Group Oral Health Movement in Brazil.

    Science.gov (United States)

    Soares, Catharina Leite Matos; Paim, Jairnilson Silva; Chaves, Sonia Cristina de Lima; Rossi, Thais Regis Aranha; Barros, Sandra Garrido; Cruz, Denise Nogueira

    2017-06-01

    Group Oral Health (GOH) is a specific phenomenon in time, separate from other "Alternative Odontology", and a theoretical reference for dental practice in healthcare services. This study is an attempt to understand how long "Alternative Odontology" will remain with the social context of struggling for oral health in Brazil, based on the positions of the founding agents and their precursors, bearing in mind the concepts of GOH, GH (Group Health) and the SUS (Unified Healthcare System). We started out with Pierre Bourdieu's Practice Theory, complemented with Gramsci's concept of hegemony and counter-hegemony. We completed 12 in-depth interviews, reviewed the literature and analyzed the scientific output. We also looked at the trajectories of the agents and their capital between 1980 and 2013. The results show that the concept of GOC and GH as a breach with health practices, which gave rise to "Alternative Odontology", prevailed among those with the political will to defend democracy and Healthcare Reforms. Although GOC is a critical proposal, the older "Odontology" remains in scientific journals, and in the practice of oral care.

  6. Education in Biomedical and Health Informatics in the Web 3.0 Era: Standards for data, curricula, and activities. Contribution of the IMIA Working Group on Health and Medical Informatics Education.

    Science.gov (United States)

    Otero, P; Hersh, W

    2011-01-01

    Web 3.0 is transforming the World Wide Web by allowing knowledge and reasoning to be gleaned from its content. Describe a new scenario in education and training known as "Education 3.0" that can help in the promotion of learning in health informatics in a collaborative way. Review of the current standards available for curricula and learning activities in in Biomedical and Health Informatics (BMHI) for a Web 3.0 scenario. A new scenario known as "Education 3.0" can provide open educational resources created and reused throughout different institutions and improved by means of an international collaborative knowledge powered by the use of E-learning. Currently there are standards that could be used in identifying and deliver content in education in BMHI in the semantic web era such as Resource Description Format (RDF), Web Ontology Language (OWL) and Sharable Content Object Reference Model (SCORM). In addition, there are other standards to support healthcare education and training. There are few experiences in the use of standards in e-learning in BMHI published in the literature. Web 3.0 can propose new approaches to building the BMHI workforce so there is a need to build tools as knowledge infrastructure to leverage it. The usefulness of standards in the content and competencies of training programs in BMHI needs more experience and research so as to promote the interoperability and sharing of resources in this growing discipline.

  7. 'Redefining health care': medical homes or archipelagos to navigate?

    Science.gov (United States)

    Enthoven, Alain C; Crosson, Francis J; Shortell, Stephen M

    2007-01-01

    This paper provides an analysis of the structure of the health care delivery system, emphasizing physician group practices. The authors argue for comprehensive integrated delivery systems (IDSs). The jumping-off point for their analysis is the recently published Redefining Health Care: Creating Value-Based Competition on Results, by Michael Porter and Elizabeth Teisberg. The authors focus on the book's core idea that competitors should be freestanding integrated practice units (or "islands in archipelagos") versus IDSs (or "medical homes"). In any case, the authors contend that this issue should be resolved by competition to attract and serve informed, cost-conscious, responsible consumers on a level playing field.

  8. Why employees resist change in medical group practice acquisitions.

    Science.gov (United States)

    Fabrizio, N

    1999-01-01

    Understanding employees' values and considerations is important in undergoing major organizational change. This research provides an insight of the business and financial aspects vs. the human relations aspects of acquiring a medical group practice. The five employees interviewed in this analysis provide insight as to the factors that employees consider in resisting change. Considering how employees feel through communicating will have a significant impact on efficiency, effectiveness and turnover.

  9. Comparing Medical and Recreational Cannabis Users on Socio-Demographic, Substance and Medication Use, and Health and Disability Characteristics.

    Science.gov (United States)

    Goulet-Stock, Sybil; Rueda, Sergio; Vafaei, Afshin; Ialomiteanu, Anca; Manthey, Jakob; Rehm, Jürgen; Fischer, Benedikt

    2017-01-01

    While recreational cannabis use is common, medical cannabis programs have proliferated across North America, including a federal program in Canada. Few comparisons of medical and recreational cannabis users (RCUs) exist; this study compared these groups on key characteristics. Data came from a community-recruited sample of formally approved medical cannabis users (MCUs; n = 53), and a sub-sample of recreational cannabis users (RCUs; n = 169) from a representative adult survey in Ontario (Canada). Samples were telephone-surveyed on identical measures, including select socio-demographic, substance and medication use, and health and disability measures. Based on initial bivariate comparisons, multivariate logistical regression with a progressive adjustment approach was performed to assess independent predictors of group status. In bivariate analyses, older age, lower household income, lower alcohol use, higher cocaine, prescription opioid, depression and anxiety medication use, and lower health and disability status were significantly associated with medical cannabis use. In the multivariate analysis, final model, household income, alcohol use, and disability levels were associated with medical cannabis use. Conclusions/Scientific Significance: Compared to RCUs, medical users appear to be mainly characterized by factors negatively influencing their overall health status. Future studies should investigate the actual impact and net benefits of medical cannabis use on these health problems. © 2017 S. Karger AG, Basel.

  10. Health literacy: a barrier to pharmacist-patient communication and medication adherence.

    Science.gov (United States)

    Ngoh, Lucy Nkukuma

    2009-01-01

    To present a summary of the existing literature on medication nonadherence, health literacy, and use of written patient information in health care and pharmacy in particular. Searches of Medline, PubMed, and International Pharmaceutical Abstracts databases were conducted using one or more of the following terms: adherence/nonadherence, compliance/noncompliance, printed/written information, literacy, patient education, communication, and health literacy. These terms were combined with the following search terms: drug information, readability, medication/drug, patient, pharmacy/pharmacist, and prescription. References of pertinent articles were hand searched to retrieve additional articles. By the author. Articles were grouped and summarized into three broad categories (nonadherence, health literacy, and communicating health information to patients), with an emphasis on the use of written patient information in health care and pharmacy practice in particular. The complexities inherent in nonadherence behavior, health literacy, and patient education are summarized, and suggestions for enhancing medication adherence, especially for patients with low health literacy skills, are provided. The health literacy skills of American adults have not changed considerably during the previous decade. This makes use of written patient medication information in pharmacy practice problematic for some patients. Limited health literacy has been associated with poorer health, medication nonadherence, medication errors, higher medical expenses, and increased hospitalization. A need exists for identifying patients with limited health literacy and tailoring medication counseling to their needs.

  11. [Health status and medical care accessibility of single, homeless persons].

    Science.gov (United States)

    Trabert, G

    1997-06-01

    The homeless population in Germany is continually increasing. Featuring prominently among those on the increase are women, young persons and homeless people from East Germany. Studies of the health of homeless individuals in recent years show that indices of illness are far higher for many disorders than for comparable groups who are housed. One result from a recent study by the University of Mainz (1994) was that more than 90% of homeless people urgently need medical treatment. According this research, the main health problems of the homeless are: cardiac disease (hypertension, CAD) (52.5%), skin disease (scabies, lice, leg ulcers, abscesses, pyodermias) and acute infections (50%), lower respiratory tract (COAD) (47.5%) and trauma victims (50%), followed by liver (30%), kidney (25%) and gastrointestinal diseases (GU) (20%). The problems of alcoholism and mental disorders of various sorts are added to this picture. Violence to homeless people is increasing. A lot of homeless people are multi-morbid. The relationship between the time of homelessness and the state of illness was not linear. It was found that in the beginning of homelessness most of the homeless people were in a poor physical condition. The poor physical condition of homeless people does not stem from only one cause, but results from a combination of different factors: individual social conditions (social class; social relations; sedentary lifestyle), personal or family life crisis (life events and coping behaviour), the individual risk behaviour (for instance the bizarre sleeping accommodations, alcohol and cigarette consumption unemployment in a depressed economy, structure of the society (cutbacks in government welfare and social service programmes). As a result of bad experiences with existing medical institutions, homeless persons do not consult the doctor or too late. Many are afraid of large institutions; most are not members of a health insurance scheme (uninsured); and many are perceived in

  12. Benchmarking medical group practices using claims data: methodological and practical problems.

    Science.gov (United States)

    Dove, H G; Greene, B R

    2000-10-01

    As claims data for physicians and groups of physicians has improved in quality and quantity, health information vendors have begun marketing information about medical groups' productivity, utilization, and quality. Based on interviews with product developers and our understanding of the evolution of their products, several methodological and practical issues remain. For now and the immediate future, health information vendors will continue to face the limitations of physicians' claims data. Vendors and purchasers should be aware of common data shortcomings such as inadequate monthly enrollment figures, possible physician upcoding to circumvent utilization management restrictions, and incorrect coding when a test is used to rule out a disease. In the longer term, several avenues seem likely to make medical groups' data better and richer because of computer-based medical records and efficiencies possible from the Internet. The field of benchmarking products for group practices is still an immature market. However, several trends suggest such products are highly desirable. Provider organizations which bear medical risk need benchmarking data to help improve their efficiency. There are many important nonprovider organizations that need good information on group practices' utilization patterns and outcomes to help them plan new products and negotiate with physicians.

  13. Mental ill health in the elderly: medical students’ social representations in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Bruno Medeiros

    2014-12-01

    Full Text Available Objective This study aims to explore medical students’ social representations of mental ill health in older adults. Method It comprises an exploratory and qualitative investigation based on the theory of social representations. Two focus groups with pre-clinical medics (group 1, N=4; group 2, N=4 and 10 individual interviews with clinical medical students were conducted. Thematic analysis at a latent level explored meanings and differences between groups. Results Three overarching themes reflect participants’ representations of mental health problems in later life – mental ill health in old age, polarisation of care, and challenges to care. Primary health care appears as an important strategy to overcome barriers to mental health care in the community. Nevertheless, disqualifying representations, stigma and organization of services constitute the main challenges to quality mental health care in later life. Conclusion This paper highlights the need to address cultural and organizational barriers to promote quality care.

  14. On Rural Medical Care and Health Undertaking Development during New Medical Reform

    Institute of Scientific and Technical Information of China (English)

    ZHAO Yi-huan

    2012-01-01

    Based on in-depth survey of township hospitals in Lushan County of Henan Province, this paper studies the development situations of rural medical care and health undertaking in the course of new medical reform. Results show that both rural medical institution and public health undertaking have considerable development in this course. Working capital situation gradually turns better. However, there are still problems and challenge of shortage of high quality medical care personnel, lack of employment mechanism, poor medical environment, and imperfect bidding and purchasing system of medicines. To further develop rural medical situation, it should improve medical environment, speed up informationization construction, and give prominence to functional orientation.

  15. Influence of the Exercise-psychology Adjustment Mode on the Mental Health of Medical Workers.

    Science.gov (United States)

    Xu, Wenxin; Ceng, Mengjuan; Yao, Jiwei; Chen, Longfei

    2017-06-01

    Chinese medical workers suffer from a high incidence of mental health problems, resulting in reduced efficiency, increased medical malpractice, rising medical costs, and other issues. The effective alleviation of mental health problems among medical workers is therefore an important focus of research and social attention. The mental health of 842 medical workers from the First Affiliated Hospital of Fujian Medical University and the Second Affiliated Hospital of Fujian Medical University in Fuzhou, China was evaluated between February 2016 and March 2016. Sixty-two workers with positive SCL-90 screening results were selected as the subjects to be investigated in the intervention experiment, with 31 in the intervention group and 31 in the control group. The control group did not participate in any regular physical exercise activity for the 4-month duration of the study, whereas the exercise-psychology adjustment mode was applied to the intervention group. Medical workers had a higher total SCL-90 score and number of positive items than the national norm (P medical workers, should be a matter of societal focus. The exercise-psychology adjustment is an effective intervention mode for the mental health of medical workers.

  16. Focus groups: a strategy for health research

    Directory of Open Access Journals (Sweden)

    Maria da Graça Kfouri LOPES

    2010-06-01

    Full Text Available Introduction: The research strategy through open interviews is a qualitative alternative that can capture the meaning embedded in opinions expressed, revealing values and feelings of the research subjects. As a constructivist method it requires the interpretative analysis of the speech. Data collection requires pragmatism from the researcher and absence of stimuli that might induce or inhibit the interviewees. Objective: This study had the following proposals: a to implement the strategy of focus groups as part of the evaluation of the Qualitative Methods discipline in a stricto sensu course; b to search the criteria that determine the patient’s choice of dental professional.Material and methods: In order to achieve the objectives of the research,an exercise was carried out aimed at understanding the content of focus groups through active learning methodology based on the experience and binomial action-reflection. The activity was developed under the theme “Determinants in the relationship established between the dental professional and their patients”, according to the patients’ opinions.The group that coordinated the activity consisted of four dentists,students of the Qualitative Methods discipline, who played the following roles: a mediator; b reporter; c observer; d recording operator.The discussion group was composed of six (N = 6 volunteers from a total of 20 students enrolled in this discipline. The exclusion criteria included those with private dental plans and/or the exclusive users of public health services. The recording was transcribed and submitted to content analysis. To this end the ATLAS.ti 5.0 computer program was used. Results: Patients select the dental professional according to the references they get from others. The personal relationship was highly valued by the group, reinforcing the skills and abilities of sensitivity and commitment to the human being presented in the text of the National Curriculum Guidelines

  17. English for Medical Purposes for Saudi Medical and Health Professionals

    Directory of Open Access Journals (Sweden)

    Fahad Alqurashi

    2016-12-01

    Full Text Available This study explored the English language needs of 156 Saudi fellowship doctors and students of medical majors who are enrolled at medical and training programs in Australian hospitals and universities. Data were collected via a questionnaire adopted from a previous study. Participants’ responses showed the most frequently used language sub-skills were those sub-skills they considered highly important. Results emphasize the findings of previous studies that learners usually attach high importance to any skills that they use frequently to help them achieve the utmost aim of improving their language abilities. In addition, the study findings suggest current college English language courses for medical majors need to focus more on improving language-related aspects like fluency, understanding, accuracy, and structure. Such changes are necessary to prepare doctors and medical professionals for work in medical jobs that depend on heavy usage of the English language and also improving communicative competence aspects to ensure smooth cultural interaction with co-workers from all around the world. The study concludes by pointing that there is a critical need to restructure English for medical purposes programs in Saudi Arabia to make better course design, content, and materials responsive to target language learners’ own future goals. Keywords: Saudi; English language skills; Needs analysis (NA; English for specific purposes (ESP; English for medical purposes (EMP

  18. Sexual Health Competencies for Undergraduate Medical Education in North America.

    Science.gov (United States)

    Bayer, Carey Roth; Eckstrand, Kristen L; Knudson, Gail; Koehler, Jean; Leibowitz, Scott; Tsai, Perry; Feldman, Jamie L

    2017-04-01

    The number of hours spent teaching sexual health content and skills in medical education continues to decrease despite the increase in sexual health issues faced by patients across the lifespan. In 2012 and 2014, experts across sexuality disciplines convened for the Summits on Medical School Education and Sexual Health to strategize and recommend approaches to improve sexual health education in medical education systems and practice settings. One of the summit recommendations was to develop sexual health competencies that could be implemented in undergraduate medical education curricula. To discuss the process of developing sexual health competencies for undergraduate medical education in North America and present the resulting competencies. From 2014 to 2016, a summit multidisciplinary subcommittee met through face-to-face, phone conference, and email meetings to review prior competency-based guidelines and then draft and vet general sexual health competencies for integration into undergraduate medical school curricula. The process built off the Association of American Medical Colleges' competency development process for training medical students to care for lesbian, gay, bisexual, transgender, and gender non-conforming patients and individuals born with differences of sex development. This report presents the final 20 sexual health competencies and 34 qualifiers aligned with the 8 overall domains of competence. Development of a comprehensive set of sexual health competencies is a necessary first step in standardizing learning expectations for medical students upon completion of undergraduate training. It is hoped that these competencies will guide the development of sexual health curricula and assessment tools that can be shared across medical schools to ensure that all medical school graduates will be adequately trained and comfortable addressing the different sexual health concerns presented by patients across the lifespan. Bayer CR, Eckstrand KL, Knudson G, et

  19. Medical marijuana: a public health perspective

    OpenAIRE

    Ushang Desai; Paras Patel

    2013-01-01

    Over the few years medical marijuana is growing in the United States. Because of the medical marijuana legislators able to legalized recreational marijuana in the two states in the US. Marijuana has several potential benefits that help in certain disease. The delivery of marijuana is also important because smoking marijuana has severe side effects. Physicians also play important role in medical marijuana, physicians also divided on the use of medical marijuana. Their attitude towards medical ...

  20. Medical Student Decision Making Regarding Pursuit of a Public Health Degree.

    Science.gov (United States)

    McFarland, Sarah L; Meyers, Peter; Sautter, Robin; Honsvall, Amanda; Prunuske, Jacob

    2016-03-01

    Few US medical school graduates receive a public health degree. We sought to identify factors involved in medical students' decisions to pursue dual medical and public health degrees and describe the decision-making process. We conducted focus group discussions and telephone interviews with medical students considering, or enrolled in, a public health degree program. Participants described early exposures to public health, perspectives on physician public health roles, advantages and disadvantages of a public health degree, and the relative importance of factors influencing their decision to pursue a public health degree. Data were coded using open codes, and thematic analysis was performed. Medical students' decisions about pursuing a public health degree are based on consideration of advantages and disadvantages of academic, personal, and financial factors. Students place weights on various factors and value guidance. Access to training and information about public health programs and career opportunities may facilitate decision-making. Knowledge of factors involved in students' decisions and the decision-making process will allow mentors, advisors, faculty, and staff working to recruit students into MPH programs to support students interested in earning dual medical and public health degrees. Future research should explore avenues for supporting medical student decision-making and further reducing barriers to public health training.

  1. [The occupational health of medical personnel of psychiatric institutions].

    Science.gov (United States)

    Ruzhenskaia, E V

    2013-01-01

    The article considers the issues of self-assessment of occupational health by medical personnel of psychiatric service. The main issues and areas of occupation health disorders are identified. The main directions of disorders prevention are presented.

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

    Science.gov (United States)

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

    2014-06-01

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

  3. HEALTH AWARENESS AMONG FEMALE UNDERGRADUATE MEDICAL STUDENTS IN SAUDI ARABIA.

    Science.gov (United States)

    Alonazi, Wadi B; Albaiz, Alyaa S; Albejaidi, Fahd M; Alenazi, Fatimah Z

    2016-01-01

    This study was conducted to assess the level of health awareness (HA) among students attending three undergraduate programs in the Colleges of Applied Medical Sciences (CAMS) in Riyadh, Saudi Arabia (SA). A modified self-reported survey was utilized to measure HA demonstrating four domains: Nutrition (NU), Personal Health (PH), Physical Exercise (PE), and Body Build (BB). The questionnaire was distributed to 302 female students attending the first semester of the academic year 2014-2015 BS degree in Radiology Sciences (RS), Clinical Laboratory (CL), and Health Education (HE) departments. Bloom's taxonomy was utilized to describe the three cognitive levels. Synthesizing, creating, and evaluating were grouped to represent high level indicators; applying cognitive skills only revealed an intermediate level; while memorizing and listing demonstrated low levels. In a 5-point Likert scale, the overall mean (M) of HA among CAMS students was 3.82 with the highest among students attending HE (M = 3.89). The domain of PH ranked first with a high average (M = 4.30). There were significant differences (α = 0.05), in the level of HA in PH and BB domains, among students in terms of program specialty only, but no such significant differences were found for other characteristics. The study recommended incorporating health promotion concepts within teaching curricula and conducting health and education campaigns by health education institutions.

  4. [Comparison between two caller groups of a medical call centre in Switzerland].

    Science.gov (United States)

    Ackermann Rau, S; Zwahlen, M

    2008-05-01

    The incidence distribution of triage advice in the medical call centre Medi24 and the pattern of service utilisation were analysed with respect to two groups of callers with different insurance schemes. Individuals having contracted insurance of the Medi24 model could use the telephone consultation service of the medical call centre Medi24 (mainly part of the mandatory basic health insurance) voluntarily and free of charge whereas individuals holding an insurance policy of the Telmed model (special contract within the mandatory basic health insurance with a premium discount ranging from 8% to 12%) were obliged to have a telephone consultation before arranging an appointment with a medical doctor. A cross-sectional study was carried out in the medical call centre Medi24 based on all triage datasets of the Medi24 and Telmed groups collected during the one year period from July 1st 2005 to June 30th 2006. The distribution of the six different urgency levels within the two groups and their respective pattern of service utilisation was determined. In a multivariable logistic regression model the Odds Ratio for every enquiry originating from the Telmed group versus those originating from the Medi24 group was calculated. During a one-year period 48 388 triage requests reached the medical call centre Medi24, 56% derived from the Telmed group and 44% from the Medi24 group. Within the Medi24 group more than 25% of the individuals received self-care advice, within the Telmed group, on the other hand, only about 18% received such advice. In contrast, 27% of the Telmed triage requests but only 18% of the Medi24 triage requests resulted in the advice to make a routine appointment with a medical doctor. The probability that an individual of the Telmed group obtained the advice to go to the accident and emergency department was lower than for an individual of the Medi24 group (OR 0.77, 95% CI 0.60-0.99). Likewise, the probability of self-care advice was decreased in regard to the

  5. Health Insurance, Medical Care, and Health Outcomes: A Model of Elderly Health Dynamics

    Science.gov (United States)

    Yang, Zhou; Gilleskie, Donna B.; Norton, Edward C.

    2009-01-01

    Prescription drug coverage creates a change in medical care consumption, beyond standard moral hazard, arising both from the differential cost-sharing and the relative effectiveness of different types of care. We model the dynamic supplemental health insurance decisions of Medicare beneficiaries, their medical care demand, and subsequent health…

  6. Health Insurance, Medical Care, and Health Outcomes: A Model of Elderly Health Dynamics

    Science.gov (United States)

    Yang, Zhou; Gilleskie, Donna B.; Norton, Edward C.

    2009-01-01

    Prescription drug coverage creates a change in medical care consumption, beyond standard moral hazard, arising both from the differential cost-sharing and the relative effectiveness of different types of care. We model the dynamic supplemental health insurance decisions of Medicare beneficiaries, their medical care demand, and subsequent health…

  7. Biomimetic Adhesive Materials Containing Cyanoacryl Group for Medical Application

    Directory of Open Access Journals (Sweden)

    Sueng Hwan Jo

    2014-10-01

    Full Text Available For underwater adhesives with biocompatible and more flexible bonds using biomimetic adhesive groups, DOPA-like adhesive molecules were modified with cyanoacrylates to obtain different repeating units and chain length copolymers. The goal of this work is to copy the mechanisms of underwater bonding to create synthetic water-borne underwater medical adhesives through blending of the modified DOPA and a triblock copolymer (PEO-PPO-PEO for practical application to repair wet living tissues and bones, and in turn, to use the synthetic adhesives to test mechanistic hypotheses about the natural adhesive. The highest values in stress and modulus of the biomimetic adhesives prepared in wet state were 165 kPa and 33 MPa, respectively.

  8. Biomimetic adhesive materials containing cyanoacryl group for medical application.

    Science.gov (United States)

    Jo, Sueng Hwan; Sohn, Jeong Sun

    2014-10-17

    For underwater adhesives with biocompatible and more flexible bonds using biomimetic adhesive groups, DOPA-like adhesive molecules were modified with cyanoacrylates to obtain different repeating units and chain length copolymers. The goal of this work is to copy the mechanisms of underwater bonding to create synthetic water-borne underwater medical adhesives through blending of the modified DOPA and a triblock copolymer (PEO-PPO-PEO) for practical application to repair wet living tissues and bones, and in turn, to use the synthetic adhesives to test mechanistic hypotheses about the natural adhesive. The highest values in stress and modulus of the biomimetic adhesives prepared in wet state were 165 kPa and 33 MPa, respectively.

  9. Self-development groups reduce medical school stress: a controlled intervention study

    Directory of Open Access Journals (Sweden)

    Stordal Kirsten I

    2010-03-01

    Full Text Available Abstract Background High stress levels and mental health problems are common among medical students and there is a lack of studies on group interventions that aim to reduce such distress during medical school. Methods A full class of students (n = 129 participated in group sessions during their third year of medical school in Bergen, Norway. The subsequent third-year class (n = 152 acted as control group, in order to create a quasi-experimental design. Two types of group intervention sessions were offered to the first class. One option was self-development groups led by trained group psychotherapists. Alternatively, students could choose discussion groups that focused on themes of special relevance to doctors, led by experienced general practitioners. The intervention comprised of 12 weekly group sessions each lasting 90 minutes. Data were gathered before the intervention (T1, and three months post intervention (T2. Distress was measured using the Perceived Medical School Stress (PMSS and Symptom Check List-5 (SCL-5 assessments. Results The intervention group showed a significant reduction in PMSS over the observation period. The subsequent year control group stayed on the same PMSS levels over the similar period. The intervention was a significant predictor of PMSS reduction in a multiple regression analysis adjusted for age and sex, β = -1.93 (-3.47 to -0.38, P = 0.02. When we analysed the effects of self-development and discussion groups with the control group as reference, self-development group was the only significant predictor of PMSS reduction, β = -2.18 (-4.03 to -0.33, P = 0.02. There was no interaction with gender in our analysis. This implicates no significant difference between men and women concerning the effect of the self-development group. There was no reduction in general mental distress (SCL-5 over this period. Conclusion A three-month follow-up showed that the intervention had a positive effect on perceived medical school

  10. Educational Strategies of Diabetes Group Medical Visits: A Review.

    Science.gov (United States)

    Kirk, Julienne K; Devoid, Hannah Marie; Strickland, Carmen

    2017-02-03

    Diabetes is a demanding disease that is growing in prevalence. Improved outcomes for patients with diabetes are highly dependent on self-management skills and the ability to make lifestyle changes. Innovative healthcare approaches are necessary to meet these specific patient needs. A group care medical visit (GMV) combines diabetes check-ups with diabetes education in a supportive and patient centered environment that promotes effective self-management. GMVs are associated with improved diabetes outcomes including hemoglobin A1C, weight, and self-efficacy; however details of the methods by which content is delivered to achieve these outcomes remain vague. Improved GMV diabetes outcomes may be the result of specific processes used in group care models. We seek to describe educational strategies, content, and qualities of facilitators that contribute to successful outcomes associated with diabetes GMVs . A review of the literature was conducted focusing on GMVs, specifically the educational strategies implemented, topics discussed, and facilitator qualities that contribute to successful outcomes. We identified 260 studies containing information about GMVs in patients with diabetes. A total of 7 citations met inclusion criteria and additional 5 were found through reference lists and relevant papers. Diabetes GMV educational topics comprise standard themes of disease process, medication, nutrition, and exercise. Several programs, however, target the development and realization of individualized patient goals, giving the patient more involvement in the session. Methods for facilitation may hold the key to successfully activating patients to reach meaningful behavior change goals. In addition to using expert clinical skills in diabetes care, effective facilitators provide support, and empower patients to take ownership of their diabetes. Rigorous evaluation of best practices for both the type and methods of delivering content in GMVs is lacking. Translational research to

  11. Women's groups' perceptions of neonatal and infant health ...

    African Journals Online (AJOL)

    infant health problems (204 groups, 3484 women), prioritised problems they ... hospitals, seven health centres that provide maternity care and three .... English speaker). ... Verbal consent was given by the groups for the data collected through ...

  12. Health economics education in undergraduate medical training: introducing the health economics education (HEe) website

    OpenAIRE

    Oppong, Raymond; Mistry, Hema; Frew, Emma

    2013-01-01

    In the UK, the General Medical Council clearly stipulates that upon completion of training, medical students should be able to discuss the principles underlying the development of health and health service policy, including issues relating to health economics. In response, researchers from the UK and other countries have called for a need to incorporate health economics training into the undergraduate medical curricula. The Health Economics education website was developed to encourage and sup...

  13. An industry perspective on Canadian patients' involvement in medical tourism: implications for public health.

    Science.gov (United States)

    Johnston, Rory; Crooks, Valorie A; Adams, Krystyna; Snyder, Jeremy; Kingsbury, Paul

    2011-05-31

    The medical tourism industry, which assists patients with accessing non-emergency medical care abroad, has grown rapidly in recent years. A lack of reliable data about medical tourism makes it difficult to create policy, health system, and public health responses to address the associated risks and shortcomings, such as spread of infectious diseases, associated with this industry. This article addresses this knowledge gap by analyzing interviews conducted with Canadian medical tourism facilitators in order to understand Canadian patients' involvement in medical tourism and the implications of this involvement for public health. Semi-structured phone interviews were conducted with 12 medical facilitators from 10 companies in 2010. An exhaustive recruitment strategy was used to identify interviewees. Questions focused on business dimensions, information exchange, medical tourists' decision-making, and facilitators' roles in medical tourism. Thematic analysis was undertaken following data collection. Facilitators helped their Canadian clients travel to 11 different countries. Estimates of the number of clients sent abroad annually varied due to demand factors. Facilitators commonly worked with medical tourists aged between 40 and 60 from a variety of socio-economic backgrounds who faced a number of potential barriers including affordability, fear of the unfamiliar, and lack of confidence. Medical tourists who chose not to use facilitators' services were thought to be interested in saving money or have cultural/familial connections to the destination country. Canadian doctors were commonly identified as barriers to securing clients. No effective Canadian public health response to medical tourism can treat medical tourists as a unified group with similar motivations for engaging in medical tourism and choosing similar mechanisms for doing so. This situation may be echoed in other countries with patients seeking care abroad. Therefore, a call for a comprehensive public

  14. An industry perspective on Canadian patients' involvement in Medical Tourism: implications for public health

    Directory of Open Access Journals (Sweden)

    Snyder Jeremy

    2011-05-01

    Full Text Available Abstract Background The medical tourism industry, which assists patients with accessing non-emergency medical care abroad, has grown rapidly in recent years. A lack of reliable data about medical tourism makes it difficult to create policy, health system, and public health responses to address the associated risks and shortcomings, such as spread of infectious diseases, associated with this industry. This article addresses this knowledge gap by analyzing interviews conducted with Canadian medical tourism facilitators in order to understand Canadian patients' involvement in medical tourism and the implications of this involvement for public health. Methods Semi-structured phone interviews were conducted with 12 medical facilitators from 10 companies in 2010. An exhaustive recruitment strategy was used to identify interviewees. Questions focused on business dimensions, information exchange, medical tourists' decision-making, and facilitators' roles in medical tourism. Thematic analysis was undertaken following data collection. Results Facilitators helped their Canadian clients travel to 11 different countries. Estimates of the number of clients sent abroad annually varied due to demand factors. Facilitators commonly worked with medical tourists aged between 40 and 60 from a variety of socio-economic backgrounds who faced a number of potential barriers including affordability, fear of the unfamiliar, and lack of confidence. Medical tourists who chose not to use facilitators' services were thought to be interested in saving money or have cultural/familial connections to the destination country. Canadian doctors were commonly identified as barriers to securing clients. Conclusions No effective Canadian public health response to medical tourism can treat medical tourists as a unified group with similar motivations for engaging in medical tourism and choosing similar mechanisms for doing so. This situation may be echoed in other countries with patients

  15. Medical health care for Viennese prostitutes.

    Science.gov (United States)

    Stary, A; Kopp, W; Söltz-Szöts, J

    1991-01-01

    In Vienna, legalized prostitution is tightly controlled by the advisory board of the Viennese Public Health Service. Registered prostitutes are routinely screened for all important STDs, such as syphilis, HIV, gonorrhea, chlamydial- and yeast-infections, and Trichomonas vaginalis. Furthermore, cytological smears are obtained from the cervix and chest X-rays are performed at least once a year. In all pathological findings, an appropriate therapy is implemented. Presenting data of 1989, out of the 713 weekly controlled registered prostitutes, Neisseria gonorrhoeae was detected in 0.3% of all examinations (110/35,368). In non-registered prostitutes, the infection rate of N. gonorrhoeae was 6.9% (27/354), and so far, 20 times higher than in registered ones. The infection rate of Chlamydia trachomatis, which has been routinely diagnosed in registered prostitutes for several years, has decreased from 20.4% in 1980 to 2.2% in 1989 compared with 31.4% and 10.9% in non-registered prostitutes. In registered prostitutes, the prevalence of genital infections, such as C. trachomatis, T. vaginalis, and yeasts was shown to be 4.9%. The corresponding data in non-registered prostitutes were much higher (18.8%). Due to examinations for cervical malignancy the incidence of Papanicolaou stain IV and V has decreased from 3.1% in 1988 to 1.6% in 1989. There was no serologic evidence for syphilis and HIV infection in both special risk groups. The data demonstrate, that due to a good health surveillance of STD-risk groups, a good information service, and free treatment, the prevalence of STDs can be reduced in prostitutes.

  16. Medical sociology and health services research: past accomplishments and future policy challenges.

    Science.gov (United States)

    Wright, Eric R; Perry, Brea L

    2010-01-01

    The rising costs and inconsistent quality of health care in the United States have raised significant questions among professionals, policy makers, and the public about the way health services are being delivered. For the past 50 years, medical sociologists have made significant contributions in improving our understanding of the nature and impact of the organizations that constitute our health care system. In this article, we discuss three central findings in the sociology of health services: (1) health services in the U.S. are unequally distributed, contributing to health inequalities across status groups; (2) social institutions reproduce health care inequalities by constraining and enabling the actions of health service organizations, health care providers, and consumers; and (3) the structure and dynamics of health care organizations shape the quality, effectiveness, and outcomes of health services for different groups and communities. We conclude with a discussion of the policy implications of these findings for future health care reform efforts.

  17. 77 FR 38838 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2012-06-29

    ..., Mental Health, and Dental Health Professional Shortage Areas AGENCY: Health Resources and Services... primary medical care, mental health, and dental health professional shortage areas (HPSAs) as of April 1... National Health Service Corps (NHSC) personnel to provide primary care, dental, or mental health...

  18. Medical Student Service Learning Program Teaches Secondary Students about Career Opportunities in Health and Medical Fields

    Science.gov (United States)

    Karpa, Kelly; Vakharia, Kavita; Caruso, Catherine A.; Vechery, Colin; Sipple, Lanette; Wang, Adrian

    2015-01-01

    Engagement of academic medical centers in community outreach provides the public with a better understanding of basic terms and concepts used in biomedical sciences and increases awareness of important health information. Medical students at one academic medical center initiated an educational outreach program, called PULSE, that targets secondary…

  19. Globalization and healthcare: understanding health and medical tourism.

    Science.gov (United States)

    Carrera, Percivil M; Bridges, John Fp

    2006-08-01

    Faced with long waiting lists, the high cost of elective treatment and fewer barriers to travel, the idea of availing healthcare in another country is gaining greater appeal to many. The objective of this review is to perform a literature review of health and medical tourism, to define health and medical tourism based on the medical literature and to estimate the size of trade in healthcare. The Medline database was used for our literature review. In our initial search for 'health tourism' and 'medical tourism' we found a paucity of formal literature as well as conceptual ambiguity in the literature. Subsequently, we reviewed the literature on 'tourism' in general and in the context of healthcare. On the basis of 149 papers, we then sought to conceptualize health tourism and medical tourism. Based on our definitions, we likewise sought to estimate market capacity internationally. We defined health tourism as "the organized travel outside one's local environment for the maintenance, enhancement or restoration of an individual's wellbeing in mind and body". A subset of this is medical tourism, which is "the organized travel outside one's natural healthcare jurisdiction for the enhancement or restoration of the individual's health through medical intervention". At the international level, health tourism is an industry sustained by 617 million individuals with an annual growth of 3.9% annually and worth US$513 billion. In conclusion, this paper underscored the issue of a severely limited formal literature that is compounded by conceptual ambiguity facing health and medical tourism scholarship. In clarifying the concepts and standardizing definitions, and providing evidence with regard to the scale of trade in healthcare, we hope to assist in furthering fundamental research tasks, including the further development of reliable and comparable data, the push and pull factors for engaging in health and medical tourism, and the impact of health tourism but, more so, medical

  20. Electronic Health Records and Cloud based Generic Medical Equipment Interface

    OpenAIRE

    Srivastava, Siddharth; Gupta, Ramji; Rai, Astha; Cheema, A. S.

    2014-01-01

    Now-a-days Health Care industry is well equipped with Medical Equipments to provide accurate and timely reports of investigation and examination results. Medical Equipments available in market are made for specific tests suited for a particular laboratory leading to a wide variety of devices. The result viewing experience on console of these devices is not only cumborsome for medical staff but inefficient. Therefore, Medical Equipment Interfaces act as backbone of any Hospital Management Info...

  1. Rates and predictors of referral for individual psychotherapy, group psychotherapy, and medications among Iraq and Afghanistan veterans with PTSD.

    Science.gov (United States)

    Mott, Juliette M; Barrera, Terri L; Hernandez, Caitlin; Graham, David P; Teng, Ellen J

    2014-04-01

    This study examined rates of referral for medication, individual psychotherapy, and group psychotherapy within a Veterans Affairs (VA) posttraumatic stress disorder (PTSD) specialty mental health clinic. Participants were 388 Iraq and Afghanistan veterans who were referred for PTSD treatment following a mental health evaluation required for all new VA enrollees. The majority of the sample was referred for medication (79 %), with comparatively fewer referrals for individual (39 %) or group psychotherapy (24 %). Forty percent of participants were referred for combined medication and psychotherapy. Patient demographic and clinical characteristics were examined to determine whether these variables predicted referral type. Female veterans and those with lower clinician ratings of overall functioning were more likely to be referred for individual therapy. Group psychotherapy referrals were more common in veterans who were older, unemployed, identified as an ethnic minority, and had a comorbid anxiety disorder. There were no significant predictors of medication referral.

  2. Psychotropic Medication Management in a Residential Group Care Program

    Science.gov (United States)

    Spellman, Douglas F.; Griffith, Annette K.; Huefner, Jonathan C.; Wise, Neil, III; McElderry, Ellen; Leslie, Laurel K.

    2010-01-01

    This article presents a psychotropic medication management approach that is used within a residential care program. The approach is used to assess medications at youths' times of entry and to facilitate decision making during care. Data from a typical case study have indicated that by making medication management decisions slowly, systematically,…

  3. 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....

  4. Medication adherence skills training for African-American breast cancer survivors: the effects on health literacy, medication adherence, and self-efficacy.

    Science.gov (United States)

    Rust, Connie F; Davis, Cindy; Moore, Matthew R

    2015-01-01

    There are gaps in research regarding medication adherence, self-efficacy in proper medication adherence, and health literacy among breast cancer survivors. This pilot randomized controlled study was conducted to provide information addressing health literacy with respect to medication adherence and self-efficacy in African American breast cancer survivors. The study sample consisted of an intervention group (n = 24) of medication adherence skills training (MST) and a control group (n = 24), with a total sample population of 48 participants. The MST workshop was a collaborative intervention between pharmacy and social work and was designed to address issues that may be encountered while taking multiple medications for various acute and chronic conditions, increase participant confidence in accessing necessary resources for improved medication usage, and enhance personal self-efficacy regarding health care. A statistically significant relationship was detected between initial health literacy and medication adherence, as well as initial health literacy and self-efficacy. These findings indicated that individuals with higher health literacy were more likely to have higher levels of self-efficacy and were more likely to adhere to medication instructions. Analysis of the intervention and treatment groups did not show a statistically significant effect on health literacy, medication adherence, or self-efficacy from pre-test to post-test.

  5. Medical cost-offset following treatment referral for alcohol and other drug use disorders in a group model HMO.

    Science.gov (United States)

    Polen, Michael R; Freeborn, Donald K; Lynch, Frances L; Mullooly, John P; Dickinson, Daniel M

    2006-07-01

    The purpose of this study was to determine whether specialty alcohol and other drug (AOD) treatment is associated with reduced subsequent medical care costs. AOD treatment costs and medical costs in a group model health maintenance organization (HMO) were collected for up to 6 years on 1,472 HMO members who were recommended for specialty AOD treatment, and on 738 members without AOD diagnoses or treatment. Addiction Severity Index measures were also obtained from a sample of 293 of those recommended for treatment. Changes in medical costs did not differ between treatment and comparison groups. Nor did individuals with improved treatment outcomes have greater reductions in medical costs. AOD treatment costs were not inversely related to subsequent medical costs, except for a subgroup with recent AOD treatment. In the interviewed sample, better treatment outcomes did not predict lower subsequent medical costs. Multiple treatment episodes may hold promise for producing cost-offsets.

  6. Impact of a Value-based Formulary on Medication Utilization, Health Services Utilization, and Expenditures.

    Science.gov (United States)

    Yeung, Kai; Basu, Anirban; Hansen, Ryan N; Watkins, John B; Sullivan, Sean D

    2017-02-01

    Value-based benefit design has been suggested as an effective approach to managing the high cost of pharmaceuticals in health insurance markets. Premera Blue Cross, a large regional health plan, implemented a value-based formulary (VBF) for pharmaceuticals in 2010 that explicitly used cost-effectiveness analysis (CEA) to inform medication copayments. The objective of the study was to determine the impact of the VBF. Interrupted time series of employer-sponsored plans from 2006 to 2013. Intervention group: 5235 beneficiaries exposed to the VBF. 11,171 beneficiaries in plans without any changes in pharmacy benefits. The VBF-assigned medications with lower value (estimated by CEA) to higher copayment tiers and assigned medications with higher value to lower copayment tiers. Primary outcome was medication expenditures from member, health plan, and member plus health plan perspectives. Secondary outcomes were medication utilization, emergency department visits, hospitalizations, office visits, and nonmedication expenditures. In the intervention group after VBF implementation, member medication expenditures increased by $2 per member per month (PMPM) [95% confidence interval (CI), $1-$3] or 9%, whereas health plan medication expenditures decreased by $10 PMPM (CI, $18-$2) or 16%, resulting in a net decrease of $8 PMPM (CI, $15-$2) or 10%, which translates to a net savings of $1.1 million. Utilization of medications moved into lower copayment tiers increased by 1.95 days' supply (CI, 1.29-2.62) or 17%. Total medication utilization, health services utilization, and nonmedication expenditures did not change. Cost-sharing informed by CEA reduced overall medication expenditures without negatively impacting medication utilization, health services utilization, or nonmedication expenditures.

  7. Patient confidentiality within the context of group medical visits: is there cause for concern?

    Science.gov (United States)

    Wong, Sabrina T; Lavoie, Josee G; Browne, Annette J; MacLeod, Martha L P; Chongo, Meck

    2015-10-01

    Group medical visits (GMVs), clinical encounters with a medical component delivered to groups of patients, have emerged as an innovative approach to potentially increasing efficiency while enhancing the quality of primary health care (PHC). GMVs have created the need to pay explicit attention to patient confidentiality. What strategies are used by providers and patients to address issues of confidentiality within GMVs? In-depth interviews were conducted with 34 PHC providers and 29 patients living in nine rural communities in British Columbia, Canada. Data were analysed using interpretive thematic analysis and a relational autonomy approach. We found three main themes: (i) choosing to disclose: balancing benefits and drawbacks of GMVs, (ii) maintaining confidentiality in GMVs and (iii) gaining strength from interdependent relationships: patients learning from each other. Confidentiality can be addressed and was not a major concern for patients attending or providers facilitating GMVs in these rural communities. Patients adopted strategies to address their own and others' concerns related to confidential health information. Providers used multiple strategies to maintain confidentiality within the group, including renegotiating what information is shared and providing examples of what information ought to be kept confidential. Although GMVs are not for all patients, a relational autonomy approach is useful in drawing attention to the context and structures which may influence their patients' ability to act autonomously. Successful delivery of GMVs requires both patients and providers to negotiate between maintaining confidentiality and an appropriate level of disclosure. © 2013 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  8. Absolute and Relative Socioeconomic Health Inequalities across Age Groups.

    Directory of Open Access Journals (Sweden)

    Sander K R van Zon

    Full Text Available The magnitude of socioeconomic health inequalities differs across age groups. It is less clear whether socioeconomic health inequalities differ across age groups by other factors that are known to affect the relation between socioeconomic position and health, like the indicator of socioeconomic position, the health outcome, gender, and as to whether socioeconomic health inequalities are measured in absolute or in relative terms. The aim is to investigate whether absolute and relative socioeconomic health inequalities differ across age groups by indicator of socioeconomic position, health outcome and gender.The study sample was derived from the baseline measurement of the LifeLines Cohort Study and consisted of 95,432 participants. Socioeconomic position was measured as educational level and household income. Physical and mental health were measured with the RAND-36. Age concerned eleven 5-years age groups. Absolute inequalities were examined by comparing means. Relative inequalities were examined by comparing Gini-coefficients. Analyses were performed for both health outcomes by both educational level and household income. Analyses were performed for all age groups, and stratified by gender.Absolute and relative socioeconomic health inequalities differed across age groups by indicator of socioeconomic position, health outcome, and gender. Absolute inequalities were most pronounced for mental health by household income. They were larger in younger than older age groups. Relative inequalities were most pronounced for physical health by educational level. Gini-coefficients were largest in young age groups and smallest in older age groups.Absolute and relative socioeconomic health inequalities differed cross-sectionally across age groups by indicator of socioeconomic position, health outcome and gender. Researchers should critically consider the implications of choosing a specific age group, in addition to the indicator of socioeconomic position and

  9. Medical education for obstetricians and gynecologists should incorporate environmental health.

    Science.gov (United States)

    Tinney, Veronica A; Paulson, Jerome A; Bathgate, Susanne L; Larsen, John W

    2015-02-01

    Obstetricians-gynecologists can protect the reproductive health of women, men, and their offspring from environmental hazards through preconception and prenatal counseling and encouraging patients to take actions to reduce environmental exposures. Although obstetricians-gynecologists are well positioned to prevent hazardous exposures, education on environmental health in medical education is limited. The Mid-Atlantic Center for Children's Health and the Environment and the Department of Obstetrics and Gynecology of George Washington University convened a meeting to begin integration of environmental health topics into medical education for obstetricians-gynecologists. Several avenues were identified to incorporate environmental health topics into medical education including continuing education requirements, inclusion of environmental health questions on board certification examinations and the creation of a curriculum on environmental health specific to obstetrics-gynecology.

  10. Pender's health promotion model in medical research.

    Science.gov (United States)

    Heydari, Abbas; Khorashadizadeh, Fatemeh

    2014-09-01

    This review shows how researchers use pander's health promotion model. We included all articles in which Pender's health promotion has been used for theoretical framework. Eligible articles were selected according to review of abstracts. Search was conducted using the electronic database from 1990 to 2012. Based on our search, 74 articles with various methodologies were relevant for review. Their aims of these studies were to predict effective factors/barriers in health promotion behaviours, to detect effects of intervention programme for improving health promotion behaviours, test the model, identify quality of life and health promotion behaviour, predict stage of change in related factors that affect health promotion behaviour, prevent the events that interfere with health promotion behaviour, develop another model similar to this model, compare this model with another model, determine the relationship of variables associated to health promotion behaviours.

  11. Evolution of Medication Administration Workflow in Implementing Electronic Health Record System

    Science.gov (United States)

    Huang, Yuan-Han

    2013-01-01

    This study focused on the clinical workflow evolutions when implementing the health information technology (HIT). The study especially emphasized on administrating medication when the electronic health record (EHR) systems were adopted at rural healthcare facilities. Mixed-mode research methods, such as survey, observation, and focus group, were…

  12. [Medical assistance for health and human reproduction].

    Science.gov (United States)

    Canesqui, A M

    1987-12-01

    Brazil's federal health policy is examined, with separate focus on the periods before and after 1964. Special attention is given to sanitation and to maternal and child health care. The impact of government involvement on health policy development and the policy's subsequent effects on demographic processes, especially fertility, are also discussed. Data are from official and other published sources. (SUMMARY IN ENG)

  13. Parental illness perceptions and medication perceptions in childhood asthma, a focus group study.

    Science.gov (United States)

    Klok, Ted; Brand, Paul L; Bomhof-Roordink, Hanna; Duiverman, Eric J; Kaptein, Adrian A

    2011-02-01

    Asthma treatment according to guidelines fails frequently, through patients' nonadherence to doctors' advice. This study aimed to explore how differences in asthma care influence parents' perceptions to inhaled corticosteroids (ICS). We conducted six semistructured focus groups, including 44 parents of asthmatic children (2-12 years of age, treated in primary or specialist care). Verbatim transcripts were analysed with standard qualitative research methods. Parents decided deliberately whether ongoing ICS use was useful for their child. This decision was based on their perceptions about illness and medication. In primary care, this issue was hardly ever discussed with the health care provider because regular scheduled follow-up was unusual. In specialist care, regular scheduled follow-up was usual, and parental perceptions about illness and medication were discussed and modified when needed. Parent-reported adherence was lower in primary care than in specialist care. This focus group study illustrates how strongly parental perceptions of illness and medication influence adherence to health care providers' advice and that such perceptions can be modified within a strong doctor-patient partnership, improving adherence. © 2010 The Author(s)/Acta Paediatrica © 2010 Foundation Acta Paediatrica.

  14. 76 FR 46677 - Requirements for Group Health Plans and Health Insurance Issuers Relating to Coverage of...

    Science.gov (United States)

    2011-08-03

    ... Internal Revenue Service 26 CFR Part 54 RIN 1545-BJ58 Requirements for Group Health Plans and Health... Center for Consumer Information & Insurance Oversight of the U.S. Department of Health and Human Services... with respect to group health plans and health insurance coverage offered in connection with a group...

  15. Attitudes and perspectives on medical abortion of health service providers; Manisa example

    Directory of Open Access Journals (Sweden)

    Saliha Ozpinar

    2015-04-01

    Full Text Available AIM: To better understand perceptions and perspectives of health service providers who provide medical abortion services and of senior students attending medical and nursing faculties in Manisa regarding medical abortion. METHODS: This study conducted in Manisa is a part of a Turkey-wide study on and #8220;health service providers and #8217; knowledge about, attitudes towards and perspectives on safe abortion and medical abortion and #8221;. It is a descriptive study. The questionnaire prepared by the researchers consists of two sections: one targeting health service providers and the other targeting students. The questionnaires were completed by individuals in the study group. RESULTS: According to the survey results, service providers know at least one abortion method. According to the study group, abortion performed by non-medical midwives ranks first in the definition of unsafe abortion. In the study, 100.0% of the gynecologists, 84.7% of the general practitioners, 74.6% of the nurses / midwives stated that they were knowledgeable about Medical abortion. According to the study group, of the advantages of medical abortion, the one ranks first is that no anesthesia is administered and of the disadvantages of medical abortion, the one ranks first is that the process takes a long time. Twenty-five percent of the obstetricians, 67.8% of the general practitioners, 57.3% of the nurses / midwives, 55.2% of the medical students and 63.2% of the nursing / midwifery students were unwilling to perform medical abortion and/or to assist it. CONCLUSION: The study indicates that although health service providers displayed a positive attitude towards medical abortion, not all of them had enough knowledge about it. Thus, it is important that medical abortion providers should attend pre-graduate training programs and that post-graduate training programs should be organized. [TAF Prev Med Bull 2015; 14(2.000: 87-92

  16. Clinical studies on health conditions of medical diagnostic X-ray workers

    Energy Technology Data Exchange (ETDEWEB)

    Liu Liqun

    1984-10-01

    The results of investigations on general health conditions of 2484 medical X-ray workers and 1718 controls were reported. It was shown that the incidences of neurasthenic syndrome, loss of appetite, baldness etc. in X-ray workers were statistically higher than those in controls. Chronic rhinitis, pharyngitis, and paranasal sinusitis also occurred more frequently in the former group. The blood pressure, pulse rate, capillary resistance and past medical history showed no significant difference between these two groups. (Author).

  17. Group Medical Visits to Provide Gynecologic Care for Women Affected by Breast Cancer

    Directory of Open Access Journals (Sweden)

    Sally R. Greenwald

    2017-01-01

    Full Text Available Purpose: Women with breast cancer have complex and unique gynecologic needs that are challenging to effectively and comprehensively meet in a traditional gynecology visit format. Group medical visits are an effective and well-received model of care in other disease settings and can provide comprehensive health education as an adjunct to one-on-one evaluation and treatment. There are limited data regarding the use of this type of health care delivery in providing gynecology-focused care to women affected by breast cancer. Methods: A group medical visit model was created for gynecology providers to see new breast cancer patient consults. From May 2012 to February 2014, 148 patients (3–6 per group participated in a 1-hour informational session followed by a 15- to 30-minute individual visit with a physician that included history, physical examination and evaluation. We surveyed 101 women who attended these visits to evaluate a group model for providing gynecologic care and educational support to women with breast cancer. Results: Of those who responded to the survey question, 100% agreed or somewhat agreed that their expectations for an initial intake visit were met during the group visit; 81% agreed or somewhat agreed that they felt a group visit was preferable to an individual introductory visit. More than 95% agreed or somewhat agreed that the information was understandable and their questions were answered during the visit. Only 5 respondents expressed dissatisfaction with the additional time commitment for this type of visit. Conclusions: The majority of women surveyed expressed satisfaction with their experience with a group visit format. The women who participated preferred this format compared to an individual intake appointment when establishing gynecology care after breast cancer diagnosis/treatment, regardless of age, menopausal status, cancer stage or hormone receptor status. While further studies are warranted to directly compare and

  18. Absolute and Relative Socioeconomic Health Inequalities across Age Groups

    NARCIS (Netherlands)

    van Zon, Sander K. R.; Bultmann, Ute; de Leon, Carlos F. Mendes; Reijneveld, Sijmen A.

    2015-01-01

    Background The magnitude of socioeconomic health inequalities differs across age groups. It is less clear whether socioeconomic health inequalities differ across age groups by other factors that are known to affect the relation between socioeconomic position and health, like the indicator of

  19. Absolute and Relative Socioeconomic Health Inequalities across Age Groups

    NARCIS (Netherlands)

    van Zon, Sander K. R.; Bultmann, Ute; de Leon, Carlos F. Mendes; Reijneveld, Sijmen A.

    2015-01-01

    Background The magnitude of socioeconomic health inequalities differs across age groups. It is less clear whether socioeconomic health inequalities differ across age groups by other factors that are known to affect the relation between socioeconomic position and health, like the indicator of socioec

  20. [Pelvic Health: Healthcare Needs From Medical and Women Perspectives].

    Science.gov (United States)

    Lyu, Ji-Yan; Chang, Lu-I; Tsai, Chuan-Hsiu

    2017-04-01

    The pelvis, one of the most important cavities in the human body, is involved in human reproduction health. The pelvis changes in females with age and reproduction-related changes in hormones. Women generally lack sufficient knowledge regarding their pelvic-health needs and feel embarrassed to seek pelvic-health-related medical advice. Conversely, medical care related to women's health focuses mainly on maternal health and cancer prevention. When facing the challenges of pelvic floor dysfunction, surgical procedures are the most common treatment modality. The present article aims to define pelvic health and to compare the differences in perspective on this issue between the medical and women. Lastly, suggestions for pelvic healthcare that focus on women's needs are made.

  1. Impact of telephone medication therapy management on medication and health-related problems, medication adherence, and Medicare Part D drug costs: a 6-month follow up.

    Science.gov (United States)

    Moczygemba, Leticia R; Barner, Jamie C; Lawson, Kenneth A; Brown, Carolyn M; Gabrillo, Evelyn R; Godley, Paul; Johnsrud, Michael

    2011-10-01

    The Medicare Modernization Act of 2003 mandated the provision of medication therapy management (MTM) to eligible Part D beneficiaries to improve medication-related outcomes. As MTM programs evolve, evaluation is necessary to help inform MTM best practices. The objective of this study was to determine the impact of pharmacist-provided telephone MTM on: (1) medication and health-related problems (MHRPs); (2) medication adherence; and (3) Part D drug costs. This quasi-experimental study included Part D beneficiaries from a Texas health plan. Andersen's Behavioral Model of Health Services Use served as the study framework. MTM utilization was the health behavior. Age, gender, and race were predisposing factors, and number of medications, chronic diseases, and medication regimen complexity were need factors. Outcomes were pre-to-post changes in: (1) MHRPs; (2) medication adherence, using the medication possession ratio (MPR); and (3) total drug costs. Multiple regression was used to analyze group differences while controlling for predisposing and need factors. At baseline, the intervention (n = 60) and control (n = 60) groups were not statistically different regarding predisposing and need factors, with the exception of gender. The intervention group had significantly (P = 0.009) more men compared with the control group (51.7% vs 28.3%). There were 4.8 (2.7) and 9.2 (2.9) MHRPs identified at baseline and 2.5 (2.0) and 7.9 (3.0) MHRPs remained at the 6-month follow up in the intervention and control groups, respectively. The intervention group (vs control) had significantly more MHRPs resolved (P = 0.0003). There were no significant predictors of change in MPR or total drug costs from baseline to follow up, although total drug costs decreased by $158 in the intervention group compared with a $118 increase in the control group. A telephone MTM program resolved significantly more MHRPs compared with a control group, but there were no significant changes in adherence and

  2. Health Insurance Competition : The Effect of Group Contracts

    NARCIS (Netherlands)

    Boone, J.; Douven, R.C.M.H.; Droge, C.; Mosca, I.

    2010-01-01

    In countries like the US and the Netherlands health insurance is provided by private firms. These private firms can offer both individual and group contracts. The strategic and welfare implications of such group contracts are not well understood. Using a Dutch data set of about 700 group health insu

  3. Hazardous Medical Waste Management as a Public Health Issue

    OpenAIRE

    Marinković, Natalija; VITALE, KSENIJA; Afrić, Ivo; Janev Holcer, Nataša

    2005-01-01

    The amount of waste produced is connected with the degree of a country’s economic development; more developed countries produce more waste. This paper reviews the quantities, manipulation and treatment methods of medical waste in Croatia, as well as hazardous potentials of medical waste for human health. Medical waste must be collected and sorted in containers suitable for its characteristics, amount, means of transportation and treatment method in order to prevent contact with environment an...

  4. Medical equipment in government health facilities: Missed opportunities

    OpenAIRE

    Pardeshi Geeta

    2005-01-01

    BACKGROUND: The availability and optimal utilization of medical equipment is important for improving the quality of health services. Significant investments are made for the purchase, maintenance and repair of medical equipment. Inadequate management of these equipment will result in financial losses and deprive the public of the intended benefits. This analysis is based on the conceptual framework drawn from the WHO recommended- lifecycle of medical equipment. AIMS: (1) To identify the probl...

  5. Medical equipment in government health facilities: Missed opportunities

    OpenAIRE

    Pardeshi Geeta

    2005-01-01

    BACKGROUND: The availability and optimal utilization of medical equipment is important for improving the quality of health services. Significant investments are made for the purchase, maintenance and repair of medical equipment. Inadequate management of these equipment will result in financial losses and deprive the public of the intended benefits. This analysis is based on the conceptual framework drawn from the WHO recommended- lifecycle of medical equipment. AIMS: (1) To identify the probl...

  6. Health inequalities and social group differences: what should we measure?

    Science.gov (United States)

    Murray, C. J.; Gakidou, E. E.; Frenk, J.

    1999-01-01

    Both health inequalities and social group health differences are important aspects of measuring population health. Despite widespread recognition of their magnitude in many high- and low-income countries, there is considerable debate about the meaning and measurement of health inequalities, social group health differences and inequities. The lack of standard definitions, measurement strategies and indicators has and will continue to limit comparisons--between and within countries, and over time--of health inequalities, and perhaps more importantly comparative analyses of their determinants. Such comparative work, however, will be essential to find effective policies for governments to reduce health inequalities. This article addresses the question of whether we should be measuring health inequalities or social group health differences. To help clarify the strengths and weaknesses of these two approaches, we review some of the major arguments for and against each of them. PMID:10444876

  7. Evolution of Facebook groups: Informal e-learning among medical laboratory scientists in Nigeria

    Directory of Open Access Journals (Sweden)

    Jarret Cassaniti

    2014-09-01

    Full Text Available Most people think of online courses when they talk about e-learning, but aspects of social media can also be considered e-learning. In 2011 the Knowledge for Health Project (K4Health began work with local partners to implement an e-learning and professional development policy for Medical Laboratory Scientists based on the needs identified by United States Agency for International Development (USAID/Nigeria. Six e-learning courses were developed and promoted through several channels including social media. A Facebook Group was created to share information about accessing and navigating the courses and attracted 8,500 members in 18 months. As the Group grew, the topics discussed evolved to include trade union news, employment opportunities and technical resources. Another Facebook Group provided insights that Facebook Groups could be used to facilitate interactions focused on continuing professional development. The findings show that Facebook Groups accommodate an informal learning style, allowing individuals to learn through peer support in flexible ways. It has also shown that the use of Facebook Groups is associated with high levels of engagement with e-learning courses.

  8. ALA Guide to Medical & Health Sciences Reference

    Science.gov (United States)

    ALA Editions, 2011

    2011-01-01

    This resource provides an annotated list of print and electronic biomedical and health-related reference sources, including Internet resources and digital image collections. Readers will find relevant research, clinical, and consumer health information resources. The emphasis is on resources within the United States, with a few representative…

  9. Exposure to Fictional Medical Television and Health: A Systematic Review

    Science.gov (United States)

    Hoffman, Beth L.; Shensa, Ariel; Wessel, Charles; Hoffman, Robert; Primack, Brian A.

    2017-01-01

    Fictional medical television programs have long been a staple of television programming, and they remain popular today. We aimed to examine published literature assessing the influence of medical television programs on health outcomes. We conducted systematic literature searches in PubMed, PsychINFO and CINAHL. Selected studies had to be scholarly…

  10. Health Care Practices for Medical Textiles in Government Hospitals

    Science.gov (United States)

    Akubue, B. N.; Anikweze, G. U.

    2015-01-01

    The purpose of this study was to investigate the health care practices for medical textiles in government hospitals Enugu State, Nigeria. Specifically, the study determined the availability and maintenance of medical textiles in government hospitals in Enugu State, Nigeria. A sample of 1200 hospital personnel were studied. One thousand two hundred…

  11. Strategies to optimize medication use in the physician group practice: the role of the clinical pharmacist.

    Science.gov (United States)

    Devine, Emily Beth; Hoang, Susan; Fisk, Albert W; Wilson-Norton, Jennifer L; Lawless, Nathan M; Louie, Clifton

    2009-01-01

    To (1) describe the role of clinical pharmacists in providing population-based pharmaceutical care as employees of a physician group practice, (2) describe the strategies used by pharmacists to optimize medication use, (3) quantify improvements in care, and (4) illustrate the calculations used to quantify cost savings. Community-based, multispecialty, physician group practice located in the north Puget Sound area between 2003 and 2007. Using four cornerstones (evidence-based medicine, therapeutic interchange, academic detailing, and a local pharmacy and therapeutics committee), the pharmacists provided population-based pharmaceutical care, leading generic switches, target drug programs, and prescription to over-the-counter medication switches. They also led disease management programs, managed drug recalls, implemented electronic health records, negotiated budgets with health plans, and led patient assistance programs and prior authorization programs to improve patient satisfaction. Implementing these strategies from the vantage point of a physician group presents a seldom-realized employment opportunity for pharmacists. The impact of these strategies is measured by process, use, and clinical outcomes metrics. These, in turn, are linked to incentive payments in the pay-for-performance environment or to a lowered per member, per month cost in the capitated environment. In 2006-2007, 71% of our hypertensive patients received generic agents compared with a network average for receiving generic agents of 43%, while the proportion of patients with controlled blood pressure increased from 45% to 60%. We saved $450,000 in inpatient costs for deep venous thrombosis. Clinical pharmacists employed in a physician group practice can optimize medication use, improve care, and reduce costs.

  12. Perceptions of personal health risks by medical and non-medical workers in a university medical center : a survey study

    NARCIS (Netherlands)

    Listyowardojo, Tita Alissa; Nap, Raoul E.; Johnson, Addie

    2010-01-01

    Background: Health care workers (HCWs) are faced with many work-related choices which may depend on how they perceive risk, such as whether or not to comply with safety regulations. Little research has investigated risk perception in medical workers in comparison with non-medical workers and the ext

  13. Perceptions of personal health risks by medical and non-medical workers in a university medical center : a survey study

    NARCIS (Netherlands)

    Listyowardojo, Tita Alissa; Nap, Raoul E.; Johnson, Addie

    2010-01-01

    Background: Health care workers (HCWs) are faced with many work-related choices which may depend on how they perceive risk, such as whether or not to comply with safety regulations. Little research has investigated risk perception in medical workers in comparison with non-medical workers and the ext

  14. Medical Informatics in Academic Health Science Centers.

    Science.gov (United States)

    Frisse, Mark E.

    1992-01-01

    An analysis of the state of medical informatics, the application of computer and information technology to biomedicine, looks at trends and concerns, including integration of traditionally distinct enterprises (clinical information systems, financial information, scholarly support activities, infrastructures); informatics career choice and…

  15. Medical Services: Nonphysician Health Care Providers

    Science.gov (United States)

    2007-11-02

    of osteopathy ). (2) PAs may write routine orders on inpatients, using DA Form 4256 (Doctor’s Orders). (3) When required, inpatient treatment...of medicine or osteopathy , who are authorized and responsible for determining, starting, or altering the regimen of medical treatment provided to a

  16. Computer-assisted group study for learning/teaching medical entomology to medical students

    Directory of Open Access Journals (Sweden)

    Sudharsanam Manni Balasubramaniam

    2012-01-01

    Full Text Available Objectives: The objective of this study was to describe an innovative method used for teaching entomology. Setting : It was performed at Department of Preventive and Social Medicine, JIPMER, Puducherry. Materials and Methods: Fifty-five second year medical students were divided into two batches. Each batch had two sessions on entomology. In each session students were divided into small groups and assigned to prepare on the various insects of medical entomological importance and present on the prepared topic. The topics included vector characteristics, vector habits, diseases transmitted and modes of transmission of diseases, control of vectors. The corresponding photographs of the insects were projected at the end of each presentation. The modes of transmission, diseases transmitted, and control measures were learnt through the oral presentations. After each session students were shown the slides under microscopes to reinforce the features. Pretest and posttest were used to find the gain in knowledge and feedback was taken at the end of each session. Results: Comparison of pretest and posttest scores showed a statistically significant gain in the knowledge. Feedback from students revealed that objectives were clear for 42 of the 55 students. Facilitating factors included interactive session (14, group discussion (31, PowerPoint presentation (24, good moderator (14. Factors which hindered learning were lack of time for preparation (13 and afternoon sessions (2. Students suggested that more of this type of classes should be taken for them in near future (28. Conclusion: This method served as an effective alternative method as judged by students′ performance and feedback.

  17. Let's dance: Organization studies, medical sociology and health policy.

    Science.gov (United States)

    Currie, Graeme; Dingwall, Robert; Kitchener, Martin; Waring, Justin

    2012-02-01

    This Special Issue of Social Science & Medicine investigates the potential for positive inter-disciplinary interaction, a 'generative dance', between organization studies (OS), and two of the journal's traditional disciplinary foundations: health policy and medical sociology. This is both necessary and timely because of the extent to which organizations have become a neglected topic within medical sociology and health policy analysis. We argue there is need for further and more sustained theoretical and conceptual synergy between OS, medical sociology and health policy, which provides, on the one-hand a cutting-edge and thought-provoking basis for the analysis of contemporary health reforms, and on the other hand, enables the development and elaboration of theory. We emphasize that sociologists and policy analysts in healthcare have been leading contributors to our understanding of organizations in modern society, that OS enhances our understanding of medical settings, and that organizations remain one of the most influential actors of our time. As a starting point to discussion, we outline the genealogy of OS and its application to healthcare settings. We then consider how medical sociology and health policy converge or diverge with the concerns of OS in the study of healthcare settings. Following this, we focus upon the material environment, specifically the position of business schools, which frames the generative dance between OS, medical sociology and health policy. This sets the context for introducing the thirteen articles that constitute the Special Issue of Social Science & Medicine. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. Mental health status among Japanese medical students: a cross-sectional survey of 20 universities.

    Science.gov (United States)

    Ohtsu, Tadahiro; Kaneita, Yoshitaka; Osaki, Yoneatsu; Kokaze, Akatsuki; Ochiai, Hirotaka; Shirasawa, Takako; Nanri, Hinako; Ohida, Takashi

    2014-12-01

    The purposes of this study were to evaluate the mental health status of Japanese medical students and to examine differences based on gender, as well as on university type and location, using the results of a nationwide survey. Between December 2006 and March 2007, we conducted a questionnaire survey among fourth-year medical students at 20 randomly selected medical schools in Japan. The data from 1,619 students (response rate: 90.6%; male: 1,074; female: 545) were analyzed. We used the Japanese version of the 12-item General Health Questionnaire (GHQ-12) to measure mental health status. Poor mental health status (GHQ-12 score of 4 points or higher) was observed in 36.6% and 48.8% of the male and female medical students, respectively. The ratio of the age-adjusted prevalence of poor mental health status in female versus male medical students was 1.33 (95% confidence interval: 1.10-1.62). The universities were categorized into two groups based on the university type (national/public: 15 vs. private: 5) or location (in a large city: 7 vs. in a local city: 13 cities). The prevalence of poor mental health status in both men and women differed between these groups, although not significantly. The GHQ-12 scores in men significantly differed between the categorized groups of universities. These results suggest that adequate attention must be paid to the mental health of medical students, especially females, and that a system for providing mental health care for medical students must be established in the context of actual conditions at each university.

  19. Social Media as Catalyzer for Connected Health: Hype or Hope? Perspectives from IMIA Working Groups.

    Science.gov (United States)

    Fernandez-Luque, Luis; Vilmarlund, Vivian; Borycki, Elizabeth; Schulz, Stefan; Kuziemsky, Craig; Marschollek, Michael; Kulikowski, Casimir A

    2016-01-01

    The Internet and social media are becoming ubiquitous technologies that are transforming the health sector. Social media has become an avenue for accessing, creating and sharing health information among patients and healthcare professionals. Furthermore, social media has become a key feature in many eHealth solutions, including wearable technologies, Big Data solutions, eLearning systems, Serious Games, Medical imaging, etc. These hyper-connected technologies are facilitating a paradigm shift towards more connected health. In this panel, representatives of different IMIA Working Groups will explore how both hope and hype contribute to social media's catalyzing role in creating connected health solutions.

  20. Medical education in cyberspace: critical considerations in the health system

    Science.gov (United States)

    YAZDANI, SHAHRAM; KHOSHGOFTAR, ZOHREH; AHMADY, SOLEIMAN; RASTEGARPOUR, HASSAN; FOROUTAN, SEYED ABBAS

    2017-01-01

    Introduction: Over the past few decades, two revolutionary approaches have emerged as a new form of medical education: Electronic Medical Education and Web-based Medical Education. A number of well-known medical institutions, such as Harvard and Johns Hopkins used a wide range of cyberspace capabilities to increase their competitiveness. Researchers have expressed that cyberspace will change health system’s main objective of training physicians and medical education. We conducted this study to identify the health system critical considerations on core issues, involving the development of medical education on cyberspace. Methods: In order to conduct this study, we observed the steps of a critical literature review, combined with the ‘Four-phase method’ adopted by Carnwell and Daly. We focused on particular literature on health and cyber system functions; it was associated with systemic approach. Results: We developed a six-level taxonomy, Cyber level, Governance level, Ministerial level, Organizational level, Program level and Performance level, as a key solution that can be applied for the success of medical education on cyberspace. The results were summarized and appraised in more details. Conclusion: Medical education on cyberspace is a complex interdisciplinary system. It is important that all aspects of the health systems be involved as integral to the development of cyber based medical education; without this convergence, we will be confused by the decisions made by others within the system. Health system should also communicate with those external sectors that are critical to achieving better learning on cyberspace. Integrated planning, governance and management of medical education in cyberspace are pivotal elements for the promotion. PMID:28124017

  1. Medical education in cyberspace: critical considerations in the health system.

    Science.gov (United States)

    Yazdani, Shahram; Khoshgoftar, Zohreh; Ahmady, Soleiman; Rastegarpour, Hassan; Foroutan, Seyed Abbas

    2017-01-01

    Over the past few decades, two revolutionary approaches have emerged as a new form of medical education: Electronic Medical Education and Web-based Medical Education. A number of well-known medical institutions, such as Harvard and Johns Hopkins used a wide range of cyberspace capabilities to increase their competitiveness. Researchers have expressed that cyberspace will change health system's main objective of training physicians and medical education. We conducted this study to identify the health system critical considerations on core issues, involving the development of medical education on cyberspace. In order to conduct this study, we observed the steps of a critical literature review, combined with the 'Four-phase method' adopted by Carnwell and Daly. We focused on particular literature on health and cyber system functions; it was associated with systemic approach. We developed a six-level taxonomy, Cyber level, Governance level, Ministerial level, Organizational level, Program level and Performance level, as a key solution that can be applied for the success of medical education on cyberspace. The results were summarized and appraised in more details. Medical education on cyberspace is a complex interdisciplinary system. It is important that all aspects of the health systems be involved as integral to the development of cyber based medical education; without this convergence, we will be confused by the decisions made by others within the system. Health system should also communicate with those external sectors that are critical to achieving better learning on cyberspace. Integrated planning, governance and management of medical education in cyberspace are pivotal elements for the promotion.

  2. Medical health care professionals' assessments of oral health needs in children with disabilities: a qualitative study.

    Science.gov (United States)

    Hallberg, Ulrika; Klingberg, Gunilla

    2005-10-01

    Good collaboration between medical and dental care is essential to provide not only good oral health care, but also more holistic care for children with disabilities. The aim was to explore and describe medical health care professionals' assessments and considerations of orofacial problems and treatment needs in children with disabilities and in their families. In-depth interviews focusing on orofacial function were carried out with 17 medical health care employees. Interviews were transcribed verbatim and analysed in open and focused (selective) coding processes according to grounded theory. A core category was identified and named focusing on basic needs, showing that oral health care assessment was not on the agenda of medical health care professionals, but was instead viewed as a responsibility of parents or dentists. This study shows that oral health issues are not fully integrated in the medical care of children with disabilities. The omission of oral health issues from the medical agenda implies a risk of oral health problems in children with disabilities. To put the oral cavity and oral health on the medical agenda, dentists need to influence the undergraduate training of medical professionals and to initiate co-operation with the medical care system.

  3. Health economics education in undergraduate medical training: introducing the health economics education (HEe) website.

    Science.gov (United States)

    Oppong, Raymond; Mistry, Hema; Frew, Emma

    2013-09-13

    In the UK, the General Medical Council clearly stipulates that upon completion of training, medical students should be able to discuss the principles underlying the development of health and health service policy, including issues relating to health economics. In response, researchers from the UK and other countries have called for a need to incorporate health economics training into the undergraduate medical curricula. The Health Economics education website was developed to encourage and support teaching and learning in health economics for medical students. It was designed to function both as a forum for teachers of health economics to communicate and to share resources and also to provide instantaneous access to supporting literature and teaching materials on health economics. The website provides a range of free online material that can be used by both health economists and non-health economists to teach the basic principles of the discipline. The Health Economics education website is the only online education resource that exists for teaching health economics to medical undergraduate students and it provides teachers of health economics with a range of comprehensive basic and advanced teaching materials that are freely available. This article presents the website as a tool to encourage the incorporation of health economics training into the undergraduate medical curricula.

  4. Medical Malpractice Phenomena: Signals for Changing Medical and Health Care Values

    DEFF Research Database (Denmark)

    Brødsgaard, I.; Moore, R.

    1990-01-01

    Excellent discussion of the economic factors such as medical malpractice and corporate medicine that have begun to interfere with the doctor-patient relationship and why this relationship is so essential in order to prevent medical malpractice. Issues of quality assurance are relevant to the doctor-patient...... relationship and the quality of health care....

  5. Annals of Medical and Health Sciences Research

    African Journals Online (AJOL)

    ... health, ethical and social issues in field of all aspects of medicine (Basic and Clinical), ... Improving Surgical Skills of OBGYN Residents through Partnership with ... Visual Impairment and Blindness in 5 Communities in IMO State, South East ...

  6. Medical tourism's impacts on health worker migration in the Caribbean: five examples and their implications for global justice

    Science.gov (United States)

    Snyder, Jeremy; Crooks, Valorie A.; Johnston, Rory; Adams, Krystyna; Whitmore, Rebecca

    2015-01-01

    Medical tourism is a practice where individuals cross international borders in order to access medical care. This practice can impact the global distribution of health workers by potentially reducing the emigration of health workers from destination countries for medical tourists and affecting the internal distribution of these workers. Little has been said, however, about the impacts of medical tourism on the immigration of health workers to medical tourism destinations. We discuss five patterns of medical tourism-driven health worker migration to medical tourism destinations: 1) long-term international migration; 2) long-term diasporic migration; 3) long-term migration and ‘black sheep’; 4) short-term migration via time share; and 5) short-term migration via patient-provider dyad. These patterns of health worker migration have repercussions for global justice that include potential negative impacts on the following: 1) health worker training; 2) health worker distributions; 3) local provision of care; and 4) local economies. In order to address these potential negative impacts, policy makers in destination countries should work to ensure that changes in health worker training and licensure aimed at promoting the medical tourism sector are also supportive of the health needs of the domestic population. Policy makers in both source and destination countries should be aware of the effects of medical tourism on health worker flows both into and out of medical tourism destinations and work to ensure that the potential harms of these worker flows to both groups are mitigated. PMID:25865122

  7. Medical tourism's impacts on health worker migration in the Caribbean: five examples and their implications for global justice.

    Science.gov (United States)

    Snyder, Jeremy; Crooks, Valorie A; Johnston, Rory; Adams, Krystyna; Whitmore, Rebecca

    2015-01-01

    Medical tourism is a practice where individuals cross international borders in order to access medical care. This practice can impact the global distribution of health workers by potentially reducing the emigration of health workers from destination countries for medical tourists and affecting the internal distribution of these workers. Little has been said, however, about the impacts of medical tourism on the immigration of health workers to medical tourism destinations. We discuss five patterns of medical tourism-driven health worker migration to medical tourism destinations: 1) long-term international migration; 2) long-term diasporic migration; 3) long-term migration and 'black sheep'; 4) short-term migration via time share; and 5) short-term migration via patient-provider dyad. These patterns of health worker migration have repercussions for global justice that include potential negative impacts on the following: 1) health worker training; 2) health worker distributions; 3) local provision of care; and 4) local economies. In order to address these potential negative impacts, policy makers in destination countries should work to ensure that changes in health worker training and licensure aimed at promoting the medical tourism sector are also supportive of the health needs of the domestic population. Policy makers in both source and destination countries should be aware of the effects of medical tourism on health worker flows both into and out of medical tourism destinations and work to ensure that the potential harms of these worker flows to both groups are mitigated.

  8. Characteristics associated with self-rated health in the CARDIA study: Contextualising health determinants by income group

    Directory of Open Access Journals (Sweden)

    Shilpa Nayak

    2016-12-01

    SRH is a multidimensional measure; CTA is useful for contextualizing risk factors in relation to health status. Findings suggest that for lower income groups, addressing contributors to chronic burden is important alongside lifestyle/medical factors. In a proportionate universalism context, in addition to differences in intensity of public health action across the socioeconomic gradient, differences in the type of interventions to improve SRH may also be important.

  9. The success of medical nutrition therapy in both genders and in different age groups

    Directory of Open Access Journals (Sweden)

    Ralević Slađana

    2013-01-01

    Full Text Available More than half of the adult population of the Republic of Serbia is overweight or obese. Obesity carries various risks and general health complications, which can significantly impair one's functioning and well-being. On the other hand, beneficial effects of body mass reduction are clearly confirmed. The therapeutic approach to obesity involves the use of various measures Treatment may include: medical nutrition therapy, programmed physical activity, medicaments and surgical treatment. The aim of this study was to examine if the effectiveness of medical nutrition therapy depends on the sex and age structure. This investigation was conducted as a retrospective study for the period from January 2008. until July 2009. During this time, 990 people came to the Counceling center. Only patients who came regularly to the controls and had BMI higher than 25 kg/m2 were included in this study. The average BMI in men was 31.55 kg/m2 and 32.66 kg/m2 in women. Compared to the first examination, majority of females (n = 35, 24.56% and males (n = 23, 25.27% reduced their BMI from 0 to 0.5 kg/m2 after medical nutrition therapy. Based on the results of X2 test, we concluded that there were statistically significant differences between men and women in effectiveness of medical nutrition therapy, while differences in the effectiveness of treatment in different age groups do not exist, neither in men nor in women.

  10. Health Benefits Mandates and Their Potential Impacts on Racial/Ethnic Group Disparities in Insurance Markets.

    Science.gov (United States)

    Charles, Shana Alex; Ponce, Ninez; Ritley, Dominique; Guendelman, Sylvia; Kempster, Jennifer; Lewis, John; Melnikow, Joy

    2017-08-01

    Addressing racial/ethnic group disparities in health insurance benefits through legislative mandates requires attention to the different proportions of racial/ethnic groups among insurance markets. This necessary baseline data, however, has proven difficult to measure. We applied racial/ethnic data from the 2009 California Health Interview Survey to the 2012 California Health Benefits Review Program Cost and Coverage Model to determine the racial/ethnic composition of ten health insurance market segments. We found disproportional representation of racial/ethnic groups by segment, thus affecting the health insurance impacts of benefit mandates. California's Medicaid program is disproportionately Latino (60 % in Medi-Cal, compared to 39 % for the entire population), and the individual insurance market is disproportionately non-Latino white. Gender differences also exist. Mandates could unintentionally increase insurance coverage racial/ethnic disparities. Policymakers should consider the distribution of existing racial/ethnic disparities as criteria for legislative action on benefit mandates across health insurance markets.

  11. The electronic medical record system: health care marvel or morass?

    Science.gov (United States)

    Silverman, D C

    1998-01-01

    The author considers the potential advantages and disadvantages, as well as possible unintended consequences, of introducing electronic medical record systems in health care organizations. Special consideration is given to the issues such information systems raise concerning privacy, confidentiality, and quality of care from both patient and provider perspectives. The potential gains from computerizing medical records include the benefit of instantaneous availability of patients' medical history, treatment regimes, and current health status in routine and emergency clinical situations. Ease of access to this information should reduce adverse outcomes. The added value of a complete and up-to-date medical record immediately available to medical caregivers seems undeniable. The potential disadvantages include issues around patient confidentiality and unauthorized access to records, the enormous capital investment for computer hardware, and system maintenance.

  12. A review of m-health in medical imaging.

    Science.gov (United States)

    Perera, Chandrashan Mahendra; Chakrabarti, Rahul

    2015-02-01

    The increasing capabilities of camera-equipped mobile phones have led to a growing body of evidence regarding their use in medical imaging across a broad range of medical specialties. This article reviews the current evidence for the use of mobile health (m-health) in medical imaging. We performed a structured review of the published literature regarding m-health in medical imaging using the Medline, PubMed, and Web of Science databases (January 2002-August 2013). The two authors independently extracted data regarding type of specialty, purpose, and study design of publications. In total, 235 articles were identified. The majority of studies were case reports or noncomparative product validation studies. The greatest volume of publications originated in the fields of radiology (21%), dermatology (15%), laboratory techniques (15%), and plastic surgery (12%). Among these studies, m-health was used as diagnostic aids, for patient monitoring, and to improve communication between health practitioners. With the growing use of mobile phones for medical imaging, considerations need to be given to informed consent, privacy, image storage and transfer, and guidelines for healthcare workers and patients. There are several novel uses of mobile devices for medical imaging that show promise across a variety of areas and subspecialties of healthcare. Currently, studies are mostly exploratory in nature. To validate these devices, studies with higher methodological rigor are required.

  13. Music and health. Phenomenological investigation of a medical humanity.

    Science.gov (United States)

    McLellan, Lucy; McLachlan, Emma; Perkins, Laurence; Dornan, Tim

    2013-05-01

    In response to the tendency for music to be under-represented in the discourse of medical humanities, we framed the question 'how can music heal?' We answered it by exploring the lived experiences of musicians with lay or professional interests in health. Two medical students and a medically qualified educationalist, all musicians, conducted a co-operative inquiry with a professional musician interested in health. All researchers and six respondents kept audio or written diaries. Three respondents were interviewed in depth. A medical school head (and experienced musician) critiqued the phenomenological analysis of respondents' accounts of music, health, and its relationship with undergraduate medical education. Respondents experienced music as promoting health, even in seriously diseased people. Music affected people's identity and emotions. Through the medium of structure and harmony, it provided a means of self-expression that adapted to whatever condition people were in. Music was a communication medium, which could make people feel less isolated. Immersion in music could change negative states of mind to more positive ones. A transport metaphor was commonly used; music 'taking people to better places'. Exercising control by becoming physically involved in music enhanced diseased people's self-esteem. Music was able to bring the spiritual, mental, and physical elements of their lives into balance, to the benefit of their wellbeing. Music could help medical students appreciate holistically that the state of health of people who are either well or diseased can be enhanced by a 'non-technical' intervention.

  14. eMedication Meets eHealth with the Electronic Medication Management Assistant (eMMA).

    Science.gov (United States)

    Tschanz, Mauro; Dorner, Tim Lucas; Denecke, Kerstin

    2017-01-01

    A patient's healthcare team is often missing a complete overview on the prescribed and dispensed medication. This is due to an inconsistent information flow between the different actors of the healthcare system. Often, only the patient himself knows exactly which drugs he is actually taking. Our objective is to exploit different eHealth technologies available or planned in Switzerland to improve the information flow of the medication data among the stakeholder and to support the patient in managing his medication. This work is embedded in the "Hospital of the Future Live" project, involving 16 companies and 6 hospitals in order to develop IT solutions for future optimized health care processes. A comprehensive set of requirements was collected from the different actors and project partners. Further, specifications of the available or planned eHealth infrastructure were reviewed to integrate relevant technologies into a coherent concept. We developed a concept that combines the medication list and an eHealth platform. The resulting electronic medication management assistant (eMMA) designed for the patient provides the current medication plan at any time and supports by providing relevant information through a conversational user interface. In Switzerland, we still need a bridging technology to combine the medication information from the electronic patient record with the medication plan's associated QR-Code. The developed app is intended to provide such bridge and demonstrates the usefulness of the eMediplan. It enables the patient to have all data regarding his medication on his personal mobile phone and he can - if necessary - provide the current medication to the health professional.

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

    Science.gov (United States)

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

    2016-12-01

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

  16. Protecting health from climate change: Preparedness of medical interns

    Directory of Open Access Journals (Sweden)

    Majra Jai

    2009-01-01

    Full Text Available Context : Climate change is a significant and emerging threat to public health and to meet the challenge, health systems require qualified staff. Aims : To study the preparedness of medical interns to meet the challenge of protecting health from climate change. Settings and Design: Medical colleges in a coastal town. Cross-sectional study. Materials and Methods: A proportionate number of medical interns from five medical colleges were included in the study. Level of awareness was used as a criterion to judge the preparedness. A self-administered, pretested, open-ended questionnaire was used. Responses were evaluated and graded. Statistical Analysis Used: Proportions, percentage, Chi-test. Results : About 90% of the medical interns were aware of the climate change and human activities that were playing a major role. Ninety-four percent were aware of the direct health impacts due to higher temperature and depletion in ozone concentration, and about 78% of the respondents were aware about the change in frequency / distribution of vector-borne diseases, water borne / related diseases, malnutrition, and health impact of population displacement. Knowledge regarding health protection was limited to mitigation of climate change and training / education. Options like adaptation, establishing / strengthening climate and disease surveillance systems, and health action in emergency were known to only nine (7%, eight (6%, and 17 (13%, respectively. Collegewise difference was statistically insignificant. Extra / co-curricular activities were the major source of knowledge. Conclusions : Majority of medical interns were aware of the causes and health impacts of climate change, but their knowledge regarding health protection measures was limited.

  17. Management of Newer Medications for Attention-Deficit Hyperactivity Disorder In Commercial Health Plans

    Science.gov (United States)

    Hodgkin, Dominic; Horgan, Constance M.; Quinn, Amity E.; Merrick, Elizabeth; Stewart, Maureen T.; Leslie, Laurel K.

    2014-01-01

    Purpose In the US, many individuals with attention deficit hyperactivity disorder (ADHD) pay for their medications using private health insurance coverage. As in other drug classes, private insurers are actively seeking to influence utilization and costs, particularly for newer and costlier medications. The approaches that insurers use may have important effects on patients’ access to medications. This paper examines approaches (e.g., copayments, prior authorization, and step therapy) that commercial health plans are employing to manage newer medications used to treat ADHD and changes in approaches since 2003. Methods Data are from a nationally representative survey of commercial health plans in 60 market areas regarding alcohol, drug abuse and mental health services in 2010. Responses were obtained from 389 plans (89% response rate), reporting on 925 insurance products. For each of six branded ADHD medications, respondents were asked whether the plan covered the medication and if so, on what copayment tier each medication was placed, and whether it was subject to prior authorization or step therapy. Measures of management approach were constructed for each medication and for the group of medications. Bivariate and multivariate analyses were used to test for association of the management approach with various health plan characteristics. Findings There was considerable variation across these 6 medications in how tightly they were managed by health plans, with newer medications being subject to more stringent management. The proportion of insurance products relying solely on copay tiering to manage novel ADHD medications appears to have decreased since 2003. Less than half of insurance products (43%) managed these 6 medications solely by use of Tier 3/4 placement, and most of the remainder (48%) used other restrictions (with or without Tier 3/4 placement). The average insurance product restricted access to at least 3 of the 6 brand-only medications examined

  18. Health economic analyses in medical nutrition: a systematic literature review

    Directory of Open Access Journals (Sweden)

    Walzer S

    2014-03-01

    Full Text Available Stefan Walzer,1,2 Daniel Droeschel,1,3 Mark Nuijten,4 Hélène Chevrou-Séverac5 1MArS Market Access and Pricing Strategy GmbH, Weil am Rhein, Germany; 2State University Baden-Wuerttemberg, Loerrach, Germany; 3Riedlingen University, SRH FernHochschule, Riedlingen, Germany; 4Ars Accessus Medica BV, Amsterdam, the Netherlands, 5Nestlé Health Science, Vevey, Switzerland Background: Medical nutrition is a specific nutrition category either covering specific dietary needs and/or nutrient deficiency in patients or feeding patients unable to eat normally. Medical nutrition is regulated by a specific bill in Europe and in the US, with specific legislation and guidelines, and is provided to patients with special nutritional needs and indications for nutrition support. Therefore, medical nutrition products are delivered by medical prescription and supervised by health care professionals. Although these products have existed for more than 2 decades, health economic evidence of medical nutrition interventions is scarce. This research assesses the current published health economic evidence for medical nutrition by performing a systematic literature review related to health economic analysis of medical nutrition. Methods: A systematic literature search was done using standard literature databases, including PubMed, the Health Technology Assessment Database, and the National Health Service Economic Evaluation Database. Additionally, a free web-based search was conducted using the same search terms utilized in the systematic database search. The clinical background and basis of the analysis, health economic design, and results were extracted from the papers finally selected. The Drummond checklist was used to validate the quality of health economic modeling studies and the AMSTAR (A Measurement Tool to Assess Systematic Reviews checklist was used for published systematic reviews. Results: Fifty-three papers were identified and obtained via PubMed, or directly

  19. Current efforts in medical education to incorporate national health priorities.

    Science.gov (United States)

    Nair, Manisha; Fellmeth, Gracia

    2017-08-03

    As a reflection on the Edinburgh Declaration, this conceptual synthesis presents six important challenges in relation to the role of medical education in meeting current national health priorities. This paper presents a conceptual synthesis of current efforts in medical education to incorporate national health priorities as a reflection on how the field has evolved since the Edinburgh Declaration. Considering that health needs vary from country to country, our paper focuses on three broad and cross-cutting themes: health equity, health systems strengthening, and changing patterns of disease. Considering the complexity of this topic, we conducted a targeted search to broadly sample and critically review the literature in two phases. Phase 1: within each theme, we assessed the current challenges in the field of medical education to meet the health priority. Phase 2: a search for various strategies in undergraduate and postgraduate education that have been tested in an effort to address the identified challenges. We conducted a qualitative synthesis of the literature followed by mapping of the identified challenges within each of the three themes with targeted efforts. We identified six important challenges: (i) mismatch between the need for generalist models of health care and medical education curricula's specialist focus; (ii) attitudes of health care providers contributing to disparities in health care; (iii) the lack of a universal approach in preparing medical students for 21st century health systems; (iv) the inability of medical education to keep up with the abundance of new health care technologies; (v) a mismatch between educational requirements for integrated care and poorly integrated, specialised health care systems; and (vi) development of a globally interdependent education system to meet global health challenges. Examples of efforts being made to address these challenges are offered. Although strategies for combatting these challenges exist, the

  20. Prostate cancer support groups, health literacy and consumerism: are community-based volunteers re-defining older men's health?

    Science.gov (United States)

    Oliffe, John L; Bottorff, Joan L; McKenzie, Michael M; Hislop, T Gregory; Gerbrandt, Julieta S; Oglov, Valerie

    2011-11-01

    In this article we describe the connections between prostate cancer support groups (PCSGs) and men's health literacy and consumer orientation to health care services. The study findings are drawn from participant observations conducted at 16 PCSGs in British Columbia, Canada and 54 individual interviews that focused on men's experiences of attending group meetings. Men's communication and interactions at PCSGs provide important insights for how men talk about and conceptualize health and illness. For example, biomedical language often predominated at group meetings, and men used numbers and measures to engage with risk discourses in linking prostate cancer markers to various treatment options and morbidity and mortality rates. Many groups afforded opportunities for men to interact with health care providers as a means to better understand the language and logic of prostate cancer management. The health literacy skills fostered at PCSGs along with specific group-informed strategies could be mobilized in the men's subsequent clinical consultations. Consumer discourses and strategies to contest power relations with health care professionals underpinned many men's search for prostate cancer information and their commitment to assisting other men. Key were patients' rights, and perhaps responsibility, to compare diverse health products and services in making decisions across the entire trajectory of their prostate cancer. Overall, the study findings reveal PCSGs as having the capacity to contest as well as align with medical expertise and services facilitating men's transition from patient to informed health care consumers. The processes through which this occurs may direct the design of older men's health promotion programs.

  1. Good Mental Health Status of Medical Students: Is There A Role for Physical Activity?

    Directory of Open Access Journals (Sweden)

    Deepthi R

    2015-01-01

    Full Text Available Background: Mental health problems are more commonly seen in youth, more so in medical students. Physical activity though known to improve mental health is difficult to follow among medical students. Aims & Objectives: This study aimed to investigate self-reported levels of anxiety and depression and compare these with self-reported physical activity among medical students in an institution of India. Material & Methods: A Cross sectional study was done among 430 medical students and interns of a medical college of rural Karnataka, India. Hospital Anxiety and Depression Scale (HADS and International Physical Activity Questionnaire (IPAQ were administered to assess mental health status and physical activity levels respectively. Results: The prevalence of anxiety (65.1%, depression (39.5% and anxiety with depression (34.4% was high among medical students. Only 18.1% of students were highly active while 35.9% were inactive when physical activity levels were measured. Students who were highly active and minimally active in physical activity showed lower levels of depression and anxiety compared to low physical activity group. Conclusion: Mental health problems are high and physical activity levels are low among medical undergraduate students. Engagement in physical activity can be an important contributory factor in positive mental health of future doctors.

  2. Implementation of STFM's "Smiles for Life" oral health curriculum in a medical school interclerkship.

    Science.gov (United States)

    Silk, Hugh; O'Grady Stille, Sheila; Baldor, Robert; Joseph, Emily

    2009-01-01

    While oral health is an important topic for medical education, it is often not covered in medical school. The Association of American Medical Colleges (AAMC) has recently set guidelines for oral health training in medical education. Our objective was to demonstrate how a mandatory interclerkship (half-day workshops taught between third-year clerkships) that covers pediatric, urgent care, examination skills, and prevention topics in oral health can lead to an increase in knowledge for medical students. Teaching methods included the use of interactive lectures, an audience response system, and small-group workshops taught by medical and dental educators. The curriculum was based on the Society of Teachers of Family Medicine (STFM) Smiles for Life National Oral Health Curriculum. Students were given pretests and posttests, including a 6-month follow-up test. Students showed a significant improvement in knowledge between pretesting and immediate posttesting across a range of topics. Long-term knowledge retention was more limited. The majority of students reported enthusiasm for this topic and found the materials essential for their training. A brief interclerkship can improve medical students' oral health knowledge and be engaging. More research is needed to evaluate means to sustaining the knowledge.

  3. [Marijuana for medical purposes--public health perspective].

    Science.gov (United States)

    Gazdek, Davorka

    2014-01-01

    Studies show significant negative effects of smoking marijuana on physical and mental health as well as social and occupational functioning. At the same time, there are more considerations about its ability to treat a number of diseases. This review summarizes current data in scientific literature that examines the medical effects of marijuana on human health with particular emphasis on its potential in medicine. Marijuana has a range of adverse health effects, particularly relating to young people because of higher risk for psychosis, traffic accidents, and cognitive impairment. Marijuana may be helpful in relieving symptoms of nausea and vomiting, increasing appetite and pain relief for persons with cancer, AIDS and multiple sclerosis. Smoking marijuana can impose significant public health risks. If there is a medical role for using marijuana, it lies in the application of clearly defined medical protocols and chemically defined compounds, not with using the unprocessed cannabis plant.

  4. [The medical rationale category and a new epistemology in health].

    Science.gov (United States)

    do Nascimento, Marilene Cabral; de Barros, Nelson Filice; Nogueira, Maria Inês; Luz, Madel Therezinha

    2013-12-01

    This article is an analytical report on the 20-year trajectory of the 'medical rationale' category that emerged in the early 1990s in the area of Social and Human Sciences in Health in the field of Public Health. Its objective was to study complex and therapeutic medical systems and traditional, complementary and alternative medicines. Based on a critical review of the literature, it presents some aspects of the cultural, political, institutional and social context of its emergence, as well as its main contributions and developments on a theoretical level and on social policies and practices in health. The southern epistemology concept of Boaventura de Sousa Santos is used to reflect upon the contribution of the 'medical rationale' category to the critique of the post-modern scientific rationale and to the creation of a new epistemology in health.

  5. MEDICAL TOURISTS' EXPECTATIONS WHEN CHOOSING LITHUANIA FOR HEALTH CARE SERVICES

    Directory of Open Access Journals (Sweden)

    Miglė Eleonora Černikovaitė

    2015-07-01

    Full Text Available Purpose – Identify medical expectations of tourists choosing Lithuania as medical tourism country and to make comparative analysis with situation in Thailand. Medical tourism is one of the most promising fields of business in the world. International trade in medical services also has huge economic potential and gradually increasing outcome for the global economy (Bookman & Bookman, 2007. Major medical tourism destinations: Thailand, India, Singapore and Malaysia attracted more than 2.5 million medical travellers (United Nations Economic and Social Commission for Asia and the Pacific, 2008. Lithuania is among the major emerging markets in medical tourism that is increasing every year. This study showed that main factors of attracting tourist to Lithuania: fast service and exceptional patient care, the high-tech medical equipment, good prices both for medical and travel services. Comparing to Thailand situation, Lithuania is attractive to the most medical tourist, because of the good quality services with affordable prices and location, while people choosing Thailand – mainly is affected by advertising. The main recommendation for attracting medical tourists to Lithuania is to initiate the advertising campaign to the targeted audiences. Design/methodology/approach – The comparative analysis of scientific literature and empirical comparative quantitative research was executed for acquiring the expectations for medical tourists in Lithuania. Findings – Overview of health and medical tourism situation in Lithuania and other emerging markets. This study showed that main factors of attracting tourist to Lithuania: fast service and exceptional patient care, the high-tech medical equipment, good prices both for medical and travel services and other. Comparative empirical analysis of medical tourist expectations in Lithuania and Thailand. Comparing to Thailand situation, Lithuania is attractive to the most medical tourist, because of the good

  6. Guidelines for Primary Health Care teaching in undergraduate medical education

    Directory of Open Access Journals (Sweden)

    Marcelo Marcos Piva Demarzo

    2011-05-01

    Full Text Available These are a set of guidelines built by the Brazilian Association of Medical Education (ABEM and the Brazilian Society of Family and Community Medicine (SBMFC with the aim of supporting medical schools in a practical and objective manner, when elaborating pedagogical-political projects on Primary Health Care (PHC. The advent of the Brazilian National Curricular Guidelines for Medical Education, which are approved by the Ministry of Education in 2001 have since improved the teaching of undergraduate medical students on PHC, but there are still wide variations in implementation and quality of it in medical curricula. These guidelines by ABEM/SBMFC partnership can exert considerable influence on medical curricula by establishing minimum requirements and core competencies for PHC in Brazil.

  7. Medical Team Training: Using Simulation as a Teaching Strategy for Group Work

    Science.gov (United States)

    Moyer, Michael R.; Brown, Rhonda Douglas

    2011-01-01

    Described is an innovative approach currently being used to inspire group work, specifically a medical team training model, referred to as The Simulation Model, which includes as its major components: (1) Prior Training in Group Work of Medical Team Members; (2) Simulation in Teams or Groups; (3) Multidisciplinary Teamwork; (4) Team Leader…

  8. Medical Team Training: Using Simulation as a Teaching Strategy for Group Work

    Science.gov (United States)

    Moyer, Michael R.; Brown, Rhonda Douglas

    2011-01-01

    Described is an innovative approach currently being used to inspire group work, specifically a medical team training model, referred to as The Simulation Model, which includes as its major components: (1) Prior Training in Group Work of Medical Team Members; (2) Simulation in Teams or Groups; (3) Multidisciplinary Teamwork; (4) Team Leader…

  9. Managing the conflict between individual needs and group interests--ethical leadership in health care organizations.

    Science.gov (United States)

    Shale, Suzanne

    2008-03-01

    This paper derives from a grounded theory study of how Medical Directors working within the UK National Health Service manage the moral quandaries that they encounter as leaders of health care organizations. The reason health care organizations exist is to provide better care for individuals through providing shared resources for groups of people. This creates a paradox at the heart of health care organization, because serving the interests of groups sometimes runs counter to serving the needs of individuals. The paradox presents ethical dilemmas at every level of the organization, from the boardroom to the bedside. Medical Directors experience these organizational ethical dilemmas most acutely by virtue of their position in the organization. As doctors, their professional ethic obliges them to put the interests of individual patients first. As executive directors, their role is to help secure the delivery of services that meet the needs of the whole patient population. What should they do when the interests of groups of patients, and of individual patients, appear to conflict? The first task of an ethical healthcare organization is to secure the trust of patients, and two examples of medical ethical leadership are discussed against this background. These examples suggest that conflict between individual and population needs is integral to health care organization, so dilemmas addressed at one level of the organization inevitably re-emerge in altered form at other levels. Finally, analysis of the ethical activity that Medical Directors have described affords insight into the interpersonal components of ethical skill and knowledge.

  10. Improving Defense Health Program Medical Research Processes

    Science.gov (United States)

    2017-08-08

    Health (NIH), Centers for Disease Control and Prevention , private foundations, and others (Figure 1b). These disparate funding sources may fund...Reed and his team’s discovery and confirmation of the transmission of deadly diseases such as typhoid fever and yellow fever. 5 Researchers also...contributed to the development of intravenous therapy for cholera ; 6 and the development of anti- malarial agents such as chloroquine, doxycycline

  11. The Heritage Harbour Health Group: doing it our way.

    Science.gov (United States)

    Ostrowski, M S

    1998-01-01

    The Heritage Harbour Health Group is a privately run, nonprofit health care organization founded by the residents of a retirement community for their own use. Such a facility is an original concept, and this article describes how home health care is being provided with a unique blend of professional and volunteer cooperation. Health care professionals may find information and inspiration to conduct their own research into similar programs.

  12. Race and Ethnic Group Differences in Comorbid Major Depressive Disorder, Generalized Anxiety Disorder, and Chronic Medical Conditions.

    Science.gov (United States)

    Watkins, Daphne C; Assari, Shervin; Johnson-Lawrence, Vicki

    2015-09-01

    This study tested whether race and ethnic group differences exist for lifetime major depressive disorder and/or general anxiety disorder with one or more chronic medical conditions. Data from the National Survey of American Life, which included 3570 African American, 1438 Caribbean Black, and 891 non-Hispanic White adults were analyzed. Outcomes included at least one and multiple chronic medical conditions, from a list of 14 medical conditions (e.g., arthritis, cancer, diabetes, kidney disease, stroke, heart disease, etc.). Logistic regressions were fitted to data to determine how the association between major depressive disorder, general anxiety disorder, and one or more chronic medical conditions vary across race and ethnicity. Lifetime major depressive disorder (but not lifetime general anxiety disorder) was associated with at least one chronic medical condition among African Americans and Caribbean Blacks, but not non-Hispanic Whites. Lifetime major depressive disorder was similarly associated with multiple chronic medical conditions among African Americans, Caribbean Blacks, and non-Hispanic Whites. For Caribbean Blacks, stronger associations were found between major depressive disorder and general anxiety disorder with one or more chronic medical conditions compared to African Americans and non-Hispanic Whites. Findings suggest that race and ethnicity may shape the links between comorbid psychiatric disorders and chronic medical conditions. Mental health screening of individuals with chronic medical conditions in primary health-care settings may benefit from tailoring based on race and ethnicity. More research is needed to understand why associations between physical and mental health vary among race and ethnic groups.

  13. CMOS IC design for wireless medical and health care

    CERN Document Server

    Wang, Zhihua; Chen, Hong

    2014-01-01

    This book provides readers with detailed explanation of the design principles of CMOS integrated circuits for wireless medical and health care, from the perspective of two successfully-commercialized applications. Design techniques for both the circuit block level and the system level are discussed, based on real design examples. CMOS IC design techniques for the entire signal chain of wireless medical and health care systems are covered, including biomedical signal acquisition, wireless transceivers, power management and SoC integration, with emphasis on ultra-low-power IC design techniques. • Discusses CMOS integrated circuit design for wireless medical and health care, based on two successfully-commercialized medical and health care applications; • Describes design techniques for the entire signal chain of wireless medical and health care systems; • Focuses on techniques for short-range wireless communication systems; • Emphasizes ultra-low-power IC design techniques; • Enables readers to tu...

  14. [Hazardous medical waste management as a public health issue].

    Science.gov (United States)

    Marinković, Natalija; Vitale, Ksenija; Afrić, Ivo; Janev Holcer, Natasa

    2005-03-01

    The amount of waste produced is connected with the degree of a country's economic development; more developed countries produce more waste. This paper reviews the quantities, manipulation and treatment methods of medical waste in Croatia, as well as hazardous potentials of medical waste for human health. Medical waste must be collected and sorted in containers suitable for its characteristics, amount, means of transportation and treatment method in order to prevent contact with environment and to protect people who are working with waste. Hazardous medical waste in Croatia is largely produced by hospitals. Even though only one hospital has a licence to incinerate infectious medical waste, many other hospitals incinerate their hazardous waste in inappropriate facilities. Healthcare institutions also store great amounts of old medical waste, mostly pharmaceutical, anti-infectious, and cytostatic drugs and chemical waste. Data on waste treatment effects on human health are scarce, while environmental problems are covered better. Croatian medical waste legislation is not being implemented. It is very important to establish a medical waste management system that would implement the existing legislation in all waste management cycles from waste production to treatment and final disposal.

  15. Physical and Sexual Violence, Mental Health indicators, and treatment seeking among street-based population groups in Tegucigalpa, Honduras

    OpenAIRE

    Rio Navarro, Javier; Cohen, Julien; Rocillo Arechaga, Eva; Zuniga, Edgardo

    2012-01-01

    To establish the prevalence of exposure to physical and sexual violence, mental health symptoms, and medical treatment-seeking behavior among three street-based subpopulation groups in Tegucigalpa, Honduras, and to assess the association between sociodemographic group, mental health indicators, and exposure to violence.

  16. A focus group study on primary health care in Johannesburg Health ...

    African Journals Online (AJOL)

    A focus group study on primary health care in Johannesburg Health District: ... Setting and subjects: Groups of nurse clinicians, clinic managers, senior ... Outcome measures: The content was thematically analysed and a model developed.

  17. The ability of older adults to use customized online medical databases to improve their health-related knowledge.

    Science.gov (United States)

    Freund, Ophir; Reychav, Iris; McHaney, Roger; Goland, Ella; Azuri, Joseph

    2017-06-01

    Patient compliance with medical advice and recommended treatment depends on perception of health condition, medical knowledge, attitude, and self-efficacy. This study investigated how use of customized online medical databases, intended to improve knowledge in a variety of relevant medical topics, influenced senior adults' perceptions. Seventy-nine older adults in residence homes completed a computerized, tablet-based questionnaire, with medical scenarios and related questions. Following an intervention, control group participants answered questions without online help while an experimental group received internet links that directed them to customized, online medical databases. Medical knowledge and test scores among the experimental group significantly improved from pre- to post-intervention (pdatabases. The study demonstrated how such databases help solve health-related questions among older adult population members, and that older patients appear willing to consider technology usage in information acquisition. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Health care utilization of mexican patients with medically unexplained physical symptoms

    Science.gov (United States)

    Ramírez Aranda, José Manuel; de los Santos Reséndiz, Homero; Lara Duarte, María Yolanda; Pazaran Zanella, Santiago Oscar; Méndez López, Jafet Felipe; Gil Alfaro, Issa; Islas Ruz, Félix Gilberto; Navarrete Floriano, Gloria; Guillen Salomón, Edith; Texon Fernández, Obdulia; Cruz Duarte, Silvia; Romo Salazar, Juan Carlos; Pérez Ruiz, Claudia Elsa; López Salas, Sara de Jesús; Benítez Amaya, Lizbeth; Zapata Gallardo, Javier Nahum

    2016-01-01

    Objective: To determine the prevalence of medically unexplained physical symptoms and the characteristics and use of health services in a group of patients with medically unexplained physical symptoms and a group of patients with other illnesses. Methods: This was a cross-sectional, retrospective and multicenter study. We included 1,043 patients over 18 years of age from 30 primary care units of a government health institution, in 11 states of Mexico, attended by 39 family physicians. The prevalence of medically unexplained physical symptoms was determined and both groups with or without symptoms were compared with regard to drug use, laboratory and other studies, leaves of absence, and referrals in the last six months. The group with medically unexplained physical symptoms was diagnosed using the Patient Health Questionnaire and the diagnostic criteria of Reid et al. Emergency or terminal illnesses were excluded. The chi square test was used with a statistical significance of p < 0.05. Results: Medically unexplained physical symptoms was diagnosed in 73 patients (7.0%). The majority were women (91.8%); their predominant symptom was from the gastrointestinal system in 56 (76.7%). This group had a greater use of clinical studies and referrals to other services (mean 1.1 vs. 0.5; p <0.0001 and 0.6 vs. 0.8; p < 0.01, respectively). Conclusions: The prevalence of medically unexplained physical symptoms was low, but with a greater impact on some health services. This could represent an overload in medical costs. PMID:27821895

  19. Medical students' attitudes toward abortion and other reproductive health services.

    Science.gov (United States)

    Rosenblatt, R A; Robinson, K B; Larson, E H; Dobie, S A

    1999-03-01

    This paper investigated the attitude toward abortion and other reproductive health services of first- and second-year medical students at the Seattle campus of the University of Washington, a large regional primary care-oriented medical school, in 1996-97. A total of 219 (76.6%) students responded. The majority of the students support the availability of a broad range of reproductive health services including abortion; 58.1% felt that first-trimester abortions should be available to patients under most circumstances. Of the 43.4% of students who anticipated a career in family practice, most expected to provide abortions in their future practices. Moreover, older students and women were more likely to support the provision of abortion services. This study concludes that despite the continuing pressure on abortion providers, most first- and second-year medical students at a fairly state-supported medical school intend to incorporate this procedure into their future practices.

  20. Perspective: a business school view of medical interprofessional rounds: transforming rounding groups into rounding teams.

    Science.gov (United States)

    Bharwani, Aleem M; Harris, G Chad; Southwick, Frederick S

    2012-12-01

    An effective interprofessional medical team can efficiently coordinate health care providers to achieve the collective outcome of improving each patient's health. To determine how current teams function, four groups of business students independently observed interprofessional work rounds on four different internal medicine services in a typical academic hospital and also interviewed the participants. In all instances, caregivers had formed working groups rather than working teams. Participants consistently exhibited parallel interdependence (individuals working alone and assuming their work would be coordinated with other caregivers) rather than reciprocal interdependence (individuals working together to actively coordinate patient care), the hallmark of effective teams. With one exception, the organization was hierarchical, with the senior attending physician possessing the authority. The interns exclusively communicated with the attending physician in one-on-one conversations that excluded all other members of the team. Although nurses and pharmacists were often present, they never contributed their ideas and rarely spoke.The authors draw on these observations to form recommendations for enhancing interprofessional rounding teams. These are to include the bedside nurse, pharmacist, and case manager as team members, begin with a formal team launch that encourages active participation by all team members, use succinct communication protocols, conduct work rounds in a quiet, distraction-free environment, have teams remain together for longer durations, and receive teamwork training and periodic coaching. High-performing businesses have effectively used teams for decades to achieve their goals, and health care professionals should follow this example.

  1. Medical error disclosure: a pressing agenda for Public Health researchers

    Directory of Open Access Journals (Sweden)

    Annegret F. Hannawa

    2012-10-01

    Full Text Available Medical errors are not a prevalent discussion topic in the current public health literature. However, their impact on patient lives across the world is alarming. In the United States alone, more than 1.3 million patients are harmed every year by medical treatments that are intended to help them. About three quarters of these adverse events are caused by preventable human error.....

  2. Hispanic Medical Organizations' Support for LGBT Health Issues.

    Science.gov (United States)

    Sánchez, John Paul; Sola, Orlando; Ramallo, Jorge; Sánchez, Nelson Felix; Dominguez, Kenneth; Romero-Leggott, Valerie

    2014-09-01

    Hispanics represent the fastest growing ethnic segment of the lesbian, gay, bisexual, and transgender (LGBT) community in the United States and are disproportionately burdened by LGBT-related health issues and limited political support from Hispanic medical organizations. Recently, the Latino Medical Student Association, the National Hispanic Medical Association, and the Hispanic Serving Health Professions Schools, representing over 60,000 Hispanic students and providers and 35 institutions, collaborated to support a resolution opposing discrimination based on sexual orientation or gender identity and recognizing the obstacles encountered by LGBTQ Hispanics. The resolution provides an important framework for organizational members and leaders to address LGBT health issues and serve to support a more positive sociopolitical climate for the Hispanic LGBT community nationally and internationally.

  3. Medical care providers' perspectives on dental information needs in electronic health records.

    Science.gov (United States)

    Acharya, Amit; Shimpi, Neel; Mahnke, Andrea; Mathias, Richard; Ye, Zhan

    2017-05-01

    The authors conducted this study to identify the most relevant patient dental information in a medical-dental integrated electronic health record (iEHR) necessary for medical care providers to inform holistic treatment. The authors collected input from a diverse sample of 65 participants from a large, regional health system representing 13 medical specialties and administrative units. The authors collected feedback from participants through 11 focus group sessions. Two independent reviewers analyzed focus group transcripts to identify major and minor themes. The authors identified 336 of 385 annotations that most medical care providers coded as relevant. Annotations strongly supporting relevancy to clinical practice aligned with 18 major thematic categories, with the top 6 categories being communication, appointments, system design, medications, treatment plan, and dental alerts. Study participants identified dental data of highest relevance to medical care providers and recommended implementation of user-friendly access to dental data in iEHRs as crucial to holistic care delivery. Identification of the patients' dental information most relevant to medical care providers will inform strategies for improving the integration of that information into the medical-dental iEHR. Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.

  4. Group concept mapping: An approach to explore group knowledge organization and collaborative learning in senior medical students.

    Science.gov (United States)

    Torre, Dario; Daley, Barbara J; Picho, Katherine; Durning, Steven J

    2017-10-01

    Group concept mapping may be used as a learning strategy that can potentially foster collaborative learning and assist instructors to assess the development of knowledge organization in medical students. Group concept maps were created by 39 medical students rotating through a fourth year medicine rotation. The group maps were developed based on a clinical vignette. Descriptive statistics and thematic analysis of students' evaluations were performed. Evaluations indicated that students enjoyed the collaborative nature of the exercise and the knowledge sharing activities associated with it. Group maps can demonstrate different knowledge organization Discussion: Group concept mapping can be used to explore students' organization and integration of knowledge structures in a collaborative setting. Additional research should focus on how group mapping and learning progresses over time and, whether group mapping can help identify curricular strengths and needs.

  5. Should women's health be a medical specialty?

    Science.gov (United States)

    Papazian, T

    1993-01-01

    The proponents of a new specialty in medicine focusing on women's health are concerned with women's total health needs, much like pediatrics is with children or geriatrics with old people. None of the 7 Lebanese physicians interviewed were aware of this issue. Among them there were 3 female doctors (a family physician, and endocrinologist, and a dermatologist) and 4 male doctors (2 surgeons, a gynecologist, and a cardiologist). The irrelevance of creating such a specialty in the Lebanese reality could be attributed to the absence of a feminist catalyst in Lebanon. All 7 physicians believed that medicine was providing comprehensive care equitably to men and women and argued that the creation of a new specialty would cause further division and segregation between the sexes. All the doctors said that the main reason for not including women in the trial testing of new drugs is fear of interfering with their reproductive system. Drugs may affect the menstrual cycle, the fetus, or the hormonal system and thus cause permanent damage. Because of cultural and traditional value systems, the endocrinologist claimed that in Lebanon men do not get a genital examination as part of a check-up by their general practitioner, and women are not examined if they do not request it themselves. All agreed that the family physician is the best person to provide comprehensive care and to refer the patient to a specialist. All the physicians with different specialties and backgrounds believed that the creation of a new specialty would be illogical or nonsensical. The fact that women doctors shared the opinion of male doctors was intriguing. It raised questions as to whether they had the same opinion or whether they reacted the same way because they belonged to the same community or because of the absence of an aggressive women's liberation movement in Lebanon.

  6. Evaluation of medication errors with implementation of electronic health record technology in the medical intensive care unit

    Directory of Open Access Journals (Sweden)

    Liao TV

    2017-05-01

    Full Text Available T Vivian Liao,1 Marina Rabinovich,2 Prasad Abraham,2 Sebastian Perez,3 Christiana DiPlotti,4 Jenny E Han,5 Greg S Martin,5 Eric Honig5 1Department of Pharmacy Practice, College of Pharmacy, Mercer Health Sciences Center, 2Department of Pharmacy and Clinical Nutrition, Grady Health System, 3Department of Surgery, Emory University, 4Pharmacy, Ingles Markets, 5Department of Medicine, Emory University, Atlanta, GA, USA Purpose: Patients in the intensive care unit (ICU are at an increased risk for medication errors (MEs and adverse drug events from multifactorial causes. ME rate ranges from 1.2 to 947 per 1,000 patient days in the medical ICU (MICU. Studies with the implementation of electronic health records (EHR have concluded that it significantly reduced overall prescribing errors and the number of errors that caused patient harm decreased. However, other types of errors, such as wrong dose and omission of required medications increased after EHR implementation. We sought to compare the number of MEs before and after EHR implementation in the MICU, with additional evaluation of error severity.Patients and methods: Prospective, observational, quality improvement study of all patients admitted to a single MICU service at an academic medical center. Patients were evaluated during four periods over 2 years: August–September 2010 (preimplementation; period I, January–February 2011 (2 months postimplementation; period II, August–September 2012 (21 months postimplementation; period III, and January–February 2013 (25 months postimplementation; period IV. All medication orders and administration records were reviewed by an ICU clinical pharmacist and ME was defined as a deviation from established standards for prescribing, dispensing, administering, or documenting medication. The frequency and classification of MEs were compared between groups by chi square; p<0.05 was considered significant.Results: There was a statistically significant increase

  7. Managing medical groups: 21st century challenges and the impact of physician leadership styles.

    Science.gov (United States)

    Martin, William E; Keogh, Timothy J

    2004-01-01

    Physician group managers and administrators charged with leading medical groups in the 21st century face a set of old and new challenges and opportunities. Leadership is assumed to make the difference between a successful and not-so-successful medical group. Yet, there is little research about how physician manager leadership styles contribute to the success of medical group practices. This article is a study of physician leadership styles using the DiSC, based upon a sample of 232 physician managers. Dominance (D) and conscientiousness (C) were the two dominant styles found in this study. Moreover, the two dominant combination leadership styles fall under the categories of the "creative" and the 'perfectionist." The article formulates practical recommendations for both physician managers and administrators for leading medical groups to respond more effectively to the challenges and opportunities facing medical groups in the 21st century.

  8. Gender differences in health and health care utilisation in various ethnic groups in the Netherlands: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Devillé Walter L

    2009-04-01

    Full Text Available Abstract Background To determine gender differences in health and health care utilisation within and between various ethnic groups in the Netherlands. Methods Data from the second Dutch National Survey of General Practice (2000–2002 were used. A total of 7,789 persons from the indigenous population and 1,512 persons from the four largest migrant groups in the Netherlands – Morocco, Netherlands Antilles, Turkey and Surinam – aged 18 years and older were interviewed. Self-reported health outcomes studied were general health status and the presence of acute (past 14 days and chronic conditions (past 12 months. And self-reported utilisation of the following health care services was analysed: having contacted a general practitioner (past 2 months, a medical specialist, physiotherapist or ambulatory mental health service (past 12 months, hospitalisation (past 12 months and use of medication (past 14 days. Gender differences in these outcomes were examined within and between the ethnic groups, using logistic regression analyses. Results In general, women showed poorer health than men; the largest differences were found for the Turkish respondents, followed by Moroccans, and Surinamese. Furthermore, women from Morocco and the Netherlands Antilles more often contacted a general practitioner than men from these countries. Women from Turkey were more hospitalised than Turkish men. Women from Morocco more often contacted ambulatory mental health care than men from this country, and women with an indigenous background more often used over the counter medication than men with an indigenous background. Conclusion In general the self-reported health of women is worse compared to that of men, although the size of the gender differences may vary according to the particular health outcome and among the ethnic groups. This information might be helpful to develop policy to improve the health status of specific groups according to gender and ethnicity. In

  9. Public health partnerships in medical toxicology education and practice.

    Science.gov (United States)

    Schier, Joshua G; Rubin, Carol; Schwartz, Michael D; Thomas, Jerry D; Geller, Robert J; Morgan, Brent W; McGeehin, Michael A; Frumkin, Howard

    2010-06-01

    In December 2002, the medical toxicology sub-board, which consists of representatives from emergency medicine, preventive medicine, and pediatrics, released revised core content for medical toxicology, aiming to better meet the academic challenges imposed by the continually expanding knowledge base of medical toxicology. These challenges included the addition of relatively new areas of interest in medical toxicology, including population health, while simultaneously ensuring that a structural framework existed to accommodate future areas of interest. There is no evidence readily available to assess how well the educational curricula of existing fellowship programs are meeting these needs. In an effort to address this, the authors describe a medical toxicology fellowship program that consists of a partnership among the Emory University School of Medicine, the Georgia Poison Control Center, and the CDC, as well as the results of a reorganization of its academic curriculum that occurred in 2006. To the best of the authors' knowledge, this is the first published report describing such a curriculum redesign. Suggestions and potential resources proposed as enhancements for the public health-associated education of medical toxicology fellows are discussed. The authors also seek to initiate a discussion among programs about how to optimally meet the new challenges developed by the medical toxicology sub-board.

  10. eHealth in the future of medications management: personalisation, monitoring and adherence

    NARCIS (Netherlands)

    Car, J.; Tan, W.S.; Huang, Z.; Sloot, P.; Franklin, B.D.

    2017-01-01

    Background Globally, healthcare systems face major challenges with medicines management and medication adherence. Medication adherence determines medication effectiveness and can be the single most effective intervention for improving health outcomes. In anticipation of growth in eHealth interventio

  11. eHealth in the future of medications management: personalisation, monitoring and adherence

    NARCIS (Netherlands)

    Car, J.; Tan, W.S.; Huang, Z.; Sloot, P.; Franklin, B.D.

    2017-01-01

    Background Globally, healthcare systems face major challenges with medicines management and medication adherence. Medication adherence determines medication effectiveness and can be the single most effective intervention for improving health outcomes. In anticipation of growth in eHealth

  12. Secure Group Formation Protocol for a Medical Sensor Network Prototype

    DEFF Research Database (Denmark)

    Andersen, Jacob

    2009-01-01

    Designing security mechanisms such as privacy and access control for medical sensor networks is a challenging task; as such systems may be operated very frequently, at a quick pace, and at times in emergency situations. Understandably, clinicians hold extra unproductive tasks in low regard......, and experience from user workshops and observations of clinicians at work on a hospital ward show that if the security mechanisms are not well designed, the technology is either rejected altogether, or they are circumvented leaving the system wide open to attacks. Our work targets the problem of designing...... wireless sensors to be both secure and usable by exploring different solutions on a fully functional prototype platform. In this paper, we present an Elliptic Curve Cryptography (ECC) based protocol, which offers fully secure sensor set-up in a few seconds on standard (Telos) hardware. We evaluate...

  13. Psychotropic medication from an object relations theory perspective: an analysis of vignettes from group psychotherapy.

    Science.gov (United States)

    Fain, Dana Shindel; Sharon, Amos; Moscovici, Lucian; Schreiber, Shaul

    2008-07-01

    In this article we explore the content and dynamics of patients' verbalizations within a "living with medications" group. Patients' perceptions of their psychotropic medications are interpreted and classified within the framework of object relations theory. One's perception of the role of medication in one's life can serve as a gateway to one's inner world and the way that he or she perceives authority figures, peers, and oneself. We suggest that working through patients' relationships with their medications can help them to achieve better integration of internal object relations. Discussing patients' views about medications should therefore be seen as an important part of psychotherapy with many individuals. Such a discussion may enhance and improve efficacy of both psychotherapy and pharmacotherapy. It is of particular importance in group therapy, within milieu environments and with individuals reluctant to explicitly discuss interpersonal matters. Vignettes from the group sessions illustrate the way in which discussing medication advances group process.

  14. Residents' satisfaction with primary medical and health services in Western China.

    Science.gov (United States)

    Dong, Weinan; Zhang, Qingyu; Yan, Chunsheng; Fu, Wanling; Xu, Linlin

    2017-04-21

    Currently, China is in the process of medical and health care reform, and the establishment of primary medical and health services covering urban and rural residents is an important aspect of this process. Studying the satisfaction of residents of underdeveloped areas with their primary medical and health services and identifying the factors that can increase the satisfaction of different groups may improve patient compliance and ultimately improve health. Moreover, such research may provide a reference for the development of medical and health undertakings in similarly underdeveloped areas. A face-to-face survey was conducted on a stratified random sample of 2200 residents in Gansu by using structured questionnaires. Demographic characteristics were collated, and questionnaires were factor-analysed and weighted using SPSS software to obtain scores for each factor, as well as total satisfaction scores. The characteristics of poorly satisfied populations were determined by a multiple linear regression analysis using SAS software. A cluster analysis was performed using SAS software for classification and a separate discussion of populations. The hypertension self-awareness rate (11.29%) of the sampled population was lower than the average hypertension prevalence (23.85%), as recorded in the 2014 Health Statistical Yearbook of the region. The disease knowledge awareness factor was the lowest factor (2.857), whereas the policy awareness factor was the highest factor (4.772). The overall satisfaction was moderate (3.898). The multivariate linear regression model was significant (p groups. A cluster analysis was used to divide the respondents into five groups. The overall satisfaction was lowest in the second population group (rural, middle-aged)(Fz = 3.64) and was highest in the fourth population group(minors) (Fz = 4.13). Different population groups showed different satisfaction rates in F1 to F6. Hypertensive patients had low self-awareness, and residents had

  15. Shaping beside student of the special medical group of the culture sound lifestyle by means of computer technology

    Directory of Open Access Journals (Sweden)

    Vovk L.V.

    2010-07-01

    Full Text Available Considered results of the pedagogical experiment with use computer information-diagnostic system "Passport of health" on shaping the culture sound lifestyle beside student of the special medical group. Two groups student have took part in experiment in amount 151 persons. It is proved that pedagogical experiment has positively influenced upon fortification of health, life activity, high level of the knowledges and practical skills during education in high school. It is installed that one of the main of the conditions to efficiency of the physical education, are a knowledges, which allow effective to solve the delivered problems of the physical education to personalities.

  16. Evidence-based public health education as preparation for medical school.

    Science.gov (United States)

    Riegelman, Richard K; Garr, David R

    2008-04-01

    The Institute of Medicine has recommended that all undergraduates have access to public health education. An evidence-based public health framework including curricula such as "Public Health 101" and "Epidemiology 101" was recommended for all colleges and universities by arts and sciences, public health, and clinical health professions educators as part of the Consensus Conference on Undergraduate Public Health Education. These courses should foster critical thinking whereby students learn to broadly frame options, critically analyze data, and understand the uncertainties that remain. College-level competencies or learning outcomes in research literature reading, determinants of health, basic understanding of health care systems, and the synergies between health care and public health can provide preparation for medical education. Formally tested competencies could substitute for a growing list of prerequisite courses. Grounded in principles similar to those of evidence-based medicine, evidence-based public health includes problem description, causation, evidence-based recommendations for intervention, and implementation considering key issues of when, who, and how to intervene. Curriculum frameworks for structuring "Public Health 101" and "Epidemiology 101" are provided by the Consensus Conference that lay the foundation for teaching evidence-based public health as well as evidence-based medicine. Medical school preparation based on this foundation should enable the Clinical Prevention and Population Health Curriculum Framework, including the evidence base for practice and health systems and health policy, to be fully integrated into the four years of medical school. A faculty development program, curriculum guide, interest group, and clear student interest are facilitating rapid acceptance of the need for these curricula.

  17. Efficient medical information retrieval in encrypted Electronic Health Records.

    Science.gov (United States)

    Pruski, Cédric; Wisniewski, François

    2012-01-01

    The recent development of eHealth platforms across the world, whose main objective is to centralize patient's healthcare information to ensure the best continuity of care, requires the development of advanced tools and techniques for supporting health professionals in retrieving relevant information in this vast quantity of data. However, for preserving patient's privacy, some countries decided to de-identify and encrypt data contained in the shared Electronic Health Records, which reinforces the complexity of proposing efficient medical information retrieval approach. In this paper, we describe an original approach exploiting standards metadata as well as knowledge organizing systems to overcome the barriers of data encryption for improving the results of medical information retrieval in centralized and encrypted Electronic Health Records. This is done through the exploitation of semantic properties provided by knowledge organizing systems, which enable query expansion. Furthermore, we provide an overview of the approach together with illustrating examples and a discussion on the advantages and limitations of the provided framework.

  18. Group purchasing of workplace health promotion services for small employers.

    Science.gov (United States)

    Harris, Jeffrey R; Hammerback, Kristen R; Hannon, Peggy A; McDowell, Julie; Katzman, Avi; Clegg-Thorp, Catherine; Gallagher, John

    2014-07-01

    Small employers are underserved with workplace health promotion services, so we explored the potential for group purchasing of these services. We conducted semistructured telephone interviews of member organizations serving small employers, as well as workplace health promotion vendors, in Washington State. We interviewed 22 employer organizations (chambers of commerce, trade associations, and an insurance trust) and vendors (of fitness facilities, healthy vending machines, fresh produce delivery, weight management services, and tobacco cessation quitlines). Both cautiously supported the idea of group purchasing but felt that small employers' workplace health promotion demand must increase first. Vendors providing off-site services, for example, quitline, found group purchasing more feasible than vendors providing on-site services, for example, produce delivery. Employer member organizations are well-positioned to group purchase workplace health promotion services; vendors are receptive if there is potential profit.

  19. Group therapy in public mental health services: approaches, patients and group therapists.

    Science.gov (United States)

    Lorentzen, S; Ruud, T

    2014-04-01

    Group therapy is used extensively within public mental health services, but more detailed knowledge is needed. All 25 health authorities in Norway were invited to describe their groups: theory, primary tasks, interventions, structure, patients and therapists. Four hundred twenty-six groups, 296 in community mental health centres and 130 in hospitals, were categorized into nine types, based on theoretical background. Psychodynamic groups were most frequent, followed by cognitive-behavioural, psycho-educative, social skills/coping and art/expressive groups. Weekly sessions of 90 min and treatment duration 12 months was most frequent. Main diagnosis for 2391 patients: depression (517), personality disorder (396), schizophrenia/psychosis (313) and social phobia (249). Patients with depression or personality disorder were mostly in psychodynamic groups, psychosis/bipolar disorder in psycho-educative groups. Cognitive-behavioural groups were used across several diagnoses. Most therapists were nurses, only 50% had a formal training in group therapy. There is a plethora of groups, some based on one theoretical school, while others integrate theory from several 'camps'. Patients with similar diagnosis were offered different group approaches, although some trends existed. More research evidence from regular clinical groups is needed, and clinician-researcher networks should be developed. More group therapists with formal training are needed. © 2013 John Wiley & Sons Ltd.

  20. How to minimise the health risks to athletes who compete in weight-sensitive sports review and position statement on behalf of the Ad Hoc Research Working Group on Body Composition, Health and Performance, under the auspices of the IOC Medical Commission.

    Science.gov (United States)

    Sundgot-Borgen, Jorunn; Meyer, Nanna L; Lohman, Timothy G; Ackland, Timothy R; Maughan, Ronald J; Stewart, Arthur D; Müller, Wolfram

    2013-11-01

    A focus on low body weight and body fat content, combined with regulations in some weight-sensitive sports, are considered risk factors for extreme dieting, eating disorders (EDs) and related health consequences among athletes. At present there are, from a health perspective, no generally accepted optimum values for body weight or percentage of fat mass in different sports and there is no 'gold standard' method for body composition assessment in athletes. On the basis of health considerations as well as performance, medical support teams should know how to approach elite athletes who seek to achieve an unrealistic body composition and how to prevent restrictive eating practices from developing into an ED. In addition, these teams must know when to raise the alarm and how to advice athletes who are affected by extreme dieting or clinical EDs. However, there is no consensus on when athletes struggling with extreme dieting or EDs should be referred for specialist medical treatment or removed from competition. Based on the present review, we conclude that there is a need for (1) sport-specific and gender-specific preventive programmes, (2) criteria for raising alarm and 'does not start' (DNS) for athletes with EDs and (3) modifications to the regulations in some sports. Further, the key areas for research identified include the development of standard methods for body composition assessment in elite athletes; screening measures for EDs among athletes; development and testing of prevention programmes; investigating the short and long-term effects of extreme dieting; and EDs on health and performance.

  1. Low-health literacy flashcards & mobile video reinforcement to improve medication adherence in patients on oral diabetes, heart failure, and hypertension medications.

    Science.gov (United States)

    Yeung, Denise L; Alvarez, Kristin S; Quinones, Marissa E; Clark, Christopher A; Oliver, George H; Alvarez, Carlos A; Jaiyeola, Adeola O

    To design and investigate a pharmacist-run intervention using low health literacy flashcards and a smartphone-activated quick response (QR) barcoded educational flashcard video to increase medication adherence and disease state understanding. Prospective, matched, quasi-experimental design. County health system in Dallas, Texas. Sixty-eight primary care patients prescribed targeted heart failure, hypertension, and diabetes medications INTERVENTION: Low health literacy medication and disease specific flashcards, which were also available as QR-coded online videos, were designed for the intervention patients. The following validated health literacy tools were conducted: Newest Vital Sign (NVS), Rapid Estimate of Adult Literacy Medicine-Short Form, and Short Assessment of Health Literacy-50. The primary outcome was the difference in medication adherence at 180 days after pharmacist intervention compared with the control group, who were matched on the basis of comorbid conditions, targeted medications, and medication class. Medication adherence was measured using a modified Pharmacy Quality Alliance proportion of days covered (PDC) calculation. Secondary outcomes included 90-day PDC, improvement of greater than 25% in baseline PDC, and final PDC greater than 80%. Linear regression was performed to evaluate the effect of potential confounders on the primary outcome. Of the 34 patients receiving the intervention, a majority of patients scored a high possibility of limited health literacy on the NVS tool (91.2%). The medication with the least adherence at baseline was metformin, followed by angiotensin-converting enzyme inhibitors and beta blockers. At 180 days after intervention, patients in the intervention group had higher PDCs compared with their matched controls (71% vs. 44%; P = 0.0069). The use of flashcards and QR-coded prescription bottles for medication and disease state education is an innovative way of improving adherence to diabetes, hypertension, and heart

  2. Oral health knowledge, attitude and practices among health professionals in King Fahad Medical City, Riyadh

    Directory of Open Access Journals (Sweden)

    Mohammad Abdul Baseer

    2012-01-01

    Conclusion: Oral health knowledge among the health professionals working in KFMC, Riyadh was lower than what would be expected of these groups, which had higher literacy levels in health care, but they showed a positive attitude toward professional dental care.

  3. [The concept of medical entomology: the management of the influence of arthropods on human health].

    Science.gov (United States)

    Rasnitsyn, S P

    1997-01-01

    The tasks of medical entomology are analyzed with special reference to the development of methods of protection against the harmful influence of arthropods on human health and the use of these animals in health sciences. Special attention is paid to the following problems: characterization of individual and group features of humans and their relationship with arthropods, elucidation of the properties of arthropods, determination of the state of their populations, estimation of the efficiency of controlling measures, their ecological consequences, etc.

  4. Making Room for Mental Health in the Medical Home

    OpenAIRE

    Hogan, Michael F.; Sederer, Lloyd I.; Smith, Thomas E.; Nossel, Ilana R.

    2010-01-01

    Discussions of health care reform emphasize the need for coordinated care, and evidence supports the effectiveness of medical home and integrated delivery system models. However, mental health often is left out of the discussion. Early intervention approaches for children and adolescents in primary care are important given the increased rates of detection of mental illness in youth. Most adults also receive treatment for mental illness from nonspecialists, underscoring the role for mental hea...

  5. Relative Deprivation and Health: Which Reference Groups Matter?

    Science.gov (United States)

    Mangyo, Eiji; Park, Albert

    2011-01-01

    We examine the extent to which self-reported health and psychosocial health are affected by relative economic status in China, for the first time examining the importance of reference groups not defined by geographic location or demographic characteristics. We propose a methodology to address potential bias from subjective reporting biases and…

  6. Oral health impacts of medications used to treat mental illness.

    Science.gov (United States)

    Cockburn, N; Pradhan, A; Taing, M W; Kisely, S; Ford, P J

    2017-12-01

    Many psychotropic medications affect oral health. This review identified oral side effects for antidepressant, antipsychotic, anticonvulsant, antianxiety and sedative drugs that are recommended in Australia for the management of common mental illnesses and provides recommendations to manage these side-effects. The Australian Therapeutic Guidelines and the Australian Medicines Handbook were searched for medications used to treat common mental health conditions. For each medication, the generic name, class, and drug company reported side-effects were extracted from the online Monthly Index of Medical Specialties (eMIMs) and UpToDate databases. Meyler's Side Effect of Drugs Encyclopaedia was used to identify additional oral adverse reactions to these medications. Fifty-seven drugs were identified: 23 antidepressants, 22 antipsychotics or mood stabilisers, and 12 anxiolytic or sedative medications. Xerostomia (91%) the most commonly reported side effect among all classes of medications of the 28 identified symptoms. Other commonly reported adverse effects included dysguesia (65%) for antidepressants, and tardive dyskinesia (94%) or increased salivation (78%) for antipsychotic medications. While xerostomia has often been reported as a common adverse effect of psychotropic drugs, this review has identified additional side effects including dysguesia from antidepressants and tardive dyskinesia and increased salivation from antipsychotics. Clinicians should consider oral consequences of psychotropic medication in addition to other side-effects when prescribing. For antidepressants, this would mean choosing duloxetine, agomelatine and any of the serotonin re-uptake inhibitors except sertraline. In the case of antipsychotics and mood stabilisers, atypical agents have less oral side effects than older alternatives. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Continuing education in the family health strategy: rethinking educational groups.

    Science.gov (United States)

    Fortuna, Cinira Magali; Matumoto, Silvia; Pereira, Maria José Bistafa; Camargo-Borges, Celiane; Kawata, Lauren Suemi; Mishima, Silvana Martins

    2013-01-01

    to analyze the experience of the family health team in resignifying the way to develop educational groups. groups of discussion, with twenty-six biweekly group meetings conducted, with an average of fifteen professionals from the family health team, during the year 2009. The empirical material consisted of the transcription of the groups, on which thematic analysis was performed. two themes were developed and explored from the collective discussions with the team: "The experience and coordination of the groups" and "The work process and educational groups in a service-school". continuing Education in Health developed with the team, not only permitted learning about the educational groups that comprised the population, but also contributed to the team's analysis of its own relationships and its work process that is traversed by institutions. This study contributed to the advancement of scientific knowledge about the process of continuing health education as well as educational groups with the population. Also noteworthy is the research design used, providing reflexivity and critical analysis on the part of the team about the group process experienced in the meetings, appropriating knowledge in a meaningful and transformative manner.

  8. Medical intelligence, security and global health: the foundations of a new health agenda.

    Science.gov (United States)

    Bowsher, G; Milner, C; Sullivan, R

    2016-07-01

    Medical intelligence, security and global health are distinct fields that often overlap, especially as the drive towards a global health security agenda gathers pace. Here, we outline some of the ways in which this has happened in the recent past during the recent Ebola epidemic in West Africa and in the killing of Osama Bin laden by US intelligence services. We evaluate medical intelligence and the role it can play in global health security; we also attempt to define a framework that illustrates how medical intelligence can be incorporated into foreign policy action in order delineate the boundaries and scope of this growing field.

  9. The ways of teaching process optimization in physical education of the students’ special medical group

    Directory of Open Access Journals (Sweden)

    Bukov U.A.

    2013-06-01

    Full Text Available Purpose – to identify the effectiveness of the use of innovative approaches in physical education teaching process of special medical group students. The study involved 15 boys aged 13-14 years. The lesson include exercises consisting of the elements of Pilates, yoga and static body-oriented therapy. The proposed program of physical exercises performed by students in the main part of the lesson and took the volume to 80% of the time. Set to increase the functionality of the skeletal muscles, the adaptive capacity of cardio-respiratory system, the health and strength of the nervous system, optimization of anthropometric indices, improved spinal mobility. A high degree of efficiency in the learning process of innovation of general preventive and therapeutic intervention is identified. Proposed to use in the educational process modern methods of prevention and correction

  10. 75 FR 34571 - Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered...

    Science.gov (United States)

    2010-06-17

    ... Revenue Service 26 CFR Part 54 RIN 1545-BJ50 Group Health Plans and Health Insurance Coverage Rules... respect to group health plans and health insurance coverage offered in connection with a group health plan... temporary regulations provide guidance to employers, group health plans, and health insurance issuers...

  11. International Service and Public Health Learning Objectives for Medical Students

    Science.gov (United States)

    Block, Robert C.; Duron, Vincent; Creigh, Peter; McIntosh, Scott

    2013-01-01

    Objective: We aimed to improve the education of medical students involved in a longitudinal perinatal health improvement project in Gowa, Malawi. Design: We conducted qualitative interviews with students who participated in the project, reviewed their quantitative reports, and assessed the application of methodologies consonant with the learning…

  12. Utilisation of medical technology assessment in health policy

    NARCIS (Netherlands)

    van den Heuvel, WJA; Wieringh, R; van den Heuvel, LPM

    1997-01-01

    Objective: To assess the contribution of medical technology assessment (MTA) to health policy decision making, the question has to be answered whether MTA is actually being used in decision-making processes and what factors are related to its utilisation. Design: We investigated recent Dutch policy

  13. The Medical Literature as a Resource for Health Care Practice.

    Science.gov (United States)

    McKibbon, K. Ann; And Others

    1995-01-01

    Discussion of evidence-based medicine (EBM) focuses on information tools to facilitate the practice of EBM that were developed, evaluated, and made more accessible by the McMaster University (Canada) Faculty of Health Sciences. Highlights include users' guides to medical literature, strategies for improving MEDLINE searches, new journals, and…

  14. Medical students' attitudes towards the primary health care approach

    African Journals Online (AJOL)

    Medical students' attitudes towards the primary health care approach: what are they, how do they change and ... Journal Home > Vol 49, No 2 (2007) > ... The context of the research presented in this article is the new MBChB curriculum at the ...

  15. Identifying barriers to healthcare to reduce health disparity in Zuni Indians using focus group conducted by community health workers.

    Science.gov (United States)

    Shah, Vallabh O; Ghahate, Donica M; Bobelu, Jeanette; Sandy, Phillip; Newman, Sara; Helitzer, Deborah L; Faber, Thomas; Zager, Philip

    2014-02-01

    The Zuni Pueblo is home to an economically disadvantaged population, which faces a public health challenge from the interrelated epidemics of obesity, diabetes and kidney disease. Efforts to decrease the impact of these epidemics have been complicated by historical, economic and cultural barriers, which may limit healthcare utilization. The NIH supported Zuni Health Initiative (ZHI) conducted a study to identify barriers to healthcare in the Zuni Pueblo. Community health representatives (CHRs) led 14 one-hour focus group sessions at which a total of 112 people participated posed unique questions that took into account the Zuni culture to elicit information on perceived barriers to healthcare. Audiotapes were translated and transcribed by bilingual ZHI staff. We reduced the text to thematic categories, constructed a coding dictionary and inserted the text into NVivo 9 program. We identified nine themes emerged regarding the barriers experienced in receiving healthcare and adhering to medical advice. These included distance; transportation; embarrassment; relating to healthcare professionals; navigating the medical system; awareness of available resources; waiting times; adhering to medication; and incentives in health promotion. In conclusion the implementation of culturally appropriate community-based health promotion programs and preventive screening techniques will improve access to healthcare and diminish health disparities. © 2013 Wiley Periodicals, Inc.

  16. 76 FR 46621 - Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under...

    Science.gov (United States)

    2011-08-03

    ...-AQ07 Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under... group health plans and health insurance coverage in the group and individual markets under provisions of... to group health plans and group health insurance issuers on August 1, 2011. ADDRESSES: Written...

  17. 76 FR 12307 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Science.gov (United States)

    2011-03-07

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and... Committee on Designation of Medically Underserved Populations and Health Professional Shortage...

  18. 76 FR 39062 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Science.gov (United States)

    2011-07-05

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and... Medically Underserved Populations and Health Professional Shortage Areas is to establish criteria and...

  19. 75 FR 79329 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Science.gov (United States)

    2010-12-20

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and... Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

  20. 75 FR 67303 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Science.gov (United States)

    2010-11-02

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and... Designation of Medically Underserved Populations and Health Professional Shortage Areas is to establish...

  1. 75 FR 79330 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Science.gov (United States)

    2010-12-20

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and... Committee on Designation of Medically Underserved Populations and Health Professional Shortage Areas is...

  2. 76 FR 53377 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Science.gov (United States)

    2011-08-26

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and... Medically Underserved Populations and Health Professional Shortage Areas is to establish criteria and...

  3. 76 FR 50442 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Science.gov (United States)

    2011-08-15

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and... Committee on Designation of Medically Underserved Populations and Health Professional Shortage Areas is...

  4. 76 FR 10825 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Science.gov (United States)

    2011-02-28

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and... Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

  5. 76 FR 20867 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Science.gov (United States)

    2011-04-14

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and... Committee on Designation of Medically Underserved Populations and Health Professional Shortage...

  6. 75 FR 82277 - Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Requirements Under the Patient...

    Science.gov (United States)

    2010-12-30

    ... ``Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Requirements Under the Patient Protection... Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Requirements accurately states our... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND...

  7. [Use of medication in combination with a modern group programme for smoking cessation].

    Science.gov (United States)

    Erfurt, L; Kröger, C B

    2015-02-01

    This study examined the acceptance, use and -adherence with regard to stop-smoking medication in addition to a smoking cessation programme. In a multi-centre field study with quasi-experimental control group design, the participants of a smoking cessation programme were asked about their smoking behaviour at the beginning and at the end of the course. A sample of 1 319 participants was contacted via telephone one year after the end of the course. Among the 1 052 participants, who could be interviewed, 312 subjects (29.7%) reported to have used stop-smoking medication while 85.2% of the medication users preferred nicotine replacement therapy. The objective medication adherence was 13.2%. 79.3% of the medication users believed that they had used the medication adherently. There were no significant differences between participants who started use of medication and non-users (long-term abstinence rate: no medication 34.6% vs. medication 31.7%; p=0.34). The outcome of a modern smoking cessation group programme could not be improved by providing additional stop-smoking medication. This finding and the lack of medication adherence raise doubts about the effectiveness of offering stop-smoking medication in addition to an intensive cognitive-behavioural-based smoking cessation programme that focusses on behavioural changes.

  8. Active games in physical education students of special medical group with limited capacity of cardiovascular system

    Directory of Open Access Journals (Sweden)

    Kovaleva M.V.

    2013-08-01

    Full Text Available It is considered the directions of the development an effective methods of usage moving elements of sports and games in exercises. The experiment involved students of special medical groups that have various abnormalities of the cardiovascular system. The study was conducted in four stages: a search, the first experimental, the second experimental, final. We used questioning and education registry books of academic work. Found that the use of sports and outdoor games is students' interest, and increasing motivation for physical activity. Justified by the possibility of using games and exercises performed their adaptation by changing the pulse value. The resulting modification of gaming exercises are divided into three groups: the game in the area of heart rate to 110, 110-130 and 130-150 beats per minute. The first version of the experimental procedure at a heart rate of 110 and 110-130 beats per minute was ineffective for the emergence of significant positive changes in the functional state of the cardiovascular system students. Recommended experimental procedure based on the alternation and equivalence ratio of mobile elements and sports games and increases the heart rate to 130-150 beats per minute. Application of the method increases the overall level of physical health, improves the functional state of the cardiovascular system, health, activity and mood of the students.

  9. The 'medical humanities' in health sciences education in South Africa.

    Science.gov (United States)

    Reid, S

    2014-02-01

    A new masters-level course, 'Medicine and the Arts" will be offered in 2014 at the University of Cape Town, setting a precedent for interdisciplinary education in the field of medical humanities in South Africa. The humanities and social sciences have always been an implicit part of undergraduate and postgraduate education in the health sciences, but increasingly they are becoming an explicit and essential component of the curriculum, as the importance of graduate attributes and outcomes in the workplace is acknowledged. Traditionally, the medical humanities have included medical ethics, history, literature and anthropology. Less prominent in the literature has been the engagement with medicine of the disciplines of sociology, politics, philosophy, linguistics, education, and law, as well as the creative and expressive arts. The development of the medical humanities in education and research in South Africa is set to expand over the next few years, and it looks as if it will be an exciting inter-disciplinary journey.

  10. Military Medics' Insight Into Providing Women's Health Care in Deployed Settings.

    Science.gov (United States)

    Wilson, Candy; Corrigan, Robert; Reese, Sharon; Almonte, Angelica; Simpson, Danielle; Wilson, Amber

    2016-11-01

    To gain better understanding of the military medics' (Navy Independent Duty Corpsman, Air Force Independent Duty Medical Technician, and Army Health Care Specialist, experiences providing health care for women in the deployed or ship setting. The researchers used an exploratory, descriptive design informed by ethnography. A total of 86 individuals participated in the focus group and individual interviews. Three themes were identified: Training Fidelity, Advocate Leader, and The Challenges of Providing Patient Care. Experience in austere settings has convinced a number of medics they need additional women's health care topics in every facet of their training. They further suggested such training should be provided in stepwise fashion, beginning with initial, technical training courses and continuing through medical skills sustainment platforms. They were especially interested in basic women's health concerns. Topics suggested included vaginal infections, urinary tract infections, and birth control management. Although the advancement of women in the military continues to make strides-it is clear the availability of quality women's health care that women feel comfortable accessing may be its defining limitation. Medics are an excellent conduit for reinforcing these healthy messages and providing first-line treatment to deployed military women. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  11. A survey on the attitudes of doctors towards health insurance payment in the medical consortium

    Institute of Scientific and Technical Information of China (English)

    SHI Ge; WU Tao; XU Wei-guo

    2011-01-01

    Background Medical consortium is a specific vertical integration model of regional medical resources.To improve medical resources utilization and control the health insurance costs by fee-for-service plans (FFS),capitation fee and diagnosis-related groups (DRGs),it is important to explore the attitudes of doctors towards the different health insurance payment in the medical consortium in Shanghai.Methods A questionnaire survey was carried out randomly on 50 doctors respectively in 3 different levels medical institutes.Results The statistical results showed that 90% of doctors in tertiary hospitals had the tendency towards FFS,whereas 78% in secondary hospitals towards DRGs and 84% in community health centers towards capitation fee.Conclusions There are some obvious differences on doctors' attitudes towards health insurance payment in 3 different levels hospitals.Thus,it is feasible that health insurance payment should be supposed to the doctors' attitudes using the bundled payments along with the third-party payment as a supervisor within consortium.

  12. Influência da propaganda na utilização de medicamentos em um grupo de idosos atendidos em uma unidade básica de saúde em Aracaju (SE, Brasil The influence of the advertising in the medication use in a group of elderly attended in a primary health care unit in Aracaju (Sergipe, Brasil

    Directory of Open Access Journals (Sweden)

    Divaldo Pereira de Lyra Jr

    2010-11-01

    Full Text Available O crescimento da população idosa brasileira tem levado a uma maior tendência ao uso de medicamentos. A sua utilização inadequada pode ser induzida por vários fatores, dentre eles a propaganda, podendo trazer danos à saúde do usuário. O objetivo do estudo foi avaliar a influência da propaganda no consumo de medicamentos por um grupo de idosos atendidos em unidade básica de saúde de Aracaju, Sergipe. No período de abril a junho de 2007, um grupo de 230 idosos, com idade acima de 60 anos, de ambos os gêneros, foi entrevistado. A maioria dos entrevistados (73% possuía pelo menos uma doença crônica e 73,9% consumiam pelo menos um medicamento regularmente. Do total de entrevistados, 17,8% da amostra relataram utilizar medicamentos por influência da propaganda; 2,2% consideraram que os medicamentos veiculados na mídia nunca fazem mal e 6,5% acreditavam que eles sempre fazem bem. No estudo, correlações foram feitas e demonstraram que quem mais consome medicamentos influenciados pela propaganda também considera que eles sempre fazem bem e vice-versa (p= 0,04. Os dados revelaram que parte dos idosos sofreu influência da propaganda no consumo de medicamentos, não levando em consideração os riscos que estes poderiam causar.The growth of the Brazilian elderly people has led to a trend to an increase in the medication use. The inadequate use of drugs can be induced by some factors, like advertisement, with the risk of damaging the user's health. The objective of the study was to evaluate the advertisement influence in medication use in a group of elderly patients in a primary health care unit in Aracaju, Sergipe, Brazil. 230 elderly aging over 60 years with both genders had been interviewed from April to June of 2007. The majority of the interviewees (73% has at least a chronic health condition and 73.9% consumed regularly at least one medication. 17.8% of the sample informed to use medication motivated by publicity influence; 2

  13. SUITABILITY OF MEDICATIONS USED BY THE ELDERLY PARTICIPANTS OF A SOCIAL GROUP, ACCORDING TO THE BEERS CRITERIA

    Directory of Open Access Journals (Sweden)

    Geysa Donária de Miranda Mascarenhas

    2014-09-01

    Full Text Available The dynamic process defined as aging progressively reduces the functional capacity of the elderly and added to the lifestyle, they can to testify to the high number of pathologies. Thus, pharmacotherapy for this age group requires special care, keeping in view its peculiarities. Given this need, a group of researchers has developed criteria that allowed the identification of inappropriate medications. Thus, the aim of this study was to investigate the suitability of medications used by the elderly participants of a social group, in Vitória da Conquista, BA, according to the Beers criteria. This research was an exploratory descriptive study and data collection conducted through semi - structured interviews. It was asked to bring all the elderly who were using medications and / or prescriptions. It was found that 12.7% of the drugs used by the elderly appeared in the list of inappropriate medicines and 42% of respondents make use of polypharmacy. Among the most prescribed inappropriate medications, there is acetylsalicylic acid, diclofenac, diazepam, piroxicam, ibuprofen and amitriptyline. The class of inappropriate drugs most used by seniors was anti - inflammatory drugs. Given this, all health professionals need to put into practice the criteria for selecting medications this age group as the reality of existing drugs in Brazil.

  14. Acceptance and commitment group therapy for health anxiety

    DEFF Research Database (Denmark)

    Eilenberg, Trine

    2013-01-01

    Health anxiety (or hypochondriasis) is prevalent, may be persistent and disabling for the sufferers and associated with high societal costs. Acceptance and Commitment Therapy (ACT) is a new third-wave behavioral cognitive therapy that has not yet been tested in health anxiety. 34 consecutive Danish...... patients with severe health anxiety were referred from general practitioners or hospital departments and received a ten session ACT group therapy. Patients were followed-up by questionnaires for 6 months. There were significant reductions in health anxiety, somatic symptoms and emotional distress at 6...

  15. The effects of capitation payment on the organizational structure of medical group practices.

    Science.gov (United States)

    Kralewski, J E; Wingert, T D; Knutson, D J; Johnson, C E; Veazie, P J

    1996-01-01

    This study explores the effects of capitation payment on the structural elements used by medical group practices to control physician-directed use of resources and the quality of patient care. Forty-five medical groups located in the highly competitive Minneapolis/St. Paul metropolitan area were studied. The range of capitation payment in these medical group practices is from 2% to 87%. Although the practices vary considerably in the extent to which they have developed these control mechanisms, it does not appear that capitation payment is a major factor influencing that pattern. It appears that many of these medical group practices either use less formal mechanisms than those included in this study to control resource use and the quality of care or use none at all. In either event, the data suggest that the effects of capitation payment on the structure of medical practices may be overestimated.

  16. Health behaviors and participation in health promotion activities among hospital staff: which occupational group performs better?

    Science.gov (United States)

    Chiou, Shu-Ti; Chiang, Jen-Huai; Huang, Nicole; Chien, Li-Yin

    2014-10-22

    Staff health behaviors affect not only their own health but also their provision of health promotion services to their patients. Although different occupational groups work in hospitals, few studies have compared health behaviors among them. The objectives of this study were to examine health behaviors, including physical activity, eating 5 portions of fruits and vegetables per day (5 a day), and stress adaptation, and participation in hospital-based health promotion activities by occupational groups in hospitals. This cross-sectional survey was conducted among full-time employees in 100 hospitals across Taiwan. This analysis included 4202 physicians, 31639 nurses, 2315 pharmacists, 8161 other health professionals, and 13079 administrative personnel. Administrative personnel attended more health promotion lectures and clubs/groups than other health professionals, pharmacists and physicians, and those workers participated more than nurses. Participation in health promotion activities provided by hospitals was associated with better practice of health behaviors. After adjustment for socio-demographics and participation in health promotion activities, physicians, pharmacists, and other health professionals reported more 5 a day than administrative staff. Other health professionals reported more physical activity than administrative staff, and they reported more than physicians. Nurses reported the lowest level of physical activity, 5 a day, and stress adaptation of all occupational groups. Nurses had worse health behaviors and less participation in health promotion activities than other groups. Workplace health promotion program for health professionals is needed, with special emphasis on nurses. Hospital-based health promotion programs could take the differences of occupational groups into consideration to tailor programs to the needs of different occupational groups.

  17. Medical student service learning program teaches secondary students about career opportunities in health and medical fields.

    Science.gov (United States)

    Karpa, Kelly; Vakharia, Kavita; Caruso, Catherine A; Vechery, Colin; Sipple, Lanette; Wang, Adrian

    2015-12-01

    Engagement of academic medical centers in community outreach provides the public with a better understanding of basic terms and concepts used in biomedical sciences and increases awareness of important health information. Medical students at one academic medical center initiated an educational outreach program, called PULSE, that targets secondary students to foster their interest in healthcare and medicine. High school student participants are engaged in a semester-long course that relies on interactive lectures, problem-based learning sessions, mentoring relationships with medical students, and opportunities for shadowing healthcare providers. To date, the curriculum has been offered for 7 consecutive years. To determine the impact that participation in the curriculum has had on college/career choices and to identify areas for improvement, an electronic questionnaire was sent to former participants. Based on a 32% response rate, 81% of former participants indicated that participation in the course influenced their decision to pursue a medical/science-related career. More than half (67%) of respondents indicated intent to pursue a MD/PhD or other postgraduate degree. Based on responses obtained, additional opportunities to incorporate laboratory-based research and simulation sessions should be explored. In addition, a more formalized mentoring component has been added to the course to enhance communication between medical students and mentees. Health/medicine-related educational outreach programs targeting high school students may serve as a pipeline to introduce or reinforce career opportunities in healthcare and related sciences. Copyright © 2015 The American Physiological Society.

  18. Evaluating direct-to-consumer marketing of race-based pharmacogenomics: a focus group study of public understandings of applied genomic medication.

    Science.gov (United States)

    Bates, Benjamin R; Poirot, Kristan; Harris, Tina M; Condit, Celeste M; Achter, Paul J

    2004-01-01

    Some medical providers have advocated applied genomics, including the use of genetically linked racial phenotypes in medical practice, raising fear that race-based medication will become justified. As with other emerging medical genetic technologies, pharmaceutical companies may advertise these treatments. Researchers fear that consumers will uncritically accept pharmaceutical messages and demand the product. In this exploratory study, we examined public reactions to advertisements for applied genomic medications. A focus group methodology was employed. Participants tended to resist the message and generated warrants for doing so, indicating critical reception of the messages. Message accepters also provided warrants. Warrants for resistance and acceptance differ between self-identified racial groups. Consumers, health care providers, and pharmaceutical corporations will benefit from a better understanding of direct-to-consumer advertisements as medical communication. Our study concludes that both advocates and opponents of direct-to-consumer advertisements should recognize that potential consumers of pharmacogenomics act as critical consumers of health advertising discourse.

  19. Medication adherence in patients with type 2 diabetes mellitus treated at primary health clinics in Malaysia

    Directory of Open Access Journals (Sweden)

    Ahmad NS

    2013-06-01

    Full Text Available Nur Sufiza Ahmad,1 Azuana Ramli,1 Farida Islahudin,2 Thomas Paraidathathu21Pharmaceutical Services Division, Ministry of Health, Petaling Jaya, Malaysia; 2Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, MalaysiaPurpose: Diabetes mellitus is a growing global health problem that affects patients of all ages. Even though diabetes mellitus is recognized as a major chronic illness, adherence to antidiabetic medicines has often been found to be unsatisfactory. This study was conducted to assess adherence to medications and to identify factors that are associated with nonadherence in type 2 diabetes mellitus (T2DM patients at Primary Health Clinics of the Ministry of Health in Malaysia.Materials and methods: The cross-sectional survey was carried out among T2DM patients to assess adherence to medication in primary health clinics. Adherence was measured by using the Medication Compliance Questionnaire that consists of a total of seven questions. Other data, such as patient demographics, treatment, outcome, and comorbidities were also collected from patient medical records.Results: A total of 557 patients were recruited in the study. Approximately 53% of patients in the study population were nonadherent. Logistic regression analysis was performed to predict the factors associated with nonadherence. Variables associated with nonadherence were age, odds ratio 0.967 (95% confidence interval [CI]: 0.948–0.986; medication knowledge, odds ratio 0.965 (95% CI: 0.946–0.984; and comorbidities, odds ratio 1.781 (95% CI: 1.064–2.981.Conclusion: Adherence to medication in T2DM patients in the primary health clinics was found to be poor. This is a cause of concern, because nonadherence could lead to a worsening of disease. Improving medication knowledge by paying particular attention to different age groups and patients with comorbidities could help improve adherence.Keywords: type 2 diabetes mellitus, adherence, glycemic control, primary

  20. Group health coaching: strengths, challenges, and next steps.

    Science.gov (United States)

    Armstrong, Colin; Wolever, Ruth Q; Manning, Linda; Elam, Roy; Moore, Margaret; Frates, Elizabeth Pegg; Duskey, Heidi; Anderson, Chelsea; Curtis, Rebecca L; Masemer, Susan; Lawson, Karen

    2013-05-01

    There is great need for cost effective approaches to increase patient engagement and improve health and well-being. Health and wellness coaching has recently demonstrated great promise, but the majority of studies to date have focused on individual coaching (ie, one coach with one client). Newer initiatives are bringing a group coaching model from corporate leadership development and educational settings into the healthcare arena. A group approach potentially increases cost-effective access to a larger number of clients and brings the possible additional benefit of group support. This article highlights some of the group coaching approaches currently being conducted across the United States. The group coaching interventions included in this overview are offered by a variety of academic and private sector institutions, use both telephonic and in-person coaching, and are facilitated by professionally trained health and wellness coaches as well as trained peer coaches. Strengths and challenges experienced in these efforts are summarized, as are recommendations to address those challenges. A working definition of "Group Health and Wellness Coaching" is proposed, and important next steps for research and for the training of group coaches are presented.

  1. Efficacy of a lay health worker led group antiretroviral medication ...

    African Journals Online (AJOL)

    Karl Peltzer, Shandir Ramlagan, Deborah Jones, Stephen M. Weiss, Henry Fomundam, and Lucia Chanetsa

    training among non-adherent HIV-positive patients in KwaZulu-Natal, South ... and task forces and was appointed to task forces under the auspices of the White ... and resistance is to be avoided. ... For example, a meta-analysis of 19 randomized controlled ... effects on adherence (d ¼ 0.62, OR ¼ 3.07), and that interven-.

  2. Emerging medical technologies and emerging conceptions of health.

    Science.gov (United States)

    Stempsey, William E

    2006-01-01

    Using ideas gleaned from the philosophy of technology of Martin Heidegger and Hans Jonas and the philosophy of health of Georges Canguilhem, I argue that one of the characteristics of emerging medical technologies is that these technologies lead to new conceptions of health. When technologies enable the body to respond to more and more challenges of disease, we thus establish new norms of health. Given the continued development of successful technologies, we come to expect more and more that our bodies should be able to respond to ever-new challenges of environment and disease by establishing ever-new norms of health. Technologies may aim at the prevention and treatment of disease, but they also bring about modifications of what we consider normal for the human being. Thus, new norms of health arise from technological innovation.

  3. Medical Tourism and the Libyan National Health Services

    Directory of Open Access Journals (Sweden)

    El Taguri A

    2007-01-01

    Full Text Available Medical tourism is a term that is used frequently by the media and travel agencies as a catchall phrase to describe a process where people travel to other countries to obtain medical, dental, and/or surgical care [1,2]. Leisure aspects of traveling are usually included on such a medical travel trip [1]. The term is also used to describe a situation where doctors travel to other places to deliver services to endogenous populations [3].Many factors have led to the recent increase in popularity of medical tourism. Among these factors are the absence of a particular service and the high cost of health care in some countries of origin on one side, and the ease and affordability of international travel, and the improvement of technology and standards of care in host countries on the other side. This phenomenon cannot be separated from globalization and tendency for a more liberal world trade. In countries that operate from a public health-care system, it can take a considerable amount of time to get needed medical care. In Britain and Canada, for example, the waiting period for a hip replacement can be a year or more, while in Bangkok or Bangalore, a patient can be in the operating room the morning after getting off a plane [2]. The post-surgery mortality rate in the 15,000 heart operations done every year in Scots Heart Institute and Research Centre in Delhi and Faridabad is only 0.8%, which is less than half of most major hospitals in the United States or Europe [2]. However, the real attraction is price [2]. The cost of surgery in India, Thailand or South Africa can be one-tenth of the price of comparable treatment in the United States or Western Europe [2]. A heart operation as an example costs €32000 in the United States, €16000 in Europe, but less than €3000 in India. A full facelift that would cost $20,000 in the U.S. runs at about $1,250 in South Africa [2]. In addition, clinics in these countries provide single-patient rooms that

  4. Team-Based Learning for Nursing and Medical Students: Focus Group Results From an Interprofessional Education Project.

    Science.gov (United States)

    Feather, Rebecca A; Carr, Doug E; Reising, Deanna L; Garletts, Derrick M

    2016-01-01

    Past research indicates that inadequacies in health care delivery create substantial preventable quality issues that can be addressed through improving relationships among clinicians to decrease the negative effects on patient outcomes. The purpose of this article is to describe the implementation of an interprofessional education project with senior nursing and third-year medical students working in teams in a clinical setting. Results include data from focus groups conducted at the conclusion of the project.

  5. Mobile-Based Medical Health Application - Medi-Chat App

    Directory of Open Access Journals (Sweden)

    Mustapha Adamu Mohammed

    2015-08-01

    Full Text Available The aftermath of the development and implementation of the Android operating system and its associated Application Programming InterfacesAPI by Google culminated in the development more mobile device-enabled applications designed for our day-to-day businesses and personal use however in recent times we are experiencing a massive revolution in the use of mobile technology in the health sectors of our economy and this revolution is termed as Mobile Health Technology MHT.This new technological breakthrough has enabled the development of powerful android applications that enabled people tract and monitor the treat of heart and kidney related diseases as well as the monitoring and evaluation certain drug prescriptions. It has also changed the way we communicate with our specialist doctors from phone text to mobile-based communication. All these interventions provided by MHT have drastically increased the efficient and effective provision of health care delivery on one side and providing a common platform for prospective patients to easily interact with health professionals for medical advice and subsequent treatment of their diseases. Moreover In Ghana It would provide a much efficient and cost effective way of improving health-care methodologies in this 21st century which is characterized by information and communication technology. In this paper the main goal is to develop a mobile health application that provides common platform prospective patients and specialist doctors give free consultation and health tips on health related conditions thereby reducing the difficulty and challenges uncounted in accessing free medical health care at the already overburdened hospitals polyclinics and health centers in Ghana.

  6. Comparison of Knowledge Scores of Medical Students in Problem-Based Learning and Traditional Curriculum on Public Health Topics

    Science.gov (United States)

    Gurpinar, Erol; Musal, Berna; Aksakoglu, Gazanfer; Ucku, Reyhan

    2005-01-01

    Background: The purpose of the study was to compare the knowledge scores of medical students in Problem-based Learning and traditional curriculum on public health topics. Methods: We planned a cross-sectional study including the fifth and sixth year medical students of Dokuz Eylul University in Turkey. The fifth year students (PBL group, n = 56)…

  7. International medical students' expectations and worries at the beginning of their medical education: a qualitative focus group study.

    Science.gov (United States)

    Huhn, Daniel; Huber, Julia; Ippen, Franziska M; Eckart, Wolfgang; Junne, Florian; Zipfel, Stephan; Herzog, Wolfgang; Nikendei, Christoph

    2016-01-28

    The number of international students has increased substantially within the last decade. Due to cultural barriers, this specific group faces diverse challenges. In comparison to German colleagues, international medical students perform significantly lower in clinical examinations and exceed the average duration of study; they suffer from personal distress as well as insufficient support. Within the present study, their individual perspectives, expectations, hopes and fears were examined. Four focus groups with first-year international medical students (N = 16) were conducted in October 2013. Each 60- to 90-min discussion was audiotaped, transcribed and analysed using qualitative methods. International medical students go abroad in search of good study-conditions. For the choice of place of study, affordability, social ties as well as an educational system following the achievement principle are decisive factors. While contact with German-students and other international students is seen as beneficial, international medical students are most concerned to encounter problems and social exclusion due to language deficits and intercultural differences. Facilitating the access to university places, the provision of financial aid and, moreover, social support, nurturing cultural integration, would greatly benefit international medical students. Hereby, the establishment of specific medical language courses as well as programs fostering intercultural-relations could prove to be valuable.

  8. Electronic Health Record A Systems Analysis of the Medications Domain

    CERN Document Server

    Scarlat, Alexander

    2012-01-01

    An accessible primer, Electronic Health Record: A Systems Analysis of the Medications Domain introduces the tools and methodology of Structured Systems Analysis as well as the nuances of the Medications domain. The first part of the book provides a top-down decomposition along two main paths: data in motion--workflows, processes, activities, and tasks in parallel to the analysis of data at rest--database structures, conceptual, logical models, and entities relationship diagrams. Structured systems analysis methodology and tools are applied to: electronic prescription, computerized physician or

  9. Global health diplomacy training for military medical researchers.

    Science.gov (United States)

    Katz, Rebecca; Blazes, David; Bae, Jennifer; Puntambekar, Nisha; Perdue, Christopher L; Fischer, Julie

    2014-04-01

    Given the unprecedented growth of global health initiatives in the past decade, informal diplomacy between technical partners plays an increasingly important role in shaping opportunities and outcomes. This article describes a course developed and executed specifically to equip U.S. military health professionals with core skills in practical diplomacy critical to help them successfully plan and implement public health surveillance, research, and capacity building programs with partner nation governments and organizations. We identified core competencies in practical diplomacy for laboratory and public health researchers, catalogued and evaluated existing training programs, and then developed a pilot course in global health diplomacy for military medical researchers. The pilot course was held in June 2012, and focused on analyzing contemporary issues related to global health diplomacy through the framework of actors, drivers, and policies that affect public health research and capacity-building, beginning at the level of global health governance and cooperation and moving progressively to regional (supranational), national, and institutional perspective. This course represents an approach geared toward meeting the needs specific to U.S. military public health personnel and researchers working in international settings. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  10. Development and Operation of a Modern Information Portal for the ISS Medical Groups

    Science.gov (United States)

    Damann, V.; Johnson, MaGee; Sargsyan, Ashot; McDonald, P. Vernon; Armstrong, C.; Scheer, M.; Duncan, J. Michael

    2007-01-01

    This viewgraph presentation begins with a review of some of the problems inherent in running medical services for the International Space Station. Part of the solution for the problems is the development of the information portal for the ISS medical groups. The presentation shows the tools that have been developed to assist in collaboration for the medical services, the security system and the capabilities of the portal.

  11. Addressing gaps in abortion education: a sexual health elective created by medical students.

    Science.gov (United States)

    Caro-Bruce, Emily; Schoenfeld, Elizabeth; Nothnagle, Melissa; Taylor, Julie

    2006-05-01

    Medical school curricula frequently contain gaps in the areas of abortion and sexual health. A group of first- and second-year medical students at the authors' institution organized a collaborative, multidisciplinary elective course to address such omissions in the preclinical curriculum. This paper describes the process of creating and implementing the elective. Medical students identified curricular gaps in the areas of abortion, sexual assault, lesbian/gay/bisexual/transgender health, and HIV counseling. Clinical faculty and community-based professionals were invited to address these topics in a weekly lecture series organized by students. The course also included a half-day experience shadowing at a local abortion clinic. Collaboration with several student groups helped broaden student interest in and increase financial support for the elective. Some 37% of all first- and second-year students enrolled in the elective and received institutional credit for the course. Written and verbal evaluations confirmed student satisfaction with the lectures and the clinical experience. Dynamic and well-prepared speakers who presented interesting medical content received the highest ratings from students. Student leaders identified several challenges in implementing the elective. Ultimately the elective proved to be a successful collaboration among students, faculty, and healthcare providers, and resulted in permanent changes in the standard medical school curriculum. Challenges for student-initiated electives include difficulty in finding administrative support, securing funding and ensuring sustainability. This paper aims to make this process accessible and applicable to other students and faculty interested in addressing curricular gaps at their respective medical schools.

  12. [How to design workshops to promote health in community groups].

    Science.gov (United States)

    Hernández-Díaz, Josefina; Paredes-Carbonell, Joan J; Marín Torrens, Rosa

    2014-01-01

    One of the strategies of health promotion is to develop life skills people considering themselves as the main health resource. A workshop has to get its participants become «asset» to make decisions and create health, focusing on the development and acquisition of skills in a motivating group and in order to achieve health objectives. The concepts behind the design of a workshop are: participatory planning, training, meaningful learning, group learning and participatory techniques. The steps to follow to design a workshop and facilitate their application are: Stage 0, founding; initial stage, host and initial evaluation; central or construction stage based learning in the acquisition of knowledge, attitudes and skills, and final stage or evaluation. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  13. Group Projects as a Method of Promoting Student Scientific Communication and Collaboration in a Public Health Microbiology Course

    Science.gov (United States)

    Walton, Kristen L. W.; Baker, Jason C.

    2009-01-01

    Communication of scientific and medical information and collaborative work are important skills for students pursuing careers in health professions and other biomedical sciences. In addition, group work and active learning can increase student engagement and analytical skills. Students in our public health microbiology class were required to work…

  14. "The group facilitates everything": meanings patients with type 2 diabetes mellitus assigned to health education groups.

    Science.gov (United States)

    de Melo, Lucas Pereira; de Campos, Edemilson Antunes

    2014-01-01

    to interpret the meanings patients with type 2 diabetes mellitus assign to health education groups. ethnographic study conducted with Hyperdia groups of a healthcare unit with 26 informants, with type 2 diabetes mellitus, and having participated in the groups for at least three years. Participant observation, social characterization, discussion groups and semi-structured interviews were used to collect data. Data were analyzed through the thematic coding technique. four thematic categories emerged: ease of access to the service and healthcare workers; guidance on diabetes; participation in groups and the experience of diabetes; and sharing knowledge and experiences. The most relevant aspect of this study is the social use the informants in relation to the Hyperdia groups under study. the studied groups are agents producing senses and meanings concerning the process of becoming ill and the means of social navigation within the official health system. We expect this study to contribute to the actions of healthcare workers coordinating these groups given the observation of the cultural universe of these individuals seeking professional care in the various public health care services.

  15. "The group facilitates everything": meanings patients with type 2 diabetes mellitus assigned to health education groups

    Directory of Open Access Journals (Sweden)

    Lucas Pereira de Melo

    2014-12-01

    Full Text Available OBJECTIVE: to interpret the meanings patients with type 2 diabetes mellitus assign to health education groups.METHOD: ethnographic study conducted with Hyperdia groups of a healthcare unit with 26 informants, with type 2 diabetes mellitus, and having participated in the groups for at least three years. Participant observation, social characterization, discussion groups and semi-structured interviews were used to collect data. Data were analyzed through the thematic coding technique.RESULTS: four thematic categories emerged: ease of access to the service and healthcare workers; guidance on diabetes; participation in groups and the experience of diabetes; and sharing knowledge and experiences. The most relevant aspect of this study is the social use the informants in relation to the Hyperdia groups under study.CONCLUSION: the studied groups are agents producing senses and meanings concerning the process of becoming ill and the means of social navigation within the official health system. We expect this study to contribute to the actions of healthcare workers coordinating these groups given the observation of the cultural universe of these individuals seeking professional care in the various public health care services.

  16. A proposal for a worldwide definition of health resort medicine, balneology, medical hydrology and climatology.

    Science.gov (United States)

    Gutenbrunner, Christoph; Bender, Tamas; Cantista, Pedro; Karagülle, Zeki

    2010-09-01

    , and the use of climatic factors for therapy is called climatotherapy. Reflecting the effects of health resort medicine, it is important to take other environmental factors into account. These can be classified within the framework of the ICF (International Classification of Functioning, Disability and Health). Examples include receiving health care by specialised doctors, being well educated (ICF-domain: e355), having an environment supporting social contacts (family, peer groups) (cf. ICF-domains: d740, d760), facilities for recreation, cultural activities, leisure and sports (cf. ICF-domain: d920), access to a health-promoting atmosphere and an environment close to nature (cf. ICF-domain: e210). The scientific field dealing with health resort medicine is called health resort sciences. It includes the medical sciences, psychology, social sciences, technical sciences, chemistry, physics, geography, jurisprudence, etc. Finally, this paper proposes a systematic international discussion of descriptions in the field of Health Resort Medicine, Balneology, Medical Hydrology and Climatology, and discusses short descriptive terms with the goal of achieving internationally accepted distinct terms. This task should be done via a structured consensus process and is of major importance for the publication of scientific results as well as for systematic reviews and meta-analyses.

  17. A proposal for a worldwide definition of health resort medicine, balneology, medical hydrology and climatology

    Science.gov (United States)

    Gutenbrunner, Christoph; Bender, Tamas; Cantista, Pedro; Karagülle, Zeki

    2010-09-01

    hydrotherapy, and the use of climatic factors for therapy is called climatotherapy. Reflecting the effects of health resort medicine, it is important to take other environmental factors into account. These can be classified within the framework of the ICF (International Classification of Functioning, Disability and Health). Examples include receiving health care by specialised doctors, being well educated (ICF-domain: e355), having an environment supporting social contacts (family, peer groups) (cf. ICF-domains: d740, d760), facilities for recreation, cultural activities, leisure and sports (cf. ICF-domain: d920), access to a health-promoting atmosphere and an environment close to nature (cf. ICF-domain: e210). The scientific field dealing with health resort medicine is called health resort sciences. It includes the medical sciences, psychology, social sciences, technical sciences, chemistry, physics, geography, jurisprudence, etc. Finally, this paper proposes a systematic international discussion of descriptions in the field of Health Resort Medicine, Balneology, Medical Hydrology and Climatology, and discusses short descriptive terms with the goal of achieving internationally accepted distinct terms. This task should be done via a structured consensus process and is of major importance for the publication of scientific results as well as for systematic reviews and meta-analyses.

  18. Health incarcerated the use of medical services within correctional facilities.

    NARCIS (Netherlands)

    Brake, J.H.M. te; Jongh, D.M. de; Bakker, D.H. de; Devillé, W.L.J.M.

    2005-01-01

    Background: In order to adequately staff correctional medical teams it is important to collect objective data on their work load, especially given the increasing call for cut-backs in the overall treatment of inmates. Moreover, inmates typically constitute a vulnerable patient group, characterized b

  19. Health incarcerated the use of medical services within correctional facilities.

    NARCIS (Netherlands)

    Brake, J.H.M. te; Jongh, D.M. de; Bakker, D.H. de; Devillé, W.L.J.M.

    2005-01-01

    Background: In order to adequately staff correctional medical teams it is important to collect objective data on their work load, especially given the increasing call for cut-backs in the overall treatment of inmates. Moreover, inmates typically constitute a vulnerable patient group, characterized b

  20. General Health of Foreign-Origin Groups and Native Population

    Science.gov (United States)

    Ardian, Nahid; Mahmoudabad, Seyed Saeid Mazloomy; Ardian, Mahdi; Karimi, Masoud

    2014-01-01

    Background: Since the mental health of marginal settlers (non-native population) may affect other citizens’ health, the present study attempts to investigate the mental health status of marginal settlers of Yazd. Materials and Methods: this study was a descriptive, cross-sectional research, in which 400 of non-native and native population have participated. To study mental health status of people, a questionnaire was used. The first section of this questionnaire was the 28-item questionnaire of GHQ and the second section dealt with demographic characteristics such as age, sex, employment status, household income, and educational level of the father of the family. The collected data was analyzed using statistical operations of Pearson correlation coefficient, T Student, univariate Anova, and non-parametric Chi Square. Results: The results revealed that the average scores of general health were 20.09±9.84 and 17.04±9.54 for native and non-native population, respectively. Among subscales of general health, the highest and lowest average scores belonged to social dysfunctions, which showed a dangerous mental health status, and depression, respectively. There was significant difference between average score of general health and educational level of the father of the family (p<.001). The temporary employment and leased household differs significantly from the average score of general health among native population. It was indicated that sex was one of the most powerful predictors of mental health and people had more mental health when they grew older. Anxiety was the strongest predictor of general health for both groups. Conclusion: It seems that background factors such as educational level and employment status effect general health of people more than living in marginal settlement. PMID:25168986

  1. Health Promotion Interventions for Low-Income Californians Through Medi-Cal Managed Care Plans, 2012

    Science.gov (United States)

    Kohatsu, Neal D.; Paciotti, Brian M.; Byrne, Jennifer V.; Kizer, Kenneth W.

    2015-01-01

    Introduction Prevention is the most cost-effective approach to promote population health, yet little is known about the delivery of health promotion interventions in the nation’s largest Medicaid program, Medi-Cal. The purpose of this study was to inventory health promotion interventions delivered through Medi-Cal Managed Care Plans; identify attributes of the interventions that plans judged to have the greatest impact on their members; and determine the extent to which the plans refer members to community assistance programs and sponsor health-promoting community activities. Methods The lead health educator from each managed care plan was asked to complete a 190-item online survey in January 2013; 20 of 21 managed care plans responded. Survey data on the health promotion interventions with the greatest impact were grouped according to intervention attributes and measures of effectiveness; quantitative data were analyzed using descriptive statistics. Results Health promotion interventions judged to have the greatest impact on Medi-Cal members were delivered in various ways; educational materials, one-on-one education, and group classes were delivered most frequently. Behavior change, knowledge gain, and improved disease management were cited most often as measures of effectiveness. Across all interventions, median educational hours were limited (2.4 h), and median Medi-Cal member participation was low (265 members per intervention). Most interventions with greatest impact (120 of 137 [88%]) focused on tertiary prevention. There were mixed results in referring members to community assistance programs and investing in community activities. Conclusion Managed care plans have many opportunities to more effectively deliver health promotion interventions. Establishing measurable, evidence-based, consensus standards for such programs could facilitate improved delivery of these services. PMID:26564012

  2. Differential impact of student behaviours on group interaction and collaborative learning: medical students' and tutors' perspectives.

    Science.gov (United States)

    Iqbal, Maha; Velan, Gary M; O'Sullivan, Anthony J; Balasooriya, Chinthaka

    2016-08-22

    Collaboration is of increasing importance in medical education and medical practice. Students' and tutors' perceptions about small group learning are valuable to inform the development of strategies to promote group dynamics and collaborative learning. This study investigated medical students' and tutors' views on competencies and behaviours which promote effective learning and interaction in small group settings. This study was conducted at UNSW Australia. Five focus group discussions were conducted with first and second year medical students and eight small group tutors were interviewed. Data were transcribed verbatim and thematic analysis was conducted. Students and tutors identified a range of behaviours that influenced collaborative learning. The main themes that emerged included: respectfulness; dominance, strong opinions and openness; constructiveness of feedback; active listening and contribution; goal orientation; acceptance of roles and responsibilities; engagement and enthusiasm; preparedness; self- awareness and positive personal attributes. An important finding was that some of these student behaviours were found to have a differential impact on group interaction compared with collaborative learning. This information could be used to promote higher quality learning in small groups. This study has identified medical students' and tutors' perceptions regarding interactional behaviours in small groups, as well as behaviours which lead to more effective learning in those settings. This information could be used to promote learning in small groups.

  3. Medical Student Beliefs about Disclosure of Mental Health Issues: A Qualitative Study.

    Science.gov (United States)

    Winter, Peter; Rix, Andrew; Grant, Andrew

    In 2012 the United Kingdom's General Medical Council (GMC) commissioned research to develop guidance for medical schools on how best to support students with mental illness. One of the key findings from medical student focus groups in the study was students' strong belief that medical schools excluded students on mental health grounds. Students believed mental illness was a fitness to practice matter that led to eventual dismissal, although neither personal experience nor empirical evidence supported this belief. The objective of the present study was a deeper exploration of this belief and its underlying social mechanisms. This included any other beliefs that influenced medical students' reluctance to disclose a mental health problem, the factors that reinforced these beliefs, and the feared consequences of revealing a mental illness. The study involved a secondary analysis of qualitative data from seven focus groups involving 40 student participants across five UK medical schools in England, Scotland, and Wales. Student beliefs clustered around (1) the unacceptability of mental illness in medicine, (2) punitive medical school support systems, and (3) the view that becoming a doctor is the only successful career outcome. Reinforcing mechanisms included pressure from senior clinicians, a culture of "presenteeism," distrust of medical school staff, and expectations about conduct. Feared consequences centered on regulatory "fitness to practice" proceedings that would lead to expulsion, reputational damage, and failure to meet parents' expectations. The study's findings provide useful information for veterinary medical educators interested in creating a culture that encourages the disclosure of mental illness and contributes to the debate about mental illness within the veterinary profession.

  4. Acceptance and commitment group therapy for health anxiety

    DEFF Research Database (Denmark)

    Eilenberg, Trine

    2013-01-01

    Health anxiety (or hypochondriasis) is prevalent, may be persistent and disabling for the sufferers and associated with high societal costs. Acceptance and Commitment Therapy (ACT) is a new third-wave behavioral cognitive therapy that has not yet been tested in health anxiety. 34 consecutive Danish...... patients with severe health anxiety were referred from general practitioners or hospital departments and received a ten session ACT group therapy. Patients were followed-up by questionnaires for 6 months. There were significant reductions in health anxiety, somatic symptoms and emotional distress at 6...... months compared to baseline: a 49% reduction in health anxiety (Whiteley-7 Index), a 47% decrease in emotional distress (SCL-8) and a 40% decrease in somatic symptoms (SCL-90-R). Furthermore, the patients’ perceptions of their illness (IPQ, a condensed Danish version) were significantly more optimistic...

  5. Marketing home health care medical services: the physician's view.

    Science.gov (United States)

    Ryan, E J; Phelps, R A

    1993-01-01

    The authors surveyed physicians serving the Jackson, Mississippi home health care market. They identified problems and studied physician perceptions regarding services provided by home health care agencies, private duty nursing agencies, and durable medical equipment suppliers. Respondents perceived home health care as providing: (1) increased patient satisfaction, (2) greater patient convenience, (3) earlier discharge, and (4) lowered patient costs. They least liked: (1) lack of control and involvement in the patient caring process, (2) paperwork, (3) quality control potential, and the possibility that patient costs could increase. Two sets of implications for health care marketers are presented that involve both national and regional levels. Overall results indicate that a growing and profitable market segment exists and is being served in an effective and socially responsible manner.

  6. Social Factors of Health Vulnerability of Marginalized Social Groups

    Directory of Open Access Journals (Sweden)

    Bojan Žikić

    2016-03-01

    Full Text Available Marginalized social groups are part of a certain apotheosis of otherness in present-day anthropological studies, being groups – such as refugees or immigrants – that come from other socio-cultural environments, and are marginalized in the anthropologists’ own environments, or environments socio-culturally similar to these. Groups that are to be considered as marginalized are those that have been put in this position contextually, through displacement from everything that represents life according to human standards, which becomes a continuous/permanent state, i.e. the way of life of the people in question, leading to the destabilization of both their physical and their mental health. The causes of this displacement are social in nature, thus constituting the primary social factors of health vulnerability of displaced populations, and they include wars and armed conflicts, persecution for various reasons, and poverty, i.e. the impossibility of subsisting on resources available in one’s own socio-economic environment. The secondary social factors of health vulnerability of marginalized social groups occur in the environments in which the groups find themselves after having been displaced from their previous socio-cultural environments; they result from the legal status of unwilling newcomers to these environments, and refer to the difficulty or impossibility of accessing the social and health care systems in their new environments.

  7. "Sexual Health Assessment" for Mental Health and Medical Practitioners: Teaching Notes

    Science.gov (United States)

    Barratt, Barnaby B.; Rand, Marsha A.

    2009-01-01

    The importance of including sexual health assessment (SHA) within the biopsychosocial evaluations of mental health and medical practice is discussed, and various protocols available in the extant literature are reviewed. Six principles for SHA are presented as well as a model protocol consisting of six basic lines of questioning with specific…

  8. "Sexual Health Assessment" for Mental Health and Medical Practitioners: Teaching Notes

    Science.gov (United States)

    Barratt, Barnaby B.; Rand, Marsha A.

    2009-01-01

    The importance of including sexual health assessment (SHA) within the biopsychosocial evaluations of mental health and medical practice is discussed, and various protocols available in the extant literature are reviewed. Six principles for SHA are presented as well as a model protocol consisting of six basic lines of questioning with specific…

  9. Health and medication information resources on the World Wide Web.

    Science.gov (United States)

    Grossman, Sara; Zerilli, Tina

    2013-04-01

    Health care practitioners have increasingly used the Internet to obtain health and medication information. The vast number of Internet Web sites providing such information and concerns with their reliability makes it essential for users to carefully select and evaluate Web sites prior to use. To this end, this article reviews the general principles to consider in this process. Moreover, as cost may limit access to subscription-based health and medication information resources with established reputability, freely accessible online resources that may serve as an invaluable addition to one's reference collection are highlighted. These include government- and organization-sponsored resources (eg, US Food and Drug Administration Web site and the American Society of Health-System Pharmacists' Drug Shortage Resource Center Web site, respectively) as well as commercial Web sites (eg, Medscape, Google Scholar). Familiarity with such online resources can assist health care professionals in their ability to efficiently navigate the Web and may potentially expedite the information gathering and decision-making process, thereby improving patient care.

  10. Personal health promotion at US medical schools: a quantitative study and qualitative description of deans' and students' perceptions

    Directory of Open Access Journals (Sweden)

    Elon Lisa K

    2004-12-01

    Full Text Available Abstract Background Prior literature has shown that physicians with healthy personal habits are more likely to encourage patients to adopt similar habits. However, despite the possibility that promoting medical student health might therefore efficiently improve patient outcomes, no one has studied whether such promotion happens in medical school. We therefore wished to describe both typical and outstanding personal health promotion environments experienced by students in U.S. medical schools. Methods We collected information through four different modalities: a literature review, written surveys of medical school deans and students, student and dean focus groups, and site visits at and interviews with medical schools with reportedly outstanding student health promotion programs. Results We found strong correlations between deans' and students' perceptions of their schools' health promotion environments, including consistent support of the idea of schools' encouraging healthy student behaviors, with less consistent follow-through by schools on this concept. Though students seemed to have thought little about the relationships between their own personal and clinical health promotion practices, deans felt strongly that faculty members should model healthy behaviors. Conclusions Deans' support of the relationship between physicians' personal and clinical health practices, and concern about their institutions' acting on this relationship augurs well for the role of student health promotion in the future of medical education. Deans seem to understand their students' health environment, and believe it could and should be improved; if this is acted on, it could create important positive changes in medical education and in disease prevention.

  11. Burnout syndrom as a mental health problem among medical students

    Directory of Open Access Journals (Sweden)

    Backović Dušan

    2012-01-01

    Full Text Available Introduction. Mental health problems of adolescents are among the prevailing problems of public health. While studying for their future medical profession, the students of medicine have to exchange emotions with the patients intensively, and the empathic relationship itself bears a risk of eventual ”emotional depletion”, which leads to ”professional lack of emotions”. The study was aimed at presenting burnout syndrome as a challenge for mental health of medical students, its importance for the future professional engagement of doctors and the possibilities of its prevention. Methods. The authors of this paper review and analyze data and conclusions of previous national and international studies from this field and suggest possibilities of overcoming the condition of burnout. Results. The frequency of burnout syndrome, which is the synonym for the above mentioned condition of emotional exhaustion, is twice as high in medical professionals, particularly young ones, as in other professions on average. Burnout syndrome is nowadays regarded as a psychological distress experienced during the educational process and it has been observed in as many as 50% of medical students. The most significant factors independently associated with student burnout are: personality traits, stressful personal life events and learning and training conditions at their faculties. Conclusions. It is of utmost importance to understand the causes and consequences of psychological distress in students, and the faculties should not only identify these problems, but also endeavor to promote health by developing strategies for improving personal well-being, which are important for future doctors to achieve professional success and develop resistance to stress.

  12. Medical students perceive better group learning processes when large classes are made to seem small.

    Directory of Open Access Journals (Sweden)

    Juliette Hommes

    Full Text Available OBJECTIVE: Medical schools struggle with large classes, which might interfere with the effectiveness of learning within small groups due to students being unfamiliar to fellow students. The aim of this study was to assess the effects of making a large class seem small on the students' collaborative learning processes. DESIGN: A randomised controlled intervention study was undertaken to make a large class seem small, without the need to reduce the number of students enrolling in the medical programme. The class was divided into subsets: two small subsets (n=50 as the intervention groups; a control group (n=102 was mixed with the remaining students (the non-randomised group n∼100 to create one large subset. SETTING: The undergraduate curriculum of the Maastricht Medical School, applying the Problem-Based Learning principles. In this learning context, students learn mainly in tutorial groups, composed randomly from a large class every 6-10 weeks. INTERVENTION: The formal group learning activities were organised within the subsets. Students from the intervention groups met frequently within the formal groups, in contrast to the students from the large subset who hardly enrolled with the same students in formal activities. MAIN OUTCOME MEASURES: Three outcome measures assessed students' group learning processes over time: learning within formally organised small groups, learning with other students in the informal context and perceptions of the intervention. RESULTS: Formal group learning processes were perceived more positive in the intervention groups from the second study year on, with a mean increase of β=0.48. Informal group learning activities occurred almost exclusively within the subsets as defined by the intervention from the first week involved in the medical curriculum (E-I indexes>-0.69. Interviews tapped mainly positive effects and negligible negative side effects of the intervention. CONCLUSION: Better group learning processes can be

  13. A Selective Group Authentication Scheme for IoT-Based Medical Information System.

    Science.gov (United States)

    Park, YoHan; Park, YoungHo

    2017-04-01

    The technology of IoT combined with medical systems is expected to support advanced medical services. However, unsolved security problems, such as misuse of medical devices, illegal access to the medical server and so on, make IoT-based medical systems not be applied widely. In addition, users have a high burden of computation to access Things for the explosive growth of IoT devices. Because medical information is critical and important, but users have a restricted computing power, IoT-based medical systems are required to provide secure and efficient authentication for users. In this paper, we propose a selective group authentication scheme using Shamir's threshold technique. The property of selectivity gives the right of choice to users to form a group which consists of things users select and access. And users can get an access authority for those Things at a time. Thus, our scheme provides an efficient user authentication for multiple Things and conditional access authority for safe IoT-based medical information system. To the best of our knowledge, our proposed scheme is the first in which selectivity is combined with group authentication in IoT environments.

  14. What Motivates Talented Medical Students to Study Simultaneously at Master of Public Health (MPH)?

    Science.gov (United States)

    Manavi, Sahar; Nedjat, Saharnaz; Pasalar, Parvin; Majdzadeh, Reza

    2013-01-01

    Nearly three decades ago, the Master of Public Health (MPH) academic degree was introduced to Tehran University of Medical Sciences' School of Public Health, Tehran, Iran. A new program for simultaneous education of medical, pharmaceutical and dental students was initiated in 2006. Talented students had the opportunity to study MPH simultaneously. There were some concerns about this kind of admission; as to whether these students who were not familiar with the health system had the appropriate attitude and background for this field of education. And with the present rate of brain drain, is this just a step towards their immigration without the fulfillment of public health? This qualitative study was conducted in 2012 where 26 students took part in focused group discussions and individual interviews. The students were questioned about their motivation and the program's impact on their future career. The participants' statements were analyzed using thematic analysis. THE PRIMARY MOTIVATIONS OF STUDENTS WHO ENTERED THIS PROGRAM WERE: learning health knowledge related issues, gaining a perspective beyond clinical practice, obtaining a degree to strengthen their academic résumé, immigration, learning academic research methods and preparing for the management of health systems in the future. Apparently, there was no considerable difference between the motivation of students and the program planners. The students' main motivation for studying MPH was a combination of various interests in research and health sciences issues. Therefore, considering the potential of this group of students, effective academic investment on MPH can have positive impact.

  15. Features of effective medical knowledge resources to support point of care learning: a focus group study.

    Directory of Open Access Journals (Sweden)

    David A Cook

    Full Text Available OBJECTIVE: Health care professionals access various information sources to quickly answer questions that arise in clinical practice. The features that favorably influence the selection and use of knowledge resources remain unclear. We sought to better understand how clinicians select among the various knowledge resources available to them, and from this to derive a model for an effective knowledge resource. METHODS: We conducted 11 focus groups at an academic medical center and outlying community sites. We included a purposive sample of 50 primary care and subspecialist internal medicine and family medicine physicians. We transcribed focus group discussions and analyzed these using a constant comparative approach to inductively identify features that influence the selection of knowledge resources. RESULTS: We identified nine features that influence users' selection of knowledge resources, namely efficiency (with sub-features of comprehensiveness, searchability, and brevity, integration with clinical workflow, credibility, user familiarity, capacity to identify a human expert, reflection of local care processes, optimization for the clinical question (e.g., diagnosis, treatment options, drug side effect, currency, and ability to support patient education. No single existing resource exemplifies all of these features. CONCLUSION: The influential features identified in this study will inform the development of knowledge resources, and could serve as a framework for future research in this field.

  16. Investigating the Distribution of Medical Services among Socioeconomic Groups in Texas

    Science.gov (United States)

    Daniel, A.; Zhao, Ph D., S.; O'Keefe, Ph D., CRNP, RN, L.

    2016-12-01

    The Environmental Justice (EJ) literature generally focuses on negative environmental externalities and disamenities found around certain types of demographic conditions such as poor and ethnic groups. This study aims to identify any relationships among environmental risks, communities, and access to hospital services. Community demographic variables will be defined by census tracts and units based on a geographic information system, such as buffer tools. Empirical analyses of the relationships between demographics and environmental burdens take a prominent position in the large EJ literature. However, there is a dearth of research regarding exposed communities and access to hospitals for medical services. Leveraging a dataset that combines hospital locations, pollution sources, and demographic information, the authors will analyze whether different social groups (defined by gender, age, income, and education level) have equal access to hospitals. The research team consists of researchers from Earth system science, public policy, and nursing, and adopts an interdisciplinary approach including ArcGIS analysis and statistical modeling. This project also bridges the literature of health, air pollution, and environmental policy.

  17. Impact of medical loss regulation on the financial performance of health insurers.

    Science.gov (United States)

    McCue, Michael; Hall, Mark; Liu, Xinliang

    2013-09-01

    The Affordable Care Act's regulation of medical loss ratios requires health insurers to use at least 80-85 percent of the premiums they collect for direct medical expenses (care delivery) or for efforts to improve the quality of care. To gauge this rule's effect on insurers' financial performance, we measured changes between 2010 and 2011 in key financial ratios reflecting insurers' operating profits, administrative costs, and medical claims. We found that the largest changes occurred in the individual market, where for-profit insurers reduced their median administrative cost ratio and operating margin by more than two percentage points each, resulting in a seven-percentage-point increase in their median medical loss ratio. Financial ratios changed much less for insurers in the small- and large-group markets.

  18. Teaching population health as a basic science at Harvard Medical School.

    Science.gov (United States)

    Finkelstein, Jonathan A; McMahon, Graham T; Peters, Antoinette; Cadigan, Rebecca; Biddinger, Paul; Simon, Steven R

    2008-04-01

    In 2006-2007, Harvard Medical School implemented a new, required course for first-year medical and dental students entitled Clinical Epidemiology and Population Health. Conceived of as a "basic science" course, its primary goal is to allow students to develop an understanding of caring for individuals and promoting the health of populations as a continuum of strategies, all requiring the engagement of physicians. In the course's first iteration, topical content accessible to first-year students was selected to exemplify physicians' roles in addressing current threats to population health. Methodological areas included domains of clinical epidemiology, decision sciences, population-level prevention and health promotion, physicians' roles in the public health system, and population-level surveillance and intervention strategies. Large-group settings were selectively used to frame the relevance of each topic, and conceptual learning of statistical and epidemiologic methods occurred in conference groups of 24 students. Finally, tutorials of eight students and one or two faculty were used for critical reading of published studies, review of problem sets, and group discussion of population health issues. To help students appreciate the structure and function of the public health system and physicians' role in public health emergencies, the course included a role-playing exercise simulating response to an influenza pandemic. The first iteration of the course was well received, and assessment of students suggested mastery of basic skills. Preclinical courses represent a progressive step in developing a workforce of physicians who embrace their responsibility to improve the health of the population as a whole, as well as the health of the patient in front of them.

  19. The Association of Health Literacy with Illness and Medication Beliefs among Patients with Chronic Obstructive Pulmonary Disease.

    Science.gov (United States)

    Kale, Minal S; Federman, Alex D; Krauskopf, Katherine; Wolf, Michael; O'Conor, Rachel; Martynenko, Melissa; Leventhal, Howard; Wisnivesky, Juan P

    2015-01-01

    Low health literacy is associated with low adherence to self-management in many chronic diseases. Additionally, health beliefs are thought to be determinants of self-management behaviors. In this study we sought to determine the association, if any, of health literacy and health beliefs among elderly individuals with COPD. We enrolled a cohort of patients with COPD from two academic urban settings in New York, NY and Chicago, IL. Health literacy was measured using the Short Test of Functional Health Literacy in Adults. Using the framework of the Self-Regulation Model, illness and medication beliefs were measured with the Brief Illness Perception Questionnaire (B-IPQ) and Beliefs about Medications Questionnaire (BMQ). Unadjusted analyses, with corresponding Cohen's d effect sizes, and multiple logistic regression were used to assess the relationships between HL and illness and medication beliefs. We enrolled 235 participants, 29% of whom had low health literacy. Patients with low health literacy were more likely to belong to a racial minority group (pillness ((p = 0.04, Cohen's d = 0.17). In analyses adjusted for sociodemographic factors and other health beliefs, patients with low health literacy were less likely to believe that they will always have COPD (odds ratio [OR]: 0.78, 95% confidence interval [CI]: 0.65-0.94). In addition, the association of low health literacy with expressed concern about medications remained significant (OR: 1.20, 95% CI: 1.05-1.37) though the association of low health literacy with belief in the necessity of medications was no longer significant (OR: 0.92, 95% CI: 0.82-1.04). In this cohort of urban individuals with COPD, low health literacy was prevalent, and associated with illness beliefs that predict decreased adherence. Our results suggest that targeted strategies to address low health literacy and related illness and medications beliefs might improve COPD medication adherence and other self-management behaviors.

  20. Biomedical Research Group, Health Division annual report 1954

    Energy Technology Data Exchange (ETDEWEB)

    Langham, W.H.; Storer, J.B.

    1955-12-31

    This report covers the activities of the Biomedical Research Group (H-4) of the Health Division during the period January 1 through December 31, 1954. Organizationally, Group H-4 is divided into five sections, namely, Biochemistry, Radiobiology, Radiopathology, Biophysics, and Organic Chemistry. The activities of the Group are summarized under the headings of the various sections. The general nature of each section`s program, publications, documents and reports originating from its members, and abstracts and summaries of the projects pursued during the year are presented.

  1. Mental health in F-111 maintenance workers: the study of Health Outcomes in Aircraft Maintenance Personnel (SHOAMP) general health and medical study.

    Science.gov (United States)

    Attia, John R; D'Este, Catherine; Schofield, Peter W; Brown, Anthony M; Gibson, Richard; Tavener, Meredith; Horsley, Keith; Harrex, Warren; Ross, James

    2006-07-01

    We sought to contrast mood disorder symptoms in F-111 aircraft Deseal/Reseal maintenance personnel with appropriate comparisons. Participants completed a comprehensive health assessment, including measures of mood disorder, self-reported mood symptom questionnaire items, and review of anxiolytic and depression medication. Multiple logistic regression was conducted for each outcome using exposure group and potential confounders as explanatory variables. There was high agreement between self-reported mood disturbance and objective tests. The exposed group was more likely to self-report previous diagnoses of depression/anxiety, had higher use of antidepressant medications, and had increased risk of diagnosis of depression/anxiety. Results were consistently strong against both comparison groups, with the exposed more likely to have mental distress and social dysfunction when compared with the Australian population. There is robust evidence for an association between F-111 Deseal/Reseal exposure and impaired mental health.

  2. Experiências com a gestão autônoma da medicação: narrativa de usuários de saúde mental no encontro dos grupos focais em centros de atenção psicossocial Experiments with autonomous management of medication: narrative of mental health users in focus group meeting in psychosocial care centers

    Directory of Open Access Journals (Sweden)

    Maria Salete Bessa Jorge

    2012-01-01

    Full Text Available Objetiva-se analisar as experiências vivenciadas pelos usuários do Centro de Atenção Psicossocial no desenvolvimento do grupo para Gestão Autônoma da Medicação (GAM. Opta-se pela pesquisa qualitativa, dentro de uma perspectiva crítica que protagoniza a vivência dos participantes do grupo operativo GAM. Realizado nos Centros de Atenção Psicossocial (CAPS Geral e Álcool e outras Drogas (AD do município de Maracanaú-CE. Os participantes foram 13 usuários de CAPS Geral e Ad do referido município. Técnica de coleta das narrativas foi constituída por três grupos narrativos e a análise pautada na hermenêutica. Segundo as narrativas desvelaram, em todo o processo de discussão sobre a medicação, fica evidente a importância da escuta e do acompanhamento individual. A abordagem singular dos usuários possibilitou melhoria significativa no estado de saúde mental e na compreensão do adoecimento. Assim, é possível ressignificar a utilização precípua do medicamento e interagir com inovações terapêuticas mais voltadas para hábitos de vida saudável.The study aimed to analyze the feelings experienced by users of the Center for Psychosocial Care in developing the group for Autonomous Management of Medication (AMM. It uses qualitative research within a critical perspective that carries the experience of participating in the operative AMM group. It was conducted at the General Center for Psychosocial Care (CAPS and Alcohol and other Drugs (AD in the city of Maracanau, state of Ceara, Brazil. The participants were 13 users of General and Ad CAPS of that city. The technique of narratives' collection consisted of three groups based in the narrative analysis and hermeneutics. According to the narratives, throughout the discussion process on the medication, it is evident the importance of listening and coaching. The unique approach of users allowed significant improvement in health status and understanding of mental illness. Thus, it

  3. Oral health and medical conditions among Amish children

    Science.gov (United States)

    Harrison, Marc-Allen; Milgrom, Peter

    2017-01-01

    Background: The Amish are a growing population who live a traditional, rural way of life, which makes them less accepting of modernism. Most Amish live in poverty and are detached from modern health care. In addition, the recent change of their lifestyle has been reported, such as consuming a nontraditional diet and the usage of electronic devices. As a result, their lifestyle change may have impacted their oral health. However, since only a single report about oral health among Amish children has been published approximately three decades ago it has not yet been updated. This study describes oral health among Amish children and their medical conditions during visits to a mobile dental unit (MDU). Material and Methods: The dental records of all patients (N=216) who visited a mobile dental unit were reviewed, which covers 1 year from May 20, 2011, the first date of service. The following factors were taken into consideration during the review process: parental perceptions of their children’s oral health care, dental care experiences, and general health information. Results: Fifty-four (27.8%) children, ages 3 to 17, have never received dental treatment before visiting the MDU; the average number of untreated decayed teeth was 6.8. In spite of this, most parents rated their children’s oral health as good or very good (87.7%). The high cost and long distance travel associated with routine, professional dental care makes it difficult for children to maintain good oral hygiene. Our analysis revealed that bleeding disorders were more prevalent among this gene pool compared to the nation at large; however, asthma was less common. Conclusions: There are oral and general health disparities among Amish children. There is a lack of awareness among Amish parents with regard to their children’s oral health. Key words:Amish, child, dental caries, mobile health units. PMID:28298971

  4. Public Health and Medical Preparedness for a Nuclear Detonation: The Nuclear Incident Medical Enterprise

    Science.gov (United States)

    Coleman, C. Norman; Sullivan, Julie M.; Bader, Judith L.; Murrain-Hill, Paula; Koerner, John F.; Garrett, Andrew L.; Weinstock, David M.; Case, Cullen; Hrdina, Chad; Adams, Steven A.; Whitcomb, Robert C.; Graeden, Ellie; Shankman, Robert; Lant, Timothy; Maidment, Bert W.; Hatchett, Richard C.

    2014-01-01

    Resilience and the ability to mitigate the consequences of a nuclear incident are enhanced by (1) effective planning, preparation and training; (2) ongoing interaction, formal exercises, and evaluation among the sectors involved; (3) effective and timely response and communication; and (4) continuous improvements based on new science, technology, experience and ideas. Public health and medical planning require a complex, multi-faceted systematic approach involving federal, state, local, tribal and territorial governments, private sector organizations, academia, industry, international partners, and individual experts and volunteers. The approach developed by the U.S. Department of Health and Human Services Nuclear Incident Medical Enterprise (NIME) is the result of efforts from government and nongovernment experts. It is a “bottom-up” systematic approach built on the available and emerging science that considers physical infrastructure damage, the spectrum of injuries, a scarce resources setting, the need for decision making in the face of a rapidly evolving situation with limited information early on, timely communication and the need for tools and just-in-time information for responders who will likely be unfamiliar with radiation medicine and uncertain and overwhelmed in the face of the large number of casualties and the presence of radioactivity. The components of NIME can be used to support planning for, response to, and recovery from the effects of a nuclear incident. Recognizing that it is a continuous work-in-progress, the current status of the public health and medical preparedness and response for a nuclear incident is provided. PMID:25551496

  5. Superstitions regarding health problems in different ethnic groups in Karachi.

    Science.gov (United States)

    Bukhari, S S I; Pardhan, A; Khan, A S; Ahmed, A; Choudry, F J; Pardhan, K; Nayeem, K; Khan, M

    2002-08-01

    To find out the superstitions regarding health problems in different ethnic groups, their implications over the socio-economic development of that group and to what extent can those superstitions be related to their level of literacy. The study was a questionnaire-based survey, 20 subjects from each ethnic group were selected by cluster sampling of residential areas where that particular group has its highest concentration, making a total of 100 subjects. It was found that most people (73%) do have some superstitious beliefs. Fifty percent of people believe in them as a part of culture and tradition, another 25% got them from their elders. No significant difference was found between different racial groups (p value = 0.9). According to literacy rate, 73.5% of literate community and 94.1% illiterate community were found to have superstitions. The occupation of the breadwinner of family didn't have a significant impact over the belief in superstitions (p value = 0.6). Majority of our population believes in superstitions, which are more common in illiterates. These superstitions not only predict health seeking behaviour of a person but also play a major role in shaping the response of a community to any health intervention program. Without the knowledge of these superstitions, effective community participation cannot be achieved.

  6. Culture and healthcare in medical education: migrants' health and beyond.

    Science.gov (United States)

    Knipper, Michael; Akinci, Secil; Soydan, Nedim

    2010-01-01

    One of the main challenges for teaching programs on immigration, ethnic diversity and health is to transform the commonplace notion of "culture" into a helpful tool for medical training and practice. This paper presents the teaching approach of an interdisciplinary course on "migrants' health" established at the University of Giessen since 2004, which has recently been complemented by a thematically related collaboration with two universities in Latin America (Ecuador, Peru). The overall goal is to translate the abstract philosophy of "think global and teach local" into medical practice, and to provide students with the insights, attitudes and skills needed for a fruitful use of concepts like "culture", "ethnicity" and "migration background". A key feature of the course is the strong commitment to ethnography as an important means for looking under the surface of superficial attributions to culture, and for grasping the interplay of medicine and health with cultural, social, religious, economic and legal aspects in its particular local and/or individual shape. Three elements of the course are presented to illustrate this approach: First, a unit on Islam and Medicine, as important parts of the local immigrant community are Muslims. The second one deals with psychosomatic aspects, because in case of immigrants, complex symptoms and disease representations like somatisation are easily misinterpreted as "cultural". The third element consists of a unit with specialized social workers form outside the university, who provide direct insights into the living conditions and health problems of local immigrant communities.

  7. 75 FR 70114 - Amendment to the Interim Final Rules for Group Health Plans and Health Insurance Coverage...

    Science.gov (United States)

    2010-11-17

    ... Group Health Plans and Health Insurance Coverage Relating to Status as a Grandfathered Health Plan Under... and Insurance Oversight, Department of Health and Human Services. ACTION: Amendment to interim final... regulations implementing the rules for group health plans and health insurance coverage in the group and...

  8. 76 FR 44491 - Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims and Appeals...

    Science.gov (United States)

    2011-07-26

    ...-AQ66 Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims and Appeals and... amendment to the interim final rules (76 FR 37208) entitled, ``Group Health Plans and Health Insurance... rule with request for comments entitled, ``Group Health Plans and Health Insurance Issuers: Rules...

  9. 75 FR 70159 - Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered...

    Science.gov (United States)

    2010-11-17

    ... Internal Revenue Service 26 CFR Part 54 RIN 1545-BJ50 Group Health Plans and Health Insurance Coverage... provide guidance to employers, group health plans, and health insurance issuers providing group health... Insurance Oversight of the U.S. Department of Health and Human Services are issuing substantially similar...

  10. Benefit distribution of social health insurance: evidence from china's urban resident basic medical insurance.

    Science.gov (United States)

    Pan, Jay; Tian, Sen; Zhou, Qin; Han, Wei

    2016-09-01

    Equity is one of the essential objectives of the social health insurance. This article evaluates the benefit distribution of the China's Urban Residents' Basic Medical Insurance (URBMI), covering 300 million urban populations. Using the URBMI Household Survey data fielded between 2007 and 2011, we estimate the benefit distribution by the two-part model, and find that the URBMI beneficiaries from lower income groups benefited less than that of higher income groups. In other words, government subsidy that was supposed to promote the universal coverage of health care flew more to the rich. Our study provides new evidence on China's health insurance system reform, and it bears meaningful policy implication for other developing countries facing similar challenges on the way to universal coverage of health insurance. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  11. Brokering health policy: coalitions, parties, and interest group influence.

    Science.gov (United States)

    Heaney, Michael T

    2006-10-01

    Assuming a position as broker between disconnected interests is one way for an interest group to influence the making of federal health policy. This study demonstrates how groups use their connections with political parties and lobbying coalitions to augment their brokerage positions and enhance their influence over policy making. Evidence is drawn from statistical analysis of 263 interviews with health policy elites and a qualitative case study of the debate over the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. The results explain, in part, how interest groups play their brokerage roles as dispersed actors in a decentralized system, rather than as central mediators that intervene in a wide range of policy disputes.

  12. Attitudes of Saudi Arabian Undergraduate Medical Students towards Health Research

    Directory of Open Access Journals (Sweden)

    Sara M. Al-Hilali

    2016-02-01

    Full Text Available Objectives: This study aimed to evaluate attitudes, perceptions and perceived barriers towards health research among Saudi Arabian undergraduate medical students. Methods: This cross-sectional study took place between August and October 2014 and included 520 students from five medical schools across Saudi Arabia. An anonymous online survey with 21 close-ended questions was designed to assess students’ attitudes towards research, contribution to research-related activities, awareness of the importance of research, perception of available resources/opportunities for research, appreciation of medical students’ research contributions and perceived barriers to research. Responses were scored on a 5-point Likert scale. Results: A total of 401 students participated in the study (response rate: 77.1%. Of these, 278 (69.3% were female. A positive attitude towards research was reported by 43.9% of the students. No statistically significant differences were observed between genders with regards to attitudes towards and available resources for research (P = 0.500 and 0.200, respectively. Clinical students had a significantly more positive attitude towards research compared to preclinical students (P = 0.007. Only 26.4% of the respondents believed that they had adequate resources/opportunities for research. According to the students, perceived barriers to undertaking research included time constraints (n = 200; 49.9%, lack of research mentors (n = 95; 23.7%, lack of formal research methodology training (n = 170; 42.4% and difficulties in conducting literature searches (n = 145; 36.2%. Conclusion: Less than half of the surveyed Saudi Arabian medical students had a positive attitude towards health research. Medical education policies should aim to counteract the barriers identified in this study.

  13. [Proposal for a media guideline to improve medical and health journalism].

    Science.gov (United States)

    Kojima, Masami

    2012-01-01

    A lot of healthcare professionals experienced annoyance with biased mass media news regarding medical and health issues. In this paper, I propose "news profiling method" and "media guideline" to improve the medical and health journalism.

  14. 76 FR 61294 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Science.gov (United States)

    2011-10-04

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and...: The purpose of the Negotiated Rulemaking Committee on Designation of Medically Underserved...

  15. Medicalization of global health 3: the medicalization of the non-communicable diseases agenda.

    Science.gov (United States)

    Clark, Jocalyn

    2014-01-01

    There is growing recognition of the massive global burden of non-communicable diseases (NCDs) due to their prevalence, projected social and economic costs, and traditional neglect compared to infectious disease. The 2011 UN Summit, WHO 25×25 targets, and support of major medical and advocacy organisations have propelled prominence of NCDs on the global health agenda. NCDs are by definition 'diseases' so already medicalized. But their social drivers and impacts are acknowledged, which demand a broad, whole-of-society approach. However, while both individual- and population-level targets are identified in the current NCD action plans, most recommended strategies tend towards the individualistic approach and do not address root causes of the NCD problem. These so-called population strategies risk being reduced to expectations of individual and behavioural change, which may have limited success and impact and deflect attention away from government policies or regulation of industry. Industry involvement in NCD agenda-setting props up a medicalized approach to NCDs: food and drink companies favour focus on individual choice and responsibility, and pharmaceutical and device companies favour calls for expanded access to medicines and treatment coverage. Current NCD framing creates expanded roles for physicians, healthcare workers, medicines and medical monitoring. The professional rather than the patient view dominates the NCD agenda and there is a lack of a broad, engaged, and independent NGO community. The challenge and opportunity lie in defining priorities and developing strategies that go beyond a narrow medicalized framing of the NCD problem and its solutions.

  16. A comparative study of mental health among Medical school students of different ethnic groups in different ethnic minority areas%少数民族地区卫校不同民族学生心理健康的比较研究

    Institute of Scientific and Technical Information of China (English)

    张丽; 杨国愉; 李晨; 贺英

    2013-01-01

    ),Han 557 (39.1%) and Lahu 46 (38.3%).The factor scores in descending order were obsessive-compulsive (38.6%),interpersonal sensitivity (33.2%),phobic anxiety (27.5%),hostility (25.3%),depression (23.6%),anxiety (22.4%),paranoid ideation (21.9%),psychotism (17.4%) and somatization (13.7%).②The ratio of psychological problems among different nationalities had shown significant differences (P<0.05,P<0.01) except for hostility factor.③In SCL-90,the scores of minority medical school students were all higher than those in the national youth norm.There existed significant differences among the most factor scores of SCL-90 (P<0.01,P<0.05).④The mental health of Wa was the worst.While,the mental health of Yi and Lahu were better than other ethnic groups.Conclusion The mental health of minorities medical school students is not optimistic.Therefore,the mental health education should be strengthened in the minority medical school students.

  17. [Electronic medical handbooks--are they suitable for implementation of guidelines in health care?].

    Science.gov (United States)

    Grimsmo, Anders

    2006-09-21

    The Directorate for Health and Social Affairs commissioned a project to evaluate the distribution and use of a Norwegian electronic medical handbook (NEL). NEL uses multimedia techniques and is distributed on a CD twice a year. A questionnaire about the use of NEL was given to 91 medical students. Health professionals at two hospitals and 12 health centres were interviewed. The use of the electronic handbook differed more within than between groups of professionals. NEL is applied for three main purposes: decision support, quality assurance and as a source for information pamphlets designed for patients. The professionals believed that NEL has contributed to patients' receiving more information and more uniform treatment. Criticism was made about the price and for the lack of integration with the electronic patient record. The study has revealed some barriers to implementation and use of electronic information sources. Under certain circumstances an electronic handbook might be suitable way for authorities and others to distribute professional guidelines.

  18. Introducing geriatric health in medical training in Ajman, United Arab Emirates: A co-curricular approach

    Directory of Open Access Journals (Sweden)

    Mathew E

    2011-06-01

    Full Text Available BackgroundMedical students’ knowledge and understanding of theelderly will affect the quality of care to the rising populationof older adults which points to a need to identify geriatrichealth training methods appropriate for the region andcurriculum. Therefore the study assessed the effect of a cocurricularintroductory workshop on knowledge regardinggeriatric health and attitude towards the elderly amongfourth year medical students in a medical universityMethodA quasi-experimental before-after study, with control wasconducted at Gulf Medical College among 60 medicalstudents from discipline-based curriculum in year IV duringMay–June 2010 of whom 16 had opted (attendees toundergo the introductory course, a five day workshop of 10hours duration. Pre- and post-testing used self-administeredquestionnaires for demographic variables: age, gender,nationality, close contact with older people; a quiz on oldpeople’s health, and Kogan’s Old People Scale (KOPS forattitude. The difference in scores on quiz and KOPS werecompared for the attendees and 26 non-attendees whoparticipated in both pre and post testing.ResultsThe attendees group had 38% male and 62% femaleparticipants and the non-attendees group had 21% and 79%respectively. The groups were not significantly different inage, sex, nationality and close contact with the elderly. Thescores on the quiz and KOPS showed no statisticallysignificant difference between the two groups before orafter the workshop. Almost all the participants evaluatedthe workshop very positively especially the interaction withhealthy elderly and inmates of old people’s home.ConclusionA 10-hour introductory co-curricular workshop made nosignificant change in the knowledge on geriatric health orattitude of fourth year medical students though theyreported it as a very enriching experience. A reflectivereport may have been a better assessment tool and theimpact on their clinical practice cannot be predicted.

  19. Improving physical health monitoring for patients with chronic mental health problems who receive antipsychotic medications

    Science.gov (United States)

    Abdallah, Nihad; Conn, Rory; Latif Marini, Abdel

    2016-01-01

    Physical health monitoring is an integral part of caring for patients with mental health problems. It is proven that serious physical health problems are more common among patients with severe mental health illness (SMI), this monitoring can be challenging and there is a need for improvement. The project aimed at improving the physical health monitoring among patients with SMI who are receiving antipsychotic medications. The improvement process focused on ensuring there is a good communication with general practitioners (GPs) as well as patient's education and education of care home staff. GP letters requesting physical health monitoring were updated; care home staff and patients were given more information about the value of regular physical health monitoring. There was an improvement in patients' engagement with the monitoring and the monitoring done by GPs was more adherent to local and national guidelines and was communicated with the mental health service. PMID:27559474

  20. Improving physical health monitoring for patients with chronic mental health problems who receive antipsychotic medications.

    Science.gov (United States)

    Abdallah, Nihad; Conn, Rory; Latif Marini, Abdel

    2016-01-01

    Physical health monitoring is an integral part of caring for patients with mental health problems. It is proven that serious physical health problems are more common among patients with severe mental health illness (SMI), this monitoring can be challenging and there is a need for improvement. The project aimed at improving the physical health monitoring among patients with SMI who are receiving antipsychotic medications. The improvement process focused on ensuring there is a good communication with general practitioners (GPs) as well as patient's education and education of care home staff. GP letters requesting physical health monitoring were updated; care home staff and patients were given more information about the value of regular physical health monitoring. There was an improvement in patients' engagement with the monitoring and the monitoring done by GPs was more adherent to local and national guidelines and was communicated with the mental health service.

  1. Smartphone Medical Applications for Women’s Health: What Is the Evidence-Base and Feedback?

    Directory of Open Access Journals (Sweden)

    Emma Derbyshire

    2013-01-01

    Full Text Available Background. Smartphone medical applications have a major role to play in women’s health with their roles being very broad, ranging from improving health behaviours to undertaking personalised tests. Objective(s. Using Medline, Web of Knowledge, and the PRISMA guidelines 15 randomized controlled trials (RCTs were identified, with mobile interventions being tested on 1603 females, in relation to key aspects of health. Using a similar systematic approach an iPhone database search identified 47 applications (apps developed to improve women’s health. Findings. Ten RCTs used text messaging or app interventions to support weight loss, with significant improvements being observed in eight studies. For other aspects of women’s health RCTs are needed to determine possible health benefits. iPhone store data analysis identified that a substantial number of women’s health apps did not have star ratings or feedback comments (68 and 49 per cent, resp., raising concerns about their validity. Conclusion. Peer-review systems, supporting statements of evidence, or certification standards would be beneficial in maintaining the quality and credibility of future health-focused apps. Patient groups should also ideally be involved in the development and testing of mobile medical apps.

  2. [World Health Organization strategies "Towards Unity for Health" and the social responsibility of medical schools].

    Science.gov (United States)

    Boelen, C

    2003-04-01

    One may wonder why multiple endeavours conducted worldwide over the last five decades to reform health systems have not achieved their expected outcomes. In light of increasing fragmentation, the current health system must be substituted by a true systems vision along with political will to create a unity of action between the five main stakeholders, namely: policy-makers, health care service managers, professionals and professional associations, academic institutions including medical schools, and civil society. Such synergy can only be established if the partners share the same commitment to core values such as quality, equity, relevance and cost-effectiveness in the health care field. Through its functions of providing education, training, research, and services, the medical school has the potential to induce reflection and stimulate action leading to a more coherent, effective, and equitable health system and policies.

  3. Think global, act local: medical students contextualize global health education.

    Science.gov (United States)

    Ibrahim, George M; Hoffart, Shawn; Lam, Russell A; Minty, Evan P; Ying, Michelle Theam; Schaefer, Jeffrey P

    2014-01-01

    There is considerable heterogeneity in the extent to which global health education is emphasized in undergraduate medical curricula. Here, we performed an exploratory analysis to test the hypothesis that exposure to global health education may influence the attitudes of medical students toward the treatment of local vulnerable patient populations. All pre-clerkship students at an urban Canadian university were invited to attend a voluntary global health education session on challenges in treating human immunodeficiency virus (HIV) in the developing world. Those who attended as well as those who did not completed pre- and post-session surveys measuring willingness to treat patients with HIV and related attitudes. A repeated measure analysis of variance (ANOVA) was performed to assess the effect of the intervention on attitudes toward locally affected populations. A total of 201 (81.4%) and 143 (58.3%) students completed the pre- and post-session surveys, respectively. Students who scored their willingness to treat patients with HIV within highest 10% of the scale on the pre-session survey were excluded from the analysis to account for a ceiling effect. On repeated measure ANOVA, willingness to treat local patients with HIV increased significantly following the session (P Students intending to attend the session also reported a greater propensity to treat patients with HIV than those who did not (P = 0.03). In this exploratory study, we find that following exposure to a global health lecture on the challenges of HIV in the developing world, students possessed more favorable attitudes toward the treatment of marginalized local patient populations, a finding that may be exploited in undergraduate and continuing medical education.

  4. The benefits of pass-fail grading on stress, mood, and group cohesion in medical students.

    Science.gov (United States)

    Rohe, Daniel E; Barrier, Patricia A; Clark, Matthew M; Cook, David A; Vickers, Kristin S; Decker, Paul A

    2006-11-01

    To objectively measure the effect of a pass-fail grading system on stress, mood, group cohesion, and test anxiety in medical students. Beginning with the class of 2006, the Mayo Medical School, Rochester, Minn, changed the grading system for first-year courses from a 5-interval grading system to a pass-fail grading system. Students in the previous class of 2005, who were graded using a 5-interval system during their first year of medical school, were compared with students in the class of 2006. Using a prospective study design, the 2 groups were compared at the end of both the first year and the second year of medical school on the Perceived Stress Scale, Profile of Mood States, Perceived Cohesion Scale, Test Anxiety Inventory, and (after year 2) the United States Medical Licensing Examination Step 1. Data collection occurred in 2002 and 2003 with the class of 2005 and in 2003 and 2004 with the class of 2006. Students graded with the pass-fail system had less perceived stress (median, 15.0 vs 21.0; P-.01) and greater group cohesion (median, 34.5 vs 30.0; P=.02) at the end of their second year of coursework than their 5-interval graded peers. The pass-fail group had better mood (median, 46.5) than the graded group (median, 64.0), but this difference was not statistically significant (P=.07). No significant differences were found between the 2 groups in test-taking anxiety or in United States Medical Licensing Examination Step 1 board scores. Pass-fail grading may reduce stress and increase group cohesion in medical students compared with traditional 5-interval grading.

  5. Mental Health Recovery in the Patient-Centered Medical Home.

    Science.gov (United States)

    Sklar, Marisa; Aarons, Gregory A; O'Connell, Maria; Davidson, Larry; Groessl, Erik J

    2015-09-01

    We examined the impact of transitioning clients from a mental health clinic to a patient-centered medical home (PCMH) on mental health recovery. We drew data from a large US County Behavioral Health Services administrative data set. We used propensity score analysis and multilevel modeling to assess the impact of the PCMH on mental health recovery by comparing PCMH participants (n = 215) to clients receiving service as usual (SAU; n = 22,394) from 2011 to 2013 in San Diego County, California. We repeatedly assessed mental health recovery over time (days since baseline assessment range = 0-1639; mean = 186) with the Illness Management and Recovery (IMR) scale and Recovery Markers Questionnaire. For total IMR (log-likelihood ratio χ(2)[1] = 4696.97; P recovery over time were greater for PCMH than SAU participants. Increases on all other measures over time were similar for PCMH and SAU participants. Greater increases in mental health recovery over time can be expected when patients with severe mental illness are provided treatment through the PCMH. Evaluative efforts should be taken to inform more widespread adoption of the PCMH.

  6. Medication therapy disease management: Geisinger's approach to population health management.

    Science.gov (United States)

    Jones, Laney K; Greskovic, Gerard; Grassi, Dante M; Graham, Jove; Sun, Haiyan; Gionfriddo, Michael R; Murray, Michael F; Manickam, Kandamurugu; Nathanson, Douglas C; Wright, Eric A; Evans, Michael A

    2017-09-15

    Pharmacists' involvement in a population health initiative focused on chronic disease management is described. Geisinger Health System has cultivated a culture of innovation in population health management, as highlighted by its ambulatory care pharmacy program, the Medication Therapy Disease Management (MTDM) program. Initiated in 1996, the MTDM program leverages pharmacists' pharmacotherapy expertise to optimize care and improve outcomes. MTDM program pharmacists are trained and credentialed to manage over 16 conditions, including atrial fibrillation (AF) and multiple sclerosis (MS). Over a 15-year period, Geisinger Health Plan (GHP)-insured patients with AF whose warfarin therapy was managed by the MTDM program had, on average, 18% fewer emergency department (ED) visits and 18% fewer hospitalizations per year than GHP enrollees with AF who did not receive MTDM services, with 23% lower annual total care costs. Over a 2-year period, GHP-insured patients with MS whose pharmacotherapy was managed by pharmacists averaged 28% fewer annual ED visits than non-pharmacist-managed patients; however, the mean annual total care cost was 21% higher among MTDM clinic patients. The Geisinger MTDM program has evolved over 20 years from a single pharmacist-run anticoagulation clinic into a large program focused on managing the health of an ever-growing population. Initial challenges in integrating pharmacists into the Geisinger patient care framework as clinical experts were overcome by demonstrating the MTDM program's positive impact on patient outcomes. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  7. Contemporary Issues in Medicine--Medical Informatics and Population Health: Report II of the Medical School Objectives Project.

    Science.gov (United States)

    Academic Medicine, 1999

    1999-01-01

    The report of the Association of American Medical Colleges' Medical School Objectives Program presents the work of two expert panels. One, on medical informatics, identified five important physician roles: lifelong learner, clinician, educator, researcher, and manager. Another panel established a definition for "population health perspective"…

  8. Medical Groups Raise Blood Pressure Rx Threshold for Healthy Adults Over 60

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_163063.html Medical Groups Raise Blood Pressure Rx Threshold for Healthy Adults Over 60 Guidelines ... benefit from more aggressive treatment is small, the groups say. Doctors ... control of blood pressure in healthy older adults may produce more harm ...

  9. Training Groups and Foreign-Born Psychiatric Medical Residents in the United States.

    Science.gov (United States)

    Greenberg, Andrea; Juthani, Nalini

    1991-01-01

    About two-thirds of all psychiatry residents are foreign-born medical graduates. Discusses the operation, content, focus, challenges, and benefits of a training group experience for the psychiatry residents at Bronx Lebanon Hospital. The goals are to aid acculturation, improve group psychotherapeutic skills, encourage self-awareness, and promote…

  10. The Use of Small Group Tutorials as an Educational Strategy in Medical Education

    Science.gov (United States)

    Ferris, Helena

    2015-01-01

    Small group tutorials are an educational strategy that is growing in popularity in medical education. This is indicative of the movement from a traditional teacher centred approach to more student-centred learning, which is characterised by active participation and autonomous learning (Hedge et al, 2011). However, small group teaching is one of…

  11. Oral health behavior and its determinants in a group of Iranian students

    Directory of Open Access Journals (Sweden)

    Neamatollahi Hossain

    2010-01-01

    Full Text Available Background: Daily toothbrushing and flossing are easy, effective and low-cost practices for removing the microbial dental plaque, which is an important factor in the development of caries and periodontal disease. Aim: The objective of this study is evaluation of oral health behaviors in a group of students from an Iranian university . Materials and Methods: This descriptive analytical cross-sectional study was carried out on 1736 Iranian students (1230 non-medical sciences students and 506 medical sciences students. Subjects were randomly selected. The students were asked to fill out a self-completion questionnaire about daily oral health behavior. Statistical Analysis Used: The chi-square test was used for evaluation of oral health behaviors and relationship between students′ oral hygiene behavior and educational levels. Results : There was no difference between the frequencies of tooth brushing in the students of two universities. Medical sciences students used dental floss more than non-medical sciences students, which was a significant difference ( P = 0.000. There was no significant difference in toothbrushing frequency among the students with different levels of education. But the students of doctorate and masters degrees used dental floss significantly more than those of bachelor or associate degrees ( P = 0.000. Conclusions: This study showed that the level of self oral care among Iranian students is at a lower level than in industrialized countries.

  12. Noise and health in vulnerable groups: A review

    Directory of Open Access Journals (Sweden)

    Irene van Kamp

    2013-01-01

    Full Text Available Vulnerable or susceptible groups are mentioned in most reviews and documents regarding noise and health. But only a few studies address this issue in a concrete and focused way. Groups at risk most often mentioned in the literature are children, the elderly, the chronically ill and people with a hearing impairment. The other categories encountered are those of sensitive persons, shiftworkers, people with mental illness (e.g., schizophrenia or autism, people suffering from tinnitus, and fetuses and neonates. The mechanism for this vulnerability has not been clearly described and relevant research has seldom focused on the health effects of noise in these groups in an integrated manner. This paper summarizes the outcomes and major conclusions of a systematic, qualitative review of studies over the past 5 years. This review was prepared for the 10 th Conference on Noise as a Public Health Problem (ICBEN, 2011. Evidence is reviewed describing effects, groups assumed to be at risk, and mechanisms pertaining to noise sensitivity and learned helplessness.

  13. Medical equipment in government health facilities: missed opportunities.

    Science.gov (United States)

    Pardeshi, Geeta S

    2005-01-01

    The availability and optimal utilization of medical equipment is important for improving the quality of health services. Significant investments are made for the purchase, maintenance and repair of medical equipment. Inadequate management of these equipment will result in financial losses and deprive the public of the intended benefits. This analysis is based on the conceptual framework drawn from the WHO recommended- lifecycle of medical equipment. (1) To identify the problems in different stages of the life cycle. (2) To assess its financial implications and effect on service delivery. Analysis of secondary data from the latest Comptroller and Auditor General (CAG) Reports for the states in India. The study variables were category of equipment, financial implications and problems in the stages of life cycle. Calculation of proportions. A total of forty instances mentioning problems in the first phase of the life cycle of medical equipment were noted in 12 state reports. The equipment from the radiology department (15), equipment in the wards (5), laboratory (3) and operation theatres (4) were the ones most frequently implicated. In a majority of cases the financial implications amounted to twenty-five lakhs. The financial implications were in the form of extra expenditure, unfruitful expenditure or locking of funds. In 25 cases the equipment could not be put to use because of non-availability of trained staff and inadequate infrastructural support. Careful procurement, incoming inspection, successful installation and synchronization of qualified trained staff and infrastructural support will ensure timely onset of use of the equipment.

  14. Evolution of Facebook groups: Informal e-learning among medical laboratory scientists in Nigeria

    OpenAIRE

    2014-01-01

    Most people think of online courses when they talk about e-learning, but aspects of social media can also be considered e-learning. In 2011 the Knowledge for Health Project (K4Health) began work with local partners to implement an e-learning and professional development policy for Medical Laboratory Scientists based on the needs identified by United States Agency for International Development (USAID)/Nigeria. Six e-learning courses were developed and promoted through several channels includin...

  15. Health professionals as mobile content creators: teaching medical students to develop mHealth applications.

    Science.gov (United States)

    Masters, Ken

    2014-10-01

    Patient access to health information and patient-provider communication is integral to medicine, and can be facilitated by mobile applications ("apps"). Traditionally, student training in mobile Health (mHealth) has focussed on health professionals as consumers of information, with negative impacts on the quality and value of medical apps. This study focuses on teaching medical students to develop their own medical apps. At Sultan Qaboos University, Oman, an app development environment, iBuildApp, was taught to medical students and used to develop their first apps. Students were surveyed on their perceptions of the project. Of the 166 students, 107 (64.5%) completed the survey. There was an increase in the perceived need for such learning, apps were aimed primarily at patients, and previous programming experience was the strongest influencer of a positive experience. A majority (77.6%) wanted more sophisticated development environments in spite of their apparent struggles. The impact of previous experience is similar to other studies; the perceived value and focus on patient apps is indicative of an awareness of patients' use of the devices not reflected in all literature. It is possible to teach medical students the fundamentals of app design so that they may contribute to app development in the future.

  16. Impact of China's Urban Employee Basic Medical Insurance on Health Care Expenditure and Health Outcomes

    OpenAIRE

    Feng Huang; Li Gan

    2015-01-01

    At the end of 1998, China launched a government-run mandatory insurance program, the Urban Employee Basic Medical Insurance (UEBMI), to replace the previous medical insurance system. Using the UEBMI reform in China as a natural experiment, this study identify variations in patient cost sharing that were imposed by the UEBMI reform and examine their effects on the demand for health-care services. Using data from the 1991-2006 waves of the China Health and Nutrition Survey, we find that the inc...

  17. Ethics reflection groups in community health services: an evaluation study.

    Science.gov (United States)

    Lillemoen, Lillian; Pedersen, Reidar

    2015-04-17

    Systematic ethics support in community health services in Norway is in the initial phase. There are few evaluation studies about the significance of ethics reflection on care. The aim of this study was to evaluate systematic ethics reflection in groups in community health (including nursing homes and residency), - from the perspectives of employees participating in the groups, the group facilitators and the service managers. The reflection groups were implemented as part of a research and development project. A mixed-methods design with qualitative focus group interviews, observations and written reports were used to evaluate. The study was conducted at two nursing homes, two home care districts and a residence for people with learning disabilities. Participants were employees, facilitators and service managers. The study was guided by ethical standard principles and was approved by the Norwegian Social Science Data Services. We found support for ethics reflection as a valuable measure to strengthen clinical practice. New and improved solutions, more cooperation between employees, and improved collaboration with patients and their families are some of the results. No negative experiences were found. Instead, the ethics reflection based on experiences and challenges in the workplace, was described as a win-win situation. The evaluation also revealed what is needed to succeed and useful tips for further development of ethics support in community health services. Ethics reflection groups focusing on ethical challenges from the participants' daily work were found to be significant for improved practice, collegial support and cooperation, personal and professional development among staff, facilitators and managers. Resources needed to succeed were managerial support, and anchoring ethics sessions in the routine of daily work.

  18. 75 FR 43557 - TA-W-73,682, Hartford Financial Services Group, Incorporated, Medical Bill Processing and...

    Science.gov (United States)

    2010-07-26

    ... Employment and Training Administration TA-W-73,682, Hartford Financial Services Group, Incorporated, Medical...; TA-W-73,682A, Hartford Financial Services Group, Incorporated Medical Bill Processing and Production... Financial Services Group, Incorporated, Medical Bill Processing and Production Center Support,...

  19. Survey on distributing situation in nursing group working in Tehran Medical Science University Emam Khomeinee Hospital During2013-14

    Directory of Open Access Journals (Sweden)

    Azari S

    2017-01-01

    Full Text Available Introduction: Nowadays justice in health and injustice elimination in health section turns out to a most important concern of health systems in the world, especially for developing countries. So current research happened with purpose to survey manner of distribution and dedication ofTehran Medical Science University Emam Khomeinee (may rest in peace Hospital nursing staff. Analysis method: The studying society of this descriptive analytical research in Tehran Medical Science University Emam Khomeinee Hospital During 2013-14 includes entire units nursing group personnel (Nurse, Paramedic and Nurse Aid. Information has been gathered by self-made forms and data analyzing has done by EXCEL Software, Descriptive statistical indexes and suggested standard guidance from Ministry of Health. Findings: Results of done estimation in 27 units of studying hospital and comparing that to current situation shows that based on suggested pattern of Health Ministry just one unit (3.7% from manpower staff matches this pattern, 18 units (66.67% were lower and 8 units (29.62% were far upon this pattern. Conclusion: Generally in studying hospital lack of nursing staff was obvious that combination and distribution of nursing forces in their different units was uneven and they didn’t match the current situation. Hereupon, intended hospitals require correct management and planning in this field, so that will cause increase in hospital performance and presenting service quality to patients.

  20. Comparison of stress among medical and not medical personnel in health care

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    Anita Mujakić

    2014-09-01

    Full Text Available Research Question (RQ: Does the opinion of the medical and non - medical staff varies on (1 the level of stress depending on seniority, (2 the staircase of stress in relation to education, and (3 how motivation affects the level of stress. Purpose: The purpose of the study is to determine whether in health care and higher education contribute to increased job stress. Also, we wanted to know whether they are more motivated workers are less exposed to occupational stress and / or employees with higher seniority also more exposed to stress. Method: We did quantitative research in public health institute. Overview of theoretical principles based on domestic and foreign professional literature. Articles and expert input was obtained in electronic databases ProQuest Online Information Service, Ebsco and SpringerLink. Statistical part of the study, we calculated the statistical program where we used the Mann - Whitney U- statistics and Wilcox W-statistics. Results: The results indicate that there is a statistical difference in understanding the importance of seniority and education on occupational stress among medical and non - medical sector. Employees in the medical sector more statistically argue that education and working life affect the career stress. We rejected our second hypothesis, which says that there is a difference between the two sectors regarding the impact of motivation on occupational stress. Both sectors they consider to be less motivated workers exposed to occupational stress. Organization: The survey can further highlight the risks that may be possible due to congestion and occupational stress. Society: positive influence on the social understanding of diversity obtained service of a single profession and thus routing problem in a disproportionate burden of healthcare workers. Healthcare professionals who work under less stress effectively and positively affect the quality of services rendered. Originality: This kind of research by

  1. Globalization of health care delivery in the United States through medical tourism.

    Science.gov (United States)

    Kumar, Sameer; Breuing, Richard; Chahal, Rajneet

    2012-01-01

    This study highlights some of the inefficiencies in the U.S. health care system and determines what effect medical tourism has had on the U.S. and global health care supply chains. This study also calls attention to insufficient health communication efforts to inform uninsured or underinsured medical tourists about the benefits and risks and determines the managerial and cost implications of various surgical procedures on the global health care system into the future. This study evaluated 3 years (2005, 2007, and 2011) of actual and projected surgical cost data. The authors selected 3 countries for analysis: the United States, India, and Thailand. The surgeries chosen for evaluation were total knee replacement (knee arthroplasty), hip replacement (hip arthroplasty), and heart bypass (coronary artery bypass graft). Comparisons of costs were made using Monte Carlo simulation with variability encapsulated by triangular distributions. The results are staggering. In 2005, the amount of money lost to India and Thailand on just these 3 surgeries because of cost inefficiencies in the U.S. health care system was between 1.3 to 2 billion dollars. In 2011, because many more Americans are expected to travel overseas for health care, this amount is anticipated to rise to between 20 and 30.2 billion dollars. Therefore, more attention should be paid to health communication efforts that truly illustrate the benefits/risks of medical travel. The challenge of finding reliable data for surgeries performed and associated surgical cost estimates was mitigated by the use of a Monte Carlo simulation of triangular distributions. The implications from this study are clear: If the U.S. health care industry is unable to eliminate waste and inefficiency and thus curb rising costs, it will continue to lose surgical revenue to foreign health providers. Copyright © Taylor & Francis Group, LLC

  2. Quality in health care and globalization of health services: accreditation and regulatory oversight of medical tourism companies.

    Science.gov (United States)

    Turner, Leigh G

    2011-02-01

    Patients are crossing national borders in search of affordable and timely health care. Many medical tourism companies are now involved in organizing cross-border health services. Despite the rapid expansion of the medical tourism industry, few standards exist to ensure that these businesses organize high-quality, competent international health care. Addressing the regulatory vacuum, 10 standards are proposed as a framework for regulating the medical tourism industry. Medical tourism companies should have to undergo accreditation review. Care should be arranged only at accredited international health-care facilities. Standards should be established to ensure that clients of medical tourism companies make informed choices. Continuity of care needs to become an integral feature of cross-border care. Restrictions should be placed on the use of waiver of liability forms by medical tourism companies. Medical tourism companies must ensure that they conform to relevant legislation governing privacy and confidentiality of patient information. Restrictions must be placed on the types of health services marketed by medical tourism companies. Representatives of medical tourism agencies should have to undergo training and certification. Medical travel insurance and medical complications insurance should be included in the health-care plans of patients traveling for care. To protect clients from financial losses, medical tourism companies should be mandated to contribute to compensation funds. Establishing high standards for the operation of medical tourism companies should reduce risks facing patients when they travel abroad for health care.

  3. Health inequalities, physician citizens and professional medical associations: an Australian case study

    Directory of Open Access Journals (Sweden)

    Naccarella Lucio

    2007-08-01

    Full Text Available Abstract Background As socioeconomic health inequalities persist and widen, the health effects of adversity are a constant presence in the daily work of physicians. Gruen and colleagues suggest that, in responding to important population health issues such as this, defining those areas of professional obligation in contrast to professional aspiration should be on the basis of evidence and feasibility. Drawing this line between obligation and aspiration is a part of the work of professional medical colleges and associations, and in doing so they must respond to members as well as a range of other interest groups. Our aim was to explore the usefulness of Gruen's model of physician responsibility in defining how professional medical colleges and associations should lead the profession in responding to socioeconomic health inequalities. Methods We report a case study of how the Royal Australian College of General Practitioners is responding to the issue of health inequalities through its work. We undertook a consultation (80 interviews with stakeholders internal and external to the College and two focus groups with general practitioners and program and policy review of core programs of College interest and responsibility: general practitioner training and setting of practice standards, as well as its work in public advocacy. Results Some strategies within each of these College program areas were seen as legitimate professional obligations in responding to socioeconomic health inequality. However, other strategies, while potentially professional obligations within Gruen's model, were nevertheless contested. The key difference between these lay in different moral orientations. Actions where agreement existed were based on an ethos of care and compassion. Actions that were contested were based on an ethos of justice and human rights. Conclusion Colleges and professional medical associations have a role in explicitly leading a debate about values

  4. Value-Added Clinical Systems Learning Roles for Medical Students That Transform Education and Health: A Guide for Building Partnerships Between Medical Schools and Health Systems.

    Science.gov (United States)

    Gonzalo, Jed D; Lucey, Catherine; Wolpaw, Terry; Chang, Anna

    2017-05-01

    To ensure physician readiness for practice and leadership in changing health systems, an emerging three-pillar framework for undergraduate medical education integrates the biomedical and clinical sciences with health systems science, which includes population health, health care policy, and interprofessional teamwork. However, the partnerships between medical schools and health systems that are commonplace today use health systems as a substrate for learning. Educators need to transform the relationship between medical schools and health systems. One opportunity is the design of authentic workplace roles for medical students to add relevance to medical education and patient care. Based on the experiences at two U.S. medical schools, the authors describe principles and strategies for meaningful medical school-health system partnerships to engage students in value-added clinical systems learning roles. In 2013, the schools began large-scale efforts to develop novel required longitudinal, authentic health systems science curricula in classrooms and workplaces for all first-year students. In designing the new medical school-health system partnerships, the authors combined two models in an intersecting manner-Kotter's change management and Kern's curriculum development steps. Mapped to this framework, they recommend strategies for building mutually beneficial medical school-health system partnerships, including developing a shared vision and strategy and identifying learning goals and objectives; empowering broad-based action and overcoming barriers in implementation; and generating short-term wins in implementation. Applying this framework can lead to value-added clinical systems learning roles for students, meaningful medical school-health system partnerships, and a generation of future physicians prepared to lead health systems change.

  5. Groups 4 Health: Evidence that a social-identity intervention that builds and strengthens social group membership improves mental health.

    Science.gov (United States)

    Haslam, Catherine; Cruwys, Tegan; Haslam, S Alexander; Dingle, Genevieve; Chang, Melissa Xue-Ling

    2016-04-01

    Social isolation and disconnection have profound negative effects on mental health, but there are few, if any, theoretically-derived interventions that directly target this problem. We evaluate a new intervention, Groups 4 Health (G4H), a manualized 5-module psychological intervention that targets the development and maintenance of social group relationships to treat psychological distress arising from social isolation. G4H was tested using a non-randomized control design. The program was delivered to young adults presenting with social isolation and affective disturbance. Primary outcome measures assessed mental health (depression, general anxiety, social anxiety, and stress), well-being (life satisfaction, self-esteem) and social connectedness (loneliness, social functioning). Our secondary goal was to assess whether mechanisms of social identification were responsible for changes in outcomes. G4H was found to significantly improve mental health, well-being, and social connectedness on all measures, both on program completion and 6-month follow-up. In line with social identity theorizing, analysis also showed that improvements in depression, anxiety, stress, loneliness, and life satisfaction were underpinned by participants' increased identification both with their G4H group and with multiple groups. This study provides preliminary evidence of the potential value of G4H and its underlying mechanisms, but further examination is required in other populations to address issues of generalizability, and in randomized controlled trials to address its wider efficacy. Results of this pilot study confirm that G4H has the potential to reduce the negative health-related consequences of social disconnection. Future research will determine its utility in wider community contexts. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

  6. The Future Impact of Healthcare Services Digitalization on Health Workforce: The Increasing Role of Medical Informatics.

    Science.gov (United States)

    Lapão, Luís Velez

    2016-01-01

    The digital revolution is gradually transforming our society. What about the effects of digitalization and Internet of Things in healthcare? Among researchers two ideas are dominating, opposing each other. These arguments will be explored and analyzed. A mix-method approach combining literature review with the results from a focus group on eHealth impact on employment is used. Several experts from the WHO and from Health Professional Associations contributed for this analysis. Depending on the type of service it will entail reductions or more need of healthcare workers, yet whatever the scenario medical informatics will play an increasing role.

  7. [International trade in health services and the medical industrial complex: implications for national health systems].

    Science.gov (United States)

    Santos, Maria Angelica Borges dos; Passos, Sonia Regina Lambert

    2010-08-01

    Health services have increasingly proven to be an innovative sector, gaining prominence in the medical industrial complex through expansion to public and international markets. International trade can foster economic development and redirect the resources and infrastructure available for healthcare in different countries in favorable or unfavorable directions. Wherever private providers play a significant role in government-funded healthcare, GATS commitments may restrict health policy options in subscribing countries. Systematic information on the impacts of electronic health services, medical tourism, health workers' migration, and foreign direct investment is needed on a case-by-case basis to build evidence for informed decision-making, so as to maximize opportunities and minimize risks of GATS commitments.

  8. The Potential Linkage between Emergency Medical Services Systems and Health Systems Agencies to Civil Defense Related Health and Medical Care Plans and Operations.

    Science.gov (United States)

    1980-07-01

    Objective 10 B. Study Methodology 10 IV. E 7SS/HSA LINKAGE TO CIVIL DEFEN SE 13 V. HEALTH AND MEDICAL PLANNING FUNCIONS 31 A. Primarily Non-Health...Department Responsibilities 31 B. Primarily Health Department Responsibilities 41 VI. DISASTER MEDICAL PLANNING IN THE SAN FRANCISCO BAY AREA 62 VII...Agency B-i APPENDIX C - State Emergency Health Service Planning Functions: Potential Agency Input C-i APPENDIX D - San Francisco Bay Area Planning D

  9. Achievement of non-cognitive goals of undergraduate medical education: perceptions of medical students, residents, faculty and other health professionals.

    Science.gov (United States)

    Mann, Karen V; Ruedy, John; Millar, Noreen; Andreou, Pantelis

    2005-01-01

    Professionalism is increasingly emphasised in medical education. Non-cognitive goals, including values, attitudes and skills, remain challenging to define and measure. The purpose of this study was to better understand these goals and their achievement in the MD programme. Graduating medical students, faculty preceptors, residents and other health professionals (OHPs) completed a systematically developed mailed survey, rating achievement of 25 attribute statements. Following analyses of means and standard deviations, factor analysis of responses was conducted. Responses were compared across respondent groups. The overall response rate was 50.1% (191/396), comprising 57.5% of the students, 54.1% of the faculty members, 30.9% of the residents and 50% of the OHPs. Five items received mean ratings over 4/5; none were below 3/5. Five factors explained 65% of variance. They were: 'Teamwork and interprofessional skills'; 'Duty and responsibility'; 'Communication and interpersonal skills'; 'Professionalism and values', and 'Trustworthiness and ethical behaviour'. The groups differed significantly on 2 factors: Teamwork and interprofessional skills (P < or = 0.0001) and Communication and interpersonal skills (P < or = 0.001). Important curriculum goals received high mean ratings. Ratings differed significantly across groups, suggesting differing perceptions of the extent to which goals were met. More study is needed to understand the basis of these perceptions.

  10. Gender difference in oral health perception and practices among Medical House Officers

    Directory of Open Access Journals (Sweden)

    Clement C. Azodo and Barnabas Unamatokpa

    2012-09-01

    Full Text Available Background: Understanding the effect of gender on oral health would facilitate the development of successful attitude and behavior modification approach towards sustainable oral health. Aim: To assess the gender difference in the oral health perception and practices among medical house officers in Benin City, Nigeria. Materials and Methods: This questionnaire-based cross-sectional study was conducted among doctors undergoing 12-months mandatory housemanship in tertiary and secondary hospitals in Benin City, Nigeria. The questionnaire assessed information on demography, perceived oral health, oral self-care, dental visit and oral disease preventive knowledge. Results: Of the 105 questionnaires distributed, 97 questionnaires were filled and returned giving a response rate of 92.4%. Females in comparison to males significantly gave good attention to their oral health, use medium strength toothbrush, brushed teeth more than once-daily, visited dentist and chose toothpaste following dentist recommendations. There was no significant gender difference in self-reported dental problem, perceived oral health, preventive knowledge in relation to dental caries and gingival bleeding, the reasons for tooth brushing and renewal of toothbrush. Conclusion: Gender played a role in the perception of general health relative oral health, dental visit, daily tooth brushing frequency and choice of toothbrush and toothpaste for oral self-care. The development of oral health attitude and behavior modification approaches towards sustainable oral health among the studied group should reflect these differences.

  11. Principles of developing a well-rounded program of physical rehabilitation for female students in the special medical group with consideration of physical activity impairment

    Directory of Open Access Journals (Sweden)

    Golod N. R.

    2015-04-01

    Full Text Available Purpose : to highlight the main provisions of a comprehensive physical rehabilitation program for students of special medical group based on violations of the motor capacity. Material : testing 24 students of special medical group and the same number of their healthy peers on standardized tests of physical qualities. To reflect the movement disorders applied functional movement screen. Results : a program of rehabilitation of the students included: lifestyle modification; morning hygienic gymnastics; kinesitherapy (using yoga fitness, functional training; aerobic exercise (swimming, Nordic Walking, jogging, aerobics wellness; massage. First presented a unified approach to working with students of special medical groups - selection based on load capacity motor disorders according to the results of tests of functional movement screen. The complexity of the impact of the program involves the impact on the physical, social and mental health components. Conclusions : the author's program of physical rehabilitation of students of special medical group is complex.

  12. [The assessment of health behaviours among Warsaw Medical University students].

    Science.gov (United States)

    Ostrowska, Alicja; Szewczyńiski, Jerzy A

    2002-01-01

    Some health behaviours among 228 students of Warsaw Medical University (130 women and 98 men) using anonymous questionnaire were examined. Percentage of smokers among female and male students was similar (13.1% and 14.3% respectively). Among respondents the greatest frequency of drinking alcohol was from a few times weekly to a few times monthly. Male students drunk alcohol more often than female ones. Beer was prefered by men, wine and beer--by women. Only male students (10.2%) used drugs (amphetamine, marihuana). About 1/3 of respondents did not do any sports. Female students had better knowledge about objective factors of their health status (blood pressure, blood glucose and cholesterol level) compared to males ones.

  13. Creating and sustaining a military women's Health Research Interest Group.

    Science.gov (United States)

    Wilson, Candy; Trego, Lori; Rychnovsky, Jacqueline; Steele, Nancy; Foradori, Megan

    2015-01-01

    In 2008, four doctorate military nurse scientists representing the triservices (Army, Navy, and Air Force) identified a common interest in the health and care of all women in the armed forces. For 7 years, the team's shared vision to improve servicewomen's health inspired them to commit to a rigorous schedule of planning, developing, and implementing an innovative program that has the capability of advancing scientific knowledge and influencing health policy and practice through research. The ultimate goal of the Military Women's Health Research Interest Group (MWHRIG) is to support military clinicians and leaders in making evidence-based practice and policy decisions. They developed a 4-pronged approach to cultivate the science of military women's healthcare: evaluate the existing evidence, develop a research agenda that addresses gaps in knowledge, facilitate the collaboration of multidisciplinary research, and build the bench of future researchers. The MWHRIG has been a resource to key leaders; its value has been validated by multiservice and multidisciplinary consultations. However, the journey to goal attainment has only been achieved by the enduring commitment of these MWHRIG leaders and their passion to ensure the health and wellbeing of the many women who serve in the United States military. This article describes their journey of dedication.

  14. Performance anxiety at English PBL groups among Taiwanese medical students: a preliminary study.

    Science.gov (United States)

    Chen, Cheng-Sheng; Lai, Chung-Sheng; Lu, Peih-Ying; Tsai, Jer-Chia; Chiang, Hung-Che; Huang, In-Ting; Yu, Hsin-Su

    2008-03-01

    Students' performance anxiety can impact negatively on the effectiveness of medical education reform, including performance in problem-based learning (PBL) and in using English in discussion. This study aimed to investigate the nature of performance anxiety among Taiwanese medical students in an English-language PBL group. Eighteen Taiwanese, one American and four Asian medical students who were attending an international PBL workshop were enrolled. A questionnaire seeking demographic data and experience in use of PBL and eight questions evaluating performance anxiety were administered. The performance anxiety of Taiwanese medical students was compared to that of the Asians and the one American. Frequencies of each performance anxiety were calculated. The results suggested that the Taiwanese students showed more anxiety than the one student from the United States, but less than other Asian students. The acts of giving a report, being the center of attention, and talking in the PBL group were the most common situations related to anxiety in PBL groups. Using English and working in a new PBL environment are possible sources of anxiety. The presence of anxiety among the Taiwanese medical students in English PBL groups implies the necessity for developing an effective strategy to deal with students' performance anxiety.

  15. 75 FR 27141 - Group Health Plans and Health Insurance Issuers Providing Dependent Coverage of Children to Age...

    Science.gov (United States)

    2010-05-13

    ... Revenue Service 26 CFR Part 54 RIN 1545-BJ45 Group Health Plans and Health Insurance Issuers Providing... Labor and the Office of Consumer Information and Insurance Oversight of the U.S. Department of Health... health plans and health insurance coverage offered in connection with a group health plan under the...

  16. 76 FR 16776 - Advisory Group on Prevention, Health Promotion, and Integrative and Public Health; Notice of Meeting

    Science.gov (United States)

    2011-03-25

    ... HUMAN SERVICES Advisory Group on Prevention, Health Promotion, and Integrative and Public Health; Notice... Assistant Secretary for Health, Office of the Surgeon General of the United States Public Health Service... for the Advisory Group on Prevention, Health Promotion, and Integrative and Public ] Health...

  17. Christians' cut: popular religion and the global health campaign for medical male circumcision in Swaziland.

    Science.gov (United States)

    Golomski, Casey; Nyawo, Sonene

    2017-08-01

    Swaziland faces one of the worst HIV epidemics in the world and is a site for the current global health campaign in sub-Saharan Africa to medically circumcise the majority of the male population. Given that Swaziland is also majority Christian, how does the most popular religion influence acceptance, rejection or understandings of medical male circumcision? This article considers interpretive differences by Christians across the Kingdom's three ecumenical organisations, showing how a diverse group people singly glossed as 'Christian' in most public health acceptability studies critically rejected the procedure in unity, but not uniformly. Participants saw medical male circumcision's promotion and messaging as offensive and circumspect, and medical male circumcision as confounding gendered expectations and sexualised ideas of the body in Swazi Culture. Pentecostal-charismatic churches were seen as more likely to accept medical male circumcision, while traditionalist African Independent Churches rejected the operation. The procedure was widely understood to be a personal choice, in line with New Testament-inspired commitments to metaphorical circumcision as a way of receiving God's grace.

  18. Determining of a role of the teacher of physical training in making up of consciousness of students of special medical groups of higher educational establishments.

    Directory of Open Access Journals (Sweden)

    Korjagin V.M.

    2010-08-01

    Full Text Available The state of health of students is construed. Students of 1 rate participated in experiment. The functional state of health of students is defined. Effect of the teacher on the relation of students of special medical groups to state of the health is defined. Possibilities of improving of health with the help of exercises on physical training are exhibited. Main routes of methodological correction of operation of the teacher with students are defined. The primal problem of the teacher is a making up at students of the realized relation of necessity of improving and conservation of health, education of crop of a healthy way of life.

  19. Medicalization of global health 3: the medicalization of the non-communicable diseases agenda

    Directory of Open Access Journals (Sweden)

    Jocalyn Clark

    2014-05-01

    Full Text Available There is growing recognition of the massive global burden of non-communicable diseases (NCDs due to their prevalence, projected social and economic costs, and traditional neglect compared to infectious disease. The 2011 UN Summit, WHO 25×25 targets, and support of major medical and advocacy organisations have propelled prominence of NCDs on the global health agenda. NCDs are by definition ‘diseases’ so already medicalized. But their social drivers and impacts are acknowledged, which demand a broad, whole-of-society approach. However, while both individual- and population-level targets are identified in the current NCD action plans, most recommended strategies tend towards the individualistic approach and do not address root causes of the NCD problem. These so-called population strategies risk being reduced to expectations of individual and behavioural change, which may have limited success and impact and deflect attention away from government policies or regulation of industry. Industry involvement in NCD agenda-setting props up a medicalized approach to NCDs: food and drink companies favour focus on individual choice and responsibility, and pharmaceutical and device companies favour calls for expanded access to medicines and treatment coverage. Current NCD framing creates expanded roles for physicians, healthcare workers, medicines and medical monitoring. The professional rather than the patient view dominates the NCD agenda and there is a lack of a broad, engaged, and independent NGO community. The challenge and opportunity lie in defining priorities and developing strategies that go beyond a narrow medicalized framing of the NCD problem and its solutions.

  20. Other-regarding behavior and motivation in health care provision: an experiment with medical and non-medical students.

    Science.gov (United States)

    Hennig-Schmidt, Heike; Wiesen, Daniel

    2014-05-01

    Other-regarding motivation is a fundamental determinant of public service provision. In health care, one example is physicians who act benevolently towards their patients when providing medical services. Such patient-regarding motivation seems closely associated with a personal sacrifice that health service providers are willing to make. Surprisingly, evidence on physicians' motivation is rare. This paper contributes to the literature by investigating prospective physicians', in particular, medical students', motivations and behavior. We measure the willingness to sacrifice own profit in order to increase the patients' health benefit. We conduct the same analysis for non-medical students. In a controlled incentivized laboratory experiment, participants decide, in the role of physicians, on the provision of medical services under fee-for-service or capitation schemes. Overall, 42 medical students and 44 non-medical students participated in five experimental sessions conducted between 2006 and 2008. We find substantial differences under both payment systems: compared to medical students, students of non-medical majors are less patient-regarding, less willing to sacrifice their own profit, and they state less motivation to improve patients' health. This results in significantly lower patient health benefits. Some implications for health care policies in light of physician shortage and for physician payment systems are discussed.

  1. A review of RSICC software for medical and health physics

    Energy Technology Data Exchange (ETDEWEB)

    Kirk, B.L. [Oak Ridge National Laboratory, Radiation Safety Information Computational Center, Nuclear Science and Technology Div., TN (United States)

    2008-07-01

    RSICC (Radiation Safety Information Computational Center) collects, organizes, evaluates and disseminates technical information (software and nuclear data) involving the transport of neutral and charged particle radiation, and shielding and protection from the radiation associated with: nuclear weapons and materials, fission and fusion reactors, outer space applications, accelerators, medical facilities, and nuclear waste management. The Center provides in-depth coverage of radiation transport topics. An RSICC software package consists of an abstract, source code, sample problem input, sample problem output, documentation, and an executable program.The paper is a synopsis of various computer code and nuclear data packages, maintained, tested and distributed by RSICC,used for medical and health physics dosimetry applications. The codes are classified into 5 categories: 1) radiation transport, shielding, and supporting codes for radiation therapy (12 codes); 2) codes devoted to medical X-ray calculations (6 codes); 3) codes for internal and external dose calculations (4 codes); 4) data collections and supporting codes useful in nuclear medicine (3 codes) and 5) codes and data collections dealing with the microdosimetry of radiation therapy. (A.C.)

  2. Medical cannabis and mental health: A guided systematic review.

    Science.gov (United States)

    Walsh, Zach; Gonzalez, Raul; Crosby, Kim; S Thiessen, Michelle; Carroll, Chris; Bonn-Miller, Marcel O

    2017-02-01

    This review considers the potential influences of the use of cannabis for therapeutic purposes (CTP) on areas of interest to mental health professionals, with foci on adult psychopathology and assessment. We identified 31 articles relating to the use of CTP and mental health, and 29 review articles on cannabis use and mental health that did not focus on use for therapeutic purposes. Results reflect the prominence of mental health conditions among the reasons for CTP use, and the relative dearth of high-quality evidence related to CTP in this context, thereby highlighting the need for further research into the harms and benefits of medical cannabis relative to other therapeutic options. Preliminary evidence suggests that CTP may have potential for the treatment of PTSD, and as a substitute for problematic use of other substances. Extrapolation from reviews of non-therapeutic cannabis use suggests that the use of CTP may be problematic among individuals with psychotic disorders. The clinical implications of CTP use among individuals with mood disorders are unclear. With regard to assessment, evidence suggests that CTP use does not increase risk of harm to self or others. Acute cannabis intoxication and recent CTP use may result in reversible deficits with the potential to influence cognitive assessment, particularly on tests of short-term memory. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. To the point: obstetrics and gynecology global health experiences for medical students.

    Science.gov (United States)

    Hampton, Brittany S; Chuang, Alice W; Abbott, Jodi F; Buery-Joyner, Samantha D; Cullimore, Amie J; Dalrymple, John L; Forstein, David A; Hueppchen, Nancy A; Kaczmarczyk, Joseph M; Page-Ramsey, Sarah; Pradhan, Archana; Wolf, Abigail; Dugoff, Lorraine

    2014-07-01

    This article, from the To the Point series prepared by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, provides educators with an overview of considerations for obstetrics and gynecology global health experiences for the medical student. Options for integration of obstetrics and gynecology global health into undergraduate medical curricula are discussed. Specific considerations for global health clinical experiences for medical students, including choosing a clinical location, oversight and mentorship, goals and objectives, predeparture preparation, and evaluation, are reviewed.

  4. Primary health care models: medical students’ knowledge and perceptions.

    Science.gov (United States)

    Brown, Judith Belle; French, Reta; McCulloch, Amy; Clendinning, Eric

    2012-03-01

    To explore the knowledge and perceptions of fourth-year medical students regarding the new models of primary health care (PHC) and to ascertain whether that knowledge influenced their decisions to pursue careers in family medicine. Qualitative study using semistructured interviews. The Schulich School of Medicine and Dentistry at The University of Western Ontario in London. Participants Fourth-year medical students graduating in 2009 who indicated family medicine as a possible career choice on their Canadian Residency Matching Service applications. Eleven semistructured interviews were conducted between January and April of 2009. Data were analyzed using an iterative and interpretive approach. The analysis strategy of immersion and crystallization assisted in synthesizing the data to provide a comprehensive view of key themes and overarching concepts. Four key themes were identified: the level of students’ knowledge regarding PHC models varied; the knowledge was generally obtained from practical experiences rather than classroom learning; students could identify both advantages and disadvantages of working within the new PHC models; and although students regarded the new PHC models positively, these models did not influence their decisions to pursue careers in family medicine. Knowledge of the new PHC models varies among fourth-year students, indicating a need for improved education strategies in the years before clinical training. Being able to identify advantages and disadvantages of the PHC models was not enough to influence participants’ choice of specialty. Educators and health care policy makers need to determine the best methods to promote and facilitate knowledge transfer about these PHC models.

  5. Interdisciplinary development of a preconception health curriculum for four medical specialties.

    Science.gov (United States)

    Freda, Margaret Comerford; Chazotte, Cynthia; Bernstein, Peter; Harrison, Ellen

    2002-02-01

    A group of obstetricians and gynecologists, along with physicians from three other medical specialties, nurses, and midwives, developed a curriculum on preconception health care for women. This curriculum was specifically aimed at residents in obstetrics and gynecology, internal medicine, pediatrics, and family medicine. The curriculum was designed to convince these physicians that they needed to participate in promotion of preconception health for many reasons, such as the need to teach women to take folic acid daily because it significantly decreases the incidence of neural tube defects. Because over 50% of all pregnancies are unplanned, it is imperative that all physicians think of themselves as preconception health providers. Our group then taught the curriculum to medical students, residents, fellows, and attending physicians in all specialties at four hospitals affiliated with the medical college. Evaluation of the curriculum in 171 physicians who participated revealed that only a small percentage of physicians took folic acid daily themselves. Almost 36% of the obstetricians did not currently provide preconception care for their patients. Most physicians in all specialties believed that the curriculum provided them with useful information for their practice. The March of Dimes is currently distributing this curriculum on its Web site.

  6. A study of medical and health queries to web search engines.

    Science.gov (United States)

    Spink, Amanda; Yang, Yin; Jansen, Jim; Nykanen, Pirrko; Lorence, Daniel P; Ozmutlu, Seda; Ozmutlu, H Cenk

    2004-03-01

    This paper reports findings from an analysis of medical or health queries to different web search engines. We report results: (i). comparing samples of 10000 web queries taken randomly from 1.2 million query logs from the AlltheWeb.com and Excite.com commercial web search engines in 2001 for medical or health queries, (ii). comparing the 2001 findings from Excite and AlltheWeb.com users with results from a previous analysis of medical and health related queries from the Excite Web search engine for 1997 and 1999, and (iii). medical or health advice-seeking queries beginning with the word 'should'. Findings suggest: (i). a small percentage of web queries are medical or health related, (ii). the top five categories of medical or health queries were: general health, weight issues, reproductive health and puberty, pregnancy/obstetrics, and human relationships, and (iii). over time, the medical and health queries may have declined as a proportion of all web queries, as the use of specialized medical/health websites and e-commerce-related queries has increased. Findings provide insights into medical and health-related web querying and suggests some implications for the use of the general web search engines when seeking medical/health information.

  7. Comparison of pain control medication in three age groups of elderly patients.

    Science.gov (United States)

    Honari, S; Patterson, D R; Gibbons, J; Martin-Herz, S P; Mann, R; Gibran, N S; Heimbach, D M

    1997-01-01

    There are no published reports of burn pain management in the elderly population. To assess the range of requirement and use of opioids among elderly patients with burns of different age categories, a retrospective review of 89 consecutive admissions of patients over 55 years of age (January 1995 through July 1996) was conducted. Complete data were available on 44 patients with a burn mean total body surface area of 17.2%. Patient ages ranged from 55 to 92 years. Individuals were divided into three age categories: Group I (55 to 65) n = 20; Group II (66 to 75) n = 14; and Group III (76 to 92) n = 10. Use of commonly prescribed opioids for procedural pain and breakthrough pain were evaluated. We compared the opioid equivalents of medications prescribed versus the actual amount administered. Paired t tests comparing minimum amount of medication ordered with that given revealed Group I patients received significantly more procedural medication than the minimum prescribed (t = 3.88, p = 0.001), and that Group III patients were given significantly less as needed medication than the minimum prescribed (t = 2.58, p < 0.05).

  8. Medical Yoga for Patients with Stress-Related Symptoms and Diagnoses in Primary Health Care: A Randomized Controlled Trial

    OpenAIRE

    Monica Köhn; Ulla Persson Lundholm; Ing-Liss Bryngelsson; Agneta Anderzén-Carlsson; Elisabeth Westerdahl

    2013-01-01

    An increasing number of patients are suffering from stress-related symptoms and diagnoses. The purpose of this study was to evaluate the medical yoga treatment in patients with stress-related symptoms and diagnoses in primary health care. A randomized controlled study was performed at a primary health care centre in Sweden from March to June, 2011. Patients were randomly allocated to a control group receiving standard care or a yoga group treated with medical yoga for 1 hour, once a week, ove...

  9. Breastfeeding women under medication treatment in the public health network

    Directory of Open Access Journals (Sweden)

    Viviane Muniz da Silva Fragoso

    2014-06-01

    Full Text Available Objective: To analyse the medications used by breastfeeding women treated in the public health network, and correlated actions. Methods: Cross-sectional, quantitative and descriptive study carried out with 100 breastfeeding women, recruited through nonprobabilistic convenience sampling, at the Municipal Hospital of Duque de Caxias, RJ, in 2012. A questionnaire was applied containing the following variables: prescribed medications, unwanted effects in nursing infants, and professionals involved in guidance on the edication. The data was analysed through descriptive statistics, based on absolute and relative frequencies. Results: It was found that 46% (n=46 of the breastfeeding women were aged 21 to 30 years, 54% (n=54 were primiparae, 52% (n=52 had complete fundamental level, and 72% (n=72 received prenatal care. It was verified that 78% (n = 78 of the sample were receiving some type of medicine and, among these, a significant percentage of nonsteroidal analgesic/anti-inflammatory medication, with 61.54% (n=48 of the breastfeeding women. All the prescribed medicines were in the category of compatible use with breastfeeding. The incidence of some unwanted symptoms was evidenced in 19.2% (n=15 of the breastfeeding women. Among the women undergoing medication therapy, 76.92% (n=60 received guidance during treatment, 55% (n=33 by doctors and 45% (n=27 by nurses. In this research, 100% of the breastfeeding women were satisfied with the acquired knowledge. Conclusion: It was noted a high percentage of breastfeeding women in the sample taking medicines, all compatible with breastfeeding. It stands out the limited engagement of the multidisciplinary team in the orientations. doi:10.5020/18061230.2014.p283

  10. Medical equipment in government health facilities: Missed opportunities

    Directory of Open Access Journals (Sweden)

    Pardeshi Geeta

    2005-01-01

    Full Text Available BACKGROUND: The availability and optimal utilization of medical equipment is important for improving the quality of health services. Significant investments are made for the purchase, maintenance and repair of medical equipment. Inadequate management of these equipment will result in financial losses and deprive the public of the intended benefits. This analysis is based on the conceptual framework drawn from the WHO recommended- lifecycle of medical equipment. AIMS: (1 To identify the problems in different stages of the life cycle. (2 To assess its financial implications and effect on service delivery. SETTINGS AND DESIGN: Analysis of secondary data from the latest Comptroller and Auditor General (CAG Reports for the states in India. The study variables were category of equipment, financial implications and problems in the stages of life cycle. STATISTICAL ANALYSIS: Calculation of proportions. RESULTS AND CONCLUSIONS: A total of forty instances mentioning problems in the first phase of the life cycle of medical equipment were noted in 12 state reports. The equipment from the radiology department (15, equipment in the wards (5, laboratory (3 and operation theatres (4 were the ones most frequently implicated. In a majority of cases the financial implications amounted to twenty-five lakhs. The financial implications were in the form of extra expenditure, unfruitful expenditure or locking of funds. In 25 cases the equipment could not be put to use because of non-availability of trained staff and inadequate infrastructural support. Careful procurement, incoming inspection, successful installation and synchronization of qualified trained staff and infrastructural support will ensure timely onset of use of the equipment.

  11. Sexual health of Dutch medical students: nothing to worry about.

    Science.gov (United States)

    Fickweiler, Freek; Keers, Joost C; Weijmar Schultz, Willibrord C M

    2011-09-01

    Little is known about the sexual lives and development of medical students because of relatively small sample sizes and, in particular, low response rates in research. Enhancing medical students' awareness and understanding of sexual behavior is imperative, as gaps in knowledge might impede effective sexual health consultations in their later professional practice. The aim of this study was to provide insight into the sexual lives and development of medical students. The main outcome measures of this study are demographic, contextual, and sexual data based on validated surveys. Preclinical medical students aged under 26 years were approached during scheduled classes and by e-mail to complete a web-based questionnaire. Our results were compared with international and Dutch normative data. Ordinal regression analysis and Pearson's correlation analysis were used to assess relationships between variables. A total of 1,598 questionnaires were returned (response rate 52%: 1,198 by women, 400 by men). There were 719 first-year students (mean age 19.17 years) and 879 third-year students (mean age 21.5 years). Gender distribution differences were seen in all the cohorts and were corrected for. Compared with international and Dutch (88%) normative data, our first- (62.7%; Psexual experience and showed different advancements in sexual behavior. However, these differences decreased, which suggests that medical students "catch-up" as their age increases. Sexual behavior in our sample did not differ from international data, except for a strikingly high sexual satisfaction (80%). We also confirmed that social and environmental characteristics change with alterations in sexual behavior. Although contraceptive measures were used more frequently (98%; P=0.006), sexually transmitted diseases were more common (4.6%; P=0.008), which suggests inappropriate use of protective measures. Independent predictive determinants for protective sexual behavior were the form of relationship

  12. Impact of a Social Media Group Page on Undergraduate Medical Physiology Learning.

    Science.gov (United States)

    Shakoori, Tania Ahmed; Mahboob, Usman; Strivens, Janet; Willis, Ian

    2017-07-01

    To investigate the impact of associating classroom learning of medical physiology with a Facebook group page in an all-women medical college of a conservative small city in Pakistan. Qualitative interpretivist study using semi-structured interviews. Women Medical College Abbottabad, Pakistan, from March to December 2014. Aclosed Facebook study group was established at a local medical college in Pakistan. It was used to upload learning resources and initiate discussions, coordinated with classroom lectures of physiology. Thirteen semistructured interviews were conducted with volunteer students according to a standard protocol. Five major themes were identified. Facebook group is something new and exciting; it motivated self-study, research, collaborative learning and improved class attendance. Convenience of easily accessible resources allowed the students to concentrate on the lecture rather than note taking. It was easier to communicate with the instructor through Facebook than face to face. Lurkers were also learning. High achievers who had adapted to the current didactic system of teaching were less receptive of the collaborative learning and favored teaching geared towards exam preparation. Using social media for e-learning in undergraduate medical education can enhance the student learning experience, especially in resource-limited regions where Information and communication technology is not an integrated part of the teaching process.

  13. Oral health promotion through an online training program for medical students.

    Science.gov (United States)

    de Sousa Eskenazi, Ednalva; de Arruda Martins, Mílton; Ferreira, Mario

    2011-05-01

    The objective of this study was to compare the impact on knowledge and counseling skills of face-to-face and Internet-based oral health training programs on medical students. Participants consisted of 148 (82 percent) of the 180 invited students attending their fifth academic year at the Faculty of Medicine, University of São Paulo, Brasil, in 2007. The interventions took place during a three-month training period in the clinical Center for Health Promotion, which comprised part of a clerkship in Internal Medicine. The students were divided into four groups: 1) Control Group (Control), with basic intervention; 2) Brochure Group (Br), with basic intervention plus complete brochure with oral health themes; 3) Cybertutor Group (Cy), with basic intervention plus access to an Internet-based training program about oral health themes; and 4) Cybertutor + Contact Group (Cy+C), the same as Cy plus brief proactive contact with a tutor. The impact of these interventions on student knowledge was measured with pre- and post assessments, and student skills in asking and counseling about oral health were assessed with an objective structured clinical examination (OSCE). Multivariate logistic regression models were applied to identify the odds ratios of scoring above Control's medians on the final assessment and the OSCE. In the results, Cy+C performed significantly better than Control on both the final assessment (OR 9.4; 95% CI 2.7-32.8) and the OSCE (OR 5.6; 95% CI 1.9-16.3) and outperformed all the other groups. The Cy+C group showed the most significant increase in knowledge and the best skills in asking and counseling about oral health.

  14. Dental Care Knowledge and Practice of a Group of Health Workers ...

    African Journals Online (AJOL)

    Annals of Medical and Health Sciences Research | Sep-Oct 2014 | Vol 4 | Special Issue 3 |. 307. Address ... assess the knowledge and practice of health workers in a private medical health facility on dental care. ..... J Hosp Tourism. Educ 2011 ...

  15. Medication adherence among hypertensive patients of primary health clinics in Malaysia

    Directory of Open Access Journals (Sweden)

    Ramli A

    2012-08-01

    Full Text Available Azuana Ramli,1 Nur Sufiza Ahmad,1 Thomas Paraidathathu21Pharmaceutical Services Division, Ministry of Health, Petaling Jaya, Malaysia; 2Faculty of Pharmacy, Universiti Kebangsaan Malaysia (UKM, Kuala Lumpur, MalaysiaPurpose: Poor adherence to prescribed medications is a major cause for treatment failure, particularly in chronic diseases such as hypertension. This study was conducted to assess adherence to medications in patients undergoing hypertensive treatment in the Primary Health Clinics of the Ministry of Health in Malaysia. Factors affecting adherence to medications were studied, and the effect of nonadherence to blood pressure control was assessed.Patients and methods: This was a cross-sectional study to assess adherence to medications by adult patients undergoing hypertensive treatment in primary care. Adherence was measured using a validated survey form for medication adherence consisting of seven questions. A retrospective medication record review was conducted to collect and confirm data on patients’ demographics, diagnosis, treatments, and outcomes.Results: Good adherence was observed in 53.4% of the 653 patients sampled. Female patients were found to be more likely to adhere to their medication regime, compared to their male counterparts (odds ratio 1.46 [95% confidence intervals [CI]: 1.05–2.04; P < 0.05]. Patients in the ethnic Chinese were twice as likely (95% CI: 1.14–3.6; P < 0.05 to adhere, compared to those in the Indian ethnic group. An increase in the score for medicine knowledge was also found to increase the odds of adherence. On the other hand, increasing the number of drugs the patient was taking and the daily dose frequencies of the medications prescribed were found to negatively affect adherence. Blood pressure control was also found to be worse in noncompliers.Conclusion: The medication adherence rate was found to be low among primary care hypertensive patients. A poor adherence rate was found to negatively

  16. Modifying the ECC-based grouping-proof RFID system to increase inpatient medication safety.

    Science.gov (United States)

    Ko, Wen-Tsai; Chiou, Shin-Yan; Lu, Erl-Huei; Chang, Henry Ker-Chang

    2014-09-01

    RFID technology is increasingly used in applications that require tracking, identification, and authentication. It attaches RFID-readable tags to objects for identification and execution of specific RFID-enabled applications. Recently, research has focused on the use of grouping-proofs for preserving privacy in RFID applications, wherein a proof of two or more tags must be simultaneously scanned. In 2010, a privacy-preserving grouping proof protocol for RFID based on ECC in public-key cryptosystem was proposed but was shown to be vulnerable to tracking attacks. A proposed enhancement protocol was also shown to have defects which prevented proper execution. In 2012, Lin et al. proposed a more efficient RFID ECC-based grouping proof protocol to promote inpatient medication safety. However, we found this protocol is also vulnerable to tracking and impersonation attacks. We then propose a secure privacy-preserving RFID grouping proof protocol for inpatient medication safety and demonstrate its resistance to such attacks.

  17. Disease prevention and health promotion in medical education: reflections from an academic health center.

    Science.gov (United States)

    Litaker, David; Cebul, Randall D; Masters, Sophia; Nosek, Thomas; Haynie, Robert; Smith, C Kent

    2004-07-01

    It is unclear whether academic health centers are successfully addressing societal needs and expectations by preparing students with knowledge and skills in disease prevention and health promotion. The authors assessed whether students were exposed to key content in these areas and whether they felt this exposure was adequate. All components of the first three years of the Case Western Reserve University (Case) curriculum were examined in 2001 to create a curricular map, using competencies in disease prevention and health promotion identified by the Association of Teachers of Preventive Medicine (ATPM) as a template to assess the scope of instruction. Case students' United States Medical Licensing Examination (USMLE) Step 2 subscores in preventive medicine and health maintenance from 1994 to 2000 and graduating seniors' assessment of the adequacy of their training were compared to national data from the Association of American Medical Colleges' 2000 Graduation Questionnaire (GQ). Most content areas identified by ATPM were present in the Case curriculum and were offered frequently in a variety of educational venues over the first three years. USMLE scores increased nationally and at Case from 1994 to 2000 and Case students' perception of training adequacy in preventive medicine and health promotion was comparable to national ratings from the 2000 GQ. Broad and frequent exposure to disease prevention and health promotion core competencies has value, but may not sufficiently prepare students to deliver health-promoting services confidently. Creative curricula highlighting prevention's relevance throughout clinical practice and incorporating formal opportunities to apply knowledge and build experience may result in greater success.

  18. Designing a bone health and soy focus group discussion guide based on the health belief model

    Science.gov (United States)

    Focus groups were used to assess the knowledge and skills of women in order to support curricula development. The Health Belief Model was applied to the discussion guide to enhance focus group findings and applications. Constructs related to perceived susceptibility, severity, benefits, and barriers...

  19. Intimate Partner Violence and Its Health Impact on Disproportionately Affected Populations, Including Minorities and Impoverished Groups

    Science.gov (United States)

    Hayashi, Hitomi; Campbell, Jacquelyn C.

    2015-01-01

    Abstract In the United States, intimate partner violence (IPV) against women disproportionately affects ethnic minorities. Further, disparities related to socioeconomic and foreign-born status impact the adverse physical and mental health outcomes as a result of IPV, further exacerbating these health consequences. This article reviews 36 U.S. studies on the physical (e.g., multiple injuries, disordered eating patterns), mental (e.g., depression, post-traumatic stress disorder), and sexual and reproductive health conditions (e.g., HIV/STIs, unintended pregnancy) resulting from IPV victimization among ethnic minority (i.e., Black/African American, Hispanic/Latina, Native American/Alaska Native, Asian American) women, some of whom are immigrants. Most studies either did not have a sufficient sample size of ethnic minority women or did not use adequate statistical techniques to examine differences among different racial/ethnic groups. Few studies focused on Native American/Alaska Native and immigrant ethnic minority women and many of the intra-ethnic group studies have confounded race/ethnicity with income and other social determinants of health. Nonetheless, of the available data, there is evidence of health inequities associated with both minority ethnicity and IPV. To appropriately respond to the health needs of these groups of women, it is necessary to consider social, cultural, structural, and political barriers (e.g., medical mistrust, historical racism and trauma, perceived discrimination, immigration status) to patient–provider communication and help-seeking behaviors related to IPV, which can influence health outcomes. This comprehensive approach will mitigate the racial/ethnic and socioeconomic disparities related to IPV and associated health outcomes and behaviors. PMID:25551432

  20. Integrated Pharmacies at Community Mental Health Centers: Medication Adherence and Outcomes.

    Science.gov (United States)

    Wright, W Abel; Gorman, Jack M; Odorzynski, Melissa; Peterson, Mark J; Clayton, Carol

    2016-11-01

    Patients receiving psychiatric services at community mental health centers (CMHCs) are often prescribed medication that is critical to the treatment of behavioral health conditions, including schizophrenia, bipolar disorder, anxiety, and depression. Previous studies have shown correlation between rates of medication adherence and risk of hospitalization, but potential differences in medication adherence and other outcomes for patients of CMHCs by pharmacy type have not been widely studied. To determine potential benefits of placing a pharmacy within a mental health service delivery setting on both adherence to medication and health outcomes. A retrospective cohort analysis of medication adherence rates, hospital and emergency department (ED) use, and related costs between patients of CMHCs was conducted using integrated pharmacies versus community pharmacies. Data were from Medicaid claims paid by Southwest Michigan Behavioral Health for all (behavioral and nonbehavioral) inpatient and outpatient services as well as pharmacy prescriptions filled from April 1, 2014, through April 30, 2015. The primary study analysis was composed of an adult dataset representing persons served from 1 of the 2 CMHCs who had filled at least 2 prescriptions for a specific medication from 1 of 2 Genoa pharmacies located in a CMHC during the study period. Each unique patient dataset in the treatment group was matched to a corresponding control patient dataset prescribed the same medication using a modified version of the Gale-Shapley algorithm. The primary analysis compared medication possession ratio, which is a measure of adherence that indicates gaps or oversupply in a patient's medication use history. Statistical tests were performed using the R statistical programming language and Microsoft Excel. Patients using pharmacies integrated within the CMHCs had higher medication adherence rates, lower rates of hospitalization, and lower ED use than those filling their prescriptions at

  1. Improving Population Health Through an Innovative Collaborative: The Be There San Diego Data for Quality Group.

    Science.gov (United States)

    Fremont, Allen; Kranz, Ashley M; Phillips, Jessica; Garber, Chandra

    2017-06-01

    In 2012, leaders from disparate health care organizations established a data group aligned around a regional goal of preventing heart attacks and strokes in San Diego. The group---now named the Be There San Diego Data for Quality (DFQ) Group---is a safe venue for medical directors and other quality-improvement leaders to share performance data on quality-of-care measures for diabetes, hypertension, and cardiovascular disease, as well as insights, lessons learned, and challenges faced by each organization in treating these conditions. The DFQ Group has focused its efforts on improving the quality of services provided by each participating health care organization, and has placed a strong emphasis on analyzing trends in combined quality data to better understand the health of the entire San Diego population. By fostering collaboration among organizations that collectively serve a large portion of the local population and other key community stakeholders, the DFQ Group has helped form the foundation of a unique, multifaceted, multi-stakeholder, regional effort that is gaining national attention and funding for its community-driven approach.

  2. [Education on ethnic diversity in health care in medical school: what can we learn from the American perspective?].

    Science.gov (United States)

    Figueroa, Caroline A; Rassam, Fadi; Spong, Karin S

    2013-01-01

    In April 2012, 20 medical students took part in a study tour to San Francisco, themed 'ethnic diversity in health care'. In this article we discuss four lessons learned from the perspective of these students. The delivery of culturally sensitive healthcare is becoming more important in the Netherlands as the ethnic minority population rate will continue to grow over the coming years. However, diversity education is not a structural component of medical curricula in the Netherlands to the same degree as in the USA where medical education pays a lot of attention to differences in health between ethnic minorities; and where there is also extensive research on this subject. We emphasize that diversity education should create awareness of differences in health outcomes between ethnic groups and awareness of one's own bias and stereotypical views. The implementation of diversity education is a challenge, which requires a change of image and the involvement of teachers from diverse medical disciplines.

  3. Student Perceptions of Independent versus Facilitated Small Group Learning Approaches to Compressed Medical Anatomy Education

    Science.gov (United States)

    Whelan, Alexander; Leddy, John J.; Mindra, Sean; Matthew Hughes, J. D.; El-Bialy, Safaa; Ramnanan, Christopher J.

    2016-01-01

    The purpose of this study was to compare student perceptions regarding two, small group learning approaches to compressed (46.5 prosection-based laboratory hours), integrated anatomy education at the University of Ottawa medical program. In the facilitated active learning (FAL) approach, tutors engage students and are expected to enable and…

  4. Comparing Two Cooperative Small Group Formats Used with Physical Therapy and Medical Students

    Science.gov (United States)

    D'Eon, Marcel; Proctor, Peggy; Reeder, Bruce

    2007-01-01

    This study compared "Structured Controversy" (a semi-formal debate like small group activity) with a traditional open discussion format for medical and physical therapy students. We found that those students who had participated in Structured Controversy changed their personal opinion on the topic more than those who were in the Open Discussion…

  5. Conceptual foundations of classes with the disciples of special medical group in secondary schools

    Directory of Open Access Journals (Sweden)

    Vaskov Y.V.

    2014-05-01

    Full Text Available Purpose: study and scientific rationale for new approaches to the organization of educational work with students of special medical group in secondary schools. Material : analyzed 15 scientific sources regarding the approaches of different authors to develop educational programs for students of special medical group. Results : focuses on the outstanding issues in a substantive, logistical and human aspects. Found that the selection of the content of educational material for special medical groups is an empirical question. Selection is carried out by copying the existing curriculum of physical culture for healthy children with an indication of the load reduction and exemption of complex elements. Established a complete absence of evaluation of educational achievements of pupils. Based on modern approaches to teaching students based on biomedical and didactic aspects: Leading defined function of each stage of training, fleshed main goals and objectives of the educational process, substantiated various kinds of sports activity, taking into account the diagnosis of diseases and the needs of students of different ages and gender. Conclusions : the main controversy in the decision of the designated problem. Substantiated leading features of each stage of training in special medical groups. A system of assessment of students' achievements.

  6. Medical Students' Opinions on Economic Aspects of the Health Care System.

    Science.gov (United States)

    Herman, Mary W.

    1985-01-01

    Responses of 423 freshmen and 410 seniors at Jefferson Medical College to 15 questions on economic aspects of health care were compared. A majority of students considered major problems to be costs of medical care and medical education, malpractice claims, and patients' failure to assume responsibility for their health. (Author/SW)

  7. Mental health symptoms in combat medic training: a longitudinal examination.

    Science.gov (United States)

    Robinson, Michael E; Teyhen, Deydre S; Wu, Samuel S; Dugan, Jessica L; Wright, Alison C; Childs, John D; Yang, Guijun; George, Steven Z

    2009-06-01

    Mental health symptoms in military populations are rising and constitute a significant health concern. This study examined the prevalence of depression, anxiety, and suicidal ideation in soldiers (N = 3,792) undergoing combat medic training. At the start of training, 10.4%, 15.5%, and 4.1% of soldiers had clinically significant depression, anxiety, or suicidal ideation, respectfully. These percentages increased to 12.2%, 20.3%, and 5.7% at completion of training, respectfully. Worsening of depression, anxiety, and suicidal ideation occurred for 7.7%, 11.4%, and 4% of soldiers. Higher percentages of symptoms were associated with females, lower education, and lower income. Active duty personnel were more likely to worsen following training with respect to suicidal ideation (OR = 1.9, 95% CI = 1.2-2.9) compared to reservists. The identification of these significant predictors of mental health status may serve to identify individuals at risk. Additional work to examine the relative contribution of anticipatory (impending deployment) factors vs. training-related factors is warranted.

  8. Behaviour of medical students in seeking mental and physical health care: exploration and comparison with psychology students.

    Science.gov (United States)

    Brimstone, Renee; Thistlethwaite, Jill E; Quirk, Frances

    2007-01-01

    Doctors are often reluctant to seek health care through the usual channels and tend to self-diagnose and prescribe. Medical students learn attitudes and values from clinician role models and may also adopt behaviour patterns that lead them to seek help for physical and mental health problems from informal sources. This study aimed to explore the behaviour of students in seeking health care for physical and mental health problems, comparing medical with psychology students, and to understand what barriers to conventional routes of seeking health care may affect this. We administered a questionnaire asking for demographic details and responses to 2 vignettes in which a student from the respondent's discipline was experiencing firstly symptoms of a mental health problem and secondly symptoms of a physical health problem. Data were analysed with spss and univariate anovas to examine differences between respondents. A total of 172 students at the psychology and medical schools at James Cook University in Australia participated. We identified a number of barriers affecting student behaviour in seeking help, which included worries about knowing the doctor they could consult at the university health centre or having future dealings with him or her, and cost of treatment. There were differences between the 2 groups of students. There are several barriers for both psychology and medical students to accessing appropriate professional mental health care. Medical students also experience barriers to attaining appropriate physical health care when needed. Psychology and medical students were more likely to seek advice informally from friends and/or family with regard to mental health care.

  9. CHAMP: Cognitive behaviour therapy for health anxiety in medical patients, a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Murphy David

    2011-06-01

    Full Text Available Abstract Background Abnormal health anxiety, also called hypochondriasis, has been successfully treated by cognitive behaviour therapy (CBT in patients recruited from primary care, but only one pilot trial has been carried out among those attending secondary medical clinics where health anxiety is likely to be more common and have a greater impact on services. The CHAMP study extends this work to examine both the clinical and cost effectiveness of CBT in this population. Method/Design The study is a randomized controlled trial with two parallel arms and equal randomization of 466 eligible patients (assuming a 20% drop-out to an active treatment group of 5-10 sessions of cognitive behaviour therapy and to a control group. The aim at baseline, after completion of all assessments but before randomization, was to give a standard simple explanation of the nature of health anxiety for all participants. Subsequently the control group was to receive whatever care might usually be available in the clinics, which is normally a combination of clinical assessment, appropriate tests and reassurance. Those allocated to the active treatment group were planned to receive between 5 and 10 sessions of an adapted form of cognitive behaviour therapy based on the Salkovskis/Warwick model, in which a set of treatment strategies are chosen aimed at helping patients understand the factors that drive and maintain health anxiety. The therapy was planned to be given by graduate research workers, nurses or other health professionals trained for this intervention whom would also have their competence assessed independently during the course of treatment. The primary outcome is reduction in health anxiety symptoms after one year and the main secondary outcome is the cost of care after two years. Discussion This represents the first trial of adapted cognitive behaviour therapy in health anxiety that is large enough to test not only the clinical benefits of treatment but also

  10. Nutritional care of medical inpatients: a health technology assessment

    Directory of Open Access Journals (Sweden)

    Kruse Filip

    2006-02-01

    Full Text Available Abstract Background The inspiration for the present assessment of the nutritional care of medical patients is puzzlement about the divide that exists between the theoretical knowledge about the importance of the diet for ill persons, and the common failure to incorporate nutritional aspects in the treatment and care of the patients. The purpose is to clarify existing problems in the nutritional care of Danish medical inpatients, to elucidate how the nutritional care for these inpatients can be improved, and to analyse the costs of this improvement. Methods Qualitative and quantitative methods are deployed to outline how nutritional care of medical inpatients is performed at three Danish hospitals. The practices observed are compared with official recommendations for nutritional care of inpatients. Factors extraneous and counterproductive to optimal nutritional care are identified from the perspectives of patients and professional staff. A review of the literature illustrates the potential for optimal nutritional care. A health economic analysis is performed to elucidate the savings potential of improved nutritional care. Results The prospects for improvements in nutritional care are ameliorated if hospital management clearly identifies nutritional care as a priority area, and enjoys access to management tools for quality assurance. The prospects are also improved if a committed professional at the ward has the necessary time resources to perform nutritional care in practice, and if the care staff can requisition patient meals rich in nutrients 24 hours a day. At the kitchen production level prospects benefit from a facilitator contact between care and kitchen staff, and if the kitchen staff controls the whole food path from the kitchen to the patient. At the patient level, prospects are improved if patients receive information about the choice of food and drink, and have a better nutrition dialogue with the care staff. Better nutritional care of

  11. Development of Community Based Learning and Education system within Undergraduate Medical Curriculum of Patan Academy of Health Sciences.

    Science.gov (United States)

    Baral, K P; Upadhyay, S K; Bhandary, S; Gongal, R N; Karki, A

    2016-01-01

    In response to continuing health disparities between rural and urban population, Patan Academy of Health Sciences (PAHS) was established in 2008. It aimed to produce physicians who would be able and willing to serve in the rural areas. In order to empower them with understanding and tools to address health issues of rural population, an innovative curriculum was developed. This paper aims to describe the community based learning and education (CBLE) system within the overall framework of PAHS undergraduate medical curriculum. A Medical School Steering Committee (MSSC) comprising of a group of committed medical educators led the curriculum development process. The committee reviewed different medical curricula, relevant literatures, and held a series of consultative meetings with the stakeholders and experts within and outside Nepal. This process resulted in defining the desirable attributes, terminal competencies of the graduates, and then the actual development of the entire curriculum including CBLE. Given the critical importance of population health, 25% of the curricular weightage was allocated to the Community Health Sciences (CHS). CBLE system was developed as the primary means of delivering CHS curriculum. The details of CBLE system was finalized for implementation with the first cohort of medical students commencing their studies from June 2010. The CBLE, a key educational strategy of PAHS curriculum, is envisaged to improve retention and performance of PAHS graduates and, thereby, health status of rural population. However, whether or not that goal will be achieved needs to be verified after the graduates join the health system.

  12. 45 CFR 146.145 - Special rules relating to group health plans.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Special rules relating to group health plans. 146.145 Section 146.145 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO....145 Special rules relating to group health plans. (a) Group health plan—(1) Definition. A group...

  13. [Geographical distribution of medical expenditure for the aged insured by National Health Insurance in secondary medical care areas in Japan].

    Science.gov (United States)

    Zhang, T; Tanihara, S; Yanagawa, H

    1998-06-01

    To determine what factors affect medical expenditure for the aged insured by the National Health Insurance among secondary medical care areas. The original data of municipalities were combined and converted into the data of secondary medical areas. The original data included medical expenditure of the aged in 1994, medical supply factors per 100,000 population (numbers of doctors, numbers of general beds in hospitals, numbers of clinics, etc.) and socio-economic factors (income, proportion of employees for three sectors of industries, population density, average size of family, etc.). Medical expenditures for inpatients and outpatients were used separately as independent variables. The medical supply and socio-economic factors have been used as dependent variables. Multiple regression models were applied to clarify the differences in the contributing factors between inpatient and outpatient. 1. The maximum inpatient and outpatient medical expenditures for the aged are respectively 4 times and 2.6 times more expensive than minimum expenditures among secondary medical care areas. 2. The numbers of beds, income per capita, numbers of doctor, average size of family, proportion of employees for third level industry and income accounted for 57.4% of variance in inpatient medical expenditure of the aged. 3. The proportion of employees for first level industry, the numbers of beds and average members of family accounted for 21.4% of variance in outpatient medical expenditure of the aged. 4. Medical expenditure for inpatients related with medical supply and socioeconomic factors differently from that of outpatients.

  14. 76 FR 58007 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2011-09-19

    ... HUMAN SERVICES Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public... Secretary for Health, Office of the Surgeon General of the United States Public Health Service. ACTION... Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (the ``Advisory...

  15. 76 FR 67731 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2011-11-02

    ... HUMAN SERVICES Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public... Secretary for Health, Office of the Surgeon General of the United States Public Health Service. ACTION... the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (the...

  16. 78 FR 48877 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2013-08-12

    ... HUMAN SERVICES Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health AGENCY: Office of the Surgeon General of the United States Public Health Service, Office of the... Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (the ``Advisory...

  17. 78 FR 14798 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2013-03-07

    ... HUMAN SERVICES Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public... Secretary for Health, Office of the Surgeon General of the United States Public Health Service. ACTION... ] Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (the ``Advisory...

  18. 78 FR 38345 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2013-06-26

    ... HUMAN SERVICES Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health AGENCY: Office of the Surgeon General of the United States Public Health Service, Office of the... Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (the ``Advisory...

  19. 78 FR 69853 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2013-11-21

    ... HUMAN SERVICES Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health AGENCY: Office of the Surgeon General of the United States Public Health Service, Office of the... Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (the ``Advisory...

  20. 77 FR 15372 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2012-03-15

    ... HUMAN SERVICES Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public... Secretary for Health, Office of the Surgeon General of the United States Public Health Service. ACTION... Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (the ``Advisory...

  1. 75 FR 27121 - Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Dependent...

    Science.gov (United States)

    2010-05-13

    ... Health Plans and Health Insurance Issuers Relating to Dependent Coverage of Children to Age 26 Under the... and Health Insurance Issuers Relating to Dependent Coverage of Children to Age 26 Under the Patient... implementing the requirements for group health plans and health insurance issuers in the group and individual...

  2. 75 FR 43329 - Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Internal...

    Science.gov (United States)

    2010-07-23

    ... Group Health Plans and Health Insurance Issuers Relating to Internal Claims and Appeals and External... CFR Part 147 RIN 0991-AB70 Interim Final Rules for Group Health Plans and Health Insurance Issuers... Administration, Department of Labor; Office of Consumer Information and Insurance Oversight, Department of Health...

  3. Community Residency Programme (CRP)--a tool for research and rural health training for medical students.

    Science.gov (United States)

    Yadav, H

    2002-12-01

    Rural health training is an important element in the training of medical students in the University of Malaya. There is a need for the undergraduates to be familiar with the rural health infrastructure and to understand the social and economic aspects of the rural poor. The objective of the training is to make the students understand the problems faced by the poor in the rural areas so that when they practice in rural health areas, after graduation, they will understand the problems of the rural poor. They will have the knowledge of the diseases in the rural areas and also understand the community and the environmental factors that contribute to the disease. The training lasts' for 4 weeks, one week for lectures on health survey, two weeks for the field trip and one week of data analysis and presentation of their findings to an expert panel. During the field trip the students are divided into groups and they go to different parts of the country. Each group will do a field survey to find out the socio-demography, environmental, economic, nutritional and health problems in the village. In addition to the survey they also do a research project on any topic. The students also do social work, visit places of public health interest like the water treatment plant, sewage disposal, factory visits and others. Apart from technical skills in statistics and epidemiology, various other managerial skills like leadership, teamwork, communications and public relations are also learnt during the training. In conclusion this rural health training is an important aspect of the medical students training as it imparts several skills to them that are needed as a doctor.

  4. Group-sparse representation with dictionary learning for medical image denoising and fusion.

    Science.gov (United States)

    Li, Shutao; Yin, Haitao; Fang, Leyuan

    2012-12-01

    Recently, sparse representation has attracted a lot of interest in various areas. However, the standard sparse representation does not consider the intrinsic structure, i.e., the nonzero elements occur in clusters, called group sparsity. Furthermore, there is no dictionary learning method for group sparse representation considering the geometrical structure of space spanned by atoms. In this paper, we propose a novel dictionary learning method, called Dictionary Learning with Group Sparsity and Graph Regularization (DL-GSGR). First, the geometrical structure of atoms is modeled as the graph regularization. Then, combining group sparsity and graph regularization, the DL-GSGR is presented, which is solved by alternating the group sparse coding and dictionary updating. In this way, the group coherence of learned dictionary can be enforced small enough such that any signal can be group sparse coded effectively. Finally, group sparse representation with DL-GSGR is applied to 3-D medical image denoising and image fusion. Specifically, in 3-D medical image denoising, a 3-D processing mechanism (using the similarity among nearby slices) and temporal regularization (to perverse the correlations across nearby slices) are exploited. The experimental results on 3-D image denoising and image fusion demonstrate the superiority of our proposed denoising and fusion approaches.

  5. Small group effectiveness during pharmacology learning sessions in a Nepalese medical school

    Directory of Open Access Journals (Sweden)

    Shankar PR

    2011-06-01

    Full Text Available BackgroundSmall group learning sessions are used in pharmacology atthe KIST Medical College, Lalitpur, Nepal. Feedback aboutstudent behaviours that enhance and hinder small groupeffectiveness was obtained. This will help us improve thesmall group sessions and will also be useful to educatorsusing small groups in other medical schools.MethodThe small groups were self-managing with a group leader,time-keeper, recorder and presenter. Small groupeffectiveness was measured using the Tutorial GroupEffectiveness Instrument (TGEI developed by Singaram andco-authors. The instrument was administered in June 2010and key findings obtained were shared with students andfacilitators. The instrument was administered again inAugust. The mean cognitive, motivational, demotivationaland overall scores were compared among differentcategories of respondents in June and August. Scores werealso compared between June and August 2010.ResultsA total of 89 students participated in the study in June and88 in August 2010. In June, females rated overall groupproductivity higher compared to males. The cognitive andmotivational scores were higher in August 2010 while thedemotivational score was lower.ConclusionThe small group effectiveness was higher in August after theeducational intervention which utilised feedback aboutproblems observed, theoretical considerations of effectivesmall groups and how this information can be applied inpractice.

  6. Exposure To Violence And Occupational Satisfaction Of Health Personnal In A Health Group Area

    Directory of Open Access Journals (Sweden)

    Elcin Balci

    2011-02-01

    Full Text Available Purpose: In this study, it evaluted that exposure to violence and effect of this exposure to occupational satisfaction of health personel in Melikgazi Health Group Area. Materials And Methods: This cross sectional and descriptive study was performed in April-May 2006. Sampling not planned, it assumed to reach all of health personel. Data were analysed using computer and chi square test were used for statistical analyses. Lesser than 0,05 values were accepted as statistically significant. Results: Of the research group 66,7 % were female and 33,3 % were male. Mean age was 34,48 ± 5,73 years. Of the study participants were working in health center, 80,4 % day time and 19,6 % in night time and mean duration of working was 11,99 ± 5,3 years. Of the study group 57,1 % were chosen profession willingly and 65,5 % of them didn’t want to their children chose same profession. Of the study group 68,2 % were thought their fare were not enough. Of the study group, 50,3 % were experinced verbal and/or physical violence with different degrees. Of the violence victims 63,6 % were working in night shift of health centers and most of them doctors. Conclusion: Exposure to violence during work effects the satisfaction negativeley. [TAF Prev Med Bull 2011; 10(1.000: 13-18

  7. Refining a personalized mHealth intervention to promote medication adherence among HIV+ methamphetamine users.

    Science.gov (United States)

    Montoya, Jessica L; Georges, Shereen; Poquette, Amelia; Depp, Colin A; Atkinson, J Hampton; Moore, David J

    2014-01-01

    Mobile health (mHealth) interventions to promote antiretroviral therapy (ART) adherence have shown promise; however, among persons living with HIV who abuse methamphetamine (MA), effective tailoring of content to match the expressed needs of this patient population may be necessary. This study aimed (1) to understand patient perspectives of barriers and facilitators of ART adherence among people with HIV who use MA, and (2) to obtain feedback on the thematic content of an mHealth intervention in order to tailor the intervention to this subgroup. Two separate focus groups, each with 10 HIV+/MA+ individuals, were conducted. Transcribed audio recordings were qualitatively analyzed to identify emergent themes. Inter-rater reliability of themes was high (mean Kappa = .97). Adherence barriers included MA use, misguided beliefs about ART adherence, memory and planning difficulties, social barriers and perceived stigma, and mental heath issues. Facilitators of effective ART adherence were cognitive compensatory strategies, promotion of well-being, health-care supports, adherence education, and social support. Additionally, the focus groups generated content for reminder text messages to be used in the medication adherence intervention. This qualitative study demonstrates the feasibility of using focus groups to derive patient-centered intervention content to address the health challenge at hand in targeted populations.

  8. Integrating Public Health and Health Promotion Practice in the Medical Curriculum: A Self-Directed Team-Based Project Approach.

    Science.gov (United States)

    Kershaw, Geraldine; Grivna, Michal; Elbarazi, Iffat; AliHassan, Souheila; Aziz, Faisal; Al Dhaheri, Aysha Ibrahim

    2017-01-01

    Preparing health professionals in health promotion (HP) and disease prevention is essential for improvement of population health, community HP, and better health care for individuals. The aim of this article is to describe an HP project in the form of a major self-directed project-based learning task integrated within the curriculum in the second year of the medical degree program at United Arab Emirates University. The project introduces students to public health and HP practice and develops students' literature searching, writing, presentation skills, and team work. Students learn the principles underlying behavioral change, and the design of HP programs and materials, through a lecture format. Small groups of students each choose a specific health topic for their project. Over 11 weeks, students obtain information about their topic from appropriate sources (library, PubMed, Google Scholar, credible health sources such as World Health Organization). Using the principles learned in the lectures, they develop appropriate materials for their target audience: for example, posters, a pamphlet, social media content, or a video or radio message. Students seek advice from specialist faculty as needed. In week 12, each team presents their project background, rationale, and materials to their colleagues in a seminar format open to all faculty. They then submit the materials they developed for assessment. Group marks are assigned for presentations and materials. Key concepts are assessed by multiple choice questions in comprehensive course examinations. By participation in the HP project, many students develop a solid background in prevention. The information retrieval, writing, and presentation skills, as well as experience of team work, are valuable both for the remaining years of their training and their future careers.

  9. Relationship Between Health Literacy and Unintentional and Intentional Medication Nonadherence in Medically Underserved Patients With Type 2 Diabetes.

    Science.gov (United States)

    Fan, Jessica H; Lyons, Sarah A; Goodman, Melody S; Blanchard, Melvin S; Kaphingst, Kimberly A

    2016-04-01

    The purpose of this study was to investigate the relationship between health literacy and overall medication nonadherence, unintentional nonadherence, and intentional nonadherence. Limited health literacy may be associated with worse diabetes outcomes, but the literature shows mixed results, and mechanisms remain unclear. Medication adherence is associated with diabetes outcomes and may be a mediating factor. Distinguishing between unintentional and intentional nonadherence may elucidate the relationship between health literacy and nonadherence in patients with type 2 diabetes. Cross-sectional study of 208 patients with type 2 diabetes recruited from a primary care clinic in St. Louis, Missouri. Information was obtained from written questionnaire and patient medical records. Bivariate and multivariable regression were used to examine predictors of medication nonadherence. The majority of patients in the study were low income, publicly insured, and African American, with limited health literacy and a high school/GED education or less. In multivariable models, limited health literacy was significantly associated with increased unintentional nonadherence but not intentional nonadherence. Results suggest differences in factors affecting intentional and unintentional nonadherence. The findings also suggest interventions are needed to decrease unintentional nonadherence among patients with type 2 diabetes and limited health literacy. Efforts to address unintentional medication nonadherence among patients with type 2 diabetes with limited health literacy may improve patient health. © 2016 The Author(s).

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

    Science.gov (United States)

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

    2014-01-01

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

  11. Experiences of sickness absence, marginality and Medically Unexplained Physical Symptoms - A focus group study

    DEFF Research Database (Denmark)

    E.L., Werner; A, Aamland; Malterud, Kirsti

    2013-01-01

    with a purposive sample of 12 participants, six men and six women, aged 24-59 years. Their average duration of sickness absence was 10.5 months. Participants were invited to share stories about experiences from the process leading to the ongoing sickness absence, with a focus on the causes being medically......PURPOSE: Medically unexplained physical symptoms (MUPS) form a major cause of sickness absence. The purpose of this study was to explore factors which may influence further marginalization among patients with MUPS on long-term sickness absence. METHODS: Two focus-group discussions were conducted...

  12. Cultural affiliation and the importance of health care attributes. Marketers can develop segmentation strategies for targeted patient groups.

    Science.gov (United States)

    Dolinsky, A L; Stinerock, R

    1998-01-01

    Culturally based values are known to influence consumer purchase decisions, but little is known about how those values affect health care choices. To rectify that situation and provide health care marketers with a framework for developing culturally based segmentation strategies, the authors undertook an exploratory research project in which Hispanic-, African-, and Anglo-Americans were asked to rate the importance of 16 different health care attributes. Those attributes can be grouped under five categories: quality of physician, quality of nurses and other medical staff, economic issues, access to health care, and nonmedically related experiential aspects. Survey responses identified distinct differences in the importance attached to the various attributes by the three cultural groups. The study also looks at the impact of six demographic and social characteristics on the evaluations made by each cultural group. Those characteristics are educational level, gender, age, health status, marital status, and number of people living in the household.

  13. Proposal for a European Public Health Research Infrastructure for Sharing of health and Medical administrative data (PHRIMA).

    Science.gov (United States)

    Burgun, Anita; Oksen, Dina V; Kuchinke, Wolfgang; Prokosch, Hans-Ulrich; Ganslandt, Thomas; Buchan, Iain; van Staa, Tjeerd; Cunningham, James; Gjerstorff, Marianne L; Dufour, Jean-Charles; Gibrat, Jean-Francois; Nikolski, Macha; Verger, Pierre; Cambon-Thomsen, Anne; Masella, Cristina; Lettieri, Emanuele; Bertele, Paolo; Salokannel, Marjut; Thiebaut, Rodolphe; Persoz, Charles; Chêne, Geneviève; Ohmann, Christian

    2015-01-01

    In Europe, health and medical administrative data is increasingly accumulating on a national level. Looking further than re-use of this data on a national level, sharing health and medical administrative data would enable large-scale analyses and European-level public health projects. There is currently no research infrastructure for this type of sharing. The PHRIMA consortium proposes to realise the Public Health Research Infrastructure for Sharing of health and Medical Administrative data (PHRIMA) which will enable and facilitate the efficient and secure sharing of healthcare data.

  14. Inclusion of vulnerable groups in health policies: Regional policies on health priorities in Africa

    Directory of Open Access Journals (Sweden)

    Margie Schneider

    2013-01-01

    Full Text Available Background: If access to equitable health care is to be achieved for all, policy documents must mention and address in some detail different needs of groups vulnerable to not accessing such health care. If these needs are not addressed in the policy documents, there is little chance that they will be addressed at the stage of implementation.Objectives: This paper reports on an analysis of 11 African Union (AU policy documents to ascertain the frequency and the extent of mention of 13 core concepts in relation to 12 vulnerable groups, with a specific focus on people with disabilities.Method: The paper applied the EquiFrame analytical framework to the 11 AU policy documents. The 11 documents were analysed in terms of how many times a core concept was mentioned and the extent of information on how the core concept should be addressed at the implementation level. Each core concept mention was further analysed in terms of the vulnerable group in referred to.Results: The analysis of regional AU policies highlighted the broad nature of the reference made to vulnerable groups, with a lack of detailed specifications of different needs of different groups. This is confirmed in the highest vulnerable group mention being for ‘universal’. The reading of the documents suggests that vulnerable groups are homogeneous in their needs, which is not the case. There is a lack of recognition of different needs of different vulnerable groups in accessing health care.Conclusion: The need for more information and knowledge on the needs of all vulnerable groups is evident. The current lack of mention and of any detail on how to address needs of vulnerable groups will significantly impair the access to equitable health care for all.

  15. 78 FR 74163 - Harrison Medical Center, a Subsidiary of Franciscan Health System Bremerton, Washington; Notice...

    Science.gov (United States)

    2013-12-10

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR Employment and Training Administration Harrison Medical Center, a Subsidiary of Franciscan Health System... Adjustment Assistance (TAA), applicable to workers and former workers of Harrison Medical Center,...

  16. 42 CFR 410.10 - Medical and other health services: Included services.

    Science.gov (United States)

    2010-10-01

    ... other diagnostic tests. (f) X-ray therapy and other radiation therapy services. (g) Medical supplies, appliances, and devices. (h) Durable medical equipment. (i) Ambulance services. (j) Rural health...

  17. 77 FR 28788 - Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Under the Patient Protection and...

    Science.gov (United States)

    2012-05-16

    ... HUMAN SERVICES 45 CFR Part 158 Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Under the... Federal Register on December 1, 2010, entitled ``Health Insurance Issuers Implementing Medical Loss Ratio... published in the Federal Register on December 30, 2010, entitled ``Health Insurance Issuers Implementing...

  18. 75 FR 29560 - Identifying Unmet Public Health Needs and Facilitating Innovation in Medical Device Development...

    Science.gov (United States)

    2010-05-26

    ... No. FDA-2010-N-0237] Identifying Unmet Public Health Needs and Facilitating Innovation in Medical...) is announcing a public workshop entitled ``Identifying Unmet Public Health Needs and Facilitating... identify the most important unmet public health needs, the barriers to innovative medical...

  19. Oeconomic thinking – efficient healing: health oeconomy as a new topic in medical faculties

    Directory of Open Access Journals (Sweden)

    Fleßa, Steffen

    2005-01-01

    Full Text Available Health economics is the science of efficiency in health care systems. The following paper presents some basic concepts of this new subject of medical curricula. It is based on the experience of the University of Heidelberg where all medical students have to study essentials of health economics in their fifth semester.

  20. Health economics evidence for medical nutrition: are these interventions value for money in integrated care?

    Directory of Open Access Journals (Sweden)

    Walzer S

    2014-05-01

    to pay threshold used in health care rarely was applied. Often, these products are either directly part of a lump sum in the financing system (for example, diagnosis-related groups, or they are covered as out-of-pocket payments by patients directly. More research would be necessary to better understand how medical nutrition interventions can be optimally funded by the health care system, given the clinical value they bring to patients in their recovery process. Keywords: systematic review, medical nutrition, health economics

  1. Mental health in medical residents: relationship with personal, work-related, and sociodemographic variables

    Directory of Open Access Journals (Sweden)

    Karina Pereira-Lima

    2016-01-01

    Full Text Available Objective: To examine association of sociodemographic characteristics, personality traits, social skills, and work variables with anxiety, depression, and alcohol dependence in medical residents. Methods: A total of 270 medical residents completed the following self-report instruments: sociodemographic and work questionnaire, Patient Health Questionnaire-4 (PHQ-4, Alcohol Use Disorders Identification Test-3 (AUDIT-3, Revised NEO-Five Factor Inventory (NEO-FFI-R, and Social Skills Inventory (SSI-Del-Prette. Data were analyzed using descriptive statistics and univariate and multivariate logistic regression analyses. Results: Multivariate analysis showed an association of neuroticism (odds ratio [OR] 2.60, p < 0.001, social skills (OR 0.41, p < 0.01, and number of shifts (OR 1.91, p = 0.03 with anxiety or depression, and of male sex (OR 3.14, p = 0.01, surgical residency (OR 4.40, p = 0.001, extraversion (OR 1.80, p < 0.01, and number of shifts (OR 2.32, p = 0.04 with alcohol dependence. Conclusion: The findings support a multidetermined nature of mental health problems in medical residents, in addition to providing data that may assist in the design of preventive measures to protect the mental health of this group.

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

    Science.gov (United States)

    Nakamura, Koshi

    2014-01-01

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

  3. [Primary health care reform and implications for the organizational culture of Health Center Groups in Portugal].

    Science.gov (United States)

    Leone, Claudia; Dussault, Gilles; Lapão, Luís Velez

    2014-01-01

    The health sector's increasing complexity poses major challenges for administrators. There is considerable consensus on workforce quality as a key determinant of success for any health reform. This study aimed to explore the changes introduced by an action-training intervention in the organizational culture of the 73 executive directors of Health Center Groups (ACES) in Portugal during the primary health care reform. The study covers two periods, before and after the one-year ACES training, during which the data were collected and analyzed. The Competing Values Framework allowed observing that after the ACES action-training intervention, the perceptions of the executive directors regarding their organizational culture were more aligned with the practices and values defended by the primary health care reform. The study highlights the need to continue monitoring results over different time periods to elaborate further conclusions.

  4. Student satisfaction and self-assessment after small group discussion in a medical ethics education program.

    Science.gov (United States)

    Joh, Hee-Kyung; Shin, Jwa-Seop

    2009-09-01

    Small group discussions are useful tools in medical ethics education. We aimed to assess student satisfaction with specific components of a small group discussion and to evaluate student self-assessment of the objectives of education. A structured questionnaire was developed after a literature review and a focus group interview. Components of the small group discussion were categorized by discussion case (self, other), individual activities (self-study, making materials, presentation experience), and group activities (preclass/in-class/postclass/plenary discussion, instructor's comments). The items for student self-assessment were: "To specify ethical issue in actual practice", "To get new knowledge", "To consider doctor's entity", "Empathy to others", "To get multidimensional viewpoint", "Viewpoint change", "To deliver my thought clearly", and "Ability to confront the medical ethics dilemma in the future". After the survey, an in-depth interview was performed to determine the reason behind the students' answers. A total of 121 students responded, for whom overall satisfaction and self-assessment were high. Students reported greater satisfaction with self-case, presentation experience, in-class discussion, and instructor's comments but less satisfaction with self-study before class and postclass discussion. Student self-assessment was highest in the ability to specify an ethical issue and lowest for viewpoint change and self-confidence. After multivariate analysis, higher student self-assessment was associated with greater satisfaction with the small group discussion. To improve the quality of medical ethics education, close investigation and monitoring of each component of the small group discussion and student achievement are essential, as is continuous feedback.

  5. Mental health provider perspectives regarding integrated medical care for patients with serious mental illness.

    Science.gov (United States)

    Kilbourne, Amy M; Greenwald, Devra E; Bauer, Mark S; Charns, Martin P; Yano, Elizabeth M

    2012-11-01

    Integrated care for medical conditions is essential for persons with serious mental illness (SMI). This qualitative study describes mental health provider perspectives regarding barriers and facilitators of integrated care for patients with SMI. We interviewed providers from a national sample of Veterans Health Administration facilities that scored in the top or bottom percentile in medical care quality. Providers from high-performing sites reported substantial in-person contacts with general medical providers, while providers from low-performing sites reported stigma and limited communication with medical providers as major concerns. Interventions to improve mental health and medical provider communication may facilitate integrated care for persons with SMI.

  6. Final-year medical students′ perceptions regarding the curriculum in public health

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    Mitrakrishnan Rayno Navinan

    2011-01-01

    Full Text Available Background: The Faculty of Medicine, University of Colombo, has an integrated curriculum in which teaching of public health takes place through a series of modules which span the full five-year study programme. Aim: To assess final year medical student perceptions regarding the public health curriculum and to identify factors which influence this. Materials and Methods: The study was cross sectional. Convenience sampling was utilized on final-year students of the Faculty of Medicine, University of Colombo, Sri Lanka. A self-administered 4-point Likert scale questionnaire covered general opinion on public healthcare and perceptions about the curriculum. Data were analyzed using descriptive statistics and Chi-square tests. Results: One hundred and eighty four students (94% participated in the study. Eighty-two percent (148 viewed public health as an important field. Only 9% (16 were interested in a career in public health. A significant association was found between choosing public health as career and the following: perception of public health as an important field; holding a good opinion about public health prior to commencement of the course; having found the field-based experience enjoyable and beneficial to the community; and feeling competent to work in the community at the end of the course (P < 0.01. With regard to teaching methods, group activities and discussion-centered activities were identified positively (153, 83% and 125, 68% respectively. The majority of students indicated that they were not stimulated to read more on the subject or regularly revise what they have learnt, both during the introductory public health programme and during the final year. Conclusions: The curriculum has been able to create a positive opinion about public health. However, students lack enthusiasm to learn independently. Experiential, group-centered teaching activities and a constructivist approach may be more effective in promoting independent learning

  7. An overiew of non medical prescribing across one strategic health authority: a questionnaire survey

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    Courtenay Molly

    2012-06-01

    Full Text Available Abstract Background Over 50,000 non-medical healthcare professionals across the United Kingdom now have prescribing capabilities. However, there is no evidence available with regards to the extent to which non-medical prescribing (NMP has been implemented within organisations across a strategic health authority (SHA. The aim of the study was to provide an overview of NMP across one SHA. Methods NMP leads across one SHA were asked to supply the email addresses of NMPs within their organisation. One thousand five hundred and eighty five NMPs were contacted and invited to complete an on-line descriptive questionnaire survey, 883 (55.7% participants responded. Data was collected between November 2010 and February 2011. Results The majority of NMPs were based in primary care and worked in a team of 2 or more. Nurse independent supplementary prescribers were the largest group (590 or 68.6% compared to community practitioner prescribers (198 or 22.4%, pharmacist independent supplementary prescribers (35 or 4%, and allied health professionals and optometrist independent and/or supplementary prescribers (8 or 0.9%. Nearly all (over 90% of nurse independent supplementary prescribers prescribed medicines. Approximately a third of pharmacist independent supplementary prescribers, allied health professionals, and community practitioner prescribers did not prescribe. Clinical governance procedures were largely in place, although fewer procedures were reported by community practitioner prescribers. General practice nurses prescribed the most items. Factors affecting prescribing practice were: employer, the level of experience prior to becoming a non-medical prescriber, existence of governance procedures and support for the prescribing role (p  Conclusion NMP in this strategic health authority reflects national development of this relatively new role in that the majority of non-medical prescribers were nurses based in primary care, with fewer pharmacist and

  8. Characteristics of the Cochrane Oral Health Group systematic reviews.

    Science.gov (United States)

    Teich, Sorin T; Lang, Lisa A; Demko, Catherine A

    2015-01-01

    The Cochrane Oral Health Group (COHG) was formed in 1994 with the aim of producing systematic reviews that primarily include oral health randomized controlled trials (RCTs). The purpose of this cross-sectional study was to characterize reviews published by the COHG. In September 2013, the COHG database was accessed, and all publications were downloaded. Reviews with no studies identified according to the inclusion criteria were labeled "empty reviews." The complete Cochrane database included a total of 5,697 reviews, of which the COHG database included 142 reviews. Of these 142, 69 (48.6%) did not reach a conclusion, including 20 (14.1%) that were identified as empty reviews. Of the 122 non-empty reviews, 116 (95.1%) were based exclusively on RCTs. The median number of RCTs and patients included in the non-empty reviews were seven and 489, respectively. The median number of included RCTs and patients for reviews that reached conclusions were 12 and 934, respectively, and there were five RCTs and 211 patients for reviews without conclusions. Overall, the characteristics of the Cochrane oral health reviews (OH-CSRs) were similar to Cochrane reviews published in other disciplines (All-CSRs). The authors observed a significant difference in the median number of RCTs and patients included when reviews that reached conclusions were separated from those that did not. A greater proportion of empty reviews were present in OH-CSRs compared with All-CSRs. Turning the Cochrane reviews into a tool that is more relevant in clinical practice will require implementation of a methodology allowing inclusion of non-RCTs while controlling for possible bias.

  9. An evaluation of the impact of patient cost sharing for antihypertensive medications on adherence, medication and health care utilization, and expenditures

    Directory of Open Access Journals (Sweden)

    Pesa JA

    2012-01-01

    Full Text Available Jacqueline A Pesa1, Jill Van Den Bos2, Travis Gray2, Colleen Hartsig2, Robert Brett McQueen3, Joseph J Saseen3, Kavita V Nair31Janssen Scientific Affairs, LLC, Louisville, CO, USA; 2Milliman, Inc, Denver, CO, USA; 3University of Colorado Anschutz Medical Campus, Aurora, CO, USAObjective: To assess the impact of patient cost-sharing for antihypertensive medications on the proportion of days covered (PDC by antihypertensive medications, medical utilization, and health care expenditures among commercially insured individuals assigned to different risk categories.Methods: Participants were identified from the Consolidated Health Cost Guidelines (CHCG database (January 1, 2006–December 31, 2008 based on a diagnosis (index claim for hypertension, continuous enrollment ≥12 months pre- and post-index, and no prior claims for antihypertensive medications. Participants were assigned to: low-risk group (no comorbidities, high-risk group (1+ selected comorbidities, or very high-risk group (prior hospitalization for 1+ selected comorbidities. The relationship between patient cost sharing and PDC by antihypertensive medications was assessed using standard linear regression models, controlling for risk group membership, and various demographic and clinical factors. The relationship between PDC and health care service utilization was subsequently examined using negative binomial regression models.Results: Of the 28,688 study patients, 66% were low risk. The multivariate regression model supported a relationship between patient cost sharing per 30-day fill and PDC in the following year. For every US$1.00 increase in cost sharing, PDC decreased by 1.1 days (P < 0.0001. Significant predictors of PDC included high risk, older age, gender, Charlson Comorbidity Index score, geography, and total post-index insurer- and patient-paid costs. An increase in PDC was associated with a decrease in all-cause and hypertension-related inpatient, outpatient, and emergency

  10. Strategies for community-based medication management services in value-based health plans.

    Science.gov (United States)

    Smith, Marie A; Spiggle, Susan; McConnell, Brody

    Health plans are moving away from a volume-driven payment structure toward value-driven and risk-based contracts. There is very limited information on commercial payers' perspectives on coverage of medication management services (MMS) in value-based alternative payment models. While some health plans have experience with Medicare Part D Medication Therapy Management (MTM) programs, this experience does not promote the integration of pharmacists as health care team members. The study objectives were to: (1) understand the evaluation process that health plan executives would use to determine benefit coverage for pharmacist-provided MMS in value-based health plans, (2) identify the facilitators and barriers that affect pharmacist-provided MTM services at the community pharmacy level, and (3) propose strategies for pharmacist-provided MMS in value-based health plans. This study used qualitative research methods that involved structured key informant interviews with commercial health plan executives and focus groups with community pharmacists who had experience providing MTM services. Health plan executives agreed conceptually that MMS could be a valuable program and recognized its potential. However, the most substantial barriers that health plan executives expressed were funding MMS in today's fee-for-service payment models; lack of physician infrastructure to implement and manage MMS; and difficulty in collecting timely, accurate data to execute and assess MMS programs. Community pharmacists identified the most serious barrier to altering health outcomes through MTM as the current lack of integration of MTM with a coordinated health care team. MTM services are conducted as a separate program by pharmacists who do not have access to patient health records, are time-constrained, and poorly incentivized. The findings can inform the development of successful strategies for pharmacist-provided MMS that align with emerging value-based health plans and alternative provider

  11. Contributions of medical family therapy to the changing health care system.

    Science.gov (United States)

    Doherty, William J; McDaniel, Susan H; Hepworth, Jeri

    2014-09-01

    Medical family therapy is a form of professional practice that uses a biopsychosocial approach and systemic family therapy principles in the collaborative treatment of individuals and families dealing with medical problems. It emerged out of the experience of family therapists working in primary medical care settings in the 1980s and 1990s. This article describes how contemporary medical family therapy can contribute to a transformed health care system in four areas: the patient experience of health care, the health of the population, the containment of health care costs, and enhanced practice environments. © 2014 FPI, Inc.

  12. Medical wage slave or worthy professional? The Dutch medical profession and the health funds 1900-1941

    NARCIS (Netherlands)

    L.A. van der Valk (Loes)

    2010-01-01

    textabstractSummary The development of mutual and commercial health insurance, and state health insurance programs in particular, typically provoked much criticism from the professionals involved with them. Moreover, the efforts of the Dutch medical association, the NMG, to influence state proposals

  13. The Nigerian health care system: Need for integrating adequate medical intelligence and surveillance systems

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    Menizibeya Osain Welcome

    2011-01-01

    Full Text Available Objectives : As an important element of national security, public health not only functions to provide adequate and timely medical care but also track, monitor, and control disease outbreak. The Nigerian health care had suffered several infectious disease outbreaks year after year. Hence, there is need to tackle the problem. This study aims to review the state of the Nigerian health care system and to provide possible recommendations to the worsening state of health care in the country. To give up-to-date recommendations for the Nigerian health care system, this study also aims at reviewing the dynamics of health care in the United States, Britain, and Europe with regards to methods of medical intelligence/surveillance. Materials and Methods : Databases were searched for relevant literatures using the following keywords: Nigerian health care, Nigerian health care system, and Nigerian primary health care system. Additional keywords used in the search were as follows: United States (OR Europe health care dynamics, Medical Intelligence, Medical Intelligence systems, Public health surveillance systems, Nigerian medical intelligence, Nigerian surveillance systems, and Nigerian health information system. Literatures were searched in scientific databases Pubmed and African Journals OnLine. Internet searches were based on Google and Search Nigeria. Results : Medical intelligence and surveillance represent a very useful component in the health care system and control diseases outbreak, bioattack, etc. There is increasing role of automated-based medical intelligence and surveillance systems, in addition to the traditional manual pattern of document retrieval in advanced medical setting such as those in western and European countries. Conclusion : The Nigerian health care system is poorly developed. No adequate and functional surveillance systems are developed. To achieve success in health care in this modern era, a system well grounded in routine

  14. Lecture-based Versus Problem-Based Learning Methods in Public Health Course for Medical Students

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    Hossein Jabbari

    2012-12-01

    Full Text Available Introduction: Problem-based learning (PBL method has progressed as an alternative to lecture-based learning (LBL method in recent decades. Benefits of PBL clearly supported by researches however several items remain unclear especially in Iranian medical universities. The aim of this paper is to compare the learning outputs of PBL and LBL methods. Methods: In this cross- sectional study public health course was prepared for three groups of students. Group 1 included medical students (n=101, Group 2 dentistry students (n=54, and Group 3 was formed of pharmacy students (n=112. Scores of final exam as well as 10 similar- root questions as a short-term outcome, scores in national basic science exam, recent similar informal exam as a mid-term output in addition to course evaluation by students, and assessment of attitude about PBL were compared between groups. Data analysis was performed by SPSS-11 using means’ comparison. Results: Scores of students in PBL group was significantly higher in final exam (P<0.001. The percentage of correct responses to 10 same- root questions in PBL (M= 6.68 were significantly higher (M=6.54. Faculty members were evaluated better in PBL group (P<0.001 in all aspects of teaching. Totally, the students who evaluated teachers in PBL group had 2 points more than LBL group (P<0.001. Scores of students in national exam (after two years and the recent survey (in the third year were higher in PBL group (P<0.001. Conclusion: Results of using PBL method indicated the higher rate of scores and better recalling of learned materials in this method.

  15. Do our medical colleges inculcate health-promoting lifestyle among medical students: a pilot study from two medical colleges from southern India.

    Science.gov (United States)

    Majra, Jp

    2013-04-01

    Behavioral risk factors are responsible for a substantial portion of chronic disease. Educating patients is a professional responsibility of medical practitioners. However, it has been observed that physicians did not practice what they preach. To study whether medical colleges inculcate health-promoting lifestyle among medical students during their stay in medical colleges. A cross-sectional study conducted in two conveniently selected medical colleges in southern India. Fourth year MBBS students were included in the study. A pre-tested self-administered multiple choice type questionnaire was used to collect data. Information was sought on the behavioral factors, namely smoking, alcohol use, junk food consumption, and physical activity, before joining the medical college and at the time of the study. SPSS version 10.0 was used to analyze the data. Frequencies, proportions, chi-square test. Out of 176 respondents, 94 (53%) were males and 82 (47%) were females. The number of smokers had increased from 24 (13.6%) to 46 (26.1%) and the number of alcohol consumers from 34 (19.3%) to 77 (43.8%) since they joined medical college. The number of students doing any physical activity declined from 76 (43.2%) to 43 (24.4%) and their food habits became unhealthier during the same period. The study reported an increase in health-risking behavior and a decline in health-promoting behavior among medical students during their stay in medical college.

  16. HEALTH SURVEY AND LIFE HABITS OF NURSES WHO WORK AT THE MEDICAL FACULTY HOSPITAL AT AIBU

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    Fatih DENIZ

    2005-04-01

    Full Text Available Objectives: Nursing is an occupation needed renunciation, patience and physical endurance. Nurses have to prevent their physical and mental health, because they can be more beneficial to patients. A cross-sectional study was conducted on AIBU Duzce Medical School Nurses to determine health problems and nutritional habits. Materials and Methods: The questionnaires forms filled by 79 nurses(%86 and analysed the data using an statistical package programme. Results: Mean age of the study group was 23.5 ± 0.2(Standard Erroryears. The answer to ‘Do you satisfied in your life?’question was reported ‘fair’ in 39.7% of the group. 65.7% reported no physical activity. Skipped meals were 80.9%. The most frequent health problems were reported as low back pain (52.9%, back pain (48.5%, stomach pain (48.5%, shoulder pain (38.2% and neck pain (38.2%. Twenty-six and half percent of the group were not immunized against to Hepatitis B. Conclusion: Occupational health and safety unit must be established in workplace. Training about occupational risks and stress management must be given to nurses. [TAF Prev Med Bull 2005; 4(2.000: 55-65

  17. The Association of Health Literacy with Illness and Medication Beliefs among Patients with Chronic Obstructive Pulmonary Disease

    Science.gov (United States)

    Kale, Minal S.; Federman, Alex D.; Krauskopf, Katherine; Wolf, Michael; O’Conor, Rachel; Martynenko, Melissa; Leventhal, Howard; Wisnivesky, Juan P.

    2015-01-01

    Background Low health literacy is associated with low adherence to self-management in many chronic diseases. Additionally, health beliefs are thought to be determinants of self-management behaviors. In this study we sought to determine the association, if any, of health literacy and health beliefs among elderly individuals with COPD. Methods We enrolled a cohort of patients with COPD from two academic urban settings in New York, NY and Chicago, IL. Health literacy was measured using the Short Test of Functional Health Literacy in Adults. Using the framework of the Self-Regulation Model, illness and medication beliefs were measured with the Brief Illness Perception Questionnaire (B-IPQ) and Beliefs about Medications Questionnaire (BMQ). Unadjusted analyses, with corresponding Cohen’s d effect sizes, and multiple logistic regression were used to assess the relationships between HL and illness and medication beliefs. Results We enrolled 235 participants, 29% of whom had low health literacy. Patients with low health literacy were more likely to belong to a racial minority group (p<0.001), not be married (p = 0.006), and to have lower income (p<0.001) or education (p<0.001). In unadjusted analyses, patients with low health literacy were less likely to believe they will always have COPD (p = 0.003, Cohen’s d = 0.42), and were more likely to be concerned about their illness ((p = 0.04, Cohen’s d = 0.17). In analyses adjusted for sociodemographic factors and other health beliefs, patients with low health literacy were less likely to believe that they will always have COPD (odds ratio [OR]: 0.78, 95% confidence interval [CI]: 0.65–0.94). In addition, the association of low health literacy with expressed concern about medications remained significant (OR: 1.20, 95% CI: 1.05–1.37) though the association of low health literacy with belief in the necessity of medications was no longer significant (OR: 0.92, 95% CI: 0.82–1.04). Conclusions In this cohort of urban

  18. The Association of Health Literacy with Illness and Medication Beliefs among Patients with Chronic Obstructive Pulmonary Disease.

    Directory of Open Access Journals (Sweden)

    Minal S Kale

    Full Text Available Low health literacy is associated with low adherence to self-management in many chronic diseases. Additionally, health beliefs are thought to be determinants of self-management behaviors. In this study we sought to determine the association, if any, of health literacy and health beliefs among elderly individuals with COPD.We enrolled a cohort of patients with COPD from two academic urban settings in New York, NY and Chicago, IL. Health literacy was measured using the Short Test of Functional Health Literacy in Adults. Using the framework of the Self-Regulation Model, illness and medication beliefs were measured with the Brief Illness Perception Questionnaire (B-IPQ and Beliefs about Medications Questionnaire (BMQ. Unadjusted analyses, with corresponding Cohen's d effect sizes, and multiple logistic regression were used to assess the relationships between HL and illness and medication beliefs.We enrolled 235 participants, 29% of whom had low health literacy. Patients with low health literacy were more likely to belong to a racial minority group (p<0.001, not be married (p = 0.006, and to have lower income (p<0.001 or education (p<0.001. In unadjusted analyses, patients with low health literacy were less likely to believe they will always have COPD (p = 0.003, Cohen's d = 0.42, and were more likely to be concerned about their illness ((p = 0.04, Cohen's d = 0.17. In analyses adjusted for sociodemographic factors and other health beliefs, patients with low health literacy were less likely to believe that they will always have COPD (odds ratio [OR]: 0.78, 95% confidence interval [CI]: 0.65-0.94. In addition, the association of low health literacy with expressed concern about medications remained significant (OR: 1.20, 95% CI: 1.05-1.37 though the association of low health literacy with belief in the necessity of medications was no longer significant (OR: 0.92, 95% CI: 0.82-1.04.In this cohort of urban individuals with COPD, low health literacy was

  19. Quality of life, treatment adherence, and locus of control: multiple family groups for chronic medical illnesses.

    Science.gov (United States)

    López-Larrosa, Silvia

    2013-12-01

    The Multiple Family Groups (MFGs) approach for patients with a chronic medical illness and their families is a structured psychoeducational program that unfolds in six weekly 90-minute sessions. In the MFGs, patients and family members explore new ways to balance illness and nonillness priorities in family life (Steinglass, 1998; Steinglass, 2000 Cuadernos de Terapia Familiar, 44-45, 11; Steinglass, Ostroff, & Steinglass, 2011 Family Process, 50, 393). © FPI, Inc.

  20. Relationships between discrimination in health care and health care outcomes among four race/ethnic groups.

    Science.gov (United States)

    Benjamins, Maureen R; Whitman, Steven

    2014-06-01

    Discrimination has been found to be detrimental to health, but less is known about the influence of discrimination in health care. To address this, the current study (1) compared levels of racial/ethnic discrimination in health care among four race/ethnic groups; (2) determined associations between this type of discrimination and health care outcomes; and (3) assessed potential mediators and moderators as suggested by previous studies. Multivariate logistic regression models were used within a population-based sample of 1,699 White, African American, Mexican, and Puerto Rican respondents. Overall, 23% of the sample reported discrimination in health care, with levels varying substantially by race/ethnicity. In adjusted models, this type of discrimination was associated with an increased likelihood of having unmet health care needs (OR = 2.48, CI = 1.57-3.90) and lower odds of perceiving excellent quality of care (OR = 0.43, CI = 0.28-0.66), but not with the use of a physician when not sick or use of alternative medicine. The mediating role of mental health factors was inconsistently observed and the relationships were not moderated by race/ethnicity. These findings expand the literature and provide preliminary evidence that can eventually inform the development of interventions and the training of health care providers.

  1. The impact of medical education on psychological health of students: a cohort study.

    Science.gov (United States)

    Yusoff, Muhamad Saiful Bahri; Abdul Rahim, Ahmad Fuad; Baba, Abdul Aziz; Ismail, Shaiful Bahari; Mat Pa, Mohamad Najib; Esa, Ab Rahman

    2013-01-01

    Many studies have shown that the prevalence of psychological distress among medical students during medical training is higher than that in general population. A few studies have shown that the prevalence of psychological distress among medical students before the onset of medical training was similar to general population. This study aimed to investigate psychological health of medical students before and during medical training. A one-year prospective study was done on successful applicants who undergo the first year of medical training for 2010/2011 academic session. The stress, anxiety and depression were measured by the DASS-21 at five intervals; during interview (Time 0), two months (Time 1), four months (Time 2), six months (Time 3) and final examination (Time 4) of the first year medical training. The prevalence of unfavourable stress, anxiety and depression before the onset of medical training was 4.1%, 55.6% and 1.8%, respectively. The prevalence of unfavourable stress during medical training ranged between 11.8% and 19.9%. The prevalence of anxiety during medical training ranged between 41.1% and 56.7%. The prevalence of depression during medical training ranged between 12% and 30%. Mean scores of stress and depression before (Time 0) and during medical training (Time 1-4) were significantly different (p depression during medical training were significantly higher than before the onset medical training. This study supports views that medical training is not an optimal environment to psychological health of medical students.

  2. Digital divide: Use of electronic personal health record by different population groups.

    Science.gov (United States)

    Kim, Eung-Hun; Kim, Yongmin

    2010-01-01

    Personal Health Record (PHR) has been increasingly recognized and actively promoted by the federal government, experts and industry as an important tool for improving healthcare in the U.S. However, the PHR use by patients and its utility have not been studied well. We have evaluated a web-based PHR in multiple locations covering diverse population groups. The study sites included a surgical specialty clinic, a medical specialty clinic, and a mental health clinic at the University of Washington, and a low-income elderly housing facility near Seattle in the state of Washington. The PHR use by the low-income elderly was limited due to poor technical skills and low physical/cognitive abilities. On the other hand, the younger and affluent populations used the web-based PHR much easily and efficiently compared to the older and low-income group. They regarded managing personal health information easy while the older group struggled. As more computer literate individuals age, the next-generation elderly are certain to be more technically skilled than the current generation. Although the reduced physical/cognitive abilities due to aging would still be a challenge, more elderly people will be able to not only use a PHR system but also use it to the full extent to get the maximum benefit.

  3. 75 FR 38099 - Establishment of the Advisory Group on Prevention, Health Promotion, and Integrative and Public...

    Science.gov (United States)

    2010-07-01

    ... HUMAN SERVICES Establishment of the Advisory Group on Prevention, Health Promotion, and Integrative and... March 23, 2010. The Advisory Group on Prevention, Health Promotion, and Integrative and Public Health... Prevention, Health Promotion, and Integrative and Public Health, as directed by Executive Order 13544....

  4. Health Systems Science Curricula in Undergraduate Medical Education: Identifying and Defining a Potential Curricular Framework.

    Science.gov (United States)

    Gonzalo, Jed D; Dekhtyar, Michael; Starr, Stephanie R; Borkan, Jeffrey; Brunett, Patrick; Fancher, Tonya; Green, Jennifer; Grethlein, Sara Jo; Lai, Cindy; Lawson, Luan; Monrad, Seetha; O'Sullivan, Patricia; Schwartz, Mark D; Skochelak, Susan

    2017-01-01

    The authors performed a review of 30 Accelerating Change in Medical Education full grant submissions and an analysis of the health systems science (HSS)-related curricula at the 11 grant recipient schools to develop a potential comprehensive HSS curricular framework with domains and subcategories. In phase 1, to identify domains, grant submissions were analyzed and coded using constant comparative analysis. In phase 2, a detailed review of all existing and planned syllabi and curriculum documents at the grantee schools was performed, and content in the core curricular domains was coded into subcategories. The lead investigators reviewed and discussed drafts of the categorization scheme, collapsed and combined domains and subcategories, and resolved disagreements via group discussion. Analysis yielded three types of domains: core, cross-cutting, and linking. Core domains included health care structures and processes; health care policy, economics, and management; clinical informatics and health information technology; population and public health; value-based care; and health system improvement. Cross-cutting domains included leadership and change agency; teamwork and interprofessional education; evidence-based medicine and practice; professionalism and ethics; and scholarship. One linking domain was identified: systems thinking. This broad framework aims to build on the traditional definition of systems-based practice and highlight the need for medical and other health professions schools to better align education programs with the anticipated needs of the systems in which students will practice. HSS will require a critical investigation into existing curricula to determine the most efficient methods for integration with the basic and clinical sciences.

  5. Group medical visits in the follow-up of women with a BRCA mutation: design of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Hoogerbrugge Nicoline

    2011-08-01

    Full Text Available Abstract Background BRCA mutation carriers have a 40-80% life-time risk of developing breast cancer. They may opt for yearly breast cancer surveillance or for prophylactic mastectomy. Both options show increased survival rates. It is a complex choice to be made between these two options. As a result most women experience high levels of distress and high needs for information. To fulfill the needs for psychosocial support and information we have introduced group medical consultations (GMCs. A GMC provides individual medical visits conducted within a group. This 90 minute group-visit with 8-12 patients gives patients the opportunity to spend more time with their clinician and a behavioral health professional and learn from other patients experiencing similar topics. However, it should be noted that group sessions may increase fear in some patients or influence their decision making. Methods/design In this randomized controlled trial, 160 BRCA mutation carriers diagnosed maximally 2 years ago are recruited from the Radboud University Nijmegen Medical Centre. Participants are randomized in a 1:1 ratio to either the GMC intervention group (onetime participation in a GMC instead of a standard individual visit or to a usual care control group. Primary outcome measures are empowerment and psychological distress (SCL 90. Secondary outcome measures are fear of cancer, information needs before the consultation and the received information, self-examination of the breasts, patient satisfaction, quality of life and cost-effectiveness. Data are collected via self-reported questionnaires 1 week before the visit, and at 1 week and at 3 months follow-up. A pilot study was conducted to test all procedures and questionnaires. Discussion The possibility for interaction with other BRCA mutation carriers within a medical visit is unique. This study will assess the effectiveness of GMCs for BRCA mutation carriers to improve empowerment and decrease distress compared

  6. Teaching medical ethics: problem-based learning or small group discussion?

    Science.gov (United States)

    Heidari, Akram; Adeli, Seyyed-Hassan; Taziki, Sadegh-Ali; Akbari, Valliollahe; Ghadir, Mohammad-Reza; Moosavi-Movahhed, Seyyed-Majid; Ahangari, Roghayyeh; Sadeghi-Moghaddam, Parvaneh; Mirzaee, Mohammad-Rahim; Damanpak-Moghaddam, Vahid

    2013-01-01

    Lecture is the most common teaching method used in ethics education, while problem-based learning (PBL) and small group discussion (SGD) have been introduced as more useful methods. This study compared these methods in teaching medical ethics. Twenty students (12 female and 8 male) were randomly assigned into two groups. The PBL method was used in one group, and the other group was taught using the SGD method. Twenty-five open-ended questions were used for assessment and at the end of the course, a course evaluation sheet was used to obtain the students' views about the advantages and disadvantages of each teaching method, their level of satisfaction with the course, their interest in attending the sessions, and their opinions regarding the effect of teaching ethics on students' behaviors. The mean score in the PBL group (16.04 ± 1.84) was higher than the SGD group (15.48 ± 2.01). The satisfaction rates in the two groups were 3.00 ± 0.47 and 2.78 ± 0.83 respectively. These differences were not statistically significant. Since the mean score and satisfaction rate in the PBL group were higher than the SGD group, the PBL method is recommended for ethics education whenever possible.

  7. Health and fertility in World Health Organization group 2 anovulatory women

    NARCIS (Netherlands)

    Baird, D. T.; Balen, A.; Escobar-Morreale, H. F.; Evers, J. L. H.; Fauser, B. C. J. M.; Franks, S.; Glasier, A.; Homburg, R.; La Vecchia, C.; Crosignani, P. G.; Devroey, P.; Diedrich, K.; Fraser, L.; Gianaroli, L.; Liebaers, I.; Sunde, A.; Tapanainen, J. S.; Tarlatzis, B.; Van Steirteghem, A.; Veiga, A.; Evers, J. L. H.

    2012-01-01

    Disruption of ovulation occurs in different types of clinical infertility. The World Health Organization (WHO) has provided a classification of ovulation disorders. This review focuses on WHO group 2 anovulation. Searches were performed in Medline/PubMed and EMBASE. Each subject summary was presente

  8. The impact of tailored text messages on health beliefs and medication adherence in adults with diabetes: A randomized pilot study.

    Science.gov (United States)

    Gatwood, Justin; Balkrishnan, Rajesh; Erickson, Steven R; An, Lawrence C; Piette, John D; Farris, Karen B

    2016-01-01

    Inadequate medication adherence reduces optimal health outcomes and can lead to increased costs, particularly in patients with diabetes. Efforts to improve adherence have resulted in limited effects; approaches leveraging mobile technology have emerged, but their focus has mainly been limited to simple reminder messages. The purpose of this pilot study was to test the effectiveness of tailored text messages focusing on improving medication adherence and health beliefs in adults with diabetes. Adults aged 21-64, with uncontrolled diabetes, and taking at least one anti-diabetic medication were recruited and randomized into 2 study arms: daily tailored text messaging for 90 days or standard care. Comparing baseline and endpoint survey responses, changes in theory-driven health beliefs and attitudes were assessed. The impact on medication adherence was evaluated using pharmacy claims by calculating the percent of days covered (PDC). A total of 75 subjects were consented, and 48 were randomized. Mean PDC at baseline were comparable between cohorts (84.4% and 87.1%, respectively). Declines in adherence were observed in both groups over time but no significant differences were observed between groups or from baseline to the end of the active study period. Unadjusted tests suggested that perceived benefits and competence might have improved in the intervention arm. Tailoring mobile phone text messages is a novel way to address medication nonadherence and health beliefs; further investigation to this combined technique is needed to better understand its impact on behavior change in adults with diabetes. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Societal output and use of research performed by health research groups

    Directory of Open Access Journals (Sweden)

    van Ark Gerrit

    2010-10-01

    Full Text Available Abstract The last decade has seen the evaluation of health research pay more and more attention to societal use and benefits of research in addition to scientific quality, both in qualitative and quantitative ways. This paper elaborates primarily on a quantitative approach to assess societal output and use of research performed by health research groups (societal quality of research. For this reason, one of the Dutch university medical centres (i.e. the Leiden University Medical Center (LUMC was chosen as the subject of a pilot study, because of its mission to integrate top patient care with medical, biomedical and healthcare research and education. All research departments were used as units of evaluation within this university medical centre. The method consisted of a four-step process to reach a societal quality score per department, based on its (research outreach to relevant societal stakeholders (the general public, healthcare professionals and the private sector. For each of these three types of stakeholders, indicators within four modes of communication were defined (knowledge production, knowledge exchange, knowledge use and earning capacity. These indicators were measured by a bottom-up approach in a qualitative way (i.e. all departments of the LUMC were asked to list all activities they would consider to be of societal relevance, after which they were converted into quantitative scores. These quantitative scores could then be compared to standardised scientific quality scores that are based on scientific publications and citations of peer-reviewed articles. Based on the LUMC pilot study, only a weak correlation was found between societal and scientific quality. This suggests that societal quality needs additional activities to be performed by health research groups and is not simply the consequence of high scientific quality. Therefore we conclude that scientific and societal evaluation should be considered to be synergistic in terms

  10. 77 FR 33220 - Advisory Group on Prevention, Health Promotion, and Integrative and Public Health; Notice of Meeting

    Science.gov (United States)

    2012-06-05

    ... HUMAN SERVICES Advisory Group on Prevention, Health Promotion, and Integrative and Public Health; Notice of Meeting AGENCY: Office of the Surgeon General of the United States Public Health Service, Office... be held for the Advisory Group on Prevention, Health Promotion, and Integrative and Public...

  11. 76 FR 26300 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2011-05-06

    ... Prevention and Health Promotion Strategy. Public participation during the Web meeting is limited. Members of... HUMAN SERVICES Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public... the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (the...

  12. Relation Between Health Beliefs and Medications Adherence in Patients with Hyperlipidemia

    Directory of Open Access Journals (Sweden)

    Leila Mardanian-Dehkordi

    2015-10-01

    Full Text Available Background: Hyperlipidemia is one of the most important factors in progression of coronary heart diseases, because of the importance of lipid control for preventing heart disease; this study has done to explore the relation between health beliefs and medications adherences in patients with hyperlipidemia.Methods: This Correlation study has done in 82 patients with hyperlipidemia. For obtain information used a questionnaire with three parts; demographic characters, adherence to medications and health beliefs. The data analyzed by Descriptive and analytical statistical tests.Results: Findings same as some studies showed relationship between health beliefs and adherences to medications in patients with hyperlipidemia (P<0.05 with high health beliefs, adherence to medication increased.Conclusion: For increasing adherence to medication, some strategies must provide for self efficacy and educational programs must be done with relationship between patient and health provider. Notice to the importance of high cholesterol and its relation with heart disease will increase adherence to medication.

  13. iMedEd: the role of mobile health technologies in medical education.

    Science.gov (United States)

    Gaglani, Shiv M; Topol, Eric J

    2014-09-01

    Mobile health (mHealth) technologies have experienced a recent surge in attention because of their potential to transform the delivery of health care. This enthusiasm is partly due to the near ubiquity of smartphones and tablets among clinicians, as well as to the stream of mobile medical apps and devices being created. While much discussion has been devoted to how these tools will impact the practice of medicine, surprisingly little has been written on the role these technologies will play in medical education. In this commentary the authors describe the opportunities, applications, and challenges of mHealth apps and devices in medical education and argue that medical schools should make efforts to integrate these technologies into their curricula. By not doing so, medical educators risk producing a generation of clinicians underprepared for the changing realities of medical practice brought on by mHealth technologies.

  14. Self Medication of Abortion Pill: Women’s Health in Jeopardy

    Directory of Open Access Journals (Sweden)

    Rajal Thaker

    2014-01-01

    Full Text Available Background: Federation of Obstetrics and Gynaecological Societies of India (FOGSI recommends close monitoring of distribution of drugs that are used for medical abortion and that the medical profession and pharmaceutical industry should exercise due diligence in the promotion and usage of drugs that are used for medical abortion. Despite this, it has been perceived by the society that, medical abortions are extremely safe option even in hands of untrained personnel, leading to its over the counter dispensing and possibly increase in unsupervised terminations and life threatening complications. Objective: To study consequences of self medication of Abortion pill on women’s health Study Design: Retrospective Observational Study Duration of Study: One Year: August 2012 to July 2013 Material and Methods: After due permission from authority, data was collected from patients who had come for follow-up and treatment after self medication (purchased over the counter by self/family member without medical guidance/supervision for Medical method of Medical Termination of Pregnancy (MTP. Results: Data was collected in 37 patients, who had history of self medication of abortion pill. More than half, 20 (54% women were in age group of 20-29 years and married women were 35 (94.5%. Uneducated women were 12 (32.4%. Majority 33(89.1% of women had complaint of bleeding per vaginum. On Ultrasonography (USG, 26(70.2% women had incomplete abortion, 4 (10.8% women had intrauterine gestational sac with cardiac activity, 2(5.4% women had complete abortion and 1(2.7% woman had missed abortion. Surgical curettage was performed in 28(75.6% women. In 2(5.4% women, there was complete abortion after oxytocin and misoprostol. One woman (2.7% wanted to continue the pregnancy. Laparotomy was performed in 2 (5.4% women having ectopic pregnancy and in 1(2.7% woman who had perforation of uterus while undergoing surgical curettage at private hospital. Moderate and severe anaemia

  15. 75 FR 26167 - Designation of Medically Underserved Populations and Health Professions Shortage Areas; Intent To...

    Science.gov (United States)

    2010-05-11

    ... Underserved Populations and Health Professions Shortage Areas; Intent To Form Negotiated Rulemaking Committee... of Medically Underserved Populations (MUPs) and Primary Care Health Professions Shortage Areas (HPSAs... indicators, representing the public's interest in assuring that the areas, populations and entities to...

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

    Data.gov (United States)

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

  17. The integration of a telemental health service into rural primary medical care.

    Science.gov (United States)

    Davis, G L; Boulger, J G; Hovland, J C; Hoven, N T

    2007-07-01

    Mental health care shortages in rural areas have resulted in the majority of services being offered through primary medical care settings. The authors argue that a paradigm shift must occur so that those in need of mental health care have reasonable, timely access to these services. Changes proposed include integrating mental health services into primary medical care settings, moving away from the traditional view of mental health care services (one therapist, one hour, and one client), and increasing the consultative role of psychologists and other mental health care providers in primary medical care. Characteristics of mental health providers that facilitate effective integration into primary medical care are presented. The results of a needs assessment survey and an example of a telemental health project are described. This project involved brief consultations with patients and their physicians from a shared care model using a broadband internet telecommunications link between a rural clinic and mental health service providers in an urban area.

  18. Role modelling of clinical tutors: a focus group study among medical students.

    Science.gov (United States)

    Burgess, Annette; Goulston, Kerry; Oates, Kim

    2015-02-14

    Role modelling by clinicians assists in development of medical students' professional competencies, values and attitudes. Three core characteristics of a positive role model include 1) clinical attributes, 2) teaching skills, and 3) personal qualities. This study was designed to explore medical students' perceptions of their bedside clinical tutors as role models during the first year of a medical program. The study was conducted with one cohort (n = 301) of students who had completed Year 1 of the Sydney Medical Program in 2013. A total of nine focus groups (n = 59) were conducted with medical students following completion of Year 1. Data were transcribed verbatim. Thematic analysis was used to code and categorise data into themes. Students identified both positive and negative characteristics and behaviour displayed by their clinical tutors. Characteristics and behaviour that students would like to emulate as medical practitioners in the future included: 1) Clinical attributes: a good knowledge base; articulate history taking skills; the ability to explain and demonstrate skills at the appropriate level for students; and empathy, respect and genuine compassion for patients. 2) Teaching skills: development of a rapport with students; provision of time towards the growth of students academically and professionally; provision of a positive learning environment; an understanding of the student curriculum and assessment requirements; immediate and useful feedback; and provision of patient interaction. 3) Personal qualities: respectful interprofessional staff interactions; preparedness for tutorials; demonstration of a passion for teaching; and demonstration of a passion for their career choice. Excellence in role modelling entails demonstration of excellent clinical care, teaching skills and personal characteristics. Our findings reinforce the important function of clinical bedside tutors as role models, which has implications for faculty development and

  19. Short-Term Medical Costs of a VHA Health Information Exchange: A CHEERS-Compliant Article.

    Science.gov (United States)

    French, Dustin D; Dixon, Brian E; Perkins, Susan M; Myers, Laura J; Weiner, Michael; Zillich, Allan J; Haggstrom, David A

    2016-01-01

    The Virtual Lifetime Electronic Record (VLER) Health program provides the Veterans Health Administration (VHA) a framework whereby VHA providers can access the veterans' electronic health record information to coordinate healthcare across multiple sites of care. As an early adopter of VLER, the Indianapolis VHA and Regenstrief Institute implemented a regional demonstration program involving bi-directional health information exchange (HIE) between VHA and non-VHA providers.The aim of the study is to determine whether implementation of VLER HIE reduces 1 year VHA medical costs.A cohort evaluation with a concurrent control group compared VHA healthcare costs using propensity score adjustment. A CHEERs compliant checklist was used to conduct the cost evaluation.Patients were enrolled in the VLER program onsite at the Indianapolis VHA in outpatient clinics or through the release-of-information office.VHA cost data (in 2014 dollars) were obtained for both enrolled and nonenrolled (control) patients for 1 year prior to, and 1 year after, the index date of patient enrollment.There were 6104 patients enrolled in VLER and 45,700 patients in the control group. The annual adjusted total cost difference per patient was associated with a higher cost for VLER enrollees $1152 (95% CI: $807-1433) (P < 0.01) (in 2014 dollars) than VLER nonenrollees.Short-term evaluation of this demonstration project did not show immediate reductions in healthcare cost as might be expected if HIE decreased redundant medical tests and treatments. Cost reductions from shared health information may be realized with longer time horizons.

  20. mHealth medication and blood pressure self-management program in Hispanic hypertensives: a proof of concept trial

    Directory of Open Access Journals (Sweden)

    Sieverdes JC

    2013-10-01

    Full Text Available John C Sieverdes,1 Mathew Gregoski,1 Sachin Patel,1 Deborah Williamson,1 Brenda Brunner-Jackson,1 Judith Rundbaken,1 Eveline Treiber,1 Lydia Davidson,1 Frank A Treiber1,21Technology Applications Center for Healthful Lifestyles, College of Nursing, 2College of Medicine, Medical University of South Carolina, Charleston, SC, USAAbstract: Patient nonadherence to medication regimens and provider therapeutic inertia (failure to respond in timely manner to clinical data are two primary contributors to ineffective chronic disease management. This 3-month proof of concept trial used an iterative design approach guided by self-determination theory and the technology acceptance model to develop a culturally sensitive, patient-centered, and provider-centered mobile health medication and blood pressure self-management program. Cellular connected electronic medication trays provided reminder signals for patients to take medications and smartphone messaging reminded patients to take at-home blood pressures using a Bluetooth-enabled monitor. Providers were given bimonthly feedback. Motivational and reinforcement text and audio messages were sent based upon medication adherence rates and blood pressure levels. Ten Hispanics with uncontrolled essential hypertension were randomized to standard care and Smartphone Medication Adherence Stops Hypertension (SMASH intervention groups. Primary outcomes of provider and patient acceptability of the program were found to be high. Retention rates for the 3-month program were 100%, with mean ± standard deviation overall medication adherence for the SMASH group at 97.2% ± 2.8%, with all strongly believing the program helped them remember to take their medication. SMASH participants measured their blood pressure every 3 days 83.2% ± 6.0% of the time and completed 89.2% ± 19.06% of the expected readings. Nonparametric tests showed statistical significance for resting blood pressure changes between groups at months 2 (P = 0

  1. Fit testing respirators for public health medical emergencies.

    Science.gov (United States)

    Brosseau, Lisa M

    2010-11-01

    Concerns about limiting pandemic infectious disease transmission when vaccines are not yet available prompted the Food and Drug Administration (FDA) to develop guidance for marketing respirators for use in public health medical emergencies. This project describes the results of filtering facepiece fit tests using 35 untrained, inexperienced subjects meeting the face size criteria of the National Institute for Occupational Safety and Health bivariate panel, in preparation for an FDA 510(k) application. Quantitative fit factors were measured for each subject on two replicates of each of two N95 filtering facepiece respirators (A and B) using the TSI Portacount Plus with N95 Companion. Subjects received no training or assistance with donning and had no prior experience with wearing respirators. The panel consisted of 20 females and 15 males; 80% were between 18 and 34 years of age. Almost all subjects properly placed the respirator on the face and formed the nose clip. Straps were improperly placed 25% of the time. Users reviewed the donning instructions 73% of the time and performed a seal check 80% of the time. Leaks were observed during 80% of the fit tests, most frequently at the chin during the head up and down exercise. For Respirator A, all but one subject had a 95% fit factor greater than 2 (the minimum required by FDA); one subject had a 95% fit factor of 1.5. All subjects had a 95% fit factor greater than 2.5 for Respirator B. Geometric mean fit factors ranged from 19-28 for these two respirators, and a majority of subjects were able to achieve a fit factor of 10 most of the time. However, fewer than 25% of subjects received the fit factor of 100 expected in workplace settings.

  2. [The place, role and importance of emergency medical care in the Serbian health care system].

    Science.gov (United States)

    Nikić-Sovilj, Ljiljana

    2009-01-01

    Emergency medical assistance is immediate, the current medical support that is provided hurted person to avoid any possible harmful consequences for his life and health. Emergency medical aid is part of the health care system that is rarely thought, but is still expected to be available always and continuously in case of need. Emergency medical assistance should always be available throughout the territory where people live, because there is no adequate replacement. Emergency Medical Services and emergency medical transportation services are health care that is provided in terms of all persons in the state of medical urgency. In urgent or emergency conditions, health care can be provided on the site of injuries and disease or health institution. Cases of medical urgency are ranked by degrees. The first and most difficult level of medical urgency indicate all urgent pathological conditions, diseases, injuries and poisoning, which occur in the workplace and public places. To expect medical team of emergency medical assistance at the scene intervened medical urgency, it is necessary to make call it. Call the phone number refers to the 94. Call sent to this number to receive orderly dispatcher. Dispatchers are employees who perform their work in the dispatching center. They appear in the phone number 94, made the assessment and screening calls, worry about the degree of urgency, and the absorption team, which team is the nearest place of the event. After received calls they send expert medical teams to the place of accident. In the dispatching center work always doctor and medical technician. Emergency medical care cases is a great professional and educational challenge and imposes a constant need in education of doctors and the whole emergency medical teams. Education of all employees in the state of emergency care is required continualy and for students too to receive new knowledge in the field of medical urgency by various professional purposes.

  3. Is a decentralized continuing medical education program feasible for Chinese rural health professionals?

    Directory of Open Access Journals (Sweden)

    Guijie Hu

    2016-04-01

    Full Text Available Purpose: Rural health professionals in township health centers (THCs tend to have less advanced educational degrees. This study aimed to ascertain the perceived feasibility of a decentralized continuing medical education (CME program to upgrade their educational levels. Methods: A cross-sectional survey of THC health professionals was conducted using a self-administered, structured questionnaire in Guangxi Zhuang Autonomous Region, China. Results: The health professionals in the THCs were overwhelmingly young with low education levels. They had a strong desire to upgrade their educational degrees. The decentralized CME program was perceived as feasible by health workers with positive attitudes about the benefit for license examination, and by those who intended to improve their clinical diagnosis and treatment skills. The target groups of such a program were those who expected to undertake a bachelor’s degree and who rated themselves as “partially capable” in clinical competency. They reported that 160-400 USD annually would be an affordable fee for the program. Conclusion: A decentralized CME program was perceived feasible to upgrade rural health workers’ education level to a bachelor’s degree and improve their clinical competency.

  4. Study of Association between Social Adjustment and Spiritual Health in Qom University of Medical Sciences Students

    Directory of Open Access Journals (Sweden)

    zahra Aliakbarzade arani

    2017-03-01

    Full Text Available Background and Objectives: Admission to university is considered an opportunity to learn more and mentally grow further. At the same time, it is considered a stressor by some students and causes maladaptive reactions in them. This study was conducted to investigate the association between social adjustment and spiritual health in university students. Methods: Two hundred and fifty students were enrolled in this descriptive-analytical, cross-sectional study according to random, systematic sampling. The used instruments were Bell Adjustment Inventory, consisting of 32 items, with 89% reliability coefficient and Paloutzian & Ellison Spiritual Well-Being Scale, consisting of 20 items, with validity and reliability of 79% and 82%, respectively. Data were analyzed by descriptive statistics, Pearson's correlation coefficient, and univariate and multivariate linear regression in SPSS 16. Results: Women comprised 50.2% of the participants. The mean (SD age of the participants was 21.72 (5.02 and only 18.4% were married. Social adjustment was significantly correlated with total score of spiritual health and scores of the subscales religious health and existential health (P<0.001. Conclusion: Because social adjustment was moderate among Qom University of Medical Sciences students, and in the light of the association between spiritual health and social adjustment, group and individual counseling services can be delivered to students with low levels of social adjustment in universities to help them improve their social and spiritual health. Keywords:

  5. Promoting social responsibility amongst health care users: medical tourists’ perspectives on an information sheet regarding ethical concerns in medical tourism

    Science.gov (United States)

    2013-01-01

    Background Medical tourists, persons that travel across international borders with the intention to access non-emergency medical care, may not be adequately informed of safety and ethical concerns related to the practice of medical tourism. Researchers indicate that the sources of information frequently used by medical tourists during their decision-making process may be biased and/or lack comprehensive information regarding individual safety and treatment outcomes, as well as potential impacts of the medical tourism industry on third parties. This paper explores the feedback from former Canadian medical tourists regarding the use of an information sheet to address this knowledge gap and raise awareness of the safety and ethical concerns related to medical tourism. Results According to feedback provided in interviews with former Canadian medical tourists, the majority of participants responded positively to the information sheet and indicated that this document prompted them to engage in further consideration of these issues. Participants indicated some frustration after reading the information sheet regarding a lack of know-how in terms of learning more about the concerns discussed in the document and changing their decision-making. This frustration was due to participants’ desperation for medical care, a topic which participants frequently discussed regarding ethical concerns related to health care provision. Conclusions The overall perceptions of former medical tourists indicate that an information sheet may promote further consideration of ethical concerns of medical tourism. However, given that these interviews were performed with former medical tourists, it remains unknown whether such a document might impact upon the decision-making of prospective medical tourists. Furthermore, participants indicated a need for an additional tool such as a website for continued discussion about these concerns. As such, along with dissemination of the information sheet

  6. Promoting social responsibility amongst health care users: medical tourists' perspectives on an information sheet regarding ethical concerns in medical tourism.

    Science.gov (United States)

    Adams, Krystyna; Snyder, Jeremy; Crooks, Valorie A; Johnston, Rory

    2013-12-06

    Medical tourists, persons that travel across international borders with the intention to access non-emergency medical care, may not be adequately informed of safety and ethical concerns related to the practice of medical tourism. Researchers indicate that the sources of information frequently used by medical tourists during their decision-making process may be biased and/or lack comprehensive information regarding individual safety and treatment outcomes, as well as potential impacts of the medical tourism industry on third parties. This paper explores the feedback from former Canadian medical tourists regarding the use of an information sheet to address this knowledge gap and raise awareness of the safety and ethical concerns related to medical tourism. According to feedback provided in interviews with former Canadian medical tourists, the majority of participants responded positively to the information sheet and indicated that this document prompted them to engage in further consideration of these issues. Participants indicated some frustration after reading the information sheet regarding a lack of know-how in terms of learning more about the concerns discussed in the document and changing their decision-making. This frustration was due to participants' desperation for medical care, a topic which participants frequently discussed regarding ethical concerns related to health care provision. The overall perceptions of former medical tourists indicate that an information sheet may promote further consideration of ethical concerns of medical tourism. However, given that these interviews were performed with former medical tourists, it remains unknown whether such a document might impact upon the decision-making of prospective medical tourists. Furthermore, participants indicated a need for an additional tool such as a website for continued discussion about these concerns. As such, along with dissemination of the information sheet, future research implications should

  7. Unrelated adult stem cell donor medical suitability: recommendations from the World Marrow Donor Association Clinical Working Group Committee.

    Science.gov (United States)

    Lown, R N; Philippe, J; Navarro, W; van Walraven, S M; Philips-Johnson, L; Fechter, M; Pawson, R; Bengtsson, M; Beksac, M; Field, S; Yang, H; Shaw, B E

    2014-07-01

    The World Marrow Donor Association (WMDA) fosters collaboration between international registries to facilitate the exchange of hematopoietic stem cell products for unrelated stem cell donor transplantation. As indications for hematopoietic SCT grow, the movement of products across the world will increase. Although competent authorities may regulate products within their country, there is a need to protect the best interests of donors and recipients by identifying universal donor medical suitability criteria. Within this report the WMDA provides a background to unrelated adult donor and recipient safety, recommends a common framework for assessing the health of unrelated adult donors at each stage of the donation pathway and presents a novel mechanism for sharing international consensus criteria for individual medical and lifestyle conditions. Wherever possible, these criteria are evidence-based. By establishing a donor medical suitability working group, the WMDA has developed a process through which donor centers and registries may request a consensus opinion on conditions not already listed, as well as challenge existing criteria. Guidance from the WMDA is intended to complement, not supersede, guidance from national competent authorities and international regulatory bodies.

  8. Health and medical blog content and its relationships with blogger credentials and blog host.

    Science.gov (United States)

    Buis, Lorraine R; Carpenter, Serena

    2009-12-01

    People may utilize various sources when searching for health information, including blogs. This study sought to describe the nature of non-personal journal health and medical blog posts and the frequency of interactive blog feature use within these blogs, as well as to understand the quality of content found within health and medical blogs as determined by blogger expertise and blog host. A quantitative content analysis was performed on 398 blog posts from a constructed 1-week sample of posts in WebMD, Yahoo!Health Expert Blogs, and independently hosted blogs. Results show most health and medical blog posts highlighted and provided commentary pertaining to medical issues found in external media such as books, television, Web sites, magazines, and newspapers, whereas only 16% contained actual health or medical information. In addition, distinct differences in patterns of content were evident between credentialed and noncredentialed bloggers, as well as different blog hosts.

  9. Health effects of atmospheric particulates: a medical geology perspective.

    Science.gov (United States)

    Duzgoren-Aydin, Nurdan S

    2008-01-01

    In this review, atmospheric particulates as composite airborne earth materials often containing both natural and anthropogenic components were examined in the context of medical geology. Despite a vast number of both experimental and epidemiological studies confirming the direct and indirect links between atmospheric particulates and human health, the exact nature of mechanisms affecting the particulate-induced pathogenesis largely remains unexplored. Future in depth research on these areas would be most successful if potential mechanisms are examined with reference to the physical (e.g., size, shape and surface), chemical, mineralogical and source characteristics of particulate matters. The underlying goal of this review was to present the relevant terminology and processes proposed in the literature to explain the interfaces and interactions between atmospheric particles and human body within the framework of "atmospheric particle cycles." The complexities of the interactions were demonstrated through case studies focusing on particulate matter air pollution and malignant mesothelioma occurrences due to environmental exposure to erionite-a fibrous zeolite mineral. There is an urgent need for a standard protocol or speciation methods applicable to earth-materials to guide and streamline studies on etiology of mineral-induced diseases. This protocol or speciation methods should provide relevant procedures to determine the level and extent of physical, chemical and mineralogical heterogeneity of particulate matters as well as quantitative in-situ particulate characteristics.

  10. Personal health records as portal to the electronic medical record.

    Science.gov (United States)

    Cahill, Jennifer E; Gilbert, Mark R; Armstrong, Terri S

    2014-03-01

    This topic review discusses the evolving clinical challenges associated with the implementation of electronic personal health records (PHR) that are fully integrated with electronic medical records (EMR). The benefits of facilitating patient access to the EMR through web-based, PHR-portals may be substantial; foremost is the potential to enhance the flow of information between patient and healthcare practitioner. The benefits of improved communication and transparency of care are presumed to be a reduction in clinical errors, increased quality of care, better patient-management of disease, and better disease and symptom comprehension. Yet PHR databases allow patients open access to newly-acquired clinical data without the benefit of concurrent expert clinical interpretation, and therefore may create the potential for greater patient distress and uncertainty. With specific attention to neuro-oncology patients, this review focuses on the developing conflicts and consequences associated with the use of a PHR that parallels data acquisition of the EMR in real-time. We conclude with a discussion of recommendations for implementing fully-integrated PHR for neuro-oncology patients.

  11. 75 FR 34537 - Interim Final Rules for Group Health Plans and Health Insurance Coverage Relating to Status as a...

    Science.gov (United States)

    2010-06-17

    ... Health Insurance Coverage Relating to Status as a Grandfathered Health Plan Under the Patient Protection...-AB68 Interim Final Rules for Group Health Plans and Health Insurance Coverage Relating to Status as a... Consumer Information and Insurance Oversight, Department of Health and Human Services. ACTION: Interim...

  12. 75 FR 37242 - Requirements for Group Health Plans and Health Insurance Issuers Under the Patient Protection and...

    Science.gov (United States)

    2010-06-28

    ... Revenue Service 26 CFR Part 54 RIN 1545-BJ57 Requirements for Group Health Plans and Health Insurance..., Health care, Health insurance, Pensions, Reporting and recordkeeping requirements. Proposed Amendments to... U.S. Department of Health and Human Services are issuing substantially similar interim final...

  13. An assessment of medical doctors′ perception of possible interrelationship between oral and general health

    Directory of Open Access Journals (Sweden)

    O I Opeodu

    2014-01-01

    Full Text Available Background: The possibility of some systemic diseases having oral manifestation is well established with the recent discovery that some oral diseases also adversely affect the general health of an individual. The question is, is the relationship casual or causal? Aim: To assess the perception of medical doctors concerning the possible link of oral diseases as causal/confounding factors of systemic diseases. Materials and Methods: A cross-sectional survey of 250 medical doctors was carried out in three tertiary health institutions in Nigeria. Questionnaires were distributed to resident doctors to assess their perception as to the possibility of any causal relationship between the general systemic diseases and oral diseases. Results: Two-hundred and seven completely filled questionnaires were returned out of the 250 distributed. Over 50% of the respondents strongly agreed to the fact that there is a link between oral diseases and conditions such as diabetes mellitus, rheumatic heart disease, valvular heart disease, and human immunodeficiency virus/acquired immune deficiency syndrome HIV/AIDS. Hypertension and premature low birth weight has the highest percentage (18.8% of respondents strongly disagreeing with the possibility of having any link with the state of the oral health. There was a statistically significant difference in the perception of the possible link between the state of oral health and myocardial infarction between male and female respondents (P < 0.04 and also when the age-groups were considered in relationship with valvular heart disease (P < 0.02. Conclusion: This study revealed that doctors′ perception of the influence of dental disease/condition on the general state of patients′ health was deficient and, therefore, require improvement through health education and awareness.

  14. Are medical students interested in sexual health education? A nationwide survey.

    Science.gov (United States)

    Turner, D; Nieder, T O; Dekker, A; Martyniuk, U; Herrmann, L; Briken, P

    2016-09-01

    The majority of medical students and medical healthcare providers do not feel comfortable when addressing sexual problems. It was suggested that more courses in sexual health are needed at medical schools to overcome this shortcoming. To assess medical students' interest in and attitude about sexual health education at medical schools in Germany, a 13-item online questionnaire was developed. The link to the questionnaire was distributed at all medical schools in Germany. In total, 3264 medical students (69.9% female) from all 37 medical schools in Germany participated. Students from all universities indicated that contents related to sexual health are taught at their university. The majority (n=1809; 62.1%) answered that courses in sexual health should be mandatory. The types of educational experiences that were viewed as most appropriate were lectures (n=2281, 78.3%) and seminars without patient contact (n=1414, 48.5%). Students were most interested in child sexual abuse and sexually transmitted infections. It should be ensured that all medical students have acquired basic knowledge in diagnosing and treating frequent sexual problems at the end of their medical studies. Suggestions are made about how to improve current efforts of sexual health education at medical schools.

  15. Improving health promotion to American Indians in the midwest United States: preferred sources of health information and its use for the medical encounter.

    Science.gov (United States)

    Geana, Mugur V; Greiner, K Allen; Cully, Angelia; Talawyma, Myrietta; Daley, Christine Makosky

    2012-12-01

    American Indians and Alaska Natives suffer significant health disparities for many infectious and chronic diseases as compared to the general population. Providing accurate and culturally tailored health information to underserved groups has been shown to influence health behaviors and health outcomes. Little prior research has explored American Indians health information use and preferences. National representative sample surveys such as the Health Information National Trends Survey provide some data on minority groups but are underpowered to provide useful information on American Indians. The present study analyzes data from a survey of over 900 American Indians from the Midwest United States and explores their sources of health information, their preferences for information presentation, and their use of health information prior to and during medical encounters. We conclude that campaigns targeting Natives should be narrowly focused and be community driven or employing community resources. American Indians use a diversity of media sources to obtain health information, with the Internet being underutilized compared to the general population. Partnership with Indian Health Service providers and pharmacists, as well as traditional healers, in the development and dissemination of new health information for Natives may provide the "expert" tone needed to promote health improvements in American Indians.

  16. Stress and mental health problems in 1st year medical students: a survey of two medical colleges in Kanpur, India

    Directory of Open Access Journals (Sweden)

    Shivendra Jena

    2015-01-01

    Full Text Available Background: Incidence of stress among medical students has been reported to be between high and very high. Medical students in pre-clinical phase are more likely to develop psychological distress than medical students in clinical phase. It may affect academic performance and lead to anxiety, depression and substance abuse. Methods: First year students of one government medical college and one private medical college of Kanpur, Uttar Pradesh, India, were surveyed to find out stress and mental health problems shortly after their admission. Results: The two colleges showed difference in the frequencies of a number of factors- current stress, sleep problem, sad mood, both parents working, parents giving sufficient time, non-participation in extra-curricular activities, sharing problem with their families, having break-up in a romantic relationship and poor relationships with classmates and roommate. More students of the government medical college reported to have current stress compared to the students of the private medical college. While all students of the government medical who had stress since admission did not recover from it, 55.56% of students of the private medical college recovered from it at the time of our survey. Conclusion: a Psychiatry Department of every medical college should be involved in screening 1st year students having stress and mental health problems and managing them. b Medical education should be imparted in more relaxed and fun filled manner to help students cope with the long and difficult course. [Int J Res Med Sci 2015; 3(1.000: 130-134

  17. An Integrated Health Care Model in Medical Education: Interviews with Faculty and Administrators.

    Science.gov (United States)

    Tresolini, Carol P.; Shugars, Daniel A.

    1994-01-01

    Faculty and administrators of 22 medical schools were interviewed for their insights into development of an approach to health care and medical education that integrates psychosocial and biomedical perspectives. Results suggest medical curricula should address development of physicians' knowledge, attitudes, and skills in relationships with both…

  18. Medication Abortion within a Student Health Care Clinic: A Review of the First 46 Consecutive Cases

    Science.gov (United States)

    Godfrey, Emily M.; Bordoloi, Anita; Moorthie, Mydhili; Pela, Emily

    2012-01-01

    Objective: Medication abortion with mifepristone and misoprostol has been available in the United States since 2000. The authors reviewed the first 46 medication abortion cases conducted at a university-based student health care clinic to determine the safety and feasibility of medication abortion in this type of clinical setting. Participants:…

  19. Medical Asepsis. Kit No. 302. Instructor's Manual [and] Student Learning Activity Guide. Health Occupations.

    Science.gov (United States)

    Edwards, Gloria

    This instructor's manual and student learning guide comprise a module on medical asepsis for a secondary-level health occupations program. The six activities in the module cover medical asepsis terms; ways organisms spread; types of medical asepsis; aseptic equipment care; proper handwashing; and procedures for using masks, gloves, and gowns.…

  20. [Podcasts, wikis and blogs: the web 2.0 tools for medical and health education].

    Science.gov (United States)

    Santoro, Eugenio

    2007-10-01

    In the recent years, we have witnessed a new revolution in the field of communication through Internet. Web 2.0, whose contents are provided by the collaboration, discussion, and sharing between more users, is replacing the traditional web (the web 1.0). The use of podcasts, wikis, and blogs is rapidly increasing, and today they are proposed as educational tools for health professionals, physicians, and medical students. Medical podcasts have been developed by online medical journals (such as the New England Journal of Medicine, the Lancet, the British Medical Journal, and the JAMA), and by medical societies, medical schools and health institutions to communicate to and educate the physicians, the students, the patients, and the health consumers. Following the example of Wikipedia, medical wikis and blogs are being developed to support the medical education, the collaboration among researchers, and the clinical practice. However, these tools present some limitations related to their openness and ease of use which virtually allows anybody to alter and edit existing contents or to create new ones. This could make the contents unreliable and inaccurate, and could introduce risks for a correct medical education and for the health of those patients deciding to follow the medical advice included. Studies are needed to evaluate limits, benefits, and efficacy of these tools when used in the contexts of medical education and clinical practice. Other studies are needed to evaluate the reliability and the accuracy of the medical contents posted online through the web 2.0 services.

  1. Medication Abortion within a Student Health Care Clinic: A Review of the First 46 Consecutive Cases

    Science.gov (United States)

    Godfrey, Emily M.; Bordoloi, Anita; Moorthie, Mydhili; Pela, Emily

    2012-01-01

    Objective: Medication abortion with mifepristone and misoprostol has been available in the United States since 2000. The authors reviewed the first 46 medication abortion cases conducted at a university-based student health care clinic to determine the safety and feasibility of medication abortion in this type of clinical setting. Participants:…

  2. The effect of early in‐hospital medication review on health outcomes: a systematic review

    National Research Council Canada - National Science Library

    Hohl, Corinne M; Wickham, Maeve E; Sobolev, Boris; Perry, Jeff J; Sivilotti, Marco L. A; Garrison, Scott; Lang, Eddy; Brasher, Penny; Doyle‐Waters, Mary M; Brar, Baljeet; Rowe, Brian H; Lexchin, Joel; Holland, Richard

    2015-01-01

    ... while minimizing their potential for harm is a public health priority . Medication review, a structured and critical examination of an individual patient's medications by a qualified healthcare provider aims to accomplish exactly these goals . Medication review is performed by a qualified healthcare provider, usually a pharmacist, and includes e...

  3. An Audit of the Effectiveness of Large Group Neurology Tutorials for Irish Undergraduate Medical Students

    LENUS (Irish Health Repository)

    Kearney, H

    2016-07-01

    The aim of this audit was to determine the effectiveness of large group tutorials for teaching neurology to medical students. Students were asked to complete a questionnaire rating their confidence on a ten point Likert scale in a number of domains in the undergraduate education guidelines from the Association of British Neurologists (ABN). We then arranged a series of interactive large group tutorials for the class and repeated the questionnaire one month after teaching. In the three core domains of neurological: history taking, examination and differential diagnosis, none of the students rated their confidence as nine or ten out of ten prior to teaching. This increased to 6% for history taking, 12 % in examination and 25% for differential diagnosis after eight weeks of tutorials. This audit demonstrates that in our centre, large group tutorials were an effective means of teaching, as measured by the ABN guidelines in undergraduate neurology.

  4. Group-based differences in anti-aging bias among medical students.

    Science.gov (United States)

    Ruiz, Jorge G; Andrade, Allen D; Anam, Ramanakumar; Taldone, Sabrina; Karanam, Chandana; Hogue, Christie; Mintzer, Michael J

    2015-01-01

    Medical students (MS) may develop ageist attitudes early in their training that may predict their future avoidance of caring for the elderly. This study sought to determine MS' patterns of explicit and implicit anti-aging bias, intent to practice with older people and using the quad model, the role of gender, race, and motivation-based differences. One hundred and three MS completed an online survey that included explicit and implicit measures. Explicit measures revealed a moderately positive perception of older people. Female medical students and those high in internal motivation showed lower anti-aging bias, and both were more likely to intend to practice with older people. Although the implicit measure revealed more negativity toward the elderly than the explicit measures, there were no group differences. However, using the quad model the authors identified gender, race, and motivation-based differences in controlled and automatic processes involved in anti-aging bias.

  5. Medical Yoga for Patients with Stress-Related Symptoms and Diagnoses in Primary Health Care: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Monica Köhn

    2013-01-01

    Full Text Available An increasing number of patients are suffering from stress-related symptoms and diagnoses. The purpose of this study was to evaluate the medical yoga treatment in patients with stress-related symptoms and diagnoses in primary health care. A randomized controlled study was performed at a primary health care centre in Sweden from March to June, 2011. Patients were randomly allocated to a control group receiving standard care or a yoga group treated with medical yoga for 1 hour, once a week, over a 12-week period in addition to the standard care. A total of 37 men and women, mean age of 53±12 years were included. General stress level (measured using Perceived Stress Scale (PSS, burnout (Shirom-Melamed Burnout Questionnaire (SMBQ, anxiety and depression (Hospital Anxiety and Depression Scale (HADS, insomnia severity (Insomnia Severity Index (ISI, pain (visual analogue scale (VAS, and overall health status (Euro Quality of Life VAS (EQ-VAS were measured before and after 12 weeks. Patients assigned to the Yoga group showed significantly greater improvements on measures of general stress level (P<0.000, anxiety (P<0.019, and overall health status (P<0.018 compared to controls. Treatment with medical yoga is effective in reducing levels of stress and anxiety in patients with stress-related symptoms in primary health care.

  6. 75 FR 22438 - Proposed Information Collection (Health Resource Center Medical Center Payment Form) Activity...

    Science.gov (United States)

    2010-04-28

    ... AFFAIRS Proposed Information Collection (Health Resource Center Medical Center Payment Form) Activity... information technology. Title: Health Resource Center Medical Center Payment Form, VA Form 10-0505. OMB... proposed collection of certain information by the agency. Under the Paperwork Reduction Act (PRA) of...

  7. 78 FR 50119 - Federal Employees Health Benefits Program: Medically Underserved Areas for 2014

    Science.gov (United States)

    2013-08-16

    ... From the Federal Register Online via the Government Publishing Office OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program: Medically Underserved Areas for 2014 AGENCY: U.S... Medically Underserved Areas under the Federal Employees Health Benefits (FEHB) Program for calendar...

  8. 77 FR 43127 - Federal Employees Health Benefits Program: Medically Underserved Areas for 2013

    Science.gov (United States)

    2012-07-23

    ... From the Federal Register Online via the Government Publishing Office OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program: Medically Underserved Areas for 2013 AGENCY: U.S... Medically Underserved Areas under the Federal Employees Health Benefits (FEHB) Program for calendar...

  9. Millennial medical anthropology: from there to here and beyond, or the problem of global health.

    Science.gov (United States)

    Gaines, Atwood D

    2011-03-01

    While much of Medical Anthropology was and is what we can call "Normal" (following Kuhn) Medical Anthropology, I coined the term Millennial Medical Anthropology for that branch of the discipline that, in the 1990s, was departing from the Normal research paradigms and was deserving of a distinct sobriquet. This paper considers the Strong Program in Medical Anthropology's Millennial Medical Anthropology and its key subdivisions, the Cultural Studies of Science and Cultural Bioethics. Specifically it considers Medical Anthropology's movement from the past into an ethical future wherein Normal Biomedicine, Bioethics and Global Health are problematized. This provides the basis for the construction of a truly anthropological global health (i.e., Global, Global Health or Global Health 2.0).

  10. Effectiveness of a group-based intervention to change medication beliefs and improve medication adherence in patients with rheumatoid arthritis: a randomized controlled trial.

    NARCIS (Netherlands)

    Zwikker, H.E.; Ende, C.H. van den; Lankveld, W.G. van; Broeder, A.A. den; Hoogen, F.H. van den; Mosselaar, B. van de; Dulmen, S. van; Bemt, B.J. van den

    2014-01-01

    Objective: To assess the effect of a group-based intervention on the balance between necessity beliefs and concern beliefs about medication and on medication non-adherence in patients with rheumatoid arthritis (RA). Methods: Non-adherent RA patients using disease-modifying anti-rheumatic drugs (DMAR

  11. [Implications in primary health care of medical genetics and genomic in type 2 diabetes mellitus].

    Science.gov (United States)

    Ramirez-Garcia, Sergio Alberto; Cabrera-Pivaral, Carlos E; Huacuja-Ruiz, Luis; Flores-Alvarado, Luis Javier; Pérez-García, Guillermo; González-Rico, José Luis; López-Velázquez, Alma; Topete-González, Luz Rosalba; Rosales-Góme, Roberto Carlos; Candelario-Mejía, Gerardo; Villa-Ruano, Nemesio

    2013-01-01

    Type 2 diabetes mellitus is a complex disease and a global health problem. Therefore, the first level of health care should handle the approaches of medical genetics and genomics to reduce its incidence. The aim is to present perspectives analyzed by our group in two areas of genetics and its clinical application. Emphasis is placed on the coexistence of several genetic forms clinically detectable in patients with diabetes, missing heritability associated with low penetrance, and epigenomics mechanism. It is discussed the effect of genetic variation associated with resistance to insulin, beta-cell dysfunction, shaft incretin, and other points of interest, such as thrifty genotype hypothesis, conformational disease, genetically unknown foods, phenocopies as clinically silent hypercortisolism, molecular phytopharmacology in the clinical management. Finally, the result was displayed in the Mexican population from genetic studies and new findings of clinical importance, such as involvement of melatonin and effect of variations in the number of copies in a genomic region.

  12. Polish system of education in maritime health care and medical assistance for seafarers.

    Science.gov (United States)

    Chodnik, Tomasz; Jeżewska, Maria; Jaremin, Bogdan; Kotłowski, Andrzej; Leszczyńska, Irena; Grubman-Nowak, Marta

    2013-01-01

    The Polish public awareness of the crucial importance of the own maritime economy to the very existenceof the national state has its historical reasons. The Polish maritime involvement has seen several dramaticcrises, but the Polish nationals have become an established group in the global marine trade workforceand are entitled to the proper health care. In this paper the main maritime health issues are mentioned.To meet the issues, also the national education system provides the opportunities for both seafarers andmedical professionals. The Polish doctors can specialise in the maritime medicine. In many cases the generalmedicine students formations include these topics as well. The psychological aspects are also takeninto account, both of the education of the seafarers and the organisational structure of the Polish healthcare system. Some recent aspects of the Polish participation in the international cooperation in the fieldof the medical support of the maritime economy are also described.

  13. Consumption of recommended food groups among children from medically underserved communities.

    Science.gov (United States)

    Kranz, Sibylle; Mitchell, Diane C; Smiciklas-Wright, Helen; Huang, Shirley H; Kumanyika, Shiriki K; Stettler, Nicolas

    2009-04-01

    This cross-sectional study of 2- to 12-year-olds living in medically underserved areas examined the proportion of children meeting the food group intake recommendations for fruits, vegetables, total grains, dairy, and meat/meat alternatives by age group and body weight status. Based on 24-hour recalls collected between July 2004 and March of 2005, mean food group intake and deviation from the recommended intake amounts were determined (actual intake minus recommended intake). Measured weight and height were used to calculate body mass index z scores using the Centers for Disease Control and Prevention growth charts. Data analyses were done for two age groups (2- to 5-year-olds and 6- to 12-year-olds) (n=214), by weight status categories (underweight or healthy weight [ or = 95th percentile]), and were repeated for the subset of children with biologically plausible reports. The majority of children lived in low-income households. More 2- to 5-year-olds met intake recommendations compared with 6- to 12-year-olds. Overall, the proportion of children meeting the food group intake recommendations was low with the exception of the meat group, which was met by 52% and 93% of the 2- to 5- and 6- to 12-year-old children, respectively. There was a positive association between the proportion of younger children meeting the fruits or total grains recommendation and increasing body weight. The data support the importance of community-level nutrition intervention programs to improve children's diet quality in low-income, medically underserved areas and suggest that such interventions may help reduce the risk of obesity.

  14. Resilient Warrior: A Stress Management Group to Improve Psychological Health in Service Members.

    Science.gov (United States)

    Sylvia, Louisa G; Bui, Eric; Baier, Allison L; Mehta, Darshan H; Denninger, John W; Fricchione, Gregory L; Casey, Aggie; Kagan, Leslee; Park, Elyse R; Simon, Naomi M

    2015-11-01

    Many veterans deployed after 9/11/2001 are impacted by subthreshold levels of posttraumatic stress, anxiety, or other psychological health problems that may interfere with successful reintegration. Conventional treatments, including medication and trauma-focused individual psychotherapies, may not be optimally adapted, accepted, or effective to treat these subsyndromal symptoms. We developed "Resilient Warrior," a 4-session, group-based, mind-body stress-management and resilience program targeted to build skills and assessed whether its format was accessible and acceptable, and potentially efficacious, to support resilience among service members. From April 2014 to October 2014, 15 participants (53.3% women; mean age=36.6 y; SD=6.2) were surveyed for program acceptability and feasibility and completed self-reported psychological health outcomes before and after program participation. The majority (71.4%) of participants reported that the program included the right number of sessions, and all of them reported that it was helpful and relevant and that they would recommend it to others. While changes in self-reported resilience were only marginal, participation was associated with improvements in depressive symptoms, perceived stress, anxiety, and general sense of self efficacy. These pilot data provide preliminary support that "Resilient Warrior," a group-based, stress reduction and resilience program, may improve psychological health in service members even when delivered in community settings. Randomized controlled trials with longer follow-up periods are needed to establish efficacy and effectiveness for this program.

  15. Recruiting for health, medical or psychosocial research using Facebook: Systematic review

    Directory of Open Access Journals (Sweden)

    Louise Thornton

    2016-05-01

    Full Text Available Recruiting participants is a challenge for many health, medical and psychosocial research projects. One tool more frequently being used to improve recruitment is the social networking website Facebook. A systematic review was conducted to identify studies that have used Facebook to recruit participants of all ages, to any psychosocial, health or medical research. 110 unique studies that used Facebook as a recruitment source were included in the review. The majority of studies used a cross-sectional design (80% and addressed a physical health or disease issue (57%. Half (49% of the included studies reported specific details of the Facebook recruitment process. Researchers paid between $1.36 and $110 per completing participants (Mean = $17.48, SD = $23.06. Among studies that examined the representativeness of their sample, the majority concluded (86% their Facebook-recruited samples were similarly representative of samples recruited via traditional methods. These results indicate that Facebook is an effective and cost-efficient recruitment method. Researchers should consider their target group, advertisement wording, offering incentives and no-cost methods of recruitment when considering Facebook as a recruitment source. It is hoped this review will assist researchers to make decisions regarding the use of Facebook as a recruitment tool in future research.

  16. How community members and health professionals conceptualize medical emergencies: implications for primary care promotion.

    Science.gov (United States)

    Wilkin, Holley A; Tannebaum, Michael A; Cohen, Elizabeth L; Leslie, Travie; Williams, Nora; Haley, Leon L

    2012-12-01

    Access to continuous care through a primary care provider is associated with improved health outcomes, but many communities rely on emergency departments (EDs) for both emergent and non-emergent health problems. This article describes one portion of a community-based participatory research project and investigates the type of education that might be needed as part of a larger intervention to encourage use of a local primary care clinic. In this article we examine how people who live in a low-income urban community and the healthcare workers who serve them conceptualize 'emergency medical condition'. We conducted forum and focus group discussions with 52 community members and individual interviews with 32 healthcare workers. Our findings indicate that while community members share a common general definition of what constitutes a medical emergency, they also desire better guidelines for how to assess health problems as requiring emergency versus primary care. Pain, uncertainty and anxiety tend to influence their choice to use EDs rather than availability of primary care. Implications for increasing primary care use are discussed.

  17. Health Economics Studies Information Exchange; Reports of Current Research in Health Economics, and Medical Care Administration. Publication No. 1719.

    Science.gov (United States)

    Public Health Service (DHEW), Arlington, VA. Home Economics Branch.

    The first volume of a continuing series reporting research in progress in health economics and medical care organization and administration was compiled by contacting (1) graduate schools offering degrees in the health professions, sociology, economics, public administration, and public health, (2) charitable foundations indicating an interest in…

  18. Gauging the feasibility of cost-sharing and medical student interest groups to reduce interview costs.

    Science.gov (United States)

    Lieber, Bryan A; Wilson, Taylor A; Bell, Randy S; Ashley, William W; Barrow, Daniel L; Wolfe, Stacey Quintero

    2014-11-01

    Indirect costs of the interview tour can be prohibitive. The authors sought to assess the desire of interviewees to mitigate these costs through ideas such as sharing hotel rooms and transportation, willingness to stay with local students, and the preferred modality to coordinate this collaboration. A survey link was posted on the Uncle Harvey website and the Facebook profile page of fourth-year medical students from 6 different medical schools shortly after the 2014 match day. There were a total of 156 respondents to the survey. The majority of the respondents were postinterview medical students (65.4%), but preinterview medical students (28.2%) and current residents (6.4%) also responded to the survey. Most respondents were pursuing a field other than neurosurgery (75.0%) and expressed a desire to share a hotel room and/or transportation (77.4%) as well as stay in the dorm room of a medical student at the program in which they are interviewing (70.0%). Students going into neurosurgery were significantly more likely to be interested in sharing hotel/transportation (89.2% neurosurgery vs 72.8% nonneurosurgery; p = 0.040) and in staying in the dorm room of a local student when on interviews (85.0% neurosurgery vs 57.1% nonneurosurgery; p = 0.040) than those going into other specialties. Among postinterview students, communication was preferred to be by private, email identification-only chat room. Given neurosurgery resident candidates' interest in collaborating to reduce interview costs, consideration should be given to creating a system that could allow students to coordinate cost sharing between interviewees. Moreover, interviewees should be connected to local students from neurosurgery interest groups as a resource.

  19. Understanding Medical Students' Experience with Stress and Its Related Constructs: A Focus Group Study from Singapore.

    Science.gov (United States)

    Farquhar, Julia; Lie, Desiree; Chan, Angelique; Ow, Mandy; Vidyarthi, Arpana

    2017-04-18

    In order to protect medical students from burnout and its untoward psychiatric effects, it is imperative to understand their stress, burnout, coping, and resilience experiences. This study aimed to derive collective definitions from the medical student perspective, to identify common themes of students' experiences, and to distinguish pre-clinical and clinical year students' experiences relating to these four constructs. The authors conducted focus groups of medical students in Singapore across 4 years using a semi-structured question guide. Participants shared their understanding, experiences, and the relationships between stress, burnout, coping, and resilience. Coders independently evaluated construct definitions and derived common themes through an iterative process, and compared transcripts of pre-clinical and clinical year students to determine differences in experience over time. Nine focus groups (54 students, 28 females, mean age 24.3) were conducted. Students identified common definitions for each construct. Nine themes emerged within three domains: (1) relating constructs to personal experience, (2) interrelating stress, burnout, coping, and resilience, and (3) understanding the necessity of stress. Compared to clinical students, pre-clinical students reported theory-based rather than reality-based experiences and exam-induced stress, defined constructs using present rather than future situations, and described constructs as independent rather than interrelated. This sample of medical students in Singapore shares a common understanding of stress, burnout, coping, and resilience, but experiences these uniquely. They perceive a positive role for stress. These findings build upon prior literature, suggesting an interrelationship between stress and its related constructs and adding the novel perspective of students from an Asian country.

  20. Enhancing medical students' reflectivity in mentoring groups for professional development - a qualitative analysis.

    Science.gov (United States)

    Lutz, Gabriele; Pankoke, Nina; Goldblatt, Hadass; Hofmann, Marzellus; Zupanic, Michaela

    2017-07-14

    Professional competence is important in delivering high quality patient care, and it can be enhanced by reflection and reflective discourse e.g. in mentoring groups. However, students are often reluctant though to engage in this discourse. A group mentoring program involving all preclinical students as well as faculty members and co-mentoring clinical students was initiated at Witten-Herdecke University. This study explores both the attitudes of those students towards such a program and factors that might hinder or enhance how students engage in reflective discourse. A qualitative design was applied using semi-structured focus group interviews with preclinical students and semi-structured individual interviews with mentors and co-mentors. The interview data were analyzed using thematic content analysis. Students' attitudes towards reflective discourse on professional challenges were diverse. Some students valued the new program and named positive outcomes regarding several features of professional development. Enriching experiences were described. Others expressed aversive attitudes. Three reasons for these were given: unclear goals and benefits, interpersonal problems within the groups hindering development and intrapersonal issues such as insecurity and traditional views of medical education. Participants mentioned several program setup factors that could enhance how students engage in such groups: explaining the program thoroughly, setting expectations and integrating the reflective discourse in a meaningful way into the curriculum, obliging participation without coercion, developing a sense of security, trust and interest in each other within the groups, randomizing group composition and facilitating group moderators as positive peer and faculty role models and as learning group members. A well-designed and empathetic setup of group mentoring programs can help raise openness towards engaging in meaningful reflective discourse. Reflection on and communication of

  1. Guidance for health and social care providers, principles of good practice in medication reconciliation

    LENUS (Irish Health Repository)

    Walsh, E K

    2010-09-01

    Multiple and inappropriate medications are often the cause for poor health status in the elderly. Medication reviews can improve prescribing. This study aimed to determine if a ten minute medication review by a general practitioner could reduce polypharmacy and inappropriate prescribing in elderly patients. A prospective, randomised study was conducted. Patients over the age of 65 (n = 50) underwent a 10-minute medication review. Inappropriate medications, dosage errors, and discrepancies between prescribed versus actual medication being consumed were recorded. A questionnaire to assess satisfaction was completed following review. The mean number of medications taken by patients was reduced (p < 0.001). A medication was stopped in 35 (70%) patients. Inappropriate medications were detected in 27 (54%) patients and reduced (p < 0.001). Dose errors were detected in 16 (32%). A high level of patient satisfaction was reported. A ten minute medication review reduces polypharmacy, improves prescribing and is associated with high levels of patient satisfaction.

  2. Scientifically Correct Racism: Health Studies' Unintended Effects against Minority Groups

    Science.gov (United States)

    La Parra Casado, Daniel; Perez, Miguel Angel Mateo

    2007-01-01

    The present paper analyses press releases, news reports and health plans to show how health communication functions in perpetuating dominant racist structures. The paper is mainly concerned with how normal science and health practices can become an instrument for justifying racism and reproducing it in our societies. The examples demonstrate that…

  3. Problematic internet use and internet searches for medical information: the role of health anxiety.

    Science.gov (United States)

    Fergus, Thomas A; Dolan, Sara L

    2014-12-01

    Individuals frequently use the Internet to search for medical information. For some individuals, repeated searches for medical information on the Internet exacerbate health anxiety. Researchers have termed this phenomenon "cyberchondria" and have suggested that cyberchondria might relate to the excessive use of the Internet for other purposes as well. The present study examined associations among Internet searches for medical information, health anxiety, and problematic Internet use (PIU) using a large sample of medically healthy community adults located in the United States (N=430). As predicted, respondents who experienced increased health anxiety following Internet searches for medical information reported significantly greater PIU than respondents for whom such searches either had no impact on or decreased their health anxiety. This effect was not attributable to the frequency of health-related online searching behavior or negative affect. Conceptual and therapeutic implications are discussed.

  4. Gender differences and similarities in medical students' experiences of mistreatment by various groups of perpetrators.

    Science.gov (United States)

    Siller, Heidi; Tauber, Gloria; Komlenac, Nikola; Hochleitner, Margarethe

    2017-08-14

    Mistreatment of medical students during medical education is a widespread concern. Studies have shown that medical students report the most mistreatment compared to students of other study programs and that the prevalence of mistreatment peaks during clinical training. For this reason, a study was conducted to assess prevalence of mistreatment among medical students committed by various groups of people. The focus was to identify whether gender was associated with the experience of mistreatment. Additionally, students' perception of university climate for reporting sexual harassment was assessed. In the study 88 medical students (45 women, 43 men) participated. A modified version of the Questionnaire on Student Abuse was used to assess students' experience of various types of mistreatment and associated distress during medical education. To explore factors that could be associated with this experience the organizational climate for reporting sexual harassment was assessed with the Psychological Climate for Sexual Harassment. The most often cited perpetrators of mistreatment were strangers (79.5%), friends (75.0%) and university staff (68.2%). Strangers mostly committed psychological mistreatment and sexual harassment, whereas friends additionally engaged in physical mistreatment of medical students. The most common form of mistreatment conducted by university staff was humiliation of students. These kinds of psychological mistreatment were reported to be distressing (43%). Gender differences were found in the prevalence of mistreatment. Women experienced more sexual harassment and humiliation than did men. On the other hand, men experienced more physical mistreatment than did women. Women reported experiencing more distress from mistreatment experiences than did men and also more often reported being mistreated by university staff than did men. Women perceived a greater risk in reporting sexual harassment to the organization than did men. Mistreatment of female and

  5. The Effect of Group Psychoeducation Program on Medication Adherence in Patients with Bipolar Mood Disorders: a Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Farnaz Rahmani

    2016-12-01

    Full Text Available Introduction: Medication nonadherence is highly prevalent in patients with bipolar disorders and often results in worsening disease prognosis. The purpose of this study was to investigate the effect of group psychoeducation on medication adherence in female patients with bipolar mood disorder type I. Methods: This randomized controlled trial was conducted on 76 patients with bipolar mood disorder admitted in female psychiatric wards of Razi teaching hospital, Tabriz, Iran. The participants were selected by convenience sampling method and were randomly assigned to experimental and control groups. Patients in experimental group received 10 continuous 90 minutes sessions of psychoeducation, two times a week. Medication adherence was measured using the medicine check list and medication adherence rating scale (MARS before and after intervention. Data analysis was performed with SPSS ver.13. Results: There was no significant difference between two groups regarding medication adherence before the intervention. After the study intervention, the mean scores of medication adherence check list and medication adherence rating scale in the experimental group were significantly higher than the control group. Conclusion: Since group psychoeducation was effective in improving patients' medication adherence, it could be recommended for psychiatric nurses to apply this intervention in the clinical setting.

  6. Coordinating medical education and health care systems: the power of the social accountability approach.

    Science.gov (United States)

    Boelen, Charles

    2017-09-07

    As the purpose of medical education is to produce graduates able to most effectively address people's health concerns, there is general agreement that coordination with the health care system is essential. For too long, coordination has been dealt with in a subjective manner with only few landmarks to ensure objective and measurable achievements. Over the last 30 years, since the Edinburgh Declaration on medical education, progress has been made, namely with the concept of social accountability. The social accountability approach provides a way to plan, deliver and assess medical education with the explicit aim to contribute to effective, equitable and sustainable health system development. It is based on a system-wide scope exploring issues from identification of people's and society's health needs to verification of the effects of medical education in meeting those needs. A wide international consultation among medical education leaders led to the adoption of the Global Consensus on Social Accountability of Medical Schools. Benchmarks of social accountability are in the process of being conceived and tested, enabling medical schools to steer medical education in a more purposeful way in relation to determinants of health. A sample of schools using the social accountability approach claims to have had a positive influence on health care system performance and people's health status. Improved coordination of medical education and other key stakeholders in the health system is an important challenge for medical schools as well as for countries confronted with an urgent need for optimal use of their health workforce. There is growing interest worldwide in defining policies and strategies and supporting experiences in this regard. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  7. Factors associated with medication information in diabetes care: differences in perceptions between patients and health care professionals

    Directory of Open Access Journals (Sweden)

    Längst G

    2015-10-01

    Full Text Available Gerda Längst,1 Hanna Marita Seidling,2,3 Marion Stützle,2,3 Dominik Ose,1 Ines Baudendistel,1 Joachim Szecsenyi,1 Michel Wensing,1,4 Cornelia Mahler1 1Department of General Practice and Health Services Research, University Hospital of Heidelberg, Heidelberg, Germany; 2Cooperation Unit Clinical Pharmacy, University of Heidelberg, Heidelberg, Germany; 3Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany; 4Radboud University Nijmegen Medical Centre, Scientific Institute for Quality of Healthcare, Nijmegen, the Netherlands Purpose: This qualitative study in patients with type 2 diabetes and health care professionals (HCPs aimed to investigate which factors they perceive to enhance or impede medication information provision in primary care. Similarities and differences in perspectives were explored.Methods: Eight semistructured focus groups were conducted, four with type 2 diabetes patients (n=25 and four with both general practitioners (n=13 and health care assistants (n=10. Sessions were audio and video recorded, transcribed verbatim, and subjected to computer-aided qualitative content analysis.Results: Diabetes patients and HCPs broadly highlighted similar factors as enablers for satisfactory medication information delivery. Perceptions substantially differed regarding impeding factors. Both patients and HCPs perceived it to be essential to deliver tailored information, to have a trustful and continuous patient–provider relationship, to regularly reconcile medications, and to provide tools for medication management. However, substantial differences in perceptions related to impeding factors included the causes of inadequate information, the detail required for risk-related information, and barriers to medication reconciliation. Medication self-management was a prevalent topic among patients, whereas HCPs’ focus was on fulfilling therapy and medication management responsibilities

  8. The Air Medical Leadership Congress: setting the health care agenda for the air medical community.

    Science.gov (United States)

    Thomas, Frank; Romig, Laurie; Hutton, Kevin; Petersen, Pat; Thomas, Stephen H; Wedel, Suzanne; Brozen, Reed

    2003-01-01

    Emergency air medical transport provides the means for critically ill or injured patients to rapidly access sophisticated medical flight teams and medical centers. However, issues such as surging emergency medical services helicopter accidents, expected pilot and nurse shortages, falling reimbursements, and new compliance regulations are now threatening these important but expensive transport services. Unless an industry strategy can be developed to address these and other threats, many medical flight programs may be forced to curtail the availability of these lifesaving services. On September 4-6, 2003, air medical leaders, experts, program managers, providers, and users of emergency air medical services gathered in Salt Lake City, Utah, to discuss and formulate recommendations to address the top issues that threaten the future of air medical transport services. This congress was open to anyone engaged in the field of air medical transport. This historic meeting resulted in a plan to enhance transport safety, foster appropriate utilization, improve in-flight medical care, maximize cost and reimbursement effectiveness, and develop strategies to reduce the adverse effects of new regulatory and compliance mandates. This article describes the significance of the Air Medical Leadership Congress and the 10-Point Plan method used to develop it.

  9. Medical students' reflective writing about a task-based learning experience on public health communication.

    Science.gov (United States)

    Koh, Yang Huang; Wong, Mee Lian; Lee, Jeanette Jen-Mai

    2014-02-01

    Medical educators constantly face the challenge of preparing students for public health practice. This study aimed to analyze students' reflections to gain insight into their task-based experiences in the public health communication selective. We have also examined their self-reported learning outcomes and benefits with regard to application of public health communication. Each student wrote a semi-structured reflective journal about his or her experiences leading to the delivery of a public health talk by the group. Records from 41 students were content-analyzed for recurring themes and sub-themes. Students reported a wide range of personal and professional issues. Their writings were characterized by a deep sense of self-awareness and social relatedness such as increased self-worth, communications skills, and collaborative learning. The learning encounter challenged assumptions, and enhanced awareness of the complexity of behaviour change Students also wrote about learning being more enjoyable and how the selective had forced them to adopt a more thoughtful stance towards knowledge acquisition and assimilation. Task-based learning combined with a process for reflection holds promise as an educational strategy for teaching public health communication, and cultivating the habits of reflective practice.

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

    Directory of Open Access Journals (Sweden)

    Mozafar Khazaei

    2012-11-01

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

  11. Are medical treatments for individuals and groups like single-play and multiple-play gambles?

    Directory of Open Access Journals (Sweden)

    Michael L. DeKay

    2006-11-01

    Full Text Available People are often more likely to accept risky monetary gambles with positive expected values when the gambles will be played more than once. We investigated whether this distinction between single-play and multiple-play gambles extends to medical treatments for individual patients and groups of patients. Resident physicians and medical students (extit{n} = 69 and undergraduates (extit{n} = 99 ranked 9 different flu shots and a no-flu-shot option in 1 of 4 combinations of perspective (individual patient vs. group of 1000 patients and uncertainty frame (probability vs. frequency. The rank of the no-flu-shot option (a measure of preference for treatment vs. no treatment was not significantly related to perspective or participant population. The main effect of uncertainty frame and the interaction between perspective and uncertainty frame approached significance (0.1 {extgreater} extit{p} {extgreater} 0.05, with the no-flu-shot option faring particularly poorly (treatment faring particularly well when decisions about many patients were based on frequency information. Undergraduate participants believed that the no-flu-shot option would be less attractive (treatment would be more attractive in decisions about many patients, but these intuitions were inconsistent with the actual ranks. These results and those of other studies suggest that medical treatments for individuals and groups are not analogous to single-play and multiple-play monetary gambles, perhaps because many people are unwilling to aggregate treatment outcomes over patients in the same way that they would compute net gains or losses over monetary gambles.

  12. Medical assessment of the health effects of short leisure trips.

    Science.gov (United States)

    Toda, Masahiro; Makino, Hiroaki; Kobayashi, Hidetoshi; Nagasawa, Shingo; Kitamura, Kazuyuki; Morimoto, Kanehisa

    2004-12-01

    Using responses to questionnaires and results of saliva samples from 40 women, the authors assessed the effects on health of participation in a short leisure trip (2 nights, 3 d) to Kyushu Island in Japan. They addressed transportation, sightseeing, and group activities during the tour, which might differ from participants' usual activities. Levels of the salivary endocrinological stress markers cortisol and chromogranin A (CgA) were determined by enzyme-linked immunosorbent assay (ELISA). In each of the groups with characteristics considered healthy and related to lifestyle, patterns of behavior, perceived stressors, and stress reactions, a decrease in the cortisol levels and an increase in the CgA levels were apparent during the tour. The baseline for stress hormone changes was the levels on awakening on Day 1 (i.e., immediately before the tour). These findings suggest that even short periods of travel can bring about a reduction in di-stress and acquisition of eu-stress, experienced as feeling uplifted or fulfilled.

  13. Group-based trajectory models: a new approach to classifying and predicting long-term medication adherence.

    Science.gov (United States)

    Franklin, Jessica M; Shrank, William H; Pakes, Juliana; Sanfélix-Gimeno, Gabriel; Matlin, Olga S; Brennan, Troyen A; Choudhry, Niteesh K

    2013-09-01

    Classifying medication adherence is important for efficiently targeting adherence improvement interventions. The purpose of this study was to evaluate the use of a novel method, group-based trajectory models, for classifying patients by their long-term adherence. We identified patients who initiated a statin between June 1, 2006 and May 30, 2007 in prescription claims from CVS Caremark and evaluated adherence over the subsequent 15 months. We compared several adherence summary measures, including proportion of days covered (PDC) and trajectory models with 2-6 groups, with the observed adherence pattern, defined by monthly indicators of full adherence (defined as having ≥24 d covered of 30). We also compared the accuracy of adherence prediction based on patient characteristics when adherence was defined by either a trajectory model or PDC. In 264,789 statin initiators, the 6-group trajectory model summarized long-term adherence best (C=0.938), whereas PDC summarized less well (C=0.881). The accuracy of adherence predictions was similar whether adherence was classified by PDC or by trajectory model. Trajectory models summarized adherence patterns better than traditional approaches and were similarly predicted by covariates. Group-based trajectory models may facilitate targeting of interventions and may be useful to adjust for confounding by health-seeking behavior.